Dustin Grooms PhD, ATC, CSCS, Assistant professor of athletic training at Ohio University talks about ACL injuries and how virtual reality can help with injury rehabilitation and prevention.
Interview conducted by Ivanhoe Broadcast News in March 2019.
What’s your background in?
DUSTIN GROOMS: My PhD is in Health and Rehabilitation sciences with a focus on neuroscience from Ohio State. Before that, I worked for a few years as a clinician at Mount St. Joseph University in Cincinnati, Ohio a college athletic trainer treating injuries. Before that, I did my masters at the University of Virginia and my undergrad at Northern Kentucky University, just outside of Cincinnati.
Can you explain a little bit about the research that you and your colleagues are doing relative to knee injury?
DUSTIN GROOMS: Yes. Our whole labs’ research emphasis is on trying to understand, not just how your movement patterns change after an injury – which is usually what the field focuses on – or the structure of your joints after an injury, but how the combination of those joint and movement changes contribute to changing how your brain functions. I think we’re missing a key avenue of therapy; a lot of times in physical therapy or in recovery from an orthopedic injury, we only think of the structure of the knee or the ligament, but we don’t think of how that impacts the rest of the nervous system.
Can you tell me about what you do here?
DUSTIN GROOMS: I’m very fortunate that the Ohio University gives me a lot of release time to focus on research and I have the privilege to teach in the athletic training program. I get to teach neuro mechanics and the neuro recovery of injury. We try to improve how athletic trainers, physical therapists and med students treat these injuries. That’s part of what my teaching focus is. However, most of my time is spent on research. We have several projects that range from trying to develop new therapies – like how to use virtual reality in the clinic to induce neuroplasticity or changes in brain function that underlie improved motor performance when they’re back on the field – to using advanced brain imaging techniques. We are one of the few places in the state of Ohio that has access to a three T (or tesla – this is an indicator of magnetic field strength), which is the level of magnetic field strength required for a research scanner and our collaboration with Holzer health systems. We’re able to do the latest and greatest neuro imaging techniques to unravel how the brain is functionally changing and structurally changing after an injury.
I want to start by asking about athletics. We saw Amir Miller earlier today. The ACL tear is one of the most common knee injuries, can you tell me a little bit about that?
DUSTIN GROOMS: Yes. It’s definitely one of the most severe knee injuries that require surgical reconstruction. There are some knee meniscus injuries or lighter ligament injuries that may happen more often, but this injury tends to happen in one to 50 young female athletes. It can happen as often as one in 20 collegiate athletes. It can be a more pronounced injury and it is not something that you can take a few weeks to recover from; like we think of more minor musculoskeletal injuries. This injury tends to require surgical reconstruction and you’re looking at anywhere from six months to two years before you start to feel normal again. When I went to go back to do my PhD, I was treating my patients and I always felt like we were missing something; we would focus so much on getting their strength back, the surgery stabilizing the knee joint again, but it seemed like when our patients went back to sport, there was just something missing. Something that we missed in training. They always made comments like, I just don’t feel the same or I just don’t feel as coordinated or even feared getting back to sports. It seemed there was definitely a neural component we were missing, so our lab is broadly focused on trying to understand that.
Can you tell me how something like virtual reality plays a part in either rehabilitation or prevention for this knee injury?
DUSTIN GROOMS: Normally, the way your body processes motion is by using a sense called proprioception, which is the ability to know where your joints are in space without seeing them. My ability to touch my fingertips together without being able to see them is based entirely on a proprioceptive feedback from my joints; your legs are wired to use this sense, which is why you rarely have to look down at your legs to walk around. You’re free to use your brain to interact with the environment. However, what happens after this injury, is that your brain starts to use your vision for motion because it’s very accurate and sensitive and it’s able to help guide your movement.
Amir is early in his second ACL rehab, but may be able to make use of what you’re talking about. Can you tell me what he might face down the road?
DUSTIN GROOMS: Here at Ohio University, we’re very lucky to have a good relationship with our athletics and physical therapy staff. They try to implement a lot of the breakthroughs we make in the lab as soon as they can. Therefore, as Amir starts to recover and starts to do a lot more running, movement, and do some football activities, James, our physical therapist, will incorporate some of the glasses work with him and will try to get him to re-engage proprioceptive control. Some of our therapists use virtual reality, and one of our earlier projects that was just published uses a roller coaster app. We train them to balance and control their body while it looks like they’re engaged in a rollercoaster; that can be pretty challenging. Those are a couple of things that we’ll use with Amir.
Is there anything I didn’t ask you that you want people to know?
DUSTIN GROOMS: I say this at every presentation I give especially for clinicians, but it also goes for patients. Your brain and nervous system are much more powerful than we give them credit for. These slight, little changes can have really big impacts on your injury recovery. I present a lot to surgeons and orthopedics, physicians, and sometimes people under estimate how powerful your brain and nervous system are to recover from an injury, or even to improve your performance. I would encourage people to remember how capable and plastic their system is; just because you feel or move a certain way because you have a certain injury, doesn’t mean you can’t expect to have good function recovery.
How long could it be before our injured men and women in the army could come to a lab like this and get a rehab?
DUSTIN GROOMS: It’ll be three years. We do work with the Army Research Lab and we work with some other labs across the country. I was just at Fort Bragg this past summer. A lot of them have similar labs and therefore, once the breakthroughs happen, a lot of them try to implement it very fast. I don’t see it being long until whatever we discover here gets spread throughout the country and to the DOD system. They’re trying to push implementation and, if what we do here doesn’t get out and help them, then it’s not really worthwhile. I try to work with them on as much as I can on how they can implement some of the breakthroughs we find and some of the new therapies.
It starts this fall, right?
DUSTIN GROOMS: Correct.
Do you have a certain number of people that you’re supposed to look at?
DUSTIN GROOMS: We’re looking at getting 30 to 40 ACL-reconstructed individuals. They’ll be matched to healthy controls. Our ROTC cadets are a big part of the study, especially for the shooting part. If they get injured, they’ll be in the study, but there will also be a lot of healthy controls to look at how do they move.
END OF INTERVIEW
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