We Want to Train You to do Rehabilitation Research

PT/PhD Pre-doctoral Training Program

 

 

 

 

 

Abstract

Recent advances in behavioral, biological, and engineering sciences provide exciting   opportunities to attack important problems faced by people with disabilities. Scientists with strong backgrounds in rehabilitation, who bring multidisciplinary research   approaches to bear on rehabilitation questions, are scarce.  The goal of this pre-doctoral training program is to improve the quality and quantity of individuals who will contribute to the knowledge base and practice of physical rehabilitation.  This innovative training program, coordinated through the Department of Physical Therapy, includes outstanding faculty members from the Mechanical Engineering and Physical Therapy Departments at the University of Delaware.  The program fuses two independent training programs: an entry level Doctorate in Physical Therapy (DPT), designed to train clinical physical therapists, and the PhD in Biomechanics and Movement Sciences (BMSC).  Research concentrations during the PhD portion of the program include Applied Physiology, Exercise Physiology, Biomechanics, Motor Control, and Rehabilitation Technology.  The program is analogous to the MD/PhD programs that are designed to train medical scientists.  Students in the proposed program become both physical therapists and research scientists.  Trainees are selected from a pool of outstanding students with diverse undergraduate backgrounds who enter the DPT program.  Many of these students express an interest in research before admission to the program.  Unfortunately, because of the sizable debt incurred during graduate school and the opportunity to earn the salaries that clinical physical therapists enjoy, very few of these students go on to pursue the PhD.  This training program attracts the best and brightest individuals who have a sincere interest in physical rehabilitation research and tracks them early in their training into research careers.  The need for these individuals is enormous.  Both new and established programs need doctorally trained individuals for teaching and research positions.  Graduates of this training program are ideal faculty members who will foster excellence in rehabilitation research.

 

 

Research Training Program Plan

 

 

Physical Therapy Program History

 

Biomechanics and Movement Sciences Program

 

PT/PhD Pre-doctoral Training Program

 

Administrative Structure of the Program

 

Director

 

Program Steering Committee

 

Advisory Board

           

Program Faculty

 

PT-Mentors

 

Stuart A. Binder-Macleod, PhD, PT, Dept. of Physical Therapy, Program Director and PT-Mentor

 

Irene McClay-Davis, PhD, PT, Dept. of Physical Therapy, Executive Committee Member and PT-Mentor

 

John Scholz, PhD, PT, Dept. of Physical Therapy, Executive Committee Member and PT-Mentor

 

Lynn Snyder-Mackler, ScD, PT, Dept. of Physical Therapy, Executive Committee Member and PT-Mentor

 

Katherine Rudolph, PhD, PT, Dept. of Physical Therapy, PT-Mentor

 

          James C. (Cole) Galloway, PhD, PT, Dept. of Physical Therapy, PT-Mentor

 

Mechanical Engineering Mentors

 

Thomas S. Buchanan, PhD, Dept. of Mechanical Engineering, Mentor

 

John E. Novotny, PhD, Dept. of Mechanical Engineering, Mentor

 

Proposed Training

 

Overview

 

Curriculum

 

Sample curricula for PT/PhD trainees (2 examples provided):

 

Concentration in Applied Physiology

 

Concentration in Motor Control

 

Research Areas

 

Seminar Series

 

Qualifying Examination

 

Monitoring of Student's Progress: Graduate Committee

           

Physical Therapy Program History

 

In 1973 an entry level baccalaureate degree granting program in Physical Therapy was established within the Division of Health Sciences of the University. In 1976 the Division merged with the Department of Biology to form the School of Life and Health Sciences. In 1986 the decision to terminate the baccalaureate program and establish an entry- level master’s of physical therapy (MPT) was made. Along with the decision to offer the MPT degree the University made a major commitment to upgrade the physical facilities and the quality of the research faculty. Early in 1987 a new program director, Dr. Paul Mettler, was hired. Dr. Mettler recruited faculty members who were both research scientists and physical therapists. The University offered significant start-up monies, adequate laboratory space and facilities, and, most important, teaching loads that would allow adequate time for research to all of the new faculty members. In addition, because the physical therapy program was housed within a research oriented department (i.e., the School of Life and Health Sciences), the faculty were assured that research productivity would be valued and rewarded. In 1993, the physical therapy program was promoted to departmental status and Dr. Mettler became the chair.  In 1998, Dr. Stuart Binder-Macleod took over as departmental chair. The tradition of supporting and rewarding a strong commitment to research and scholarship by the faculty has continued.

In the spring of 2002, the University of Delaware Faculty Senate approved the establishment of the DPT and the disestablishment of the MPT. The PT department admitted its first DPT class, with the students commencing training summer of 2002. The present proposal combines the recently approved Doctorate in Physical Therapy (DPT) with the PhD in BMSC. The DPT has rapidly replaced the MPT as the entry level degree in Physical Therapy at the University of Delaware and numerous other PT programs around the country. Based on information provided by the American Physical Therapy, approximately half of all entry level PT programs will be doctoral level by 2004.

