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Division of Physical Therapy
UNM Health Sciences Center
MSC 09-5230
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone: 505-272-5479
Fax: 505-272-8079

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A positive Russian and US collaboration to improve family centered, evidence-based practices


In the midst of a last minute move to the new classrooms in the Domenici North West Wing and the first day of school, Marybeth Barkocy, PT, DPT, PCS led a training for a group of 13 Russians from Tula, Moscow, and St. Petersburg, Russia under a Naked Heart Foundation grant to improve care for children with cerebral palsy and their families.  From August 19-26, a group of Russian medical professionals (neurologists, rehabilitologists who are similar to PTs, communication specialists, the director of the Tula Center, the director of Naked Heart Foundation, and a child psychologist) enjoyed a bit of New Mexico, collaboration with the UNM Health Science Center and surrounding community organizations, and training in approaches we use for children with cerebral palsy.  Under the direction of John Phillips, UNM pediatric neurologist, the collaboration over the last year under a 2 year grant from the Naked Heart Foundation has allowed professionals from the Tula Center to travel to Albuquerque for training and a multidisciplinary group to go to Tula in March 2017. 

Serial casting     Calder dinner

After a fun day at Acoma Pueblo and shopping at Albuquerque Uptown on Sunday, the group hit the ground running and never stopped for the week.  Evidence-based practice with hands on training with our wonderful librarian and pediatric neurology resident was followed up by solar eclipse viewing.  Some of the week, the group worked together in a multidisciplinary approach, including at NMSBVI, the preschool for the blind and visually impaired where the group participated in a staffing of 2 children they had observed in the classrooms.  In addition, training in occupational therapy approaches and augmentative and assistive communication expanded the options for the team to consider in Russia.  Individual disciplines also had hands on training in various interventions, which for the rehabilitation team, included pediatric orthoses, splinting, serial casting, aquatic therapy, and PT interventions done in a medical model versus school model. 

Acoma Pueblo

A database of Russian patient outcomes at the Tula Center has been established for a collaborative study, and family centered care is now a focus.  Biweekly Skype case discussions occur throughout the year.  In October, Marybeth will travel back to Moscow to present at the Every Child Needs a Family conference in Moscow. 

Please read this uplifting article from the ABQ Journal on the project!

Funabashi Healthy Plan

Funabashi Healthy Plan

Since a concept of local autonomy was introduced in Japan more than 70 years ago, the local autonomies have contributed to provide both a healthy living environment and a unity of the community. It often plays a significant role in promoting health, especially preventative medicine. The local government of Funabashi-city, located east of Tokyo with approximately 60,000 residencies, provides a community care system with five primary assists; health-, nursing-, preventative-, social-, and living assistants.

In 2005, they started a new strategic plan called Funabashi Healthy Plan 21, which contributed to health- and preventative programs.

health and prevention     health and prevention continued

One of their current projects - Normative Values for the ‘Locomotive Syndrome test’ in American Adults (Locomo) - is based on a preventative approach against mobility deficits in Japan. Therefore, the primary investigator, Dr. Yoshida, visited Funabashi-city to learn about their community-based approach. As a highlight, she visited a 6-day course to become a certified ‘Silver Rehabilitation-Exercise Instructor’. The qualified participants of which are elderly residencies in the city. Instructors must take 23 classes for a week with an optional 4-classes as follow-up and learn basic anatomy, physiology, kinesiology and gerontology from healthcare professionals (MD, PT, PHN, and OT).

Silver Rehabilitation

Instructors also receive an internship with a supervision by healthcare professionals prior to obtaining the certification. The entire training aims to evangelize benefits of healthy aging and to promote activities in elderly neighbors. When interviewing the trainees, all of them describe that their participation benefits not only their physical health, but also perceptions of fulfillment in their life. Japan is recognized as a ‘super-aging society’ due to highest proportion of older adults, and Funabashi city set a goal to become a ‘super-healthy aging society’. Hopefull, our current ‘Locomo’ project will enrich their community elderly individuals in the near future. Lastly, Dr Yoshida would like to thank each individual in the city who arranged this visit and shared an excellent community-based approach.


Collaboration with Joint Replacement Center in Japan

Japan collaboration

Dr. Yoshida visited Sonoda-kai Joint Replacement Center in Japan in June. She observed that rehabilitation after knee replacements follows a typical course there. A highlight for her was learning cultural differences between Japan and the United States regarding rehabilitation after joint replacements . 


Many clinicians, who are part of one of the most diligent study groups in Japan, attended a study seminar lead by Dr. Yoshida after work hours and had great discussions with her. Their appreciation and effort to study her research articles encouraged her to keep working on a meaningful, collaborative research agenda around total joint replacements.

Collaboration with The Naked Heart Foundation in Russia


Marybeth Barkocy shares her experience:

If ever you get an opportunity to travel to another country and collaborate with healthcare professionals and patients/families from another healthcare model - grab the opportunity. I was blessed this year to have been chosen by John Phillips, pediatric neurologist, to work on a joint US/Russia project to improve healthcare for children with disabilities.

The Naked Heart Foundation in Russia seeks to improve accessibility and resources for children with disabilities in the largest country in the world. Although the foundation has built numerous accessible playgrounds and worked with the NM Autism Program to improve evidence-based practice for children with Autism Spectrum Disorder, the Tula Project is the first project funded by the foundation to focus on children with cerebral palsy and developmental disorders.

Health care in Russia falls far below western standards for people with disabilities. The impact of former Communist control, traditions of interventions that are not evidence-based, long-standing beliefs, and inequity of access to healthcare are barriers the foundation hopes to overcome.

Russia     Russia
A group of 10 Russians including medical professionals, an administrator from the center, and a pediatric neurologist and a psychologist who translated, came to UNM in the fall. I worked with Dr. Phillips and a team of medical professionals to educate and collaborate with this Russian team on evidence based practices, family centered care, interdisciplinary and transdisciplinary models of care, use of standardized outcome measures, classification systems in CP, and SMART goal writing. We have been skyping with the Russians and collaborating on their cases every two weeks since then, incorporating what they have learned and providing resources they need. A group from the Tula Center will come again in August 2017 for the 2nd year of the project.


In March 2017, our US team of 4 traveled to Moscow and Tula, Russia. We recorded a surprise (to us) 2-hour interactive webinar to answer questions parents had written in, which was broadcast to 14 different Russian-speaking countries: https://youtu.be/H2JAbPiAfqM  

After a sneak peek at Red Square, the Kremlin, and St. Basil’s cathedral, we hopped on a high-speed train and traveled 2 hours south to Tula. We presented at a conference on "Modern technologies of rehabilitation of children with motor disabilities.”
I presented on Production of functional purposes when working with families of children with cerebral palsy, and my daughter told the story of her brother, Nathan, and what impacted us as a family to emphasize the importance of family centered care (which is not current practice in Russia yet):  https://youtu.be/xgKmtY1NYvw   

Then we spent 4 days at the Tula Center to provide hands on training with patients/families and collaborating on research to document patient outcomes of the project with our Russian colleagues. The hope is to publish the data collected from this project, educate other medical professionals outside the center in Moscow, empower families and encourage medical professionals to practice family centered and evidence-based practice, and promote OT, PT, and Speech Language Therapy as professions in Russia. 

I have many stories to share, if you want me to bend your ear someday. We should all learn from the Russians to provide excellent hospitality, participate in unending toasts, give meaningful gifts and gratitude, and take true breaks with no work during the lunch hour. ~ Marybeth