Grants

A Pilot Study to Demonstrate the Feasibility of Correlating Anatomical Changes and Clinical Outcomes in Reverse Total Shoulder Replacement Patients.

PI: Ram Haddas, PhD, MBA; Ilya Voloshin, MD
Co-Investigators: Sandeep Mannava, MD, PhD; Brian Nicandri, MD; Edward Schwarz, PhD; Chao Xie, MD, MSBA

Aim: To determine whether anatomical changes following reverse total shoulder arthroplasty (rTSA)—including changes in the prosthetic center of rotation, rotator cuff muscle atrophy, and tendon integrity—are associated with objective recovery of activities of daily living (ADLs). The study integrates 3D-CT, MRI, motion analysis, and electromyography to establish feasibility and generate preliminary data for a larger prospective clinical trial.

Outcomes: Primary outcomes include shoulder range of motion, compensatory trunk and adjacent-joint motion, neuromuscular activation and efficiency during ADLs, MRI-derived measures of rotator cuff muscle integrity, and 3D-CT measures of prosthetic center of rotation. These measures are used to examine how postoperative anatomy relates to biomechanical and functional recovery.

Clinical Application: This work aims to establish objective links between surgical anatomy and functional recovery, with the potential to improve patient-specific implant positioning, preoperative planning, postoperative rehabilitation, and prediction of functional outcomes following rTSA.

Defining Initial Recovery of Activities of Daily Living After Human Dermal Allograft Augmentation of the Repair of High Grade Degenerative Articular-Sided Partial Supraspinatus Tears Utilizing Motion Analysis.

PI: Ram Haddas, PhD, MBA; Ilya Voloshin, MD

Aim: To determine whether human dermal allograft augmentation accelerates early functional recovery following repair of high-grade (>50%) partial-thickness supraspinatus tears compared with standard rotator cuff repair, and to identify when clinically important ADLs are restored.

Outcomes: Longitudinal assessments include 3D shoulder kinematics, compensatory trunk motion, surface EMG-derived neuromuscular activation, functional ADL performance, patient-reported outcomes, and imaging-based healing. The study evaluates whether augmentation is associated with improved shoulder mechanics, reduced compensatory movement, more normalized neuromuscular activation, and earlier return toward normal functional performance.

Clinical Application: The study addresses whether improved structural healing translates into meaningful functional recovery. Objective recovery biomarkers may help guide rehabilitation progression, return-to-activity decisions, and patient selection for biologic augmentation while complementing traditional imaging and patient-reported outcomes.

Patient-Centered Digital Platform for Assessing and Detecting Fall Risk. 

PI: Ram Haddas, PhD, MBA
Co-Investigators: Tyler Schmidt, DO; Varun Puvanesarajah, MD

Aim: To develop and evaluate a rapid, objective digital screening platform for identifying fall risk, initially using patients with cervical spondylotic myelopathy as a high-risk clinical model. The study seeks to establish a multidimensional fall-risk profile and determine how digital screening results relate to established clinical diagnoses and outcomes.

Outcomes: The platform integrates quantitative gait, balance, dexterity, force-plate, motion-capture, EMG, EEG, and computerized dynamic posturography measures to identify characteristic “red-flag” movement patterns. Digital outcomes are compared with MRI findings, physical examination, PROMIS, mJOA, NDI, and kinesiophobia measures.

Clinical Application: The long-term goal is to create an accessible point-of-care screening tool that can objectively stratify fall risk, identify patients who may require specialist evaluation, and facilitate earlier preventive interventions. The platform also has potential applications across aging, neurologic, and musculoskeletal populations at elevated risk for falls.

Improving Care for Spinal Deformity Patients: Utilizing Wearable Tools for Functional and Disability Assessments.

PI: Ram Haddas, PhD, MBA
Co-Investigators: Varun Puvanesarajah, MD; Paul Rubery, MD; Addisu Mesfin, MD; William Lavelle, MD; Yair Barzilay, MD

Aim: To quantify how adult spinal deformity surgery changes patients’ real-world function using spine-specific wearable Disability and Functional Outcome Measurements (DFOMs) collected in the home environment, and to determine how these objective measures relate to conventional clinical outcomes.

