Author: Sydney Flowers

Geiger to assess effects of some chemicals on children’s sleep

May 22, 2023 | Vince Lara-Cinisomo

Multiple studies have shown that children who regularly get an adequate amount of sleep have better overall mental and physical health. Not getting enough sleep can lead to high blood pressure, obesity and depression. KCH Assistant Professor Sarah Geiger wants to help mitigate those sleep issues

Multiple studies have shown that children who regularly get an adequate amount of sleep have improved attention, behavior, learning, memory, and overall mental and physical health. Not getting enough sleep can lead to high blood pressure, obesity and depression. An Illinois researcher wants to help mitigate those sleep issues. 

Kinesiology and Community Health Assistant Professor Sarah Geiger is planning to assess how the exposure to certain chemicals while in the womb affects child sleep later in life and can lead to poorer health outcomes. Geiger’s study is funded by an R03 grant from the National Institute of Environmental Health Sciences, the National Institutes of Health component dedicated to environmental health research. In the grant application, Geiger writes that “the potential for prenatal exposures to endocrine disrupting chemicals to adversely impact children’s health is a growing public health issue.” As Geiger explains, perfluoroalkyl and polyfluoroalkyl substances are EDCs found in many common household items and found in our blood.

“They’re so pervasive in terms of products,” said Geiger, who investigates environmental pollutants and chronic disease risk factors, including sleep problems, among children. “Studies have shown them to be found in foods (and) they’re notorious for these non-stick surfaces, but that’s really just one of so many types of things they’re in. Plastic water bottles, plastic fast food containers. They’re even in biomedical devices and things like IV bags and makeup, all sorts of cosmetics, nail polish.”

Geiger said her study is looking at the pregnant moms’ concentrations of those chemicals in their blood, and then looking at outcomes in children.

“We’re measuring her levels as a proxy of what they’re being exposed to,” Geiger said. “The idea is that developmental exposure in the womb to those chemicals that their mother has been exposed to is somehow altering their development and manifesting later as sleep problems. What we’re really interested in is looking at the association between the two. Are moms with higher levels of these chemicals in their blood more likely to have children who have poorer sleep quality? And if so, then we can think about maybe what is the mechanism that is causing that to happen?”

Geiger added that the study is not only looking at how chemical exposure in the womb affects child sleep later on, but also how stress and depression and other factors during pregnancy can affect child’s sleep later on. The study is important, Geiger said, because sleep, or the lack of it, is a predictor for health. Lack of sleep for a child can lead them to be unfocused and unproductive. And a lack of sleep in childhood is predictive of sleep issues in adulthood, she said, adding that sleep problems in adulthood cost the U.S. billions of in health care.

Another reason this research is important is how long certain PFAS can stay in a person’s body.

“They are sometimes called forever chemicals; they have an extremely long half-life compared to other types of endocrine-disrupting chemicals,” Geiger said. “The half-life might be like five years. Let’s say you have a certain level of this one chemical in your blood, after five years, half of it would have been metabolized or excreted from your body. To give you a comparison, like BPA (bisphenol A), another common endocrine-disrupting chemical, the half life is more like five hours.”

As important as the research is, Geiger is realistic that studies like hers and others are not likely to force companies to limit their use of PFAS.

“These are extremely powerful market forces … I would like to think that all of the research combined on sleep and other things may apply some pressure, but—and I do think that the end goal is to try to remove or limit these types of chemicals if they are harmful—but that’s much easier said than done. It’s a pretty difficult task. 

“There’s this push and pull with just the way the U.S. approaches chemical exposures. We don’t have a very proactive or cautious approach to it. In fact, quite the opposite. And so people in the area that I work in, we’re constantly having to chase down these individual chemicals and show that this is not safe for kids, or for anybody. And then–maybe then it’ll be replaced with, as I said, typically another chemical, and you do the same thing.”

Editor’s note:

To reach Vince Lara-Cinisomo, email vinlara@illinois.edu.
 

