Dr. Stark is Associate Professor of Occupational Therapy, Neurology and Social Work at the Washington University School of Medicine in St. Louis.  Dr. Stark has built an impressive research program examining environmental modifications and adaptation to support aging-in-place for community-dwelling older adults. She has focused her efforts on older adults vulnerable for institutional placement, particularly those with impairments due to chronic and degenerative conditions such as stroke and dementia. Dr. Stark’s thematically linked research program has direct implications for occupational therapy research and practice. What sets Dr. Stark’s research apart from most aging research is her study of the lived environment. Perhaps this is not innovative in the mind of an occupational therapy scientist; however, it is very innovative to scientists outside our discipline. In addition, Dr. Stark’s studies address a complex range of personal, environmental, and functional factors that contribute to falls in the home. Her more recent research examines the timing of falls in the progression of preclinical Alzheimer’s disease, and the association between this timing and pre-identified neuroimaging correlates. Findings from this study are likely to improve early identification of candidates likely to benefit from intervention, with the intent that such intervention may contribute to slowed trajectories of decline.

Q & A

Identify three words that others have used to describe you.
My three favorite are: open-minded, gritty, altruistic.

How do you hope to make a difference in the world through research?
The informal motto of our lab has always been to “make the world a little better place.” Our motto is the touchstone we use to make decisions about new opportunities. It is my hope that through our research we will influence OT practice and health policy. We hope to provide environmental support for adults and older adults with disabilities so they can live safe and fulfilling lives with their families at home and in their communities. My approach is to develop home modification interventions, demonstrate their efficacy, demonstrate their implementation and effectiveness, and disseminate the information to occupational therapy practitioners. 

What is one piece of advice you have for individuals considering a career in science and research?
Study something you are passionate about, find good and kind mentors (really listen to them), be tenacious. 

Beside your own areas of inquiry, what is one research priority that you believe is important for the future of occupational science and occupational therapy?
Participation, as defined by the International Classification of Functioning, Disability and Health is “involvement in a life situation.”  Understanding the participation restrictions people experience (functioning of a person as a member of society) is a fundamental core question of occupational therapy.  The most important research priority for OT is operationalizing and measuring participation, intervening to improve participation outcomes and preventing participation restrictions (disability). 

Describe the most important role that mentors played in your professional journey.  
In addition to being my strong advocates, my kind and generous mentors have given me a roadmap to success in my research.  They have provided me with clear goals and expectations, explicit directions to achieve the goals, and access to resources.  These are the important (often unwritten) “how-to’s” for a successful research career.  Having that roadmap available helped me set my course and stay true. Their “map” showed me where to find resources, where I should detour, what rocky roads lay ahead, and were I could rest.  My mentors have given me a clear picture of where I could go and the costs and benefits of the journey. 

Identify a favorite occupation that renews you outside of your work. 
Time with my family, especially travel.    

What has been the most surprising or rewarding aspects of a career in science and research?
The most rewarding aspect of my career are the relationships I have as a result of my work.  I treasure the relationships I have forged with colleagues, research participants and trainees. 

Selected References

Stark, S, Keglovits, M, Arbesman, M, & Lieberman, D. (2017). Effect of home modification interventions on the participation of community-dwelling adults with health conditions: A systematic review. American Journal of Occupational Therapy, 71, 7102290010. https://doi.org/10.5014/ajot.2017.018887

Stark, SL, Somerville, E, Keglovits, M, Smason, A, & Bigham, K. (2015). Clinical reasoning guideline for home modification interventions. American Journal of Occupational Therapy, 69, 6902290030. http://dx.doi.org/ 10.5014/ajot.2015.014266

Stark, S, Keglovits, M, Somerville, E, Hu, YL, Conte, J, Yan, Y. Feasibility of a novel intervention to improve participation after stroke. (2017) British Journal of Occupational Therapy 1, 1–9

Stark, S. L, Somerville, EK, & Morris, JC. (2010). In-Home Occupational Performance Evaluation (I–HOPE). American Journal of Occupational Therapy, 64, 580–589. doi: 10.5014/ajot.2010.08065

Stark, SL, Roe, CM, Grant, EA, Hollingsworth, H, Benzinger, TL, Buckles, VD, Morris, JC. (2013) Preclinical Alzheimer disease and risk of falls.  Neurology 81.

