Approximately 1.7 million people in the United States use manual wheelchairs. But while some people undergo fit evaluations to find the best wheelchair, many do not have proper training on how to actually use one. “A lack of evidence-based training programs makes it difficult for therapists to know how to teach someone the best way to push a wheelchair,” says Kerri Morgan,

MSOT ‘98, OTR/L, ATP, an instructor in occupational therapy and neurology who is completing a doctorate in movement science related to manual wheelchair propulsion. The issue is critical because manual wheelchair users often develop chronic upper extremity pain or over-use injuries. Many of them also use their upper extremities for activities of daily living (e.g. dressing, eating, bathing), so injuries or pain from wheelchair propulsion may limit the ability to participate in major life activities. Morgan has teamed up with biomedical engineer Joe Klaesner, PhD, associate professor in the program in physical therapy, to fine tune optimal movement and force with the creation of the world’s first “WheelMill” System (WMS), a

In Washington University’s Human Performance Laboratory, an artificial robotic horse stands quietly in the corner waiting to be used by clients. On computer screens, motion-

activated video games are being transformed into rehabilitation therapies. In a nearby room, a specialized treadmill for wheel-chairs has been built and is undergoing testing. The wide variety of research in the occupational therapy laboratory is all aimed at analyzing movement to gain a better understanding of how people with and without disabilities perform daily activi-ties. The largest area in the laboratory is equipped like a mini-movie set, with eight high-speed motion capture cameras mounted in the ceiling that capture movement from reflective surface markers placed on children or adults. “The surface markers are dots that

are placed on a person’s body, arms, and legs,” says Jack Engsberg, PhD, laboratory director. “It’s the same thing that they do in the movie industry to create computer-animated effects but instead of creating effects, we are interested in the vector or tinker toy image that gives us angular information such as movement in a wrist, elbow, shoulder, or ankle.” The data enables researchers to see performance differences before and after an intervention. For example, Bill Janes, OTD ‘11, MSCI, OTR/L, is using motion-capture to evaluate performance differences before and after nerve transplants to see if the procedure is effective in restoring movement. Engsberg combines motion capture vector images and

Program in Occupational Therapy • Washington University School of Medicine • Spring 2013

Kerri Morgan

Program in Occupational Therapy Campus Box 8505, 4444 Forest Park Ave. St. Louis, MO 63108-2212 (314) 286-1600 / (800) 279-3229 / TDD: (314) 286-1651 wuotinfo@wusm.wustl.edu • ot.wustl.edu

Occupational Therapy

Tracking Movement

From Treadmill to WheelMillCONTINUED ON PAGE 3

O.T. Link

A young client with student Emily Berkowitz, MSOT/S ‘13 (l) and Dr. Tim Shurtleff (r).

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Researchers Develop First WheelMill System for Manual Wheelchair Users

Science of Human Performance Leads to Occupational Therapy Innovations

Video game tailored to a client’s needs.

From the Director

The spring semester is underway at the Program in Occupational Therapy! Our first-year students are wondering how the first semester went by so quickly and

our graduating students are preparing for presentations at OT Scholarship Day on April 19, 2013 and then graduation on May 17, 2013. You are invited to attend – please see the back of this newsletter for more information. The new semester also brings the exciting opportunity of fieldwork for our students. Our program offers an extremely comprehensive list of hundreds of approved fieldwork sites across the globe. Jeanenne Dallas, MA, OTR/L, works with each student to ensure the best fit for their needs and career goals. Integrating what they’ve learned in the classroom and through research into their fieldwork experiences is enlighten-ing for students and they are able to see the fruition of their hard work come alive in a clinical setting. We are also excited to announce the creation of a new website for the Program, set to be unveiled this spring! Still located at ot.wustl.edu, the site will have features and tools to help alumni in their chosen practice areas, as well as a new look and feel. The site will be used to showcase the Program as a leader in the field of occupational science and to provide information on our degree programs, clinical practice, scientific research and community involvement. You can read more about the new website on page 4. As alumni, you know the thrill of putting your education into practice, and faculty, alumni and students from the Program continue building our science to meet the needs of people from around the world. I know you will enjoy reading about the work and travels of Emily Wallace, OTD ‘10, OTR/L, and Kit Sinclair, PhD, OT ‘67, OTR, FWOT, FAOTA, on pages 4-5. The Program welcomed several of its members of the Eliot Society for a luncheon this fall to thank them for their

