George Mason University
George Mason University Mason
George Mason University

Research Projects

Center for Health Policy Research and Ethics

CareFirst Patient-Centered Medical Home Program Evaluation

Evaluation of the CareFirst Patient-Centered Medical Home Program (PCMH)

A team led by George Mason University’s CHPRE evaluated the patient-centered medical home program of CareFirst Mid-Atlantic to test if costs were lowered and quality was enhanced. The project used medical claims and enrollment files, patient survey data, and focus group plus in-depth qualitative interviews. Results from 2010-2013 were published in the Journal of General Internal Medicine and the Journal of the American Board of Family Medicine in 2016, with four more papers expected to be submitted in 2018 with updated data from 2010-2016. 

Len Nichols, Primary Investigator

Helping Primary Care Practices Use Patient Centered Outcomes Research

Restoring Primary Care in Virginia: Patient Centered Outcomes Research (PCOR) Learning as a Pathway to Value

A George Mason University team led by CHPRE and complemented by survey and qualitative research experts from Alan Newman Research in Richmond is evaluating a primary care transformation initiative designed by Virginia Commonwealth University physicians in conjunction with the Virginia Center for Health Innovation and its partners.  The project is part of a seven location effort funded by the Agency for Health Care Research and Quality to enhance the capacity of primary care physicians to better manage patients with or at risk for heart conditions. The research team will analyze electronic clinical quality data, practice survey data, and qualitative interviews to test for the impact of the intervention on performance and to learn which elements of the intervention were most and least helpful to the 200+ small practices that were targeted.   Results and lessons learned extracting these data from small practices will be submitted for peer reviewed publications beginning in 2018.  

Len Nichols, Primary Investigator

Effects of Primary Care Payment Incentives on Referrals

Effects of Payment Incentives on Referral Processes in Multi-Ethnic Networks Serving the Uninsured

This project was a collaboration among George Mason University health service researchers from the Center for Health Policy Research and Ethics, Fairfax County Health Department (as the payer for three safety net clinics in Fairfax County, VA), and first Molina Healthcare and then INOVA Health System as the providers implementing payment and delivery reform at the granular level in the clinics. The goal of the project was to test if provider payment incentives could be used to reduce ethnic disparities in clinical outcomes in an uninsured patient population. Progress was observed in hypertension control but not in diabetes control or cervical cancer screening.  Preliminary results were presented at two research conferences in 2017 and will be turned into a journal article in the spring of 2018. 

Len Nichols, Primary Investigator

Center for Study of Chronic Illness and Disability

Making Rehabilitation Research and Information More Accessible

American Institute for Research's (AIR) Model Systems Knowledge Translation Center (MSKTC)

The MSKTC summarizes research, identifies health information needs, and develops information resources to support the model systems programs in meeting the needs of individuals with traumatic brain injury (TBI), spinal cord injury (SCI), and burn injury. This project will include semi-structured interviews with MSKTC stakeholders, specifically patients, caregivers, and clinicians to identify and understand how to make rehabilitation research and information more relevant and accessible for these audiences.

The purpose of the study are to explore (1) what barriers researchers encounter when engaging with key stakeholder groups in the research process; (2) what barriers individuals with SCI, TBI, and burn injury and their family members have experienced when engaging in the research process; (3) what topics are important to clinicians when assessing the usefulness of research; (4) what products and formats are useful to communicate research findings to clinicians; and (5) how researchers can help to make research papers useful to clinicians.

Ali Weinstein, Principal Investigator

Global and Community Health

Elimination of Malaria in Haiti

Modeling Prospects of Malaria Elimination in Haiti 

Haiti is one of the few remaining Caribbean nations that has endemic malaria transmission. Collaborating with researchers from the College of Science, we seek to apply state-of-the-art mathematical models to previous data, while simultaneously conducting simulations focusing on malaria elimination at varying treatment thresholds. It is likely that there are high rates of asymptomatic carriage in Haiti, which means that control efforts will need to rely on mass drug administration strategies (MDA) that incorporate primaquine to reach elimination goals. The results from this project will serve as a preliminary investigation into the feasibility of malaria elimination by the Haitian ministry of health's 2020 deadline.

Michael von Fricken, Principal Investigator

 

Structural and Personal Influences on Cancer Treatment

Multidisciplinary Research Grant

Cancer Health Disparities: Modeling Social, Hospital, and Policy Factors Associated with Colorectal Cancer Survival              

This project will explore structural characteristics and personal characteristics that may influence cancer treatment. The aims of the work are to, for survival and time-to-treatment: (1) Identify hospital/provider-level characteristics that are associated and evaluate the interaction between hospital/provider-level characteristics and patient-level characteristics. Specifically, the research team will be evaluating race and Hispanic ethnicity for patient-level characteristics. (2) Evaluate the association or interaction of these hospital/provider-level and patient-level characteristics with social environment. Specifically, they will be looking at neighborhood race, ethnicity, and income composition and segregation. 