 

Biomechanics and Movement Sciences Program

 

In 1993 faculty members from four different academic units at the University of Delaware proposed the creation of an Interdisciplinary Graduate Program in Biomechanics and Movement Sciences (BMSC). This proposal grew out of the desire by faculty members from each unit to establish an interdisciplinary academic program that dealt with the application of science and engineering toward solving problems realized by individuals who are physically challenged. The University of Delaware approved the program in the fall of 1994. This graduate level interdisciplinary program combines faculty and physical resources from the Departments of Physical Therapy, Mechanical Engineering, and Health and Exercise Sciences. The number of faculty members from the Physical Therapy and Mechanical Engineering Departments who are involved in the BMSC program has grown from six (4 PT and 2 ME) in 1995, when the training grant was first proposed, to eleven (6 PT and 5 ME). In addition to growth in faculty, the BMSC program has enjoyed considerable growth and popularity. There are currently 23 full-time doctoral students in the program, two of whom were previously supported on the training grant. Of these 23 full-time students, 17 are working in PT faculty laboratories. Fifteen of these students are physical therapists and 6 are graduates of the MPT program.

 

PT/PhD Pre-doctoral Training Program

 

The training program combines the Doctorate in Physical Therapy and the PhD in BMSC programs into an integrated program. The goal of this program is to attract and train students who have the greatest potential to become outstanding research scientists in the field of physical rehabilitation. The program provides students with the financial support and training that they need to complete both the DPT and PhD degrees. The program is based in the Physical Therapy Department.

 

Administrative Structure of the Program

 

Director

 

The administrative responsibilities for the PT/PhD Pre-doctoral Training Program are vested in the Program Director, Dr. Binder-Macleod, who oversees all aspects of the Program. He will be assisted in all aspects of implementation of training by the Program Steering Committee.

 

Program Steering Committee

 

The program steering committee consists of the senior faculty from the Physical Therapy Department: Drs. Davis, Scholz, and Snyder-Mackler. The steering committee meets regularly to evaluate the program and to consider major policy issues related to the program. In addition to this PT/PhD Training Program steering committee, the Interdisciplinary Graduate Program in Biomechanics and Movement Sciences has an executive committee. This committee consists of the program director, presently Dr. Buchanan, of the Department of Mechanical Engineering, and one member from each of the three departments comprising the BMSC program. The executive committee serves as the major governing board for the BMSC program.

 

Advisory Board

 

An Advisory Board, consisting of three members from outside of the training program, has been established for this PT/PhD Training Program. The members of the Board are: 1) Rebecca Craik, PhD, PT, Chair of the Dept. of Physical Therapy, Beaver College, 2) David Ermann, PhD, Professor, Department of Sociology, university of Delaware and consumer of physical therapy services, and 3) William F. Huxtable, a consumer of physical therapy services. The Board will meet once a year at the University of Delaware, at which time the trainees in the program will present their ongoing research. In addition, the Board will question the students and faculty regarding any other matters of training that they believe is important. The Board will then make recommendations to the Program Director regarding any changes in the program that they believe are needed. The board will receive a written response within 30 days from the Program Director that outlines the actions taken in response to the Board’s recommendations.

 

Program Faculty

 

Outstanding faculty members from the Physical Therapy and Mechanical Engineering Departments at the University of Delaware will mentor and train students in the program. All of these participating faculty members are active members in the BMSC program and have active research programs in an area of movement science.

 

 

PT Mentors

 

One primary strength of the proposed training program is the outstanding faculty within the Physical Therapy Department that is available to mentor students. Besides active research programs, all of the PT- The four PT mentors who serve on the executive committee, Drs. Binder-Macleod, Davis, Scholz, and Snyder-Mackler, have gained significant national recognition in recent years. As examples, Drs. Binder-Macleod and Snyder-Mackler, have received the Eugene Michels New Investigator Award from the American Physical therapy Association (APTA) and Dr. Binder-Macleod has won the APTA’s Marion Williams award, for being the 1999 outstanding physical therapy researcher. Drs. Binder-Macleod, Davis, Scholz, and Snyder-Mackler have been offered editorial board positions on professional journals; Drs. Binder-Macleod and Scholz have been invited by the Section on Research of the APTA to be the Michels Forum presenters. Dr. Snyder-Mackler is the Past President of the Section on research and Dr. Binder-Macleod the former Treasurer. Drs. Binder-Macleod, Davis, Scholz, and Snyder-Mackler have all been PI’s on Federal research and Foundation for Physical Therapy grants. They have all presented their research at national and international meetings for physical therapists and at interdisciplinary scientific meetings, such as the annual meetings of the Society for Neuroscience, international Society for Biomechanics, Federation of the American Society for Experimental Biology (FASEB) and orthopedic Research Society.

