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 impairment, functional limitation, and physical disability rehabilitation research domains; and to conduct clinical research into the efficacy of rehabilitation interventions. During 2006, the PDB continued to expand its research portfolio in each of these areas.

Led by Steven Stanhope, the Human Movement Disorders Section has 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 ankle strength and gait function. In other cases, the brace assists patients by reducing required effort. The Section has initiated work to develop and test customized dynamic ankle braces to assist patients in their quest for an optimal level of function. Maria Lebiedowska used a portable measurement method to quantify knee joint resistance during different movement velocities to differentiate between types of hypertonia in patients with cerebral palsy. In addition, she has developed an experimentally derived model of human body growth that may be less variable than BMI in quantifying body size and shape in children age 6-18 years. Karen Siegel has applied an advanced biomechanical model to patients with severe muscle weakness to show how they exploit musculoskeletal redundancy. Her goal is to develop alternative movement control strategies during gait to compensate for lost muscle function. Jeri Miller used non-invasive biometric measures of upper airway structures and spectral Doppler analyses of inspiratory and expiratory fluid-related breath patterns from a number of human fetuses to determine that trends in volumes exchanged during emergent respiratory activity correlate with the maturation and growth of aerodigestive structures. Gloria Chi-Fishman has continued research on optimized magnetic resonance and ultrasound imaging methodologies to study the structure-function relationships of the in vivo human tongue.

The Biomechanics and Biomedical Engineering Section has continued 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 has continued the development and testing of custom dynamic ankle-foot orthoses to determine their effect on the walking patterns of both normal subjects and patients with impaired lower-extremity function. By completing a project that evaluated an enhanced model using an induced velocity analysis of a baseball pitch, Thomas Kepple has continued efforts to develop, test, and apply advanced biomechanical models for clinical movement analysis research. Saryn Goldberg led a team that used acceleration analysis to determine whether accurate evaluation of the role of the gastrocnemius muscle at the knee during stance phase requires measurement of the moment arms of the muscle on a subject-by-subject basis. In an effort that recently produced the first dynamic cartilage contact model, Frances Sheehan led a project to measure and analyze non-invasively precise skeletal motion and human joint function. Clinical research applications of the novel technique extend to children and adults diagnosed with cerebral palsy, Ehlers-Danlos syndrome, stroke, and patellofemoral pain syndrome.