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DPT Research

The University of Wisconsin–Madison is recognized as one of the premier research institutions in the country and research within the Doctor of Physical Therapy (DPT) program contributes to this reputation.

Faculty within the program conduct research on a variety of topics and their work ranges from basic science to applied clinical research. Faculty are well-respected in their research and clinical fields, and give numerous presentations nationwide and internationally.

Students learn from accomplished clinicians who are creating new knowledge in physical therapy and across the health sciences.

DPT Faculty Research

Natalie Blonien

Clinical evaluator for physical outcome measures for multi-center Clinical Trials for Gene Modifying Therapy, Gene Replacement Therapy and other pharmacological interventions to improve functional outcome for Children with Spinal Muscular Atrophy.

Dan Cobian

Sport Exposure, Lower Extremity Injury, and Physical Function Pre-injury and Post-anterior Cruciate Ligament Reconstruction in Elite Collegiate Athletes

Over 480,000 young adults participate in National Collegiate Athletic Association (NCAA) sports annually. Collegiate sports that involve cutting, jumping, and pivoting carry a risk of anterior cruciate ligament (ACL) injury. Following ACL reconstruction, most athletes eventually return to sport (RTS) but may do so with significant limitations in an already short athletic career. ACL injury and surgery (ACLR) results in physical and cognitive impairments which may negatively affect sports performance and contribute to increased risk of future injury, but these relationships are not well defined in elite collegiate athletes. This study will uniquely examine a population of closely monitored, Division I, collegiate athletes and compare pre- and post-ACLR quantity of sport participation and incidence of lower extremity (LE) injuries. Additionally, this study will explore the relationship between the recovery of functional performance with sport participation and subsequent LE injury after ACLR. The goal of this study is to objectively define how ACLR can affect sport exposure and subsequent LE injury in elite collegiate athletes. Furthermore, this study will help determine factors related to a successful RTS and assist in guiding rehabilitation efforts to facilitate RTS.

Read More of Cobian's Research

Influence of Neurocognitive Demand on Hop Testing Post-Operative Anterior Cruciate Ligament Reconstruction

Current standards for determination of readiness to return to sport (RTS) following anterior cruciate ligament reconstruction (ACLR) requires that the surgical limb score within 90% of the non-surgical limb during a battery of neuromuscular and functional tests. Despite these standards, re-injury rates upon RTS as high as 25% have been reported. This supports the notion that current standards for determining RTS readiness may not adequately detect persistent deficits that contribute to increased risk for subsequent injury. More stringent or specific RTS testing may be warranted. Assessment of neurocognitive function following ACLR has gained substantial interest over the last few years.  Significant neurophysiological adaptations have been detected following peripheral joint injury such as reduced corticospinal tract excitability and increased activity of visual centers of the brain.  Furthermore, most sports are performed in an open environment with constant neurocognitive demands, such as reacting to a ball or another player. Conversely, current assessments of RTS readiness, such as standard hop testing, are typically performed as an isolated task with internal focus of control, in a closed environment. There is a significant discrepancy between the information that may be obtained from standard RTS assessments and what level of neurocognitive flexibility is required for successful sports performance. RTS assessments incorporating neurocognitive challenges could improve specificity of targeted interventions to maximize successful RTS and minimize re-injury risk post-ACLR. The goals of this study are to 1) determine normative values for the difference between traditional and neurocognitive-based vertical and horizontal hop tasks in healthy individuals and 2) to evaluate the difference in neurocognitive hop performance between healthy subjects and athletes post-ACLR with a goal of returning to sport.

Lower Extremity Movement Biomechanics and Functional Recovery after Anterior Cruciate Ligament Reconstruction

Abnormal lower extremity (LE) biomechanics post-anterior cruciate ligament reconstruction (ACLR) may increase re-injury risk and reduce sports performance. Although most athletes return to sport (RTS) within 1 year from ACLR, the timeline for recovery of LE kinetics and kinematics during athletic tasks is not well defined. Identifying specific movement deficiencies will guide rehabilitation efforts to promote successful RTS and reduce re-injury risk. The objectives of this ongoing investigation are to: 1) evaluate knee, hip, and ankle joint kinetics and kinematics during running and jumping in elite collegiate athletes throughout recovery post-ACLR; 2) compare and contrast the extent of kinetic and kinematic asymmetries across tasks post-ACLR; 3) compare LE movement biomechanics between post-ACLR athletes and control subjects matched by gender, sport, and position.

