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Research
Proposal:
The effect of gait training to improve walking performance
in older men and women using the AutoAmbulator™.
Principal
Investigator:
Stephen Sayers, Ph.D., University of Missouri, Department
of Physical Therapy, School of Health Professions
Study Physician:
Joseph Burris, M.D., University of Missouri, School of Medicine,
Department of Physical Medicine and Rehabilitation
Funding
Source: HealthSouth Corporation
Funding
Period: November 1, 2005 – October
31, 2006
Specific
Aim:
To examine whether robotic, gait-assisted therapy can improve
mobility in older adults with walking limitations.
Hypothesis:
A progressive mobility-training intervention using the AutoAmbulator™
will improve clinical measures of gait and mobility performance
compared to conventional training.
Study Rationale:
America is rapidly aging, with more than 35 million men
and women 65 years of age or older, and this number is expected
to double by the year 2030. Currently, more than 5 million
older adults have a physical disability, and with the demographic
shift toward an aging population, these numbers will likely
increase. Older adults with disabilities related to walking
are less likely to maintain independence and have higher
rates of morbidity and mortality. Reducing mobility limitations
could have a large public health impact by keeping older
adults living independently within the community.
Currently, conventional exercise interventions
such as resistance training, overground training and balance
training have demonstrated little effectiveness at improving
mobility in older adults with walking limitations. Because
coordination and movement speed deteriorate with age, conventional
exercise performed by older adults at slower speeds may
not be specific to the requirements of various mobility
tasks. Robotic, gait-assisted therapy, which facilitates
the appropriate gait patterns and movement speeds necessary
for successful ambulation, has the potential to be a highly
successful method to improve mobility in older adults.
Research
Proposal:
Testosterone Screening among Men with Spinal Cord Injury
Principal
Investigator:
Laura Schopp, Ph.D., Department of Health Psychology, School
of Health Professions
Study Physician:
Mike Acuff, M.D., Department of Physical Medicine and Rehabilitation,
School of Medicine
Funding Source:
Spinal Cord Injuries Research Program, Office of the Vice
President for Academic Affairs, University of Missouri-Columbia
Funding Period:
March 1, 2005 – February 28, 2006
Abstract:
Low testosterone levels may cause decreased energy levels
and psychosocial well-being. These factors negatively affect
rehabilitation success and long-term well-being. Although
research has found that 16 to 100 percent of men with spinal
cord injuries have low levels of total testosterone, other
studies have not found differences between men with spinal
cord injuries and those without injuries. The purpose of
this cross-sectional study is to report the total testosterone
levels of men with spinal cord injuries admitted to four
acute inpatient rehabilitation centers. A secondary research
question is to identify sociodemographic, medical and injury
variables related to low total testosterone levels. Men
who meet the eligibility criteria will be enrolled from
the following Missouri facilities: Rusk Rehabilitation Center
in Columbia, Missouri Rehabilitation Center in Mt. Vernon,
St. John’s Regional Health Center in Springfield,
and Sisters of Saint Mary (SSM) Rehabilitation in St. Louis.
The research participants will receive a total testosterone
blood test and a chart review will be conducted to obtain
demographic, injury, and medical data. The frequency and
percentage of participants with low testosterone levels
will be identified. Sociodemographic, injury and medical
variables associated with low testosterone levels will be
collected also. This study will provide information that
may influence the medical treatment of persons with SCI.
Research Proposal:
High Velocity Resistance Training in Older Men and Women
Principal Investigator:
Stephen P. Sayers, Ph.D., Department of Physical Therapy,
School of Health Professions
Study Physician:
Martin K. Childers, D.O., Ph.D., Department of Physical
Medicine and Rehabilitation, School of Medicine
Funding Source:
NIH (R03)
Award Number:
1 R03 AG025141
Funding Period:
February 1, 2005 – January 31, 2007
Specific Aim:
The primary aim of this research is to examine the efficacy
of a novel RT protocol in functionally limited older adults
at risk for subsequent physical disability. Specific aims
are to: 1) examine velocity training in older adults to
determine its effect on strength, velocity and muscle power
output at various functional resistances, and 2) examine
velocity training in older adults to determine its effect
on functional performance and physical disability compared
to traditional strength training.