 

In addition to the four senior PT faculty members, over the past three years the department has hired two new faculty members, Drs. Rudolph and Galloway. Both of these new faculty members are physical therapists, have completed post-doctoral training, and have considerable clinical experience.

 

Besides active research programs, all of the PT mentors have maintained ongoing, active clinical involvement. Our physical therapy clinic, which is on-site, is an outpatient facility where a variety of patients are treated. All of the faculty serve as consultants to the clinic and are regularly called to the clinic to help with difficult or interesting teaching cases. The PT-Mentors will help the PT/PhD student to integrate their clinical, didactic, and research training. Each PT/PhD student will need to identify a primary PT-Mentor by the end of his/her first year of graduate study. Though any of the identified trainers may serve as the research advisor for the PhD portion of the proposed program, it is anticipated that for most students their primary PT-Mentor will serve as their research advisor. The following is a summary of the research and clinical interests of the PT-Mentors.

 

Stuart A. Binder-Macleod, PhD, PT, Dept. of Physical Therapy, Program Director

 

Dr. Binder-Macleod's 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. Traditional neurophysiological techniques, where animal and human skeletal muscle are stimulated electrically and the electromyographic and force responses are recorded, are used in Dr. Binder-Macleod's laboratory. In addition, simulation experiments in collaboration with Dr. Wexler from Mechanical Engineering, where the contractile characteristics of whole muscles are mathematically modeled, are being used to provide insights into the mechanisms operating and to predict the optimal pattern of stimulation. Most recently, Dr. Binder-Macleod has developed a collaborative effort with the research department of Shriner’s Hospital for Children-Philadelphia to study the responses of patients with spinal cord injuries to electrical stimulation. Results to date have been encouraging. Recent findings have suggested that the stimulation patterns presently used with patients are not optimal. All published clinical studies that have used electrical stimulation to activate the muscles of individuals with damaged central nervous systems have used constant-frequency trains (i.e., all pulses within a train are separated by regular intervals). In contrast, Dr. Binder-Macleod's work has shown that varying the stimulation frequency within a brief train of pulses can produce greater forces from the muscle than the traditionally used constant-frequency trains. Current work is exploring how the optimal pattern of activation varies under a variety of physiological conditions including: fatigue state of the muscle, muscle length, and velocity of muscle shortening and lengthening. Dr. Binder-Macleod’s areas of clinical interest include EMG biofeedback and electrical stimulation of skeletal muscle.

 

Irene McClay-Davis, PhD, PT, Dept. of Physical Therapy

 

Dr. McClay-Davis' research interest is focused on the relationships between lower extremity structure, mechanics and injury. Dr. Davis has used running as a model to study these relationships as is it often the threshold of this activity that precipitates the overuse injury. However, once an injury has been sustained, the symptoms and loss of function often carry over to simple activities of daily living. In addition, many of these injuries can progress to chronic disabilities such as osteoarthritis

The findings of Dr. Davis’ research to date supports relationships between lower extremity structure, mechanics and injury. Her current research investigates how the combination of an individual's structure, alignment, and biomechanics places them at risk for injury. Her research also investigates how therapeutic interventions (i.e., exercise, orthotics, retraining, and surgery) affect these pathomechanics. The lower extremity and running are the primary areas of study. She is currently engaged in four studies: 1) an investigation of the relationship between excessive pronation and knee mechanics along with exploring differences in mechanics between rearfoot and forefoot strike patterns in runners, 2) an investigation of the relationship between subtalar joint axis orientation and lower extremity mechanics, 3) an assessment of the differential effects of orthotics versus strengthening on pronation and pronation velocity in runners, 4) the biomechanics of skating including a longitudinal study to monitor the injury pattern in skaters and a study of the relationship between various strength measures and ground reaction forces during an axel and double axel jump. Dr. McClay-Davis’ clinical interests are in foot, ankle and lower quarter problems, particularly related to overuse injuries. Dr. McClay-Davis is the director of the University of Delaware Running Injury Clinic.

 

John Scholz PhD, PT, Dept. of Physical Therapy

 

The goal of Dr. Scholz's research seeks 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 leads to stable temporal sequences of these postural states. 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, are- and gender matched subjects as well as to explore differences in control in right and left brained lesions.

Collaborative projects have also been proposed with Dr. Sunil Agrawal, of Mechanical Engineering, to develop robotic devices that can be used to explore new methods of treating stroke and other neurological deficits.

Dr. Scholz’s area of clinic interest is the treatment of adult and pediatric patients with motor dysfunction due to central nervous system damage (e.g., stroke, cerebral palsy).

