What are your general research interests?
My interests lie in the area of outcomes research for patients with osteoarthritis and patients who undergo total joint arthroplasty. Using biomechanical and functional assessments, we evaluate patient-specific impairments. Then we develop and implement targeted treatment strategies to address these impairments and optimize short- and long-term outcomes.
What are your current projects and how are they funded?
We have several research projects taking place in the lab that are funded by the National Institutes of Health. We are currently analyzing data from our project titled “Optimizing Functional and Biomechanical Outcomes after Total Knee Replacement.” In this project we have used the Wii Balance Board as an inexpensive, innovative method to provide visual biofeedback of how much force is under each foot while patients perform strengthening and functional retraining exercises after surgery. When patients are given the feedback during the exercise, they use their limbs more symmetrically, and we hope that this will speed up their recovery process.
Who are your collaborators on these projects?
Dr. Lynn Snyder-Mackler has been a great collaborator and mentor during my time here as a junior faculty member. We also collaborate with clinicians from the community. Surgeons from the Advanced Center for Joint Replacement and therapists at PT Plus, which are part of Christiana Care Health Systems, are co-investigators on several of our outcomes studies.
What are the likely “next steps” in your work?
The main motivation for the work I am doing is to develop rehabilitation strategies that can be directly implemented in a real-world clinical setting. We are in the planning stages of a randomized clinical trial of our Symmetry Biofeedback Protocol. Using a multi-center design that includes community-based rehabilitation clinics, we will test whether the Symmetry Protocol enhances functional recovery, improves movement symmetry, and reduces the incidence of osteoarthritis progression on the opposite limb. If successful, we hope that this will become the new standard of care after total joint replacement.
How would you describe your work’s importance to an interested lay audience?
Nearly 850,000 total hip and knee replacements were performed last year in the United States, and this number is expected to dramatically increase in the next decade. Total joint replacement reduces the pain associated with end-stage arthritis, but patients continue to walk asymmetrically and demonstrate reduced ability to climb stairs or walk long distances, even one year after surgery. These persistent impairments increase reliance on the non-operated limb and may lead to osteoarthritis progression on that side. Our work will help to normalize movement patterns after surgery, reduce recovery time and hopefully reduce the disease progression on the non-operated joints.