Cara Frankenfeld, Principal Investigator

Health Administration and Policy

Effects of Physician Consolidation

Physician Consolidation and Its Effect on Specialist Care:  An Analysis with Machine Leaning

Physician consolidation into larger practices has increased over time. While there is hope that larger physician organizations may be in a better position to promote a Culture of Health, monitor population health and improve care coordination for chronic conditions and quality, consolidation has raised concerns among federal regulators and payers about physician market power and higher prices.The goal of the project is inform policy discussions among federal and state regulators and help payers better understand the implications of physician consolidation into larger practices. This study will use Health Care Cost Institute data to document and visually display the extent and nature of U.S. physician consolidation focusing on which specialties, organizations and communities are most impacted by provider consolidation. In addition, the research team will estimate how physician consolidation affects the price of medical care by combining econometrics and machine learning (“big data”) techniques.

Alison Cuellar, Principal Investigator

Effects of Social Security Disability Insurance Overpayments

How Do Work-Related Overpayments Affect the Earnings of Social Security Disability Insurance Beneficiaries?

Recent research suggests that work-related overpayments are prevalent among Social Security Disability Insurance beneficiaries who engage in work activity. These overpayments occur when the Social Security Administration (SSA) issues a monthly benefit to which an individual is not entitled because SSA either is not aware that the beneficiary has sufficient earnings to be ineligible for benefits in that month, or has not yet investigated earnings and suspended or terminated benefits accordingly. Beneficiaries are required to repay this debt, which can negatively affect their attitudes towards employment. In this study, researchers estimate the impact of the notification of a work-related overpayment on beneficiary work outcomes and explore how the size of the overpayment affects the magnitude of these impacts. They use SSA administrative data to identify the causal impact of an overpayment notification on earnings by comparing beneficiary work activity in the period immediately after the notification to work activity in the period immediately before.

Priyanka Anand, Principal Investigator

Evaluation of Restoring Primary Care in Virginia

Evaluation of Restoring Primary Care in Virginia, Heart of Virginia Healthcare

This study will use both qualitative methodology and survey research to understand primary care practice (group and individual) responses to practice transformation efforts.  The researchers will analyze loss of organizational effectiveness of participating small primary care practices by understanding “change perceptions” and “change reactions” including indicators of stress in practice employees and clinicians influenced by the interventions. They will also conduct in-depth case studies of practices to understand differences between practices that successfully completed intervention objectives and those that were promising but failed to fully implement intervention.  They will use reflective analysis to assess perceptions of the project through the use of key informant interviews of project leadership and staff.

Debora Goetz Goldberg, Principal Investigator

Generating Realistic Synthetic Patient Data

Intelligent Patient Data Generator

This project focuses on large scale generation of realistic synthetic patient data. Our mission is to go beyond what is often seen in synthetic data (e.g., demographics or claims) to generate additional clinical and consumer-generated data that is more realistic. The researchers use machine learning to learn models from real data, combine these models with expert knowledge, and together apply to generate new synthetic data. Read More.

Janusz Wojtusiak, Principal Investigator

Improved Care to Vulnerable Populations

Factors of Successful Cross-Sector Collaborations to Improve Care to Vulnerable Populations

The main goal of this study is to gain an in-depth understanding of cross-sector collaborations for care to vulnerable populations. The objectives are to (1) identify facilitators and barriers of cross-sector collaborations for improving care to vulnerable populations; (2) identify contextual factors, such as political environment and previous institutional relationships, that influence the ability of cross-sector collaborations to achieve their goals; and (3) utilize study results to develop a survey instrument. Critical areas under review include degree (intensity) and type of relationship (formal-informal), incentives for collaborations, individual partner goals for the collaboration, level of participation, and other aspects considered important by study participants.  The study is based on qualitative case study research using semi-structured key informant interviews, document review, on-site visits, and descriptive statistics.