Research Proposal:
Treatment of Knee Osteoarthritis with High Velocity Resistance
Principal Investigator:
Stephen P. Sayers, Ph.D., Department of Physical Therapy,
School of Health Professions
Study Physician:
Martin K. Childers, D.O., Ph.D., Department of Physical
Medicine and Rehabilitation, School of Medicine
Funding Source:
Arthritis Foundation
Funding Period:
January 1, 2006 – December 31, 2006
Short Abstract:
The number one medical condition in the U.S. contributing
to more chronic disability in older adults is knee osteoarthritis
(OA). A primary focus of rehabilitation in older adults
with OA has been strength training using moderate to heavy
resistance. Yet, this traditional approach has been shown
to improve functioning in only some studies, and these effects
have been small to moderate. Several of our studies suggest
that the speed at which muscles move is more important to
performing functional tasks than how strong the muscles
are. We plan to explore a unique weight-training program
for men and women 65 years or older that stresses high speed
training using moderate resistance. We will compare high
speed weight-training with traditional strength training
in 53 older men and women with knee OA to determine which
method has the greatest effects on muscle strength, speed
of movement, functional performance, physical disability,
and joint pain and stiffness. We believe that high speed
training may change the way weight-training exercise is
practiced in the community and prescribed in the clinic
for older adults with knee OA.
Research Proposal:
High Speed Resistance Training in Older Adults with Knee
Osteoarthritis
Principal Investigator:
Stephen P. Sayers, Ph.D., Department of Physical Therapy,
School of Health Professions
Study Physician:
Martin K. Childers, D.O., Ph.D., Department of Physical
Medicine and Rehabilitation, School of Medicine
Funding Source:
American College of Rheumatology Research & Education
Foundation
Funding Period:
January 1, 2006 – December 31, 2007
Abstract:
Resistance training with a strengthening component has been
a primary focus of knee osteoarthritis rehabilitation; however,
traditional resistance training has demonstrated only modest
effects on measures of function, pain, and disability. Data
now suggest speed of movement (velocity) may exert beneficial
effects on the arthritic knee compared to slow speed contractions
and may be more important to functional performance than
strength. The proposed study will compare velocity training
to traditional resistance training in a randomized, single-blind
controlled intervention trial consisting of a 12-week laboratory-based
resistance training intervention followed by 3 months of
self-directed exercise. 53 men and women 65 years or older
with knee osteoarthritis will be randomized into one of
three groups, velocity, training, strength training, or
control. Training will consist of 3 sets of 8-10 repetitions
at 40% (velocity training) or 80% (strength training) of
maximal strength using leg press and knee extension exercises
3 times per week for 12 weeks. The control group will perform
lower extremity range of motion and flexibility exercises
twice per week. Baseline measures of muscle strength, power,
contraction velocity, functional performance, and self-reported
pain and disability will be collected prior to randomization.
Changes in these outcome measures will be compared among
groups at 12 weeks and at 3-months follow-up. To test the
hypothesis that there will be differences across groups,
a 3x3 (group x time) analysis of covariance (ANCOVA) with
repeated measures over time will be used for each dependent
variable. Statistical significance will be accepted at p<0.05.
There is a critical need to investigate alternatives to
traditional strength training and identify the most appropriate
strategy to improve measures of function and disability
and reduce pain in this population. These findings could
change the way resistance training exercise is practiced
in the community and prescribed in the clinic.
Research Proposal:
Graduate Psychology Education Program
Principal Investigator:
George Johnstone, Ph.D., Department of Health Psychology,
School of Health Professions
Study Physician:
Robert R. Conway, M.D., Department of Physical Medicine
and Rehabilitation, School of Medicine
Funding Source:
Health Resources Service Administration (HRSA)
Funding Period:
September 1, 2004 – August 31, 2007
Purpose:
Consistent with the goals of Healthy People 2010 (Chapter
6), the purpose of the Rural Missouri Rehabilitation Psychology
Internship Program is to improve the health outcomes of
persons with disabilities, and increase their access to
psychological services in rural areas.
