1998 — 2002 |
Henry, Sharon M |
K01Activity Code Description: For support of a scientist, committed to research, in need of both advanced research training and additional experience. |
Low Back Pain: a Motor Control Impairment? @ University of Vermont &St Agric College
The candidate for this Mentored Research Scientist Development Award, Sharon M. Henry, Ph.D. PT, is a physical therapist. Her clinical work covers the rehabilitation of persons with neurological and musculoskeletal impairments particularly low back pain (LBP). She has assisted with several clinical studies of LBP patients conducted through the Rehabilitation Engineering Center (REC) for LBP at the University of Vermont (UVM). Being interested in the role of somatosensory information in motor control, Dr. Henry proceeded to earn her Ph.D. in the Anatomy and Neurobiology Department at UVM, and completed her post- doctoral fellowship with Dr. Fay Horak in Portland OR. During this time, Dr. Henry received three post-doctoral awards and completed studies examining postural responses in healthy and spinal cord injured subjects. Her long term goals include examining motor control issues in patients with musculoskeletal impairments, specifically LBP. As a researcher and clinician, Dr. Henry wishes to contribute to the field of medical to the field of medical rehabilitation and conduct research that will impact on the way physical therapists and other rehabilitation specialists treat patients. Dr. Henry has a position as assistant professor in the Physical Therapy Department at UVM. The Department has committed to starting a new 2100 square foot state-of-the-art Motion Analysis Laboratory and has committed to fostering Dr. Henry's career as an independent investigator. Within the Department, there are several other faculty members who are involved in motor control and LBP research. In addition, there is an active scientific community on campus through the REC that has been conducting LBP research since 1982. The studies proposed in this application reflect a merging of Dr. Henry's background and interests. It has long been thought that poor neuromuscular control of trunk muscles may lead to injury by causing local mechanical damage to spinal structures, and thus, LBP. However, little is known about the function of specific trunk muscles in normal subjects during various activities of daily living (Specific aim 1), and the precise muscle dysfunction associated with LBP has not been satisfactorily characterized (Specific aim 2). Therefore, a better understanding is needed of when trunk muscles in active spinal and postural stabilization in healthy and in selected groups of persons with LBP. This goal will be achieved by characterizing muscle, kinematic, and force strategies used to control truck/spine in postural responses to multi-directional, multi-velocity surface translations. By having a better understanding of trunk motor coordination, evaluation and treatment strategies can be more specific and more effective in the rehabilitation of persons with LBP.
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2003 — 2010 |
Henry, Sharon M |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Mechanisms of Specific Trunk Exercises in Low Back Pain @ University of Vermont &St Agric College
[unreadable] DESCRIPTION (provided by applicant): Poor neuromuscular control, such as delayed muscle recruitment or alterations in levels of muscle activation, can lead to abnormal loads on joints and ligaments of the spine, leading to spinal instability and lower back pain (LBP). Active contraction of trunk muscles helps to control inter-segmental movement and stability in the lumbar spine by adding stiffness to the trunk. Muscle dysfunction associated with LBP has been thought to involve deep, local trunk muscles - the transversus abdominis (TA) and multifidus muscles. These muscles are hypothesized to provide stability to the lumbar spine. Treatments which focus on retraining TA and multifidus by using low level isometric contractions of these specific deep trunk muscles during particular tasks and functional activities have been effective at reducing LBP and improving function for selected subgroups of LBP subjects. The precise muscle dysfunction associated with LBP has not been satisfactorily characterized, in part because muscles such as TA and multifidus are difficult to characterize directly given their anatomical location. However, analytical modeling can assist in characterizing these deeper muscles. A more complete characterization of the function of these muscles can lead to more precise treatments of LBP. [unreadable] [unreadable] The three major aims of this project are: 1) to characterize the pre-treatment motor control alterations (alterations in muscle latencies or in modulation of muscle activity level) in subjects with spondylolisthesis and mechanical LBP compared to healthy control subjects, and to determine whether specific deep trunk-muscle exercises (low level isometric contractions of TA and multifidus) improve these alterations compared to a general exercise protocol. We hypothesize that prior to treatment, muscle latencies will be earlier in LBP groups compared to the control group and that the latencies will improve (increase) in LBP subjects receiving specific trunk exercise protocol but not in subjects receiving a general exercise protocol at all time points post-treatment; 2) to employ biomechanical modeling to study mechanisms underlying these specific deep trunk muscle exercises. We hypothesize that increased activation of TA and multifidus muscles increases stability of the trunk by reducing intervetebral motion; and 3) to determine the effects of specific trunk exercises compared to more general strengthening and endurance exercises on pain and function during activities of daily living in the LBP subjects. We hypothesize that subjects in a specific exercise protocol will have decreased pain and increased functional ability compared to subjects in a general exercise protocol, at all time points post-treatment.
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