Dr. Sainburg is a Professor of Kinesiology and Neurology at Penn State University and Penn State College of Medicine, and Director of the Center for Movement Science and Technology (C-MOST) in the Huck Institute of Life Sciences. He manages two laboratories, the Movement Neuroscience laboratory at Penn State University, department of Kinesiology on the main (University Park) campus and the Neurorehabilitation Research Laboratory at Penn State College of Medicine (Hershey), department of Neurology. His research program is fundamentally translational, focusing on understanding basic neural mechanisms that underlie control, coordination, adaptation, and learning of voluntary movements in humans. A major theme of his research has been neural lateralization for motor control. His research in patient populations addresses the functional neuroanatomy underlying lateralized processes of motor control, and the deficits that occur due to neuronal damage to the associated structures. Dr. Sainburg’s research has led to a model of neural lateralization that attributes different aspects of control to each hemisphere, such that each hemisphere contributes unique control mechanisms to both sides of the body. This bi-hemispheric model of motor control has been able to predict hemisphere-specific deficits in both arms of unilaterally lesioned stroke patients. Most importantly, this work has led to a mechanistic understanding of non-paretic arm (ipsilesional) motor deficits in stroke patients. His current research along with Collaborator Carolee Winstein PT PhD at USC is exploring occupational therapy based clinical intervention that uses virtual reality and real-world training to ameliorate these deficits and improve functional independence in stroke patients. 

Q & A

Identify three words that others have used to describe you.
Irreverent, Energetic, Gregarious 

How do you hope to make a difference in the world through research?
I think that in order to achieve the ideal of translational research in rehabilitation for neural diseases and stroke, it is incredibly important to understand the mechanisms that underlie the neurobehavioral functions that are affected by damage and disease. I have tried to follow a logical progression in delineating the lateralized mechanisms of neural control that underlie voluntary motor behavior through combining techniques of biomechanics, neural imaging, computational simulations, and empirical studies in individuals with and without neurological disease and stroke. This has led from basic mechanism to interventions, and has been tremendously satisfying. However, the greatest impact that I have is in mentoring early stage scientists, including students, post-docs, and faculty. 

What is one piece of advice you have for individuals considering a career in science and research?
As with all things in life, the best reason to pursue something is that you cannot not pursue it. That is, if you are so excited to engage in the experience, and you wake up every morning with that excitement about your interests, then the chances are that your choice is very well made. After all, the best work is play.

Beside your own areas of inquiry, what is one research priority that you believe is important for the future of occupational science and occupational therapy?
I think that it is incredibly important to pursue a better understanding of the cognitive-perceptual-motor interface in humans. This very complex interplay between domains of function is the very basis of the occupational performance that OT’s confront every day. No other rehabilitation professional has taken on this interface as the basis of their professional focus. I believe that it is time for OT’s to claim this incredibly important aspect of human performance, and integrate more specific and detailed studies of these domains into professional training. 

Describe the most important role that mentors played in your professional journey. 
The role of mentors in my professional life has been so incredibly important, and continues to be so important, that answering this question is near impossible, except to say that I have been tremendously lucky to have had absolutely fantastic mentors at all stages of my career.
  
Identify a favorite occupation that renews you outside of your work.
Hiking, biking, camping, and traveling with family and friends. This includes but is not limited to sampling the world’s best Belgian ales.

What has been the most surprising or rewarding aspects of a career in science and research?
The great privilege of a life in academics and science is the people that you develop friendships with through research. I have some very strong and deep friendships with scientists over the many years of my career. For those young academicians who may be reading this, cherish your professional friendships. These are the people who you will see and interact with over many years, and who share many of your passions. 