Objectives:
1) Improve access to quality health care through appropriate
preparation of rehabilitation psychologists, pediatric neuropsychologists,
and adult neuropsychologists to support quality primary
care in underserved, rural counties of Missouri; and 2)
Improve access to a diverse and culturally competent and
sensitive psychology workforce in rural areas by a) increasing
the number of minority interns; and b) providing training
in rural cultural issues through didactics and clinical
practicum with rural interdisciplinary health care teams.
Need:
There are an estimated 54 million Americans with disabilities,
many who are in need of psychological services, and particularly
in rural areas. Although 32% of Missourians (1.7 million
people) live in rural counties, there are only 11 board
certified rehabilitation/neuropsychologists in the state
(only 1 in a rural county). Although the MU Department of
Health Psychology (DHP) has been the primary training site
in Missouri for rehabilitation/neuropsychologists since
1986, the DHP has not been able to fund interns since 2000
because of intern billing restrictions.
Curriculum/Experiential
Training:
Interns will participate in one of three training tracks:
a) pediatric neuropsychology; b) adult neuropsychology;
or c) rehabilitation psychology. The training year will
be divided into 3 major rotations (75% effort, 4 months
duration) and 2 minor rotations (25% effort, 6 months duration).
All clinical and didactic training is interdisciplinary
(i.e., physicians; rehabilitation therapists; vocational
counselors; school staff, etc.). Interns will participate
in all APA Accredited Missouri Health Sciences Psychology
Consortium training experiences, including DHP didactics,
which follow APA Division 22 and 40 training guidelines.
Setting:
The primary training will occur at Rusk Rehabilitation Center
(RRC), a 60 bed inpatient rehabilitation center that serves
the primarily rural counties of central Missouri, and the
Missouri Rehabilitation Center (MRC) in Mt Vernon, a 136
bed inpatient rehabilitation hospital in one of the most
rural areas of Missouri. Trainees will also provide psychological
services to 6 state Division of Vocational Rehabilitation
(DVR) offices in rural Missouri, which serve 37 rural counties,
28 of which are in Medically Underserved Areas.
Resources:
Interns will have access to all the resources of the APA
Accredited Missouri Health Psychology Consortium; MU Health
Care System (Schools of Medicine, Nursing, Health Professions);
Rusk Rehabilitation Center; and the Missouri Rehabilitation
Center.
Faculty Supervisors:
Interns will be supervised by the10 DHP faculty members,
including 6 board certified rehabilitation/neuropsychologists
(over 50% of board certified NP/RP in MO).
Evaluation:
The program will be evaluated in terms of the number of
interns who complete the internship; the number eventually
employed in rural areas, and a qualitative assessment by
referral sources, rural agencies, and other rural community
stakeholders.
Research Proposal:
Leupeptin in a Canine Model of Duchenne Muscular Dystrophy
Principal Investigator:
Martin K. Childers, D.O., Ph.D., Department of Physical
Medicine and Rehabilitation, School of Medicine
Co-PI: Joe
Kornegay, Ph.D.
Funding Source:
NIH (1 R21 NS050135)
Funding Period:
July 1, 2005 – June 30, 2007
Purpose:
This study seeks to determine efficacy of the calpain inhibitor,
leupeptin, in the treatment of Duchenne Muscular Dystrophy
(DMD) using a canine model.
Research Proposal:
Center for Religion, the Professions, and the Public
Principal Investigator:
Edmund Lambeth, Director, Center for Religion, the Professions, and the Public
Study Physician: Jon Rupright, D.O., Department of Physical Medicine and Rehabilitation
Funding Source: The Pew Charitable Trusts
Funding Period: March 1, 2006 – February 28, 2008
Purpose:
To strengthen religion journalism by research, student instruction, and creative activity that advance democratic values in the new century;
To foster constructive public discourse about issues of religion and public;
To foster research, teaching, and public dissemination of new knowledge and information about the relationship among religion, religiousness, and the coping abilities of persons disabled by long-term injuries and diseases – a pioneering direction in the scholarship and instruction related to spirituality and health. This goal is especially important as Americans live longer in a cultural environment of increased religious diversity;
To create an MU Consortium on Professional Ethics to provide settings to discuss issues and define questions for research and teaching that are non-sectarian in nature, but have engaged citizens concerned in various ways about the relationship of religion and public life.
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