Jenni Buckley, PhD (ME Mike Santare)

Title: "Adventures in OrthoLand: Management of Industry-Funded Clinical Biomechanics Research”

Representative Papers:
Equizable, Johnny, et. al. "Pure Moment Testing for Spinal Biomechanics Applications: Fixed versus Sliding Ring Cable-Driven Test Designs." 2010. pdf.

Wheeler, Daniel, et. al. "Inter-laboratory Variability in in vitro Spinal Segment Flexibility Testing." 2011. pdf

Cole Galloway, PhD (PT)

Margie Roos PT, DPT, NCS

Title: "Reliability and Validity of Dynamic Balance Outcome Measures & the Influence of Dynamic Balance on Ambulation Activity Post Stroke"

Abstract: Over one million adults in the US have functional limitations after stroke which limit their activity and social participation at home and in the community.  In addition, a high percentage of individuals report falling within one year following stroke, having repeat falls, and falling while walking.  The high incidence of falls early after discharge from a clinical setting suggests that people post stroke may not be adequately prepared for the challenges that are encountered at home and in the community.  A possible reason for this is the lack of measures of dynamic balance that are valid and reliable in this patient group.  Investigations often include measures of balance such as the Berg Balance Score (BBS) which involves postures and movements that are more static than those used during locomotion or the Timed up and Go (TUG) test that involves simple straight pathway ambulation.  The BBS has been shown to have ceiling effect in people post stroke, while the TUG is not able to distinguish between fallers and non-fallers.  Therefore, these outcome measures are not suitable to identify the balance deficits in individuals post stroke across a wide range of stroke severity. Balance measures that are more challenging and include postural transitions such as walking and turning, stepping over objects, and walking at varying speeds would provide a better understanding of the effect of balance on ambulatory activity than the tests commonly encountered in the locomotion literature.

This project investigated intra-rater and inter-rater reliability and construct validity on two dynamic balance outcome measures, the Functional Gait Assessment (FGA) and the Four Square Step Test (FSST).  Unfortunately, a large percentage (49%) of subjects was unable to complete the FSST which prompted modifications so that a wide range of individuals post stroke could complete the dynamic balance measure. Each modification of the FSST and the FGA demonstrated construct validity when using a construct of Significantly Impaired Balance developed from commonly used balance outcome measures (BBS, TUG, ABC).  As the modification which asked individuals to step over tape while allowing leg rotation demonstrated intra-rater and inter-rater reliability, construct validity, and could be completed by a large percentage of individuals post stroke, this modification was renamed the Modified Four Square Step Test (mFSST).  Individuals who were more functionally limited had greater difficulty completing obstacle avoidance as measured by the FSST and mFSST.  To establish concurrent validity of the mFSST, moderate negative correlations were found between mFSST and BBS (Spearman r=-.616, p=.000), and ABC (Spearman r = -.449, p=.004) and moderate positive correlation between mFSST and TUG (Spearman r = .726, p=.000).  Intra-rater reliability of the Total FGA Score was ICC (3, 1): 0.918 (CI95:0.856, 0.961).  Inter-rater reliability of each Task Score ranged from moderate to almost perfect for all tasks except Task 5 that demonstrated fair reliability, although all 5 raters agreed on scoring for 20/22 subjects (91%).  Inter-rater reliability of the Total FGA Score was ICC (3, 1): 0.907 (CI95: .835, .955).  The FGA demonstrated concurrent validity as moderate and significant correlations were noted between the FGA and ABC (Spearman r = 0.637, p=.000), BBS (Spearman r = 0.747, p=.000) and TUG (Spearman r = -0.827, p=.000).  The scale width of the FGA was deemed adequate as no subjects received a score between 0 and the MDC (3.4 points), and no subjects received a score between the MDC and the maximum score of 30.

