Chicago Neuroscience Institute
(847) 888-1811 Elgin, Illinois
(847) 888-1811 Elgin, Illinois
Testing in the Human Performance Lab
About the HUMAN PERFORMANCE Lab
HUMAN PERFORMANCE EVALUATION
The Division of Neuro-Orthopedics of the Chicago Neuroscience Institute (CNI) houses a World Class Human Performance Laboratory (HPL). The lab is used to quantify physical limitations secondary to neurological compromise and to evaluate athletic (sports) performance. Human performance assessment in the lab serves as an extension of the history and physical examination.
The HPL is integrated with other diagnostic services at CNI to help determine how a neurological or neuromuscular disorder impacts an individual’s physical performance and to help set goals for therapeutic intervention. A workup in the lab may involve assessing the functional significance of abnormalities on advanced neuroimaging studies such as CT or MRI. Human performance evaluation may include one or more of the following considerations; body composition analysis, biomechanical assessment, quantitative sensory testing, gait and balance testing, lower body neuromuscular assessment, upper body neuromuscular assessment, and motion analysis.
Neurological Disorders and Performance Testing
Nerve compromise often results in a loss of nerve signal to muscle. This leads to varying degrees of muscle in coordination, muscle weakness, and/or muscle atrophy. CNI has developed special testing protocols to assess muscular performance associated with various types, degrees and levels of neurological compromise. Impaired human performance can be subtle in the presence of mild neurologic compromise. For example, mild nerve compromise usually presents with exertional muscle fatigue a finding which is not obvious during a routine physical examination. Testing in the CNI Human Performance Lab can be used to assess the following findings and performance attributes.
- body composition
- strength
- power
- endurance
- balance
- muscle mass
- coordination
- reaction time
- range of motion
- patterns of integrated movement
Central and/or peripheral nerve compromise often results in varying degrees of impaired sensation. CNI offers special tests and protocols which are used to evaluate and record sensory integrity. This approach is referred to as quantitative sensory testing (QST). An objective baseline of sensory and/or muscular testing can be used to follow disease progression, to evaluate treatment outcome, and to assess the impact of training on athletes.
Gait and Motion Analysis
The CNI Human Performance Lab houses specialized equipment used for gait and motion analysis. Quantitative and qualitative methods and used to evaluate how a patient walks and moves under certain circumstances. A comprehensive gait evaluation typically includes balance assessment, single leg stability measures, analysis of pressure distribution under the foot and observation of walking biomechanics. Video recording and computer analysis may be used for detailed biomechanical evaluation. Gait and motion analysis results can be used to help develop orthotics, guide treatment and measure therapeutic outcome. In special cases the assessment may be used to guide the development and application of supportive bracing and Neuroprosthetics..
Body Composition Analysis
Body composition analysis refers to the quantitative assessment of the distribution of muscle, fat, and water in the body. The distribution and quantity of biological constituents and interrelated tissues plays an important role in health and human performance. Excess body fat and abnormal distribution of body fat increases the risk of acquiring many different chronic diseases. Excess fat, and an abnormal ratio of fat to muscle, limits physical performance and places potentially harmful stress on the spine, as well as, extremity joints. CNI uses state-of-the-art bioelectrical impedance analysis (BIA) methods to assess lean body mass, fat mass, water distribution, body mass index (BMI), percent body fat (PBF) and extremity muscle distribution. Technology is used to monitor changes in body composition associated with medication, lifestyle modification, exercise habits and therapeutic intervention.
Human performance: evaluation of nerve compromise & Recovery
EVALUATION OF NERVE COMPROMISE AND RECOVERY
The most common causes of neurological compromise are compression, inflammation, ischemia and trauma. If nerve compromise goes untreated it may lead to permanent impairment of neurological function. Nerves have a limited capacity for recovery. It is important to identify nerve damage, intervene and monitor recovery within the limited “window of opportunity” to improve the likelihood of maximum recovery.