Quadriceps Activation Patterns during Functional Activities following Anterior Cruciate Ligament Reconstruction

Elite-level athletes possess a tremendous ability to perform explosive and rapid movements, developing muscular force within a short time frame. Knee joint trauma, particularly anterior cruciate ligament (ACL) rupture and reconstruction, can contribute to quadriceps neuromuscular dysfunction that impairs rapid muscle activation and force development. Poor quadriceps function can persist for years after surgery and inhibits successful return to sport as strong and powerful quadriceps contractions are required for many athletic activities. The purpose of this series of studies is to 1) investigate quadriceps rate of activation during running and jumping in Division I collegiate athletes post-ACL reconstruction; 2) determine how quadriceps activation patterns change throughout the year post-reconstruction; 3) assess the relationships between quadriceps rate of activation and commonly measured knee joint kinetics and kinematics during running and jumping.

Knee Extensor Torque Steadiness and Quadriceps Activation Variability across the Vastus Medialis, Vastus Lateralis, and Rectus Femoris in Collegiate Athletes Post-Anterior Cruciate Ligament Reconstruction

Muscle morphology and neuromuscular control after anterior cruciate ligament (ACL) injury and surgery varies among the individual quadriceps muscles. Greater atrophy and altered specificity of the uniarticular vasti muscles compared to the biarticular rectus femoris has been previously reported. Reduced knee extensor torque steadiness is a common finding following ACL reconstruction which can contribute to functional limitations, but the relationships between activation patterns of the superficial quadriceps muscles and knee extensor torque output is not well defined. The purpose of this investigation is to quantify the degree of activation variability among the superficial quadriceps muscles and determine the relative contribution to impaired torque steadiness throughout the first year following ACL reconstruction in collegiate athletes.

Detection of Clinical Gait Abnormalities via Slo Motion Videoanalysis and the Relationships between Knee Joint Loading during Running and Quadriceps Strength, Power, and Rapid Activation

Running is a foundational task for participation in sports. Running mechanics, particularly knee joint kinetics and kinematics, may be impaired for years following ACLR. Patients are typically allowed to return to running 3-5 months post-surgery, but return-to-running criteria are often poorly defined and of questionable value. Laboratory-grade quantification of running mechanics are cost, time, and space-prohibitive for the majority of clinical settings, which is a barrier to utilizing new scientific knowledge to improve clinical practice. As the availability and cost of video camera technology has improved, it may be possible to obtain meaningful information from observation of slo-motion videoanalysis. We have developed a protocol to instruct clinicians to obtain detailed and specific information from observational gait analysis to correlate with 3D obtained information and determine the magnitude of dysfunction in post-ACLR running mechanics. The goal of this investigation is to determine how accurate clinician observational gait analysis of slo-motion running gait is in regards to identifying the magnitude of gait abnormalities post-ACL reconstruction. A secondary purpose of this investigation is to determine how knee joint loading during running correlates with quadriceps strength, power, and rapid activation measured in isolation.

Movement Biomechanics, Neuromuscular Performance, and Functional Recovery after ACLR (Cobian and Heiderscheit)

Abnormal lower extremity movement biomechanics and neuromuscular performance are a barrier to successful return to sport in people post-anterior cruciate ligament injury and reconstruction (ACLR).

Our laboratory maintains ongoing investigations to:

  1. Evaluate common clinical measures of recovery such as muscle mass and strength, single-leg hops, and patient-reported outcome surveys
  2. Lower-extremity joint kinetics and kinematics during running and jumping in elite collegiate athletes throughout recovery post-ACLR
  3. Assess leg muscle activation patterns during running and jumping in collegiate athletes post-ACLR
  4. Compare movement biomechanics and muscle activation between post-ACLR athletes and control subjects

Countermovement Jump Analysis in Division I Student Athletes (Cobian/Heiderscheit)

Countermovement jump (CMJ) performance is an important indicator of lower extremity explosiveness and can differentiate elite athletes from their novice counterparts. Greater CMJ eccentric (ECC) phase rate of force development (RFD) may enhance the stretch-shortening cycle kinetics and maximize CMJ performance. CMJ ECC RFD is inconsistently quantified, poorly defined, and has not been comprehensively investigated.

The objectives of this project are to:

  1. Comprehensively define ground reaction force-time curve ECC and concentric (CON) phase variables, and determine which variables are significant predictors of CMJ height in collegiate athletes
  2. Evaluate changes in CMJ performance and force-time curve variables throughout the collegiate career of individual athletes
  3. Determine the influence of anterior cruciate ligament reconstruction on CMJ performance and force-time curve profiles of collegiate athletes

Judy Dewane

The Impact of Tele-Health on Effectiveness of Interprofessional Pro Bono Clinic

Students’ attitudes related to tele-health delivery for Pro Bono clinic. With the onset of the pandemic and the need to reach the underserved, the use of tele-health has greatly expanded. This study seeks to understand the effectiveness of tele-heath both for the participants and for the students. A secondary goal is a better understanding of the impact on the development of an interprofessional model using tele-health.

