New lab propels USF Physical Therapy research

Equipment matters in the world of research. And when it comes to winning major research grants, having a full cadre of state-of-the-art technology is a must.

That’s why the new Human Functional Performance Laboratory in USF’s School of Physical Therapy and Rehabilitation Sciences is so important. Without it, much of the funded research for the young school would not exist and hope for future funding would be wasted.

“This type of laboratory is required for many translational and clinical studies, so to be part of cutting edge research, you have to have a cutting-edge lab,” said William S. Quillen, PT, PhD, associate dean in the College of Medicine, and professor and director of the School of Physical Therapy and Rehabilitation Sciences. Dr. Quillen has worked to create the Human Functional Performance Laboratory since joining USF in 2004.

Dr. William Quillen at the Lab’s entrance.

The Human Functional Performance Laboratory features equipment specially designed to assess human movement and function, including the basic functions of walking, balance, range of motion, and endurance.

Nearly 6,000 square feet of space is devoted to the Human Functional Performance Laboratory, which is housed in the School of Physical Therapy and Rehabilitation Sciences area of the MDT building on the USF campus. Six key areas include muscular strength and endurance, posture and joint assessment, gait, electromyography and advanced musculoskeletal imaging, functional evaluation, applied cardiopulmonary testing, and applied neurosensory testing (see descriptions of each below).

“The equipment in the Human Functional Performance Laboratory is crucial to giving faculty a competitive edge when they apply for grant funding,” said Rebecca Miro, research administrator for the School of Physical Therapy and Rehabilitation Sciences.

Miro’s main job is to find grants that fit the expertise of the School’s faculty who use the lab and the connection between having a fully equipped lab and successfully competing for major grants is obvious to her.

“The majority of research applications require details about what type of equipment the faculty has at his/her disposal that allows them to carry out the research,” she said. “Having the latest equipment greatly expands the research opportunities.”

A lab of this caliber also helps recruit top-tier faculty.

“Such a comprehensive lab is an advantage in faculty recruitment and a tour of our Human Functional Performance Laboratory is given during each recruitment visit,” Dr. Quillen said. “Any faculty member considering the USF School of Physical Therapy and Rehabilitation Sciences knows that he/she will have access to cutting edge equipment, which will greatly expand their research.”

Consider the following examples of innovative research that is impacting the lives of amputees, diabetes patients and stroke patients.

Jason Highsmith, DPT, assistant professor, in the School of Physical Therapy and Rehabilitation Sciences, is looking at the effectiveness of certain devices and therapies in helping amputees improve their gait.

“Recently, we used the Gaitrite portable walkway system in the Human Functional Performance Laboratory  to determine side to side differences in individual amputee gait,” Dr. Highsmith said. “Essentially, we were able to confirm that amputees tend to take a shorter sound side step and the Gaitrite clarified that the sound side step is notably shorter in duration as opposed to length. Our conclusion was that amputees are seeking symmetry with the length of the step but prefer to bear weight only as long as necessary possibly due to discomfort or instability in the prosthesis. This has implications in planning interventions and therapies to improve amputee gait.”

Dr. Jason Highsmith helps amputees improve their gaits.

Dr. Highsmith was recently awarded a contract from the well-known prosthetics firm Otto-Bock to conduct research on a microprocessor prosthetic knee, which is in the final stages of development. The study was leveraged further by a matching grant from the Florida High Tech Corridor.

Another example comes from Heather Hartsell, PT, PhD, associate professor in the School of Physical Therapy and Rehabilitation Sciences. Dr. Hartsell is using AcuStep to measure pressure points on the feet of diabetes patients. An insole with 99 sensors is placed in the shoes of patients, who then walk in the lab in order for the insole to gather data. The data is transferred from the insole to a computer that uses imaging software to determine where pressure is taking place at different points on the foot. Dr. Hartsell then sends the data to a company that fabricates custom orthotics.

“The AcuStep is great for diabetes patients because it will help find these pressure points early, before they develop into the peripheral neuropathy that typically plagues diabetes patients and leads to amputation down the road, Dr. Hartsell said. “These patients already have reduced circulation and sensation in their feet, so finding pressure points early on minimizes their pain and more serious problems later.”

 

Dr. Heather Hartsell.

