What are your general research interests?
My work focuses on improving the function of individuals with central nervous system injury through the application of electrical stimulation to activate paralyzed, paretic or weakened muscles. Electrical stimulation can be used as a tool to study the physiologic characteristics of muscle and its functional relationships with the central and peripheral nervous system; as a rehabilitative or training modality to improve fitness, muscle function and muscle strength; and as a neuroprosthesis to produce functional movement of impaired muscles.
What are your current projects and how are they funded? Who are your collaborators on these projects?
I have three current funded projects that focus on children and adolescents with cerebral palsy (CP), a non-progressive developmental disorder of the brain that results in muscle spasticity, reduced strength, and impaired coordination. Lack of physical activity is associated with obesity, cardiovascular disease, diabetes and other chronic diseases, and the need for activity and exercise is especially acute for youth with physical disabilities. Children with CP tend to peak in walking ability because of the disparity that occurs when muscle strength gains don’t keep up with gains in body size or weight.
In my first project, we’re assessing the effects of functional electrical stimulation (FES)-assisted cycling on physical conditioning and general lower-extremity muscle strength in adolescents with spastic CP. This work is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development within NIH (R01HD062588). My co-investigators include Stuart Binder-Macleod (UD Physical Therapy) and Therese Johnston (University of Sciences and Scientific Staff at Shriners Hospitals for Children).
In my second project, we are developing an FES system that acts as a neuroprosthesis to help individuals with CP who walk with a crouched gait to walk more upright. We will then use the FES system for intensive fast walking training regimes designed to improve fitness and ambulatory ability. This work is funded by Shriners Hospitals for Children (grant #71011). Collaborators include Binder-Macleod and Susan Marion (UD Physical Therapy); Jessica Rose (Stanford University); and Edward Sazonov (University of Alabama).
Third, I’m a co-investigator on a project using transcranial magnetic stimulation and MRI imaging of the brain to examine cortical organization patterns in individuals with CP in an effort to understand how these patterns are related to muscle strength, motor function, and the potential for response to rehabilitation. This work is supported by a Delaware Health Sciences Alliance pilot grant and is led by Binder-MacLeod. Other co-investigators include Trisha Kesar (UD Physical Therapy), George Whittenberg (University of Maryland), Freeman Miller (A.I. DuPont Hospital for Children), Susan Duff (Thomas Jefferson University), and Kert Anzilotti (Christiana Care).
What are the likely “next steps” in your work?
We hope to provide compelling evidence that FES can be used to augment the intensity at which individuals with CP can exercise and that FES-induced exercise is accompanied by central and peripheral mediated changes that help to improve function. With evidence-based results, we hope to show that FES-assisted exercise is more than just a laboratory-based activity but can be clinically deployed and used in the community. The ultimate goal is demonstrate that FES-assisted exercise can be used as a fun way to maintain fitness, strength and function.
How would you describe your work’s importance to an interested lay audience?
I hope to provide individuals with CP a means of assistive exercise that can be fun and engaging as well as vigorous enough to help prevent the typical downward spiral of walking function in this population. By using FES in vigorous training regimens, we hope to induce carry-over in improving fitness and ambulatory ability even when FES is not used.
Photos courtesy of: Brian W. O’Doherty,Coordinator Media Services, Shriners Hospitals for Children® - Philadelphia