M. Carolyn Baum

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Baum Named Outstanding Scholar

Carolyn Baum, PhD, OTR/L, FAOTA, was presented with the Outstanding Transdisciplinary Public Health Scholar Award in October, at the Institute for Public Health’s

Annual Conference. The award is given to an Institute Scholar who demonstrates outstanding leadership in conducting transdisciplinary work through partnerships across the campus and/or community. “I see our Program being involved in interdisciplinary work in mental health, chronic health conditions, disability, aging and pediatrics. We have a history of interdisciplinary work with social work, psychology, engineering, neurology, medicine, otolaryngology, and psychiatry. I believe that health will only be realized when we build systems of care that bridge medical and community health and put more knowledge into the public’s hands to identify, seek help and learn to manage health problems that enhance their ability to live productive and meaningful lives,” she says. Dr. Baum was nominated and introduced by Nancy Morrow-Howell, PhD, Director, Harvey A. Friedman Center for Aging, and Ralph and Muriel Pumphrey Professor of Social Work, and was presented the award by Institute for Public Health Director Edward F. Lawlor, PhD, Dean and William E. Gordon Distinguished Professor of the Brown School of Social Work. Please join us in congratulating her on her latest achievement!

Dr. Nancy Morrow-Howell, Dr. Carolyn Baum, Dr. Edward F. Lawlor at the award presentation.

continued support of our current students. We are so grateful for our alumni and friends, and are always thrilled to share in your success. Please let us know about the wonderful things you are accomplishing every day.

M. Carolyn Baum, PhD, OTR/L, FAOTA

Professor of Occupational Therapy and NeurologyElias Michael Executive Director,

Program in Occupational Therapy

Please Donate to the Program in Occupational Therapy Scholarship

FundPlease help support future occupational therapists

with a donation to the Program in Occupational Therapy Scholarship Fund. A gift to the Program fills an immediate need by lessening the debt burden on our students, allowing them to focus on their education

and training. Donations also may be made in honor or in memory of an individual. Checks should be payable

to Washington University and mailed to: The Program in Occupational Therapy

Washington University School of Medicine 4444 Forest Park Ave., Campus Box 8505

St. Louis, MO 63108

virtual reality video games to create fun therapy programs for clients undergoing rehabilitation with disabilities

resulting from cerebral palsy, stroke and autism as well as spinal cord or brain injuries. “It’s like Kinect™ or Wii Fit™ games in that movement from the player creates movement in the game,” explains Engsberg. “For example, a patient can raise his arm to a certain height and trigger a flipper in a video pinball game. By changing the software that determines which

movement makes a particular game work, we can tailor game-play to the type of activity needed for rehabilitation.” The research is still developing, but Engsberg has big plans. “I envision that this could be used for global telerehabili-tation, especially where occupational therapists are not available. People anywhere could download a computer rehabilitative game and do the therapy in their home while clinicians monitor their progress from afar.” Innovative performance research such as this has caught the attention of therapists on the other side of the globe. This year, Joshua You, PhD, director of physical therapy at Yansei University in Korea, is serving as one of the laboratory’s research fellows. He is working with Tim Shurtleff, OTD ‘06, OTR/L, evaluating the benefits of hippotherapy. One of the questions is whether a real horse is necessary for optimal rehabilitative benefits and whether the environment plays a

critical role. To answer that, a robotic horse is now in the laboratory.“Horses are not available or are expensive in many areas,

including Korea,” says Engsberg. “So we want to know if going to the barn and smelling and touching a horse makes a difference in rehabilitation outcomes when compared to a robotic horse.” “A lot of the projects we have under way now are very exciting and cutting edge. I actually love coming to work because I can see global implications in many of the things we do.”