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SHS’ Rispoli retired from academia, but not done educating

May 21, 2023 | Vince Lara-Cinisomo

It really should not surprise anyone that someone who grew up in Brooklyn, N.Y., had an interest in languages. After all, Brooklynese is its own special code, spoken by millions.

So, the fact that Matt Rispoli—Illinois professor by way of Marine Park (a neighborhood way at the south end of Flatbush Avenue and home of Nathan’s, Coney Island and Buddy’s Fairyland)—ended up as an academic researcher whose expertise is developmental psycholinguistics makes perfect sense.

Rispoli—who recently retired after four decades in academia—credited his teachers, starting with Judith Marcus, his Spanish teacher at Madison High, and primarily his professors at Hunter College in New York, for influencing his interest in linguistics.

“When I got to Hunter, they had a bunch of great teachers, and I remember them really well,” he said in an accent that gives away his birthplace. “A guy named Robert White, (and also) Tamara Green. They taught Greek and Latin. Best of all was Ralph Ward. The stuff he knew was incredible. I’m lucky I got a chance to study with the guy.

“Those were my influences. Their enthusiasm for language inspired me.”

After graduating from Hunter, Rispoli got his master’s degree in Library Science at Queens College and worked as a librarian for four years in New York, including at the Brooklyn Public Library from 1978-79. 

But his love for language kept calling and he answered, receiving a master’s degree in linguistics at Penn. He followed with a Ph.D. in developmental and educational psychology at Teachers College at Columbia University in New York, and then embarked on an academic career that wound from Cal-Berkeley through the Midwest—the University of Kansas, where he met future wife Pamela Hadley, now the department head of the Department of Speech and Hearing Science at Illinois—to Oklahoma State, Northern Arizona and Arizona State.

Family reasons brought Rispoli and Hadley to Northern Illinois in 1999, and it wasn’t long before the couple/colleagues ended up in Urbana-Champaign.

“It was only a matter of time before someone at Illinois noticed my wife’s career and said, ‘Gee, we’d love for you to come down here,” said Rispoli, who joined the SHS faculty in 2007 as a visiting assistant professor and became an associate professor in 2017.

“I was delighted to move down to a campus where they actually have a linguistics department and great psychology department, but most of all, a department where we get the brightest kids in the state.” 

Hadley and Rispoli have collaborated on dozens of projects and publications and Rispoli enjoyed the work, but at the end of 2022, he felt it was time to step away.

“I’m 70,” he said when asked why he retired. 

But he had no desire to sit on his couch all day or go play golf.

“After you retire you begin to say, ‘What can I give back?’ I have the time. I have the passion.”

With that time and passion, Rispoli expanded on the Sentence-Focused Framework project created by him and Hadley. The pair developed the Sentence-Focused Framework to build a bridge between early vocabulary and grammar interventions for toddlers and preschoolers with language disorders.

The Sentence-Focused Framework is an approach to language intervention that helps toddlers produce more diverse simple sentences, Rispoli said. 

“Then in retirement, I learned how to animate and create films,” he said. “Now I can actually give expression to these ideas, visualizations that I had while I was lecturing that never came through.”

Rispoli developed a YouTube channel also called the Sentence-Focused Framework, uploading a series of 24 videos that explore language, language development and language intervention. The intended audience is students of language development, parents of young children and professionals involved in early intervention. Rispoli encourages instructors to use the videos in class. 

“It (the YouTube channel) really comes off of my experiences teaching (SHS 320) which is language development. In 320, we couldn’t really be sure of the student’s background and how much they understood or knew. We knew we needed to augment. But I never had enough time as an instructor to augment, to really build up the teaching materials

Rispoli sees Sentence-Focused Framework as addition to the college curriculum, and has just finished a website that houses the videos and other tools.

Whatever the future for that project, it’s clear retirement hasn’t slowed Rispoli, who sees it as just another phase of life.

