STATEMENT OF PROPOSED STUDY OR RESEARCH – Winner #1, Netherlands, Engineering Biomechanics of a Functional Task in Arthritic Subjects My interest in biomedical engineering is in the area of biomechanics, specifically the biomechanics of human movement. The most common disease that impairs movement in people is arthritis, a painful, degenerative joint disease. Biomechanical analyses are among the most effective means of tracking the progression of impaired function caused by arthritis as well as evaluating the effectiveness of treatment regimes designed to improve function and reduce pain in arthritic patients. Over the past eight months I have been working as a Pratt School of Engineering Undergraduate Fellow in the lab of Dr. Farshid Guilak, a leading osteoarthritis researcher. I have been studying the activity levels and biomechanics of locomotion of arthritic and non-arthritic mice to develop new non-invasive behavioral biomarkers for evaluating disease progression in mouse models of osteoarthritis. By conducting my own research project I was able to explore my interests in both biomechanics and osteoarthritis and see how they were related. In the future I would like to expand my research to include the study of human locomotion and examine how arthritis and other musculoskeletal diseases affect human movement. Spending a year doing research in the laboratory of Dr. Maarten Bobbert at the V rije Universiteit (VU University) in Amsterdam would be an ideal next step for me in my research career. The Netherlands is renowned in the scientific community for both its focus on biomechanics research and its population level studies of arthritisi,ii. This will be an excellent environment to build upon my current research experiences. Dr. Bobbert's lab is part of the Institute for Fundamental and Clinical Human Movement Sciences (lFKB). This institute includes researchers and clinicians from the Faculty of Human Movement Sciences at the VU University, the Medical Center of the VU University of Amsterdam, and the Faculty of Medical Sciences and Hospital of the University of Nijmegen. This type of organized collaboration between biomechanics researchers and doctors is rare in the United States and thus will be a great opportunity for me to explore my interest in human movement science as it relates to clinical applications. As Dr. Bobbert says, "Although the primary objective is to gain fundamental insights, the results are translated whenever possible into recommendations for rehabilitation programs in health care." In the Amsterdam lab, I will be able to expand my knowledge of biomechanics through the emphasis they place on the fundamentals of human movement and at the same time see the immediate clinical applications of the research through their close partnership with the VU University's Medical Center. In order to incorporate some of my current research interests into a meaningful Fulbright project, I discussed with Dr. Bobbert the possibility of doing a project that had clinical applications specifically for arthritis patients. The IFKB is only a few years old, and thus my interest of a more clinically applied project aligned well with Dr. Bobbert's interests of developing more clinical ties as part of the IFKB. He has located a clinical partner from the IFKB, Dr. Willem Lems, a highly regarded rheumatologist, who has joined us in this project and will help us locate the arthritic subjects for our study and assist us in getting approval from the appropriate committee in order to do research with human subjects. Many different clinical methods are used to assess disease progression, pain, and function in arthritic patients. A standard clinical test to evaluate functional impairment is the sit- to-stand (STS) test, where a patient sits in an armless, backless chair and is asked to rise to a standing position while being timed, without using his arms for support. The STS movement is a very common movement used in a domestic setting and one of the first functional tasks that arthritic patients have difficulty with, due to the large loads placed on the joints during this taskiii. I propose to observe the movement pattern, ground reaction forces, muscle activity, and selfreported pain during the STS test in patients with unilateral arthritis of the knee and compare them with those of age- and sex-matched healthy controls. I hypothesize that the arthritis patients will use a different movement pattern in order to minimize the compression forces in the knee in an attempt to minimize pain in the knee. To lend further support to our hypothesis, I will also use my computer programming experience and the resources available in the Amsterdam lab to develop a computer simulation (using both forward and inverse dynamics modeling) that allows for estimation of the compression forces in the knee and for prediction of a movement pattern that helps to minimize these forces. While the STS is a commonly used clinical test, very few studies have made a biomechanical comparison of the execution of this test by arthritic versus non-arthritic patients or used a simulation model to support their results. I am confident that this project will give us better insight into an already widely used medical assessment as it relates to arthritic patients. By providing clinicians in the IFKB, such as Dr. Lems, with further scientific understanding of the movement patterns utilized by arthritic patients during the STS test, this project will facilitate the design of better treatment regimes to improve function and minimize pain in these patients. Successful results of nine months of research in Dr. Bobbert's lab would include a better understanding of the tools used to characterize human movement, knowledge of how to successfully apply my simulation skills to biomechanical projects, an appreciation of the organization of a Dutch research institute such as the IFKB, and a publication of my research in a scientific journal. In addition, I plan to take classes at the VU to increase my knowledge of anatomy, physiology, and movement control, and to increase my interaction with the wider University community. Taking one class a semester, such as "Simulation Models of Neuromuscular Systems" and "Theory and History of Movement Sciences", will help supplement my learning experience while I am conducting my research. Conducting this work in Dr. Bobbert's lab, with the support of Dr. Lems, will make this project a success. Dr. Bobbert's lab has a wide range of biomechanical testing equipment, including an Optotrak system for kinematic analysis, force-plates, and EMG equipment, which will be necessary for my clinical study, as well as previously developed simulation models for various locomotor activities, which will be helpful in creating my simulation models of the STS test. The opportunity to conduct this research in Dr. Bobbert's lab and to be involved in this innovative Dutch scientific community will be invaluable to my development as a successful biomechanics researcher. i Van Tuyl et al. Why are Dutch rheumatologists reluctant to use the COBRA treatment strategy in early rheumatoid arthritis? Ann Rheum Dis. 2007 Jul; 66(7):974-6. ii Van Jaarsveld et al. Effects of rheumatoid arthritis on employment and social participation during the first years of disease in The Netherlands. Br J Rheumatol. 1998 Aug; 37(8):848-53. iii Yoshioka et al. Computation of the kinematics and the minimum peak joint moments of sit- tostand movements. Biomed Eng Online. 2007 July; 6(1):26.