CUA
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NRH
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The Catholic University of America |
National Rehabilitation Hospital |
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Neuromuscular Systems |
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The focus of this track is to take a basic sciences approach to studying the behaviors of neurological and musculoskeletal systems, in hopes of understanding their function in a healthy state, as well as after neurological injuries such as stroke and spinal cord injury. The goal is to transfer the knowledge gained in these studies directly into the clinics so that our patients will have the best possible chances to make meaningful recoveries. |
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Current Projects
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Assessing motor function after stroke
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PROJECT DESCRIPTION:
After a stroke, patients have difficulty activating and coordinating muscles to perform basic movements. Our goal is to analyze reaching movements and hand functionality of stroke patients in the in-patient setting. Patients are instructed to perform basic arm, hand, and finger movements as best as they can. By using kinematic and dynamometry data, motor control of the arm and hand can be quantified and analyzed. Measures are obtained at two time points, upon admittance to the hospital and before discharge, to assess recovery of motor function. Experimental measures are then compared to traditional clinical measures of stroke to determine any possible correlations. |
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| PERSONNEL |
T. Metzger, A. Dromerick, L. Monroe, and P. Lum |
| FUNDING SOURCE |
Department of Defense |
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Motor control of upper extremity prosthetic users
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PROJECT DESCRIPTION:
Upper extremity amputees have to adjust to the limited proprioceptive nature of the residual limb and inertial properties of the prostheses to perform reaching tasks. Our goal is analyze the reaching movements of prosthetic users to determine the role of vision and proprioception. Using a horizontal planar robotic manipulandum, upper extremity prosthetic users are first asked to reach to targets with real-time visual feedback. Occlusion of the prosthetic limb is then implemented to eliminate the role of vision, thus forcing the individual to rely on proprioception to reach to the same targets. Endpoint error, trajectory error, and variability are calculated to quantify overall performance of the individual. Performance of prosthetic users is compared to age-matched controls to determine any significant differences. |
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| PERSONNEL |
T. Metzger, A. Dromerick, C. Schabowsky, R. Holley, L. Monroe, A. Markotic, and P. Lum |
| FUNDING SOURCE |
Department of Defense |
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Autonomic dysreflexia in SCI: effects on blood flow and skin oxygen levels
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PROJECT DESCRIPTION:
More than half of individuals with spinal cord injury (SCI) will experience a decubitus ulcer (also known as a pressure sore) in their lifetime. If left untreated, pressure sores can lead to immobility, surgery, and in extreme cases, serious infections resulting in death. It is therefore not surprising that in the United States alone, pressure sore related health care costs were estimated at between 2.2 and 3.6 billion dollars in 2005. While factors such as temperature, nutrition, and moisture have been shown to be important factors leading to pressure sores, ischemia, the decrease in blood supply to the skin and underlying tissues has been connected to dermal failure. Ischemia has traditionally been attributed to pressures on the skin, particularly over bony prominences but there is another factor common to spinal cord injury that may also be playing a significant role. Autonomic Dysreflexia (AD) is an inappropriate response of the sympathetic nervous system that occurs when SCI patients with T6 injury level or above are subjected to a noxious stimulus below the level of injury. An AD event can be put into motion by something as simple as an ingrown toenail or a full bladder, with symptoms ranging from headache, high blood pressure, and even stroke. An AD event impacts the skin in several ways; AD will cause an increase in skin moisture and partial ischemia due to vasoconstriction below the injury level. Additionally, we have found in our pilot studies that during an AD event, the amount of oxygen to the skin drops by as much as 40%. We hypothesize that in individuals with spinal cord injuries at or above T6, the combination of pressure related ischemia combined with AD-related ischemia and increased perspiration places these individuals at significant risk for developing a pressure sore below the injury site. The research will for the first time quantify the effects of Autonomic Dysreflexia on blood flow, oxygen levels, skin moisture and skin temperature in individuals with upper thoracic, and cervical spinal cord injuries. If our hypothesis is correct, it has strong clinical implications where individuals with SCI will need to be better educated at detecting the early signs of AD as well of its management in order to minimize the risks for developing pressure ulcers. |
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| PERSONNEL |
J. Ramella-Roman (Catholic University) and J. Hidler |
| FUNDING SOURCE |
Christopher and Dana Reeve Foundation |
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