Selected References

Mani S, Mutha PK, Przybyla A, Haaland KY, Good D, Sainburg RL. (2013) Contralesional motor deficits after unilateral stroke reflect hemisphere-specific control mechanisms. Brain 136(Pt 4):1288-303.

Sainburg RL. Convergent Models of Handedness and Brain Lateralization, (2014) Frontiers in Psychology, Movement Science and Sport Psychology 5, 1092-1108.

Schaefer SY, Mutha, PK, Haaland, KY, Sainburg, RL. (2012) Hemispheric specialization for movement control produces dissociable differences in online corrections after stroke. Cerebral Cortex 22, 6, 1407-1419.

Sainburg RL, Frey S, Liew SL, and Clark F. (2017) Promoting the translation between movement science and occupational therapy. J Mot Behav 49(1):1-7. doi: 10.1080/00222895.2016.1271299. 

Sainburg RL, Ghilardi MF, Poizner H, Ghez C. (1995) The control of limb dynamics in normal subjects and patients without proprioception. J Neurophysiol. 73, 2, 820-835.

Dr. Reistetter is Professor and Associate Dean for Research in the School of Health Professions at the University of Texas Health Sciences Center in San Antonio (as of January 2019). He is widely recognized for his leadership in health services research within rehabilitation in general, and in occupational therapy specifically. Through Dr. Reistetter’s K12, K01, and subsequently his currently funded Agency for Healthcare Research and Quality R01, he has brought the discussion of how to measure rehabilitation geographic regions to the forefront. Specifically, he is translating methodology from the hospital-centric research conducted at Dartmouth College and implementing these approaches to a rehabilitation context to define rehabilitation geographic services areas. Prior to Dr. Reistetter’s seminal work, any researchers examining geographic variations in rehabilitation quality of care were limited to the hospital-based regions, called Hospital Service Areas, even if they did not adequately reflect the context and environment in which rehabilitation was provided across the country, as this was the accepted approach. Thus, it has been Tim’s work, which has focused on developing and evaluating Rehabilitation Service Areas that has provided health services researchers with the necessary tools to effectively measure variations in service delivery, access, and quality. 

Selected References

Reistetter, TA, Chang, PJ, & Abreu, BC (2009) Showering habits: Time, steps, and products used after brain injury. American Journal of Occupational Therapy, 63, 5, 641-645.

Reistetter, TA, Graham, JE, Deutsch, A, Markello, S, Granger, CV, & Ottenbacher, KJ (2010) Utility of functional status for classifying community versus institutional discharges following inpatient rehabilitation for stroke. Archives of Physical Medicine and Rehabilitation, 91, 345-350.

Reistetter, TA, Graham, JE, Deutsch, A, Markello, S, Granger, CV, & Ottenbacher, KJ (2011) Age and diabetes comorbidity tier groups influence length of stay, functional status and discharge setting in persons with hip fracture receiving inpatient medical rehabilitation. Diabetes Care, 34, 137-139. 

Ottenbacher, KJ, Karmarkar, A, Graham, JE, Kuo, YF, Deutsch, A, Reistetter, TA, Al Snih, S, Granger, CV (2014) Thirty-Day hospital readmission following discharge from post-acute inpatient rehabilitation in fee-for-service Medicare patients. JAMA, 31, 6, 604-614. 

Reistetter ,TA, Kuo, YF, Karmarkar, A, Eschbach, K, Srinivas, T, Freeman, J, Ottenbacher, KJ (2015) Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status. Archives of Physical Medicine & Rehabilitation, 96, 1248-54. 