Limited ambulatory activity post-stroke is often a major focus in rehabilitation and many rehabilitation researchers are studying the best way to improve ambulation activity in this population.  Balance has been noted to have a moderate relationship to daily step count in people post stroke.  However, the BBS has a ceiling effect in people post stroke and it may not be the most sensitive measure to detect balance deficits while walking.  We hypothesized that dynamic balance as measured by the mFSST and FGA would correlate more strongly to steps per day in people post stroke than the BBS.   The BBS, FGA, and mFSST correlated significantly with each other.  Spearman rho correlations between BBS and SPD were ρ =.592 (p=.000); between FGA and SPD ρ = .440 (p=.000); FSST and SPD ρ = -.520 (p=.003); and mFSST and SPD ρ =-.428 (p=.008).  The FSST, mFSST and FGA did not have a stronger correlation to SPD than did the BBS reinforcing the idea that many factors other than dynamic balance contribute to activity limitation in people post stroke. The findings of this research project established the reliability and validity of dynamic balance outcome measures, mFSST and FGA in people post stroke and provided an understanding of influence of dynamic balance on ambulation activity in people post stroke.

Lynn Snyder-Mackler, PT, ScD
Alumni Distinguished Professor

Title: “I (my son/daughter/friend) just tore my ACL!  What should I do?” Thoughts from the front
lines of international ACL research."

Abstract: Our early work at the University of Delaware suggested that we can identify those with potential for dynamic knee stability early after ACL rupture (potential copers), and that  a rehabilitation program that includes specific neuromuscular training results in the short term ability to return to functional activity in most potential copers without the occurrence of episodes of giving way.  Practice patterns in the US for active young people with ACL rupture limited our ability to assess dynamic stability before they underwent surgical reconstruction. 

Our nearly ten year collaboration with Oslo University Hospital in Norway, where the practice pattern requires a substantial period of rehabilitation before they undergo reconstructive surgery, provided the platform for this unique cohort.  Our work in over the past five years has provided considerable evidence in support of our hypothesis that there is a differential response to ACL injury that can be affected by rehabilitation, but also demonstrated that as rehabilitation continues before surgery, stability strategies change. Categories are fluid, non-copers can become more stable, potential copers can become unstable and while surgery introduces passive stability, successful outcome is not inevitable.   Intent to return to previous level of activity is not a predictor of actual return. Prediction of medium term (1 year) success (with or without ACLR) from modifiable impairments and physical performance measures is robust and prediction is better after a period of rehabilitation than acutely after injury. In this seminar, I will highlight the work we have done, and describe how we plan to  (1) begin to elucidate the particular clinical markers that contribute to the success or failure following ACL rupture and reconstruction and/or return to full activity, (2) provide clinicians with practical, useful and evidence-based treatment options that may improve function after ACL injury and reconstruction and (3) directly impact clinician and patient decision making for the individual patient with ACL rupture and will guide future research.

Representative Papers:
Grindem, Hege et.al. "Single-Legged Hop Test as Predictors of Self-Reported Knee Function in Nonoperatively Treated Individuals with Anterior Cruciate Ligament Injury" pdf

Hartigan, Erin et. al. "Pre-operative Predictors for Non-Copers to Pass Return to Sports Criteria After ACL Reconstruction" pdf

Andrew Judge, PhD University of Florida Department of Physical Therapy (Edwards, KAAP)

Title: "Role of heat shock protein 70 (Hsp70) in muscle regeneration."

Representative Papers:
Senf, Sarah et.al. "Hsp overexpression inhibits NF-kB and Foxo3a transcriptional actvities and prevents skeletal muscle atrophy" pdf

Senf, Sarah, Stephen L. Dodd and Andrew R. Judge. "FOXO signalling is required for disuse muscle atrophy and is directly regulated by Hsp 70" pdf

Randy Duncan PhD (Biology)

Title: Channels in Bone: Excitement in a Non-Excitable Tissue.

Abstract: Osteoporosis affects more than 10 million Americans with an additional 34 million at risk with low bone density.  While a number of drugs are available to reduce this risk, most only inhibit bone resorption rather than increase bone formation.  This could potentially lead to weaker bones.  Exercise is known to reduce postmenopausal osteoporosis through increased bone formation, but the cellular mechanisms associated with this stimulus have yet to be delineated.    Here, we will discuss ion channels that could be potential “mechanosensors” in bone and how these membrane proteins can alter bone remodeling.  We will also discuss how our understanding of mechanotransduction in bone can impact our understanding of tissue maintenance and repair in other musculoskeletal systems.

