The focus of our work is to examine the relationship between anatomical and biomechanical factors of the foot and ankle and mechanisms of injury, interventions, and treatment outcomes.

Our research combines multiple, non-invasive measures of muscle, tendon, and fascial function with kinematic analysis of movement. We have developed the methodology necessary to measure muscle, fat, tendon, and fascial volumes as well as bony alignment. The use of imaging techniques in physical therapy related research has allowed us to explore the contribution of tissue level abnormalities to foot and ankle dysfunction.

The kinematic analysis of foot and ankle motion is captured using a multi-segmental foot model. Previous work modeled the foot as a single segment with motion occurring at the ankle. The multi-segmental foot model allows measurement of motion within the foot. The expanded model allows us to discover the role of motion at the midfoot and toes during functional activities and to explore the contribution of the motion to foot deformity and pain.

Faculty Investigators

Mary K. Hastings, PT, DPT, MSCI, ATC [Profile ]

Student Members

Hyo-Jung Jeong, PT, MS, PhD, Postdoctoral Research Associate
Emily Kaszyk, DPT Student
Trenton Dickens, DPT Student

Current Research Studies

Muscle, joint, and movement deterioration contributing to neuropathic forefoot deformity
Funding Source: NIH/NIDDK R01 DK107809

Forefoot deformity in individuals with diabetes and neuropathy increases the risk of skin breakdown and possibility of lower extremity amputation. We will follow individuals with diabetes and neuropathy over 3 years and measure key factors we believe contribute to toe deformity (foot muscle and fat volumes, toe extension movement pattern, and advanced glycation end products). In addition we have included an intervention to assess the ability of a foot specific stretching and strengthening foot program to impact short term and long term deformity progression.

The role of intermuscular fat in diabetic muscle pathology
Source: Academy of Foot and Ankle Society and Program in Physical Therapy, Washington University School of Medicine

The pilot project is investigating the role of intermuscular adipose tissue in the lower extremity muscle pathology of individuals with diabetes. We are obtaining muscle and fat samples from the calf and foot and will use gene chip technology to understand how changes in IMAT-sensitive pathways might regulate muscle function.

Past Research Studies

  • Characterization of microcirculatory function in diabetic leg and foot with MRI: Individuals with diabetes have reduced ability to increase blood flow in skeletal muscle blood flow reserve is correlated with physical function.
  • Biomechanical Contributions to Acquired Foot Deformity in Diabetes (Comprehensive Opportunities in Rehabilitation Research Training NIH/NICHD, NCMRR, NINDS K12 HD055931)
  • Botulinum Toxin’s Effects on Plantar Ulcer Recurrence (NIH/NICH/NCMRR R21 HD048972)