Steven J. Stanhope, PhD, Chief

The research missions of the Physical Disabilities Branch (PDB) are to develop and disseminate innovative rehabilitation technologies; conduct basic and translational research into the causal relationship that links impairment, functional limitation, and physical disability rehabilitation research; and conduct clinical research into the efficacy of rehabilitation interventions. During the past year, the PDB continued to expand its research portfolio in each of these areas. Listed below are examples.

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 ambulation in patients with ankle joint weakness. In some cases, the brace augments ankle strength and gait function. In other cases, the brace assists patients by reducing their level of effort. Work to develop and test customized dynamic ankle braces has begun, with the hope of helping patients reach an optimal level of function. Jeri Miller used noninvasive 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 the trends in volumes exchanged during emergent respiratory activity are correlated with the maturation and growth of aerodigestive structures. Maria Lebiedowska used a portable measurement method to quantify knee joint resistance during different movement velocities, finding different types of hypertonia in patients with cerebral palsy. In addition, she developed an experimentally derived model of human body growth capable of determining changes attributable to age-related growth and changes in body composition in children age six to 18 years. Gloria Chi-Fishman continued research on optimized magnetic resonance and ultrasound imaging methodologies to study the structure-function relationships of the human tongue. Karen Siegel applied an advanced biomechanical model to patients with severe muscle weakness to show how they exploit musculoskeletal redundancy to develop a variety of alternative movement control strategies during gait to compensate for lost muscle function.

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 continued the development and testing of custom dynamic ankle joint orthoses to determine their effect on normal subjects and the walking patterns of patients with impaired lower-extremity function. Thomas Kepple continued efforts to develop, test, and apply advanced biomechanical models for use in clinical movement analysis research by completing a unique project that tested an enhanced model by performing an induced-velocity analysis of a baseball pitch. 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 this muscle on a subject-by-subject basis. Frances Sheehan is leading an effort to measure non-invasively and analyze skeletal motion and human joint function, work that recently produced the first dynamic cartilage contact model. Recent clinical research applications of the novel technique include children and adults diagnosed with cerebral palsy, Ehlers Danlos syndrome, stroke, and patellofemoral pain syndrome.