Bone and Joint logo photo of Rehabilitation R&D Center

To advance the discovery of new knowledge
that optimizes rehabilitation health care

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The overall mission of the VA Palo Alto Health Care System's Bone and Joint Rehabilitation Research and Development Center of Excellence is to develop novel clinical treatments for the rehabilitation of veterans.

Working to preserve and restore bone and joint health

The goal of the Center's activities is to reduce pain and improve function in VA patients diagnosed with impairments involving the musculoskeletal system. The primary areas of investigation are:

right arrow developing novel physical interventions for prevention of bone loss due to disuse, and the restoration of normal bone density,
right arrow halting the progression of osteoarthritis, and reversal of cartilage degeneration, and
right arrow improving the rehabilitative course and ultimate outcome of orthopaedic techniques such as fracture repair and total joint replacement.

From concept to clinic

Peripheral quantitative computer tomography (pQCT) can be used to obtain detailed three-dimensional information about cross-sectional geometry and density with the bones of living subjects. This information can be used to predict fracture risk in individuals with low bone density and osteoporosis.

The effects of load bearing body weight support using treadmill training (Lokomat) are being studied to improve gait in persons with post-stroke hemiparesis.

Surgeons and engineers test the strength and stiffness of different fracture fixation constructs to improve healing and reduce surgical risk.

Scientists analyze the kinematics of gait to understand the mechanical factors influencing osteoarthritis and osteoporosis development. Novel devices and rehabilitation treatments are evaluated for efficacy in improving walking biomechanics for these and other musculoskeletal conditions.

Clinicians and engineers collaborate to improve outcomes of upper extremity surgical reconstructions using biomechanical models and patient assessments.

At the Bone and Joint Rehabilitation Research and Development Center, we believe that successful rehabilitation strategies are grounded in a firm scientific understanding of the underlying impairment and that a multi-disciplinary team most effectively accomplishes bone and joint research. By conducting a full range of research from basic science to clinical studies of the mechanisms responsible for orthopedic impairments, we create a strong basis for developing new clinical treatments that reduce the disability of veterans and improve the effectiveness and efficiency of healthcare delivery by VA clinicians.

Basic Science - At the basic research level our investigations are aimed at identifying the molecular mechanisms that affect skeletal health. Increased understanding of these relationships can lead to clinical and pharmacological treatments of diseases such as osteoporosis and osteoarthritis.

Translational Research - We engage in translational research using innovative techniques including motion capture, computational modeling, and gait analysis. These techniques provide the practical knowledge needed to design therapeutic interventions ranging from surgical techniques to physical therapy that can aid patients experiencing pain, fractures, and loss of mobility and function.

Clinical Studies - At the clinical trial stage we conduct human trials to test and refine new medical techniques and surgical procedures that result from our research.

We apply the concept to clinic approach to address problems related to loss of function from arthritis and osteoporosis, two of the most common skeletal diseases in the elderly. Our efforts are directed towards identifying new design concepts for longer lasting joint replacements, improving cartilage repair and regeneration, and developing therapy devices and protocols that will preserve and restore bone and joint health.


The Center engages in research projects and develops innovative diagnostic, training, and assistive devices for veterans with physical and/or neurologic disabilities to increase their independence and improve their quality of life.

Affiliations:
Department of Veterans Affairs
link to Department of Veterans Affairs homepage link to VA Research and Development Service homepage link to VA Rehabilitation Research and Development Service homepage
 
Stanford University
link to Stanford University homepage link to Stanford University School of Engineering homepage link to Stanford University School of Medicine homepage

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Send questions or comments about this website to: dljaffe -at- stanford.edu