Research

Director: Kornelia Kulig, PhD, PT, FAPTA

I am committed to studying human movement and postural control in those who suffer from recurrent musculoskeletal pain. My research is clinically motivated, theoretically informed, and the derived hypotheses are experimentally tested. In this population, I study peripheral and central adaptations to a history of recurrent pain and/or degeneration in the trunk and lower extremities. I seek to refine the experimentally developed, vertically integrated neuromechanical framework  for the study of recurrent painful conditions and to develop intervention and prevention strategies for recurrent pain in the low back and lower extremity. I am curious whether a history of pain leaves a footprint on movement and subsequently an ill-performed movement contributes to painful episodes. My research program benefits from close collaborations with practicing clinicians to ensure clinical relevance and an enhanced impact on clinical practice.

Movement Variability, Coordination and Neuromechanical Adaptations to History of Pain and/or Degeneration, Following Bouts of Tendon Pain

Tendinopathy, an overuse injury, is a significant source of morbidity. We examine morphological, movement-related,and systemic factors which may contribute to the development or progression of tendinopathies. We have been conducting laboratory and clinical studies of lower extremity tendons, including Achilles, flexor hallucis longus, tibialis posterior, and patellar. Our work documented peripheral and central adaptations to tendon degeneration, and altered coordinative strategies during dynamic tasks. This led us to continue exploring the underlying mechanisms of effective or ineffective adaptations to a history of pain in those with and without morphological signs of tendon degeneration. We continue to explore aspects of coordination and movement variability in persons with varying stages of tendinopathy. The long-term goal of our research program is to provide a robust mechanistic foundation for clinical studies examining efficacy and effectiveness of non-surgical interventions for tendon pathologies. Ultimately, we aim to provide a scientific foundation for strategies to prevent tendon pathology.

Trunk Control during Functional and Well-ControlledTasks following Recurrent Painful Low Back Pain Episodes

Low back dysfunction is the main cause of musculoskeletal disability. Our multidisciplinary research program systematically examines the impact of a history of pain and pathology on postural and locomotor control, and movement-related mental processing. Our studies on trunk mechanics and muscle activation informed us about the role of structural morphology and neuro-motor control in the presence and absence of pathology. We applied our observations of morphological and physiological adaptations accompanying a history of low back pain to develop and test rehabilitative strategies in a clinical trial. Recently, we have been probing the movement system using cognitive dual-tasking to provide insight into cognitive-motor processing related to pathology and/or a history of pain. Our findings contribute to the framework for the study of multi-level adaptations that may be present during painful episodes and in symptom remission. This framework informs the development of effective multi-modal intervention strategies.

Director: Christopher Powers, PhD, PT, FAPTA

My research program is focused on understanding the pathomechanics underlying lower extremity injury. My research interests are guided by the belief that the identification of basic injury mechanisms will lead to the development of more effective clinical interventions. To this end, my work seeks to understand the root causes of various orthopaedic diagnoses using a combination of experimental methodologies including: in-vitro simulations, dynamic magnetic resonance imaging, functional biomechanical assessments, and subject-specific musculoskeletal modeling.

Current areas of research focus include:

• Pathomechanics underlying femoracetabular impingement (FAI)

• Pathomechanics underlying patellar tendinopathy

• Influence of bony morphology, strength and neuromuscular control on hip and knee kinematics in runners

• Centrally mediated factors underlying movement impairments related to knee pain & injury

• Development & validation of a movement-based screening assessment to evaluate readiness to return to sport following ACL injury

• Upper extremity responses used to regain balance following a slip perturbation

Director: George J. Salem, PhD

This program recognizes the growing importance of exercise and activity interventions in improving health and life-quality across the lifespan.Investigations are designed to: 1) quantify the musculoskeletal loading and neuromuscular recruitment patterns associated with functional activities and exercise (e.g. golf); 2) examine the influence of exercise prescription on muscle dynamics, tissue adaptation, neural control, physical performance, brain function, and ultimately life quality; and 3) examine the feasibility,efficacy, and mechanisms-of-action associated with the integration of complementary and alternative modalities (CAM), such as yoga, meditation, and guided imagery, with traditional rehabilitation therapy. Study participants include children, younger & older adults, elite athletes, and patients with neurological disease.

Healthy Older Adults: Previous studies have characterized the musculoskeletal loading patterns and adaptations associated with a variety of exercises and activities performed by older adults (e.g.weighted-vest, yoga, resistance exercise). Current and future investigations will examine the effects of resistance level, movement speed, repetition number, program frequency, anthropometric-specific prescriptions, as well as integrative modalities (e.g. meditation), on the efficacy and safety of exercise for healthy older adults.

Neurological Disease: Studies in this area are designed to explore there lations among functional performance (chair standing, stair climbing, and walking), neuromuscular dynamics (EMG, strength, power), and muscle physiology(mass, fiber type, substrate utilization) in patients with neurological disease. This information can then be used to more effectively design exercise programs (e.g. body-weight supported treadmill training) that improve physical function and preserve independence.

Senior Golf Science: Given the balance, speed, strength, cardiovascular, flexibility, cognitive, motor skill, and social requirements of golf participation, we believe that golf is a uniquely comprehensive therapeutic intervention that can be used to promote well-being and improved quality of life in healthy and physically-impaired older adults. Golf is a recreational activity that includes regular walking over uneven and often hilly terrain interspersed between high power golf swings, precise putts and various changes in body position (e.g. picking-up a ball). In older adults, this walking is of moderate to high intensity; thus,golf can be used to promote cardiovascular health. The golf swing is a high speed yet precise movement that requires coordinated control of major muscle groups throughout a large range of motion. A successful golf swing is also dependent upon bilateral weight shift, rotation of the head and trunk, and control of momentum; thus, it challenges dynamic postural control. On the other hand, putting requires the individual to maintain a still position in order to appropriately modulate the power—challenging the static postural control of the individual. Golfing also requires continued attention and decision making, alterations in swing speed and direction, and the execution of motor-control strategies that change with each type of shot. Thus, golf is likely to also influence neuroplasticity, including brain morphology and cognitive function. Lastly, golf is played in groups of individuals (2-4) and consequently is likely to increase socialization and reduce isolation, which are problems common among seniors.Unfortunately, golf research has traditionally focused on golfing performance in younger adults and not on the physiological and psychological benefits of participation in seniors. That is why we have developed the Institute for Senior Golf Science. Our goal is to study the feasibility, safety, and efficacy of senior-specific golf training programs for individuals that do not currently golf. Additionally, the institute is examining the use of golf as a therapeutic intervention in persons with disability (e.g.stroke and multiple sclerosis).

Funding for these projects has come from Federal Institutes (NIH, NIA), National Foundations (APTA, NATA,NCAA), Private Foundations (Strause Sports Medicine Research Foundation,California Physical Therapy Fund, Arthroscopic Association of North America,Kinetics Foundation, Fitness Quest, Alfta Rehabilitation Center), and intramural grants (UCLA, CSULB, and USC).