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Physical Therapist/Clinical Research Specialist
Mayo Clinic Florida
NAME: C. Joseph Yelvington DPT
eRA COMMONS USER NAME (credential, e.g., agency login):
POSITION TITLE: Physical Therapist, Clinical Research Specialist
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)
INSTITUTION AND LOCATION DEGREE
(if applicable)
Completion Date
MM/YYYY
FIELD OF STUDY
A. Florida State University, Tallahassee, FL
B.University of Florida, Gainesville, FL
C. University of St. Augustine, St Augustine, FL
BA
BS
DPT 12/1987
05/1994
2014
Finance
Physical Therapy
Physical Therapy
A. Personal Statement.
This is my first project as a primary investigator. My interest in this line of research began in 2012 when working with Dr. Christopher Sletton in the pain rehabilitation department at Mayo Clinic in Jacksonville. It occurred during a simple conversation on non cardiac chest pain patients. There was a planned collaboration with GI department at creating a pipeline of individuals with confirmed non-cardiac chest pain who failed a PPI trail into a multidisciplinary pain rehabilitation program for treatment. Suffering from chronic gerd symptoms I began investigating contributions to GERD including weakness at the gastroesophageal junction (GEJ). Most interventions from acid reflux address acid. I wanted to turn the focus on controlling the reflux event. I found a few other studies on this topic, but he required attending in person visits, performed requiring PT visits to train individuals in a diaphragmatic training program. While attending the National Academy of Science, Engineering and Medcine conference (virtually) I came away with the understanding that it generally takes 15 years to get 15% of scientific conclusions translated into bedside care. I set out to correct both of these short comings and bridge the problem (access to knowledge, access to care) and the solution, with this study. We collaborated with family medicine who created a patient database and provided research interns and space, phones and computers for research activites to take place. Even through covid I had to adapt and modify our IRB twice to keep the study enrolling to completion. Meanwhile I have learned several necessary software systems involved in the research process: EPIC, Ptrax, redcap, Protocol lifestyle Management, IRB, unified database, all to augment further study production. And since have assisted many other researchers in many other aspects of their projects and currently augmenting collaborations with PM and R, family medicine, neurology and ENT.
I continue to hone my knowledge using the vast support network, now including AI, to carry forward studies on a wide array of topics in our rehabilitation department.
B. Positions, Scientific Appointments, and Honors
Outpatient Orthopedics and Work hardening - West Florida Regional Medical Center, Pensacola, Florida 1994 - 1997
Director of Rehabilitation - Santa Rosa Medical Center, Milton, Florida 1997 - 2003
Outpatient Orthopedics - Sacred Heart Hospital, Pensacola, Florida 2003 - 2011
PRN Physical Therapist - Unihealth Assisted Living Facility, Milton, Florida 2010 - 2011
Outpatient Staff PT - Baptist Hospital, Jacksonville, Florida
Pain Rehabilitation/split with acute care: Mayo Clinic Jacksonville
Acute care, transplant PT: Mayo Clinic Jacksonville
2011
2011-2012
2012-present
C. Contributions to Science
My independent literature investigations also led to 2 poster presentations on control mechanisms in the lower end of the esophagus. While initating another investigation into grading diaphragm strength, compared to visual observation during modified barium swallow studies (MBBS), observations of the GEJ during MBBS demonstrated a powerful barrier that develops during strong breath holding, enough to prevent transit of several consistencies of material form the esophagus into the stomach. Conclusion: this breath holding may be able to control transit in the reverse, problematic direction. Being a physical therapist of nearly 30 years its easy to understand any structure under volitional control can be strengthened, I proceeded with this study to see if it could be done remotely, to reduce strain on the medical system and individuals suffering from GERD. Preliminary results (64 of 190 final enrollment) were initially published in virtual presentation at the Karolinksa institute.
Observing existing esophageal manometric images further demonstrate a mini parastaltic-like motion caused by the diaphragmatic crus sliding down the eosphagus as it contracted. This pressure wave is easy to visualize, once attention is brought to it. I named this “para”stalsis and made a case for this as a possible mechanism for enhanceing the anti reflux barrier: the deficiencies of which are the primary cause of reflux. Two subsequent posters describing this phenomon were presented at PTs National Combined Sections meeting and the Karolinsa Instutute/Mayo collaboration (virtual).