Bob Gailey: Helping Amputees Enjoy a Better World
|Gailey works with Sergeant Dan Metzdorf at the Blaze Amputee Running Clinic in Warm Spring, Georgia.|
When you meet Robert Gailey, PhD, PT, one of the first things that impresses you is his boundless energy and enthusiasm. Bob lives large--he's passionate about his profession, his family--and life itself. An associate professor at the University of Miami School of Medicine, Department of Physical Therapy, he has taught, practiced clinically, and conducted research for more than two decades.
A mover and shaker in the field of amputee rehabilitation, Gailey is intensely focused on helping amputees get the most out of their prostheses, achieve their goals, and live their lives to the fullest.
Gailey also has a joint position with the Department of Veterans Affairs (VA) Miami Medical Center as a health science researcher and has been strongly involved with the rehabilitation of soldiers wounded in Iraq and Afghanistan at the Walter Reed Medical Center, Washington, DC. He also has participated in various workshops and symposiums centered on military rehab programs. Gailey is proud and excited about the VA's new Functional Outcomes Research and Evaluation Center in Miami, which celebrated its Grand Opening March 31. The new laboratory is dedicated to clinically related research with the mission of improving the physical abilities of male and female veterans who receive care within the VA Healthcare System (VAHS).
The mission of the new lab is right up Bob's alley. He continues to direct research efforts toward evidence-based amputee rehabilitation, functional assessment, the biomechanics and metabolic cost of prosthetic gait, and athletic pursuits of amputees and others with disabilities, and has authored numerous publications on these subjects.
Finding Amputee Functional Levels
One of Gailey's most noted achievements is his role in developing the Amputee Mobility Predictor (AMP), a practical test instrument to objectively determine an amputee's Medicare Functional Level. The results of several years of effort were published in the Archives of Physical Medicine and Rehabilitation in 2002. Noted prosthetics and orthotics expert and consultant John Michael, MEd, CPO, FAAOP, FISPO, said "Inter-rater and intra-rater reliability were between 97 percent and 99 percent, suggesting that this is a very accurate determination and that it corresponds very close to the subjective decisions made by experienced clinicians."
Continuing his comments in "John Michael's Corner," September 2002, he observed, "Since it takes less than 15 minutes to administer and requires little equipment or space, the Amputee Mobility Predictor should prove to be practical in a clinical setting." Michael lauds it as "one of the first critical steps in establishing objective data about amputee rehabilitation that will help us make more defensible decisions about the level of technology individual patients receive." Also, Michael noted that a version that did not require wearing a prosthesis also was highly predictive, a fact which could help determine the components for the initial prosthesis and "ultimately minimize the widespread tendency toward being too conservative in the prescription of and therefore failing to offer every amputee the most functional level of technology that they can utilize."
"It was neat to be a part of this," says Bob, "but I think outcomes research is still in its infancy; we still have a long way to go, but it was a good first step."
Highlights: Technology and Paralympics
When asked about his career highlights, Bob answers, "One has been seeing the technology move forward during the last 20 years that I've been involved. For instance, ten years ago, we thought that computerized knees would never hold up, and now we are all working with computerized knees."
Among Bob's most memorable experiences was working during the Paralympic Games in both Barcelona, Spain, in 1992, and Atlanta, Georgia, in 1996.
"For me, one of the greatest highlights of my career was walking into the Opening Ceremonies & and seeing athletes I knew when they were in their darkest depths--when they had just lost a limb or suffered injury, and then a few short years later they were accepted unconditionally as athletes at the second largest international athletic competition in the world. Just seeing the looks on their faces the first time they come in and knowing that I was a small part of their lives and that I may have helped in some small way to get them there--that is one of the greatest feelings I have ever had."
Bob's Biggest Achievement
But to Bob, his greatest achievement was "marrying my wife Ann and the birth of our two children." He continues, "I just feel very fortunate I have been able to do what I do because of my wife's support." Bob and Ann own Advanced Rehab Therapy in Miami. Ann also is a physical therapist, plus she later obtained a degree in special education. "She has a real interest in that," says Bob. "One of our sons is dyslexic, like I am, so she wanted to learn more about it. She teaches at one of the local private schools for children with learning disabilities."