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treadmill specifically engineered to work with any type of wheelchair and that simulates surfaces such as slanted sidewalks, ramps, tile or thick carpeting. “It’s computer-controlled to simulate the resistance and incline that a manual wheelchair user encounters in real life,” says Klaesner, whose work is funded by a grant from University of Missouri Systems Spinal Cord Injury Research fund. The design has evolved for the past decade and Morgan says they’re now fine-tuning software to make sure that the resistance generated by the WMS accurately matches that of a wheelchair in a real environment. Morgan also has developed a new training program for therapists to enable them to educate wheelchair users on proper propulsion mechanics. “We want to prevent injury and minimize the onset of pain to retain a high level of independence through better propulsion mechanics. What we ultimately feel we’ve developed with the WMS is a training device that will help to achieve this.”

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Morgan and Klaesner with a client.

Dr. You and a client with the robotic horse.

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Dr. Jack Engsberg

In the Zhytomyr region of Ukraine, many people with special needs live isolated from their communities and the routines of day-to-day life. Working with the indigenously run Mission to Ukraine (through U.S.-based Helmer Global Initia-tives), Emily Wallace, OTD ‘10, OTR/L, is developing a program there to bring hope to people with

disabilities and those who care for them. It is a challenging job in a country where occupational therapy is not a recognized profession. “Most children with disabilities are never given the opportunity to succeed in meaningful activities,” she says. Many don’t leave their homes; they haven’t been taught social skills — how to set the table, how to feed themselves, or how to dress. With Mission to Ukraine, Wallace is building a sustain-able framework of outpatient care for adolescents and young adults with disabilities. She is also developing a long-term program at an orphanage for boys with disabilities. And by building relationships with community organizations, she hopes to change social attitudes toward people with disabili-ties. “I’m drawn to helping people who typical society looks at as not having a lot of worth,” says Wallace, whose brother has

Down syndrome. “I really have a heart for those who others may underestimate.”Wallace’s work in Ukraine concludes in September 2013. She is already extending her expertise to Kenya, developing a model of services for a new orphanage in Nairobi. “Sustainability is my biggest goal,” she says. “In Zhyto-myr, I’m putting specific measures in place to ensure the program will be implemented on a long-term basis even without my oversight.”

Visit Emily’s blog at http://keeping-things-whole.blogspot.com/ to

read more about her work and travels!

Program to Introduce New Website in Spring

The Program in Occupational Therapy at Washington University School of Medicine in St. Louis will be introduc-ing a new and improved website this spring! The unveiling will culminate months of surveys, research and testing that went into producing the new design. The new site will be used to showcase the Program’s place as a leader in the fields of occupational, rehabilitation, and participation science!

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The Program will introduce a new website in spring at www.ot.wustl.edu.

Emily Wallace

Spotlight: Monica Perlmutter, OTD ‘12, OTR/L, SCLVPost-Professional OTD Graduate and Instructor, Occupational Therapy, Ophthalmology & Visual Sciences

I chose to pursue the Post-Professional Doctorate in Occupational Therapy (PPOTD) to achieve greater independence in my research efforts and mentoring of students, and to gain further depth of knowledge and experience with older adults, low vision, community based practice, and measurement development. The PPOTD further qualified me for other teaching roles, and I also enjoyed being in school and loved the sense of personal accomplishment! I learned so much and grew during the process, even at my 50-something age!

Alumni NewsBuilding Hope for Children with DisabilitiesIn December, Larry J. Shapiro, MD, Executive Vice Chancellor for Medical Affairs and Dean, Washington University School of Medicine, introduced a website to recognize alumni giving back to communities around the world. Emily Wallace ‘10, OTD, OTR/L, was one of six alumni featured. See all alumni stories at http://medschool.wustl.edu/holiday2012.

Tim Wolf, OTD ‘07, MSCI, OTR/L, Running For AOTA BoardDr. Wolf, assistant professor of occupational therapy and neurology, is running for a Director position. If you are a member of

AOTA, please go to http://www.aota.org/Governance/Elections-2013.aspx to vote before February 26. Thank you!

