At first glance, the work of Assistant Professor Matt Miller, PT, PhD, and postdoctoral fellow Tiana Nguyen, PhD, OTD, couldn’t be farther apart. Miller studies how to improve rehabilitation for older adults, especially those living with cognitive change. Dr. Nguyen focuses on the earliest days of life, asking how rehabilitation can better support premature infants.
Although they focus on opposite ends of the lifespan, their goals are the same: translate the data we already have and the voices of clinicians and patients into practical improvements in rehabilitation.
“We both use clinician voices, patient voices, and electronic medical record data and large datasets to understand the current state of practice, and to figure out what might improve care,” Dr. Miller said.
Mining NICU Data for Better Beginnings
Dr. Nguyen’s path began as an occupational therapist. She worked with school-aged children, preschool-aged children and ultimately infants in the NICU.
While working one-on-one with babies and families in the NICU, Dr. Nguyen found herself thinking about the bigger picture. “It was awesome to be able to impact families directly,” she said, “but I kept wondering about changes we could make at the unit level that might benefit every baby and family.” That curiosity led her into program development and quality improvement projects, and eventually to the decision to pursue a PhD.
Her goal was to answer the broader questions she and her colleagues grappled with every day: When should therapy begin? How often should it be delivered? Could evidence about the optimal timing and frequency of therapy interventions help justify more appropriate staffing and ultimately expand access for babies who need it? “Providers always said, ‘We want more therapists, every baby needs therapy,’” she explained. “But the reality is there aren’t enough of us. I wanted to generate the kind of research that could influence policy and staffing, not just help one baby at a time, but shift the system for all babies.”
Now, through her postdoctoral fellowship, she is extending that work to infants with hypoxic-ischemic encephalopathy (HIE), a condition her own child faced. She has built a cohort across UCSF and Oakland NICUs to ask pragmatic questions: When is it safe to begin feeding? What intensity of therapy leads to faster progresss? And how can parents be more involved during cooling therapy, when holding is rare but potentially beneficial?
“There’s so much rich information in the NICU, both in structured fields and in clinicians’ notes,” Nguyen explained. “I’m using natural-language processing and large language models to make that unstructured data interpretable and meaningful, so we can answer questions that directly change practice.”
Already, her work has influenced local policy around oral feeding during therapeutic hypothermia and sparked broader conversations about parent involvement and developmental care. “What excites me is seeing research translate quickly into practice,” she said.
Linking Cognitive Change and Mobility in Older Adults
Back in Dr. Miller’s lab, the focus is on aging and mobility. With support from a recent career development grant, he and his team are mapping how specific cognitive domains relate to rehab outcomes such as walking difficulty, fall history, and physical inactivity. The early signal is clear: which domain is impaired matters.
“While we often think of memory loss first, people with isolated executive-function challenges—planning, problem-solving, anticipating obstacles—show a higher prevalence of walking difficulty, inactivity, and falls than those with other isolated impairments,” Dr. Miller said. “Someone with intact executive function may be able to compensate for memory or language weaknesses.”
His team is also prototyping a clinician-facing toolbox: plain-language guidance, case vignettes, and strategies for adapting rehab when cognition is part of the picture. “We have so much evidence, but it’s scattered,” he said. “If we want widespread impact, we need flexible tools that fit different clinics, time constraints, and comfort levels.”
Shared Methods, Shared Mission
Though their patient populations are different, Drs. Miller and Nguyen emphasize how much they learn from each other.
“Even though we work in very different areas, our methodologies are similar,” said Dr. Nguyen. “Matt has been a great mentor, helping me shape answerable questions with the data I have and build the skills to advance as an independent investigator.”
Together, their work highlights a throughline across the lifespan: whether caring for the most vulnerable newborns or older adults navigating cognitive decline, the combination of clinician insight, patient experience, and better use of data can transform rehabilitation practice.