NO representative papers

Dr. Tamerah Hunt (Kaminski, KAAP)

Title: From the field to the clinic: The adolescent concussion epidemic.

Abstract: Concussion has reached near-epidemic proportions in contact sports at both professional and amateur levels; there are an estimated 1.6 to 3.8 million sport-related concussions occurring in the United States annually. Despite the lack of empirical evidence to guide sports concussion assessment and management, it has become a focus of research over the past five years because of the heightened awareness that has resulted from well publicized injuries of prominent sports athletes. Adolescent athletes’ frequent participation in high school athletics increases their risk of concussion when compared to their adult counterparts. Given the high numbers of youth athletes participating in sports, and given the potential for catastrophic injury following concussion, an understanding of research available following a concussive injury and the translation into clinical practice in youth athletes is extremely important.  This seminar will highlight the research conducted in adolescent athletes intended to provide evidence for clinicians working with adolescent athletes. This will include research addressing 1) concussion testing paradigms 2) appropriate assessment tools 3) confounding variables that affect concussion testing and 4) education and management strategies tailored for young athletes.

Representative Papers:

Hunt, Tamerah N. et. al.“The effect of effort on baseline neuropsychological test scores in high school football athletes” pdf

McCrory, P, et. al. “Consensus Statement on Concussion in Sport” pdf

Hunt, Tamerah N., Ferrara, Michael S., “Age-Related Differences in Neuropsychological Testing Among High School Athletes” pdf

Dr. Hsiang-han Huang (PT)

Title: "Affordances for Reach and Grasp Actions"

Abstract: The purpose of this study is to examine the impacts of body-scaled information on emergent reaching and grasping patterns for children with hemiplegic cerebral palsy (CP).  In the first experiment, we asked 20 adults and 17 typically developing children (TD children) to reach and grasp ten different sizes of cubes to examine the body-scaled information that specifies the relation of hand size, object size, and reach and grasp patterns. Our findings indicate that body-scaled information, expressed by dimensionless ratios, guides similar emergent reaching and grasping patterns for adults and children regardless of the differences in body dimensions. In the second experiment, we asked nine children with hemiplegic CP (3-5 years old) to complete the same task with the aim of gaining a more thorough understanding of the impacts of body-scaled information on reaching for children with altered personal constraints. Our
findings indicate that the specific dimensionless ratio was not significantly different for either preferred or non-preferred arms both within and between children with hemiplegic CP and TD children groups. Moreover, we demonstrate that the variability for the paretic and non-preferred arms is similar for both groups.These findings suggest the importance of the upper limb intervention of this preschool age for children with CP because they are able to perceive similar body-scaled information for the emergent action patterns as TD children. Investigating the relationship between perceived body-scale
information and the emergent reaching patterns for children with hemiplegic CP may provide us with a more explicit understanding of the critical factors influencing this emergent action. Future research is encouraged to further systematically examine the relationship of different constraints and the body-scaled information, and how this information affects the emergent actions.

Representative Papers:
Van De Meer, Audrey L.H. "Visual Guidance of Passing Under a Barrier" pdf

Newell, K.M. et.al. "Body Scale and Development of Prehension" pdf

Bill Vincenzino, PhD University of Queensland (Kaminski, KAAP)

Title: Lateral Epicondylalagia: To inject or not to inject?   An evidence informed response.

Abstract: Corticosteroid injections are commonly offered to patients presenting to general medical practice, mainly because there is prima facia clinical and level 1 evidence that they are very effective (>80% success rate). However, this effectiveness is short lived with several high quality randomised clinical trials reporting patients to be worse after 6-8 weeks than if patients adopted a no active treatment wait and see policy.(1) This relatively poorer outcome, which reflects a delay in recuperation, is compounded by a higher absolute recurrence rate following corticosteroid injections of 63% compared to adoption of a wait and see approach. 

