Written by Allison Farrelly ’16
Photos by Beau Jones

While working as a physical therapist for more than 30 years, two particular parts of the job caught Christine Clarkin’s interest: the questions her patients asked about their diagnoses and the fulfillment she felt educating doctor of physical therapy students during their clinical rotations. These two interests developed over the course of her career and led the Rhode Island native on a serendipitous path to her current position as an assistant professor of physical therapy and core faculty as a Ryan research assistant professor of neuroscience at the University of Rhode Island (URI).

As a clinician, Clarkin worked with patients with a variety of neuro-diagnoses—from spinal cord injuries and stroke patients to amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. These experiences have guided her purpose as a researcher—to educate clinicians, to improve interventions, and to engage the community.

“I just want to improve the lives of those living with neurologic disorders,” she says. “I can do that by educating new clinicians and existing clinicians to have more knowledge in and around neuroscience so they can be better clinicians and provide a more effective treatment. I can study actual interventions and work directly with the neurologic community, with the final component being community. I can make my research accessible to the people that need to know about it most.”

Clarkin’s Neuro Collaborative Lab, aptly named for her passion for interdisciplinary work and collaboration with patients, community, and colleagues, is working on research supporting her three guiding pillars.

Educate Clinicians

One of the experiential learning opportunities available to students in URI’s Doctor of Physical Therapy program is to volunteer at the Parkinson’s Exercise Group – a student led community exercise program for people with Parkinson’s. In 2019, Clarkin received a Parkinson’s Foundation Physical Therapy Faculty Award for $10,000 to study how this interactive experience improved the confidence and competency of students who participated. She’s currently concluding the findings, but to date, the results—both qualitative and quantitative—have indicated an enormous positive impact on student learning.

“The feedback that I’ve gotten from students that have gone through the program and are now out in the workforce has been that they have been sought out as ‘experts’ in Parkinson’s treatment even as a new graduate or early career therapist,” Clarkin says. “So, to me, that is such a success to say that we’re educating the workforce in and around the needs of people living with Parkinson’s.”

Improve Interventions

Exercise is one of the most effective ways to treat Parkinson’s, according to Clarkin. And while equipment like stationary bikes is often recommended to those diagnosed, little research has been done on exactly what type of equipment is most effective. Funded by a $25,000 grant from the Rhode Island Foundation, Clarkin’s lab is comparing the effects of active assistance exercise, specifically a motorized cycle similar, versus self-selective exercise where the patient picks the pace they’re working using a seated elliptical cycle. These two pieces of equipment integrate lower and upper body movements.

Clarkin compares the types of exercise to riding her electric bike in contrast to riding her standard bicycle to work. The first takes 40 minutes and is a little easier on the hills, thanks to moderate assists. The second takes some leg work and gets her to campus in 55 minutes. But both are still a workout.

“One of the issues for people living with Parkinson’s is fatigue, and they can have decreased self-efficacy doing exercise,” she says. “But if they could get on a bike that provides some assistance when they start to get tired, they can keep going, but maybe do a little bit less work and they feel OK.”

Clarkin and her team began enrolling participants this summer and fall and hope to present findings later this year.

Engage Community

This past year, Clarkin piloted an interdisciplinary clinic, Empower PD, staffed by URI researchers, is focused on empowering people living with Parkinson’s disease. The clinic could change the way people with neurologic conditions approach their health and wellbeing. Empower PD, funded by a $37,500 grant from Brown University’s Advance-Clinical and Translational Research program is an intensive “boot-camp” style of integrated health care delivery. Providing education, support, and recommendations as soon as a diagnosis has been provided. Clarkin hopes the program will be a new model of care for treating various other neurologic disorders, including ALS, strokes, and multiple sclerosis.

In phase one, Clarkin met with community members living with Parkinson’s and their caregivers to gather feedback on their experience receiving a diagnosis, living with the disease, and the missing pieces in their health care needs.

Next, the clinic was developed, and participants received a comprehensive evaluation by a physical therapist, speech language pathologist, registered dietitian, and a pharmacist. The clinicians then met, discussed the patients, and made goals for each. After their assessment, participants attended a two and-a-half-hour seminar about managing Parkinson’s that covered topics from nutrition and socialization to medication management and exercise.

Clarkin shares that recruiting participants for studies can be challenging, regardless of the topic or discipline. However, her two 10-person clinics were both filled within a week.

“I just think it really speaks to a gap in health care services that these folks are receiving,” she says. “My goal is to establish a long-term biannual clinic in the state of Rhode Island for people living with Parkinson’s disease.”

The Path to URI

After already working as a physical therapist for more than 20 years, in 2010, Clarkin returned to school and received her doctorate of physical therapy degree from Simmons University. When URI launched its Interdisciplinary Neuroscience program at the George & Anne Ryan Institute for Neuroscience in 2013, Clarkin was working in home care in southern Rhode Island, and decided to take a one credit doctoral seminar course.

“I was a single mom at that time with three kids, so I knew I was going to be maybe on a little bit slower track,” Clarkin says. “It was one of those seminars where guest speakers come in every week to talk about their research or scientific theories. I remember sitting there and somebody was talking about their research on the nervous system of lobsters. And I was like, ‘I have no clue what’s going on right now, but I love it.’”

Clarkin went on to take a seminar per semester for a few semesters, until she landed in an introductory neuroscience class and found herself hooked. She completed her doctorate at URI in 2020 and launched full time into teaching and research.

The interdisciplinary focus of research at URI has been a huge draw to Clarkin who spent her career as a clinical physical therapist working in collaboration with speech therapy, nursing, occupation therapy, neuropsychology, and social work.

When she reflects on her career to date, Clarkin says she is grateful that she was open to the serendipity that led her to her research and URI.

“I thank God I didn’t try and plan it out because there’s so many nuances for such a large goal, I never would have been able to do it,” Clarkin says. “I never would have taken a step forward if I actually thought through the whole process, which is a good thing. It’s kind of like when we’re with our patients: Don’t think about the big picture. Let’s just take one step forward now, and then we’ll see where we end up.”