PHYSICAL
DISABILITIES BRANCH
|
Steven J. Stanhope,
PhD, Chief The
research mission of the Physical Disabilities Branch (PDB) is to develop and
disseminate innovative rehabilitation technologies; to conduct basic and
translational research into the causal relationship that links the
impairment, functional limitation, and physical disability rehabilitation
research domains; and to conduct clinical research into the efficacy of
rehabilitation interventions. During the past year, the PDB has continued to
expand its research portfolio in each of these areas. Listed below are select
examples. Led
by Steven Stanhope, the
Human Movement Disorders Section developed a technique to measure the
extent to which a special type of ankle brace assists patients with ankle
joint weakness as they walk. In some cases, the brace augments
patients’ ankle strength and gait function. In other cases, the brace
assists patients by reducing their level of effort. Work has begun to develop
and test customized dynamic ankle braces with the hope of assisting patients
in their quest to reach an optimal level of function. The section completed
an investigation into the ability of elderly subjects to implement
compensatory movement strategies needed to rise to a standing position from a
range of seat heights. Claudia Mazzà and a team of investigators demonstrated
a clear hierarchy of compensatory movement strategies in which the effectiveness
of each strategy to rise from a sitting position is strongly influenced by
both the individual’s general functional status and the difficulty of
the sit-to-stand task. The Biomechanics
and Biomedical Engineering Section continues to develop and test advanced
methods for the visualization and analysis of human movement in a
rehabilitation context. Under the direction of Steven Stanhope, the
section worked in collaboration to develop a novel method for displaying the
often data-dense results of a clinical movement analysis study in an
efficient and enhanced color-coded format. In addition, one team recently
determined the efficacy of skeletal movement estimates by using skin-mounted
sensors and optical-based motion-capture technologies. Thomas Kepple led the
section’s efforts to develop, test, and apply advanced biomechanical
models for use in clinical movement analysis research. Examples of such
models include induced acceleration analysis methods for determining the
sources of deformation and mechanical energy flow patterns in dynamic ankle
braces. The section recently used the methods to study the efficacy of
different compensatory strategies used by individuals with lower-extremity
muscle weakness to produce knee extension during the stance phase of walking.
Frances Sheehan is leading an effort to measure and analyze noninvasively the
precise skeletal motion and human joint function. The Virtual Functional
Anatomy project is an extensive and ongoing effort in the section. Recent
technical developments include improvements in movement integration
algorithms and completion of a preliminary registration algorithm for
matching three-dimensional skeletal models to motion data derived from
dynamic imaging methods. Clinical application of these advanced techniques
continues to focus on knee and ankle joint function. Led
by Barbara Sonies, the
Oral Motor Function Section has completed the characterization of
swallowing dysfunction in nephropathic cystinosis. The project’s goal
was to determine if cysteamine would be effective in preventing oral-motor
muscular and swallowing dysfunction. The results indicate that swallowing
worsened in patients medicated for shorter times and that the declines in
swallowing either stabilized or improved in patients medicated for longer
periods. Jeri Miller is leading the section’s efforts to quantify form
and function of the prenatal developing human aerodigestive system. Using
three- and four-dimensional ultrasound techniques, the team is developing a
three-dimensional database of development from 16 to 38 weeks of gestation.
One goal is to incorporate data on respiration and ingestion into complex
computerized models of morphological and functional relationships to permit a
better understanding of neonatal aerodigestive functions. Gloria Chi-Fishman
and her team in the section are conducting basic research into the
anatomy and biomechanics of tongue function. Using an array of advanced
imaging technologies, the team quantified task-induced changes in tongue
volume, measured lingual musculature in three dimensions, and measured
task-induced changes in lingual hemodynamics. |