Q&A with Dr. Rebecca Craik and Dr. Kate Mangione
To better understand the results of the study, “Effect of a Multicomponent Home-Based Physical Therapy Intervention on Ambulation After Hip Fracture in Older Adults,” Dr. Rebecca Craik, dean of the College of Health Sciences, and Dr. Mangione, professor of Physical Therapy, addressed the history of the study and hip fracture research, their backgrounds, and what it means for research going forward.
Arcadia: Dr. Craik, what aspects of the study did you oversee as co-principal investigator?
Dr. Craik: As Co-PI, I was responsible for ensuring, along with Dr. Magaziner [from the University of Maryland], that the study proceeded as proposed according to the timeline and within the budget. When the grant was awarded from the NIA and NICHD, it was for $10 million and involved three clinical sites at Arcadia, University of Maryland at Baltimore, and the University of Connecticut. Dartmouth College participated in an economic analysis.
Arcadia: Dr. Mangione oversaw the design of treatments, as well as the patients at the three study sites. How did the research team go about designing the treatment plans?
Dr. Craik: Prior to receiving this grant, Dr. Mangione was involved in research that investigated different methods to treat persons after hip fracture. She received funding from NIH to assist her in this effort. The Community Ambulation Grant (CAP) was designed to test two different approaches to help older adults with hip fracture to achieve a higher level of function than usually occurs. The treatments were designed by Dr. Mangione, and she was responsible for training of physical therapists and overseeing the treatment of patients at the three clinical sites.
Dr. Mangione: In 1998, as Dr. Craik noted, I was awarded the Vitetta Professorship to design and test two different treatments to improve function in older adults after hip fracture. This initial award allowed me to receive funding from the Foundation for Physical Therapy, Inc. and the NIH to further refine and test the interventions.
Arcadia: How does this tie into each of your previous research?
Dr. Craik: Both of us are devoted to enhancing the quality of life in older adults. I had the opportunity to participate in a large multisite clinical trial of persons with hip fracture in the 1980s. Dr. Mangione was funded to investigate treatments to optimize outcomes for persons post-hip fracture. We each have published a series of papers related to this work and have collaborated on this current effort.
In 2002, members of the team involved in the recent publication participated in a clinical research project funded by the National Center for Medical Rehabilitation Research (NCMRR), NIH, to develop a larger multi-site clinical trial, and I was Principal Investigator on this grant.
Arcadia: For patients recovering from a hip fracture, how could this study impact the care they receive?
Dr. Craik: The results of this study suggest that more physical therapy than current persons with hip fracture receive may improve walking speed and endurance, balance, and function.
Dr. Mangione: I think the results of this study lead to more questions.
Arcadia: How was the campus used as a study site? Were students involved in any steps of the process?
Dr. Mangione: The patients went through a few hours of testing in the two-to-three times they visited campus, which included walking tests, balance and strength tests, and questionnaires querying health, psychological issue, nutrition, and activity levels. Now that the study is completed, student groups are starting to use the data to answer other clinical questions that were not addressed in the primary paper.