Current Projects

ACTIVE RESEARCH PROJECTS

The ulnar collateral ligament (UCL) provides ~50% of the counter to elbow varus torque during pitching, putting it at risk for injury. Varus torque increases with faster ball velocity during pitching, but not for all pitchers.  We hypothesize that physical factors of movement quality and quantity of the shoulder, trunk and hip movement are able to moderate the forces transmitted to the elbow during pitching. The goal of this project is to define the ball velocity-elbow varus torque relationship, and the level by which physical factors can moderate this relationship to reduce elbow torque. A player profile for UCL injury risk developed for each pitcher can be used in 3 ways; to target the identified physical factors for prevention and rehabilitation after injury, specify return to sport criteria, and guide performance enhancement.

Read more about this study at HSC News.

Status: Pre-Enrollment

Co- Principal investigators:
Andrew Karduna, PhD

Co-investigators:
Roksana Karim, PhD

Collaborators: 
Paul Diaz, ATC; Head Athletic Trainer for USC Baseball (USC)
Seth Gamradt, MD; Director of Orthopaedic Athletic Medicine, MD for USC Baseball (USC)
Tom Embree, ATC; Head Athletic Trainer for UO Baseball (UO)
Jeremy Vail, PT, ATC; Rehab Coordinator; Carl Stocklin, ATC, Head ATC, Baseball (UCLA)
Andrew Hawkins, PT, ATC; Minor League Rehab Coordinator. (Los Angeles Angels of Anaheim)

Funding Mechanism:
PAC-12 Student-Athlete Health and Well Being Grant. 2019 – 2022.

Multi-Site Institutions:
University of Southern California (USC), University of Oregon (UO), University of California, Los Angeles (UCLA)

The purpose of this study is to characterize the central nervous system mechanisms using brain imaging and identify predictors of a positive response to spinal manual therapy in patients with rotator cuff disease. The findings will optimize the delivery and treatment response to spinal manual therapy.

Status: Pre-Enrollment

Co- Principal investigators:
Jason Kutch, PhD

Co-investigators:
Amy Hegarty, PhD

Funding Mechanism:
The Charles D. and Mary A. Bauer Foundation.  2018 – 2020.

The purpose of this study is to characterize the effects of close chain exercises for patients with rotator cuff disease. Changes in motor performance will be evaluated by analyzing the peripheral and central nervous system. Predictors of positive response to treatment will be investigated for patients with rotator cuff disease. The findings will optimize the delivery and treatment response for closed chain exercises for patients with rotator cuff disease.

Enrollment: Pre-Enrollment

Co- Principal investigators:
Jason Kutch, PhD

Co-investigators:
Amy Hegarty, PhD

Funding Mechanism:
The Charles D. and Mary A. Bauer Foundation.  2018 – 2020.

The purpose of this study is to characterize the risk of upper extremity injury in baseball players based on preseason measures of shoulder range of motion, shoulder strength, and trunk/hip stability and strength. Besides, we aim to develop a streamlined screening battery of tests that can be used to identify risk factors associated with upper extremity injury.

Defining the deficits in the shoulder, trunk, and hip that prognosticate upper extremity injuries will lead to a better understanding of how these factors individually and in combination predict injury risk. The evidence-based screening exam can be used to identify injury risk, and those modifiable risk factors related to injury. Long-term, the goal is to leverage the findings of this study to develop pre-season and in-season prevention program to reduce injuries.

Status: Active

Enrollment: N/A

Co-investigators:
Hillary Plummer, PhD, ATC;
Bernard Li, PT, DPT, OCS, SCS;
Jonathan Sum, PT, DPT, OCS, SCS

Funding Mechanism:
Major League Baseball Research Grant.  $47,677.  2018 – 2019.

The purpose of this study are to determine the predictive validity of sonographic imaging as an early detection measure for work-related shoulder pain, and to determine the effects of first-time exposure to intensive work-related tasks on shoulder function, pain, strength, range of motion, nerve mobility, and tendon morphology.

Limited information exists regarding potential risk factors for the development of shoulder work-related pain and work-related musculoskeletal disorders. Early detection methods are needed to identify individuals at risk, in order to intervene before the development of shoulder pathology. By studying dental hygienist students we will be able to control for task-exposure, as all the participants will be exposed to similar profession-related tasks at the same time.

Status: Active

Enrollment: N/A

Co-investigators:
Shawn Roll, PhD, OT
Federico Pozzi, PhD, PT
Hillary Plummer, PhD, ATC
Catarina de Oliveira Sousa, PhD, PT

Funding Mechanism:
The Charles D. and Mary A. Bauer Foundation.  $25,000.  2017 – 2019.

National Institute for Occupational Safety and Health / Centers for Disease Control (R01-OH010665). $2,324,186. 2015 – 2019.

For more info click here.