Further underpinning this high level evidence of poorer outcomes following corticosteroid injection, a potent anti-inflammatory treatment, are the consistent findings over the last 4 decades of a lack of inflammatory aetiology.

So if corticosteroid injection is not indicated, what is? There are a plethora of other types of injections (eg, autologous blood, polidocanol, botulum, sodium hyaluronate) that are being propagated as better options – though they remain to be as rigorously tested as corticosteroid injections,(2) and their premise is largely based on a failed healing basis of tennis elbow, which may only be part of the issue in this condition. (3)

This presentation will provide practitioners with evidence-informed approaches to managing tennis elbow, including its underlying pathology, as well as some evidence on which to advocate for patients when they are trying to make a decision on injections.

Representative papers attached:
Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006 September 29, 2006:bmj.38961.584653.AE. pdf

Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. [Review]. 2010 Nov 20;376(9754):1751-67. pdf

Coombes BK, Bisset L, vicenzino B. An integrative model of lateral epicondylalgia. British Journal of Sports Medicine. 2008 Dec 2. pdf

Michele Lobo, PT, PhD (Galloway, PT)

Title: "Data out the wazoo, what do I do?"

Abstract: As our program grows so does the strength of our studies and this typically means we are faced with the task of managing and relating large amounts of data across a variety of measures. In this seminar I will present ways in which a relational database can be useful for improving efficiency and productivity, ensuring data integrity and security, and streamlining research processes. This presentation will be followed by a discussion among participants about how different groups in the program tackle the problem of managing large data sets in the hopes of sharing information that will help us all become more successful at this task.

Jose Luis Contreras-Vidal, PhD Univ of Maryland (Higginson ME)

Title: "Towards a Noninvasive Brain-Machine Interface to Robotic Exoskeletons for Restoration of Walking"

Abstract: We have recently shown the feasibility of inferring natural reaching, grasping and lower-limb kinematics from the amplitude modulations (AM) of a plurality of scalp EEG signals in the delta (< 5 Hz) frequency band using linear decoders with memory. The EEG time-domain decoders enable subjects to accomplish closed-loop brain to computer interface control in a single session, making noninvasive brain-machine interface (BMI) systems to control multi-functional prosthetics/orthotics for rehabilitation of upper-limb movements and gait clinically feasible. These demonstrations challenge the perceived limitations of scalp EEG as a source signal for 'reading' the brain/mind, while providing new opportunities in noninvasive neural, cognitive, and rehabilitation engineering. In this talk I will outline the challenges and solutions towards the development of noninvasive BMIs for the control of powered lower-limb exoskeletons for restoration of walking in spinal cord injury and stroke.

Representative Articles:

Bradberry, Trent J, Rudolph J. Gentill and Jose L. Contreas-Vidal. " Fast Attainment of Computer Cursor Control with Non-invasively Acquired Brain Signal" pdf

Presacco, Alessandro, Ronald Goodman, Larry Forrester and Jose L. Contreas-Vidal. . "Neural Decoding of Treadmill Walking From Noninvasive Electroencephalographic Signals" pdf

5

Amber Collins, PhD (Higginson ME)

Title:  Developing disease-modifying therapies for knee osteoarthritis

Abstract: Knee osteoarthritis is a common and debilitating problem with treatments focusing on the amelioration of disease symptoms, rather than the modification of disease onset or progression. The focus of this talk is on developing and investigating potential disease-modifying interventions for osteoarthritis of the knee.  I will present results from my dissertation work, which focused on the investigation of stochastic resonance’s effect on proprioception, gait, and postural control in those with knee osteoarthritis.  Continuing the idea of developing potential disease modifying interventions I will then present ideas for future work which focuses on introducing interventions earlier in the disease process, specifically after ACL injury.  The ultimate goal of this research is to determine whether these interventions can affect disease onset and/or progression. 

