PhD Student and Research Associate
University of Washington
NAME: Rachel Ann Prusynski
POSITION TITLE: PhD Student, University of Washington Program in Rehabilitation Science
University of Portland, Portland OR - B.A. Spanish & B.S. Life Science- 2009
University of Puget Sound, Tacoma WA - DPT Physical Therapy - 2012
University of Washington, Seattle WA - PhD In Progress - Rehabilitation Science
A. Personal Statement
My research agenda is to inform equitable policy that will facilitate quality evidence-based rehabilitative care and to promote physical therapy treatment that will reduce disability. As a second-year student in the PhD Program in Rehabilitation Science PhD at the University of Washington, I am leveraging my clinical, teaching, and prior research experience to gain the skills necessary to support my long-term research goals. My interest in research began as an undergraduate when I participated in a genetics research study which gave me the opportunity to learn lab techniques, guide underclassman, and write a senior thesis. This early research experience prepared me for my capstone project during my Doctor of Physical Therapy program, where I led a research team in study design, recruitment, and manuscript completion for a case series on wheelchair seating modifications for patients with thoracic spinal cord injury. I have since gained experience as a clinician, working in acute care and community rehabilitation settings in the US and Haiti. My clinical work has focused on the geriatric and neurologic populations, and, in 2017, I became a board-certified specialist in Neurologic Physical Therapy. As a clinician and therapy instructor in settings with limited resources such as Haiti, I have experienced firsthand the myriad challenges in applying rehabilitation research to physical therapy practice. Encountering these systematic barriers has led to my interest in implementation science, health policy, and health services research.
I have designed my PhD coursework around three cognates: Large Data Analysis, Health Policy, and Implementation in Global Health. I have applied these skills by contributing to multiple projects along the spectrum from knowledge translation to health policy. Together with Dr. Ellen McGough, PT, PhD, I worked to implement and evaluate a train-the-trainer model for an evidence-based exercise and behavioral intervention for patients with dementia in a Program for All-Inclusive Care of the Elderly program in Seattle. With Dr. Sujata Pradhan, PT, PhD, I analyzed actigraphy data to characterize the association between sleep and physical activity in the Parkinson’s disease population. With Dr. Tracy Mroz, PhD, OTR/L, I am taking a health services and policy research approach to examine the relationship between structures and processes of rehabilitation services and patient outcomes in skilled nursing facilities. This work is especially timely as recent payment policy changes will surely impact therapy provision in skilled nursing facilities.
B. Positions and Honors
2012 Physical Therapist, Kindred Hospital, Seattle WA
2012-2017 Physical Therapist & Internship Coordinator, Virginia Mason Hospital, Seattle WA
2017-Present Physical Therapist, Providence Elderplace, Seattle WA
2018 Adjunct Faculty, University of Puget Sound Onsite Clinic, Tacoma WA
2018-2019 Research Associate, Department of Rehabilitation Medicine, University of Washington, Seattle WA
2019-Present Teaching Associate, Department of Rehabilitation Medicine, University of Washington, Seattle WA
Volunteer and Elected Positions
2012-2019 Associate Board Founder/Chair, Regional Board Member, Nuestros Pequeños Hermanos USA, Bellevue WA
2012-2018 Physical Therapy Instructor, St. Luke & St. Damien Hospitals, Tabarre Haiti
2014-2017 Regent, University of Portland Board of Regents
2018-2021 Nominating Committee Member, Academy of Neurologic PT Stroke Special Interest Group
2019-2021 Specialization Academy of Content Experts, American Board of Physical Therapy Specialties
2019 Abstract Reviewer, World Confederation for Physical Therapy 2019 Congress
2018-2020 Washington Delegate, American Physical Therapy Association House of Delegates
Certifications and Professional Memberships
2009-Present Member, American Physical Therapy Association
2012-Present Physical Therapist License #60278046 Exp 5/2019, Washington State
2014-2016 National Stroke Association Certified Stroke Rehabilitation Specialist
2015-Present APTA Certified Clinical Instructor
2015-Present Member, APTA Academy of Neurologic Physical Therapy
2017-Present Board-Certified Specialist in Neurologic Physical Therapy (NCS)
2018-Present Member, APTA Section on Research
2019-Present Member, APTA Health Policy & Administration Section
2005-2009 Archbishop Christie Undergraduate Scholarship, University of Portland
2008 M.J. Murdock Charitable Trust Undergraduate Research Fellowship
2009 Manuel Macías Certificate in Excellent in Spanish, University of Portland
2009 Blondel-Carlton Award for Excellence in Biology, University of Portland
2009 Valedictorian, University of Portland class of 2009
2009-2012 Physical Therapy Academic Fellowship, University of Puget Sound
2011 NPH USA National Board Above & Beyond Award
2014 University of Portland Contemporary Alumni Service Award
2018 Seattle Met Magazine Light a Fire Awards: Extraordinary Board Member
2018 University of Washington Graduate School Top Scholar Award
2020 Best Abstract, Post-Professional Student Category, Academy of Neurologic Physical Therapy
C. Contributions to Science
At this point in my research development, I have been developing my skills in study design, large data management, community-based implementation science, and statistical analysis. In my first year in the PhD program in Rehabilitation Science at the University of Washington, I was able to contribute to multiple research studies and determine a direction for my dissertation work.
