Current and Past Research Projects

  

Dr. Taylor's Dissertation

Courage Project

Rutgers Project

 

Re-Membering Our Back Pain: A Collaborative Inquiry Back School for Individuals with Chronic Back Pain

Matthew’s 2006 dissertation project with the following abstract. Please contact Matthew if you would like more information or to read the dissertation:

 

ABSTRACT

For individuals with a diagnosis of chronic back pain—CBP— who have exhausted other resources, a final treatment option traditionally has been attending a back school to learn a mechanistic approach to managing and living with CBP. The success of back schools over 30 years has been mixed at best, despite numerous designs and curricula. This study attempted to change the delivery model of back schools to a new pedagogy and to broaden the perspectives addressed in the curriculum to better accommodate the complexity of CBP and identify the individual needs of the person living with CBP.

The format for this qualitative study was collaborative inquiry, a form of participatory action research. The study was a case study of a group of eight participants, including the researcher, who participated in an eight-week prototype, participatory back school (PBS). The study spanned 14 weeks from entry interview to final post-treatment survey. The data focused on the experiences of the individuals and the group as a whole. 

The results indicated a multiple systems effect that promoted limited self-care and suggested that in light of new understandings about chronic pain, the traditional back school model may require significant restructuring. In addition to self-care skills, valuable skills were identified for future participants and facilitators who might participate in a PBS. The participants reported value in the interactive group learning process and the materials on the emotional and spiritual influences on chronic pain. Each participant struggled with compliance, despite having experienced the support and insight the new skills provided and having the resources to continue the new behaviors. Participant reflections on this failure to comply suggested a spiritual dilemma rather than a motivation or learning deficit.

 

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Organizational Change and Rehabilitation 

At the APTA Annual conference in Baltimore, MD June 2009   Matt Sanford, MA and I shared our research experience at the Courage Center in MN. Now in our second full year of the study we were able to invite Sarah Hinck, PT from the Center to share her experience as one of the participants in the first round. The audience was spell bound to hear firsthand the experiences of change in Sarah, her colleagues and the organization. The first year’s data yielded positively significant results in every parameter we measured. The results were presented at this fall's 2009 AMPRA conference in San Antonio.  In February of 2008, we began to introduce the ideas of Mind Body Integration with a group of 20 staff. After the first year of the Mind Body Integration Project, we found significant changes in staff job satisfaction, quality of life, decreased job stress and increased commitment to Courage Center.

In terms of job satisfaction, the group was similar to the organization as a whole at the beginning of the project. At the end of one year, staff had increased their job satisfaction significantly. In another survey, staff reported improvements in quality of life and those findings were supported by qualitative data we collected. The data indicated that staff were able to create compassionate boundaries with their clients, leave work concerns at work, and better manage stress even though the number of stressors increased across the time of the study. Another important finding was that the use of these simple techniques is wide spread. Staff reported using mind body techniques in 61 to 80% of their client interactions. In addition, therapists report that they are more focused on the interaction with the client, and their state of mind as they approached the treatment sessions. The results are impressive and indicate how the work in organizational healing is possible AND pays for itself! Contact us if you want to learn more or how to bring it to your organization.

 

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Alternative Neural Pathways

 

June 7, 2009 ...Rutgers University, Newark NJ Sunday night at Newark airport... I pull out my laptop waiting for Matt Sanford to arrive from MN and almost burn my hand....yep, the hard drive had fried in sleep mode landing. Something big must be going to happen!

 

Dr Barry Komisaruk's outstanding research team. Barry is assoc. dean of the Psych dept and brought with him our fMRI tech Pat, (far left), 3 grad assistants, senior grad asst Nan Wise (orange shirt) , a physicist (not pictured) and the two Matts...one went in the MRI and the other, (who's idea this research project was) provided the variable neurofacilitation techniques during the study!

 What we are looking for are the neuroanatomical correlates for Matt Sanford's ability as a complete T4 paraplegic to have awareness of his body below the level of his lesion. We've both taught the process of developing awareness and know it can be achieved in others, but this was the hunt to answer the "how" questions. This is Barry's specialty.

The team met early on Monday a.m. to finalize the methodology we'd been working on for months. Barry is an amazing facilitator and leader. He draws each of the people into the conversation and expects new ideas and different questions. At 11 a.m. the fMRI was ready and we assembled in the observation room. Once baseline scans were obtained we went through over an hour more "stimulus on/stimulus off" tests. It was grueling for Matt S but he hung in there all the way. The above shot shows me providing axial load and alignment on Matt's legs to see if his sensory cortex fires in the area of his legs. Barry is in the foreground with signal laser pen in hand as the noise of the fMRI precludes voice communication.

 
The very preliminary results demonstrate some remarkable activation  of the supplementary motor cortex and motor cortex, but especially the sensory cortex from regions below Matt's lesion which were not expected in the current understanding of somatic awareness. Also noted were increases in the orbital frontal cortex with motor imaging and major activation his cerebellum with manual facilitations below the lesion level. The team is carefully analyzing the data, correlating activity patterns in the scans to try to determine potential pathways outside the cord (see the link on Barry above for his work with women with spinal cord lesions).  Our hope is this will be sufficient documentation to bid for future funding as we work to articulate on the scanner how what we here at DSR know is possible when we bring focus to our internal locus of sensation, thought and emotions. The data will only accelerate what has been so many past patients' experiences...healing happens when we honor the complexity and sensitivity of the entire human experience!   More as we learn more from Rutgers!

 

"Let me know if I can be of service in assisting you in your research or helping you with a paper/project!" - Matthew

 

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