The goal of our research is to develop effective rehabilitation strategies for people with musculoskeletal hip pain that will improve function and prevent or delay the need for surgical or pharmacological intervention.

The RROC team is committed to conducting clinical, translational research that will improve rehabilitation strategies for people with musculoskeletal hip pain including arthritic and pre-arthritic conditions. Our primary goals are to 1) understand the factors that contribute to pain problems, such as impairments of structure and function and activities and participation (type and intensity) and 2) develop rehabilitation strategies targeting specific movement system impairments and functional activity modifications to improve performance and functional ability.

Current projects implement clinical examination, motion analysis, and imaging to assess impairments of structure and function, as well as self-report questionnaires to quantify activity and participation. In addition, rehabilitation strategies, including movement pattern training and strengthening are being tested to determine their effect on improving function and physical fitness.

Faculty Investigators

Marcie Harris-Hayes, PT, DPT, MSCI

Staff

Megan Burgess
Dave Candy
Becky DeMargel
Martha Hessler
Suzanne Kuebler

Student Members

Stefanie Foster, PhD Candidate
Kristen Koch, DPT Student, Research Assistantship
Riley Cook, DPT Student
Taylor Burlis, DPT Student, Research Assistantship

Current Research Studies

Comparison of movement pattern training and manual therapy for prearthritic hip disorders: a pilot randomized clinical trial
Funded by the Paris Patla Musculoskeletal Grant from the Foundation for Physical Therapy Research.

Pre-arthritic hip disease (PAHD), such as femoroacetabular impingement, hip dysplasia, and labral tears, is a major cause of hip dysfunction and activity limitation in young adults that, without proper management, may progress to hip osteoarthritis (OA). Effective treatment of PAHD is needed to improve function in the young adult and prevent or delay the onset of hip OA. The goal of this project is to compare the effectiveness of movement pattern training and joint mobilization for people with PAHD. Upon completion of this study, we will be positioned to implement a large RCT to definitively assess the efficacy of MoveTrain and ManTher to improve PAHD.

Movement System Impairments in Patients with Lower Urinary Tract Symptoms
Funded by The Foundation for Barnes-Jewish Hospital and the NIH/National Center for Advancing Translational Sciences (NCATS) grant UL1 TR002345

An estimated 75% of women experience lower urinary tract symptoms (LUTS). National US costs for LUTS are projected at over $82 billion by 2020 and patients report poorer quality of life, quality of sleep, depression, and anxiety than age-matched controls. Patients often experience only partial relief and/or bothersome side effects from medical treatments for LUTS, therefore, more effective treatment strategies are warranted. The purpose of this study is to compare movement system factors, such as hip muscle and pelvic floor strength, between women with and without LUTS. Achievement of our proposed aims will lead to better understanding of the mechanisms contributing to LUTS and the development of new rehabilitation strategies.

Collaborative Research Studies

Clinical planning grant on motion analysis in femoroacetabular impingement
Collaboration with Texas Scottish Rite Hospital for Children; Funded by Pediatric Orthopaedic Society of North America

The purpose of this project is to design a prospective research protocol to quantitatively assess the pathological movement patterns and biomechanical, non-operative and/or operative treatment outcomes in patients with FAI. This protocol will assess the biomechanics of multiple tasks which can be administered at several institutions across North America. Work from this project will support future studies to assess patient outcomes following non-operative and operative treatment.

Past Research Studies

Investigation of Proposed Risk Factors for Intra-Articular Hip Disorders (Funded by Mallinckrodt Institute of Radiology)


Movement Pattern Training in People with Intra-articular, Prearthritic Hip Disorder (PAHD)
Funded by National Center for Medical Rehabilitation Research (NCMRR) of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grant R21HD086644, the Foundation for Physical Therapy grant and Washington University Institute of Clinical and Translational Sciences grant UL1TR000448.

Intra-articular, prearthritic hip disorders (PAHD) result in substantial dysfunction in young adults and are proposed precursors to hip osteoarthritis. Our long term goal is to develop effective treatment strategies for people with PAHD that will improve function and prevent or delay the onset of OA. Movement pattern training is an innovative rehabilitation approach designed to reduce stresses on the hip joint by optimizing the biomechanics of functional tasks through task-specific instruction. The purpose of this study is to assess the feasibility of conducting a multicenter randomized clinical trial (RCT) to determine the efficacy of movement pattern training compared to standard rehabilitation for people with PAHD. We are completing this study in collaboration with G. Kelley Fitzgerald, PT, PhD at the University of Pittsburgh. Participants enrolled at Washington University and University of Pittsburgh are randomized into one of two treatment groups, movement pattern training or standard rehabilitation. Treatment includes 10 treatment sessions over 12 weeks.


Rehabilitation Factors in Pre-arthritic Hip Disease
Funded by National Center for Medical Rehabilitation Research, National Institute of Neurological Disorders and Stroke No. K23 HD067343 and K12 HD055931NIH

rehabilitation research kinematics

Pre-arthritic hip disease (PAHD), such as femoroacetabular impingement, hip dysplasia, and labral tears, is a major cause of hip dysfunction and activity limitation in young adults that, without proper management, may progress to hip osteoarthritis (OA). Effective treatment of PAHD is needed to improve function in the young adult and prevent or delay the onset of hip OA. The goal of this project is to improve the understanding of factors that contribute to PAHD and will be the first study to assess the effectiveness of a rehabilitation strategy targeted at specific impairments in people with PAHD.


Physical Examination Measures of the Hip
Funded by National Center for Medical Rehabilitation Research, National Institute of Neurological Disorders and Stroke No. K12 HD055931NIH

We are performing this study in collaboration with the Department of Athletic Training at Washington University in St. Louis. The purpose of this study is to prospectively document physical parameters, such as ROM and movement quality, related to the lower extremity in healthy athletes to determine factors that may predict injury of the lower extremity.