Rehabilitation

Researchers are investigating the relationship between functional measures of balance and gait and objective kinetic and kinematic parameters in people with Multiple Sclerosis (MS). This cross-sectional observational study aims to understand how biomechanical gait and balance data collected through the Vicon motion analysis system relate to clinical assessments of balance, gait, and physical performance. The study seeks to identify which biomechanical factors are most closely linked to functional abilities and mobility challenges in MS. Participants will attend a single laboratory session where they will undergo biomechanical analysis of balance and gait using the Vicon motion capture system. They will also complete standardized functional tests including the Mini Balance Evaluation Systems Test, Functional Gait Assessment, Short Physical Performance Battery, and a 2-Minute Walk Test. Additionally, they will fill out questionnaires assessing fear of falling and fatigue and have their lower-limb spasticity evaluated with the modified Ashworth Scale. During the session, which takes about 40 minutes for the primary kinetic and kinematic analysis and additional time for functional assessments, researchers will collect detailed movement data alongside clinical measures. This data will be analyzed to explore correlations between biomechanical parameters and functional outcomes. The study includes assessments of postural control, gait performance, physical endurance, fatigue, and spasticity. The findings aim to improve understanding of movement impairments in MS and support better clinical assessments and rehabilitation approaches.

This research aims to evaluate a 6-month community walking program called the 10,000 Step Club (10KSC) for people with Parkinson's disease (PD) and their caregivers in Las Vegas, Nevada. The program focuses on increasing physical activity, reducing sedentary behavior, fear of falling, loneliness, and social isolation among participants. It is designed to encourage connection among people with PD and promote accountability for reaching a goal of 10,000 steps per day. Participants will join one of three weekly walking groups held in local parks across the Las Vegas valley. Each group, led by University of Nevada, Las Vegas physical therapy students, will meet once a week for a 60-minute walk using Nordic walking poles to support stability and posture. Participants will receive a step watch to track their daily steps in real-time and may attend additional walking sessions if desired. The program is offered in English and Spanish and includes an incentive system to motivate participants. During the study, participants will be assessed before and after the 6-month program. Researchers will monitor daily average step counts, fear of falling avoidance behavior, social isolation, loneliness, and self-efficacy. They will also evaluate the program's feasibility, safety, and diversity of enrollment. The total participation time is 6 months, with ongoing encouragement to increase physical activity while fostering social connections among people with Parkinson's disease.

Researchers are conducting the 100-Year Human Aging Study, an observational trial designed to follow participants over their lifespans to investigate which health measurements can predict mortality, serious diseases, and functional disability. The study aims to validate many longevity measures that currently lack prospective evidence by tracking physiological, cognitive, social, and environmental factors that change with aging. This research will generate important data to improve understanding of aging and longevity medicine. Participants undergo comprehensive multi-system clinical screenings including tests like cardiopulmonary exercise testing, body composition assessment by DEXA, echocardiography, electrocardiography, spirometry, neurocognitive testing, sensory assessments, metabolic testing, and detailed medical and social histories. The study allows for different levels of participation, from single tests to full two-visit screening batteries, and encourages repeat testing to capture health changes over time. During the study, participants receive individualized reports including investigational estimates of biological age and predicted cause of death. Researchers collect data on mortality, serious health events, chronic diseases, functional ability, and lifestyle changes through periodic follow-up over many years, potentially up to 100 years. This extensive data collection helps evaluate how well these measurements predict aging outcomes. All data are stored in raw form for future analysis and participants are supported with ongoing contact and opportunities for repeat assessments.

