Research
Assessing Balance, Gait, and Falls in Elderly African-Americans with Hypertension
Normal age related and age associated changes in the cardiovascular system are contributors to hypertensive diseases in the elderly. Data from the National Center for Health Statistics (NCHS) shows that elderly African-Americans demonstrate a higher occurrence of hypertension (66.9%) as compared to all adults age 65 and older (50.1%) Additionally, these changes contribute to increased fall risk among the elderly such that greater than one-third of those age 65 and older experience falls annually. Blood pressure changes associated with hypertension contribute to decreased brain and muscle tissue perfusion which, in turn, increases the risk of falls in the elderly. The primary objective of this study is to decrease the number of falls in community dwelling elderly African-Americans with hypertension. The effect of falls can include physical limitations, increased cost of care or even death. This study will help with identification of those elderly African-Americans who are at high risk for falls. This study will offer a basis for developing fall prevention programs to help community dwelling elderly African-Americans maintain independent living and a better quality of life for as long as possible.
This 2 year pilot study; (6/2009 – 5/2011) coordinated by Judy Foxworth, PT, PhD, OCS is funded ($70,000) by the Center for Research to Improve Minority Health and Eliminate Health Disparities through an EXPORT grant (NIH 5P20 MD002303-03)
Effects of Acetabular Labral Tears on Proprioceptive Parameters of the Human Hip Joint
Acetabular labral tears constitute a relatively common pathology in younger, highly active, and athletic populations. While this intraarticular lesion poses significant morbidity and activity restrictions, historically there have been very limited treatment options due to the activity limitations and wear associated with traditional prosthetic arthroplasties. Furthermore, labral tears present diagnostic challenges, even with the advent of newer imaging modalities, and definitive diagnoses often depends on arthroscopic procedures. Though the limitations in activity of the pathology are known, we are aware of no study that investigated differences in balance between labral tear patients and normal controls. We hypothesize that labral tears are associated with decreased hip joint proprioception as quantified with established balance measurements.
Driving Simulation
“When is it safe to resume driving following reconstructive surgery?” Many factors may contribute to answering this question. One of these factors may be reaction time. At highway speeds of 70 mph, a vehicle travels over 100 feet in one second. As a result, a reduction in reaction speed may cause collisions that may otherwise be avoided placing the driver, occupants, and others on the road at increased risk. Reaction time may be divided into several components. These include the cognitive recognition of a stimuli (brake lights), muscle activation leading to generation force in agonist and inhibition of force in antagonistic muscles, release of gas pedal, movement of leg from gas to brake, and full application of braking force. We hypothesize that reconstructive surgery reduces reaction time and that reaction time is recovered at some time following surgery.
Joint Movements in Working Dogs
Working dogs perform a variety of important tasks for the military and law enforcement officials. These special dogs are routinely asked to perform various movements that include explosives detection, patrol and sentry, search and rescue, and missing persons tracking. Due to these physically demanding activities many of these dogs suffer from joint related disabilities. The purpose of the current project is to incorporate multi-slice CT, motion capture, and computer animation to model joint movements in these working dogs. With the information gained from this work, we hope to provide early detection and treatment to minimize loss of man-hours, financial investment, and mission readiness. We are collaborating with researchers from the Virginia-Maryland Regional College of Veterinary Medicine at Virginia Tech, the Center for Biomolecular Imaging at Wake Forest University Baptist Medical Center, and the Department of Fine Art at Winston-Salem State University. (link)
Evaluating Implant Performance
Avascular necrosis of the femoral head accounts for approximately 25% of hip joint replacements. Loss of bony material at the femoral head results in insufficient structure to support overlying joint cartilage. This condition often occurs in relatively young people (20s to 50s). If these young patients receive a total hip replacement, they may require a second surgery to replace the first artificial joint due to normal wear. Femoral head resurfacing is an attractive alternative joint replacement because it conserves the majority of the proximal femur allowing future total joint replacement surgery. Joints that are good candidates for resurfacing must have enough structural integrity to support the implant. Recommendations for use vary from a degenerative pit diameter of less than 1 cm to degeneration of 25% or even 50% of the femoral head. The two most common failure modes for resurfaced hip joints are wear and loosening. The purpose of this investigation is to determine the changes in gait following femoral head resurfacing. Hypothesis: joint kinematics will return to within one standard deviation of normal following surgery.
Quantative Assesment of Surgical Techniques
The use of inter medullar (IM) nails has become the standard of care for treatment of mid-shaft, closed, fractures. Alternate surgical procedures have been developed to implant these IM nails. However, each technique has its own theoretical and/or documented side effects.
Muscle that are detached or displaced during the surgery may become weak. Different muscles are affected depending on the direction of surgical approach. We plan to used gait analysis to quantify differences in gait and physical capability following surgery. We can use this knowledge to help to decide which surgical approach to use in the future.