Research

Falling in older adulthood can lead to significant injuries that can cascade into further health problems. Unfortunately, the risk of falling also increases with age, and with the development of many different diseases. Research in our school seeks to better understand balance and falls with aging and disease (e.g., diabetes and multiple sclerosis), and to determine effective strategies for decreasing falls risk.

Selected Publications

1. Morrison, S., Simmons, R., Colberg, S.R., Parson, H.K., and Vinik, A.I. (2018). Supervised Balance Training and Wii Fit-Based Exercises Lower Falls Risk in Older Adults with Type 2 Diabetes. Journal of the American Medical Directors Association, 19,(2) 185.e7-185.e13.
2. Morrison S, Colberg SR, Parson HK, Vinik AI. Relation between risk of falling and postural sway complexity in diabetes. Gait and Posture, 2012; 35:662-668.
3. Sosnoff JJ, Socie MJ, Boes MK, Sandroff BM, Pula JH, Suh Y, Weikert M, Balantrapu S, Morrison S, Motl RW. Mobility, balance and falls in persons with multiple sclerosis. PLoS ONE, 2011; 6(11):e28021.
4. Morrison S, Colberg SR, Mariano M, Parson HK, Vinik AI. (2010). Balance training reduces falls risk in older individuals with type 2 diabetes. Diabetes Care, 2010; 33(4):748-750.

Walking is a ubiquitous activity across humans and is critical for maintaining independence. Research in our school aims to better understand how healthy individuals control gait and how this changes with musculoskeletal or neurological disorders and with aging. This knowledge is being used to develop efficacious gait training for individuals with movement disorders.

Selected Publications

1. Russell DM, Haworth JL. Walking at the preferred stride frequency maximizes local dynamic stability of knee motion. Journal of Biomechanics, 2014; 47:102-108.
2. Kott K, Held SL, Giles EF, Franjoine MR. Predictors of Standardized Walking Obstacle Course outcome measures in a sample of children with and without developmental disabilities. Pediatric Physical Therapy, 2011; 23:365-373.
3. Russell DM, Kalbach CR, Massimini CM, Martinez-Garza C. Leg asymmetries and coordination dynamics in walking. Journal of Motor Behavior, 2010; 42:157-168.
4. Kavanagh JJ, Barrett RS, Morrison S. Age-related differences in head and trunk coordination during walking. Human Movement Science. 2005; 24(4):574-587.

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Individuals of all ages have tremor, although for most of us this is unnoticeable unless we are performing a motor task like threading a needle which requires a degree of finesse and manual dexterity or if we are tired and fatigued. For healthy individuals, any tremor is usually very small and hardy noticeable to the human eye. It only becomes more noticeable physically amplified, as can often be seen for persons who develop diseases such as Parkinson's disease or Essential Tremor. Under these situations, tremor can have a major negative impact on a person's quality of life. Our research is focused on understanding the mechanisms of tremor in healthy adults of all ages and how this differs for persons with diseases such as Parkinson's or essential tremor. We are also interested in whether specific tremor forms can be modified with targeted exercises and training.

Selected Publications

1. Morrison, S., Kavanagh, J.K., and Newell, K.M (2019). Cross-limb dynamics of postural tremor due to limb loading to fatigue: neural overflow but not coupling. Journal of Neurophysiology, 122(2), 572-584.
2. Morrison, S., Kavanagh, J., and Newell, K.M (2017). Differences in Postural Tremor Dynamics with Age and Neurological Disease. Experimental Brain Research, 235, 1719-1729.
3. Keogh JWL, O'Reilly S, O'Brien E, Morrison S, Kavanagh JJ (2019) Can Resistance Training Improve Upper Limb Postural Tremor, Force Steadiness and Dexterity in Older Adults? A Systematic Review. Sports Med 49:1199-1216
4. Morrison, S., N. Cortes, K.M. Newell, P.A. Silburn, and G. Kerr, (2013). Variability, regularity and coupling measures distinguish PD tremor from voluntary 5 Hz tremor. Neuroscience Letters. 534: p. 69-74.

Athletes with lower extremity joint injuries commonly return to sport before all structure and functional impairments are resolved. Additionally, athletes commonly experience recurrent injury and chronic joint instability, particularly following an ankle sprain. Thus, within our School, we aim to determine the influence of residual impairments on recurrent injury and chronic instability. Large-scale, community-based studies involving high school and collegiate athletes and clinical athletic trainers examine the predictive value of common clinical evaluations techniques used by athletic trainers. Information from this area can improve long-term outcomes for injured athletes and improve the efficiency of care provided by athletic trainers.