Debora Goetz Goldberg, Principal Investigator

Low Cost Alternative to Advanced Cataract Surgery

A Low Cost Alternative to Advanced Cataract Surgery with High Patient Satisfaction

Cataract surgery with pseudophakic mini-monovision has considerable lower out-of-pocket patient expense than multifocal intraocular lenses. The purpose of this study is to evaluate visual function, patient-reported satisfaction and spectacle dependence for distance, midrange, and near functions after cataract surgery with pseudophakic mini-monovision. This study is a prospective cohort study that included 56 patients (112 eyes) who underwent bilateral cataract surgery with pseudophakic mini-monovision.  The main study outcomes were assessed at the last follow-up appointment and included refraction, visual acuity, patient reported spectacle use, and patient satisfaction.

Debora Goetz Goldberg, Principal Investigator

Ontology-Guided Machine Learning for Biomedical Applications

Ontology-Guided Machine Learning

This research aims to advance computational and machine learning (ML) methods in order to achieve better applicability in real-world biomedical applications. Specifically, the goal is to develop an ontology-guided ML method to promote the effectiveness of data analytics in healthcare. The ontology-guided ML program involves the use of ontology and verifiable inferences based on the ontology to effectively analyze the complex and heterogeneous biomedical data. The method will be applied to large and complex dataset called SEER-MEDICARE and SEER-MHOS. Read More.

Hua Min, Principal Investigator
Janusz Wojtusiak, Co-Investigator

 

 

 

Prediction of Patients’ Functional Status from Medical Records

Prediction of Patients’ Functional Status from Medical Records

Assessing patients’ functional status is a complicated process that requires time consuming data collection or is self-reported. This project focuses on automated methods for assessing patients’ functional status (e.g., ability to walk, eat, use the bathroom)  from clinical or administrative health data. The methods are also capable of predicting likely functional status changes up to one year ahead. The modes are based on two distinct populations: Medicare Beneficiaries and Veterans in nursing homes. Read more.

Janusz Wojtusiak, Principal Investigator

Prediction of Wandering Patterns in People with Alzheimer’s Disease

Prediction of Wandering Patterns in People with Alzheimer’s Disease

Machine learning tools may provide new modalities for locating lost individuals, including those with medical conditions such as Alzheimer’s disease (AD) or dementia. This is a sizable percentage of the population, with an estimated about 5.4 million individuals with dementia in the United States, of which over 60% are at risk due to a history of wandering.  This project focuses on the specific aspect of wandering in which people with dementia get lost. These people may get hurt, require medical attention, cause distress to families and caregivers, and require costly search parties. One solution to is use GPS trackers. An important feature of using GPS trackers is availability of detailed location data that can be used to analyze patterns of movement and behaviors, both planned and those when wandering. These patterns can be in turn used to predict important areas to search for a missing person when the device is not working properly. Our work supports the idea that not only is it possible to detect patterns of movement and predict location, but also to detect changes in the pattern of behavior over time.

Janusz Wojtusiak, Principal Investigator

Senior Housing Coordinated Care Delivery

ASHA Member Survey on Coordinated Care Delivery Models in Independent and Assisted Living Communities

This project will complete a national survey of senior housing provider members of the American Seniors Housing Association (ASHA). The purpose of the survey is to determine current senior housing readiness and/or preparation for participation in an expanded continuum of health care services for the elderly, to include pre-acute, acute, post-acute, and long-term care services, including senior housing.The survey will assess senior housing status in terms of its role in the health care continuum in two areas:

  1. The extent to which current ASHA members are or are planning to provide ancillary services to residents of senior housing communities, beyond those currently identified within the resident services agreement. This will include services either provided as an additionally owned/operated service of the provider, and/or those accessed through direct or indirect relationships with third party health care providers.
  2. The extent to which ASHA members are or are planning to identify and utilize benchmark outcomes of resident health and wellness, with a  focus on those measures that may prevent or reduce either hospital admissions and/or readmissions among the resident population, improving quality of life for the elderly and reducing costs associated with their care within the healthcare system.

John Cantiello, Principal Investigator

Social Security Disability Insurance (SSDI) Eligibility

Understanding Subsequent SSDI Eligibility Among First-Time SSI-Only Entrants

Researchers will use administrative data from the Social Security Administration to examine first-time Supplemental Security Income (SSI) awardees that were subsequently awarded Social Security Disability Insurance (SSDI) benefits in the five years following the initial award. The analysis will identify how many first-time SSI-only awardees subsequently received SSDI benefits, and whether they were first entitled to SSDI benefits because they attained disability insured status subsequent to SSI award versus other reasons (such as qualifying as a disabled adult child or disabled widow(er) beneficiary). They will then explore the characteristics that are associated with a subsequent SSDI award for those initially awarded SSI using both descriptive and regression analyses. Finally, they will examine whether the work activity that led to first-time SSI-only awardees acquiring subsequent SSDI benefits is sustained after the SSDI award. This analysis will provide a better understanding of events that led up to SSDI award among first-time SSI-only awardees as well as insight into the timing of work-related behavior before and after receiving SSDI benefits.