Representative Papers:

Collins, Amber, Troy Blackburn, Chris Olcott, Bing Yu, Paul Weinhold." The Impact of Stochastic Resonance Electrical Stimulation and Knee Sleeve on Impulsive Loading and Muscle Co-contraction During Gait in Knee Osteoarthritis" (2011). pdf

Elisa Schrank, PhD (Higginson/Stanhope)

Title: Identifying compensatory strategies to walking with stiffness-customized PD-AFOs

Abstract: Passive-dynamic ankle-foot orthoses (PD-AFOs) are a frequently prescribed class of ankle orthoses that rely on design features and material properties to establish functional characteristics.  Currently, customizing PD-AFO characteristics for optimal gait function is limited by the craft-based methods currently used to manually fabricate orthoses.  Furthermore, prescribing the optimal PD-AFO is complicated by the limited understanding of how the orthosis interacts with the complex dynamics of the lower-extremity musculoskeletal system.  We have developed a novel framework to customize and rapidly fabricate PD-AFOs with objectively-tuned fit and functional characteristics, enabling the influence of orthosis design characteristics on biomechanical function to be explored in a controlled and systemic manner.  Characteristics that can readily be customized using this framework include PD-AFO stiffness, which is a key functional characteristic that dictates the resistance to bending and thus the amount of assistance provided by the orthosis. In this talk, I will present experimental and simulation results from a subject walking in several customized PD-AFOs with a range of stiffness values as I work to identify the influences of PD-AFO stiffness on gait function.

Representative Paper:

Schrank, Elisa S. and Steven J. Stanhope. "Dimensional accuracy of ankle-foot orthoses constructed by rapid customization and manufacturing framework" (2011). pdf

Melynda Schreiber (Galloway, PT)

Title: Open Area Harness System – A New Device to Advance the Training and Study of Mobility and Socialization

Abstract: Cognitive and social skills are driven by our ability to explore our environment.  Specifically, the emergence of crawling and walking in infancy are causal factors in the development of the physical body, cognition and socialization. Not surprisingly, children who cannot walk, skip and run are at serious risk for cognitive and social impairments and additional levels of disability.

Body weight supported treadmill training (BWSTT) may improve a child’s walking distance, speed, and leg strength.  Because of the design features and use of BWSTT, it may not be as effective for improving over ground mobility in non laboratory spaces such as grocery stores, schools, or playgrounds.  The purpose of this project is to create a dynamic body weight support system, called an Open Area Harness System (OAHS), in which users receive body weight support as they move throughout open areas.  We will briefly summarize OAHS design features, then lead an audience discussion focused on the creative use of the OAHS for training and study across the lifespan.

Representative Paper:

Damiano D, DeJong SL (2009) Systematic Review of the Effectiveness of Treadmill Training and Body Weight Support in Pediatric Rehabilitation. J Neurol Phys Ther  33: 27–44. pdf

Catherine Kirn-Safran (Biology)

Title: Utility of Preclinical Models of Osteoarthritis

Abstract: Osteoarthritis (OA) is a progressive disorder characterized by articular cartilage attrition and metabolic changes in the subchondral bone and the synovium. Although it is well known that in OA articular cartilage can no longer act as a shock absorber because of an imbalance between synthesis and degradation of both cartilage and bone, OA is typically diagnosed when irreversible damage has already taken place. Thus, in order to modify disease progression, intervention needs to take place before permanent damage has occurred, and a good understanding of the molecular mechanisms involved in the formation of the tissue is necessary to identify degradation pathways involved in the early steps of the disease. Currently, my research utilizes different approaches to help discover novel treatment and detection methods for inhibition/prevention of OA progression.

First, I will report on the utility of an early mouse model of knee OA (papain model) for testing of the therapeutic potential of cartilage repair biomaterials. This work is performed in collaboration with Drs. Mary C. Farach-Carson (Rice University, Dept. Biochemistry & Cell Biology) and Xinqiao Jia (UD, Dept. Materials Science & Engineering). In the second half of my talk, I will discuss more severe mouse models of OA (knee destabilization and meniscectomy models) that are used to mimic the disease process for the discovery of diagnostic biomarker. This work is performed in collaboration with Drs. Randall Duncan and Erica Selva (UD, Dept. Biological Sciences). A discussion related to the clinical relevance of this project will be initiated at the conclusion of this presentation.

