About

Meryl Alappattu, DPT, PhD, is associated with UF Health and is listed in the UF Health Directory. The provided page text does not include specific details about her research focus, background, or key contributions. Therefore, a detailed professional biography cannot be extracted from the available information.

Research topics

• Medicine
• Internal medicine
• Physical medicine and rehabilitation
• Food science
• Anesthesia
• Traditional medicine
• Pathology
• Dermatology
• Physical therapy
• Chemistry
• Surgery

Selected publications

• Association between changes in conditioned pain modulation efficiency and pain sensitivity: a randomized controlled trial

  Frontiers in Pain Research · 2026-03-26

  articleOpen access

  Conditioned pain modulation (CPM) reflects endogenous inhibitory capacity and may demonstrate neuroplastic adaptations with repeated activation. However, the association between CPM efficiency changes and pain sensitivity remains unclear. This planned secondary analysis examined whether improvements in CPM efficiency were associated with changes in quantitative sensory testing (QST) measures and psychological factors in healthy adults. Study design, participants, and primary intervention effects have been reported previously in the primary trial publication. Sixty participants (aged 18–75 years) were randomized to high CPM exposure (five sessions), low CPM exposure (two sessions), or no CPM exposure groups. Multiple linear regression examined associations between changes in CPM efficiency and QST measures (thermal and pressure pain thresholds, tolerance, and ratings) and psychological factors (depression, anxiety, fear of pain, affect, and expectations), controlling for group and age. Improvements in CPM efficiency significantly predicted increases in heat pain threshold temperature ( β = −1.90, p < 0.001, R 2 = 0.43) and heat tolerance temperature ( β = −0.56, p = 0.010, R 2 = 0.34), indicating that participants required higher temperatures to detect and tolerate pain. However, pain intensity ratings at these thresholds remained unchanged. Age independently predicted smaller threshold improvements ( β = −0.11, p < 0.001). No associations emerged between CPM changes and pressure pain measures, aftersensations, or psychological factors. CPM-induced neuroplasticity selectively enhanced thermal nociceptive detection through descending modulation without altering suprathreshold pain intensity encoding or affecting mechanical pain pathways. CPM induced with thermal stimuli functions as a thermal-specific biomarker rather than a global pain sensitivity indicator, with implications for clinical assessment and interventions targeting descending inhibitory pathways.

  PublisherOA PDFDOI

• Characterizing the Prevalence of Pelvic Floor Disorders in Males and Females With Lower Limb Amputation: Initial Study Findings: Erratum

  Journal of Women s & Pelvic Health Physical Therapy · 2026-01-01

  article
  PublisherDOI

• Manual Therapy

  2025-07-22

  book-chapter

  The manual therapies are a very old discipline that developed in parallel in many cultures across the world. Muscle-biased techniques, for example, have been represented in foundational documents of traditional Chinese medicine and Sanskrit writings from India. Early texts by Hippocrates describe the use of joint- and muscle-biased techniques. More recent history saw the development of osteopathy and chiropractic philosophies and theories. Today, there is a staggering variety of practices within manual therapy used by many different professions to manage musculoskeletal disorders. These therapies include techniques biased toward the joints, the soft tissues (including muscle and fascia), and neurovascular structures. Manual therapy is embedded within the inception of the physical therapy profession and is described in the profession’s early literature. 1 Specifically, the physical therapy profession evolved during World War I with the rehabilitation needs of wounded soldiers, and massage was considered an integral component for the management of these patients. Historically, physical therapists were trained in manual therapy by physicians. 2 , 3 Well-known physical therapists in the field of manual therapy, such as Freddy Kaltenborn, Geoffrey Maitland, Stanley Paris, Gregory Grieve, and David Lamb, all trained under or were influenced by orthopedic physicians such as James Mennell, James Cyriax, and Allan Stoddard. 1 Subsequently, the early physical therapy clinical decision-making approach to manual therapy was heavily influenced by osteopathic and orthopaedic physicians. In this chapter, the present traditional and more current theories regarding why manual therapy is effective for some patients presenting with musculoskeletal disorders will be presented, along with the general principles for the successful implementation of manual therapy into clinical practice. The evidence specific to the risk and general efficacy of manual therapy will be presented along with the modern definition of the broader context of how Orthopedic Manual Physical Therapy is described today.