Dr. Yael Goverover, an Associate Professor, New York University and visiting scientist, Kessler Foundation, established her scholarship based upon the need for research studies in occupational therapy that advance rehabilitation to improve the lives of persons with functional cognitive impairments following multiple sclerosis and traumatic brain injury. Her research focuses in two key areas: (1) Development and investigation of functional cognition assessments for persons with cognitive and functional impairments; (2) Development and investigation of occupationally focused interventions for persons with functional cognitive difficulties. Her research is unique because it focuses on treatment and assessment of functional, everyday activities, using rigorous methodology. Her scholarship in occupational therapy and rehabilitation is supported by research grants from the National Institute on Disability and Rehabilitation Research, the National Multiple Sclerosis Society, and BioGen IDEC and has been published in prominent peer-reviewed rehabilitation journals. She has also presented her work by invitation both nationally and internationally.

Q and A

Identify three words that others have used to describe you: 
Driven, honest, and curious 
 
How do you hope to make a difference in the world through research?
I have devoted the past 15 years of my professional life to learning more about the link between cognition and everyday life performance to better understand how we can improve the lives of people with cognitive impairments. The evidence generated by these studies provides patients these patients a toolbox of evidence based strategies to use in their daily life. I believe that the dissemination of this work can help professionals and patients improve their lives and be more satisfied with their lives. I hope that my work (and others) will improve the lives of persons with cognitive impairments: I hope that the research we do will alleviate cognitive impairments, and facilitate the transfer and generalization of treatment gains into their daily life. 
 
What is one piece of advice you have for individuals considering a career in science and research?
There are many ways to do research, especially in the field of occupational therapy. One can work and observe the world around us or one can choose the more academic course and pursue a doctorate and beyond. For me, the academic route, and especially the post-doc experience were very significant as it enhanced my collaboration with other professionals who do research similar to mine and enhanced my research skills in general. Above all, no matter what path you choose, stay curious and don’t accept the world as is. Always ask questions about your observations and your work. 
 
Besides your own areas of inquiry, what is one research priority that you believe is important for the future of occupational science and occupational therapy?
There are so many research priorities to consider. Recently I participated in a conference where I heard about the field of culinary medicine, a new evidence-based field that blends the art of food and cooking with the science of medicine. OTs should participate in this research. Another priority field is technology. As technology advances, OTs should work integrate it into our treatment and research. At the same time, we should strive to understand the disparities in its use and why some people use it more than others from various perspectives, including a social justice perspective. 
 
Describe the most important role that mentors played in your professional journey. 
I have had a few significant academic, clinical and scientific mentors in my life and each played a unique role. The most important role a mentor played in my life was teaching me to observe and believe in myself as an independent researcher by providing me the space to develop an independent line of research. Mentors have also provided feedback that brought my work to the next level.

Identify a favorite occupation that renews you outside of your work. 
I have many occupations, but recently I have come to enjoy acrylic painting and daily exercise (during which I think about the best way to analyze data). 
 
What has been the most surprising or rewarding aspects of a career in science and research?
There are so many rewarding aspects of this career. First, the people I meet and work with in my research and academic life, both participants and professionals. My research participants teach me about life with disabilities in America and make me aware of issues related to social justice. Through my academic life I meet colleagues who become my family and who enlighten my thinking. Second, making a difference in a person’s life. I once received a letter from a mother of study participant with TBI thanking me for the improvement she saw in her son, or a study participant with MS told me that he felt alive again. Finally, seeing a published manuscript is always very rewarding. 

Selected References

Goverover, Y, Chiaravalloti, N, Genova, H & DeLuca, J. (2017). An RCT to treat impaired learning and memory in multiple sclerosis: The self-GEN trial. Multiple Sclerosis 1:1352458517709955. doi: 10.1177/1352458517709955. PMID: 28485659.

Goverover, Y, O’Brien, A, Moore, NB, & DeLuca, J. (2010). Actual Reality: A new approach to functional assessment in persons with multiple sclerosis. Archives of Physical Medicine & Rehabilitation 91, 252-260.  doi: 10.1016/j.apmr.2009.09.022. PMID:  20159130.  

Goverover, Y, Johnston, MV, Toglia, J, & DeLuca, J. (2007).  Treatment to improve self-awareness for persons with acquired brain injury. Brain Injury 21, 913-923. PMID:17729044.