The Department of Physical Medicine & Rehabilitation RISE (Research Innovation Services Enterprise) is pleased to provide Pilot Award funding to Faculty members through its Research Pilot Award competition. The objective of the Pilot Award competition is to enhance the value and effectiveness of pilot research conducted within the Department to accomplish three objectives:
All recipients of PM&R Pilot Awards are required to complete studies according to the award requirements outlined by the Department of Physical Medicine and Rehabilitation in the Call for Proposals. If reporting and operating requirements have been met and the Principal Investigator (PI) is in good standing with the University of Colorado, PIs may request a one-time no-cost extension (NCE) to the project end date. Time extensions may be requested for periods of up to one year.
Proposal abstracts should be submitted by email to Lauren.B.Collins@cuanschutz.edu .
Questions regarding the application may be directed to Lisa.2.Brenner@cuanschutz.edu .
Principal Investigator: Andrew Smith, PT, PhD
Title: Machine learning to quantify muscle changes, lean body mass, and function in obese adults
Abstract: Just under half of Americans suffer from obesity, a condition related to heart disease, stroke, type 2
diabetes and types of cancer that can lead to preventable, premature death. Obesity is diagnosed using an
individual’s body-mass index, which is a metric that fails to account for high muscle composition versus high
fat composition. A more informative anthropometric measure is Lean Body Mass (LBM), which characterizes
the amount of fat-free tissue. Relationships between measures of body composition (i.e. LBM) to physical
function are mediated by measures of intramuscular adipose tissue (IMAT). Elevated IMAT in obese
individuals escalates the onset and progression of sarcopenia; and thus has prompted muscle quality to be
used as a diagnostic criteria for sarcopenia.
Although LBM is quantified using duel energy x-ray absorptiometry which exposes the patient to
ionizing radiation, existing magnetic resonance imaging (MRI) is now able to accurately estimate LBM.
Specifically, using only one mid-thigh MRI axial slice, thigh muscle cross-sectional area has been found to
predict LBM and accurately quantify IMAT.
However, the manual measurement of MRI scans can be subjective and time-consuming, limiting the
clinical applicability to estimate LBM and quantify IMAT. The ability to automate procedures to estimate LBM
from existing medical imaging would provide a convenient option for clinicians to provide data-driven
individualized care. Recently, convolutional neural networks (CNNs) have been reported as a viable
machine-learning-based approach to rapidly and accurately measure MRI of skeletal muscle. An available
CNN to provide swift quantification of LBM and IMAT and predict the functional status of obese individuals
would facilitate the desired data-driven individualized care of this patient population. Accordingly, the main
objective of the proposed research is to train and test a machine-learning model to automatically measure
mid-thigh muscle cross sectional area to both provide rapid estimation of LBM and IMAT, and predict the
functional status of obese adults. To accomplish this, we will leverage a pre-existing clinical MRI dataset from
the Department of Endocrinology.
Principal Investigator: Meredith Mealer, RN,
Title: The feasibility and acceptability of a written exposure therapy (WET) intervention in critical care rehabilitation nurses.
Abstract: Psychological distress is common in healthcare professionals, particularly in high stress areas such as the intensive care or progressive care units. This pilot study will assess the feasibility and acceptability of a 5-week written exposure therapy (WET) resiliency focused intervention for critical care rehabilitation nurses. Developed over 30 years ago, expressive writing or written exposure therapies were founded on the Principal that the suppression of traumatic events inhibits the ability to cope with traumatic experiences. Critical care nurses will be asked to write for 30 minutes about the most significant traumatic event they have experienced while working at the bedside as well as an experience that is still causes them distress. Each week will continue to build off the prior weeks writing session with the ultimate goal of reframing the nurse's trauma narrative and future perspective when working in similar distressing environments. This pilot study will help refine the intervention for feasibility and acceptability, so that a larger study can be conducted to determine the efficacy of the intervention at increasing resilience and decreasing symptoms of psychological distress in critical care rehabilitation nurses.
Principal Investigator: Scott Laker, MD
Title: Factors Influencing Parental Return-to-Play Decisions in Post Adolescent Sport-Related Concussions: A Mixed-Methods Exploratory Study
Abstract: This is a mixed-methods exploratory study of factors influencing parental concerns regarding their children’s return to play (RTP) following a sports related-concussion (SRC). The study participants will be the parents of adolescents (age 13-18 years) that present to the Children’s’ Hospital Colorado Concussion Program with a SRC. We will recruit 100 participants (parents of adolescents with SRC) to complete a quantitative survey. Twenty of these individuals will also be asked to participate in a qualitative, telephonic interview. As part of regular clinical care, all patients and parents complete a standardized intake questionnaire that includes injury mechanism and characteristics, a symptom severity scale, data about past medical and surgical history, and additional historical information. Permissions will be obtained to use this data. As part of the proposed study protocol, one parent will complete a quantitative pen and paper survey to ascertain factors associated with their child’s current injury that they expect will influence their decision to allow their child to RTP. This survey will also be used to gather information regarding demographics including socioeconomic status, and baseline concussion knowledge. The same parent will be invited to complete a qualitative, telephonic interview, delivered by our post-doctoral team member, to increase understanding regarding factors associated with the parent’s decision making about their child’s RTP. These quantitative and qualitative data will be analyzed to highlight parental concerns in RTP decisions, and to determine if there are any observations that warrant further study.
Principal Investigator: Cory Christiansen, PT, PhD
Title: Movement Strategies and Physical Activity after Dysvascular Amputation
Abstract: Project Abstract: Over 1 million Americans currently live with lower-limb amputation and the number is expected to more than double by 2050. More than 80% of all lower-limb amputations result from vascular complications due to diseases such as severe diabetes mellitus and/or severe peripheral artery disease, known as dysvascular amputation. Patients with dysvascular amputation have difficulty achieving and sustaining independent ambulation with a prosthesis and have low levels of physical activity. Such poor ambulation and physical activity outcomes are likely linked to the compensatory movement patterns that patients adopt following dysvascular amputation. Therefore, the overall aim of this investigation is to improve our understanding of the compensatory movement patterns adopted by patients with unilateral transtibial amputation to achieve independent ambulation and assess how the movement compensations relate to overall physical activity and disability. To identify compensatory movement strategies after dysvascular amputation, a group of participants with diabetes and unilateral transtibial amputation (EXP group) will be compared to a group of participants with diabetes and no major lower limb amputation (CTL group) using measurements of whole-body and body-segment angular momentum. Whole-body and body-segment angular momentum will be measured using 3-dimensional instrumented motion analysis while participants perform level-ground walking (primary functional task), as well as 90 degree turns and stepping up/down onto stair steps. We expect that the EXP group will have 1) higher variability in movement patterns, 2) higher peak to-peak ranges in whole-body angular momentum and larger segmental momentum contributions to whole-body angular momentum, and 3) higher segmental contributions to whole-body angular momentum from the torso/pelvis and contralateral limb compared to the CTL group. Identifying specific compensatory movement pattern characteristics following unilateral transtibial amputation (dysvascular) will provide a basis for developing targeted rehabilitation assessment tools and intervention strategies. In addition, we will examine the correlations that compensatory movement strategies have with gait speed, overall physical activity, and participant-reported disability.