Priyanka Anand, Principal Investigator

Video Telemedicine

The Impact of Direct-to-Consumer Video Telemedicine

With changes in health insurance, improvements in internet access, and greater use of mobile devices, more patients have the means to access providers via telemedicine from their home, potentially improving access and convenience more broadly.  Understanding how video telemedicine, when made widely accessible, changes the patient-provider interface is critical to understanding how to more efficiently and effectively deliver care.

This study is designed to shed light on the impact of broad-based, video telehealth that is accessible from the home rather than from provider offices. The multi-year study will take advantage of a natural experiment provided by an insurer’s introduction of the broadly available, home-based telemedicine tool to study the effect of the tool on 1) patient access to care, 2) quality of care, and 3) utilization and expenditures for common conditions across alternative sources of care (retail clinics, primary care offices, emergency room). The study is innovative in its analysis of a unique natural experiment that created differential financial incentives for video telemedicine use among insured adults, its use of unique data, the size of the intervention group (19 million adult enrollees), and its longitudinal design. Findings from this study will inform private insurer, Medicare and Medicaid coverage policy where coverage is geographically limited or restricted to a narrow set of services, as well as state telemedicine laws and regulations.

Alison Cuellar, Principal Investigator

Nursing

African-Born Nurses’ Delivery of End-of-Life Care in the United States

The Process by Which African-Born Nurses Deliver Palliative and End-of-Life Care in Intensive Care Settings Under the American Healthcare System

Nurses in American hospitals are expected to address the palliative and end-of-life care (PEOLC) issues of patients and families. However, nurses from African cultures may encounter personal and cultural challenges in speaking openly about impending death as it may be a cultural taboo. This grounded theory study examines the process by which nurses who grew up in African cultures acculturate to delivering PEOLC in the ICU setting in American hospitals.

Supports PhD Dissertation: Samuel Asamoah

Alternative Light for Detecting Bruises

Analysis of Alternate Light in the Detection and Visibility of Cutaneous Bruises

Victims of violence often have bruises that are hidden or barely visible to the naked eye due to skin color or injury age. The resulting unidentified or undocumented injuries can cause a disparity in the forensic investigation impacting legal outcomes. Alternate light, or light of a specific bandwidths, has been proposed by the Department of Justice as a potential solution for this problem. However, research on the effectiveness of this technology is limited. The purpose of our study is to determine if alternate light improves the detection and visualization of bruises on diverse skin colors. This multisite study is a partnership between George Mason University and Texas A & M Health Science Center. After creating two bruises using innovative induction methods, each participant (N=156) is followed for 21 visits over four weeks until bruise resolution. This randomized controlled trial aims to compare alternate light to white light (normal examination lighting) in the detection and visualization of bruises and determine which wavelengths are most effective. Skin color, gender, bruise age, and localized fat are all factors being explored. The knowledge gained from this research will ultimately improve the forensic clinical care of victims of violence.

For more information on the project, read the news story.

Katherine Scafide, Principal Investigator

Cardiovascular Health of Arab-Americans

Acculturative Stress, Psychological Flexibility and Cardiovascular Health Risk Factors in Arab-Americans

Scant research has explored the factors that affect the cardiovascular health of Arab-Americans. This descriptive, correlational predictive study will examine the relationships between acculturative stress, psychological flexibility, and select cardiovascular health risk factors in a sample of Arab-Americans in the metropolitan DC area.

Supports PhD Dissertation: Randa Merizian

Effects of Chemotherapies on Cognition

Neurobiological Mechanisms of Chemobrain: A Feasibility Study Using an Animal Model

The purpose of this study is to evaluate the effect of chemotherapies on cognition using a multi-omic approach, including metabolomics and proteomics, using an animal model for chemobrain.  We  conducted a feasibility study utilizing an animal model to elucidate the possible neurobiological mechanisms of ‘chemobrain’, specifically memory dysfunction, that are associated with  chemotherapies used in the treatment of breast cancer. Eight Long Evans rats were randomly assigned to one of four treatment groups. The laboratory animals were given four weekly intraperitoneal injections of 1) docetaxel 8 mg/kg, or 2) cyclophosphamide 30 mg/kg or 3) docetaxel plus cyclophosphamide or 4) normal saline.The Y-maze test was used to characterize memory behavior at two time points (pre-treatment and post treatment). Cells of brain regions of interest (cerebellum, cerebral cortex, hippocampus and olfactory region) were harvested under direct visualization using Laser Capture Microdissection (LCM).  Reverse Phase Protein Array (RPPA) was conducted to quantify targeted memory associated proteins and compare abundance between treated and untreated animals.  As well, a global, untargeted assessment of the chemotherapy treated and untreated brain tissue metabolome was completed using liquid chromatography, tandem mass spectrometry (LC-MS/MS).