Researchers are evaluating the optimization of 18F-DOPA PET/CT imaging in specific patient groups including pediatric patients with congenital hyperinsulinism or neuroblastoma, pediatric and adult patients with neuroendocrine tumors or brain tumors, and adults suspected of Parkinson's disease or Lewy body dementia. The study aims to improve image quality using a new digital PET/CT scanner and intravenous furosemide, while also exploring gallbladder activity patterns related to dopaminergic degeneration. Participants will receive an intravenous injection of 18F-DOPA, with some also receiving a single intravenous dose of furosemide. The study includes a primary objective of assessing image quality improvements in the pelvis area and a secondary objective examining gallbladder activity patterns using dynamic imaging in a subgroup. Imaging data will be compared to previous scans with older technology. During the study, participants will undergo PET/CT scans, with measurements of lesion size and activity, bladder activity, and image artifact scoring. A questionnaire will screen for gallbladder disease history. The research team will analyze the imaging results and gallbladder activity patterns, with follow-up assessments occurring within one to three months. The total planned enrollment is 800 patients over approximately five years, with detailed monitoring of image optimization and gallbladder activity.

Researchers are investigating the long-term safety, tolerability, and effectiveness of a home-based peroneal electrical transcutaneous neuromodulation (eTNM4) treatment using the URIS I12 device in people with Parkinson's disease (PD) or Essential Tremor (ET). Earlier, a 6-week pilot study with 24 participants showed that this home treatment was safe, well tolerated, and had high adherence, with no treatment-related side effects. Although not designed to prove effectiveness, the pilot suggested improvements in tremor symptoms that lasted for weeks after treatment ended. This extension study aims to further evaluate these outcomes over a longer period. All participants will receive the peroneal eTNM treatment using the URIS I12 neurostimulator device. This device delivers electrical stimulation directly through the skin to the peroneal nerve. The study follows the same treatment procedure as previous studies but applies it over a longer timeframe to assess ongoing effects. This is an open-label, single-site study lasting 24 months, during which participants will continue home-based therapy under the study protocol. Participants will be monitored for safety and tolerability throughout the 24-month treatment period, with particular attention to any adverse events related to the therapy. Effectiveness will be assessed using patient self-reports and clinical scales measuring tremor severity and motor function. Researchers will also track participants' adherence and overall experience with the home treatment. The study aims to provide comprehensive data on the long-term impact of this non-invasive neuromodulation therapy on symptoms related to movement disorders in PD and ET.

Researchers are evaluating the clinical performance of 3M™ Filtek™ Supreme Flowable Composite for dental restorations, focusing on Class IV cavities and veneers on anterior maxillary teeth. This non-randomized clinical study aims to provide data on the survival and aesthetic and functional outcomes of this flowable composite material, which has been developed to improve ease of use and adaptability compared to traditional paste composites. The study includes follow-ups at 7 days, 6 months, 12 months, and 24 months, using a modified Fédération Dentaire Internationale (FDI) score updated in 2023 to assess the restorations. Participants will receive 3M™ Filtek™ Supreme Flowable Composite treatment applied to either Class IV restorations or veneers, with veneers performed only on paired contralateral teeth. The composite contains a mix of resins and various fillers designed for improved handling and performance. The study is conducted at a single site and includes at least 50 Class IV and 25 veneer restorations. Evaluations will be performed by two calibrated examiners different from the treating operator to ensure objective scoring. During the study, participants will have their dental restorations photographed and assessed at each follow-up visit for up to 24 months. The primary outcome is the survival of the treated site over this period. Secondary outcomes include evaluations of esthetic and functional properties. Participants must attend all scheduled follow-up visits and maintain good oral hygiene. Safety and performance data will be collected throughout the study duration, which lasts up to 24 months post-treatment.

Researchers are evaluating how high frequency repetitive transcranial magnetic stimulation (rTMS) may improve postural instability, a disabling symptom in Parkinson's disease (PD) that leads to frequent falls and loss of independence. This study focuses on patients aged 55 to 70 years with mild to moderate PD, aiming to assess the long-term effects of this treatment on balance and stability. Participants will be randomly assigned to one of two groups: one receiving a designed physical therapy program including aerobic exercise, stretching, proprioceptive neuromuscular facilitation techniques, active exercises, gait training, and weight shifting exercises three times a week for four weeks; the other receiving the same physical therapy plus 12 sessions of high frequency rTMS over the primary motor cortex also three times a week for four weeks. The rTMS sessions last 20 to 30 minutes and are delivered using a specialized device. During the study, researchers will measure balance using the Biodex balance system before treatment, immediately after, and at one-month follow-up. They will assess stability indices including overall, anteroposterior, and mediolateral balance, as well as directional control and time to complete balance tests. The study lasts for six months, with ongoing monitoring to evaluate the lasting effects of the interventions on postural stability.