“First chapter I was a librarian,” he said with a laugh. “Second chapter I was a Ph.D. Third chapter I’m an educator of sorts. … who really speaks Adobe Premiere.”

Editor’s note:

To reach Vince Lara-Cinisomo, email vinlara@illinois.edu.
 

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‘What Did You Say?’ Understanding speech in noise a common problem

May 19, 2023 | Anna Flanagan

While some might assume that hearing in noise is a problem of aging, it turns out that children can also have difficulty understanding speech in noisy environments

A common complaint that audiologists hear from clients coming in for hearing assessments is difficulty hearing in noisy backgrounds. It’s a problem that affects millions of adults and can become more of a problem with age, but it also affects children and adolescents as well.

While the problem might be common, adequate ways of addressing the problem are not. Effective solutions require a deep understanding of the reasons the problem is occurring. Three faculty in the Department of Speech and Hearing Science—Assistant Professor Mary Flaherty, Associate Professor Dan Fogerty and Assistant Professor Ian Mertes—focus their research in this area with the goal of gaining that deep understanding and finding solutions in order to improve the quality of life of those who struggle with understanding speech in noise.

“If people are unable to hear clearly in noisy environments such as restaurants, it can negatively impact their ability to socialize and communicate in those settings and, ultimately, to enjoy those settings,” Mertes said.

Mechanics are There; Understanding is Not

While some might assume that hearing in noise is a problem of aging, it turns out that children can also have difficulty understanding speech in noisy environments. It’s known that children with normal hearing have fully developed auditory systems by their first birthday, but that their brains take longer—into their teenage years—to develop the ability to process speech in noise effectively. What isn’t known is why this is. That’s what Mary Flaherty wants to find out.

“We know it has something to do with attention and sound-source segregation, separating different sounds in the environment,” she said. “We also know children just need more information than adults. They aren’t as good as adults at putting puzzles together when they are missing pieces. But we don’t really understand what it is that children need to help them.” 

Flaherty’s concern is that children who struggle with understanding speech in complex acoustic environments may fall behind in school. Moreover, the true problem may go undiagnosed and the child labeled negatively by teachers and classmates. And if this is true of children with normal hearing, imagine the extra burden faced by children with hearing loss who experience greater difficulty understanding speech in noise.

Adults use cues such as voice pitch to focus on one speaker in noise and ignore everyone else. Children cannot do that. So what cues can help children? Flaherty currently is investigating talker familiarity. She worked with a graduate student in audiology to develop a game that familiarizes children with a voice while they’re playing. A pilot study in which children played the game 10 minutes a day for five days found that their speech-in-noise perception for that particular voice increased. Flaherty plans to pursue research that tests this phenomenon in the classroom.

This summer, she will collaborate with researchers at Lurie Children’s Hospital of Chicago to investigate hearing-in-noise difficulties faced by children who use hearing aids. Among the issues she will investigate is whether talker familiarity also can help children with hearing loss, which has never before been studied. As she continues her research efforts, Flaherty hopes to identify primary factors that account for the long trajectory of children’s development of speech-in-noise perception, and to use the knowledge to improve hearing in noise, especially for clinical populations. She also collaborates with SHS colleague Pasquale Bottalico on classroom studies that they hope will lead to a method of predicting which children may have difficulty understanding speech in noise, identifying characteristics that they have in common, and recommending effective interventions.

More Cues, but More Potential Deficits with Age

Dan Fogerty focuses on older adults in his studies of how noise interferes with speech processing, how it impacts understanding a message and how it requires listeners to recruit other cognitive and sensory processes to help make sense of it.

A predominant perspective on how noise makes speech understanding difficult is that it exerts two primary effects: energetic masking and informational masking.

“In energetic masking, the noise covers up the speech energy in time and frequency,” Fogerty said. “Informational masking refers to all of the other things that might make it difficult, such as the message or familiarity of a competing talker that can draw your attention.”

