High-impact student research rethinks postpartum care, exemplifies depth of PT education and student authorship

High-impact student research rethinks postpartum care, exemplifies depth of PT education and student authorship

Lisa VanWiel's research is rooted in personal experience and a broader public health need.

The UW-La Crosse physical therapy assistant professor experienced a traumatic delivery of her first born child and struggled mentally in the months that followed. What helped her recover wasn't just time - it was access to a CrossFit gym offering classes specifically for mothers, where she found both physical support and a sense of community.

But she quickly realized that kind of access isn't universal.

"Many mothers dropped out of the class because of pelvic floor issues," VanWiel says. "That class saved me. If physical activity hadn't been accessible to me, my life would look very different right now."

Today, VanWiel studies pelvic floor dysfunction - research inspired not only by her own experience, but also by a larger question: why cardiovascular disease remains the leading cause of death for women in the U.S., and why so many contributing factors remain poorly understood.

As she began exploring the topic, one gap stood out.

"Very little of women's lived experience is reflected in the research," she says. "We need to have conversations with women postpartum. We need to listen to what they've found challenging."

Her work is beginning to fill that gap. VanWiel's research has found urinary incontinence is directly associated with physical activity, mental health and cardiovascular risk in women.

In two recent studies published in "Midwifery" in 2025, VanWiel collaborated with UWL Doctor of Physical Therapy students Grace Conway and Olivia Butler to better understand those relationships.

The first study, co-authored with Conway, found that higher levels of urinary incontinence were associated with lower levels of physical activity among postpartum women.

The second study, with Butler, took a deeper look - interviewing 20 women from the original cohort to understand why activity levels declined and what support they needed. Butler helped lead the intensive process of coding interviews and identifying themes.

Together, the findings point to a critical gap - not just in treatment, but in education.

"We found there is a huge gap in understanding what is safe and appropriate in the postpartum period," VanWiel says. "Women wanted guidance. They wanted someone to help them navigate what activity could look like."

Students as scholars and collaborators

VanWiel's focus on research mentorship with her students is a defining component of the UWL physical therapy program, where students don't just learn existing knowledge - they help create it.

UWL physical therapy faculty have a long history of producing research, going back decades and involving many students. Posters and manuscripts, with student names highlighted, paper the walls of the Strelczyk Biomechanics Lab on campus.

"Conducting meaningful clinical research while mentoring future clinicians is a centerpiece of the program, and all our students get that experience," says Patrick Grabowski, PT program director and professor. "For those who choose to engage the process further, outcomes such as national presentations and publications occur with some frequency."

The Doctor of Physical Therapy Class of 2026 - a cohort of 42 students - exemplifies that model. Throughout their 34-month program, students collaborated with faculty to produce seven published research papers, with two more under review. They also delivered 11 presentations at major national conferences, including the American Physical Therapy Association Combined Sections Meeting and the American College of Sports Medicine Annual Meeting. Their work earned local and and national recognition for the program, garnering awards from the UWL Graduate School, as well as the American College of Sports Medicine's Biomechanics Interest Group. Partial funding for student travel to conferences came from UWL Graduate Studies and the UWL Alumni & Friends Foundation.

Student authorship reflects meaningful contribution, not formality.

"Medical journals have strict criteria for authorship," says Tom Kernozek, professor and chair of the Health Professions Department. "Our students earn their place on those publications."

While research participation is required in physical therapy programs, Kernozek says UWL stands out for the depth and impact of those experiences - contributing to both strong scholarly output and outcomes like a 100% first-time pass rate on the national licensure exam in 2025.

"Becoming a scholarly clinician is about more than applying established knowledge," Kernozek says. "It's about advancing the profession and delivering high-quality, evidence-based care. Clinicians who engage in research help bridge the gap between science and patient care."

For students, that means developing the ability to question, investigate and apply research directly to patient care.

"They're going into clinical settings where they need to find and evaluate evidence to treat patients," VanWiel says. "That ability to critically appraise research makes them more responsible clinicians."

From research to real-world care

Butler, who assisted VanWiel with the postpartum research, says the research experience played a pivotal role in shaping her clinical interests and expanding her skill set.

One of the most impactful aspects of the study was hearing directly from participants during interviews where many postpartum women expressed feeling underwhelmed by the guidance they received on returning to physical activity, says Butler.

"Listening to participants' personal accounts was something that stuck with me," she says.

This experience motivated Butler to pursue further training in pelvic health, completing the Herman & Wallace Level 1 Pelvic Function course, which allowed her to participate in a women's health clinical rotation during her final year of the PT program.

During that final clinical rotation, she experienced a full-circle moment while providing acute pelvic floor physical therapy on a postpartum hospital unit where she was seeing patients shortly after cesarean or vaginal deliveries. Focusing on early intervention and screening for pelvic floor dysfunction, it reinforced the importance of early, proactive care and its potential to improve postpartum outcomes.

"It was incredibly meaningful to apply what I had learned through research and training in a real-world clinical setting, and it solidified my passion for working in pelvic health physical therapy," she says.

Conway, VanWiel's other student co-researcher, says the work was eye opening.

"I really enjoyed my research project and learned how important advocating for pelvic health physical therapy is, especially in the postpartum population," she says.

New digital postpartum program

In addition to shaping career paths and interests, VanWiel's research is shaping the future of care.

Building on feedback from participants in her second study, she and an incoming cohort of students are launching a new intervention this fall: a digital postpartum program designed to help women safely return to physical activity.

The program will combine education about pelvic health with practical strategies - such as techniques to manage bladder symptoms - alongside guided video exercise sessions three times per week. Students will play a central role in developing the content and supporting participants.

Designed with flexibility in mind, the program allows new mothers to engage on their own schedule, while also offering one-on-one health coaching from trained physical therapy students.

"Much of the existing literature can feel paternalistic," VanWiel says. "It tells women they're less active but doesn't ask why. We asked. It's a simple shift, but it changes everything."

Ultimately, that approach - grounded in curiosity, collaboration and accountability - defines what it means to be a scholarly clinician.

"It empowers both students and faculty not only to apply evidence, but to generate it," Kernozek says. "That's how patient care improves, and how the profession continues to move forward."

Getting more certified providers

VanWiel also created a new level 1 pelvic health certification program on campus, included in the PT program cost, to help reduce barriers to accessing qualified pelvic health providers. Last year 16 PT students were certified through the program and another 22 are currently working toward certification.