|PT Faculty Research|
Binder-Macleod, PhD, PT
research focuses on the neural control of skeletal muscle force output.
He currently is attempting to identify stimulation patterns that minimize
fatigue by most efficiently activating skeletal muscle. The loss
of motor control due to central nervous system (CNS) trauma can be both
a psychologically and physically devastating injury. A number of
recent studies have reported the feasibility of using electrical stimulation
to help patients walk following spinal cord injury (SCI). One limiting
factor in the clinical application of electrical stimulation is the rapid
skeletal muscle fatigue that accompanies its use. Identifying stimulation
patterns that minimize fatigue should increase the clinical usefulness
of functional electrical stimulation.
C. (Cole) Galloway, PhD, PT
Dr. Galloway’s research
focuses on the neuromotor control of infant and adult behavior. He
is especially interested in learning how very young infants coordinate
'non functional' limb movements such as flapping and kicking for behaviors
such as reaching and walking. Dr. Galloway uses standard biomechanical
tools and techniques (high speed motion analysis, surface EMG and multijoint
equations of motion) to address how coordinated motor behavior emerges
from the interaction of the nervous system, the body's mechanics, and the
environment. In addition to developmental psychology, his work draws from
and has implications for neurophysiology, biomechanics, developmental and
evolutionary biology and neurorehabilitation.
McClay, PhD, PT
The Healthy People
2000 and 2010 Initiative of the national Public Health Service has the
broad goal of increasing the quality and years of healthy life. This
initiative has identified regular physical fitness as being an important
factor in overall health, longevity, productivity and reduction of health
care costs. Running has become one of the most popular forms of physical
fitness in the past few decades. However, this has been associated
with an increase in the number of running-related injuries. The etiology
of these injuries is still not well-understood, however it is believed
that the factors of structure, biomechanics and intensity play strong roles
in the development of running injuries. Once these injuries develop,
they can progress to chronic conditions such as osteoarthritis and interfere
with activities of daily living. Therefore, the focus of Dr. McClay's
research is to further understand the relationship between lower extremity
structure, mechanics and injuries in runners.
S. Rudolph, PhD, PT
Reflex Activation of Muscles in People with Medial Compartment Osteoarthritis. This project investigates muscle reactions in people with medial compartment osteoarthritis of the knee after rapid perturbations at the knee produce a varus stress at the knee. A reflex arc between the lateral knee ligaments and muscles in the lower extremity has been demonstrated with electrical stimulation of the medial and lateral collateral ligaments. Reflexive muscle activation has also been shown in response to varus and valgus stresses at the knee in a non-weight bearing position. Reflexive muscle activation could provide stability to the knee under stress, but it is unclear to what extent muscles respond to stresses when the limb is in a weight bearing position. The purpose of this study is to examine reflex muscle activation in young and older people without knee impairment, and in people with OA in response to rapid varus perturbations with the limb in a loaded position. We also intend to investigate how the laxity associated with medial compartment arthritis affects muscle activity patterns in the knee.
The Effect of Quadriceps Strengthening on Adduction Moments in People with Medial Compartment Osteoarthritis. Researchers have shown that people with medial compartment osteoarthritis (OA) have increased adduction moments during the stance phase of gait. An excessive external adduction moment during walking could lead to a cycle of medial joint destruction, varus angulation, increased adduction moments and further medial joint destruction. Rehabilitation techniques should focus on methods to reduce the adduction moment during walking to slow down the progression of OA in the knee. Some investigators have suggested that quadriceps femoris weakness, pervasive in people with OA, may not only be the result of OA but may contribute to the development of OA. Researchers have studied the effect of quadriceps femoris muscle weakness on the development of OA and found that individuals with radiographic evidence of OA and no pain had significant quadriceps strength deficits. They argued quadriceps weakness may precede the development of OA in the knee and that even relatively small increases in quadriceps femoris strength would predict a 20-30% decrease in the odds for having OA. The question remains, what affect does the strengthening have on the biomechanical factors involved in the development of OA? Will quadriceps femoris strengthening reduce the adduction moment in people with medial compartment arthritis? The purpose of this study is to investigate changes in the adduction moment in people with medial compartment OA in response to a quadriceps femoris strengthening program. Subjects will be evaluated for the degree of angulation in the knee as well as severity of arthritic changes in the knee in an effort to delineate if patients with fewer arthritic changes would benefit more from strengthening than those with severely involved knees.
Effect of Neuromuscular Electrical Stimulation
of the Pretibial Muscles on Gait Patterns in People with Hemiplegia.
Patients with hemiplegia following cerebral vascular accident (CVA) often
have diminished control of the muscles of the lower extremity. A
common gait deviation associated with hemiplegia is excessive ankle plantarflexion
during the swing phase of gait due to weak pretibial muscles.
The purpose of this study is to determine the affect of neuromuscular electrical
stimulation (NMES) for strengthening of the pretibial muscles on the ankle
kinematics during the swing phase of gait.
P. Scholz, PhD, PT
The goal of Dr.
Scholz’s research is to understand motor control processes in healthy individuals
and patients who have neurological dysfunction, particularly stroke.
His current work combines mathematical modeling with experiments to determine
how the nervous system solves the problem of motor redundancy. This
work has focused, to date, on the control structure underlying the stability
of postural states of important task variables. He is currently extending
this approach to identify how the coordination of underlying joint motions
lead to stable temporal sequences of these postural states. In addition,
a collaborative proposal with Dr. Thomas Buchanan has recently been submitted
to extend this work to the neuromuscular level by incorporating muscle
modeling. This work studies patients with mild to moderate arm dysfunction
following a stroke. The goal is to determine how their motor control
system is altered compared to healthy, age- and gender matched subjects
as well as to explore differences in control in right and left brain lesions.
Snyder-Mackler, ScD, PT
research efforts focus on dynamic stability of knee and the responses of
the quadriceps muscle after anterior cruciate ligament (ACL) injury.
Studies of the mechanisms by which and the way neuromuscular electrical
stimulation (NMES) and perturbation training can be used to augment muscle
strength and affect function in patients after this injury as well
as randomized controlled clinical trials of these interventions comprise
the majority of her research. This research reflects an overarching
clinical interest in the effectiveness of therapeutic interventions, particularly
NMES as well as an interest in the relationships between impairments (eg.
quadriceps strength) and dysfunction (eg. gait abnormalities) after ACL
injury. Dr. Snyder-Mackler's most recent work has proceeded on several
levels, first characterization of the quadriceps in patients with
anterior cruciate ligament injury, second, the relationship between
quadriceps impairments and function, and third, controlled clinical trials
of interventions. The laboratory has attempted to characterize the
quadriceps impairment that occurs after ACL injury by examining their
strength and fatigue properties, as well as morphology. The role of failure
of central activation in the weakness and fatigue properties of the
quadriceps have been investigated. In a large, multicenter trial, the effectiveness
of NMES was compared with volitional quadriceps exercise in restoring
quadriceps strength and normal gait after ACL reconstruction. Dr. Snyder-Mackler
is also investigating the relationship between instability, laxity
and dysfunction after ACL injury. She has studies the small sub-population
of ACL deficient patients who can return to all activities without
episodes of instability or swelling and without reconstructive surgery
to determine if the characteristics identified in those patients
who do not compensate well are different than the population who do compensate.
A training program has been developed based on these characteristic and
has been tested in a randomized clinical trial. Most recently, Dr. Snyder-Mackler
has begun to study some of these same problems in the elderly and those
with total knee replacement. This work has already result in two
papers with Dr. Binder-Macleod. A trial of the use of NMES in elderly
patients following total knee replacements is now being undertaken.
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