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Muscle Performance (MP) Lab


Director: Dr. Jennifer Stevens-Lapsley, PT, PhD

The mission of the Muscle Performance Laboratory is to understand the causes of lower extremity muscle weakness that impairs function after total knee and hip arthroplasty and to improve functional outcomes.

We use a multifaceted approach to study skeletal muscle dysfunction in older adults to ultimately enhance the effectiveness of rehabilitation programs. We use a dynamometer to test lower extremity muscle strength, superimposed electrical stimulation for measures of central activation of muscle, electromyography, transcranial magnetic stimulation, Dual energy X-ray absorptiometry, and clinical measures of functional performance.

The laboratory is equipped with 2 isokinetic dynamometers (HUMAC NORM and KinCom), physiological data acquisition modules to monitor force and EMG, and accelerometers.  The laboratory is closely tied to clinical facilities in the Clinical Translational Research Center, IMAGE group, Interdisciplinary Movement Science Lab (IMSL), and Transcranial Magnetic Stimulation (TMS) Lab

We have clinical partnerships with the University of Colorado Hospital, Colorado Joint Replacement Center at Porter Adventist Hospital, Active Motion Physical Therapy, Ascent Physical Therapy, and Best Care Home Health.



Ongoing Investigations


 

Progressive Resistance Rehabilitation Program after Total Knee Arthroplasty

The major goal of this investigation is to conduct a prospective,
randomized, controlled clinical trial to evaluate the effectiveness of a progressive
resistance rehabilitation program after total knee arthroplasty (TKA) compared to
a traditional rehabilitation program. We assess functional mobility and muscle
function for each intervention. We also examine cortical and
corticospinal mechanisms for central activation deficits to further identify the
source of quadriceps muscle central activation deficits following TKA.




 

Improving activity, participation, and function after acute hospitalization in older adults with multiple chronic conditions

The major goal of this multi-site investigation is to determine if a progressive multi-component intervention in a home setting, initiated upon discharge from an acute care hospital, improves function at the end of one episode of care more than documented usual care physical therapy. The proposed multicomponent intervention combines high intensity strength training, motor control based systems of gait and balance training.


 

Determination of Pain Phenotypes in Older Adults with Knee Osteoarthritis

The goal of this investigation is to better understand what causes painful knee osteoarthritis (OA) so that more effective treatment options can be developed. We will use clinically measurable musculoskeletal and non-musculoskeletal variables to explore for pain phenotypes within knee OA in older adults. We will measure variables from each of the following domains: 1) peripheral joint damage, 2) psychological distress and 3) central nervous system dysfunction.


 

Multi-Component Rehabilitation After THA

The goal of this investigation is to compare the efficacy, feasibility, and safety of a comprehensive, multi-component (CMC) intervention with a control (CON) intervention. The CMC intervention involves strength, neuromuscular control and functional training to improve muscle coordination around the hip and pelvis to enhance functional performance. The CON group receives education and functional training.


 

Understanding Mechanisms for Quadriceps Central Activation Deficits

The major goal of this investigation is to use transcranial magnetic stimulation measurements of motor cortex excitability to provide information regarding centrally-mediated, intra-cortical regulatory mechanisms that may contribute to our understanding of activation deficits and muscle weakness after TKA.


 

Rehabilitation outcomes following lower limb amputation

The purpose of this study is to describe functional outcomes for people with non-traumatic lower limb amputation to provide a basis for future studies to refine rehabilitation strategies.









Recently Completed


 

Improving Function with Weight-Bearing Biofeedback

The major goals of this study are to determine the effects of a weight-bearing biofeedback intervention on functional weight bearing asymmetry during sit to stand transitions, gait, and stair climbing as well as on functional performance and strength recovery following total knee arthroplasty.


 

Strength and Function Following Total Hip Arthroplasty

The overall goal of this longitudinal study is to determine whether adults who have undergone total hip arthroplasty (THA) for end-stage osteoarthritis have post-operative deficits in strength of the surgical lower extremity, postural control, and functional performance compared to healthy, age-matched counterparts.


 

NMES after Total Knee Arthroplasty to Counter Quadriceps Muscle Activation Deficits

The goal of this study is to assess the effectiveness of NMES on countering quadriceps activation deficits after TKA and relate acute measures of quadriceps muscle presynaptic inhibition to longer term outcomes.

