MUSC professor advocates for cost-effective treatments for cerebral palsy patients

According to the Centers for Disease Control and Prevention (CDC), 10,000 babies are born with cerebral palsy, a disorder of movement, muscle tone, or posture that is caused by damage to an immature, developing brain, in the United States every year. It’s been difficult to treat this condition without access to newer and oftentimes expensive therapies. For Patty Coker-Bolt, Ph.D., OTR/L, a combination of potential, perseverance, and opportunity helps her idealize a nexus of solutions through research and long work hours.

Coker-Bolt is an advocate for cost-effective, evidence-based treatments that translate to people who are underserved in the U.S. and abroad. She has helped pioneer treatment for young children who are affected by cerebral palsy called P-CIMT, pediatric constraint-induced movement therapy. P-CIMT helps develop motors skills in children by constraining their dominant arm using playful hand puppets. This increases the child’s comfort while participating in therapy, and helps to improve motor responses in the weaker arm. “My passion is translating truly effective interventions and bringing them to people who are underserved and cannot afford to pay for a skilled therapist to provide intensive one-on-one therapy,” explained Bolt. “We’d like to take the core elements of constraint-induced movement therapy and provide it in a cost-effective manner so that more people can receive this type of therapy.”

Coker-Bolt is an Associate Professor of occupational therapy in the College of Health Professions at MUSC, where her research focuses on infant motor development, constraint-induced movement therapy (CIMT), and early power mobility. She is a recipient of the MUSC Center for Global Health faculty pilot grant program that awarded five MUSC faculty members $20,000 in funds to conduct preliminary research around the globe to help set the stage for larger grants from external sources.

Coker-Bolt’s goal is to apply what she has developed at MUSC in a cost-effective way in low-income countries beginning with CURE Ethiopia Children’s Hospital, a 36-bed hospital established by CURE International with a focus to provide surgical specialty care to disabled children. The data she obtains while abroad will help inform future research and practices so that P-CIMT is translatable to all geographies. She also hopes to sustainably train Ethiopian health workers to administer P-CIMT. What’s more, families will learn to use this therapy regimentally to nurture greater motor function in their children. “Families should not be dependent on outside intervention,” Coker-Bolt said. “Therapy in some of these countries is hard to come by, especially the amount of therapy needed for these children.”

Much of the fieldwork and research Coker-Bolt conducts is by no means run of the mill. Her work is infinitely enjoyable. She has the opportunity to work with kids from all backgrounds, giving them the confidence to overcome their disabilities. Outside of MUSC, Coker-Bolt helps run Camp Hand 2 Hands, a camp for young children that provides a fun, exciting mechanism to administer CIMT to improve motor skills in young children. Coker-Bolt also serves on the Board of Directors for PlayToday Foundation, the Charleston Miracle League, Pattison’s Academy and volunteers with Palmetto Medical Initiative. “The most exciting thing about being a therapist is that we are able to see changes in the children we work with,” said Coker-Bolt. “Although some cases are very heart-rending we provide some sense of hope for the family and the children.”

Between spending time with family and friends, Coker-Bolt tries to live in her experiences whether they are in other countries or here in the U.S. During her first trip to Africa, exposure to regions with little to no western influence shaped her perspective and adjusted the lens through which she views life in the developed world. “I realized that you can be amazingly happy with little resources,” said Coker-Bolt. “Once a patient told me that I was ‘lucky to be born in this region of the world.’ I realize now that it is not material things that fulfill you, but your personal interactions with others.”

Luck does not determine who’s adversely affected by the conditions Coker-Bolt treats. By and large, the very same neurological conditions she has seen in Africa are also prevalent here in the United States. She remains optimistic for the cutting-edge, cost-effective advances researchers are making to minimize dependence on expensive technology and treatments. “We’re introducing children that are non-ambulatory, with significant disabilities to early power mobility using commercially available ride-on toys,” explained Coker-Bolt. “We have a way children can go out in play areas, move around in their environment and their home to be more autonomous from mom and dad. It’s important emotionally, physically, and cognitively for the child and for the family—they see that it can be done.”

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