Sometimes the noise dominates the signal received by the brain, depriving the listener of information. Speech dominates the signal at other times, and from these glimpses of information, listeners can piece together an interpretation of what is being said. Fogerty’s research uses glimpsing theory to examine what cues are available to the listener at any given time, but also extends the theory to how speech information changes over time.

“Amplitude modulation, the temporal rhythm of speech, is critical for understanding speech,” he said. “We’re finding that if the competing sounds vary similarly to the rhythmic aspects of speech, it can make speech understanding difficult. If we separate out these properties so that noise is varying at a faster or slower rate, then people are better able to glimpse or extract information.”

Fogerty’s primary research populations are individuals who have mild or moderate hearing loss as well as individuals who are aging with the typical sensory and cognitive changes that occur but without dementia or significant cognitive decline. He also tests college-age individuals so that effects related to aging or hearing loss are clearer. One thing he notes is important to remember is that being older doesn’t always mean performing more poorly on speech understanding tasks.

“We have a lot of older adults who do just as well or better than college students on some tasks,” he said. “That’s important for us because we want to know what is preserving their ability to understand speech in noise. What strategies are they using that are particularly helpful?”

His research goals are to contribute to the design of better hearing devices, but also to address issues that might not have a technology solution.

“That’s why we’re so interested in finding out what the abilities are that people bring to the task of listening in noise, and whether certain skills can be sharpened through training,” he said.

The Physiology Behind it All

From animal and human studies, we know that when sound enters the ear, the brain has the ability to fine tune the sound by controlling how the middle and inner ear responds. Animal studies have shown that these responses can help encode sounds in background noise. 

Ian Mertes is studying these top-down mechanisms in young adults with normal hearing to determine if they also help humans understand speech in noise. Both mechanisms rely on the brain stem. One mechanism contracts a muscle, which pulls on a bone of the middle ear, affecting how noise is transmitted through the auditory system. It can reduce the noise. The brain stem also can change how the inner ear amplifies sound, which also can turn down noise. 

“I’m looking at how these two mechanisms, which are reflexes, work together,” Mertes said. “They may work at different frequency regions, the lower frequencies or pitches and the middle frequencies or pitches. Working together, they may help people hear in background noise.”

Using otoacoustic emissions, a clinical audiology test of inner ear function, his studies have shown the physiological mechanisms are correlated with the ability to understand speech in noise. But, he said, it’s complicated.

“It can depend on how we do the physiological measurement, the types of sounds we present to the ears, and the speech perception task,” he said. His current focus on individuals without hearing problems gives him the “best look” at normally functioning auditory systems. “They have the most robust physiological responses and are able to participate in the perceptual tasks, and that can help me create a good template for adapting those measurements when I extend my work to clinical populations.”

Working with Vanderbilt University colleague Ben Hornsby, an associate professor of hearing and speech sciences, Mertes also plans to add another auditory concept called listening effort to the physiological picture of understanding speech in noise. Do individuals with weak top-down reflexes have to put more effort into completing speech perception tasks? What are the consequences of this additional effort?

The in-depth knowledge Mertes is gaining through his research may help explain why some young adults with clinically normal hearing report having difficulty hearing in background noise, another area of interest to him.

Summing up what he hopes will be the outcome of his research program, he said, “I’d ultimately like to make a significant contribution to treatment—strengthening auditory reflexes or simulating them in devices, increasing understanding of messages while reducing the effort it takes to reach that understanding.”

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Message from HK Department Head Kim Graber

May 22, 2023 | Kim Graber

It’s my pleasure to share with you the spring 2023 issue of KCH E-News. As you will see, we’ve had an eventful semester and academic year. I am extremely proud to be the head of a department in which scholars are making so many significant contributions to health, physical activity, and disability studies.

Many faculty in KCH consistently receive grants to help fund their research. For example, with support from the National Institute of Environmental Health Sciences (the National Institutes of Health component dedicated to environmental health research), assistant professor Sarah Geiger will investigate how exposure to certain chemicals in the womb affect how children sleep later in life. 

