Profile in excellence.

G Kelley Fitzgerald, PT, PhD, OCS, University of Pittsburgh, Assistant Professor, Department of Physical Therapy, a 1995, 1997, and 1998 doctoral award and 2000 research grant recipient, has been developing a research career in the areas of anterior cruciate ligament rehabilitation and knee osteoarthritis (OA) and has been assisted by the Foundation in this endeavor.

Fitzgerald was awarded a 4-year, $1.425 million grant in April 2004 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) fur a project, "Knee Stability Training in Individuals With Knee Osteoarthritis." In addition to strength and joint mobility exercises, incorporating balance and agility training techniques (knee stability training) may improve the effectiveness of exercise therapy by inducing favorable changes in lower-extremity biomechanics and allowing for greater improvements in functional status than what can be achieved by strength and joint mobility exercise alone.

The results of this project will help determine whether knee stability, training techniques are likely to enhance lower-extremity biomechanical and neuromuscular function as well as physical performance and disability over standard training techniques in patients with knee OA. The knee stability training program being tested in this project is a modification of the program developed during Fitzgerald's 1995 and 1997 Foundation doctoral funding.

This year, Fitzgerald published 4 articles on knee OA:

   Fitzgerald GK, Piva SR, Irrgang JJ, et al.
   Quadriceps activation failure as a moderator
   of the relationship between
   quadriceps strength and physical function
   in individuals with knee osteoarthritis.
   Arthritis Rheum. 2004;51:40-48.

   Fitzgerald GK, Oatis C. The role of physical
   therapy in the management of knee
   osteoarthritis. Curt Opin Rheumatol.
   2004;16:143-147.

   Piva SR, Fitzgerald GK, Irrgang JJ, et al.
   Get Up and Go Test in patients with knee
   osteoarthritis. Arch Phys Med Rehabil.
   2004;85:284-289.

   Childs JD, Sparto PJ, Fitzgerald GK, et al.
   Alterations in lower extremity movement
   and muscle activation patterns in individuals
   with knee osteoarthritis. Clin
   Biomech (Bristol, Avon). 2004;19:44-49.

Fitzgerald is an expert in anterior cruciate ligament reconstruction (ACLR). His article published in the Journal of Orthopaedic and Sports Physical Therapy (Fitzgerald GK, Piva SR, Irrgang JJ. A modified neuromuscular electrical stimulation protocol for quadriceps strength training following anterior cruciate ligament reconstruction. 2003;33:492-501), the product of research from his 2000 Foundation grant, reports on the results of a modified version of the neuromuscular electrical stimulation (NMES) protocol, with the knee in extension to reduce patellar discomfort, following ACLR. Fitzgerald and his colleagues found that, although the treatment effect of the modified NMES protocol was not as strong as reported in previous studies of patients who had ACLR and received the standard NMES protocol, the modified version can be beneficial for patients who have difficulty tolerating existing NMES protocols and can be a useful adjunct to ACLR in clinics that do not have instrumented dynamometers.

Fitzgerald also published 3 additional articles in the area of ACLR that stem from his Foundation doctoral awards:

   Fitzgerald GK, Axe MJ, Snyder-Mackler L.
   A decision-making scheme for returning
   patients to high-level activity with non-operative
   treatment after anterior cruciate
   ligament rupture. Knee Surg Sports
   Traumatol Arthrosc. 2000;8:76-82.

   Fitzgerald GK, Axe MJ, Snyder-Mackler L.
   The efficacy of perturbation training in
   nonoperative anterior cruciate ligament
   rehabilitation programs for physically
   active individuals. Phys Ther. 2000;
   80:128-140.

   Fitzgerald GK, Axe MJ, Snyder-Mackler L.
   Proposed practice guidelines for nonoperative
   anterior cruciate ligament
   rehabilitation. J Orthop Sports Phys Ther.
   2000;30:194-203.

Fitzgerald noted, "The funding I received as a doctoral student and later as a new investigator played an important role in preparing me for a career as an independent investigator. The skills and interventions that I developed during these projects, and the publications resulting from these projects, provided me with the background and justification that enabled me to eventually obtain my current funding from NIAMS."