Mara Brandsoy, OTR/L, PRC

Can you give us a brief history of your background?  How did you become interested in becoming an Occupational Therapist?
I considered OT and PT and became an OT because there is such a wide variety of treatment settings – from cognitive rehab to sensory integration to orthopaedics.  I graduated from the College of Saint Catherine located in Saint Paul, Minnesota in 1999 and shortly after was hired by a hospital in south-central MN.  Through the hospital I was contracted into a chiropractic clinic.  The treatment team consisted of a D.C., massage therapist and myself.  This integrated approach gave me the foundation to work in a multi-disciplinary setting with complex patients.

Tell us about your current work setting.  How many OT’s, PT’s, etc…how do you integrate together?
I have worked at IMPACT Physical Medicine and Aquatic Center for 7 ½ years and currently manage the occupational therapists.  Our medical director is a PM&R physician and we have 7 OT’s, 5 PT’s, a chiropractor and a massage therapist.  We provide land and aquatic therapy at our facility with PRI principles being the primary focus of treatment.  Our commitment to PRI concepts is so strong that the PRISM pool was developed and built at our clinic.  We have had the exciting opportunity to work closely with Ron Hruska to be the first facility to fully incorporate PRI principles into an aquatic setting.

Each of the therapists, whether OT or PT, has their own specialty area; we refer to each other to make use of each person’s talents. We truly take a team approach to treatment.  For example, an OT may initiate a myokinematic program and refer to PT for PRI based orthotics in order to provide additional proprioceptive input to achieve proper foot mechanics.

Are there certain areas of patient care that excite you most?
Our clinic specializes in chronic, multi-site pain conditions.  Often these patients have had many failed attempts at therapy in other settings.  What motivates me the most is being an OT who can work successfully and have positive outcomes in such a challenging environment with complex patients.

Over the years, you’ve attended several PRI courses.  How did you first learn about PRI?
My first exposure to PRI was watching a PT treat a family member utilizing PRI techniques.  The philosophy and rationale for treatment made a lot of sense and I started re-evaluating how I was currently treating my patients.  This PT then presented a Protonics course at our clinic in 2002 and from that point on I started taking PRI coursework.

What was your initial impression of the material?
Honestly, my initial impression was, “Why didn’t I learn this in school?”  As an OT, we are taught that the entire body/system functions as a whole but the treatment approach was a very traditional orthopaedic approach that treats one joint at a time.  PRI doesn’t treat just the symptoms at the joint, it treats the entire kinetic chain and the total body system.  PRI provided me with a paradigm/model with which I could evaluate, measure and treat that total system. 

Was PRI something you were easily able to incorporate into your clinical skills?
Absolutely.  PRI is a perfect fit for an OT because from the beginning we are taught to view the body as an integrated system.  The ability to fully incorporate PRI principles into everyday treatment requires years of dedication to coursework and patient care.  I have continued to improve my depth of knowledge by repeating PRI courses and ultimately completing the PRC process. 

You were one of the very first OT’s to go through our Postural Restoration Certification process last year. How do you see Postural Restoration specifically complimenting the OT profession?
Incorporating OT’s into Postural Restoration will provide additional perspective on the implementation of PRI with ADL’s and overall function.  I believe that PRI principles provide the foundation for addressing most orthopaedic and/or neuro-muscular diagnoses.  When I train new hires and OT students, I describe PRI as “a neurological approach to treating biomechanical dysfunction.”  Combining a neuro re-ed approach with biomechanics is an easy relationship for an OT to assimilate, since OT’s are integration specialists who focus on total body function. 

Has becoming certified presented any new opportunities you feel you wouldn’t have had otherwise?
The process of certification was a learning experience for me and it provided me the opportunity to evolve my PRI skills.  I am also hoping that becoming certified will increase awareness of what an OT has to offer in this practice area. 

In March, you attended a four day Interdisciplinary Integration course.  One of those four days covered Vision Vestibular Integration.  From what I understand, this is an area that was covered in your OT course curriculum.  Can you elaborate on this a little more?
We are introduced to vision rehab in school as related to a neurological event and taught how to assess, retrain &/or accommodate the person or environment.  Vision rehab is a very specialized area of OT and is not utilized in all settings.  We also have a background in sensory integration in which our role is to assess and provide proper integration of sensory input – which includes the vision and vestibular system. 

Is the material presented during this course going to be something you can use in your current clinical setting?
After attending the Interdisciplinary Integration course, I was able to add some of these principles to my previous knowledge base.  The next week I had a patient who had received vision-vestibular rehab previously and achieved a certain level of success.  By incorporating PRI principles with her vision program, she experienced a new level of challenge she had not previously had.

Another benefit of the Interdisciplinary Integration course was meeting with other providers who appreciate a neurological approach, including optometrists, dentists and a podiatrist.  We returned to our clinic with hopes of networking with these professionals to build collaborative working relationships.

Do you have any other professional plans for this year?  Any big projects you plan to work on?
I will continue to mentor OT students in order to gain awareness of OT in this non-traditional setting.  I’m planning to establish a role in the academic arena by presenting information re: OT and PRI concepts to students and faculty.

Later this fall, our OT group is presenting at MOTA (Minnesota Occupational Therapy Association) on OT and incorporating PRI concepts into treatment.  Two years ago we presented and the material was well received by the audience.


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