  PublisherDOI

• Effects of an Accessible Hybrid Telehealth Respiratory Strengthening Program to Alleviate Chronic Constipation: A Pilot Study

  Journal of Women s & Pelvic Health Physical Therapy · 2025-07-01

  article

  Purpose: This pilot study aimed to evaluate the effectiveness of a hybrid telehealth physical therapy (HTPT) model, targeting respiratory muscle strength and coordination, in improving chronic constipation (CC) symptoms and its relationship with respiratory performance measures. Methods: The quasi-experimental study included an intervention group (HTPT) and historical control group that received in-person physical therapy. The HTPT group underwent initial testing of maximal inspiratory and expiratory pressure (MIP and MEP) and received breathing education for defecation and a respiratory muscle strengthening program using a respiratory muscle training device, with weekly telehealth sessions. CC symptoms were assessed using the Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire. Results: Out of 28 subjects, 21 completed the 8-week protocol. This resulted in a significant average increase in MIP (24.68%) and MEP (9.18%), along with a significant decrease in PAC-SYM scores. The intervention group’s mean PAC-SYM score decreased from 1.75 at baseline to 1.20 at 4 weeks and 0.97 at 8 weeks ( p < .001), with a large effect size ( ηp 2 = 0.687). Post-hoc comparisons showed significant improvements starting at 4 weeks ( p < .001). No significant differences in PAC-SYM scores were found between the HTPT and historical control group ( N = 35) when comparing post-treatment scores versus pre-treatment scores. A significant moderate negative correlation occurred between changes in MEP and the PAC-SYM ( r = −.402, p < .05). Discussion: The HTPT model significantly improved patient-reported CC symptoms. Exclusive in-person physical therapy that often included internal interventions showed no significant differences compared to the HTPT group. Future research on MEP-targeted interventions for CC appears warranted.

  PublisherDOI

• Prioritization and multilevel mapping of implementation strategies for a cancer rehabilitation navigation program

  PM&R · 2025-01-13 · 1 citations

  article

  BACKGROUND: Although determinants and strategies for implementing a cancer rehabilitation navigation (CRNav) program have been described, defining specific implementation interventions could improve uptake in oncology care delivery. This manuscript shares prioritized implementation interventions using a multilevel framework. METHODS: We convened interdisciplinary stakeholders from two CRNav programs to participate in an implementation mapping focus group. Using a multilevel framework that considered provider-, clinic-, and system-level interventions, the focus group discussion guide sought participant input on specific interventions that needed to occur at each level to facilitate implementation. The focus group transcript was analyzed using deductive thematic coding to identify program implementation interventions at each level. The interventions were then shared with all stakeholders to seek agreement and prioritization using a modified Delphi process. A priori a 70% threshold was established to define agreement. Two rounds of Delphi were conducted. RESULTS: Fifteen stakeholders were recruited and nine participated in the focus group. The implementation mapping exercise identified 19 different interventions within the following Expert Recommendations for Implementing Change domains by level: provider level-use evaluative and iterative strategies, provide interactive assistance, train and educate stakeholders, support clinicians; clinic level-change infrastructure, support clinicians, adapt and tailor to context, use evaluative and iterative strategies; and system level-develop stakeholder interrelationship, use financial strategies, change infrastructure. Seven of 15 individuals completed both rounds of the Delphi. Fourteen interventions achieved agreement for high importance. Highest prioritized implementation interventions were develop a core champion team, develop a rationale for program justification, agree upon outcomes measures for the program, and examine and contextualize barriers that will influence the program. CONCLUSION: Clinical implementation of an innovative care delivery model requires attention to specific interventions that affect various levels within a health care system. These findings will inform future research and clinical efforts in the implementation of CRNav programs.