Quantitative measures of neurological function are critical steps toward determining whether neurological compromise is present or whether a neurological disorder is improving, stable or progressive. A quantitative approach also offers an objective measure of treatment outcome. Test results can be used to assess the pattern of progressive nerve compromise and the pattern of nerve recovery. The level of nerve function and the pattern of nerve recovery can be measured directly or indirectly through a variety of methods. Most spinal nerve roots and peripheral nerves contain autonomic, sensory and motor nerve fibers. Each of these elements can be evaluated.
One or more of the following methods can be used to objectively assess neurological integrity and recovery:
Sensory:
- Sensory Nerve Conduction Studies
- Somatosensory Evoked Potential Studies
- Disposable Pinprick and/or Pinwheel Assessment
- Two Point Discrimination (static or moving)
- Joint Position Sense
- Vibrometry
- Simmes Monofilament Assessment
- Current Perceptual Threshold Assessment
Motor:
- Muscle Strength and Power Assessment
- Muscle Endurance Assessment
- Muscle Volume/Girth Measurements
- Needle Electromyographic Assessment
- Quantitative Needle Electromyographic Assessment
- Motor Nerve Conduction Studies
- Magnetic Evoked Potential Studies
- Body Composition Evaluation (Region Specific Lean Mass Measurement)
Sensory-Motor:
- Gait Evaluation
- Dynamic Posturography
- Selective Functional Capacity Evaluation
- Task Assessment
- Dynavision D2 Assessment
Autonomic
- Special EKG test (R-R Interval Assessment)
- Sudomotor Sweet Test
- Tilt Table Test
- Orthostatic Blood Pressure Study
Functional Testing
Gait Analysis
Extremity Assessment
Extremity Assessment
The Chicago Neuroscience Institute performs offers advanced gait analysis services. Gait analysis refers to the evaluation of posture and movement patterns while walking or jogging. Gait analysis is used to evaluate the complex integration of neurological and musculoskeletal performance. It may be performed using a specialized quantitative Biodex treadmill allowing for variable manipulation such as speed and incline. Gait analysis can provide valuable information about postural control which involves spinal cord function, peripheral nerve function, vision, balance involving the inner ear, and control from the brainstem and higher cortical (brain) centers.
Gait analysis can also be particularly helpful in the assessment of muscle weakness and associated movement disorders secondary to central and/or peripheral nervous system pathology. The use of a variable speed treadmill can help detect gait abnormalities that would not be readily obvious while watching the patient walk a short distance at a slow pace during the course of a traditional physical examination.
Extremity Assessment
Extremity Assessment
Extremity Assessment
The Chicago Neuroscience Institute (CNI) offers functional testing with state-of-the-art technology and protocols. JTECH equipment offers highly effective methods for quickly and objectively recording and documenting functional testing data. The CNI collection of functional assessment equipment includes electronic goniometry, digital range-of-motion (inclinometry) assessment devices, digital pressure algometers, grip and pinch assessment tools, muscle testing equipment, and more.
The Institute also uses physical assessment software which makes our workup more efficient by automatically collecting and compiling testing data. Our primary goal is use tools, software, and equipment capable of dramatically speeding up assessment time while simultaneously improving the reliability, reproducibility, and accuracy of the data that’s recorded. Objective tools allow us to assign real numbers to a patient's physical performance, as well as, to pain thresholds and tolerances to help accurately determine the best course of treatment and to objectively measure treatment outcome.
Isokinetic Testing:
Extremity Assessment
Dynavision D2 Testing
Isokinetic testing is usually performed as part of a more comprehensive assessment of physical performance. It typically involves placing a patient on specialized equipment so that the specific body and joint movements can be isolated and measured. The equipment is set at different speeds and the force applied is measured throughout the range of movement. The results are recorded at different speeds so that a speed/strength/power relationship can be seen. Comparative evaluation of muscle strength and power can be performed with side-to-side assessment and with ipsilateral agonists/antagonists assessment.
The Chicago Neuroscience Institute (CNI) invested in Lido and Biodex systems to capture upper and lower extremity measures. Isokinetic testing is used to evaluate impairment of muscle function secondary to central, spinal or peripheral nerve compromise. Quantitative measures can be used to baseline physical performance. Isokinetic testing can also be used to help assess sports performance, as well as, neurological and neuromuscular recovery.