 

The purpose of this study is to assess the feasibility, reliability, and discriminate ability of a shoulder performance test that simulates activities of daily living in patients with shoulder pain. We will also test the ability of the shoulder performance test to discriminate between those with and without shoulder pain, by having participants without shoulder pain perform the test. We will also assess the relationship between the shoulder performance test and self-report of functional loss, and impairments of shoulder range of motion (ROM) and strength.

The results of this study will help to improve the evaluation of the shoulder by using a performance test to determine shoulder functional ability, and to assist the clinical decision making about the extent of recovery of patients throughout the course of the rehabilitation program. 

 

Status: Enrollment

For more information, please contact the COOR Lab: 
COORlab@pt.usc.edu or call 323-224-5032

Co-Investigators:  

Catarina de Oliveira Sousa, PhD, PT
Jonathan Sum, DPT
Brian McNeil, DPT
Federico Pozzi, PhD, PT

The purpose of this study is to determine the feasibility, acceptability, and patient-reported and performance outcomes of a 5-month closed-chain rehabilitation protocol for patients with full-thickness rotator cuff tears. Secondarily, the effects of the closed-chain rehabilitation protocol on, shoulder impairments, tendon morphology, and shoulder biomechanics will be assessed. These rehabilitation exercises, if demonstrated to be effective, could be used to direct treatment for future patients with rotator cuff tears.

Enrollment: Active

Status: Patient Enrollment

Do you have a rotator cuff tear?
We are inviting individuals between the ages of 40 and 85 who have a full-thickness rotator cuff or a failed rotator cuff repair and have not participated in physical therapy within the last 3 months.

For more information, please contact the COOR Lab:
COORlab@pt.usc.edu or call 323-224-5032

Funding Mechanism:
Barbara Fried, Fried Companies, Inc. 2015 – 2019

Shoulder dysfunction is prevalent in individuals with spinal accessory nerve injury. Spinal accessory nerve injury affects the muscle activity and function of the lower trapezius muscle.Weakness or paralysis of the trapezius muscle may cause a loss in shoulder and scapula motor control. However biomechanical factors such as tendon characteristics, shoulder mechanics and muscle activation during arm elevation are not well understood. The purpose of this study is to investigate shoulder function and muscle activity in patients with spinal accessory nerve injury.

Enrollment: Active

Status: Patient Enrollment

Co-Investigators

Kimi Yamada, PT, DPT, OCS, ATC, CLT, CSCS

Laboratory studies have revealed abnormal scapular kinematics, reduced scapular muscle performance, and reduced shoulder flexibility in patients with shoulder pain as compared to asymptomatic shoulders. The Scapular Assistance and Scapular Reposition Tests are commonly used during clinical evaluation of patient with shoulder pain however the reliability and validity of these tests has not been established. The purpose of this study is to (1) determine the reliability of the Scapular Assistance and Scapular Reposition Tests and (2) assess if the Scapular Assistance and Scapular Reposition Tests can identify patients who would benefit from scapular focused treatment.

Enrollment: Active

Status: Patient Enrollment

Co-Investigators

Aimee Winston, PT, DPT
University of Southern California Orthopedic Physical Therapy Resident

Jessica Mullane, PT, DPT
University of Southern California Orthopedic Physical Therapy Resident

 

HEALTH SERVICES RESEARCH

Manual therapy (MT) is in the scope of practice of multiple healthcare providers, and can be an effective intervention for shoulder disorders. However, it is not clear as how much MT (dose)should be used, and if it should be combined with exercise(delivery). Prior research on MT as a treatment for shoulder pain has focused on patient-rated outcomes. Our overall goal is to determine the impact of MT characteristics on downstream utilization of healthcare services and costs. Specifically, the aims of the project are to characterize the influence of MT dosing and MT delivery (alone or combined with exercise) on downstream utilization of healthcare services and costs in the 12 months after an initial visit for a shoulder condition.

Enrollment: NA

Status: Database Acquisition

Co-Investigators

Federico Pozzi, PhD, PT
Daniel Rhon, DSc, PT, OCS, FAAOMPT
Chad Cook, PhD, PT, FAAOMPT

Clinical Practice Guidelines (CPGs), such as those developed by the Orthopaedic Section, were written to enable clinical decision-making. Shoulder pain is a common complaint, and rotator cuff (RC) disease is the most prevalent shoulder diagnosis.Recently, evidence-based CPGs have been published for RC disease, but to guide clinicians in the treatment of RC disease. While these CPGs are evidence-based, there is a lack of evidence as to the effects of adherence to the CPGs on patient-rated outcomes, and the relationship to dose of care. This project will convert clinical data into meaningful data elements to define CPG adherence for RC disease, and define the relationships to patient outcomes and dose of care.

Enrollment: NA

Status: database acquisition

Funding: Orthopaedic Section of APTA; Clinical Research Network (CRN) Grant, 2017 – 2019

Co-Investigators

Co-PI: Chuck Thigpen, PhD, PT, ATC

Co-Investigators

Chad Cook, PhD, PT, FAAOMPT
Federico Pozzi, PhD, PT

Funding Mechanism:
Orthopaedic Section of the APTA.  2017- 2019.