Bernadette Gillick

Baby Brain Recovery Study

One in 2,300 babies have a stroke or bleeding in the brain. These babies have a risk of developing difficulty moving due to changes in the brain. To provide treatment when it may be most helpful, we first need to understand how the brain changes in babies after they had an early brain injury. In the Baby Brain Recovery Study we use brain pictures (magnetic resonance imaging, or MRI) and magnetic pulses (Transcranial Magnetic Stimulation) to study the way a baby’s brain is connected. We also analyze how the baby is moving and other areas of development. Looking at how the brain develops at this young age will help us understand brain function in babies with early brain injury and improve treatments and outcomes.

Teleneuromodulation Study

Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture. Most CP is related to when an infant has an injury in the part of the brain that controls movement. Transcranial Direct Current Stimulation (tDCS) is a form of non-invasive brain stimulation. Applying tDCS in combination with clinical therapy may result in significant improvements for children with CP. In the Pediatric Brain and Movement study we work with children and young adults with hemiparetic cerebral palsy between the ages of 8-21 to assess remote in-home non-invasive brain stimulation with the goal to improve motor rehabilitation outcomes, reduce treatment costs, and improve access to health care especially in rural communities.

Kristi Hallisy

Tai Chi Prime™

Having developed the National Council on Aging evidence-based falls prevention program Tai Chi Prime (TCP) with funding from two UW-Madison Institute for Clinical and Translational Research (ICTR) grants (2015-2019), the team is now adapting Tai Chi Prime training and community delivery in communities of color in Milwaukee. Wisconsin is a leader in falls (one in four adults) and number one in deaths from falls (157 per 100,000) in older adults (CDC, 2021). Annually, falls cost the state of Wisconsin $781 million. Aging populations, noncommunicable diseases including arthritis, heart disease, diabetes, and dementia, exponentially increase fall rates in Wisconsin and worldwide. The coronavirus disease (COVID) disproportionately exacerbated these issues in underserved communities of color. This profile amplifies the need for evidence-based interventions to decrease the risk of falls mortality and morbidity among community dwelling older adults in Wisconsin.

Using funding for the Baldwin Wisconsin Idea Project Grant, a two year effort (July 1, 2022-June 30, 2024) is now underway to test the fit, feasibility and sustainability of TCP in Milwaukee’s Latinx and African American communities. The “Inclusive Tai Chi: Promoting Leaders of Color to Adapt Tai Chi for Latinx and African American Elders” grant seeks to achieve for key aims: 1)  Establish two ongoing Advisory Boards representative of their communities to help plan, recruit, deliver and evaluate TCP leader training and subsequent TCP community courses; 2)  Train peer concordant TCP leaders from Latinx and African American communities, 3) Offer a sequence of three TCP community classes (Spring 2023, Fall 2023, Spring 2024) in each community to reduce falls risk and embed daily tai chi exercise practice habits and 4) Use a modified RE-AIM framework to evaluate the reach, adoption (effectiveness), implementation, acceptability, and maintenance of TCP in multicultural communities. A supplemental grant (“Disseminating and Implementing Inclusive Tai Chi Prime to Latinx Communities”) from the ICTR Dissemination and Implementation Launchpad will scale up three critical areas for our dissemination and implementation of a  Latinx version of TCP. Key goals include: 1) translating more Spanish TCP training and community dissemination materials for a Latinx TCP; 2) Exploring a collaborative TCP purveyor plan adapted to Latinx communities that helps fill a marketing gap of the purveyor Tai Chi Health and 3) Developing a long-term marketing plan to meet the needs of our Latinx community partners in Milwaukee, Wisconsin and beyond.

Jeff Hartman

Exploring the Characteristics of Doctor of Physical Therapy Students Intending to Work in Medically Underserved Areas/Populations

This study is attempting to identify the association between personal characteristics of DPT students, their family upbringing, and formal education with a desire to work within a Medically Underserved Area or with Medically Underserved Populations within one year of graduation. Faculty from the University of Wisconsin, University of Texas- El Paso, University of Minnesota and Emory University are collaborating in this study.

Prevalence of Disability and Access to Social Protection in a Rural District of Nepal

This is a descriptive study looking at the types and prevalence of disabilities presenting to a district hospital in Eastern Nepal. This information will lay the groundwork for a community-based rehabilitation project to be implemented in the region and will be used to advocate for governmental investment in the lives of persons living with disability in Nepal.

