Dr. Jerry Parker is the Associate Dean for Research at the MU School of Medicine. Parker is a Clinical Professor of Physical Medicine and Rehabilitation and Director of the Missouri Arthritis Rehabilitation Research and Training Center (MARRTC) at MU.

He has received more than $12 million in funding for the multidisciplinary center from the National Institute on Disability and Rehabilitation Research. Parker also has served as associate chief of staff for research and development at Truman Veterans’ Hospital. He has been with the hospital and medical school since receiving his doctorate in counseling psychology from MU in 1976. Parker has served on the NIH National Advisory Board for Arthritis and Musculoskeletal Diseases and several NIH consensus panels and committees. He has received awards for outstanding research and clinical scholarship from the American Psychological Association and the Arthritis Foundation. His research program has focused on improving health outcomes for people with rheumatoid arthritis, including a series of randomized trials that have demonstrated the clinical benefits of self-management programs.

Dr. John Hewett will serve as Co-director of the training program. Dr. Hewett is Director of the Biostatistics Group, School of Medicine, University of Missouri-Columbia, with an adjunct appointment in the Department of Physical Medicine and Rehabilitation. He is also Professor Emeritus of Statistics, having been a faculty member in the Department of Statistics for 35 years. Hewett also served as the Ph.D. thesis advisor for thirteen students in the Department of Statistics. He has authored or co-authored over 130 scientific papers published in a variety of statistics and applied journals and in 1999 was selected as “Distinguished Scholar” by the Association of Rheumatology Health Professions.

Hewett’s many service activities include serving as a member of the Committee on Publications of the American College of Rheumatology. He has also served as a proposal reviewer for NIDRR for several years. Each year, for the past fourteen years, Hewett has presented workshops at the annual meeting of the Association of Rheumatology Health Professionals, which is a subset of the American College of Rheumatology. He has also provided statistic consultations to applied investigators at the University of Missouri Health Care Center and to other investigators across the campus for over thirty years. Hewett has been a host faculty member of all the Research Enrichment Programs conducted by UMC. Not only will trainees benefit from Hewett’s extensive statistical knowledge, Hewett will also serve as a role model and mentor for commitment and contributions to professional organizations.

Dr. Frank Booth’s research is focused on skeletal muscle, its plasticity, and the molecular and cellular responses to activity/inactivity. He is currently evaluating the factors responsible for the failure of old skeletal muscle to regrow after ending limb immobilization when young skeletal muscle is completely successful in regrowth from limb immobilization. To this end, the mechanisms regulating satellite cell proliferation are being determined. Another area of current research is the discovery of genes responsive to activity/inactivity being determined by genomics and proteomics techniques. Experiments are ongoing to block signaling pathways in successful regrowth and to activate pathways in failed regrowth to determine which pathways are necessary for successful regrowth. In addition, Dr. Booth’s lab is undertaking experiments on inactivity-induced insulin resistance. Thus, Dr. Booth has a wide area of research pursuits available for our trainees.

Dr. Marybeth Brown’s research strands include aging, exercise, and inactivity effects, primarily on skeletal muscle and secondarily on bone, with a strong emphasis on rehabilitation across strands. Using an animal model, Dr. Brown is investigating the effects of rehabilitation versus prehabilitation programs as modifiers of the detrimental effects of simulated bed rest. One week of simulated bed rest (hindlimb unweighting) is either preceded by 10 days of exercise activity (prehabilitation) or 10 days of exercise followed by 7 days of inactivity (traditional rehabilitation). Skeletal muscle contractile properties and stiffness are being examined as well as bone mineral content and strength.

In a clinically relevant project, community-dwelling older adults (75+ years of age) are randomly assigned to one of three exercise interventions for the modification of physical frailty; flexibility/balance activities, traditional weight-training, or aerobic exercise.

Dr. Brown is also participating in a rehabilitation intensification program for older men and women who fractured a hip. Currently, Medicare recipients are discharged from physical therapy within a month to six weeks following fracture. Yet studies indicate that most of the improvement in function occurs between three and six months post injury. Three months of low-intensity flexibility and balance exercise, followed by three months of weight-training, are being given to participants to gain a better understanding of the rehabilitation potential remaining in these patients. Dr. Brown’s research approach is innovative in that she integrates investigators and students with varying approaches and research questions to provide trainees with a more comprehensive overview of rehabilitation in its broadest sense.