Researchers are evaluating the use of [18F]-MFBG PET scans to assess heart nerve activity in people with Parkinson's disease (PD), multiple system atrophy (MSA), dementia with Lewy bodies (DLB), and Alzheimer's disease (AD). The study compares this method with the current standard [123I]-MIBG SPECT scans, focusing on distinguishing between PD and MSA as well as DLB and AD. This is a prospective study conducted at two centers, aiming to validate the accuracy and feasibility of [18F]-MFBG PET for these neurological conditions. Participants will undergo several imaging tests including dynamic cardiac [18F]-MFBG PET, [123I]-MIBG SPECT, and cerebral [18F]-PE2I PET scans. Healthy volunteers and patients with confirmed diagnoses will be included, with groups divided by age and disease duration. A dosimetry study will also be conducted for healthy volunteers to measure radiation exposure from [18F]-MFBG. Multiple visits to the hospital are required for scans and assessments. During the study, participants will have thorough neurological assessments, brain MRI scans, and blood sampling alongside PET and SPECT imaging. Researchers will evaluate diagnostic accuracy, effect size of tracer uptake changes, and relationships between heart nerve imaging and brain dopamine transporter changes and autonomic dysfunction. The study includes monitoring for safety and will analyze regional heart uptake patterns. Participants can expect 3 to 4 hospital visits with detailed imaging and clinical evaluations over the study period.

Alpha-synucleinopathies are age-related neurodegenerative disorders characterized by the build-up of alpha-synuclein in nerve cells, leading to conditions like Parkinson's disease, Multiple System Atrophy, and Dementia with Lewy Bodies. Pure Autonomic Failure is a related condition affecting the peripheral autonomic nervous system and may signal risk for developing central nervous system synucleinopathies. Researchers aim to identify biomarkers, especially changes in dopamine production in key brain areas, to predict progression from peripheral to central disease. Participants receive a radiolabeled drug called [18F]F-DOPA, which is used in PET scans to study dopamine activity in the brain. Before the PET scan, patients take oral doses of carbidopa and entacapone to enhance imaging quality by reducing peripheral metabolism of [18F]F-DOPA. The PET scan involves a slow injection of [18F]F-DOPA followed by about 95 minutes of serial brain imaging to observe dopamine-related changes. During the study, participants undergo clinical exams to confirm diagnosis and receive the PET imaging procedure. Researchers measure differences in [18F]F-DOPA uptake across patient groups 95 minutes after imaging starts to assess dopamine function. The study includes patients with autonomic failure, possible synucleinopathies, and healthy adults aged 18 and older. The study is designed to monitor safety and gather detailed imaging data over the scan period.

Researchers are evaluating a digital health intervention called PROMOTE to support lung cancer survivors undergoing treatment aimed at cure. The study focuses on people with stages I-III non-small cell lung cancer receiving chemotherapy with curative intent. It aims to improve physical function, manage breathlessness and sleep problems, increase physical activity, encourage healthy eating, and enhance overall wellbeing. The trial compares PROMOTE to enhanced usual care, including educational materials, to see which better supports survivors' health and quality of life. Participants will be randomly assigned to one of two groups: one receives the PROMOTE app delivered on a tablet, which includes educational modules and behavioral strategies for managing symptoms and improving lifestyle; the other group receives standard oncology care plus health education materials from the American Cancer Society. The intervention lasts about 10 to 12 weeks, during which participants use the app at their own pace alongside usual cancer treatment. Throughout the study, participants complete surveys at enrollment and at 6, 12, and 24 weeks to track changes in physical function, breathing difficulties, sleep disturbance, physical activity, diet, mood, and quality of life. The study also monitors participants' confidence in managing their health and coping skills. After 24 weeks, those in the control group will have the option to access the PROMOTE app. The total participation time spans about 24 weeks from enrollment to final assessment.