Barbara Smith
BS, Molecular Biology, Grove City College
MPT, University of Pittsburgh
MHS, Physical Therapy, University of Florida

Student Profile:
Barbara Smith is a physical therapist with 15 years of acute care and cardiopulmonary clinical experience. She received her entry-level physical therapy degree from University of Pittsburgh, and an advanced Master’s Degree in Physical Therapy from University of Florida in 1998. She returned to the Rehabilitation Science Doctorate program in 2007, and her current research focuses upon the effects of strength training in hospitalized adults with inspiratory or limb muscle weakness. Barbara completed her qualifying examinations in October 2008, and she is preparing a dissertation proposal for the spring of 2009. Her clinical mentor is Dr. Danny Martin (Physical Therapy), and her basic science mentor is Dr. Paul Davenport (Physiological Sciences).

Research Project Description:
The prevalence of prolonged mechanical ventilation, an estimated $16 billion annual expense, is expected to increase over 200% by 2020. In order to reverse these disturbing trends, it is vital for physical therapists to identify strategies to treat inspiratory muscle weakness. Barbara’s research objective is to help acute care physical therapists provide the most effective procedures to treat functional dependence due to prolonged critical illness and mechanical ventilation. To achieve this goal she is examining the use of inspiratory muscle strength training, while focusing upon cellular modifications associated with strength gains. Despite the potential benefit of inspiratory exercises, mechanisms of diaphragm remodeling are largely unknown. In collaboration with cardiothoracic surgeons, patients will be trained prior to surgery, and histological tests will be performed on biopsied diaphragm tissue. Tests of this tissue can tell scientists whether the diaphragm muscle fibers have hypertrophied, and permit a microscopic analysis of inflammatory changes. Histological adaptations will be compared to simultaneous changes in strength and breathing function. Collectively, this research may help therapists to develop treatments to prevent or treat inspiratory weakness due to medical illness or surgery. This project will not only help physical therapists understand whether strength training is an effective therapy intervention to prevent diaphragm disuse atrophy, it will help us understand when and how it occurs.

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