In other research developments in the department, Assistant Professor Dominika Pindus recently published a study which found that adolescent girls who engage in more moderate and vigorous physical activity each day have better attentional control. Associate Professor Sandraluz Lara-Cinisomo’s recent research explored the mental health of Black and Latina women during the pandemic lockdown and found increases in depression and anxiety.

Assistant Professor Rachel Hoopsick’s research showed that methamphetamine’s mortality rate increased fiftyfold between 1999 and 2021, with most of the added deaths also involving heroin or fentanyl. All of these findings have significant implications for designing effective interventions that improve health.

In this issue, you also will meet two of the newest scholars to join KCH, Assistant Professors Matt Hanks and Josh Leonardis. Both apply biomechanics to the study of shoulder pain and pathologies in people who use manual wheelchairs. While Josh’s goal is to fully understand why some users experience pain while others do not in hopes of creating more specific and effective treatments, Matt’s research focuses on the role of physical activity in addressing the problem.

The Department of Kinesiology and Community Health is strong. Our faculty’s productivity and innovation in classrooms and laboratories ensure that our students at both the undergraduate and graduate levels are receiving a world class education that is research-based and on the cutting edge of knowledge. I am committed as head of this department to providing faculty, students, and staff with the resources they need not only to succeed but also to excel. I hope if you are ever on campus, you will stop by to say hello and see this commitment in action.

Kim Graber
Professor and Department Head

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AHS well-represented among Community-Academic Scholars

April 03, 2024 | Hannah Wirth

Thirteen of the Community-Academic Scholars are either majoring in programs within the College of Applied Health Sciences, minoring in those programs or working with AHS faculty members.

The Interdisciplinary Health Sciences Institute, in partnership with the Center for Social and Behavioral Science and with support from the Office of the Vice Chancellor for Diversity, Equity, & Inclusion, is proud to introduce our 2023 Community-Academic Scholars! The 18 scholars in this cohort represent 18 majors and six minors in eight colleges and schools, encompassing a diverse array of fields of study, from community health to geography to economics.

Thirteen of the scholars are either majoring in programs within the College of Applied Health Sciences, minoring in those programs or working with AHS faculty members. Learn more about them and their projects below and at this webpage.

Afnaan Afsar Ali (she/her) is a sophomore studying community health with a concentration in health planning and administration, and minoring in business. She’ll be working with KCH Professor Wendy Rogers.

Ryiah Barnes (she/they) is a junior majoring in community health with a concentration in health education and promotion with plans to pursue a career in midwifery or gynecology. 

Brianna Brice (she/her) is a junior on a nursing track minoring in public health with plans to become a nurse-midwife, eventually opening a community birthing center to combat racial disparities in maternal care.

Emma Darbro (she/her) is a sophomore studying brain and cognitive science with a double minor in gender and women’s studies and public health. 

Stella Emezue (she/her) is a junior majoring in interdisciplinary health sciences with plans to become an OBGYN and open clinics in underserved communities. 

Isabelle Gawedzki (they/them) is a sophomore majoring in integrative biology. They will be working with KCH Assistant Prof. Hyojung Kang.

Norman A. Hernandez II (he/him) is a junior majoring in kinesiology and minoring in public health with plans for a career in public health. He’ll be working with KCH Associate Professor Andiara Schwingel.

Kaylee Janakos (she/her) is a junior majoring in information sciences with a double minor in psychology and health technology.  She’ll be working on the project with Isabelle Gawedzki and Professor Kang.

Alena (Allie) Kormos (she/her) is a senior majoring in community health with a passion to increase equitable health services and educational opportunities for fellow immigrants, children, and low-SES families, as well as improving maternal-infant health outcomes. She’ll be working with KCH Associate Professor Sandraluz Lara-Cinisomo.

