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Human Performance Lab (HPL)


Director: Dr. Margaret Schenkman, PT, PhD, FAPTA

The mission of the Human Performance Laboratory is to provide a venue to quantify performance of many typical daily functional tasks and activities in the context of performance of individuals with a variety of underlying conditions.

The Human Performance Laboratory is equipped to quantify performance of many typical daily functional tasks and activities. Included is a comprehensive physical functional performance test that quantifies performance of sixteen functional activities such as moving laundry from a washer to a dryer, climbing up steps while carrying a weighted suitcase [the steps are the same height as required to get onto a city bus], and moving a pot with weight from one counter to another. These tasks are quantified by weight, time to complete, and (in some tasks) distance covered. Also conducted in the laboratory are a variety of other physical performance tests (e.g., functional reach, functional axial rotation, timed up and go) as well as cognitive tasks.


 
 

Exploratory study of different doses of endurance exercise in people with Parkinson's disease.

Schenkman, M (PI); Corcos, D (Co-PI)

This exploratory Phase II clinical trial is a multi-center, randomized, controlled (no-exercise arm), evaluator-blinded study of two intensities of endurance exercise over six months. The two levels of exercise are moderate (4 days/wk at mean 60-65% HRmax) and vigorous (4 days/wk at mean 80-85% HRmax). The first aim is to find out if patients can exercise at the higher level of intensity. The second aim is to find out if either or both of the exercise intensities yield benefits consistent with meaningful clinical change in the Unified Parkinson's Disease Rating Scale (UPDRS). The third aim is to document key responses associated with clinical trials, such as adverse events and attrition across the different treatments and the 3 different sites. This study is being conducted in collaboration with colleagues at the University of Illinois, Chicago, Rush Medical Center in Chicago, and the University of Pittsburgh.

 

Vestibular rehabilitation for persons with multiple sclerosis: who benefits the most?

Hebert, J (PI); Schenkman, M (Co-PI)

This 16-week, two-group, stratified-blocked randomized controlled trial is designed to determine if vestibular rehabilitation for persons with MS is more effective in improving balance for those who have brainstem and/or cerebellar involvement compared to persons with MS who do not. In addition, because eye movement exercises are an important part of the proposed vestibular rehabilitation program, we will determine if significant changes in visual stability for persons with MS who present with abnormal eye movements are possible following participation in this program. Lastly, we will expand our knowledge of the benefits of vestibular rehabilitation on fatigue.

 

 
 
 

Economy of Movement in People who have Parkinson’s Disease

People with Parkinson’s disease (PD) have increased energy expenditure during walking (i.e., poor walking economy) compared to similarly aged healthy adults. The implication of poor walking economy for individuals with PD is that the relative intensity of walking is high. This high intensity of walking could contribute to excessive fatigue, a major problem that develops early in the disease process.

 

The goal of this research is to determine the extent to which factors specific to PD explain variability in walking economy above and beyond typical aging.

 

 
 
 

Critical Illness Weakness
Moss M, (PI), Nordon-Craft A, Schenkman M, Quan D

This investigation is designed to diagnose and characterize individuals who are critically ill and require mechanical ventilation for at least seven days. An important part of the investigation is designed to characterize impairments and functional limitations of these individuals and to determine the benefits of physical therapy intervention.

Participants are randomly assigned to a physical intervention program, specifically tailored to individuals in the ICU, or to usual care. They are treated for a month, beginning in the ICU and continuing on the medical ward and / or home, depending on their length of hospital stay. The goal is to determine whether the physical intervention improves outcomes, both immediately and after six months.

 

Exercise, Physical Function, and Parkinson’s Disease

This study compared benefits of three different exercise interventions for people who have Parkinson’s disease. The interventions included the following: 1) usual care, in which the participant performs exercises recommended by the National Parkinson’s Foundation; 2) aerobic conditioning in which the participant exercises on a treadmill, bicycle, or elliptical trainer; 3) flexibility and function in which the participant first learned specific exercises (one-on-one with the physical therapist) to improve axial flexibility and then participated in a group exercise with exercises designed to incorporate flexibility in the context of balance and function.

Participants exercised in a supervised setting for four months and then exercised on their own (with once monthly sessions) for an additional year (16 months total). Our primary outcomes were at 10 months and our goal was to determine which of these three exercise approaches best improved balance, economy of movement and overall functional ability. In addition, our secondary goals were to examine specificity of treatment at 4 months and to determine which exercise the participants can continue with on their own for best outcomes at 16 months.

We have completed enrollment and analysis of the primary questions. Participants in the flexibility and function group showed greater functional improvement at four months compared with the other groups. Those in the aerobic conditioning group showed improvements in economy of movement at all three time points compared to the other groups. (Phys Ther 2012;92:1395-1410). Secondary analyses are ongoing.