Representative Papers:

Jody Greaney (Farquhar Host)

Title: "The muscle metaboreflex and its interaction with the arterial baroreflex in the control of sympathetic outflow in older adults."

Abstract: Limited information suggests that aging attenuates the exercise pressor reflex (EPR); however, whether an alteration in the metabolic or mechanical component contributes remains unclear. In addition, the ability of the muscle metaboreflex to increase arterial baroreflex muscle sympathetic nerve activity (MSNA) gain has not been examined in older adults. Therefore, we examined the influence of healthy aging on the metabolic component of the EPR and its interaction with the arterial baroreflex using graded intensities of muscle metaboreflex activation. In young (n=17; 23±1 yrs; resting blood pressure (BP) 111±3/69±3 mmHg) and older (n=22; 60±1 yrs; resting BP 112±3/67±3 mmHg) adults graded isolation of the muscle metaboreflex was achieved using post-exercise ischemia (PEI) following moderate (PEI-M) and high intensity (PEI-H) static handgrip performed at 30% and 40% maximum voluntary contraction, respectively. Arterial BP (Finometer) and MSNA were measured continuously. Weighted linear regression analysis between MSNA and diastolic BP was used to estimate arterial baroreflex MSNA gain. Compared to young adults, the increases in mean BP and MSNA burst frequency were attenuated in older adults during both PEI-M (Δ18±2 young vs. Δ11±1 older mmHg and Δ12±2 young vs. Δ2±1 older bursts/min; both P<0.05) and PEI-H (Δ24±3 young vs. Δ14±1 older mmHg and Δ11±2 young vs. Δ2±2 older bursts/min; both P<0.05). In contrast, sympathetic baroreflex sensitivity increased to a similar extent in both groups during PEI-M and PEI-H (P>0.05 for both). Collectively, these data indicate that the skeletal muscle metaboreflex is blunted, while its interaction with the arterial baroreflex is preserved, in healthy aging.

Representative Papers:

Markel, Troy A, Joseph C. Daley III, Cynthia S. Hogeman, Michael D. Herr, Mazhar H. Khan, Kristen S. Gray, Allen R. Kunselman and Lawrence I. Sinoway (2003). Aging and the Exercise Pressor Reflex in Humans. pdf

Darryl Thelen, PhD, (Host Higginson)

Title: "Biarticular Muscle Function During Locomotion"

Abstract: Biarticular muscles such as the hamstrings, rectus femoris and gastrocnemius are often implicated in gait disorders, and tend to be more prone to injury in dynamic movements. The underlying reasons are not completely understood, but may relate to the unique biomechanical function that biarticular muscles exhibit.  Muscle function is traditionally assumed to be describable based purely on anatomical considerations. However, multi-body dynamic models suggest that biarticular muscles are capable of more complex, and often non-intuitive, behavior. In this seminar, we will describe experiments we have performed to directly measure biarticular muscle function during walking, with the results strongly supporting the need to consider whole body dynamics. We will also discuss the action of the biarticular hamstrings during running, and how whole body coordination can affect hamstring injury susceptibility. The use of such information for enhancing the treatment of gait disorders and rehabilitation of muscle strain injuries will be discussed.

Representative Papers:

Dr.Jochen Baumeister, University of Paderborn, Germany (Host Swanik)

12-1pm, Colburn 104

Title: “Brain mechanisms and sensorimotor control after ACL reconstruction”

Abstract: A large quantity of research has examined functional, biomechanical and neuromuscular changes associated with Anterior Cruciate Ligament (ACL) injury and repair. There appears to be a ´barrier´ to ACL related research related to brain function, cortical plasticity and cognitive function changes, all of which are likely to underpin the functional changes described previously, perhaps due to previous deficits in required research techniques available. In this talk, work using neuroscience research techniques (EEG) in this field of interest will examine the effect of ACL injury and repair on basic brain function.