Supports PhD Dissertation: Grace Lawrence

Obese Nurses Managing Their Weight

Obese Nurses Managing Their Weight: A Grounded Theory Study

Health care providers in the United States rarely discuss weight management with their overweight and obese patients. Little is known about how nurses manage their own obesity. This grounded theory study will explore the process by which nurses who are obese – or who have a history of obesity – manage their weight. The findings may inform interventions to increase the likelihood of nurses addressing weight issues with their patients when the nurse may have personal challenges with obesity. 

 Supports PhD Dissertation: Anne-Mette Harding

Sleep Promotion by Nurses in Saudi Arabian ICUs

A Grounded Theory Study of Sleep Promotion by Nurses in the Kingdom of Saudi Arabia Intensive Care Units

The importance of sleep for patients in the intensive care unit (ICU) setting is rarely addressed in the Kingdom of Saudi Arabia. Nurses have a central role in the implementation of actions to promote sleep for ICU patients. This grounded theory study is designed to uncover the process by which nurses promote sleep in the ICU setting; the barriers and facilitators to promoting sleep will be identified. The personal, contextual, situational, and conditional factors affecting the process will be highlighted.

Supports PhD Dissertation: Ghada Kurban

Swaziland Nurses’ Development of Values-Based Practice

The Process by Which Nurses in Swaziland Develop a Values-Based Practice: A Mixed-Methods Study

Nurses in the Kingdom of Swaziland have a poor reputation among the public due to frequent acts of unprofessional behaviors towards patients, families, and others. Ranging from neglect to disrespect to verbal or physical abuse, the nurses’ behaviors may undermine the trust needed to engage patients in care or support successful clinical outcomes. Nurses who do not have a practice grounded in nursing professional values may be threatening the health and wellbeing of nurses, patients, and families in Swaziland. This mixed-methods study examines the variables that predict nursing caring behaviors and uncovers the facilitators and barriers to the process by which nurses develop a values-based practice.

 Supports PhD Dissertation: Bongani Sibandze

Nutrition and Food Studies

Healthy Food Access

Increasing Healthy Food Access through Collaboration in Bailey's Crossroads: An Evaluation

Lack of access to healthy foods is a major contributor to poor health outcomes in low-income communities in the US. Arcadia Food Inc. is implementing a community-based project aimed at creating a healthier, more equitable, and sustainable food system in the Bailey’s Crossroads community in Fairfax County. The project focuses on four program areas namely, Community Engagement, Nutrition Education, Gardening, and Food Access. The evaluation of the project utilizes a mixed methods approach to assess the effect of the project on food access and fruit and vegetable consumption among target community members. Results of the evaluation will inform the implementation of similar projects among low-income communities in Fairfax County and beyond. 

Constance A. Gewa, Principal Investigator

Rehabilitation Science

Activity-Based Rehabilitations for Patients with Spinal Cord Injury

Evaluation of an Activity-Based Rehabilitation (ABR) Program for Individuals with Spinal Cord Injury (SCI)

This exploratory pilot project will use an observational case series design to describe and characterize: (1) what tests and measures may have the most clinical utility for evaluating the outcomes of ABR; (2) what training parameters are most promising as an experimental intervention; (3) what are the time commitments required from participants that would be necessary to explore dose-response relationships in a larger study; and (4) what are the research logistics and resource feasibility of conducting a larger study on the outcomes of ABR?  

Andrew Guccione, Principal Investigator
Co-investigators: Lisa ChinClinton Wutzke
Student Co-investigators:  Donal Murray, MS; Brian Neville, DPT; Caitlin Bryson, DPT; Kerry Bollen; Michele Nofal; Andrew Pechstein

Aerobic Exercise in Women with Lupus

Pilot Study Characterizing Aerobic Exercise in Women with Systemic Lupus Erythematosus

In this pilot study we intend to examine the feasibility of translating the methodology currently used for women with SLE who do not have overt cardiac, pulmonary or other systemic complications. The specific aim is to generate data that can be used for the submission of a U01 clinical trial on exercise training, fatigability and physical functioning in women with SLE in collaboration with the NIH Clinical Center.  