 

Lynn Snyder-Mackler, ScD, PT, Dept. of Physical Therapy

 

Dr. Snyder-Mackler's research efforts focus on dynamic stability of knee and the responses of the quadriceps muscle after anterior cruciate ligament injury. The mechanistic studies of 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 Dr. Snyder-Mackler’s research. The research reflects an overarching clinical interest in the effectiveness of therapeutic interventions, particularly NMES and neuromuscular training. Dr. Snyder-Mackler is most interested in the relationships between impairments (e.g. quadriceps strength) and dysfunction (e.g. gait abnormalities) after ACL injury, although her laboratory also investigates mechanistic questions that arise as a consequence of the clinical research. Dr. Snyder-Mackler is a clinical scientist and an active clinical practitioner. In addition to reports of research, she also publishes papers that describe clinical practice guidelines derived from clinical trials.

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, specifically NMES. The laboratory has characterized the quadriceps impairment that occurs after ACL injury by examining their strength, fatigue properties, and morphology. The quadriceps are weaker, more fatigue resistant and display no consistent morphological alterations. Failure of central activation of the quadriceps does not appear to occur in most individuals after this injury. In a large, multi-center trial, she demonstrated that NMES was more effective than volitional quadriceps exercise for restoring quadriceps strength and normal gait after ACL reconstruction. She has demonstrated that joint laxity does not necessarily result in knee instability and dysfunction after ACL injury. Her group studied the small sub-population of ACL deficient patients who can return to all activities without episodes of instability or swelling and without reconstructive surgery (copers) and determined that their movement characteristics are different from patients who do not compensate well (non-copers). A training program of systematic perturbation of support surfaces (perturbation training) was developed based on the identified characteristics and has been tested in a randomized clinical trial and was superior to a traditional program in returning individuals to a higher level of activity after ACL injury. Most recently, she has begun to study some of the same problems in the elderly and those with total knee replacement. This work has already resulted 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.

Dr. Snyder-Mackler regularly collaborates with colleagues in the Physical Therapy and Mechanical Engineering Departments. Dr. Michael Santare and Dr. Snyder-Mackler have collaborated on orthopedic biomechanics projects and have two published articles on fatigue characteristics of fixation devices used in shoulder surgery. They have collectively supervised two students, one in Mechanical Engineering and one in BMSC. Similarly, Dr. Thomas Buchanan and Dr. Snyder-Mackler collaborate on two projects and three successful grant applications. First, was the aforementioned study of what makes “copers” and “non-copers” by studying the subjects’ kinematics (i.e. gait analysis) and muscle activation patterns (EMG’s) during a variety of tasks. The second is a new approach to in vivo analysis of musculoskeletal dynamics uses Cine-phase contrast (Cine-PQ magnetic resonance imaging (MRI) to image and track the moving knee. Cine-PC MRI, a non-invasive technique, is capable of measuring 3D muscle fiber and skeletal velocity, in vivo, during dynamic tasks. Through integration, 3D musculoskeletal movement can be tracked. A combination of the use of this new technology and conventional MRI, electromyography, and musculoskeletal modeling provide a unique opportunity to elucidate the compensation strategies employed by patients with anterior cruciate ligament (ACL) injuries. The third investigates the mechanisms underlying the development of dynamic knee stability after ACL rupture and extends the clinical trials of perturbation training to the non-coper population. Dr. Snyder-Mackler has recently to collaborate on two projects with Dr. John Novotny involving shoulder mechanics and rehabilitation.

 

 

Katherine Rudolph, PhD, PT

 

          Dr. Rudolph’s research focuses on analyses of movement of persons with orthopedic and neurologic injuries with particular interest in assessing treatment efficacy. Dr. Rudolph is co-investigator on a recently funded, 5-year study investigating mechanisms underlying treatment of ACL rupture. The overall goal of this work is to determine whether effective rehabilitation programs to dynamically stabilize the knee reduce the adaptations that lead to osteoarthritis in a population at great risk for the development of knee OA. Eighty individuals with ACL rupture who are scheduled for surgery will be randomly assigned to a group that receives a form of neuromuscular training called perturbation training, or a standard rehabilitation group. Subjects will be evaluated before and after surgery using motion analysis and radiography. In vivo measures of kinematics, kinetics, tibial translation and EMG-based models of joint compression will be used for comparison. The information derived from this study will provide valuable insight into the management of the approximately 100,000 Americans who rupture their ACL’s each year and undergo reconstructive surgery.

                        Dr. Rudolph is PI on a recently funded grant to investigate how ligamentous laxity influences the development of osteoarthritis (OA) in the knee in persons with genu varum. The overall goal of this study is to determine whether anatomic realignment of the tibiofemoral joint in persons with moderate genu varus deformity allows for changes in muscle strength, knee joint laxity, knee joint instability and proprioception that is compatible with halting the progression of knee OA. Specifically, is normal function restored as measured by quadriceps function, knee motion and moments, neuromuscular responses during walking, static and stress radiography, and reflexive muscle activation?

