Contact
Email: axk939@miami.edu
Roles
Assistant Professor of Clinical Physical Therapy
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Biography
Dr. Anat Kristal is an assistant professor of physical therapy at the University of Miami, Miller School of Medicine appointed after successfully completing her PhD at the U. Her responsibilities include teaching Clinical Research I and Human Gait and Locomotion. She received her master’s and bachelor’s degrees in physical therapy from the University of Tel-Aviv, Israel. Prior to immigrating to the US, Dr. Kristal led physical therapy services of the orthopedic rehabilitation department at Sheba Medical Center, taught Prosthetic Rehabilitation at Haifa University and for the Tel Aviv University MD residency program in Israel. She also volunteered her clinical expertise following the 2010 earthquake in Haiti, directing Israel’s physical therapy efforts.
Dr. Kristal’s research is focused on developing outcome measures for people with lower-limb amputation (LLA). In 2015, she led the Hebrew translation of the Amputee Mobility Predictor, which the Israeli Ministry of Health adopted as a mandatory preauthorization test for country-wide prosthetic prescriptions. Dr. Kristal’s dissertation examined the reliability and validity of an observational gait analysis tool, the Functional Lower-limb Amputee Gait Assessment (FLAG Assessment). During her PhD studies, she assisted in developing the Comprehensive Lower limb Amputee Socket Survey (CLASS), a self-report measure of prosthetic socket satisfaction.
Currently, Dr. Kristal collaborates with researchers from the University of Washington to develop the PROsthetic Mobility Performance Test (PROMPT), a flexible measure of mobility for people with LLA. In addition, she continues to work with Israeli professionals as a consultant to develop the Children Amputee Mobility Predictor (CAMP) outcome measure in partnership with ALYN Children’s Hospital in Jerusalem.
Dr. Kristal is a member of the American Physical Therapy Association and the International Society for Prosthetics and Orthotics and has presented her research at national and international conferences. She is excited to share her love for gait analysis, rehabilitation of people with limb loss, and outcome measures research. -
Education & Training
Education
Licensures and Certifications
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Honors & Awards
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Teaching Interests
My ultimate goal as an educator is to promote a classroom environment where students can achieve their potential and learn to think as physical therapists. When curiosity and enthusiasm are fostered, students are more inclined to engage with course material. The best way to promote curiosity and enthusiasm is by using inquiry-based learning strategies. I use clinical examples to raise interesting and challenging questions in my courses. As a result, students are infused with the desire to learn more, ask questions, and use evidence-based literature to satisfy their curiosity.
Developing guided inquiry-based activities promotes active participation and debate. For example, in teaching gait deviations, each student had to observe a video of a patient demonstrating a gait deviation and complete a set of questions that promote a systematic approach to observational gait analysis. Then, each gait deviation was discussed in class, and different answers were debated until everyone agreed. When students are afforded a systematic approach to observational gait analysis, in addition to having the opportunity to debate their clinical observations, they are likely to conceptualize the material and retain the information for a longer period.
My commitment as an educator is to provide students with learning experiences that will enable them to achieve their potential. By fostering a safe and welcoming environment, I can balance demanding excellence with consistent reassurance. Ideally, my goal is that students will be competent and feel confident utilizing skills from my classrooms as often as possible throughout their professional careers. -
Research Interests
As a physical therapy clinician, I searched for evidence-based resources to guide my care plan for people with lower-limb amputation (LLA). Outcome measures enable clinicians to measure a patient’s current condition, measure change over time, provide clear insight into interventions, and, importantly, allow for multidisciplinary collaboration. The sparse evidence on reliable and valid outcome measures for people with LLA inspired my research interest.
My past research examined residual limb internal stress differences between people with transtibial amputation using hydraulic energy-stored and conventional energy-stored prosthetic feet. We found hydraulic feet reduced peak internal stress and loading rate. This finding is significant, as using a hydraulic foot may prevent pressure-related injury and residual limb pain.
In focused research on the gait of people with unilateral LLA, I examined spatiotemporal parameters and their effects on walking speed. I found that prosthetic single limb support duration accounted for >50% of the variance in walking speed. This significant finding can inform clinicians seeking to improve patient mobility.
Throughout my dissertation studies, I worked to develop the Comprehensive Lower-limb Amputee Socket Survey (CLASS) and the Functional Lower-limb Amputee Gait Assessment (FLAG Assessment) at the University of Miami. The focus of my dissertation is the FLAG Assessment, an observational gait analysis tool developed to engender communication and collaboration between physical therapists and certified prosthetists. My research found that seven gait deviations included in the FLAG Assessment were reliable, and of those, four were valid. I am currently working on submitting my dissertation chapters for publication.
Currently, I am involved in collaborative research with the University of Washington to develop the PROsthetic Mobility Performance Test (PROMPT). An in-development-related paper looks at the applicability of the Four-Square Step Test for assessing fall risk in people with LLA. Additionally, I am engaged in developing the Children Amputee Mobility Predictor (CAMP) with colleagues from the ALYN Hospital in Jerusalem, Israel.
My research is focused on developing and testing the psychometric properties of outcome measures for people with LLA. -
Publications
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