Explore other Johns Hopkins Sites
 
 
 
 
 

Biomechanics Research

biodex.gif

Biomechanics Research

Our research is collaborative, involving the Johns Hopkins Departments of Neurology, Neurosurgery, Pediatrics, Physical Medicine & Rehabilitation,?Biomedical Engineering, and the Kennedy Krieger Institute. The Tone Lab was established in 1997 under the directorship of Dr. Barbara deLateur.

Mission

To advance neuromuscular functional assessment using objective measurements of muscle tone, strength, and gait.

Goal

To apply innovative techniques to facilitate improved treatment strategies and research evaluation.

Our work includes measurement of neuromuscular and musculoskeletal function and dysfunction, with emphasis on quantification of the interrelationships of muscle tone, strength, and gait related to medical diagnosis such as:

  • Cerebral Palsy
  • Parkinson's Disease
  • Spinal Cord Injury
  • Primary Progressive Multiple Sclerosis
  • Normal Pressure Hydrocephalus
  • Obesity?
  • Normal aging
  • Stroke
  • Transverse Myelitis
  • Traumatic Brain Injury
  • Peripheral Neuropathy
  • Rett Syndrome
  • Other neuromuscular and musculoskeletalconditions

Definitions of Muscle Tone, Strength, Gait, and Related Assessments

Tone is a term that describes muscle resistance to passive stretch. Clinically, quantification of tone is useful in evaluating patients with conditions that cause increased (spasticity; rigidity) or decreased (hypotonia from various causes) tone in the skeletal muscle. It is also important to measure tone in?individuals without impairment or disability to serve as a?comparison.

We define relative strength as the strength of a particular muscle (usually measured as peak isokinetic torque in Newton-meters) divided by body weight (usually measured in kilograms) and divided again by body height (usually measured in meters). We are particularly interested in the relationship between strength and size, which we refer to as relative strength.

Gait is the series of movements of the limbs and the trunk that propels?a person over the ground. It is extremely complex and individualized. However, careful analysis of gait patterns can be useful in identifying and treating specific abnormalities. Self-selected walking speed is a highly sensitive (though nonspecific) indicator of changes in numerous physical, mental and emotional conditions.

Most clinical systems for the assessment of tone, such as the Ashworth scale, are qualitative and subjective in nature and, therefore,?insufficiently sensitive or reliable for research. Qualitative measurements, based on the "touch and feel" responses that a clinician reports, can vary from clinician to clinician.? We wish to introduce into clinical care easily adapted quantitative methods and tools to supplement those that are qualitative in nature, with emphasis on tone, strength, and gait.

We consider the assessment continuum to span diagnosis, pathology,?impairment, disability, disruption of participation in?family and community, and alteration in quality of life. This includes measurement of the effects of intervention in a variety of developmental and acquired neuromuscular and musculoskeletal conditions.?

Biomech

Quantitative Measurement Tools Used In Our Laboratory

ULTMS (Upper Limb Tone Measurement System)??
Our upper limb tone assessment device is unique. This is an automated robotic tone assessment device that non-invasively quantifies tone of the flexor/extensor muscle groups that control the movement of the wrist. ?Dr. deLateur participated in the invention of the upper limb device with the Whiting School of Engineering at the Johns Hopkins University. A patent (Published PCT WO 02/19907 U.S. Patent 6,589,190) has been received.?????

?biomech2.gif2nd Generation ULTMS

This is a new, small-scale, portable device being developed by our?group for use in the operating? room to give muscle torque and tone feedback to the neurosurgeon?for selecting Deep Brain Simulator (DBS) settings and locations in the brain to alleviate excess muscle tone with minimal loss in function.

LLSMS (Lower Limb Spasticity Measurement gaitriteSystem)
Johns Hopkins has one of only four state-of-the-art lower limb tone assessment devices. The LLSMS was developed at the University of Washington (Robert Price, M.S.E., Justus Lehmann, M.D. and Barbara de Lateur, M.D.) to quantitatively measure tone of the muscles about the ankle joint.

GAITRite
The GAITRite Portable Walkway System?(CIR Systems, Inc.) is used internationally to obtain quantitative gait parameters.

Biodex??biodex

The Biodex System 3 (Biodex Corporation, Shirley, NY) is used internationally to obtain quantitative strength parameters.

Research Studies and Publications
Current Ongoing Studies
?