Dynavision D2 Testing
The Real Runner Technology
Dynavision D2 Testing
The Chicago Neuroscience Institute (CNI) uses the Dynavision D2™ technology to evaluate visual and motor performance including reaction time and central nervous system processing. The technology has been recognized as a highly effective method for objectively evaluating reaction time, peripeahrl vision, multitask performance and cognitive fatigue. Specialized software applications enable individualized diagnostic and rehabilitative approaches.
Balance Assessment
The Real Runner Technology
The Real Runner Technology
The Chicago neuroscience Institute (CNI) uses the most popular and one of the most accurate Balance Systems to evaluate and treat patients. The Biodex Balance System SD was designed to meet the needs of individuals looking to improve balance, increase agility, and to develop muscle. The system can also be sued to assess and treat a wide variety of pathologies. The system offers an efficient, accurate and versatile fall risk screening for older adults. The Balance System SD serves as an important rehabilitative tool, which is used to enhance kinesthetic (joint/limb positon sense) after injury. The CNI staff also uses the system to assess neuromuscular control by quantifying an individual’s ability to maintain dynamic bilateral and unilateral postural stability on a static or unstable surface.
The Real Runner Technology
The Real Runner Technology
The Real Runner Technology
Chicago Neuroscience Institute (CNI) added the “Real Runner” system to its Human Performance Lab. The technology is used for specialized evaluation and for enhancing human performance. The Real Runner
is a low impact, high-intensity cardiovascular training system which simulates a runner's stride, providing a full range of motion while simultaneously providing hydraulic based resistance through the entire arc of movement. The system is used to help evaluate as well as developing stride length, stride frequency, and endurance, acceleration and power.
According to the manufacturer the ‘real runner” system offers “...high-intensity training which uses isokinetic resistance in both the extension and flexion of the hip and knee joints while also promoting dorsiflexion of the ankle”. The “Real Runner” was specifically designed to assess and train muscles of the lower body in manner which simulates running and sprinting movements. The system has been used in various settings by professional, world class, Olympic, and college-level athletes. System can also be used by young athletes or the casual runner to improve physical and cardiovascular performance. CNI offers the option of video recording activity on the real Runner for biomechanical assessment and to document biomechanical adaptation and alteration secondary to fatigue.
Quantitative Sensory Testing:
Sensory Testing
Dynavision D2 Testing
Dynavision D2 Testing
Quantitative sensory testing (QST) is used here at the Chicago Neuroscience Institute (CNI) to help identify nerve damage. It is also be used to provide a safe and effective method to measure peripheral nerve integrity and function. QST refers to sensory tests, which are gradated and able to provide repeatable quantification of sensibility. QST results can be used to help identify whether a condition affecting a nerve or nerves is recovering or progressively getting worse. Most quantitative sensory testing is non-invasive and painless. Quantitative sensory assessment is often performed as an n extension of subjective sensory assessment during the course of testing performed during the physical examination process.
There are many ways which neurosensory testing can be performed. More common methods of quantitative sensory testing include: static and moving 2-point discrimination, Semmes-Weinstein monofilament testing, joint position assessment (kinesthesia), barognosis (sense of weight), quantitative vibrometry and current perceptual threshold (CPT) testing. Sensorimotor reaction time testing can also provide quantitative measures with the right technology. Detailed sensory testing allows for sensory mapping of specific body regions.
Dynavision D2 Testing
Dynavision D2 Testing
Dynavision D2 Testing
The Chicago Neuroscience Institute (CNI) uses the Dynavision D2™ technology to evaluate visual and motor performance including reaction time and central nervous system processing. The technology has been recognized as a highly effective method for objectively evaluating reaction time, peripeahrl vision, multitask performance and cognitive fatigue. Specialized software applications enable individualized diagnostic and rehabilitative approaches.
Barognosis
Dynavision D2 Testing
Barognosis
Barognosis, or baresthesia, refers to is the ability to perceive and evaluate the weight of objects, or to differentiate objects of different weights, by holding or lifting them. Accuracy requires an intact and healthy peripheral and central nervous system to transmit sensations such as light touch, tactile pressure, texture recognition, joint position sense (kinesthesia), and proprioception. Interpretation of sensory stimuli takes place at higher brain levels which must also be intact.