                        Finally, Dr. Rudolph has received one grant and is preparing another to develop rehabilitation devices using magnetorheologic (MR) fluid: fluid that changes its viscosity in response to an applied magnetic field. In collaboration with Dr. Jian-Quao Sun in the Department of Mechanical Engineering and Dr. Binder-Macleod, Dr. Rudolph is developing a low cost, portable, light weight exercise device that could ultimately be used to strengthen multiple joints of the body. This variable resistance exercise device (VRED) will incorporate microprocessor technology to allow a therapist to program resistance applied to a patient’s muscles in a precisely controlled manner by modifying a very small amount of current from a simple battery. Prototype development and a pilot study of strengthening efficacy on a sample of patients with quadriceps weakness are included in this project. The other MR fluid rehabilitation device proposed by Dr. Rudolph and Dr. Sun is a variable resistance orthosis (VRO) for use in re-training gait in persons with hemiplegia. The MR fluid will be incorporated into existing knee brace designs such that the resistance to movement in the knee joint during functional activities, including gait, will allow customized resistance for each patient. In this project the investigators will build a prototype knee VRO with a programmable electronic control system; test the feasibility of brace use with a group of subjects who have hemiparesis resulting from stroke; and determine changes in gait in subjects with hemiparesis while using the VRO.

                        Dr. Rudolph’s clinical interests are in rehabilitation of persons with orthopaedic and neurologic injuries.

 

            James C. (Cole) Galloway, PhD, PT, Dept. of Physical Therapy

 

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 spontaneous 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 multi-joint 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. Current infant projects include several studies on the development of object exploration with the arms and legs; coordination between the shoulder, elbow and wrist during the development of reaching; and learning and memory in healthy, full-term infants at risk for coordination disorders such as cerebral palsy. Dr. Galloway’s laboratory has also collaborated with toy producers in the development of interactive toys for young infants and infants at risk for developmental delay. Dr. Galloway’s lab has been funded by the University of Delaware, toy industry sources, and the American Physical Therapy Association (APTA).  Future projects will focus on extending Dr. Galloway’s infant work to pediatric populations such as pre term infants at high risk for developing motor delay. Dr. Galloway’s clinical interests are in the physical rehabilitation of adults following stroke and in the treatment of children with motor developmental delays due to central nervous system dysfunction. He is awaiting a decision on an NIH RO3 application and an APTA Pediatric section grant, and submitted an NSF grant in July, 2002 and an NIH RO1 in Fall, 2002.

 

Mechanical Engineering Mentors

 

Faculty members within the BMSC program who collaborate with physical therapy faculty members or who potentially may serve as research advisors or graduate committee members for the PT/PhD trainees have been designated as trainers. It should be noted that each student is required to have at least one of the following trainers serve on each his/her graduate committee (see Monitoring of Student's Progress: Graduate Committee). The following is a summary of the research interests of the trainers.  There are five outstanding members of the Mechanical Engineering Department that are actively involved in the BMSC program: Drs. Agrawal, Buchanan, Novotny, Santare, and Sun. However, only two members from Mechanical Engineering, Drs. Buchanan and Novotny have been designated as mentors in the present training program. These two faculty members were selected as Mentor because of their strong backgrounds as movement scientists. 

 

 

Thomas S. Buchanan, PhD, Dept. of Mechanical Engineering

 

Thomas S. Buchanan has a Ph.D. in Theoretical & Applied Mechanics from Northwestern University and does research in the field of neuromuscular biomechanics. Upon graduation he did post-doctoral work at MIT in the Department of Brain and Cognitive Sciences and then returned to do additional post-doctoral work at Northwestern University in Rehabilitation Medicine. He subsequently served on the faculty of Northwestern University Medical School with appointments in the Departments of Physical Medicine & Rehabilitation and Biomedical Engineering. During his seven years as Associate Director of the Sensory Motor Performance Program at the Rehabilitation Institute of Chicago, he was appointed Falk Medical Research Scholar. He is currently an Associate Professor of Mechanical Engineering at the University of Delaware and is also on the faculty of the Biomechanics and Movement Sciences Program. He is the recipient of several NIH grants as well as several grants from private foundations such as the Arthritis Foundation. He is a member of the Editorial Board of the Journal of Applied Biomechanics and is a reviewer for numerous 10) journals in the fields of biomechanics and neuroscience. Additionally, he has served as a grant reviewer for the NIH, NSF and the VA. He is the author of over sixty publications (journal articles and conference proceedings) in periodicals such as J. Biomechanics, J. Biomechanical Engineering, J. Orthopedic Research, J. Neurophysiology, Experimental Brain Research, Archives of Physical Medicine & Rehabilitation and Medicine & Science in Sports and Exercise. Dr. Buchanan is currently on the executive council of the American Society of Biomechanics, and the Program Director for the BMSC program. Dr. Buchanan has developed collaborative efforts with Drs. Snyder-Mackler and Scholz in the Physical Therapy Department.

            Dr. Buchanan and his colleagues have been studying mechanisms for maintaining joint stability at the elbow and knee. Using EMG studies and biomechanical models, they have examined which load types require ligaments to be loaded (i.e. those for which muscles are insufficient to counter external loads).