Her work also carries over to professional athletes, who suffer with foot problems from years of wearing shoes that offer no real support, she said. She is coordinating several studies that will look at this population, specifically professional baseball players.

 

Dr. Heather Hartsell attaches the AcuStep insole. Data is collected to determine foot pressure points.

Seok Hun Kim, PT, PhD, assistant professor in the School of Physical Therapy and Rehabilitation Sciences, is using the split belt treadmill in the Motion Analysis core of the Human Functional Performance Laboratory for research that aims to help amputees, as well as stroke patients, retrain their brains to regain normal gait patterns. Patients walk on the treadmill as the two belts move at differing speeds, which requires the affected side to make corrections that result in a more normal gait.

“We are testing our theory that stroke patients can receive rehabilitation that will normalize their asymmetric gait pattern,” Dr. Kim said. “We are currently working with (the College of) Engineering to develop a device to be used along with the split belt treadmill that can measure, and also correct, the posture of stroke patients, who typically lean as they walk to compensate for their affected side.”

John Mayer, DC, PhD, associate professor in the School of Physical Therapy and Rehabilitation Sciences and Lincoln Endowed Chair in Biomechanical & Chiropractic Research, focuses on functional assessment and rehabilitation of musculoskeletal disorders, particularly in the low back. Dr. Mayer’s specific interests include research on low back injury prevention in firefighters and the military. Dr. Mayer states, “Low back pain is the most common, costly, and disabling musculoskeletal disorder in the nation, and affects all segments of society including our military personnel and first responders. Our research aims to develop and test innovative prevention and treatment strategies for this disorder.”

The following is a listing of the equipment within the Human Functional Performance Laboratory. One of the highlights is found in the Motion Analysis Laboratory, which has the Vicon Camera System that features eight cameras that track every movement from numerous angles. The multiple cameras collect data in real time to measure kinetic (force) and kinematic (motion). The data is used by computer software to displays those motions as 3-D human form, helping staff analyze that movement. The cameras were used in the making of a recent Oscar-winning film.

BodPod
   • State-of the-art system for assessing body composition
   • Generates a highly accurate measure of body composition (including % body fat and fat-free mass) in a few minutes. Unlike other validated body composition assessment instruments, the BodPod is non-invasive and easy to administer.
   • Practical gold standard for body composition assessment that can be used for a wide variety of individuals, including athletes, children, older adults, the obese, and those with physical disabilities.
Muscular Strength and Endurance
   • BIODEX computerized dynamometer: skeletal muscle performance in isokinetic, isometric and isotonic modes.
   • MedX cervical and lumbar exercise testing and training dynamometers: spinal muscle strength, endurance, and range of motion.
Posture and Joint Assessment
   • BIODEX Balance System SD force platform: posturography.


   • Medmetric KT-2000 ligament laxity arthrometer.
Gait
   • GaitRite Mat
   • Bertec Split Belt Instrumented Treadmill
   • Vicon 8 Camera Motion Analysis System
   • AcuStep
Electromyography and Advanced Imaging
   • Grass stimulator: skeletal muscle stimulation
   • Noraxon Myosystem 12 channel telemetric surface and needle EMG system with foot switch and electric goniometric inputs: isolated muscle performance, gait, and joint range of motion.
   • Biosound MyLab25 diagnostic ultrasound with Doppler: soft tissue morphology, vascular perfusion, and muscle activation.
Functional Evaluation
   • Physical Functional Performance-10 Test: validated assessment of ability to perform common activities of daily living
   • EPIC Lift Capacity workstation
Applied Cardiopulmonary Testing
   • Integrated cardiopulmonary stress testing system with two breath-by-breath gas exchange analysis systems  SensorMedics, Vmax 229, metabolic cart for measuring ventilation, oxygen uptake, cardiac output,  and pulmonary function (spirometry, lung volumes/capacities, and lung diffusion capacity);
   •  COSMED K4b2 portable metabolic system, which can provide energy expenditure measures during functional activities or in field-testing settings
   • 12-lead electrocardiograhic stress system (Quinton Q Stress) with treadmill and cycle ergometer.
   • Pulse oximeter for % arterial oxygen saturation measurements.
Applied Neurosensory Testing
   • Neurothesiometer (Scientific Laboratories)

Story by Sarah A. Worth, Photos by Eric Younghans, USF Health Office of Communications

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