  PublisherDOI

• Urinary Incontinence Self-Management in Rural Midlife Women: A Mixed Methods Study

  Western Journal of Nursing Research · 2025-09-28

  article

  Background: Urinary incontinence (UI) affects over half of adult women in the United States and negatively impacts physical and psychological health. Our understanding of UI self-management is limited to older, urban women despite the prevalence of UI in all women, particularly during the midlife period. Purpose: The purpose of this study was to examine how contextual factors influence UI self-management behaviors of rural, midlife women with UI. Methods: A convergent, mixed-methods study was conducted with 31 rural women aged 30-60 years who were recruited via social media. Participants completed a demographics questionnaire, individual interview, and questionnaires to assess contextual factors: UI subtype, incontinence severity, access to care, and quality of life (QOL) impact. Analyses included qualitative description, descriptive statistics and correlations, and data integration to assess for convergence. Results: Qualitative interview results have been published. The strongest correlation was seen between incontinence severity and QOL impact. Significant correlations were found between postmenopausal status, UI subtype, incontinence severity, and QOL impact. Integration of qualitative and quantitative data revealed difference between incontinence severity and the qualitative themes self-management behaviors and medical encounters . As incontinence severity increased, the intensity of self-management behaviors increased. Lacking knowledge about symptom reduction and providers’ fatalistic attitudes were barriers to improving UI self-management in this rural sample. Conclusion: Findings demonstrate a need for specific health care educational resources and supportive interactions to reduce the QOL impact of UI in rural midlife women.

  PublisherDOI

• Enhancing Pain Relief: The Role of Repeated Conditioned Pain Modulation and Mind-Body Interaction

  Journal of Pain · 2025-04-01

  article
  PublisherDOI

• Preliminary Evidence of the Prevalence of Pelvic Floor Disorders in Veterans with Major Lower Limb Amputation 1139

  Archives of Physical Medicine and Rehabilitation · 2025-04-01

  article
  PublisherDOI

• Characterizing the Prevalence of Pelvic Floor Disorders in Males and Females With Lower Limb Amputation: Initial Study Findings

  Journal of Women s & Pelvic Health Physical Therapy · 2025-05-06 · 1 citations

  articleOpen access

  Purpose: Investigate the prevalence of pelvic floor disorder symptoms in males and females with unilateral lower limb amputation. Methods: This was a cross-sectional survey-based study. Study surveys were administered online through a study-specific Qualtrics site and participants accessed surveys from the privacy of their own environment. The Pelvic Floor Distress Inventory-20 was utilized to determine the presence and severity of pelvic floor disorder symptoms. Both traditional and contemporary methods of scoring were utilized in reporting results, with the newer scoring method offering a severity of distress classification. Results: Respondents were 135 individuals with unilateral lower limb amputation who utilize a prosthetic limb for daily mobility. Preliminary results indicate that 98% of participants are experiencing some level of distress from pelvic floor disorder symptoms. Additionally, 71.9% of participants reported previous medical treatment for low back pain and 59.3% reported falling in the past year. Correlation between traditional and contemporary scoring techniques was strong (r s = 0.97, P < .001). Female participants, and those with previous low back pain or falls presented with significantly higher scores ( P < .01). Discussion: This is the first study to explore the magnitude of pelvic floor disorders in males and females with lower limb amputation. Results indicate that a high percentage of individuals with unilateral major leg amputations are experiencing some level of distress due to pelvic floor symptoms, with concomitant reports of low back pain and falls. Continued investigation is warranted to further identify the effects of pelvic floor symptoms on functioning and quality of life.

  PublisherOA PDFDOI

• Changes in Sexual Function After Minimally Invasive Hysterectomy in Reproductive-Aged Women: A Systematic Review and Meta-Analysis

  Journal of Minimally Invasive Gynecology · 2025-05-30 · 2 citations

  review
  PublisherDOI

Frequent coauthors

• Mark D. Bishop

  25 shared

• Michael Robinson

  University of British Columbia

  14 shared

• Georgine Lamvu

  Orlando Health

  13 shared

• Jason M. Beneciuk

  Brooks Rehabilitation Clinical Research Center

  10 shared

• Kathryn Witzeman

  10 shared

• Jeff Boissoneault

  University of Minnesota

  7 shared

• Joel E. Bialosky

  University of Florida

  7 shared

• Shana Harrington

  6 shared