 

            John E. Novotny, PhD, Dept. of Mechanical Engineering

                  

Dr. Novotny’s present research has focused on techniques to explore the biomechanics of the shoulder and to understand the clinical problems of gleno-humeral instability and rotator cuff pathology. This includes biomechanical, biological, and clinical studies of the shoulder. In vitro biomechanical testing has been performed using electro-magnetic position and orientation sensors. The device was used to quantify glenohumeral kinematics and the effects of Bankart lesions and repairs. An analytical model of the glenohumeral joint has also been formulated. Combining this model with data from previous experiments allowed for predictions to be made of the deformation of the glenohumeral capsule and the articular contact forces generated by simulated throwing. Expansion of this model will continue to a dynamic model that will use optimization methods to model multiple muscular forces. With such a model, various glenohumeral joint injury mechanisms could be simulated. Application of finite element modeling techniques to the structure of the glenohumeral ligaments could be implemented to elucidate its function. Biologically, tissue mechanics in the glenohumeral capsule have begun to be studied to correlate ligamentous mechanics at a gross scale to cellular mechanics at a microscopic scale using techniques of immunofluorescent staining and confocal scanning laser microscopy. This work could be coupled with mathematical modeling, using analytical methods to describe the continuum of behavior of the tissue. Tissue mechanics research has required investigating the development of animal models for the glenohumeral joint to study the effects of injury and healing processes using biomechanical outcomes. A model of glenohumeral instability and rotator cuff pathology is the goal of this development. Studies of articular cartilage mechanics at a cellular level have also been initiated. Use of a model to induce uni-compartmental osteoarthritis has been proposed to study cartilage healing. Clinically, a glenohumeral laxity device was produced for use in vivo, to quantify the torque-rotation response for diagnostic purposes and for use in surgical planning, and during rehabilitation after injury and surgical repair. Use of biological technique to study the composition of the glenohumeral capsule and rotator cuff tendons from subjects with pathology are also in development. The degenerative aspects of these disease processes will be studied to understand the control of collagen types, metalloproteinases and their inhibitors. Previous research has also focused on the human spine. These include a number of studies on spine and vertebral segmental motion, response to vibration, seat design, rehabilitation engineering, the role of facet joint morphology in spondylolisthesis, spinal stenosis and their surgical treatments, and spinal implant testing.

 

 

Proposed Training

 

Overview

 

This unique, combined degree (PT/PhD), interdisciplinary program attracts outstanding students from diverse undergraduate backgrounds. Five years of funding are provided to complete this training program- one year of funding to complete the DPT portion of the program (I.E. the last year of the two and one-half year DPT program) and four years of funding to complete the PhD in BMSC. Prior to entering the training program, trainees will complete one and one-half years of DPT training, giving the trainees a total of six and one-half years of post-baccalaureate training. This program provides an opportunity for graduates to gain the clinical and research training needed to attack problems in medical rehabilitation research in a way not possible through more traditional programs.

Students completing the PT/PhD program will have: 1) a broad background in the clinical practice of physical therapy, 2) a solid foundation in biomechanics and movement sciences, 3) unique abilities to address rehabilitation research questions, 4) detailed expertise in the specific area of their research projects. This training will equip them to be leaders in the rehabilitation research in academic institutions or clinical research centers.

 

Curriculum

 

The PT/PhD program is a five-year, full-time program. The first one and one-half years of the DPT program (i.e., the curriculum prior to entering the formal training program) will not be modified for the trainees and will include the required course work and clinical rotations (see sample curricula below). Please note, the trainees will enter the proposed training program during the Spring semester of their second year in the DPT program to allow funding during the last year of the DPT program.

The DPT program is slightly modified during the last year of DPT training to include: 1) three, five-week, laboratory rotations during the spring semester. These rotations are not part of the DPT program and are used to help the students select their research mentor. 2) enrollment in the Biomechanics and Movement Science (BMSC) program’s seminar in the spring semester. This course is also not required of the DPT students and helps to integrate the trainees into the BMSC portion of the curriculum. 3) a seven-week independent study research course during the summer session. This independent study is not part of the DPT program. The trainees will conduct an extensive literature search and identify a project they can complete over the upcoming year (preliminary project); and 4) an eight-week research internship during the fall semester. This internship is a major modification of the eight-week, required, elective internship that all DPT students must take. During this internship, the trainees collect and analyze the data needed for their preliminary projects.

The spring semester following the DPT portion of the curriculum, students enter the PhD portion of the BMSC program. The remaining four years of the program consist of course work and dissertation credits required for the PhD in BMSC. Research concentrations in applied physiology, exercise physiology, biomechanics, motor control, or rehabilitation technology are available. The basic requirements for all students in the PhD program in BMSC include 32 credits of course work plus 9 credits of dissertation. Specific course requirements include: 3 semesters of BMSC seminar, 1 course in experimental design and/or statistics, 1 course in instrumentation, computing or engineering applications, and 2 BMSC courses in concentrations other than the student's major area of study.