Randall Keyser, Principal Investigator
Co-investigators: Lisa Chin, John Collins
Student Co-investigators:  Zoe Williams, MS; Liana Wooten, DPT

Breathing Pattern and Timing in Adults With and Without Incomplete Spinal Cord Injury

Characterizing Exercise Breathing Pattern and Timing in Adults With and Without Incomplete Spinal Cord Injury

The primary aim of this hypothesis-driven study is to describe the breathing pattern and timing during submaximal exercise in adults without and with incomplete spinal cord injury. We will challenge participants with three different sub-maximal exercise intervals during both arm and leg ergometer, and measure their inspiratory, expiratory respiratory variables that describe the pulmonary response. Incomplete spinal cord injury presents as a model to test the impact of cortical spinal neuron interruptions on the pairing of respiration to skeletal muscle activation. 

Jeffrey Herrick, Principal Investigator

Cardiac Response to Exertion in Patients with Complete Spinal Cord Injury

Left Ventricular Inotropic Response to an Exertional Challenge after Sympathetic Decentralization in Humans

The objective of this study is to characterize the influence of sympathetic decentralization on cardiac inotropicity. The specific aim is to characterize the change in left ventricular inotropicity from rest to a severe exercise challenge in the sympathetically decentralized heart in people who have complete cervical spinal cord injury. We hypothesize there will be a blunting of cardiac inotropicity that is independent of preloading and afterloading conditions. 

Randall Keyser, Principal Investigator
Supports PhD Dissertation:  Baian Baattaiah, DPT

Cardiorespiratory Insufficiency in Women with Systemic Lupus Erythematosus

Cardiorespiratory Insufficiency in Women with Systemic Lupus Erythematosus

This study involvers a deidentified data set using baseline only data from exercise tests in women with lupus and healthy controls collected at the University of Maryland School of Medicine in Baltimore. 

Randall Keyser, Principal Investigator
Student Co-investigators: Liana Wooten, DPT; Monira Aldhahi, DPT, MS.

Community-Based Exercise for Stroke Survivors

Resiliency and Self-Efficacy: Keys to Participation and Quality of Life in Chronic Stroke Survivors and Effects of Community Based Exercise

The overall purpose of this study is to clarify the relative contributions of self-efficacy and resiliency to Participation and Quality of Life (QOL) in chronic stroke survivors following nine weeks of community based exercise training (CBET).   

Andrew Guccione, Principal Investigator
Supports PhD Dissertation: Amanda Rounds

Effect of Exercise Training in Patients with Traumatic Brain Injury

Effect of Exercise Training on Physical, Cognitive and Behavioral Function in Patients with Traumatic Brain Injury

The broad objective of this study is to examine the effects of moderate and more intense aerobic exercise as an intervention on cognitive performance, physical functioning and health-related quality of life in patients with chronic traumatic brain injury (TBI). Importantly, structural and biological brain changes will be measured to examine whether functional outcomes are related to exercise-induced adaptations. The study consists of 3 months of an exercise training program and 3 months of follow-up.

Lisa Chin, Principal Investigator

Effect of Muscle Mass on Cardiac Pressure and Volume

Effect of Active Muscle Mass on Cardiac Loading Conditions and Inotropicity

Previous research has found that as the muscle mass involved in physical activity decreases pressure load on the left ventricle is exacerbated. The objective of this study is to characterize pressure verses volume loading conditions, as they occur during exercise recruiting small versus large active mucle masses. More specifically, the project will focus on  left ventricular hemodynamics and inotropicity during 2-leg and 1-leg cycling and 1-arm cycling. 

Randall Keyser, Principal Investigator
Student Co-Investigators:  Donal Murray, MS; Liana Wooten, DPT; Monira Aldhahi, DPT, MS

Effects of Aerobic Exercise Training on Cardiovascular Function in Individuals with Motor Incomplete Spinal Cord Injury

Effects of Aerobic Exercise Training on Cardiovascular Function in Individuals with Motor Incomplete Spinal Cord Injury

Several lines of evidence suggest greater cardiorespiratory and functional aerobic adaptation after aerobic exercise training. Importantly, substantial effects of aerobic exercise training (AET)have been documented in the scientific literature among individuals with a range of different comorbidities. In view of this consideration, AET could have potentially significant implications for improving cardiovascular function and endurance performance in those with iSCI. Proposed is an exploratory study with the objective of to characterizing the effect of 10 weeks of AET training on central and peripheral cardiovascular adaptations and functional capacity. The project is therefore not hypothetically driven and is designed to be hypothesis generating. 

