“We are more prone to falls as we age,” says Jeffrey Kinsella-Shaw, associate professor in the Department of Kinesiology and director of the Doctor of Physical Therapy (DPT) program (DPT). “Keeping people from falling and hitting the ground is hugely important, as falls are the fourth biggest killer of Americans over the age of sixty-five.”
While a physical therapist at Windham Hospital, Kinsella-Shaw directed a fall risk reduction program and support group for patients with Parkinson’s disease and multiple sclerosis, as well as stroke survivors. Working with these patients gave him an insider’s view into living with balance issues.
His current research focuses on two areas. The first is looking at the biophysics of postural control, evaluating fall risks and examining how aging in the brain and other perceptual systems affect movement and balance.
His other area of interest is determining how exercise affects neurotrophic factors in the brain relating to aging, to improve short term and spatial memory as well as stave off major depressive disorders often seen in elderly patients. This research will be done at UConn’s newly constructed Brain Imaging Research Center (BIRC).
“One of the exciting things at UConn is the new Siemens 3 tesla Prisma MRI scanner housed in the BIRC,” Kinsella-Shaw says. “We are now one of the best-equipped research facilities on the East Coast for clinical and cognitive neuroscience.”
So why do we fall more as we age?
“The changes are principally neuromuscular,” Kinsella-Shaw explains. “This includes both a slower reaction time and a general loss of balance that parallels changes in vision, hearing and the entire nervous system.”
The most common way people fall is to misjudge the height of a surface when stepping up or down, tripping over a step, uneven surface or clutter, or by experiencing a loss of balance.
“In physical therapy we find that people change the degree in which they penetrate the local environment,” Kinsella-Shaw says. “They engage in fewer activities because they feel an escalated sense of risk, or worse, don’t change until they’ve had an accident. People lose their ability to judge what they are capable of doing.”
Anything that affects movement of fluid in the ears or that damages the cells in the inner ear can influence balance. This could include exposure to second-hand smoke, high levels of noise pressure and overuse of antibiotics in the erythromycin family.
Kinsella-Shaw and a team of DPT students are conducting a study on the potential of minimalist running shoes to improve balance.
“We know that the use of minimalist shoes by long distance runners creates healthy changes in foot mechanics,” Kinsella-Shaw explains. “We want to see if using these shoes will give elderly folks better contact with the ground and improve their balance.”
The study will compare the use of minimalist shoes and standard shoes. New Balance is supporting the project by providing shoes.
In another study supported through a seed grant ($10,000 to pay for twenty MRI sessions), Kinsella-Shaw is partnering with Assistant Professor in Residence of Kinesiology Adam Lepley in a patient-centered study at the BIRC. The project will involve transcranial magnetic stimulation (TMS) to determine whether brain stimulation will improve recovery from ACL knee surgery. The idea is to train the muscles while applying direct facilitatory stimulation to the part of the brain that controls the muscles in the upper thigh and knee, examining any changes in the motor cortex after stimulation through a functional MRI (fMRI). While a structural MRI provides images of tissues, an fMRI maps brain activity.
Such research could lead to advances in treating patients with other health issues such as stroke or total knee replacement. “This is a step toward a new class of clinical interventions in regenerative medicine,” Kinsella-Shaw points out.
Regenerative medicine is a relatively new area, but one with exciting potential to treat a variety of illnesses such as Parkinson’s disease and multiple sclerosis.
When asked what Kinsella-Shaw would most like to learn about the brain, he says, “I’d like to identify why we are not symmetrical. Why our left and right sides don’t do the same jobs on the same schedule. It has huge clinical implications.”
“We know a lot about sections of the brain, but not why it works altogether,” he says. “We are in a period of history where the expansion of our knowledge base is more rapid than ever before, because we finally have the tools that allow us to examine the brain from a molecular to holistic level.”