The PhD portion of the BMSC program is modified to include: 1) a course on Scientific Integrity and Ethical Principles in Research. This new course was designed by Dr. Rivers Singleton, Jr., Director of the University's Center for Science and Culture (See Responsible Conduct of Research section below for more details) and 2) annual presentations by students to the Advisory Board, and 3) at least one semester of part-time additional clinical experience in a physical therapy clinic. The additional clinical experience was not part of our original proposal. However, based on feedback from the students and faculty, it was decided to add this component to the training curriculum. All of the current students have gained their additional clinical experience in the PT clinic located in our department.

            Trainees who do not complete all of their PhD requirements within the five years that they are covered by the training grant will be guaranteed an additional year of funding either as a teaching assistant (TA) or a research assistant (RA). The funding for a TA position will come from the Department of Physical Therapy. RA funding will come from the advisor’s grant support or departmental funds. The nature and source of funding will be determined by consultation between the trainee, the trainee’s advisor, and Dr. Binder-Macleod. The decision will be made based on available resources and the trainee’s needs. No additional funding is guaranteed beyond this additional year. All trainees will be strongly encouraged to complete their training in a timely manner and do not extend beyond the fifth year if possible. We very strongly discourage the trainees from extending their training beyond the sixth year. Students must achieve at least a grade point average of 3.0 in the courses that fulfill the course requirements.

 

Sample curricula for PT/PhD trainees (2 examples provided):

 

Research concentrations during the PhD portion of the program include Applied Physiology, Exercise Physiology, Biomechanics, Motor Control, and Rehabilitation Technology. The following courses represent the courses required during the first year and one-half of the DPT program that will be taken by all trainees prior to entering the program.

 

 


 

 

DPT- Year I:

 

Summer:

PHYT 600 PT as a Profession (1 cr)

PHYT 622 Gross Anatomy (6)

PHYT 641 Rounds (1 P/F)

 

Fall:

PHYT 631 PT in the Acute Care Environment (4)

PHYT 604 Functional Anat &Kinesiol (4)

PHYT 606 Research (3)

PHYT 624 Basic Evaluation Techniques (2)

PHYT 642 Rounds (1 P/F)

 

 

Winter:

PHYT 632 Applied Physiology I (3)

PHYT 620 Ed Process in Commun Health (1)

PHYT 643 Rounds (1 P/F)

 

Spring:

PHYT 801 Med Sci I- General Medicine (3)

PHYT 633* Applied Physiology II (3)

PHYT 634 Phys Agents, Electrother (4)

PHYT 623 Clinical Neuroscience (4)

PHYT 644 Rounds (1 P/F)

 

 

 

 

DPT- Year II:

 

Summer I: (1st  7 weeks)

PHYT 608 Musculoskel Eval & Treat (4)

PHYT 802 Clinical Med II- Orthopedics (3)

PHYT 641* Rounds (1 P/F)

 

Summer II: (2nd  7 weeks)

PHYT 831 Clinical Intern I- Acute Care (3 P/F)

 

Fall:

PHYT 804 Neurophysiol Eval & Treat (4)

PHYT 805 Rehabilitation (4)

PHYT 806 Geriatrics (4)

PHYT 803 Med Sci III- Neurology (3)

PHYT 642 Rounds (1 P/F)

 

Winter:

PHYT 807 Advanced Seminar (5)

PHYT 821 Ortho Integrated Clin Exper (3)

PHYT 643 Rounds (1 P/F)

 

 

The following courses are required during the last year of the DPT program (first year of training program):

 

 

Spring:

PHYT 808* Spine Management (4)

PHYT 809 Psychosoc Aspects of Health and Disease (4)

PHYT 810 Clinical Mgt. & Admin (3)

PHYT 644 Rounds (1 P/F)

PHYT 822 Geriatric Integr Clin Exp (3)

BMSC Seminar (0)

 

 

Summer I: (7 weeks)

PHYT 811 Peds (4)

PHYT 812 Peds Int Clin Exp (1)

PHYT 641 Rounds (1 P/F)

 

Summer II: (7 weeks)

BMSC 667 Research (3)

 

Fall:

PHYT 832 Clin Intern II- Inpt Rehab (3 P/F)

PHYT 833 Clin Intern III- 8 week Research Internship (3 P/F)

 

 

 

 

The following is a sample curriculum of the PhD portion of a concentration in Applied Physiology:


 


 

PhD- Year I :

 


BISC 605/606 Advanced Mammalian Physiology (8 cr)                                             

CHEM 527 Biochemistry (3)

PHER 803 Introduction to Laboratory Instruments (3)

BMSC 865 Seminar (0)

BMSC 868 Research (4)

CSCC 667 The Practice of Science (2)

PHYT 667 Muscle Physiology (3)

Supervised Clinical PT Experience (8 hrs/wk)

 

 

PhD- Year II :

 