Zara Lateef (she/her) is a James Scholar and sophomore majoring in computer science + chemistry with plans to become a doctor advocating for community health and social justice and researching medical advancements. She’ll be working with KCH Associate Professor Laura Rice.

Julian Martinez (he/him) is a sophomore majoring in natural resources and environmental sciences. He’ll be working with RST Assistant Professor Sharon Zou.

Adam Syed (he/him) is a sophomore majoring in food science and human nutrition with a concentration in and minoring in Spanish with a passion for building opportunities and uplifting communities. He’ll be working with KCH Professor Wendy Rogers.

Leyna Tran (she/her) is a sophomore majoring in speech and hearing science with plans for a career in policy analysis or population data. She’ll be working with SHS Associate Professor Raksha Mudar.

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SHS’ Nudelman takes Research Live prize

May 22, 2023 |

The Graduate College in April announced the winners of the 2023 Research Live! competition.

Now in its eighth year, Research Live! is a fun, fast-paced competition that celebrates graduate student research at the University of Illinois. Twelve finalists shared their passions in three minutes or less at the Knight Auditorium at the Spurlock Museum on April 6. 

The winners are: 
The Visionary Award: $200
Yaman Yu, Information Science, “How do Internet Users from Bangladesh and India Deal with Targeted Ads on Social Media?”

The Storyteller Award: $200
Joe Mirabelli, Educational Psychology, “How Ecological Perspectives Can Help Address Graduate Student Stress”

The Impact Award: $200
Ricky Price, Special Education, “Why Work Matters”

The Design Award: $200
Erick Hernandez Alvarez, Materials Science and Engineering, “How much is a color worth? Quantum dots can tell you!”

The People’s Choice Award: $200
Abdulgafar Sulaiman, Civil Engineering, “Be Asphalt, My Friend!”

The Grand Prize: $500
Charles Nudelman, Speech and Hearing Science, “Preventing Vocal Injuries in Teachers Using Voice Acoustic Biomarkers and Immersive Virtual Reality”

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2023 SHS Awards

May 21, 2023 |

Congratulations to the recipients of 2023 scholarships and awards. The undergraduate and graduate students recognized within these pages have shown outstanding dedication and creativity in the pursuit of their personal and professional goals. We are very proud of your achievements. Click the link to read the PDF program.

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Fritz: ‘Fitting In Is Overrated’

May 22, 2023 | Janasia Phillips

From as young as seven years old, Kevin Fritz knew something was different. But the alum of the College of Applied Health Sciences never saw different as a negative.

From as young as seven years old, Kevin Fritz knew something was different. 

He had spent the past three months in the hospital, but for someone born with muscular dystrophy, that was not unusual. What was unusual was the reception he received.

“I remember, there were three garbage bags of cards from my first-grade teacher’s class and videos of kids wishing I would get better,” Fritz said via Zoom from his home in Miami. “I kept thinking, ‘Why am I sick and other people not sick? I think that was the first recognition of (being different).”

But the alum of the College of Applied Health Sciences never saw different as a negative.

“I think I’ve always just wanted to be included,” said Fritz, who is now employment counsel at Gusto, an human resources management software company. “I think as I’ve gotten older, I’ve realized that fitting in is very overrated.”

Muscular dystrophy (MD) is a genetic neurological disease that causes muscle weakness and decreased mobility, not just of arms and legs, but vital organs as well. With MD, everyday tasks progressively become extremely difficult to manage without assistance. Given the progression of the disease, many people with MD don’t survive into adulthood, which makes Fritz’s life and career that much more inspiring.

MD made Fritz’s childhood a challenge, but when his health stabilized, he started thinking about college. A Pennsylvania native, Fritz wasn’t sure where Illinois was, but he knew it was ranked among the best schools to accommodate students with disabilities.

He called the Division of Disability Resources and Educational Services (DRES) and spoke with Susann Sears, who is now director of the Beckwith Residential Support Services program for people with severe physical disabilities. After a campus visit, Fritz was sold.