  • Quantification of Muscle Properties and Tone in the Wrist (IRB #99-03-19-01)
  • Quantification of the Relationship of Gait, Strength, and Muscle Tone (IRB #04-02-03-05)
  • Adipose Tissue Loss/Retention in Post-menopausal Females, 30% or more above?Ideal Body Weight, Swimming in Cold or Warm Water (IRB #HBV02-01-30-01) called ?The Swim Study?
  • Rett Syndrome Gait Analysis (IRB #03-07-30-10; Sponsor NICHD)

Upcoming Studies
Several exciting projects have been proposed, some in conjunction with the Johns Hopkins Transverse Myelitis Center (JHTMC), such as treatment of spasticity in transverse myelitis patients and the ?Evaluation of Functional Electrical Stimulation (FES) Therapy on Disability and Function in Patents with Primary Progressive and Secondary Progressive Multiple Sclerosis.

Recently Completed Studies

  • A Pilot Study to Assess Changes in Motor Functions of Upper and Lower Extremities in Normal-Pressure Hydrocephalus (NPH) Patients (IRB #NPH-PATHO-01-2002).
  • Cortical Plasticity and Upper Limb Spasticity in Cerebral Palsy?? (IRB #00-03-24-07)
  • Quantification of Muscle Properties and Rigidity in Patients with Parkinson?s Disease and other Movement Disorders using a One Degree of Freedom Robot before and after Implantation of Deep Brain Stimulation. (IRB #02-10-25-01; Sponsor NIH)

Recently Published Articles?

A Comparison of Gait Assessment Methods: Tinetti and Gaitrite Electronic Walkway.? Shore W, Williams MA, Kuhlemeier KV, Imetyez H, Rose G, deLateur BJ. Journal of the American Geriatric Society, November 2005; 53(11): 2044.


Objective Assessment of Gait in Normal Pressure Hydrocephalus. Williams MA, Thomas G, deLateur BJ, Imteyaz H, Rose JG, Shore W, Kharkar S, Rigamonti D. ? Am J Phys Med Rehabil? Jan,2008;87:39-45.

Relative Strength Predicts Function Even in the Obese.? deLateur BJ, Shore W, Morozova O, Lee J, Buchner D,. Journal of the American Geriatric Society, July 2006; 54(7):1158-1159.

Prevention and treatment of frailty in the postmenopausal woman.? Shore WS, DeLateur BJ.??? Phys Med Rehabil Clin N Am. 2007 Aug;18(3):609-21, xii. Review

Augmented Exercise in the Treatment of Deconditioning From Major Burn Injury. deLateur BJ, Magyar-Russell G, Bresnick MG, Bernier FA, Ober MS, Kraback BJ, Ware L, Hayes MP, Fauerbach JA.? Arch Phys Med Rehabil 2007:88 (12Suppl2): S18-23

Effects of Human Cerebellar Thalamus Disruption on Adaptive Control of Reaching.? Chen H, Hua SE, Smith MA, Lenz FA, Shadmehr R, Cerebral Cortex, Oct 2006, 16:1462-1473.

Biomechanics Research Team
Our team represents a wide range of interests and expertise in?areas such?as pediatric and adult physical medicine and rehabilitation, neurophysiology and neurosurgery, exercise physiology, biomedical engineering, occupational therapy, biostatistics and public health, with consultants in neurology and physical therapy.

Barbara J. de Lateur, M.D., M.S.

Frank Pidcock, M.D.

Sherwin Hua, M.D., Ph.D.

Wendy Shore, Ph.D.

J. Gregory Rose, M.S.

Kathy Zackowski, Ph.D., OT

Joanne Flanagan, M.S., OT/RL

Make a donation
If you wish to make a contribution to biomechanics research, you can make a tax-deductible donation in any amount by contacting Dr. Barbara deLateur?by telephone at 410-550-5299 or by email at bdelate1@jhmi.edu.

Contact Us

For more information, please?contact:?


Wendy Shore
Tone Measurement Lab
707 N. Broadway, Suite G-32
Baltimore, MD 21205-1888

Phone: 443-923-2649
Fax: 443-923-9445

Email: wshore1@jhmi.edu

 
 
 
 
 

© The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System, All rights reserved.

About Johns Hopkins Medicine | Patient Care | Education | Research | Health Information Library
Get Directions | Contact Us | Request an Appointment | Refer a Patient | Find a Doctor | Media Inquiries