Current Research

Physiatry

Our Physiatry practice has several clinical research projects ongoing.  Participants are typically found during clinic. If you feel like you would qualify for one of the below studies, please ask your physician at your scheduled appointment time.

Current Physiatry Research Projects:

 

Return to Dance Activity-P.I.: Devyani Hunt, MD

The purpose of this study is to assess the ability of dancers to return to dance activity after hip preservation surgery including hip scopes, surgical dislocations and periacetabular osteotomies and to identify correlates between pre-surgical factors such as hip pathology, dance style, level of expertise to post surgical levels of activity. These correlations will be used to identify factors that could predict the ability of dancers to return to their previous level of activity after hip preservation surgery.

The Joint Preservation Repository will be searched for subjects between the ages of 13 - 40 yo with a UCLA score of equal to or greater than 8 and who have had a hip scope, surgical dislocation or periacetabular osteotomy from 2007 – 2013. The chart will be reviewed and the dancers will be identified. The following information will be gathered on each dancer: 1) Basic demographic information (gender, race, age at the time of surgery, and BMI; 2) Diagnosis, surgical procedure and surgical findings; 3) Pre operative and 1 yr post operative standardized orthopedic patient outcome scores. A questionnaire assessing return to dance activity and standardized orthopedic outcome scores will be administered via a telephone conversation. We would like to follow the participants long term by recontacting the participants in this study 1 year and 4 years after their initial contact.

 

Utility of Diagnostic Hip Injections in Pre-Arthritic Hip Disorders- P.I.: Devyani Hunt, MD

There are currently no studies that examine the effect of a diagnostic injection on a combined assessment of patient reported pain scores, physical examination provocative maneuvers, and hip range of motion. This study aims to describe the elements of what should constitute a positive diagnostic hip injection. Furthermore, this study will addresses the positive predictive value of this assessment paired with diagnostic intra-articular hip injection on the success of a hip arthroscopy at 12 month follow up, as measured by improvement in pain and function.

 

Washington University-Woman’s Soccer Injury Repository - PI: Heidi Prather, DO

The purpose of the present study is to develop a soccer repository to facilitate inter-disciplinary investigation into the incidence and prevalence of hip, knee and bone disorders among elite soccer athletes, and the risk factors that contribute to these problems. By studying elite soccer players from the youth to professional levels over time, this study will provide cross-sectional and longitudinal data that will hopefully lead to better mechanisms for injury prevention in this cohort.

This study is designed to follow athletes from elite youth soccer clubs in the St. Louis area as well as professional soccer in the St. Louis area. In collaboration with various clubs, we will ask athletes from the ages of 10 and up to enroll in the study. We have designed modular data collection to facilitate gathering and storing age and gender specific information for athletes on an annual basis. The study is outlined below based on this arrangement.

 

The Hip-Spine Syndrome: A Prospective Descriptive Study of Clinical Presentation and Diagnostic Tests for Patients with Coexisting Hip and Spine Disorders - P.I.: Heidi Prather, DO

We are trying to develop a consensus regarding what is the best criteria to collect information to diagnose this syndrome (i.e. self report, physical examination, and imaging) that can be used across healthcare disciplines. This will determine the presence of primary hip, primary spine, or coexisting hip and spine dysfunction (hip-spine syndrome). This criteria will also include a physician self-report developed to monitor physician's treatment recommendations.

The patient will come to his/her regularly scheduled appointment for a low back and or hip problem. Once the PI or study physician recognized a patient is eligible for enrollment in this study, he/she will come and inform the research coordinator. The appropriate patient questionnaires and physician intake exam forms are gathered and the research coordinator with enter the room and collect the information prior to the examination. The physician will perform all examinations and inform the research coordinator of the results for recording in the physician intake sheet. All examination is standard of care than would be performed if the participant was enrolled in the study or not.

Insomnia Prevalence and Severity in Patients with Hip Pain- P.I. Heidi Prather, DO

Hip osteoarthritis (OA) is common and affects 27% of people over the age of 45 (Jordan). Nearly half of hip OA to intrinsic hip deformity, otherwise known as pre-arthritic hip disorders. This group includes acetabular labral tears, developmental hip dysplasia (DDH) and femoracetabular impingement (FAI) (Harris Hayes PM&R). Pre-arthrtic hip disorders clinically present with symptoms that overlap with other clinical syndromes including the lumbar spine and pelvic girdle. As a result, the time of symptom onset to appropriate diagnosis can be prolonged with 2 years being the average time to diagnosis. Due to delayed clinical diagnosis, often these patients develop the components of chronic pain syndromes similar to other chronic musculoskeletal disorders. Treating the sleep disorder becomes an important part of successful comprehensive treatment for these patients. There is an association of sleep disorders in patients with chronic pain. We hypothesize that patients with chronic pain (>6 months duration) related to a pre-arthritic hip disorder have an increased prevalence of sleep disorders as compared to age matched asymptomatic controls.

The primary purpose of this study is to describe the prevalence of sleep disturbance in patients with pre-arthritic hip disorders. We believe that pre-arthritic hip disorders are associated with increased sleep disturbance. Impaired sleep leads to fatigue, reduced sense of well-being and augments perception of pain . Treating a sleep disorder is an unrecognized but important component of the comprehensive treatment of patients with pre-arthritic hip disorders.

 

Interobserver Reliability of Ultrasound in Measuring Rotator Cuff Tears: A Comparative Analysis of Radiologist vs Physiatrist- P.I.: Chi-Tsai Tang, MD

The purpose of this study is to see if there is good reliability in measuring rotator cuff tears using ultrasound. The study will be a comparative analysis between a radiologist and physiatrist, using different machines, to see if there is reasonable agreement in size, side (bursal vs articular), and location of the tear. A standard error of measurement can be calculated. If there is good reliability, ultrasound would be a useful method to follow size of rotator cuff tears in patients over time, due to its cost savings and accessibility compared to MRI.

 

Washington University - Acupuncture Repository- P.I.: Chi-Tsai Tang, MD

The purpose of this present study is to develop an acupuncture repository to study the benefits of acupuncture and how it can be best integrated in a Western medicine orthopedic practice. Different acupuncture treatments will be studied in various specific diagnoses in order to determine which diagnoses acupuncture may be most beneficial in. Benefits of acupuncture will be studied over time to determine short and long term effects of acupuncture, and see how acupuncture may alter or modify a patient’s disease process.

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