Dr. Vicki Conn’s research is focused on interventions to increase physical activity/exercise among chronically ill adults. She recently completed an NIH-funded study that tests two interventions, in a randomized factorial study, to increase exercise among community-dwelling older women. The study was successful in increasing physical activity among these vulnerable women (Conn, Burks, Minor, & Mehr, 2003). Dr. Conn’s other research emphasis uses quantitative synthesis, meta-analysis, to integrate the existing primary research testing interventions to increase physical activity. This NIH-funded study applies meta-analytic strategies to physical activity enhancing interventions tested with chronically ill adults. An early subproject is examining exercise interventions among adults with arthritis. Studies of individuals with MS are also being included. Studies of rehabilitation clients with other problems are being excluded when they include behavioral outcomes. This work is particularly timely: A sizable body of literature has accumulated in the last decade and the diversity of interventions available precludes efficient comparisons in randomized trials.

Dr. Marc Hamilton’s long-term research goal is to delineate molecular and physiological mechanisms of physical inactivity that cause chronic metabolic diseases associated with impaired lipid metabolism. His recent work has focused upon understanding the mechanisms that regulate lipoprotein lipase (LPL). People with low levels of the LPL enzyme have a high incidence of premature coronary artery disease, reduced HDL cholesterol, and delayed clearance of triglyceride-rich lipoproteins from plasma.

Studies in Hamilton’s laboratory found that LPL activity was increased ~3-fold in white glycolytic muscles after voluntary running, whereas, LPL levels decreased to only 10% of control in red oxidative muscles after hindlimb suspension in rats. One powerful approach to determine the specific cellular events regulating LPL during altered contractile activity has been the ongoing development of “null” models in which the aforementioned changes can be abolished by experimental manipulations. These studies will be important in future mechanistic studies of lipid metabolism, because they are revealing the feasibility for completely preventing the effects of inactivity on suppressing LPL activity by genetic or chemical manipulations.

Hamilton’s translational studies are testing the most salient features of the animal gene expression profile of skeletal muscle using DNA microarrays. activity/inactivity findings in humans. Complementary work has been characterizing the global

Dr. Eileen Hasser’s research focuses on neurohumoral control of the circulation. Her primary interest is in central nervous system mechanisms involved in control of the sympathetic nervous system and blood pressure. Currently, her laboratory is involved in three primary projects. The first project investigates the neurotransmitter and neuromodulator systems involved in plasticity of cardiovascular reflex and sympathetic nervous system function. The second project examines mechanisms responsible for circulatory dysfunction due to cardiovascular deconditioning following prolonged exposure to inactivity such as spaceflight or bedrest. Dr. Hasser’s third area of investigation focuses on the interaction of circulating humoral factors with cardiovascular reflex regulation of the sympathetic nervous system and blood pressure. These questions are examined utilizing conscious animals which are chronically instrumented for recording of blood pressure, blood flow and sympathetic nerve activity. The overall goal of this work is to understand the central nervous system mechanisms underlying cardiovascular regulation in normal and altered states.

Dr. M. Harold Laughlin’s research is focused on cardiorespiratory effects of exercise. His primary goal is to understand the effects of exercise training on the coronary circulation and skeletal muscle vascular beds. Exercise training produces increases in the capacity of myocardial and skeletal muscle vascular beds to transport oxygen and other nutrients. The training induced changes in vascular transport capacity are associated with growth of new capillaries, enlargement of arteries and veins, and alterations in factors that control blood flow in the heart and skeletal muscle. Laughlin’s laboratory is currently investigating the mechanisms responsible for these changes. Studies are conducted with isolated vascular cells, isolated muscle tissue, single blood vessels and in conscious, chronically instrumented animals during exercise. To allow examination of the relationships among vascular adaptations and the response of the myocytes to training-induced increases in the functional demands of the muscles, Laughlin also measures the effects of training on biochemical and histological characteristics of the muscles. Over the past five years Laughlin and his trainees have made significant progress in the application of molecular techniques to the study of exercise-induced adaptations of arterial vascular cells, with a primary focus on determination of endothelial cell phenotype.

