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Dr. Rudolph's research interest is neuromuscular control of locomotion. She studies people with joint instability in anterior cruciate ligament deficiency and knee osteoarthritis; people with hemiparesis post-stroke and older adults. She is also interested in developing new technologies for use in rehabilitation including muscle strengthening devices and rehabilitation robots for gait training. Below are some brief descriptions of current and past research projects.
Experimental Bioengineering Research Grant (EBRG) (top)
Delayed therapy often leads to secondary impairments that exacerbate a patient's functional losses such as disuse atrophy and general deconditioning. Currently, therapists can begin rehabilitation of walking by using lower extremity braces or body weight supported treadmill training to support the weak limb. No currently available lower extremity braces can provide the patient the experience of typical movement patterns; rather braces are designed to immobilze the limb on which the patient bears weight. This fosters abnormal, inefficient and very energy costly movement patterns that might be difficult to overcome. This project involves the development of a Smart Knee Brace (SKB) for use in rehabilitation of walking in persons with lower extremity weakness. The purpose of this study is to develop the SKB that will help to control knee movement during the stance phase of gait by encouraging more normal movement patterns while allowing free knee motion during the swing phase, something no commercially available braces can do. The SKB will provide control of the knee joint that will be adjusted for each patient based on his or her walking ability and the goals of their rehabilitation. This study represented the first phase of the work to develop the SBK and its electronic controllers based on walking patterns from healthy older subjects. Feasibility of the SKB will also be tested on healthy subjects and patients with hemiparesis from stroke. The data collected during the proposed work will be used to plan future clinical phases of the work.
Temel M, Rudolph KS, Agrawal S. Gait Recovery in Healthy Subjects: Perturbations to the Knee Motion with a Smart Knee Brace. Proceedings of the IEEE/ASME International Conference on Advanced Intelligent Mechatronics (AIM 2010) July 6-9, 2010 at Montréal, Canada.
Bioengineering Research Grant (top)
Innovative Smart Brace Balance Training: Enhancement, Investigation, Application
The long term goal of the work is to develop training programs that will improve functional mobility in older adults at risk for falling. The current proposal presents methods to refine and improve the existing SB, and outlines studies designed to investigate the response of young, older adult subjects as well as older adults with a risk of falls to novel and creative SB paradigms. We will develop a mathematical model to predict subject responses to perturbations that will be useful in future training studies, and will complete a study of reactions to perturbation algorithms that might be used during a balance training program that will provide pilot data for a future randomized controlled clinical trial. The results of this study will provide insight into dynamic balance during walking and develop methods for a training program to improve dynamic balance and reduce the risk of falls in older adults.
Beginning Grant-In-aid (top)
Relationship between speed and walking function post-stroke (PI: Reisman)
The Aims of this project are to: 1) understand the effects of systematic increases in walking speed on the walking pattern of persons with post-stroke hemiparesis and to understand how this is influenced by the level of walking impairment and 2) understand the effects of systematic increases in walking speed on the energy expenditure of persons with post-stroke hemiparesis and understand how this is influenced by the level of walking impairment. In the proposed studies, measurements of the walking pattern and energy expenditure will be taken at multiple speeds in groups of subjects with differing levels of impairment post-stroke to understand the relationship between speed, walking patterns and energy cost. The long term goal of this research is to develop scientifically based speed dependent treadmill training programs that improve walking speed, efficiency and ultimately, community participation in people with hemiparesis after stroke.
Reisman DS, Rudolph KS, Farquhar WB. Influence of Speed on Walking Economy Poststroke Neurorehabilitation and Neural Repair. Jul 2009;23(6):529-534.
RESEARCH PARTNERSHIPS FOR IMPROVING FUNCTIONAL OUTCOMES (top)
Fast Treadmill Training & Functional Electrical Stimulation (fastFES) to Improve Walking Post-stroke (PI: Binder-Macleod)
The overall goal of the project is to develop a physiologically based intervention to improve functional ambulation in individuals who have sustained a stroke. The Specific Aims are to: 1) develop and test a fast treadmill training and functional electrical stimulation (FastFES) intervention that improves the walking patterns and energy efficiency during treadmill -walking in individuals who have sustained a stroke, 2) develop and test a 12-week training protocol using FastFES to improve body structure and function in individuals who have sustained a stroke, and 3) demonstrate the feasibility and effects of FastFES training compared to traditional and Fast treadmill training on body structure and function, activity, and participation in individuals who have sustained a stroke. For more information please see the fastFES web site.
center for biomedical engineering research (COBRE2) competetive renewal (top)
Knee Stiffness, Proprioception and Instability affect Knee Control in OA (PI: Rudolph)
PhD Dissertation (top)
The studies in this project represent a comprehensive evaluation of common characteristics of persons with medial knee OA and their impact on movement and muscle activation patterns. Subjects were studied walking on level ground and also when exposed to a lateral perturbation* that was intended to challenge knee stability in order to investigate muscle stabilization strategies in people in which the sensation of knee instability affected their daily activities and those who did not experience knee instability. The findings from these studies provide insight into knee stabilization strategies that will ultimately lead to the development of rehabilitation interventions with the goals of slowing the cycle of OA progression and maximizing the quality of life of people with OA. Click here for Video of the perturbation.
Center for biomedical engineering Research (COBRE) (top)
Knee Alignment and the Progression of Osteoarthritis (PI: Rudolph)
In the first phase of this project the focus will be on individuals with hemiparesis from stroke, however many other patient populations may benefit from this work. The movements for these individuals will be improved or "optimized" in four ways: Nonrisk (maximize postural stability), Injury (minimize musculoskeletal injury (e.g., arthritis) during movement), Cosmesis (develop a more natural looking gait), and Energy (minimize metabolic energy consumption during movement). The "NICE" optimization will be achieved through musculoskeletal modeling, robotic assistance, functional electrical stimulation, and neuromuscular training. The specific task we will study will be ambulation on a treadmill.
The organization of this project has been divided into 3 distinct aims: Aim 1: Identify impairments in the locomotor patterns of the lower extremity in patients with hemiparetic stroke and create a paradigm to optimize the movement patterns ("NICE" optimization). This will be accomplished through biomechanical modeling using gait analysis and electromyographic data. Aim 2: Develop the methods and equipment ("NICE" rehabilitation system) necessary to implements the "NICE" optimization of locomotion in patients with stroke. We will achieve this through the use of a robotic device and an electrical stimulation system. Aim 3: Test the feasibility of the use of the "NICE" rehabilitation system in patients with hemiparesis and make adjustments to the system based on the patient trials. Our ten-year goal is to produce a portable (wearable) FES system to assist patients with CNS dysfunction in the production of coordinated movements.
INNOVATIVE REHABILITATION INterventions (top)
Smart Fluids for Physical Rehabilitation (PI: Rudolph)
Smart Fluid is one that contains magnetic particles that align in response to an applied magnetic field (from an electromagnet powered by a battery) to change its viscosity or resistance. The amount of resistance can be varied simply by turning a dial and can be adjusted manually by microprocessor to provide unique, patient specific resistance profiles. The goal of this three-year project is to develop and test a programmable, Smart Fluid, variable resistance exercise device (VRED) that can be used in rehabilitation of the knee (see prototype below). Future plans will include the development of VREDs that are capable of strengthening other joints.
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