Representative papers:

Jacqueline Palmer, SPT, BMSC Doctoral Student

Title: "Transcranial Magnetic Stimulation as a measure of lower extremity Corticospinal Excitability:  Test-retest reliability and changes with walking "

Abstract:  The term neuroplasticity refers to the ability of the adult human brain to adapt and show structural and functional changes in response to experience, learning, or rehabilitation.  Transcranial magnetic stimulation (TMS) is a technique that can be used to demonstrate training-induced neuroplasticity in the primary motor cortex.  Our lab is interested in investigating the relationship between corticospinal excitability, strength, and functional measures in patient populations with brain injury as well as the neuroplastic changes that occur in response to intervention in these populations.  We are currently investigating changes in neuroplasticity through measures of corticospinal excitability of lower extremity muscles that occur with neuro-rehabilitation interventions such as functional electrical stimulation and treadmill training.  As a first step, we are conducting a  pilot study in able-bodied adults to (1) determine the test/retest reliability of TMS-derived measures of corticospinal excitability in able-bodied individuals,  and (2) investigate the changes in corticospinal excitability that occur with treadmill walking and in response to a novel motor learning task.  Results of date support the potential use of measuring changes in corticospinal excitability with walking and novel motor learning tasks and may help us identify mechanisms for improvements following rehabilitation. 

Representative papers:

Hallett, M. (2007). Transcranial Magnetic Stimulation: A Primer. Neuron, 55, 187-199. pdf

Kesar, T. M., et al. (2011). Motor cortical functional geometry in cerebral palsy and its relationship to disability.  Clinical Neurophysiology, doi:10.1016/j.clinph.2011.11.005 pdf

Adam Marmon, PhD (PT)

Title: “Quadriceps Power, Movement Patterns and Function after Total Knee Arthroplasty”

Abstract: The primary motivating factors for electing to undergo total knee arthroplasty include reducing pain and recovering lower extremity functional ability. Individuals recovering from total knee arthroplasty can be characterized as having significant improvements in both of these areas compared to preoperative levels; however, functional limitations continue to persist. The purpose of this project is to examine the functional relevance of knee extensor power and the use of power as a clinical measure for evaluating the efficacy of post-surgical rehabilitation after total knee arthroplasty. Establishing the functional importance of knee extensor power may have implications on post-surgical rehabilitation and the need to further explore the benefits of power training exercises for rehabilitating individuals who undergo total knee arthroplasty.

Representative papers:

NIH Biosketch doc

Peterson, S., et. al. (2009). Improved Function From Progressive Strengthening Interventions After Total Knee Arthroplasty: A Randomized Clinical Trial With an Imbedded Prospective Cohort.  Arthritis & Rheumatism, 61, 174 - 183. pdf

Nancy Getchell (KAAP)

Title: “ The “Clumsiness” Connection:  Using movement to help identify learning disabilities”

Abstract: Within the United States, an estimated 15 – 20% of the population have some form of learning disability (LD), with dyslexia being the most common sub-type.  Children must begin to show discrepancies between academic performance and intellectual performance in order to be identified with an LD.  The National Center for Learning Disabilities lists both gross and fine motor coordination issues (e.g. clumsiness) as early signs of LD; however, movement is rarely used as diagnostic criteria for learning disabilities.  Can early movement differences be used to more systematically screen for children at risk for LD?  With this in mind, my research has focused on understanding and quantifying the notion of ‘clumsiness’ in children with different learning disabilities.  I will review research on children with learning disabilities, focusing on gross motor coordination during a dual motor task (clapping while walking).  After discussing this research, I will offer some practical ways in which movement practitioners can help identify children who may be at risk for LD.

