Ph.D., University of Virginia Curry School of Education 2004; M.S. Indiana State University Health and Human Performance 2000; B.S. California University of Pennsylvania Human Services 1999
While musculoskeletal conditions are many, my research is focused on traumatic knee joint injuries and knee osteoarthritis (OA). Ligament sprains and ruptures are often perceived to be insignificant because many consider them to be curable or surmountable after time, rehabilitation, or in extreme cases surgical repair. However, orthopedic practitioners and rehabilitation specialists recognize these injuries as substantial, often leading to long-term dysfunction, resulting in deterioration of joint structures and early onset osteoarthritis. Knee osteoarthritis is well recognized as a prevalent disease that leads to significant and prolonged disability, with many patients eventually needing extensive surgical intervention. While the most effective goal to minimize the impact of these conditions would be prevention, universal prevention is still not attainable. Therefore, my research focuses on the consequences of joint injuries and osteoarthritis that contribute to the pain and functional difficulties, with the goal of diminishing their negative impact and improving patient quality of life. My primary research focus is to understand the neuromuscular consequences that arise from traumatic joint injuries and idiopathic knee osteoarthritis. One particular neuromuscular deficit, arthrogenic muscle inhibition, has garnered most of my attention. Arthrogenic muscle inhibition (AMI) is a centrally-mediated weakness of muscles surrounding an injured or diseased joint. AMI transpires despite the fact that the muscles are structurally intact. It often lingers following surgical repair and “successful” rehabilitation, leading to long-term consequences. AMI is most often described in the quadriceps following traumatic knee injury and accompanying knee OA, but has also been identified in muscles surrounding other joints. As muscle strength is crucial for dynamic joint function, it should not be surprising that weakness has been linked with poor patient-reported outcomes, functional difficulties, and increased pain. Further, quadriceps muscle weakness, which can be the result of AMI, is hypothesized to contribute to the onset of both idiopathic and post-traumatic OA. Employing techniques derived from neurophysiological and biomechanical foundations, we address the underlying mechanisms of AMI and its functional consequences. Further, we conduct randomized clinical trials to evaluate the efficacy of interventions to combat AMI and improve symptoms in persons with joint injury and disease.
Thomas AC, Palmieri-Smith RM, McLean SG. Isolated hip and ankle fatigue are unlikely risk factors for ACL injury. Scand J Med Sci Sports. 2011; 21: 359-68.
Kipp K, McLean SG, Palmieri-Smith RM. Patterns of hip flexion motion predict frontal and transverse plane knee torques during a single-leg land-and-cut maneuver. Clin Biomech. 2011;26:504-8.
Palmieri-Smith RM, Thomas AC, Karvonen-Gutierrez, Sowers MF. A clinical trial of neuromuscular electrical stimulation in improving quadriceps strength and activation among women with mild and moderate osteoarthritis. Phys Ther. 2010; 1441-52.
Palmieri-Smith RM, Thomas AC, Karvonen-Gutierrez, Sowers MF. Isometric Quadriceps Strength in Women with Mild, Moderate, and Severe Knee Osteoarthritis. Am J Phys Med Rehab. 2010;89:541-8.
Thomas AC, Sowers M, Karvonen-Gutierrez C, Palmieri-Smith RM. Lack of quadriceps dysfunction in women with early knee osteoarthritis. J Orthop Res. 2010; 28: 595-9.