Prevention, Rehabilitation & Maintenance in Musculoskeletal Conditions

The goal of our work is to understand how the musculoskeletal and nervous systems interact to contribute to the development of musculoskeletal conditions across the lifespan. We also are interested in how psychosocial and environmental factors impact these interactions.

MAL (2)

Musculoskeletal conditions are among the most disabling and costly conditions experienced by Americans and are the leading cause of physical disability in the United States. Treatments that prevent or lessen the long-term impact of these conditions are needed. Our major funded studies have focused on low back pain (LBP) conditions. These studies have included testing the reliability and validity of a classification system for non-specific LBP as well as understanding the relationships between posture and movement characteristics and variables such as symptoms, sex, activity demands, and neural and musculoskeletal factors. We also have examined the efficacy of different non-surgical treatments for people with LBP and explored the role of adherence on short- and long-term outcomes.

Faculty Investigator

Linda Van Dillen, PT, PhD

Staff

Sara Francois, PT, DPT, MSCI
Kristen Roles, MS

Students

Gabe Dorn, DPT Student
Quenten Hooker, PhD Student
CT Hwang, PhD Student
Kristen Ivy, DPT Student
Katherine McGowan, DPT Student
Kara Ringkamp, DPT Student

Current Research Studies

Risk Factors for LBP Development during Static Postures

We are working to understand risk factors contributing to the development of LBP during standing. We are using a functional, prolonged loading paradigm in which back-healthy people and people with LBP stand for 2 hours performing simulated light work tasks while LBP symptoms are monitored. We are also exploring the role of sensory processing as a risk factor, as well as various aspects of motor behavior during the standing task. Our work in this area is particularly intriguing because it will allow us to identify variables in multiple domains that put a person at risk before clinical LBP is manifested.

Treatment of People with Chronic LBP

Exercise is one of the primary non-surgical approaches used for managing LBP. In people with chronic LBP, however, little is known about (1) which exercise is best for which patient, (2) why exercise effects tend to be small and inconsistent for outcomes such as pain and function, (3) the mechanisms underlying different types of exercise-based treatments, and (4) the effects on outcomes of adherence to different types of exercise-based treatments. We are interested in examining the amount and duration of adherence to the different types of treatment, and the impact of the different types of adherence on outcomes.

The Interaction of the Hip and Back in People with Low Back Pain and Hip Pain

Using clinical tests and imaging, we are investigating the prevalence of both extra-articular and intra-articular hip findings in people with LBP. We are examining the impact of coexistent hip and spine dysfunction on pain and function in people with degenerative hip disorders and in people with LBP. Finally, we are interested in how coexistent dysfunction affects the course of LBP conditions, healthcare utilization, and the response to treatment. Our work in this area should improve the diagnosis of hip and spine conditions and provide a basis for more targeted treatments, with the goal of improving the long-term course of the LBP or hip condition.

The Relationship between Movements and Postures Used during Clinical Tests and Functional Activities

The goal is to understand the relationship between patterns of movement and alignment used during performance of clinical examination tests often used by physical therapists and functional activities people with LBP report as painful and difficult to perform because of their LBP. The information obtained from this project could improve our understanding of movement-system related mechanisms underlying LBP. The information also could change the emphasis of treatment, as well as the specific types of treatment used with people with LBP.