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Forces: A Rich Life
In the United States alone, Marian Minor can count 46 million friends. She hasn’t met most of them and never will. But with her groundbreaking arthritis research — boldly declaring and proving that exercise, rather than bed rest is the best treatment — she improved the way a generation of arthritis sufferers has been managed.
Arthritis patients who know her say she changed their life with her exercise programs; those who don’t know someone helped them. As one colleague put it, her studies “completely changed the expectation of rehabilitation research. Rarely does one’s research have such an impact on a medical field.” And rarely does one person have such impact on the betterment of humanity.
Marian Minor and John Hewett have collaborated on research for nearly 25 years. Both recently received lifetime achievement honors from the American College of Rheumatology. Photos by Nicholas Banner.
For her part, Minor is modest. As chair of the School of Health Professions’ Department of Physical Therapy, she would rather illuminate the work of faculty and students. The medical world sees it differently, however, and she has been accorded the highest honors of the National Arthritis Foundation and the American College of Rheumatology.
A paradigm shift
Osteoarthritis (OA) is the leading cause of functional decline with aging and it causes more mobility problems and decline in function than heart disease, cancer and diabetes combined.
A world-renowned researcher herself, MU physical therapy Professor Marybeth Brown says the magnitude of functional decline with OA would be far greater in this century worldwide “were it not for the treatment approaches taken in Dr. Minor’s research and the paradigm shift she created.” Working alongside Minor since 2002, she says the notion that led to Minor’s approach was “radical.” That radicalism might have started with Minor’s first patient, a Kansas farm wife with severe rheumatoid arthritis.
It was 1965, a time when arthritis patients were treated with high doses of steroids and bed rest. “The adverse effects of that we really didn’t know at that time,” Minor says. “Up to that point steroids were the magic drug for rheumatoid arthritis. They masked the pain and inflammation, but the disease process was still going on.” Frustrated by the lack of treatment options, and noticing a growing national interest in fitness, Minor wondered what impact exercise could have on a patient with arthritis.
“The notion of exercising a patient with joint disease was completely at odds with prevailing dogma,” Brown says. “It was not uncommon to observe disability at a very young age because movement was so restricted and muscles so wasted. Now, just 20 years later, it is considered malpractice to recommend inactivity for OA patients. This magnitude of change in two decades represents a nearly cataclysmic shift in a field where changes in practice patterns typically occur at glacial speed.”
In 1984, Minor secured research funding from the National Institutes of Health (NIH) as part of the Department of Medicine Multipurpose Arthritis Center for her research. Her mentor then, John Hewett, is still a close friend and colleague. Now director of the Biostatistics Group in the School of Medicine, Hewett recalls Minor’s determination. “She has always been involved in projects designed to directly help individuals. She really cares about the people she works with,” he says.
And that is when the great shift occurred. “We found out that the reason people stopped on the treadmill was not pain; they were just tired,” Minor says. “But, when they exercised regularly their function got better, the pain got better, their fitness got better and there was no sign of the disease getting worse. Their sore joints actually got better.”
Minor’s current work with the Missouri Arthritis Research Rehabilitation and Training Center (MARRTC) seeks to determine which exercise is best for people with knee osteoarthritis. Her research team will examine 150 volunteer subjects in the next 18 months. That’s Marian Minor. Always asking “why?” and then seeking the answer. Stanford University Patient Education Research Center Director Kate Lorig says that attitude puts Minor at the head of her class. “If one were to name the top non-physician researchers in the field of rheumatology, Dr. Minor would definitely be among the top five,” she says. “It this were limited to physical therapists, Dr. Minor would probably stand alone in first place.”
A global impact
Other researchers, doctors and physical therapists across the globe have looked to Minor for guidance as they studied and treated patients through the years. Her major papers are published in the most highly respected peer-reviewed journals and she has spearheaded major scientific conferences that have changed how the world practices rheumatology rehabilitation.
Harvard Medical School Senior Scientist Marian Hannan speaks to Minor’s global impact. “Her work not only affected the arthritis scientific community but also changed the curriculums of physical therapy programs across the U.S. and the world. She has shaped the future of young clinicians and investigators in the field, not only in Missouri but across America and abroad.”
Minor also mentors scientists such as Christina Opava, a professor at the Karolinska Institutet in Huddinge, Sweden. Opava had read Minor’s work; the two met in 1992. “Since then she has always been there for me. I am absolutely confident she has been an appreciated role model for many students and faculty members and an excellent leader of the Association of Rheumatology Health Professionals (ARHP).”
The Health Connection
One of the lasting tributes to Minor’s work is The Health Connection, the School of Health Professions’ community fitness center. Minor started it as a base for her research, working with community volunteers. Brown calls this “radical” as well. “She had the vision to create a wellness center before it became fashionable to do so.”
One of those pioneering exercisers was Petey Bank — who was diagnosed with rheumatoid arthritis in 1985 and prescribed rest for treatment. “That prescription and philosophy didn’t set well with my active lifestyle,” Bank recalls. “Marian’s work has made a significant difference in my life and the lives of many of my friends. But more importantly, she has made a difference for 46 million Americans who suffer from arthritis.”
One of the most touching testimonials to Minor’s work came a few months ago when she spoke at a senior center in Slater, Mo., a small town about 100 miles northwest of Columbia. She encountered one of those first volunteers, a woman who had been involved in one of Minor’s early 80s studies. “She said, ‘When I saw your name on the program I just wanted to tell you that being in that study changed by life. I do things now that I never could have done before and it’s been ten years,’ ” Minor recalls. “That’s why you do it. Benefitting the people who are volunteers in your work is so thrilling. It was really quite a wonderful evening.”
Standing alone
Awards are nice and they allow us to showcase those who are outstanding in their field. However, Minor’s impact will never be defined by her awards. It is what she has done, and continues to do, in the area of research and treatment of arthritis: a curiosity to ask questions, a drive to find answers and a desire to help others that started 33 years ago.
In discussing her work, Minor is reflective, saying she is so glad she’s a physical therapist. Her thoughts return to that Kansas farm wife. “I remember her strength and my lack of treatment tools to help her then,” Minor says. Then, with renewed determination, she adds, “I have had the opportunity in my work life to be with people who were in need of help. You see their strength and determination. To be called to be part of that makes for a very rich life.”
Minor’s Honors and Awards
Association of Rheumatology Health Professions Lifetime Achievement Award • School of Health Professions Faculty Research Award • National Arthritis Foundation National Service Citation • Virginia P. Engalitcheff Award for Impact on the Quality of Life • Missouri Department of Health and Senior Services Wilma L. Gillespie Arthritis Advocacy Award • Missouri Physical Therapy Association Research Service Award • Humanitarian of the Year – Eastern Missouri Chapter – Arthritis Foundation • Scientist of the Year – Missouri Arthritis Rehabilitation Research and Training Center • Humanitarian Award – Midland Empire Arthritis Center
Related Links
- SHP Department of Physical Therapy
- The Health Connection
- National Institutes of
Health (NIH) - Touchstone, Spring 2008
Mary Lee Williams, exercising at The Health Connection, was one of Marian Minor’s first arthritis research volunteers at MU. Williams says, “She saved my life and I still exercise regularly because of her.”
Page last updated on: August 25, 2009
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