Ryan Boggs, PT, DPT, DSc(c) Cert. VRS is an assistant professor in the Department of Physical Therapy at Daemen College in Amherst NY. He is currently a Doctoral Candidate in the Doctor of Science program at Rocky Mountain University of Health Professions where he is investigating retrograde axonal atrophy in patients with carpal tunnel syndrome. He is currently the At-Large officer for the Neuromusculoskeletal Ultrasound SIG of the ACEWM. A certified vestibular rehabilitation specialist by the American Musculoskeletal Institute, Ryan has taught continuing education courses in concussion management and frequently lectures on the topic of clinical electrophysiology and biophysical agents. Additionally, Ryan has delivered multiple scientific presentations and publications on red flag-screening and differential diagnosis. He earned a Doctor of Physical Therapy degree and a Bachelor’s degree in Natural Science with a minor in biology from Daemen College.
Note: You should consult with your doctor or physical therapist for recommendations on treatment. The views and opinions expressed in this article are those of Dr. Boggs and do not necessarily reflect the official policy or position of OnlinePhysicalTherapyPrograms.com
How did you become interested in researching compression bandaging?
I first became interested in compression bandaging in 2012 when I was still an undergraduate student at Daemen College. I was extremely lucky to connect with Dr. Nicole Chimera, PhD, CAT(C), ATC, CSCS and Dr. Michael Brogan PT, DPT, MS, PhD, CWS, FACCWS who were both starting to research the effect of multilayer compression bandaging systems on peripheral vascular dynamics for wound healing.
This is your second year as a professor, correct? What have you learned so far?
Yes, I am currently in my second year as an Assistant Professor in the Department of Physical Therapy at Daemen College. I think the list of what I have learned may be too long for this interview. Haha. The biggest piece of advice I have been given is “never forget why you wanted to do this” and I think that resonates across all aspects of our profession. In clinical practice, it’s easy to get weighed down with the immense amounts of paperwork or documentation requirements. In education, there are so many moving parts at the college, department, and even course level that it’s easy to get lost in the process and forget why you wanted to do this… for the students.
How can our knowledge of the effect of compression and biophysical agents on microcirculation improve outcomes for patients?
From an integumentary perspective, edema is a well known cause of chronic, non-healing wounds. The literature on this topic shows that multilayer compression dressings help decrease edema, wound size, and time to healing for patients with venous related ulcers. Many patients who have non-healing wounds also have concomitant peripheral arterial disease. Historically, the use of multilayer compression dressings in patients with peripheral arterial disease and wounds has been contraindicated due to fear of compressing an already compromised arterial system. In our study, 20 healthy adults underwent lower extremity compression with a multilayer bandaging system. Interestingly, we found an increase in skin perfusion pressure (restoration of microcirculatory blood flow following release of carefully controlled occlusion) and decreased edema. We also found an increase in ankle dorsiflexion range of motion, which may help the diabetic patient offload the forefoot.
What are some of the most important things we have learned in this area of the field in recent years?
Unfortunately, there are still no high-quality guidelines for the use of multilayer compression dressings in patients with peripheral arterial disease. All we can say for now is that patients with mild to moderate peripheral arterial disease may possibly benefit from compression, but more research is needed in diabetic and vasculopathic populations to determine safety and efficacy.
You are currently pursuing a doctorate in electrophysiology, how is this enhancing your knowledge as a PT?
I am currently a Doctor of Science Candidate in Clinical Electrophysiology at Rocky Mountain University of Health Professions. This program has expanded my knowledge of electrophysiologic testing and my knowledge of anatomy, neurophysiology, and pathophysiology in patients with suspected peripheral nerve and muscle pathology. As a PT who performs electrophysiologic testing, this degree has enhanced my ability to provide these services to potential patients, interpret research, and conduct my own research which ultimately benefits patients and other providers of this testing.
How does your team come up with new research topics?
The new topics we decide to research are frequently just gaps in the literature that we find interesting and think are worth further inquiry. Currently, with my mentor, Dr. Richard McKibben, we are investigating retrograde axonal atrophy in patients with severe carpal tunnel syndrome, and examining if proposed electrophysiologic tests can determine the presence of retrograde changes in peripheral nerves. I am also leading a project right now, with 4 DPT students, looking at depression and suicidal ideations in Doctor of Physical Therapy Students. We know students enrolled in graduate healthcare programs experience higher rates compared to the general population, but we have little to no data on DPT students.
What aspect of your research are you most proud of?
That’s a tough questions. The research on compression bandaging was the first big project I was involved in. I was immersed in the topic and that study for almost 3 years from start to finish and will always be proud of that. If it wasn’t for that project and the guidance and support of Dr. Nicole Chimera, I certainly wouldn’t be where I am now. With that said, my current research on retrograde axon atrophy has an opportunity to answer some long-standing questions in the field of electrophysiologic testing so I am certainly proud of that. The research on mental health and DPT students has the opportunity to have an immediate impact on my current job and hopefully can act as a catalyst for larger changes at the college and national level.
Do you have any advice for those considering a career in physical therapy?
It’s a great field and I would encourage anyone who is interested to look into it. Spend time shadowing in all settings to get enough exposure so that you have the ability to make an informed decision. It’s a long road but is ultimately worth it. As PTs, we are a crucial part of the team that manages patients with pain and disability. Lastly, I would say if you are an aspiring PT in your undergraduate or graduate coursework, never forget why you want to do this.