Evidence-based practice and patient-centered care are emergent concepts in both Athletic Training and Physical Therapy. To contribute to these concepts, several lines of research within our School are dedicated to advancing our knowledge of the best practices related to the evaluation, management, and prevention of injuries; particularly related to the lower extremity. Another emphasis area is specifically related to patient-centered healthcare and understanding how patient-reported outcome measures can be best incorporated into injury evaluation and management. In addition to the original research studies dedicated to this area, faculty and students are regularly performing systematics reviews, meta-analyses, and critically appraised topics to synthesize and interpret the existing evidence in the field.

Selected Publications

1. Hoch JM, Druvenga B, Ferguson B, Houston MN, Hoch MC. Patient-reported outcomes in male and female collegiate soccer athletes during an athletic season. Journal of Athletic Training. In Press.
2. Houston MN, Van Lunen BL, Hoch MC. Health-related quality of life in individuals with chronic ankle instability. Journal of Athletic Training. In Press.
3. Gilbreath JP, Gaven SL, Van Lunen BL, Hoch MC. The effects of mobilization with movement on dorsiflexion range of motion, dynamic balance, and self-reported function in individuals with chronic ankle instability. Manual Therapy, 2014; 19(2):152-157.
4. Paszkewicz J, McCarty CW, Van Lunen BL. Comparison of functional and static evaluation tools among adolescent athletes. Journal of Strength and Conditioning Research, 2013; 27(10):2842-2850.
5. Facchini S, Ferguson B, Hoch JM. Outcomes following ACL reconstruction utilizing the quadriceps tendon autograft: a critically appraised topic. International Journal of Athletic Therapy & Training, 2014; 9(4):3-9.
6. Farwell KE, Powden CJ, Powell MR, Welch McCarty C, Hoch MC. The effectiveness of prophylactic ankle braces in reducing the incidence of acute ankle injuries in adolescent athletes: A critically appraised topic. Journal of Sport Rehabilitation, 2013; 22(2):137-142.

Advancing the outcomes related to educational competency development and implementation for students currently enrolled in AT and PT programs is pivotal for advancement in each respective field. Understanding effective methods to provide continuing education to practicing clinicians is also critical for professional advancement and provides unique challenges for educators. These areas are particularly concerning for developing competency in evidence-based practice in all clinicians and health professions. Several research projects in our School are dedicated specifically to educational competency development and implementation in the area of evidence-based practice. Other areas of educational research are related to understanding the role of preceptors and clinical education coordinators in educational outcomes and understanding the appropriate entry-level degree for AT education.

Selected Publications

1. Welch CE, Hankemeier DA, Wyant AL, Hays DG, Pitney WA, Van Lunen BL. Future directions of evidence-based practice in athletic training: perceived strategies to enhance the use of EBP. Journal of Athletic Training, 2014; 49(2):234-244.
2. Welch CE, Van Lunen BL, Hankemeier DA, Thornton A, Mutchler J, Pitney W, Hays D. Perceived outcomes of web-based modules designed to enhance athletic trainers' knowledge of evidence-based practice Journal of Athletic Training, 2014; 49(2):220-233.
3. Hankemeier DA, Walter JM, McCarty CW, Newton EJ, Walker SE, Pribesh SL, Jamali BE, Manspeaker SA, Van Lunen BL. Use of evidence-based practice among athletic training educators, clinicians, and students, Part 1: Perceived importance, knowledge, and confidence. Journal of Athletic Training, 2013; 48(3):394-404.
4. Hankemeier D, Van Lunen BL. Perceptions of approved clinical instructors: barriers in the implementation of evidence-based practice. Journal of Athletic Training, 2013; 48(3):382-393.
5. Manspeaker SA, Van Lunen BL, Turocy P, Pribesh S, Hankemeier DA. Student knowledge, attitudes, and use of evidence-based concepts following an educational intervention. Athletic Training Education Journal, 2011; 6(2):88-98.

Sports related concussions represent a significant risk when participating in athletic activities. Following concussion, most symptoms typically last for approximately 7 to 10 days. However, there are also long-term consequences of repeated head contact which include depression, central nervous system impairment and mild cognitive impairment. Even after recovery, the effects of head trauma can persist, as concussed athletes are at increased risk for lower extremity injury when they return-to-play. The goal of the IPLAI (Improving Participation, Limiting Athletic Injuries) lab group is to develop a greater understanding of techniques and strategies to limit athletic injury and maintain participation.