Randall Keyser, Principal Investigator
Co-investigator/Student Investigator:  Monira Aldhahi, DPT, MS

Effects of Training Program on Muscle Oxygenation and Walking in Patients with Incomplete Spinal Cord Injury

Are Shifts in the Muscle Power-Frequency Associated with Changes in Muscle Oxygenation and Improvements in Walking Performance in People Who Have Incomplete Spinal Cord Injury (iSCI)?

The purpose of the study is to characterize the potential changes in skeletal muscle activation and muscle oxygenation during a treadmill walking protocol in iSCI following a 12-week locomotor training program.

Andrew Guccione, Principal Investigator
Supports PhD Dissertation: Donal Murray, MS

Evaluation of a Power, Agility, and Coordination Program for Individuals with Parkinson’s Disease

Evaluation of a Power, Agility, and Coordination Program for Individuals with Parkinson’s Disease

Very few programs for individuals with Parkinson’s disease have used an approach that targets both gait initiation and steady-state gait by means of power, agility, and coordination (PAC). The purpose of this pilot project is to characterize and investigate the effects of this intervention on gait quality and safety. The aims of this study are to: 1) characterize changes of gait quality and safety, 2) what training parameters are most promising as an intervention, 3) exploration into the sensitivity of coordination, agility, and power related outcomes, and 4) what are the research logistics and resource feasibility of conducting a larger study on the outcomes?

Clinton Wutzke, Principal Investigator
Student investigator Co-investigator: Caitlin Bryson, DPT; Kerry Bollen

Fatigue and Fitness in Women with Lupus

Fatigability and Cardiorespiratory Fitness in Adolescent and Young Women with Systemic Lupus Erythematosus

Impaired cardiorespiratory capacity is thought to be nearly as prevalent as Systemic Lupus Erythematosus (SLE) fatigue in people who have the disease (over 80% on both accounts).  Our evidence suggests that this impairment is etiologically mediated and that the functional limitation occurs at levels that are far below those of physiologic deconditioning resulting from even an extremely sedentary lifestyle. This is an exploratory study with the objective of characterizing the influence cardiorespiratory fitness on fatigability in adolescents and young women who have SLE and significant patient reported fatigue. This project is funded through a grant from the PNC Trust. 

Randall Keyser, Prinicipal Investigator
Student Co-investigator: Liana Wooten, DPT

Fitness and Independence Following Spinal Cord Injury

Fitness and Independence Following SCI: Defining Meaningful Change and Thresholds

In this project we aim: 1) to determine a) how much the fitness of an individual living with spinal cord injury or spinal cord disease (SCI/D) must increase to support a meaningful gain in independence and b) the lowest fitness level that allows most people to transfer independently between wheelchair and bed toilet or tub or car.  Additionally, we aim to determine if and how these numbers differ by injury severity, current fitness level, and time since injury, 2) to develop a clinical risk calculator (CRC) to allows SCI/D clinicians and consumers to determine the likelihood that an individual's fitness is too low to enable independent bed, toilet-tub, or car transfers, and 3) to use the healthy individuals as a comparison group to the SCI/D group. This will allow us to determine if there if a difference or how much of a difference in fitness exists between the two groups. 

Randall Keyser, Principal Investigator
Student Co-investigator:  Donal Murray, MS

Gait and Balance in People with Parkinson’s Disease

Gait and Balance in People with Parkinson’s Disease

The purpose of the study is to describe walking and postural control patterns of movement in people with Parkinson's disease using traditional analysis techniques as well as novel techniques. The aim of this study is to determine if novel techniques of analysis are capable of describing walking function and balance in people with Parkinson's disease more accurately than traditional techniques of analysis.

Clinton Wutzke, Principal Investigator
Student ​Co-investigator: Caitlin Bryson, DPT; Kerry Bollen

Influence of a Dual Tasks Paradigm on Locomotor Function during Treadmill Walking

The Influence of a Dual Tasks Paradigm on Locomotor Function during Treadmill Walking

The purpose of the study is to characterize the effects of attention allocation on gait quality during a visual-cognitive dual task while walking on a split belt treadmill.

Clinton Wutzke, Principal Investigator
Co-investigator/Student investigator: Kerry Bollen

Influence of Navigational Direction on Muscle Activation in People with Incomplete Spinal Cord Injury and Unimpaired Adults

The Influence of Navigational Direction on Muscle Activation in People with Incomplete Spinal Cord Injury and Unimpaired Adults

Although rehabilitation interventions may choose to focus on the whole task of gait or break the movement down into its component segments, the majority of programs use forward walking as the primary direction during training. However, there is evidence that programs that utilize backward directed or lateral stepping movements may elicit greater improvements in locomotor function. The purpose of this study is to examine lower extremity muscle activation patterns in unimpaired and individuals with incomplete spinal cord injury during locomotor activities in multiple directions.