Gailey also appreciates the support he has received from the University of Miami, "where they have allowed me to work and research, travel, and do all the things that I do. Without that time and latitude, the university and my boss, Dr. Sherri Hayes, have afforded me, I could not have done the things that I have done."
Earning a PhD in prosthetics at the renowned University of Strathclyde in Scotland is another achievement that Bob takes pride in. When he first began to be involved in prosthetics, he recalls that, "Initially it was a little difficult as a PT attending and being involved in prosthetic meetings." But over time, "prosthetists have become some of the greatest advocates and best partners anyone could have." He adds, "That's why it saddens me to see the relationship between our two professions become strained over the last couple of years. I see the good in both professions and we get a lot from each other."
Sports Sparks PT Interest
Bob grew up in Livingston, New Jersey; the family moved to Florida during his high school years. "I ended up going to the University of Miami, and just never left." He comes by his athletic interest naturally. "We never had a meal together other than Sunday because all other times everybody was just passing through between practices and games," Bob recalls.
Gailey's own athletic endeavors sparked his interest in physical therapy. "I played football and baseball in high school and, as a result, I ended up injured more often than not. While I was playing baseball, I had surgery for a knee injury, and I could not believe how little rehab there was at the time. I became interested as to how rehab could be better, and that's how I really got involved in sports medicine and rehab." Gailey decided to pursue physical therapy in the late 70s and later took what he learned in sports-related therapy and adapted it to disabled athletics.
Bob credits much of his achievement to serendipity--being in the right place at the right time. The field has mushroomed, he notes, with more research being undertaken and more consumer involvement, with an increase in support groups. Gailey was at the first meeting of the Amputee Coalition of America (ACA) and has been involved ever since. The American Academy of Orthotists and Prosthetists (the Academy) has been more involved in research and development, he adds, plus the VA and other military agencies have increased their initiatives in prosthetic research and care programs.
|Bob and Ann with sons Robby and Max.|
As mentors and sources of inspiration, Gailey credits Ira Fiebert, PhD, PT, of the University of Miami and Alan Finnieston, CPO, of Arthur Finnieston Inc., Hialeah, Florida. Fiebert was "on the cutting edge of orthopedic evaluation and assessment and also was involved in continuing education," says Gailey. "He was smart, funny, and an extremely skilled clinician. He mentored me in learning how to do research and development and to be a good clinician."
Gailey met many of the movers and shakers in the orthotics and prosthetics field, including those who were developing new socket technology. When Gailey was establishing an orthopedic and rehab facility and wanted to include P&O, he met Finnieston, who was developing socket technology. "We began working together," Gailey says, "Alan Finnieston was probably one of my key inspirations in getting excited about the potential in prosthetics."
Passing the Torch
What are Bob's plans for the future? "Right now, it is to work with the VA to try to develop an evidence-based rehab system where we can use the same outcome measures to design better rehab programs. We want to help amputees reach their goals and, for as many as possible, to return to active, healthy lifestyle."
But mainly, Bob wants to help pass the torch to a new generation of healthcare professionals that will carry on the work and "challenge us further." Some physical therapy PhD students will begin a program in July that focuses on amputee rehabilitation at the University of Miami and at the VA Medical Center. "Our focus is not on developing a better prosthesis, but rather on how to help amputees take full advantage of prosthetic care and maximize their performance with their prostheses," Gailey explains.
What advice does Bob have for those entering the O&P or physical therapy professions?
"If there is anything I have learned it is to listen to your patients. When I first came in the field, there were not a lot of textbooks. So I began listening to the patients, and nine times out of ten they knew exactly what they needed. It was just my job to make sure they received what they did need."
His second piece of advice is: "Do what you enjoy doing."
He continues, "I get up every day and look forward to going to work. It's been great to be able to pursue my interest in sports medicine with disabled athletes and pursue my interests in amputee rehab and research in academia. You need to do what feels right in your heart and go after it. Enjoy it, and be a good listener."
Bob's enthusiasm for his work and life shine through these words, and probably explain why he seems able to squeeze 48 hours out of every 24-hour day.
His grandfather said, "Do what you love and good things will happen." This could indeed be the motto for Bob Gailey, his life, and his work.