Body
Edelle Field-Fote was a teenager growing up in small town Maine when her mother, who was a nurse, suggested she volunteer at a local nursing home. She ended up helping a physical therapist with tasks like getting equipment ready for the therapy sessions. Field-Fote liked how the therapist got to know her patients and worked closely with them over an extended period of time. “I loved the idea of movement as a treatment for many of the things that were ailing these elderly patients,” she remembers. Later, as a runner in high school and college, she was on the receiving end of physical therapy and “these experiences were really affirming. I knew this was the career for me.”
After Field-Fote graduated from the University of Miami with a degree in physical therapy, she was hired by a new rehabilitation hospital that was scheduled to open soon after graduation. But the opening ended up being delayed for a year so she worked as a contract therapist in a community hospital and met a 23-year-old father, the same age as she was, with a serious spinal cord injury. “I remember thinking, ‘If there’s anybody I can help, please let it be this person.’” She was happy to learn that he was being transferred to a hospital that specialized in spinal cord injuries, knowing that he would get cutting-edge care there. When the new rehabilitation hospital finally opened, Field-Fote took on the responsibility of developing its spinal cord injury program.
Field-Fote went on to get an interdisciplinary master’s degree in industrial engineering and epidemiology from the University of Miami and then a PhD in movement science at Washington University in St. Louis. There during a neuroscience lecture, she learned about central pattern generators (CPGs), neural circuits that generate rhythmic actions like breathing, walking, swimming and chewing so the rest of the brain can focus on more complex functions. “I was fascinated by the complex scratching behaviors that could be coordinated by the spinal cord in a turtle, even after the spinal cord had been completely disconnected from the brain. I was completely enchanted by the idea of these elegant CPG circuits and decided this had to be the focus of my work,” she says. Field-Fote did her PhD in the lab of Paul Stein, PhD, researching turtle scratching and how CPGs that control scratching and swimming may be related.
I was completely enchanted by the idea of these elegant CPG circuits and decided this had to be the focus of my work.
Edelle Field-Fote PT, Ph.D., FAPTA
Body
While attending a scientific conference in California, Field-Fote heard about an investigator who had identified involuntary stepping behavior in a person with spinal cord injury. Blair Calancie, PhD, at the Miami Project to Cure Paralysis had done a series of experiments to show that the behavior was likely produced by spinal CPGs in humans, a controversial idea at the time. He had just had his findings accepted for publication in a respected scientific journal. Field-Fote tracked him down and ended up doing a post-doctoral fellowship under his mentorship.
Field-Fote knew from her research that CPGs don’t function the same way in humans as they do in turtles, which is why people with complete spinal cord injuries can’t walk. For humans to be able to walk, the spinal CPGs must be activated by inputs from the brain. The focus of her studies on walking turned to understanding how to improve the brain’s ability to activate these spinal CPGs through practice combined with neuromodulation that used brain, spinal or nerve stimulation. “Back when I was a physical therapy student, we were taught that if the nervous system was damaged, we could only compensate for it with splints and orthotics. Over the course of my career, we’ve gained a much greater understanding that after injury the nervous system can reorganize in a way that supports improved movement, but this reorganization requires repeated experience and practice.”
Throughout her career, Field-Fote has been conducting research on how combining practice with stimulation promotes neuroplasticity in people with spinal cord injuries. After almost 20 years at the Miami Project to Cure Paralysis, she joined the Shepherd Center in Atlanta as Director of Spinal Cord Injury Research in 2014. She directs a team that includes research physical and occupational therapists, PhD students, post-doctoral fellows, an engineer and a data manager. In her role as professor at the Emory University School of Medicine and the Georgia Institute of Technology, she oversees the DPT-PhD dual degree program where students can earn a clinical doctorate in physical therapy at Emory University, and a PhD in applied physiology at Georgia Tech. In addition, she has collaborated with the Center for Rehabilitation Outcomes Research at the Shirley Ryan AbilityLab on several studies related to use of robotic exoskeletons in spinal cord injury rehabilitation (see related article.) With numerous ongoing research studies and graduate students to advise, she has rarely been busier or more confident that she made the right career choice. “It’s been a fascinating time to be a neurologic physical therapist researcher,” she says. “We’ve learned so much about the potential of the human nervous system, and there is so much more to know.”