Dr. Kerry McDonald’s research focuses on the cellular and molecular mechanisms involved in the regulation of striated muscle contraction and how these regulatory processes are altered by disease and other physiological stresses such as exercise. To address these questions, McDonald has taken multi-faceted approaches to incorporating tissue, cellular, and molecular preparations. He utilizes preparations of single skeletal muscle fibers or single cardiac myocytes from which the sarcolemma has been chemically removed. Myofilaments remain intact so that mechanical measurements can be made. In these experiments, the chemical environment surrounding the myofilaments can be manipulated, allowing precise control of the cell’s level of activation. McDonald is also investigating the factors that regulate power output capacity of single cardiac myocytes, which is a physiological variable that is essential for the heart to move blood throughout the circulatory system. His trainees are examining how power output is regulated by factors such as contractile protein isoforms, activator calcium, sarcomere length, and phosphorylation states of myofibrillar proteins. McDonald’s research program also provides a means for trainees in our program to examine either the mechanical behavior or altered biochemical properties of striated muscle in response to various models of muscle disease or altered muscle activity.

Dr. Marian Minor’s research studies the role of exercise and physical activity in managing disease, reducing disability, and promoting health in patients with rheumatic conditions. The scope of enquiry encompasses both applied (clinical) research and community-based investigations in rehabilitation science. Research questions include not only issues of impairment, functional limitation and disability; but also other relevant factors ranging from measurement and assessment methods to behavioral variables and mechanisms of physiologic adaptation. Building upon clinical studies establishing the efficacy of exercise in this population, the scope of enquiry has expanded to include community-based studies to investigate the effectiveness of exercise in non-clinical settings and educational strategies to promote self-directed exercise adoption and maintenance in adults with various forms of arthritis. Arthritis is the major cause of disability in the United States today. Physical inactivity is a major contributor to arthritis-related disability and to the cost of health care in people with arthritis. Dr. Minor’s work provides trainees with evidence that shows how effective clinical and community-based interventions may increase physical activity and decrease disability in this population.

Dr. Elmer Price’s research focuses on mechanisms underlying the control of vascular tone in the coronary and peripheral circulation and the adaptations of these processes after exercise in normal animals and after development of diabetes and the presence of dyslipidemia. Dr. Price is the director of molecular biology of the PPG on Exercise Training and Coronary Disease. This research program provides a general resource for trainees in the form of state-of-the-art molecular biology and traditional biochemistry allowing them to become versed in functional (physiological) genomics. Dr. Price’s laboratory uses both molecular biology and biochemistry to address questions of biomedical relevance. One project involves the structure/function study of the Na, K-ATPase. Recombinant versions of the enzyme are expressed in cultured cells to determine which amino acid residues are involved in cardiac glycoside binding, cation binding, or ATP hydrolysis. A second project is the detailed molecular dissection of the protein defective in cystic fibrosis, the CFTR. Molecular and biochemical tools are used to explore questions regarding the protein’s structure and the mechanism underlying its processing/biosynthesis and regulation.

Dr. Ronald Terjung's research focus is on energy metabolism in skeletal muscle, vascular remodeling, exercise training adaptations and their potential health benefit. A current research emphasis involves the study of cellular and molecular events during muscle contractions in the hope of understanding optimal muscle function. His research group is evaluating differences in metabolism among skeletal muscle fiber types, critical responses during contractions, and adaptations induced by muscle use. A second area of study involves neovascular development and exercise-induced increase in collateral blood flow which likely involves the angiogenic growth factors. His research evaluates the interaction between ischemia, exercise and exogenously infused recombinant angiogenic growth factors; the function significance of the vascular adaptations; and the t tissue events related to neovascularization and offers trainees experiences in systems physiology, biochemical and molecular biological techniques.

Dr. Tom Thomas’ general objective is to determine the role of exercise in preventing cardiovascular disease and specifically atherosclerosis. His primary research focus is to determine the interactions between exercise and fat ingestion in humans. Thomas’ hypothesis is that exercise helps reduce the impact of fat in the diet by altering its effect on the lipoprotein profile and associated enzymes such as lipoprotein lipase and lecithin cholesterol acyltransferase. The role of fat ingestion and exercise on body weight and body composition also is explored in this model. Thomas’ research contributes to our understanding of the preventative influence of activity obesity and dyslipidemia and the sequelae of vascular dysfunction and disease progression that would otherwise follow. His trainee research involves primarily human studies, however, he also collaborates with Dr. Laughlin in using the pig model to examine the diet-exercise interaction.