A Community Health major, Fritz set out to make an immediate impact, displaying an inner resolve he is proud of.

“I think that I’ve always had a drive to be just as good as the other person,” Fritz said. “When I was much younger, I used to do a lot of theater. I remember, there was a dance audition for a musical. And the director said, ‘Obviously, Kevin, you don’t need to do this.’ I said, ‘You know what? I’m going to do it.’ And I put like a muscle shirt and a headband and really went all out on it.

“It was really embarrassing but also very empowering.”

Armed with that new skill, Fritz became a student senator and acclimated himself with health care issues that were challenging to people with disabilities. One of Fritz’s internships while at Illinois was working with Lynne Barnes, the then-president at Carle Foundation Hospital. Although Fritz enjoyed working in health care, it was Barnes whose advice took him down a different path.

Barnes encouraged him to apply his “analytical mind” and passion to law school, Fritz said. Barnes introduced him to Carle’s vice president of legal affairs and she said that Fritz would make a good lawyer because he’d “like to fight the issues.”

Fritz’s interest in law was also shaped by his time as a student senator, during which he accepted a job in Washington, D.C., interning for then-Sen. Barack Obama where his work was heavily health-policy related. Another chance meeting again diverted Fritz’s path.

Upon meeting Rep. Jim Langevin (D-RI), who also uses a wheelchair, Fritz saw the possibilities for himself.

“When I met him, my whole world changed because there’s a guy like me 20 years later, with an assistant just like me, wearing a suit that’s like perfectly fit to his disabled person, just like I like to do,” Fritz said. “I only met him that one time, but I realized that it can happen. I could run for Congress. I could have a job. I could be successful.”

Pursuing law came with its challenges, Fritz said, but he knew that he wanted to be on the employer’s side of accommodation and representation for disabilities.

He started in employment law and spent nearly 10 years as working to defend Fortune companies against lawsuits. Not only was Fritz the first wheelchair user at his firm but to this day he is one of the only wheelchair users with a “significant disability” at a top-50 law firm in the United States.

Today, Fritz has a significant position in counseling and litigation at Gusto, playing a role in employee relations and policy review. Although Fritz has had his share of challenges living with MD, he continues to view his condition not as something to heal or fix, but something to thrive with.

“I don’t have time to just sit around and pray that everything will be better for me physically. I have to live the life I was given and make the best of it. You should always be yourself, and that’s exactly enough.” 

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New KCH faculty members study biomechanics of shoulder pain

April 03, 2024 | Anna Flanagan

According to an article published in 2020 in Clinical Rehabilitation, up to 71 percent of manual wheelchair users report that they have experienced shoulder pain at some point in their lives. There is no question that manual wheelchair propulsion puts stress on the upper extremities. But if the pain is related only to the repetitive motion of wheelchair propulsion or overuse, why don’t all manual wheelchair users experience shoulder pain? Why are adults who began using a wheelchair in adulthood more likely to experience pain than adults who began using a wheelchair in childhood, despite significantly fewer years of wheelchair use? Why do female wheelchair users experience shoulder pain at twice the rate and intensity of males? What are the most effective ways of treating shoulder pain? What role does physical activity play in reducing pain and pathology?

These are some of the questions two of the newest scholars in the Department of Kinesiology and Community Health hope to answer through their research. Assistant Professors Matt Hanks and Josh Leonardis joined KCH last fall. Both had just completed post-doctoral research fellowships at the University of Wisconsin-Milwaukee in the Department of Rehabilitation Sciences and Technology. 

The Biomechanics of Shoulder Pain

As a doctoral student in kinesiology at the University of Michigan who focused on shoulder biomechanics and neuromuscular control, Leonardis had been investigating shoulder morbidities in breast cancer survivors. Treatments for breast cancer are highly invasive to the shoulder joint complex and upper extremity musculature. “There are a lot of downstream effects that are underappreciated because the focus is on beating breast cancer,” he said. “As breast cancer becomes an increasingly survivable disease, the focus needs to shift to what life is like after the fact.” A small percentage of biomechanics literature focuses on the shoulder, he added, because it’s difficult to study. 