In the News: University Hospital Insider article, CBS4 news story


 

Functional Outcomes Following Minimally Invasive Total Knee Arthroplasty

The goal of this study is to determine if minimally invasive TKA improves functional performance, quadriceps muscle force and activation, increases knee range of motion, and decreases post-operative pain compared to traditional TKA.

In the News: CBS4 news story


 

Limb Loading Asymmetry with Total Knee Arthroplasty

The major goals of this line of investigation are to 1) examine the presence of lower limb loading asymmetry during functional mobility tasks and 2) examine the relationships between loading asymmetry and both functional mobility and muscle strength before and after unilateral TKA.


MP Lab Staff Portrait

 

Lab Members

Director

Dr. Jennifer Stevens-Lapsley, PT, PhD

Post Doctoral Fellows

Joshua Winters, PhD, CSCS

PhD Students

Dana Judd, PT, DPT

Andrew Kittelson, DPT

Clinical Research Colleagues

Cory Christiansen, PT, PhD

Tami Struessel, PT, DPT

Professional Research Assistants

Jennifer Palmer, PT
Michelle Reynolds

DPT Student Research Assistants

Crystal Deidker
Erin Evers
John Farris
Brea Galvin
Emily Hoke
Erica Hylton
Mitch Luce
Kelsey Miller
Emily Roberts
Stacey Sellner
Kristin Thomas

OUR COLLABORATORS

Dr. Benzi Kluger, TMS Laboratory, University of Colorado, Denver

Dr. Wendy Kohrt, IMAGE Laboratory, University of Colorado, Denver

Dr. Ryan Mizner, School of Physical Therapy & Rehabilitation, University of Montana

We have clinical partnerships with the University of Colorado Hospital, Colorado Joint Replacement Center at Porter Adventist Hospital, Active Motion Physical Therapy, Ascent Physical Therapy, and Best Care Home Health.

ACTIVE GRANTS

National Institutes of Health (R01-HD065900)
Progressive Rehabilitation for Total Knee Arthroplasty(7/2011-6/2013)
Stevens-Lapsley, PI
$2,469,362

National Institutes of Health (K23AG029978)
Early NMES to Improve Quadriceps Muscle Function After Total Knee Arthroplasty (9/2008-9/2013)
Stevens-Lapsley, PI
$716,144

American Physical Therapy Home Health Section Grant
Improving Activity, Participation and Function after Acute Hospitalization in Older Adults. 11/12-10/13
Stevens-Lapsley, PI
$10,000

RECENTLY COMPLETED GRANTS

Bob Doctor Memorial Research Award;
Limb Loading Asymmetry with Total Knee Arthroplasty (1/2009-12/2012)
Stevens-Lapsley, Co-PI
$8000

Arthritis Foundation New Investigator Award
Quadriceps Muscle Function After Minimally Invasive Total Knee Arthroplasty (11/2008-10/2012)
Stevens-Lapsley, PI
$150,000

National Institutes of Health (R03AR054538)
Functional Outcomes Following Minimally Invasive Total Knee Arthroplasty (3/2008-2/2012)
Stevens-Lapsley, PI
$150,000

American College of Rheumatology New Investigator Award
Optimizing Lower Extremity Muscle Function after Total Knee Arthroplasty (completed 10/2009)
Stevens-Lapsley, PI

Foundation for Physical Therapy Pittsburgh-Marquette Challenge Grant
NMES after Total Knee Arthroplasty to Counter Quadriceps Muscle Activation Deficits (completed 8/2008)
Stevens-Lapsley, PI

GCRC Pilot and Feasibility Grant
General Clinical Research Center Pilot and Feasibility Grant (completed 6/2007)
Stevens-Lapsley, PI

RECENT PUBLICATIONS

Stevens-Lapsley JE, Balter JE, Wolfe P, Eckhoff DG, Kohrt WM. Early Neuromuscular Electrical Stimulation to Improve Quadriceps Muscle Strength after Total Knee Arthroplasty: A Randomized Controlled Trial. Physical Therapy Journal. Feb 2012; 92(2).

Christiansen CL, Bade MJ, Judd DL, Stevens-Lapsley JE. Weight-Bearing Asymmetry During Sit-Stand Transitions Related to Impairment and Functional Mobility After Total Knee Arthroplasty. Oct 2011; 92(10), 1624-9.