Representative papers:

Getchell, N., McMenamin, S. and Whitall, J. (2005).  Dual motor task coordination in children with and without learning disabilities.  Adapted Physical Activity Quarterly, 22, 21 – 38. pdf

Getchell, N., Mackenzie, S &, Marmon, A.  (2010).  Multilimb coordination in children with and without dyslexia:  Effects of task and training.  Adaptive Physical Activity Quarterly, 27, 32 - 46. pdf

No BIOMS seminar, CBER DAY

Shannon Lennon Edwards

Title: Mechanisms of Exercise-induced Cardioprotection

Abstract: Heart disease remains the number one killer in the U.S.  The main manifestation of heart disease is myocardial damage due to ischemia-reperfusion (I-R) injury.  The level of I-R injury can range from limited myocardial damage to myocyte death.  Numerous countermeasures have been developed to better survive this insult however none are as sustainable and practical as regular bouts of exercise.  Exercise training can provide cardioprotection in as little as 3 days of training.  This talk will explore the mechanisms of exercise-induced cardioprotection. 

Representative papers:

Lennon, Shannon L., John Quindry, Karyn L. Hamilton, Joel French, Jessica Staib, Jawahar L. Mehta and Scott K. Powers. Loss of exercise-induced cardioprotection after cessation of exercise. J Appl Physiol 96:1299-1305, 2004. First published 12 December 2003. pdf

Powers, Scott K. , John C. Quindry, Andreas N. Kavazis. Exercise-induced cardioprotection against myocardial
ischemia–reperfusion injury. Free Radical Biology & Medicine 44 (2008) 193–201. pdf

Vineet Vashista

Title: Force Adaptation in Human Walking with Symmetrically Applied Downward Forces on the Pelvis

Abstract: The application of external constraints and/or applied forces during movement can lead to reactive as well as adaptive changes in human motion. Previous researches in the literature have usually focused on adaptation in human kinematics when external forces were applied using exoskeletons during the swing phase of gait. This work aims to study adaptation in human walking when externally applied forces are present on the pelvis both during the swing and stance phases of the gait. A novel tethered pelvic assist device (TPAD) was used to passively apply downward forces on the human pelvis while walking. During the experiment, healthy subjects walked on a treadmill at a constant speed while their kinematics and foot pressure data were recorded. Data analysis revealed that the healthy subjects exhibited both reactive as well as adaptive changes in their gait parameters. The immediate response of the subjects was to increase their hip flexion to clear their foot off the ground as they were unable to lift their pelvis to their usual height during normal motion. Seven out of eight subjects in the study resisted the downward forces to move their pelvis up. Eventually, they reached a level of downward force that they could sustain over the training. This adaptation to the downward force was reflected in the heel peak pressure values during the cycles of the gait. On removing the tethers, aftereffects in heel peak pressure during the gait cycles were observed which resulted from increased magnitude of the pelvic vertical acceleration. In summary, symmetrically applied external forces on the pelvis during swing and stance phases resulted in adaptation of the gait kinetics, i.e., in the peak heel pressure, once the tethers were removed.

Representative papers:

Joe Zeni

Title: Gait after unilateral Total Knee Arthroplasty

Abstract: Total Knee Arthroplasty (TKA) reliably reduces the pain associated with end-stage knee osteoarthritis (OA). Despite a resolution of symptoms soon after surgery, many patients continue to demonstrate functional limitations and muscle weakness compared to age-matched individuals without lower extremity pathology, even one year after surgery. Additionally, many patients after primary unilateral TKA develop pain and OA in their contralateral joints and require a contralateral TKA within 5 years of surgery. Incidence of contralateral joint replacement within 5 years in a sample of patients from our previous study was 41%. It is especially concerning because all of these patients in that had no marked signs or symptoms of OA or pain in their contralateral knee at baseline. The incidence of disease progression in the contralateral limb after primary TKA may be attributed to a variety of factors, including weight gain and movement asymmetries that overload the non-operated limb, as well as progressive weakness in the non-operated limb. These potential causes as well as the results from interventions aimed at optimizing biomechanical and functional recovery after TKA will be discussed.

Representative papers:

Alnahdi A, Zeni J, Snyder-Mackler L, (2010) "Gait after Unilateral Total Knee Arthroplasty: Frontal Plane Analysis". Journal of Orthopaedic Research, May, 647-652 pdf