 

Lab Members

Director

Clinical Research Assistants

Professional Research Assistant

  • Toby Wellington

Our Collaborators

University of Colorado Denver

Other Institutions

FUNDED GRANTS

Schenkman M (PI), Corcos D (Co-PI), Kohrt W, Berman B, Robichaud J, Hall D, Comella C, Delitto A, Moore C, Jain S. Exploratory Study of Different Doses of Endurance Exercise in People with Parkinson’s Disease. This phase II randomized clinical trial is designed to determine parameters of exercise intensity that attenuate progression of symptoms of PD. Upon the completion of this study parameters will have been defined for a phase III clinical trial. National Institutes of Health (NIH) / NINDS. Awarded 2011-2015 ($2.99 million)

Hebert J (PI), Schenkman M (Co-PI), Corboy C, Vollmer T. Vestibular Rehabilitation for Persons with Multiple Sclerosis: Who Benefits the Most? The aims of this study are 1) to study the effects of vestibular rehabilitation for persons with MS who have brainstem and/or cerebellar involvement compared to persons with MS who do not, 2) examine benefits with respect to visual stability (eye movements) and fatigue, and 3) to compare changes in self-reported fatigue based on brainstem and/or cerebellar involvement stratum and between the two study groups. National Multiple Sclerosis Society. Awarded: 2012-2015 ($536,295)

Moss M (PI), Quan D, Nordon-Craft A, Schenkman M. The Diagnosis and Treatment of Critical Care Polyneuromyopathy. Determine whether critical care illness can be identified early and determine the impact of an impact of intensive physical intervention for people with acute respiratory failure who have developed polyneuromyopathy. National Institutes of Health (NIH). Awarded: 2009-2014. ($2.28 million)

Schenkman M (PI), Carollo JJ, Christiansen CL, Davidson BS, Maluf KS, Solomonow M, Stevens-Lapsley J (Co-I). Interdisciplinary Movement Science Laboratory. Academic Enrichment Fund, New Strategic Research Initiative, School of Medicine, University of Colorado Denver. Awarded: 2008-2012 ($245,636)

Recently Completed Grants

National Institutes of Health (Schenkman M)
Exercise intervention for people with Parkinson’s disease
2003-2007
$1.125 million

PUBLICATIONS (Selected from the last five years of 74 total)

Christiansen CL, Davidson BS, Schenkman M, Kohrt WM. Muscle co-activation and stride variability: implications for walking economy in people with Parkinsons’s disease. PM&R in press.

Kluger BM, Brown RP, Aerts S, Schenkman M. Determinants of objectively measured physical functional performance in Parkinson’s disease. PM&R in press.

Ellis R, Cress ME, Wood R, Schenkman M. Exploring the relationship between physical activity and participation in older adults with Parkinson’s disease. Topics in Geriatrics Rehabilitation, Accepted for publication.

Nordon-Craft A, Schenkman M, Edbrook L, Malone D, Moss M, Denehy L. The physical function intensive care test: implementation in survivors of critical illness. Phys Ther ePub Ahead of Print: 05/2014; DOI: 10.2522/ptj.20130451.

Ellis T, Schenkman M. The Benefits of Exercise and Physical Activity in Patients with Parkinson Disease. Focus on Parkinson's Disease, Amsterdam 2014;24:21-25.

Moore CG, Schenkman M, Kohrt WK, Delitto A, Hall DA Corcos D. Study in Parkinson Disease of Exercise (SPARX): Translating high-intensity exercise from animals to humans. Contemporary Clinical Trials. 2013; 36: 90-98. DOI information: 10.1016/j.cct.2013.06.002.

Nordon-Craft A, Moss M, Quan D, Schenkman M. Intensive care unit-Acquired Weakness, Implications for physical therapist management. Phys Ther. 2012;92:1494-1506.

Schenkman M, Hall DA, Barón A, Schwartz RS, Mettler P, Kohrt WM Exercise for People in Early and Mid-Stages of Parkinson’s Disease: A 16-month Randomized Controlled Trial. Physical Therapy, 2012;92:1395-1410.

Stevens-Lapsley J, Kluger B, Schenkman M. Quadriceps muscle weakness, activation deficits, and fatigue with Parkinson’s disease. Neurorehabil and Neural Repair. 2012;26:533-541.

Hebert J, Manago M, Corboy J, Schenkman M. The effects of vestibular rehabilitation on MS-related fatigue: a randomized controlled trial. Phys Ther. 2011;91:1166–1183.

Schenkman M, Ellis T, Christiansen C, et al. Profile of Functional Limitations and Task Performance among People with Early and Mid-Stage Parkinson Disease. Phys Ther. 2011;91:1339-1354.

Ene H, McRae C, Schenkman M. Attitudes of people with Parkinson disease toward exercise following participation in an exercise intervention study. JNPT, 2011, 35;34-40.

Schenkman M, McFann K, Barón, AE. “PROFILE PD”: Profile Of Function and Impairment Level Experience with PD. Clinimetric Properties of a Rating Scale for Physical Therapist Practice. JNPT 2010;34:182-192.

Morris ME, Martin CL, Schenkman M. Striding out with Parkinson disease: evidence based physical therapy for gait disorders. Phys Ther 2010;90:280-288.

Christiansen CL, Schenkman ML, McFann K, Wolfe P, Kohrt WM. Walking economy in people with Parkinson&'s disease. Mov Disord. 2009 Jul 30;24(10):1481-7.

Additional publications by Margaret Schenkman

AWARDS AND RECOGNITIONS


Margaret Schenkman

Dr. Margaret Schenkman was awarded the following prestigous awards:

  • Catherine Worthingham Fellow of the APTA, March 2008
  • Jack Walker Award, Best Article on Clinical Practice in Physical Therapy, 2007
  • Bob Doctor Service Award, Colorado Chapter of the APTA, April 2006
  • Research Award, Neurology Section, APTA, 2004
  • Marian Williams Award for Research in Physical Therapy, APTA, 2003
  • Golden Pen Award, APTA, 2003

LAB CONTACT INFORMATION

Lab Address:

Department of Physical Medicine & Rehabilitation
Physical Therapy Program
Anschutz Medical Campus
13001 E. 17th Place-Bldg. 500, Rm. EG310
Aurora, CO 80045

Phone: 303-724-9375
Fax: 303-724-9016

Email: Margaret.Schenkman@ucdenver.edu