Outcomes: Wearable-derived measures assess mobility, trunk kinematics, balance, and functional performance before and after surgical correction. Postoperative function is compared with age- and sex-matched controls, while DFOMs are also correlated with radiographic alignment, patient-reported outcomes, psychological status, and medication use.

Clinical Application: Home-based wearable assessment may extend functional evaluation beyond static radiographs and episodic clinic visits. This approach could support objective monitoring of real-world recovery, identification of abnormal recovery trajectories, more individualized rehabilitation, and improved surgical planning and outcome prediction.

Feasibility of telehealth functional assessments using wearables to improve the treatment of low back pain among suburban, and underrepresented minority populations: A pilot study. 

PI: Ram Haddas, PhD, MBA
Co-Investigator: Edward Schwarz, PhD

Aim: To determine whether home-based wearable functional assessment delivered through telehealth is feasible across diverse populations with chronic low back pain, with particular emphasis on extending wearable-based assessment to underserved and underrepresented urban populations. The study also evaluates postoperative functional change and relationships between wearable-derived outcomes and conventional clinical measures.

Outcomes: Primary outcomes include feasibility and patient compliance, pre- to postoperative changes in wearable-derived function and disability, comparison with healthy controls, and associations with patient-reported outcomes, psychological status, pain, and medication use.

Clinical Application: This project examines whether objective functional assessment can be moved from specialized motion laboratories into patients’ homes, potentially expanding access to quantitative spine care through telehealth while reducing geographic, socioeconomic, and resource-related barriers.

The Effect of Surgical Intervention on Daily Function Activity on Spine Degenerative Patients Based on A Low-Cost Wearable Device: Evolution, The Concept of Movement, Severity Level, and Correlation to Clinical Outcomes. 

PI: Ram Haddas, PhD, MBA
Co-Investigators: Varun Puvanesarajah, MD; Paul Rubery, MD; Addisu Mesfin, MD; William Lavelle, MD; Yair Barzilay, MD

Aim: To use a low-cost, spine-specific wearable sensor to objectively characterize functional impairment in patients with degenerative spine disorders and evaluate changes in daily movement and function associated with surgical intervention. The broader framework examines whether wearable-derived functional metrics can characterize disease severity and complement conventional clinical assessments.

Outcomes: The wearable framework quantifies clinically relevant trunk kinematics and functional performance during gait, standing and balance, lifting, and transitional activities. Validation work demonstrated strong agreement between the spine-specific wearable and gold-standard motion capture across these functional tasks, supporting its use for objective assessment of global trunk motion, compensatory strategies, mobility, and balance.

Clinical Application: This work supports translation of laboratory biomechanics into a scalable clinical tool for quantifying spine-related disability, monitoring postoperative recovery, identifying functional decline, and guiding individualized rehabilitation. It also provides a foundation for remote monitoring and the future development of wearable-derived prognostic biomarkers in spine care.

Home-Based Functional Outcome Measurements: Validation and Evolution of Healthy Control Database.

PI: Ram Haddas, PhD, MBA
Co-Investigators: Varun Puvanesarajah, MD; Paul Rubery, MD; Addisu Mesfin, MD; William Lavelle, MD; Yair Barzilay, MD

Aim: To establish and validate home-based functional outcome measurements using wearable technology and develop a normative healthy-control database that can serve as a reference for evaluating functional impairment and recovery in patients with spine disorders.

Outcomes: The program focuses on wearable-derived trunk kinematics, gait, balance and postural control, lifting, transitional movements, and other standardized daily functional activities. Subsequent validation demonstrated that a spine-specific wearable IMU can provide clinically interpretable measures of trunk function with strong agreement with laboratory-based motion capture.

Clinical Application: A validated normative database provides an objective reference for determining the magnitude of functional impairment and the extent to which an individual patient returns toward normal function. This framework may support disease-severity classification, longitudinal recovery tracking, remote patient monitoring, and patient-specific rehabilitation goals while complementing imaging and patient-reported outcomes.

Research Support

We gratefully acknowledge the organizations that have supported and contributed to this body of research, including the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH); National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); Zimmer Biomet; Arthrex; Scoliosis Research Society; and Medtronic, Inc.