We combine state-of-the-art virtual reality and immersive technology with a real-time motion data collection system to study motor behavior and develop pain interventions. We have linked Unity Engine with The Motion Monitor, and by using Vicon Tracker marker clusters we have developed the ability to create a virtual world that maps precisely to the real world. Because these events are so tightly synchronized, we can create almost any environment and assess the effects of target size, target location, and speed of movement on performance in both healthy and impaired populations. In collaboration with Steven Coombes, University of Florida Laboratory for Rehabilitation Neuroscience, we are integrating EEG technology with our virtual environment to better understand neurophysiological mechanisms underlying pain and altered motor behaviors. Most recently we have developed a way to use Vive Pucks to track motion in real time which will potentially allow our novel interventions to move quickly from bench to bedside.

Reaching tasks such as ringing a doorbell, wiping a child's face or retrieving the morning paper are so common in our everyday experience that we rarely contemplate the complexity of such motor tasks or the variety of movement patterns that can be used to perform them. There are an infinite number of joint configurations that can be used to complete these reaching tasks and studying these movements is important for shedding light on central nervous system control. The standardized reaching protocol developed by Dr. Thomas has been shown to be effective in assessing alterations in motor control strategy in individuals with both neurologic and orthopedic impairments.

The Motor Control Lab's Core Muscle Activation Test (CMAT) device is custom designed and fabricated to apply precision pulls to the torso to study trunk stiffness and motor coordination. The CMAT system consists of 4 parker motors which are controlled by custom LabVIEW software developed by Peter Pidcoe, Ph.D., PT, at Virginia Commonwealth University's Engineering and Biomechanics Research Lab. This perturbation system is fully integrated with our Vicon data collection system to allow us to collect real-time force and motion data during these suddenly applied perturbations. In addition to assessing motion and force, we also utilize a 16-channel Delys Trigno wireless EMG system to measure muscle activity.

We have modified an activator device typically used in chiropractic practice to apply a short duration pulse to the erector spinae muscle which elicits the short latency reflex response. This has allowed us to develop a robust method to assess short latency reflexes of the erector spinae.

The Motor Control Lab's Fatigue Table is a custom made articulated table that allows for the simultaneous measurement of muscle activity, force production, and position change during trunk extension activities. The table consists of one 6-degree of freedom load cell, one single-degree of freedom load cell, four 600 lb holding capacity electromagnets, two electrogoniometers, a 16-channel Delsys Bagnoli EMG system, and a custom made LabView control system. Using the Fatigue Table, we have the ability to measure the strength and endurance of the trunk extensor muscles during a variety of protocols. Using the HTC Vive headset, we can also have participants complete trunk extension tasks while fully immersed in Virtual Reality.

A Magstim stimulator is interconnected and integrated with a 16-channel Delys Trigno wireless EMG system using paried pulse TMS to determine the level of excitator or inhibitory response to various interventions.

Transcranial direct current stimulation (t-DCS) is a painless, non-invasive brain stimulation using direct current to stimulate specific areas of the brain. The lab performs t-DCS stimulation integrated with surface EMG of the trunk extensor muscles system to measure how this stimulus affects muscle activation in healthy controls and low back pain sufferers.

We have modified a standard MED X Lumbar Machine by placing a load cell in series to measure both dynamic and static loading during trunk extension tasks. We have also placed a custom high gain potentiometer to precisely measure trunk angular displacement. This modified device is used to study the effects of load type on time-to-task failure as well as to quantify the effects of Transcranial Direct Current Stimulation on force production of the trunk extensors.

VIGOR - Virtual Immersive Gaming to Optimize Recovery in Low Back Pain (or VIGOR) is a research study using an interactive game that may help reduce fear and increase spine motion in individuals with low back pain. The purpose of the study is to learn a new way to treat back pain. You are being asked to consider this study because you have chronic lower back pain and may have fear associated with movement.

• RELIEF Study (Researching the Effectiveness of Lumbar Interventions for Enhancing Function Study)

Susanne van der Veen, Ph.D., Post-Doctoral Fellow

Dr. van der Veen is a licensed physical therapist with clinical experience specializing in mobility in the elderly population with neurological and orthopedic disabilities. During her master’s degree and doctorate studies, the primary research focus has been on motor control and factors that affect foot placement accuracy. This determined how important balance is for safe gait and gait adaptability.

Since January 2018 she has been working with Dr. Thomas on various VR projects and is responsible for running the VIGOR study (Phase II RCT examining the effectiveness of virtual dodgeball to reduce pain in and disability in chronic low back pain). Further, she has worked with our lead programmer to develop a series VR tools for balance assessment and treatment.

Education
Salford University, Salford, United Kingdom - 2018, Ph.D. Health Science
Vrije Universiteit van Amsterdam, Amsterdam, The Netherlands - 2014, M.S. Human Movement Science
Hoge school van Utrecht, Utrecht, The Netherlands - 2010, B.S. Physical Therapy 

Alexander Stamenkovic, Ph.D., Post-Doctoral Fellow

Having a keen interest in the link between human structure and function, Dr. Stamenkovic’s research focuses on the underlying neuromuscular coordination that drives human movement. Under an Australian Government Research Training Program Scholarship, his doctoral studies (University of Wollongong, Australia) investigated the role that body posture plays in the control of balance and movement preparation during goal-directed reaching. During this time, he was awarded the University of Wollongong Vice Chancellor’s Sessional Award for Outstanding Contribution to Teaching and Learning (OCTAL) and inducted as a Fellow of the Wollongong Academy for Tertiary Teaching & Learning Experience (WATTLE).

Currently, he assists Dr. Thomas in the NIH-funded Phase II Clinical Trial, ‘Project VIGOR’ and is exploring how immersive technologies influence sensorimotor control. He is an active member of the International Society of Posture & Gait Research (ISPGR), holding roles on both the Communications and Strategic Planning committees. 

Education
University of Wollongong, Australia – 2018, Ph.D. Motor Control
University of Wollongong, Australia – 2011, B.S. (Hons. Class I) Exercise Science 

Matt Underation, Software Engineer

Matt is a Software Engineer who specializes in VR/AR development using Unity Engine and C#. He also has experience with web development and creating web applications (NodeJs). Joining the team in early 2017, he worked with a small team of developers to create the VIGOR study VR games. Since then he has been developing game platforms for other research studies, as well as handling most things involving technology within the lab. 

Education:
Ohio University, B.S. Computer Science

• Megan Applegate, PhD - Post-doctoral Research Fellow at Harvard University - Wyss Institute for Biologically Inspired Engineering