Scope of Practice

This study is investigating scope of practice issues related to physical therapists and PT students from high-income countries who practice, study or volunteer in low-middle income countries. The results of this study will contribute to ongoing conversation around the ethics of global health participation and education and will potentially guide future curricular development and investigation.

Decolonizing Global Health

This work is a multi-country, interdisciplinary effort through the Consortium of Universities for Global Health aimed and investigating the implications of decolonizing Global Health education around the world. The results will contribute to a revised edition of a Global Health competency tool kit.

Keith Knurr

Rehabilitation management of patients following orthopedic and sports medicine injuries and surgeries to facilitate return to performance and lifelong physical activity and wellness

Anterior cruciate ligament reconstruction (ACLR) is the most common knee ligament surgery in young athletes and frequently leads to the development of post-traumatic knee osteoarthritis (PTOA). It is currently unknown why PTOA is so prevalent in this population. During my Doctor of Physical Therapy education and sports physical therapy residency at UW Health, I worked on a multi-disciplinary team to manage athlete care from the initial on-field injury, through ACLR rehabilitation, and return-to-sport, which is typically a 9- to 12-month process. Most patients strive to return to their prior level of sport, with little consideration of their long-term joint health. Similarly, most providers, including myself, focus on the return-to-sport goal because there are currently no clinical strategies to mitigate the risk of PTOA. As such, my research aims to characterize the impact ACLR has on long-term outcomes in former athletes and identify associations between clinically modifiable factors and knee cartilage health. This line of research will help guide the development of intervention-based trials targeting modifiable factors associated with knee cartilage health, with the ultimate goal of mitigating PTOA and long-term complications following ACLR. I additionally have secondary research focuses including:

  1. Post-Operative Bone Health — We have previously found a significant reduction in bone mineral density of the distal femur in athletes within the first 2 years post-ACLR compared to preinjury levels. The long-term implications of reduced bone mineral density are unknown, but may be related to osteoarthritis or increase surgical complications if the individual requires a future total knee arthroplasty. I am continuing this line of research by assessing bone health in individual’s long-term post-injury.
  2. Femoral Acetabular Impingement and Post-Operative Hip Arthroscopy Outcomes — As the rate of hip arthroscopy surgeries has increased tremendously over the past two decades, there is a need to understand both the “why” behind the development of femoral acetabular impingement, and to understand the long-term implication of surgical and non-surgical management of this condition. Teaming up with Dr. Andrea Spiker, I plan to collaborate with her on the “Profiling the Athletic Hip” study. Moreover, I plan to develop a study focused on long-term hip joint health in former collegiate athletes.

Tim McGuine

The Use of Guardian Caps in High School Football Players

Sport Related Concussions (SRCs) are a concern for adolescent athletes as well as their parents, coaches and medical providers.  Football continues to be the most popular high school team sport in the United States. Despite the fact that nearly half of the SRCs sustained in high school sports take place in football, effective SRC prevention strategies in football are not well documented.  Guardian Caps™ (GCs) are a type of exterior helmet padding that have been shown to reduce the magnitude of head impacts in laboratory settings.  In recent years, the National Football League has claimed that the incidence of SRCs was reduced by 50% in their players wearing GCs in practices.  As a result, a growing number of high school teams across the U.S. are purchasing Guardian Caps for their players.   Despite their increased popularity, there is limited data that shows GCs will reduce the incidence of SRCs in high school players.  The goal of this prospective cohort study is to determine if the use of the Guardian Caps reduces the risk of sustaining an SRC in high school football players.

Evan Nelson

Development and Validation of the University of Wisconsin Running Injury and Recovery Index (Nelson/Bryan Heiderscheit)

The objective of this project is to develop the first running specific patient-reported outcome measure enabling clinicians and researchers to quantify limitations in running resulting from an injury. This project involves a multi-stage, iterative process to develop the outcome measure and evaluate the psychometric properties.

Student Physical Therapists’ Acquisition of Joint Manipulation Skills

This project aims to assess how student physical therapists acquire the technical skill and self-efficacy required to proficiently perform joint manipulation interventions. Joint manipulation skill development is tracked, in combination with the curriculum, throughout the entry-level program. Through this process, we evaluate the effectiveness of various instructional methods in all phases of DPT education.

Sue Wenker

Dr. Wenker is involved in educational research and program development collaborating with interprofessional students, WI Department of Health Services, and UW Center for Interprofessional Practice and Education, Healthy Aging Initiative.