Clinton Wutzke, Principal Investigator
Student Co-investigator: Michele Nofal, Saad Alhammad

Influence of Transcranial Magnetic Stimulation on Overground and Treadmill Walking in People with Parkinson’s Disease

Influence of Transcranial Magnetic Stimulation on Overground and Treadmill Walking in People with Parkinson’s Disease

The purpose of the study is to determine the influence of transcranial magnetic stimulation on lower extremity movement patterns in people with Parkinson's disease. The aim of this study is to determine if transcranial magnetic stimulation applied during a motor task (walking on a treadmill) influences neuromotor pathways more than transcranial magnetic stimulation applied when static.

Clinton Wutzke, Principal Investigator
Co-investigator/Student investigator: Caitlin Bryson, DPT; Kerry Bollen

Intermuscular Coherence and Intralimb Coordination in Walking After Stroke

Intermuscular Coherence and Intralimb Coordination in Walking After Stroke

The overall goal of the study is to identify neural adaptations in individuals with chronic stroke and to relate those changes to walking performance.

  • Specific aim #1: To determine the influence of intramuscular and intermuscular coherence on lower extremity walking patterns of people with mild to moderate functional impairment post-stroke. 
  • Specific aim #2: To determine if intermuscular coherence is associated with functional walking performance in people with mild to moderate impairment post stroke and if joint angle variability moderates this relationship.

Clinton Wutzke, Principal Investigator
​Supports PhD Dissertation: Peter Jo, DC, MS

Osher Lifelong Learning Institute Older Adult Exercise Program

The primary aim of this study is characterize the health and physical fitness outcomes from adults that self-direct to an exercise program based upon the National Institute of Aging (NIA) Exercise and Physical Activity Guide. In addition, a goal of the research program is to encourage exercise and physical activity and to provide exercise fitness testing for members of the Osher Lifelong Learning Institute (OLLI). 

Jeffrey Herrick, Principal Investigator

Co-investigators: Lisa Chin, Clinton Wutzke

Co-investigator/Student Investigator:  Jordan Hazlewood; Michelle Nofal; Saad Alhammad, MS; Baian Baattaiah, DPT; Mutasim Alharbi, DPT; Khalid Alwadeai, MS

Problem-Solving in Rehabilitation Intervention

The Role of Problem-solving in Rehabilitation Intervention Adherence and Outcomes

The purpose of this study is to determine the contributions of problem-solving competency to rehabilitation program success for adults entering an exercise prescription-based rehabilitation program,  in terms of clinical health outcomes markers, program fidelity, and behavior change adoption, taking into account the contributions of self-regulatory efficacy, problem-solving/barriers self-efficacy and motivation.

Andrew Guccione, Principal Investigator
Supports PhD Dissertation: Jillian Price

Sleep Apnea and Skeletal Muscle Oxygenation During Exercise

Is Obstructive Sleep Apnea Severity Associated With Impaired Skeletal Muscle Oxygenation During Progressive Exercise In Adults?

The primary aim of this hypothesis driven study is to evaluate the relationship between obstructive sleep apnea (OSA) severity and skeletal muscle oxygenation during moderate aerobic exercise. The findings from this study will determine the plausibility for muscle oxygenation impairment as a major contributor to primary daytime limitations associated with OSA and lend to a conceptual framework suggesting that these limitations might indeed be reversible through therapeutic exercise training.

Jeffrey Herrick, Principal Investigator

Supports PhD Dissertation: Shipra Puri

Use of Physical Therapy Services in Assisted Living

Factors Contributing to Utilization of Physical Therapy Services in Assisted Living

This project uses de-identified data from a large rehabilitation provider on older adults residing in assisted living. Researchers are using these data to explore the factors contributing to utilization of physical therapy services.

Andrew Guccione, Principal Investigator
John Collins, Co-investigator

Social Work

Kinship Family Institute Program Implementation and Evaluation

Kinship Family Institute (KFI) Implementation and Evaluation

The objectives of this project are to provide program evaluation of the five core programs and any additional programs and services that the KFI implements. All programs are evaluated relative to the well-being of the kinship children, the well-being of the caregiver, the safety of the children, placement stability, permanence, and improved relationships among family members. Support for this project has been provided through a Fairfax County Department of Family Services contract.

Cathy Tompkins, Principal Investigator

Schools & Programs