1. I continue to work Dr. Mroz at the University of Washington on developing experience in large data health services research that will form the basis for my dissertation moving forward. Thus far, I have contributed to an analysis on the variation in therapist assistant staffing in skilled nursing facilities and applied my experience in statistics and large data analysis to examine the associations between facility-level characteristics, financially motivated therapy, and rehabilitation outcomes in skilled nursing facilities. We were able to determine specific facility characteristics, including profit status and employment of contractors, that were associated with higher rates of a financially motivated therapy practice called thresholding. The analysis also demonstrated that, while inefficient, this practice has minimal impact on patient quality outcomes. As recent payment reforms change financial incentives for therapy provision in skilled nursing facilities, this analysis will help guide which facilities were historically prone to respond to financial incentives.
Prusynski R, Frogner B, Skillman S, Dahal A, Mroz T. Skilled Nursing Facility characteristics associated with financially motivated therapy and relation to quality. Journal of the American Medical Directors Association (In Press).
Mroz T, Frogner B, Skillman S, Dahal A, Prusynski R. Variation in Employment of Therapy Assistants in Skilled Nursing Facilities Based on Organizational Factors (under review). Medical Care Research and Review. Submitted September 2019.
2. With Dr. McGough at the University of Washington, I performed training fidelity observations and analyzed qualitative data on the barriers and facilitators to implementing a train-the-trainer model of physical activity promotion in people with dementia. We presented a poster on our model for physical activity promotion at the 2019 Physical Therapy Association of Washington annual conference. I also co-authored a new chapter on health promotion for a new edition of a geriatric rehabilitation textbook. Finally, our model for the program will be presented as a platform presentation at the 2020 Combined Sections Meeting of the American Physical Therapy Association.
McGough E, Prusynski R, Lam NY: Health Promotion. In: A Comprehensive Guide to Rehabilitation of the Older Patient (In Press). 4th ed. London: Elsevier.
3. With Dr. Pradhan at the University of Washington, I am preparing a manuscript for a study on the association between sleep and physical activity for people with Parkinson’s disease. Participants with Parkinson’s and healthy older adults participated in this study and wore commercially available activity trackers over a two-week period including during nighttime sleep. I completed statistical analysis comparing sleep and physical activity variables as well as associations between physical activity and sleep between people with Parkinson’s and healthy older adults. Our analysis demonstrated decreased physical activity and reduced sleep for people with Parkinson’s disease compared to healthy older adults. We also found a significant association between decreased nighttime sleep and increased sedentary behavior in both people with early Parkinson’s disease and healthy older adults. These results suggest that, similar to healthy older adults, interventions to improve sleep may impact physical activity in the Parkinson’s population, which may have implications for disease progression and functional mobility and independence. These results will also be presented as a platform presentation at the 2020 Combined Sections Meeting of the American Physical Therapy Association.
Prusynski R, Fogelberg D, Kelly VE, Pradhan S. The association between sleep deficits and sedentary behavior in people with Parkinson Disease. Future Submission to Disability & Rehabilitation.
4. I contributed to the field of physical therapy research via a capstone project during my DPT program at the University of Puget Sound. The study explored personalized wheelchair seating interventions for subjects with thoracic SCI, including a retrospective chart review of 15 patients with SCI receiving interventions from a single seating expert. There were statistically significant decreases in seat-to-back angles and increases in seated height after intervention. A prospective four-week A-B-A-B design case series with three subjects receiving seating interventions from the same expert then explored the relationship between the seating intervention, posture, and upper quarter pain. While all subjects reported satisfaction with individualized seating intervention and all chose to remain in their intervention configurations, there were variable changes in pain and seated height. During the case series portion, the intervention wheelchair seat-to-back angle varied based on individual subjects’ physiology. Because no consistent relationship could be found between a specific wheelchair composite angle and posture and upper quarter pain, this small study reinforced the importance of individualized seating intervention for this heterogeneous population. Results were presented as a platform presentation at the World Congress for NeuroRehabilitation in May 2012 and Academy of Spinal Cord Injury Professionals annual conference in September 2013.
Prusynski R, Collins E, Stabler A, Bartel H, Hastings J. (2012) Posture and upper quarter pain: individualized wheelchair seating intervention for subjects with thoracic SCI: a case series (WNCR Oral Abstract 613), Neurorehabilitation and Neural Repair. 26(6): 654-694.
5. As an undergraduate, I worked to characterize the mutated -galactosidase protein in ovine tissue affected by GM1 Gangliosidosis, a fatal lysosomal storage disease. Initially, I first completed a project that ensured lack of cross-contamination between GM1-gangliosidosis-affected tissue and control tissue within our lab at the University of Portland. I then worked to develop a western blotting technique that attempted to shed light on the processing of the -gal protein in GM1-affected sheep by isolating the -gal protein and comparing its size between sheep brain and liver tissue samples. Results were disseminated via a platform presentation at the 2008 Murdock Regional Conference on Undergraduate Research and at Sigma Xi Regional Research Symposia in 2008 and 2009.
D. Research Support
2020: Group and Concurrent Therapy in Skilled Nursing Facilities and Association with Patient Outcomes. University of Washington Department of Rehabilitation Medicine Stolov Award ($2,000) and PhD Program in Rehabilitation Science Education and Training Fund ($500). Role: Principal Investigator.
2019: Improving Healthcare for Cognitively Impaired Elders and their Caregivers. NIH National Institute of Aging (5P30AG034592-07), 25% FTE ($8,500). Role: Research Associate.
2018-2019: University of Washington Graduate School Top Scholar Award: 50% FTE ($30,192). Role: Research Associate.
2012: University of Puget Sound University Enrichment Committee support for attendance to World Congress for NeuroRehabilitation, $2,000. Role: Platform Presenter
2008: University of Portland summer research grant funded by M.J. Murdock Charitable Trust for genetics work with Dr. Amelia Ahern-Rindell. $2,000 plus housing allowance. Role: Student researcher.