Alumni NewsAdvancing Occupational Therapy as a Profession in Asia

For more than 45 years, Kit Sinclair, OT ‘67, PhD, OTR, FWOT, FAOTA, has lived and worked throughout Asia, first as a Peace Corps volunteer and then as a practicing

occupational therapist, educator and global advocate for the expansion of occupational therapy programs and services. “I served in Korea in the Peace Corps for two years,” Sinclair says. “After six months working in public health in the countryside, I realized I was one of only two occupational therapists in the country.” She moved to Seoul and began working with orphaned children with multiple disabilities.

“Those were very interesting times in a country of all night curfews and skirmishes along the DMZ with North Korea,” she recalls. Early on, she pushed to expand the education and use of occupational therapists in Asia, becoming herself one of the founding occupational therapy faculty at Hong Kong Polytech-nic University in 1978. From a pool of only 25 practicing occupational therapists in the country at the time, today Sinclair says there are more than 1,300 local occupational therapists, most of whom have been her former students. “Occupational therapy practice differs from the U.S. in many ways here,” she says. “The most obvious is the hospital-based nature of most services and thus dominance of a medical model, though this emphasis is now changing.” Her advocacy efforts led to her active role in the World Federation of Occupational Therapists (WFOT). She served as the organization’s treasurer for a decade before becoming President from 2002 to 2008. The global position enabled her to foster the development of occupational therapy programs

and services in South America, Africa, and Asia. After a major tsunami struck the Indian Ocean region in 2004, Sinclair headed a project to investi-gate and promote

the role of occupational therapists in post-disaster recoveries. That effort continues today. In the past 20 years, her passion has focused on advancing occupational therapy in the People’s Republic of China. Clearly embracing the growing use of the Internet, Sinclair has

developed and taught numerous online and in-person occupa-tional therapy courses to enhance what she calls “occupation-based, client-centered occupational therapy” at the university level.

She championed the translation of the WFOT Minimum Standards for the Education of Occupational Therapists into Chinese for use in all rehabilitation programs, although she freely laughs that even as she teaches others, “my Mandarin has not overly improved,” but that she has devoted translators. “Even after all these years, I very much appreciate that my career started with the Program in Occupational Therapy. I have been fortunate that I have been allowed to develop and use the knowledge, skills and attitudes I learned there through-out my life.”

Kit Sinclair

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Sinclair with children in SiChuan, China, one year after an earthquake impacted the area.

Sinclair at a workshop in Sri Lanka.

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Sinclair with Hong Kong PolyU first graduates.

Sinclair with the Chinese occupational therapy students she supervised.

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The link between WUSOTA and Guatemala has been in place since 2009. The Program partners with Service for Peace, an international service organization, to visit not only ANINI, but also a local nursing home and hospital. “Occupational therapy is a very client-driven profession, making it important for therapists to broaden their scope of knowledge and exposure to other ethnicities and ways of life,” says doctoral student Rachael Baum, OTD/S ’14, this year’s trip organizer. “One of the many ways Guatemala is an eye-opening experience is through exposure to diagnoses we may never see in the United States. It helps us gain perspective and appreciation for our own culture, provides us with hand-on experiences, and assists in recognizing the need to help others.” Hoyt, along with Steve Taff, PhD, MSOT ‘97, OTR/L, associate director of professional programs for the Program

in Occupational Therapy, recently published an article in OT Practice detailing some of the experiences in Guatemala. In the article, the two noted that the challenge is not simply to ‘grow’ occupational therapy in developing nations, “but also to find culturally specific and appropriate ways to help implement client-centered practice while realizing that results

may not resemble the Western or American version of the profession.” At ANINI in particular, Hoyt said she saw significant changes on the most recent trip. “Fewer children were restrained and they have more opportunities to be out of their wheelchairs during the day. We’ve been asked to add more to the therapy manual, including mat and therapy ball exercises as well as even more activities that could be done with children seated in wheel-chairs. I’m excited to be able to help these caregivers continue to improve the quality of life for these children in Guatemala.”