When he began looking for a post-doctoral position, he wanted to study shoulder biomechanics in a new population in which pain and pathology were ongoing secondary problems. He chose to complete a post-doctoral fellowship in rehabilitation engineering in the Mobility Lab at the University of Wisconsin-Milwaukee, where studies of wheelchair propulsion biomechanics and shoulder pain and pathology in pediatric and adult populations were underway.

“It felt as though I was given the opportunity to contribute toward improving the quality of life of a couple of different populations, and that was important to me.” Leonardis said.

He describes his general research interest as the adaptability of the neuromusculoskeletal system. One question he will pursue is whether the absence of shoulder pain in some wheelchair users with pediatric-onset disabilities and the presence of pain in others is related to adaptations to the neuromuscular and musculoskeletal systems that occur during the transition from childhood to adulthood, a period between the ages of 8 and 21 when bodies grow and change tremendously. He currently is investigating the possibility of sex-specific adaptations during this period that might contribute to females experiencing pain more frequently and more intensely than males. Similarly, he also believes adaptation might explain why pain is more common in people who begin using wheelchairs as adults when compared to adults who began using wheelchairs as children and adolescents.

The Role of Physical Activity

Matt Hanks, who completed his Ph.D. in Kinesiology at Auburn University, had been investigating the biomechanics of sports-related movement, primarily overhead throwing, in adapted and traditional sport athletes. Working as an athletic trainer with wheelchair athletes sparked his interest in understanding the shoulder biomechanics of manual wheelchair users during activities of daily living and in sport and their association with the development of shoulder pain and pathology. He pursued this during his post-doctoral experience in Milwaukee by investigating shoulder biomechanics during wheelchair propulsion and adapted sport among children and adults with spinal cord injuries. His particular focus is on the potential effects of physical activity to mitigate shoulder pain and pathology in manual wheelchair users by examining changes in shoulder musculoskeletal development and biomechanics as a result of engaging in physical activity during childhood and early adulthood.

“Manual wheelchair users, particularly children and young adults, are populations that are largely understudied in the physical activity realm,” he said. “Of the research that does exist, there is not a clear consensus on the benefits and drawbacks of physical activity. Is it helpful or hurtful? How much makes a difference? How much is too much? When should it begin? A lot of the broad questions remain to be answered.”

Hanks believes children and adults perceive physical activity differently, which can impact motivation and adherence to physical activity. Children are typically motivated by the opportunity to play, have fun, and interact with others socially. Adults often are more motivated by aesthetics and health. They want to look or feel better, or their doctor has encouraged them to be more active. Using a manual wheelchair can certainly make engaging in physical activity more complicated.

“Now you introduce the obstacles of accessibility, the need for adapted equipment and facilities, and adapted educators—people who understand you and are qualified to give you sound advice based on research,” Hanks said.

Both Hanks and Leonardis observe that the biomechanical study of manual wheelchair users is relatively young. As techniques and technology evolve, they said, the means for identifying factors that go into shoulder pain and pathologies as well as effective interventions get better and better. They will pursue answers to their various research questions individually and in collaboration. Hanks is the director of the Disability and Movement Biomechanics Laboratory. His team’s multimodal approach to investigating the role of physical activity on shoulder health in manual wheelchair users utilizes motion analysis and biomechanical modeling, diagnostic and quantitative imaging, and upper extremity strength testing. Leonardis directs the Musculoskeletal Morphology and Biomechanics Laboratory, where he and his team investigate the intimate relationship between musculoskeletal structure and function using traditional biomechanical technologies, computational evaluations of neuromuscular control, and quantitative musculoskeletal imaging techniques. They also co-direct the Movement Analysis Laboratory, a state-of-the-art space equipped for the biomechanical evaluation of various populations across the lifespan. 

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