Selected Publications

1. Schussler E, Stark D, Kang YS, Bolte J, Onate J. Comparison of a head mounted impact measurement device to the Hybrid III anthropomorphic testing device in a controlled laboratory setting. International Journal of Sports Physical Therapy, 2017; 12(4):592-600.
2. Clifton D, Djoko A, Schussler E, Kerr Z, Onate J. Epidemiology of knee sprains in youth, high school, and collegiate American football. Journal of Athletic Training, 2017; 52(5):464-473.
3. Onate J, Starkel C, Clifton D, FPPE Group (Best T, Borchers J, Chaudhari A, Comstock D, Cortes N, Grooms D, Hertel J, Hewett TE, Miller M, Pan X, Schussler E, Van Lunen B). Normative functional performance values in high school athletes (The FPPE Project). Journal of Athletic Training, (in press).

Perceptual information about the environment and the body is critical in guiding action, and can be used to stimulate and alter movements. We are investigating how visual, auditory and somatosensory information is used in the performance of different movements. Further research in our school is also determining how virtual environments or rhythmic auditory stimulation can be employed to enhance gait in individuals with neurological problems, such as stroke, cerebral palsy, peripheral neuropathy and Parkinson's disease.

Selected Publications

1. Wood, T.A., Morrison, S., and Sosnoff, J.J (2019). Can Sports Medicine Research on Concussion Provide Insight into Traumatic Brain Injuries in Older Adults? Frontiers in Medicine, 6, 53.
2. Russell DM, Greska EK, Kelleran KJ. Visual flow alters gait in treadmill walking. Journal of Sport and Exercise Psychology, 2013; 35:S48.
3. Katsumata H, Russell DM. Prospective versus predictive control in timing of hitting a falling ball. Experimental Brain Research, 2012; 216:499-514.
4. Walker M, Ringleb S, Maihafer G, Walker R, Crouch JR, Van Lunen B, Morrison S. Reality enhanced partial body-weight supported treadmill training post stroke: Feasibility and effectiveness in six individuals. Archives of Physical Medicine and Rehabilitation, 2010; 91:115-122.
5. Kott K, Lesher K, DeLeo G. Combining a virtual reality system with treadmill training for children with cerebral palsy. Journal of Cybertherapy and Rehabilitation, 2009; 2:35-42.

Several joint injuries are associated with residual deficits in both sensory and motor aspects of function. Further defining sensorimotor alterations following injury may lead to novel intervention strategies to enhance short-term recovery, reduce the long-term implications, and prevent many injuries. The research conducted in our School is primarily focused on sensorimotor issues related to ankle and knee injuries. Specifically, recent studies have focused on somatosensory alterations, functional movement patterns, and changes in biomechanics related to chronic ankle instability and anterior cruciate ligament injuries. In addition to defining new areas of sensorimotor compromise, research is also being conducted to identify novel strategies to address these types of impairments and activity limitations in individuals with an injury history or those at risk.

Selected Publications

1. Powell MP, Powden CP, Houston MN, Hoch MC. Plantar cutaneous sensitivity and balance in those with and without chronic ankle instability. Clinical Journal of Sports Medicine. In Press.
2. Hoch MC, Farwell KE, Gaven SL, Weinhandl JT. Weight-bearing dorsiflexion range of motion and landing biomechanics in individuals with chronic ankle instability. Journal of Athletic Training. In Press.
3. Hoch MC, Mullineaux DR, Andreatta RD, McKeon JM, Mattacola CG, English R, McKeon PO. Effect of a 2-week joint mobilization intervention on instrumented measures of single-limb balance and ankle mechanics in those with chronic ankle instability. Journal of Sport Rehabilitation, 2014; 23(1):18-26.
4. Quammen D, Cortes N, Van Lunen, BL, Lucci S, Ringleb SI, Onate J. Two different fatigue protocols and lower extremity motion patterns during a stop-jump task. Journal of Athletic Training, 2012; 47(1):32.
5. Cortes N, Morrison S, Van Lunen BL, Onate JA. Landing technique affects knee loading and position during athletic tasks. Journal of Science and Medicine in Sport, 2012; 15(2):175-181.