Stevens-Lapsley JE, Schenkman ML, Dayton MR. Comparison of self-reported Knee injury and Osteoarthritis Outcome Score (KOOS) to objective measures of performance in patients after total knee arthroplasty. Physical Medicine and Rehabilitation. Jun 2011; 3(6):541-9.

Bade MJ, Kohrt WM, Stevens-Lapsley JE. Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther. 2010 Sep;40(9):559-67.

Stevens-Lapsley JE, Balter JE, Kohrt WM, Eckhoff D. Quadriceps and Hamstrings Muscle Dysfunction after Total Knee Arthroplasty. Clinical Orthopaedics and Related Research, 2010 Sep;468(9):2460-8.

 

More Publications for Dr. Stevens-Lapsley

STUDENT AWARDS AND RECOGNITIONS

 

 

PhD student Mike Bade was awarded the 2009 Outstanding PhD Student Award in Clinical Investigation, from the Clinical Science Program at UCD.

Mike was also a recent recipient of a Predoctoral T32 Aging Grant that will focus on optimizing rehabilitation following TKA.

 

PhD student Dana Judd was awarded the 2010 Outstanding PhD Student Award in Clinical Investigation, from the Clinical Science Program at UCD.

Dana has also received an ACR REF/Abbott Health Professional Graduate Student Research Preceptorship award (2010).

 

Post-doc Abbey Thomas was the recipient of a Predoctoral T32 Aging Grant that will focus on optimizing rehabilitation following TKA.

 

 

 

 

 

CONFERENCE HIGHLIGHTS 

Dr. Donald Eckhoff and Dr. Michael Dayton attended the American Academy of Orthopaedic Surgery Annual Meeting in San Francisco, February 2012. This annual meeting attracts orthopaedic surgeons and other health care professionals specializing in orthopaedics to share cutting edge research. Dr. Eckhoff presented results of a clinical trial using neuromuscular electrical stimulation to mitigate quadriceps strength loss after TKA. Dr. Dayton presented results of a clinical trial comparing minimally invasive and conventional TKA surgical techniques.

Dr. Jennifer Stevens-Lapsley, postdoctoral fellow Abbey Thomas, PhD students Michael Bade and Dana Judd, and DPT student Emily Hoke attended the American College of Sports Medicine Conference in Denver in May 2011. This annual meeting brings together physicians, athletic trainers, exercise scientists, physical therapists, and other health care professionals in the field of exercise science from around the world to share new clinical techniques, scientific advancements and cutting-edge research in sports medicine, exercise science, physical activity and public health. Dana presented her research on quadriceps muscle weakness and abnormal movement patterns during daily activities in patients with end-stage osteoarthritis. Emily presented a poster comparing quadriceps muscle strength, central activation, and muscle fatigue with Parkinson’s Disease with healthy controls.

Dr. Jennifer Stevens-Lapsley, PhD students Michael Bade and Dana Judd, DPT graduates Angela Moquin and Laurie Kramer and DPT student Jim Hedgecock attended the American Physical Therapy Association Combined Sections Meeting in New Orleans in February 2011. This annual meeting brings together physical therapists to share new clinical techniques, scientific advancements and cutting-edge research in rehabilitation. Dana presented her research on lower extremity strength loss after total knee arthroplasty (TKA). Michael presented his research exploring the relationship between weight-bearing assymetry quadriceps strength, and stair climbing performance after TKA. Laurie presented results of a study investigating functional performance, muscle weakness and quadriceps activation in individuals with Danon disease. Angie presented a case report of a patient following lower extremity amputation. Jim presented results of a study using transcranial magnetic stimulation to assess intracortical and corticospinal excitability of the quadriceps in healthy younger and older adults.

PhD students Michael Bade and Dana Judd attended the American College of Rheumatology Conference November 2010 (Atlanta, Georgia) and 2011 (Chicago) respectively. This annual meeting brings together a variety of health care professionals involved in research and/or the delivery of rheumatologic care or services. Michael presented his research on a progressive exercise program for patients following TKA.

IN THE COMMUNITY 

 

Our MP Lab members participated in the Arthritis Foundation Walk in May of 2010.

 

 

 

LAB CONTACT INFORMATION 

Lab Address:

Anschutz Medical Campus
Clinical Translational Research Center
Leprino Office Bldg., 3rd Floor
12401 East 17th Ave    
Aurora, CO 80045

Phone:

303-724-9590 or fax 303-724-0863

Email: TKA.Study@ucdenver.edu