Jeanine R. Schierbecker of St. Louis has been a physical therapist (PT) at Washington University School of Medicine’s MDA clinic since 1985, 11 years before it was designated an MDA/ALS center.
A team approach
|Physical therapist Jeanine Schierbecker tests the strength of ALS patient Glen Houston, who was in a clinical trial at Washington University.
Schierbecker’s one of four PTs working in the MDA/ALS center, which is one of the clinics under the direction of the department of neurology.
“When the doctor walks in the room and says, ‘This is the problem the patient is having,’ we all jump in and try to address that problem to the best of our abilities,” she said. “If we feel that it exceeds our skills, then we make sure we get the right person involved.”
Every day’s different for Schierbecker. From showing a caregiver how to stretch a tight joint to teaching a family member the correct method of transferring, there’s a lot of educating involved in her position. She works with patients and their families to solve mobility issues.
Another part of her position is to help recognize when special dietary changes are necessary for those who are having trouble chewing and swallowing. Sometimes it’s something simple like thickening liquids or changing the texture of food. Other times it requires the expertise of a dietician, and the clinic’s dietician is called in to evaluate the patient’s needs.
Schierbecker enjoys being a resource for people with ALS and their families and helping them find the answers to their questions.
She received her education at Washington University, earning a bachelor’s degree in PT in 1982 and a master’s in health science in 1992.
“I tend to think in a mechanical way. The human body is kind of the ultimate machine, if you will,” Schierbecker said. “Figuring out how everything works — and when it doesn’t work how can you make it work again, or, what can you do instead — is probably what intrigued me the most about physical therapy.
“Because there’s no occupational therapist (OT) within the neuromuscular division, we put on our OT hats once in a while, too,” said Schierbecker.
When she’s wearing her “OT hat,” Schierbecker runs down her list of questions about activities of daily living such as feeding, dressing, bathing and toileting to see if she can make any suggestions. She recommends assistive devices.
“We’ve found that an in-home assessment by an OT is invaluable and usually more ‘real’ than what we are able to do in a clinical setting,” she said. “We’re fortunate that our OT program at WU has a community outreach program that provides in-home assessments.”
Besides her work in the neuromuscular outpatient clinic, Schierbecker is involved in the clinical drug trials unit within the neuromuscular division.
Since she’s familiar with patients from clinic, Schierbecker assists in finding and recruiting subjects for the clinical trials. She offers participation to every patient who meets the criteria of any particular study.
“When we start a study, we take advantage of that dual role and say, ‘By the way, I don’t know if you are interested in a clinical trial or not, but this is what we are going to be doing in the near future,’” she said. “If we’re not ready to start enrolling, we at least share what information we have, take their names and call them when we are up and running.”
Schierbecker is also a clinical evaluator in the clinical trials unit. A clinical evaluator assesses the patient, usually including an assessment of the person’s strength before and after the ALS treatment in question, and provides the data derived from the assessment for the study’s primary and secondary outcomes.
“Whenever you’re doing any kind of clinical trial research in [the ALS] population, what you are hoping for is an improvement in strength, or a slowing of the progression of the disease, ” Schierbecker said. “It’s really critical that your clinical evaluator understand all the nuances of muscle testing and strength assessment involved in these trials. So much of our physical therapy education focuses on assessing movement and strength, so it’s a great use of our education and clinical skills.”
Above and beyond
Schierbecker’s duties extend well beyond the neuromuscular clinic and ALS clinical trials.
Involved in various local MDA support groups, including two support groups concerning the issues of living with ALS, she often speaks about physical therapy issues of interest to the group and answers questions about exercise, mobility, body mechanics and equipment. Sometimes she visits school districts and speaks with school therapists who work with children in the school system.
This summer was Schierbecker’s 20th year as a volunteer at the St. Louis-area MDA summer camp held at Babler State Park Outdoor Education Center in Chesterfield, Mo.
Since Schierbecker’s on the summer camp planning committee, she gets to help pick each year’s camp theme and decide on camp activities.
“It’s fun for me because the kids respond to me differently at camp than they do in clinic. In clinic, I am part of the white-coat team, but at camp I’m just a volunteer.
“It creates a different dynamic that I think helps me be a better clinician when I see them outside of camp; they feel more comfortable and might share more with me in clinic.”