You can read the full OT Practice article here:http://bit.ly/Uatbeh

Student NewsThe Power of Global Interactions

At an orphanage for special needs children in Guatemala called ANINI, students from the Program in Occupa-tional Therapy see firsthand the need for occupational

therapy to enhance daily living for dozens of children. The annual trip to Guatemala, under the auspices of WUSOTA’s International Assistance Committee, enables students and faculty to expand their knowledge of other cultures, engage in service opportunities, and work with local caregivers to develop needed therapy programs in a country with few occupational therapy resources. “Last year we created a Spanish language picture manual to give local caregivers ideas for activities and stretches that could be done with the children at ANINI,” says Catherine Hoyt, OTD ‘10, OTR/L, who was one of two faculty advisors (including Eliza Prager, OTD ‘10, OTR/L) on the most recent trip to Guatemala in January 2013. “We were thrilled to talk with three caregivers who were using the manual every day for two hours of therapy activi-ties. They were eager to discuss what was working well, what activities they liked, and what they wanted us to add the next time we came for a visit.”

Occupational Therapy Students visit Guatemala.

Hoyt with a child at ANINI.

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Student Rachael Baum with a caregiver discussing the activity manual.

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Visit our Facebook, Twitter and LinkedIn pages for all the Program news and information you crave. From events to program updates, we’ve got it all. Do you have news or photos you’d like to share? Send, post or tweet it to us and you could become one of our social media stars!

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Dr. Parul Bakhshi addresses stu-dents at World Disability Day.

How do we define disability in the United States and is it different from other

countries and cultures? With more than one billion people — 15 percent of the world’s popula-tion — living with some form of disability, it’s no wonder that the answers to those questions vary. For the past 20 years, the United Nations has fostered greater understanding of disabilities by

promoting an International Day of Persons with Disabilities. In December 2012, students involved in Washington University’s Global International Committee hosted a series of discussions about definitions of disability, barriers often faced, and the role of human rights initiatives. “This year’s theme worldwide was ‘Removing Barriers to Create an Inclusive and Accessible Society for All,” says Kristin Will, OTD/S ‘14, an occupational therapy student and one of the organizers of the campus event. “I think there were thoughtful discussions and students learned a lot about the issues presented.” Parul Bakhshi, PhD, DEA (M.Phil), research assistant professor in occupational therapy, facilitated the discussions. She teaches classes that focus on international perspectives of occupational therapy, including the topics of disability and health policies as well as community-based rehabilitation. “I hope that this event not only opens students’ eyes to is-sues pertaining to disability on a global level but inspires them to also get informed and make a difference,” adds Will.

Students hear from Dr. David Gray.

2013 Pi Theta Epsilon Inductees: Congratulations to the newest members of the student honor society! The society recognizes and encourages superior scholarship and service among occupational therapy students.

Students visited Hope Lodge (American Cancer Society) this past fall to prepare and serve a meal to guests, and to speak to residents.

Left to right: Sarah Hendred, MSOT/S ‘14, and Laura McCarty, OTD/S ‘15, at work during the WUSOTA Gingerbread Decorating Contest; Keland Scher, MSOT/S ‘13 performs for students at the Arts Commission Coffee House.

Program in Occupational TherapyWashington University School of MedicineCampus Box 85054444 Forest Park Ave. St. Louis, MO 63108-2212

Occupational T herapy

Upcoming EventsApril 19, 2013OT Scholarship Day Eric P. Newman Educational Center (EPNEC) 320 S. Euclid Ave., St. Louis, MO 63110Registration information to come at: ot.wustl.edu

April 25-28, 2013AOTA 93rd Annual Conference & ExpoSan Diego, CA San Diego Convention Center - Booth #1031www.aota.org/ConfandEvents/ 2013Conference.aspx

You are invited to the Program in Occupational Therapy Alumni Reception on April 27, 7:30-9:30 p.m. at the Hilton San Diego Bayfront, in the Elevation Room. More information to follow.

May 17, 2013Commencement

Please visit us at ot.wustl.edu and on Facebook, LinkedIn and Twitter for more Program news!

Program in Occupational Therapy Commencement 2012.

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