The clinical condition referred to as abarognosis or the inability to differentiate between the weights of objects occurs with different types of pathology affecting the nervous system. The Institute uses a variety of different methods to assess barognosis. One of the more common methods is to place an individual in front of a set of small measured and weighted objects which individuals required to place in a particular order. The results of the test are scored. The results may serve as a baseline, as a measure of treatment outcome and/or as a measure of disease progression.
Gait Testing and Assessment
Gait Analysis
Foot Biomechanics (Gait Scan)
Foot Biomechanics (Gait Scan)
The Chicago Neuroscience Institute performs offers advanced gait analysis services. Gait analysis refers to the evaluation of posture and movement patterns while walking or jogging. Gait analysis is used to evaluate the complex integration of neurological and musculoskeletal performance. It may be performed using a specialized quantitative Biodex treadmill allowing for variable manipulation such as speed and incline. Gait analysis can provide valuable information about postural control which involves spinal cord function, peripheral nerve function, vision, balance involving the inner ear, and control from the brainstem and higher cortical (brain) centers. Gait analysis can also be particularly helpful in the assessment of muscle weakness and associated movement disorders secondary to central and/or peripheral nervous system pathology. The use of a variable speed treadmill can help detect gait abnormalities that would not be readily obvious while watching the patient walk a short distance at a slow pace during the course of a traditional physical examination.
Foot Biomechanics (Gait Scan)
Foot Biomechanics (Gait Scan)
Foot Biomechanics (Gait Scan)
The Chicago Neuroscience Institute (CNI) uses of the industry leader’s technologies referred to as the GaitScan™ system. The system includes specialized software and a digital casting device that allows practitioners to analyze patient biomechanics and order custom orthotics. With 4096 sensors and a scan rate of 300Hz (frames per second), GaitScan™ is the industry leader in dynamic scanning capability. The system offers both diagnostic and educational capabilities. The GaitScan™ provides a comprehensive biomechanical evaluation for each patient. In-depth, informative reports give you access to over a million data points which break down deviations from optimal biomechanics and assists the CNI staff in effectively diagnosing and prescribing orthotic solutions for you.
Motion Analysis
Foot Biomechanics (Gait Scan)
Motion Analysis
Motion analysis is used here at the Chicago Neuroscience Institute (CNI) to evaluate human movement under various circumstances. This form of testing helps evaluate the integrity of the neurologic control of muscle and the neurological feedback systems required to perform purposeful acts and to adapt to environmental stimuli. Motion analysis involves integration of computer vision, image processing, high-speed photography and computational analysis. Video measures of motion may also be used to provide feedback to a patient or athlete in a specialized setting. Visual data is sometimes acquired through the use of the specialized high-speed camera or video camera. The data is then analyzed using special software and digital metrics. Motion analysis may be performed in the human performance lab, in a clinical setting and/or on the athletic field. In the case of sports medicine application motion analysis data may be evaluated by clinical specialists, as well as, sport-specific experts. .
TAKE ACTION NOW!
The Division of Neuro-Orthopedics of the Chicago Neuroscience Institute (CNI) houses a World Class Human Performance Laboratory (HPL). The lab is used to quantify physical limitations secondary to neurological compromise and to evaluate athletic (sports) performance. Human performance assessment in the lab serves as an extension of the history and physical examination.
- The HPL is integrated with other diagnostic services at CNI to help determine how a neurological or neuromuscular disorder impacts an individual’s physical performance and to help set goals for therapeutic intervention.
- A workup in the lab may involve assessing the functional significance of abnormalities on advanced neuroimaging studies such as CT or MRI.
- Human performance evaluation may include one or more of the following considerations; body composition analysis, biomechanical assessment, quantitative sensory testing, gait and balance testing, lower body neuromuscular assessment, upper body neuromuscular assessment, and motion analysis.
Call to schedule an evaluation today!
Chicago Neuroscience Institute
1795 Grandstand Place
Elgin, Illinois, 60123
Phone: 847-888-1811