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Don Knabe Wellness Center

Pathokinesiology Laboratory

The world-renowned Pathokinesiology Laboratory investigates human movement, especially the biomechanics, muscle function and energy requirements of walking and mobility. The overriding goal of the lab’s clinical and research efforts are improvement of patient care for individuals with movement disorders which include orthopedic disabilities, spinal cord injury, brain injury, cerebral palsy, stroke, and post-polio syndrome. The unit was founded in 1968 by pioneering orthopedic surgeon, Jacquelin Perry, MD, and is now under the direction of Sara Mulroy, PhD, PT with consultation from orthopedic surgeons, Vance Eberly, MD, and Kevin Rolfe, MD. Dr. Mulroy and the staff of the Pathokinesiology Laboratory collaborate in many of their clinical research endeavors with Rancho’s Rehabilitation Engineering department under the direction of Philip Requejo, PhD.

Clinical Service

The Pathokinesiology Laboratory provides quantitative analyses of patients’ functions during walking and other activities of daily living. Physicians refer their patients to the Pathokinesiology Laboratory to obtain a detailed evaluation of their function and recommendations for therapeutic and surgical interventions that could not be determined by standard clinical evaluations procedures. The data obtained by the Pathokinesiology Laboratory are used to:

Identify which muscles/structures are contributing to the patient’s functional limitations.

Determine whether a non-invasive therapeutic program would be indicated to optimize the patient’s function such as bracing or orthotic support, assistive devices and muscle strengthening by exercise or electrical stimulation.

Determine if a patient would benefit from constructive surgery,

Delineate what surgery should be performed,

Prevent inappropriate surgery,

This detailed approach maximizes patients’ outcomes and minimizes complications, unsuccessful surgeries, and multiple procedures.

The specific clinical questions for each patient are addressed at the Pathokinesiology Laboratory by a tailored quantitative analysis of the patient’s impairment during walking or other activities of daily living. Depending on the patient’s needs, this may include analysis of the muscle activity, joint motion, joint forces, foot pressure or energy expenditure. Muscle dysfunction is ca common, but often unsuspected, source of pathology. The Pathokinesiology Laboratory is unique in its exclusive use of dynamic fine wire electromyography (EMG) to record the patient’s muscle function. Other clinical laboratories without this expertise must rely on surface recordings of muscle activity that cannot differentiate signals from nearby muscles or record signals from deep musculature. Decisions regarding which muscles to operate on must be made with the accurate information provided by fine-wire EMG to prevent inappropriate surgeries.

The Pathokinesiology Laboratory is equipped to study a wide variety of activities including walking, running, stair climbing, ramp walking, bicycling, and arm function during wheelchair propulsion, crutch walking, walker use, self-care activities, and reach and grasping function in the arm and hand. The patient’s electronic data are then analyzed and compared to a large database of information on normal human movement. The movement deficits are evaluated in light of quantitated measures of the patient’s muscle weakness, spasticity and joint contracture to identify the underlying causes of the functional limitations. The test results provide information to guide and refine patients’ treatment plans.

Pathokinesiology Laboratory Referral Form - Lower Extremity

Pathokinesiology Laboratory Referral Form - Upper Extremity