“Physical Therapists need to know the tools to use to help children with CP” — Kristie Bjornson, PT, PhD
Family ties and adversity sent physical therapist and well-established researcher Kristie Bjornson on her path to improving strength training for children with cerebral palsy.
Kristie Bjornson was in middle school when her older brother Keith endured a severe spinal cord injury after a diving accident. Helping him ignited her initial passion for physical therapy.
But it was her brother’s wife, Sherry, who has Spastic Diplegia CP, who opened her eyes to the challenges of the CP community. Bjornson was drawn to learn more, and during her PT training in St. Paul, Minnesota, she began an internship working with children with cerebral palsy. It was the start of a 20-year career working with children with CP.
In 2000, Bjornson decided to go back to graduate school to expand her knowledge further.
“I realized physical therapists didn’t have enough research to know what tools to use in the toolbox to help children with CP,” she told CPRN. “I am a much more evidence-based clinician today. Presently, I have National Institutes for Health funding for three trials exploring varying treatments to help children with CP walk and move about the world easier.”
Bjornson is based at Seattle Children’s Hospital & Research Institute, where she is Associate Professor of Pediatrics and Rehabilitation Medicine, appointed by the University of Washington. She spends one day a week working as a physical therapist, and the other four days are spent on her research projects at the Research Institute.
The goal of her research is to maximize how efficiently a person with CP can walk. Her first project, a two-year study on orthotics, focused on researching the best orthotics and shoe combinations. The second project is a five-year study, a home-based program for elementary school children aged four to six, which is now in its third year.
The study of 72 children involves a standard treadmill being set up in each child’s home with a therapist overseeing forty sessions of treadmill training over eight to ten weeks. The study compares two different types of treadmill exercise: traditional vs. short burst interval.
During the traditional treadmill sessions, children walk at a steady pace for thirty minutes, with speed increasing a little each time. During the short burst interval training, the child walks at a comfortable pace for thirty seconds and then begins alternating with walking faster for thirty-second bursts (fast, slow, fast, slow). Pilot project data shows the latter technique to be more beneficial in helping children with CP walk better.
Bjornson’s third project has just entered its fourth year and features middle grade and high school-aged children and teenagers. The five-year study uses a piece of equipment called a “Total Gym” system.
This study compares strength training with a traditional steady-paced method to power training using the short burst interval method. Pilot data shows the power training combined with short burst interval treadmill training to help this age group walk better.
As her work continues, Bjornson says she would like to see more clinicians use evidence-based practice and a national electronic health record established. She believes these two things would make it easier for researchers to contact people with CP, their parents, or caregivers to improve treatment and research rather than the current model, which the provider controls.
“Doing research with persons with CP is not black and white because no two people present exactly the same way,” she explains. “We’re beginning to chip away at the iceberg we can see above the water.”
As an active member of the CP Research Network, Bjornson says she appreciates how the network has brought persons with CP, parents, and caregivers to the table with providers and researchers for the first time.
“The honestly and resilience of the children and families I get to work with is why I feel so fortunate to do this work,” she adds. “They are just amazing and have taught me so much. They are the reason I chose to pursue my research training after practicing for many years.”