Enabling Mobility in the Community

Kerri Morgan, PhD, OTR/L, ATP, is a familiar name in the Program in Occupational Therapy. Known for her numerous personal and professional accomplishments, Morgan is a 1998 Program alumna who has served in several capacities including as a research staff member, a clinician, an instructor and now a scientist. She serves in leadership positions on many organizational and state boards, and is an avid wheelchair athlete. Morgan has been a member of the U.S. Paralympic Track and Field Team since 2008, and she competed in the 2016 Rio Games, where she won a silver medal (women’s 100 meters) and a bronze medal (women’s 400 meters). Morgan is frequently described by colleagues as energetic, competitive, driven and focused. Those qualities caught the attention of her mentor, the late David Gray, PhD, when she was a student in his laboratory.

“For the record, I did not come to OT school to be a researcher. After I graduated, Dr. Gray offered me a part-time job as a research assistant in his lab until ‘I found something else,’” recalls Morgan fondly. “Needless to say, that didn’t happen.”

Morgan worked for many years in Gray’s Disability and Community Participation Research Office (DACPRO) and helped him develop nationally and internationally recognized participation measures. During this time, Gray impressed on Morgan the importance of conducting research in communities in addition to medical or rehabilitation institutions.

“The key thing he taught me was any time you study people with disabilities, you have to measure their participation from their perspetive. Our lab was purposely situated in that community with direct access to the population we were working with,” shares Morgan. The Program leased space for DACPRO at Paraquad, a nonprofit agency that serves more than 3,000 people with disabilities annually in the St. Louis area. Paraquad provides direct services and advocates for systemic change to promote accessibility, integration, opportunity and independence. The relationship provided multiple benefits to each organization and the surrounding community.

In 2004, Gray applied for and received a grant from the Missouri Foundation for Health to fund a health and wellness program for people with disabilities. In partnership with the Program in Occupational Therapy, the Enabling Mobility Center was established at Paraquad. The program provided tools, education and exercise equipment to participants for 12 weeks before transitioning them to another community facility. There was just one problem with that plan that they didn’t anticipate.

“The participants didn’t want to leave our program or the Enabling Mobility Center. We quickly realized that we were giving them a unique, OT-supported environment with equipment they could use to meet their fitness goals that they couldn’t find in a traditional gym setting. Our data was showing the participants were experiencing increased strength, increased endurance and decreased pain from the program,” says Morgan. Because of the apparent need in the community, Paraquad kept the Enabling Mobility Center going when the funding ended in 2008. The gym consistently served about 125 participants each year, with dozens more on the waiting list.

Morgan became an instructor in the Program as she continued to develop her research skills. Deciding that she wanted to become an independent investigator, Morgan applied to the PhD in Movement Science program in the Program in Physical Therapy at Washington University.

“I already had a strong grasp on environment in relation to participation because of my experience with Dr. Gray, so I purposely picked a program that was focused on the person instead. I was able to study neuroscience, biomechanics and exercise physiology, with the end goal of designing interventions to help people transition into the community after rehabilitation,” says Morgan, who earned her PhD in May 2015. Sadly, Gray passed away unexpectedly a few months before her graduation.

Morgan went on to complete a postdoctoral fellowship at the University of Alabama-Birmingham. In January 2016, Paraquad began construction of a new 22,000-square-foot Accessible Health and Wellness Center, which will enable up to 500 people with disabilities to achieve their fitness goals each year. As Morgan prepared to return to the Program, she discussed plans for her new research laboratory with Carolyn Baum, PhD, OTR/L, FAOTA.

“Dr. Baum was extremely open in allowing me to define what the lab’s mission would be. I wanted to explore the gap between rehabilitation services and community resources. I wanted to ask research questions such as how can we get people to transition easier and faster to the community, provide more supports and get them on a healthier, educated routine faster,” explains Morgan. “The timing worked out perfectly with Paraquad’s expansion so the lab could be in incorporated into the new facility.”

The Accessible Health and Wellness Center opened in January 2017, and Morgan’s Enabling Mobility in the Community laboratory is positioned as part of the center. The space also houses the Wheelchair Seating and Mobility Clinic and the Parenting with Disabilities Program, which are part of the Program’s Community Practice services. The lab’s primary study population is patients with lower leg mobility limitations including spinal cord injury, multiple sclerosis and cerebral palsy. The proximity to the new gym and its members opens the door to further community-based research to promote health, decrease secondary conditions and enhance participation in people with disabilities. It also provides more opportunities for master’s, doctoral and PhD students in the Program.

“Graduate students can work with me on research projects, or they can work with the Program’s Community Practice clinicians. The new facility can be used for case-based learning, assistive technology and other educational activities to enhance the student’s experiences in our Program,” says Morgan. “I was fortunate to have PhD student Benny Chen, MA, join my lab. We have been looking at ways to measure the effectiveness of the 12-week exercise program once the participant returns to their home. We can educate someone on how to exercise and eat healthy, but are they really doing it outside of the lab environment?”

Morgan is also studying the implementation of interventions to train manual wheelchair users in propulsion biomechanics using motor learning principles; developing and testing a computer-controlled dynamometer for use with manual wheelchair users for wheelchair training; and examining the duration and intensity of exercise programs to change the overall physical fitness of people with disabilities. Throughout her multi-faceted research, the goals remain the same.

“I want to develop an understanding of what happens when a person leaves rehabilitation and returns to their community setting. What is that process and how can we get the interventions to meet them where they are emotionally, physically and geographically?” says Morgan. “In the next few years, I want to see the lab well-funded, the students engaged in our work and contributing to the literature of rehabilitation science and occupational therapy.”