BISC 661 Biology of Striated Muscle (3)

PSYC 860 Psychological Statistics (3)

HPER 800 Advanced Physiology of Exercise (4)

BMSC 667 BMSC Seminar (0)

BMSC 868 Research (3)

MEEG 667 Mechanics of Human Movement (3)

 


PhD- Year III :

BMSC 865 Seminar (0)           

BMSC 964 Pre-Candidacy (4)

BMSC 866 Independent Study (2)

 

PhD- Year IV :

 

BMSC 865 Seminar (0)

BMSC 969 Dissertation

 

 

 


 

 

The Following is a sample curriculum of the PhD portion of a concentration in Motor Control:

 

 

PhD- Year I :

 

BMSC 667 Control of Human Movement (3)

BMSC 866 Special Problems- Mathematics of Human Motor Control (4)

BMSC 865 Seminar (0)

BMSC 868 Research (3)

HESC 609 Biomechanical Methods (3)

PSYC 860 Psychological Statistics (3)

 

 

 

PhD- Year II :

 

PSYC 861 Psychological Statistics II (3)

BMSC 667 Muscle Physiology (3)

MATH 667 Applications of Non-Linear Dynamics (3)

BMSC 865 Seminar (0)

BMSC 868 Research (3)

HESC 803 Laboratory Instrumentation (3)

MEEG 667 Biomechanics of Human Movement (3)

 

 

 

PhD- Year III :

 

BMSC 865 Seminar (0)

BMSC 964 Pre-Candidacy (4)

BMSC 866 Independent Study (2)

 

 

PhD- Year IV :

 

BMSC 865 Seminar (0)

BMSC 969 Dissertation

 

 

 

 

 

 

Research Areas

 

The primary focus of the doctoral program is on research. The student's research advisor may be selected from among faculty members within the BMSC program that are designated as Mentors. It is anticipated that for most students the PT-Mentor will serve as the student's research advisor. Potential areas include motor control, rehabilitation technology, biomechanics, applied physiology and exercise physiology. Students will identify a research advisor before entering the PhD program. Before formal admission to the PhD program, the student along with his/her PT-Mentor/Advisor, will put together a program of study to be presented to the BMSC graduate committee.

 

Seminar Series

 

A seminar series is organized by the BMSC seminar committee to provide a multi-disciplinary forum for presentation of faculty research and to bring in appropriate outside speakers. The series is conducted in conjunction with BMSC 865, the student’s’ required seminar course. The committee is made up of one representative from each component of the program. The BMSC faculty, partially in response to the reviewers’ comments from our previous grant application, have recently modified this seminar course to give all BMSC graduate students a  greater opportunity to develop their presentation skills and receive feedback on their projects from BMSC faculty. The seminars occur weekly.  Three student centered presentation formats are used.  First, there are “student seminars,” which are modeled after the very successful format used in the multidisciplinary program in the neurobiology of motor control training program at the University of Arizona. This format provides maximum speaker-audience interaction and thus provides trainees with an educational opportunity to defend their science and practice public speaking. Typically, two students present their “work in progress” at least once per year. Second, we have a “send-off” seminar, where each student who is presenting at a national meeting presents his/her talk prior to leaving for the meeting. The students valued these experiences and noted that they helped to improve their presentations. Finally, in addition to the weekly seminars, the BMSC program will organize a research retreat once each semester, during which graduate students will present their completed research projects. Trainees will be required to present their completed projects at these retreats. In addition to the student seminar, there are typically one or two outside speakers invited to present BMSC seminars per month. With the beginning of the COBRE grant, additional funds are now available to support travel for speakers from around the country and even several international speakers.

In addition to the BMSC seminars, other programs and departments in the university (Physical Therapy, Neuroscience, Biological Sciences, and Mechanical Engineering) offer seminars that will be of interest to students in this program. Relevant research lectures are also scheduled at various institutions in the Delaware-Philadelphia area. Trainees are required to attend the BMSC seminars and are encouraged to attend seminars from other departments and institutions as appropriate.

 

Dissertation Proposal Defense and Qualifying Examination

 

The student’s dissertation proposal, written in the format of an NIH R-01 proposal, must be approved by the student’s Graduate Committee and then must be defended orally before the entire BMSC faculty. This oral defense serves as the qualifying examination for the candidacy phase of the program.

 

Monitoring of Student's Progress: Graduate Committee

 

By the end of the first year in the PhD program each student will need to identify a Graduate Committee. This Graduate Committee consists of the PT-Mentor/ Research Advisor and at least three other scientists with expertise in areas relevant to the potential thesis topic. Three of the faculty must be members of the BMSC program.  One BMSC member must be from outside the student's major area of concentration. In addition, at least one committee member must be from outside the BMSC program. This committee will serve to evaluate and guide the student in research, and will meet with the student at least once per year. The Graduate Committee will serve as the examination committee for the written dissertation and for the oral defense by the student.

 

 

 

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Last updated 3/16/2005