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Today, Shirley Ryan 嫩B研究院’s Monica Perez, PT, PhD, scientific chair of the Harris Family Foundation Arms + Hands Lab, is one of the world’s leading scientists investigating the benefits of combinatorial therapy — combining targeted electrical stimulation with physical therapy — for patients with spinal cord injury (SCI).
However, early in her career, she was a newly trained physical therapist working at the Hospital del Salvador in Santiago, Chile.
In the following Q&A, Dr. Perez shares how her desire to help patients led her to pursue physical therapy and scientific research — and ultimately brought her to Shirley Ryan 嫩B研究院.
How long were you a physical therapist before you decided to get a PhD and move into research?
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I worked as a physical therapist in Chile for about two years and then for around three years in Florida. Over time, I realized that I wanted to continue my education and find ways to make a greater impact on patients' lives. One way to do that was to better understand how the nervous system is affected after an injury and use that knowledge to develop new treatments and address some of the unmet needs in healthcare. That was a major reason I decided to pursue science.
I was always interested in understanding how, after a central nervous system injury, patients can develop spasticity, which involves involuntary movements. How can you move when the brain is no longer telling you to move? I found this fascinating and wanted to understand what was happening in the nervous system. Today, we study the mechanisms underlying spasticity (a disruption of normal muscle function in which all the muscles contract at once causing muscle tightness or rigidity) in people with SCI. We want to understand why these symptoms develop and how we can better treat them.
After earning your PhD at the University of Miami, you pursued postdoctoral research in Denmark and at the National Institutes of Health (NIH). What were these experiences like?
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These were important steps in my scientific career. I strongly believe in the value of developing deep scientific expertise, particularly in a competitive field like neuroscience. In Denmark and at the NIH, I developed expertise in spinal cord and brain circuitry, which became an important foundation for my research. This training helped me better understand the neural mechanisms underlying movement and dysfunction after SCI and gave me the scientific background to begin developing my own research program.
Why did you decide to join Shirley Ryan 嫩B研究院?
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Shirley Ryan 嫩B研究院 was particularly attractive to me because of its commitment to advancing rehabilitation through research and clinical integration. I wanted to work in an environment where scientists and clinicians collaborate closely and where scientific discoveries can be translated into better treatments for patients. For me, that connection between understanding the mechanisms of injury and developing treatments to improve function was particularly compelling.
Where did the inspiration for your combinatorial approach to SCI treatment come from?
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The inspiration comes from a “combination” of factors. For example, both animal and human studies show that exercise, stimulation and other interventions can have beneficial effects, but no single approach is likely to address all the complexities of severe paralysis; working with patients reinforces this idea. SCI affects multiple neural pathways and mechanisms, so we need to understand how different interventions work and how we can combine them to maximize recovery. I think this is one of the major challenges in our field today: How do we move beyond individual interventions and develop combinations of treatments based on the underlying mechanisms, with the goal of achieving greater functional improvements than we could with any single intervention alone?
How does your physical therapy background inform your research to help patients with SCI?
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My background reminds me that patients' needs and goals must always be a priority when we design experiments and develop treatments. My experience having worked directly with patients helps me understand the real challenges that they and their families face and the importance of developing treatments that make a difference in their daily lives.
I also believe that physical therapists and other rehabilitation professionals are essential partners in translating scientific discoveries into clinical practice. They understand the challenges patients face during rehabilitation and what is needed to improve function and independence. That clinical perspective helps me connect the questions we ask in the laboratory with the challenges patients experience in everyday life.
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