When Brian Noehren, PT, PhD, FACSM, first began practicing as a physical therapist he had zero intention of pursuing a career in research. “I didn’t think I would step foot back on a college campus except to watch sports,” he quipped. But, after spending 4.5 years as a clinician, he grew dissatisfied with the lack of scientific evidence that supported the methods he used as a practitioner.
Now, Noehren is immersed in research as an associate professor in the divisions of physical therapy and rehabilitation sciences, and as the director of the University of Kentucky College Health Sciences Biomotion Lab. “I decided I wanted to be someone who was contributing to the solutions of what my patients were facing instead of feeling like I was on the sidelines,” he said.
Noehren’s progression from physical therapist to clinician scientist was a natural one, and the Biomotion Lab was born out of his desire to better understand movement dysfunction. “The name “Biomotion Lab” really hits at the heart of much of the research that we are involved in,” he explained. “It incorporated the biological mechanisms that drive motion such as muscle and the nervous sytsem and sets up the foundation for what we do here.”
The Biomotion Lab is used by a wide variety of investigators who study conditions ranging from multiple sclerosis to sarcopenia (the loss of muscle tissue that is a natural part of aging).
The overarching focus of the aspects Noehren is responsible for includes studying patients with orthopedic injuries and developing physical therapy strategies to alleviate chronic pain, improve muscle function, and restore healthy movement patterns. The bulk of the team’s research portfolio centers around anterior cruciate ligament (ACL) injuries which disproportionately affect younger people.
“We started out by looking at the long-term effects of an ACL reconstruction. Our goal was to find the underlying mechanisms and address the injury through new treatments,” Noehren said. “Our lab was one of the first groups to show there are changes in the composition of the muscle after sustaining a basic orthopedic injury.”
This revelation sparked a profound paradigm shift in the health sciences community about muscle loss from orthopedic injuries and opened up a new area to be tested. According to Noehren, previous scientific findings pointed to changes in the nervous system as the main culprit for muscle loss.
“However, if the nervous system isn’t accounting for this loss of muscle strength, it has to come from somewhere else. This discovery required a team with expertise in muscle physiology, physical therapy, and biomechanics. That’s what makes the Biomotion Lab and its partnerships so unique,” he said.
Thanks to a National Institutes of Health grant, the Biomotion Lab is exploring a new treatment for muscle atrophy called “blood flow restricted training”. This approach partially excludes blood flow to an injured limb and study participants then begin training at a light weight.
“The results of this research look to be impactful for reducing muscle loss after a surgery,” Noehren said. “Blood flow restricted training replicates the outcomes of heavy resistance training but is safe for patients to perform early after undergoing a surgical procedure. It still needs to be rigorously tested, but we are hopeful.”
The lab is also making strides in assessing muscle function. Noehren’s team has developed several imaging techniques that allow scientists to observe muscle function without performing invasive procedures like a muscle biopsy. Additionally, his group found novel ways to reevaluate muscle strength during the recovery process.
“After an injury, the most important question is how quickly can you make your muscles work? We’ve even extended our findings in this area to create strategies for patients with osteoarthritis.” Noehren said.
The Biomotion team is even tackling the opioid epidemic through a project led by one of Noehren’s graduate students, Josh Van Wyngaarden. “In any recovery process, a patient may experience acute pain that progresses to chronic pain. Josh’s project seeks to understand this process and see if it can be stopped. If we can halt the progression to chronic pain, then patients may never need to be prescribed opioids,” Noehren said.
Noehren will tell you he considers mentoring and educating students as one of his most important duties. “There is a strong link between the undergraduate education happening in this lab and our overall research enterprise,” he said. “We want to educate and train young students so they can become promising scientists and clinicians like the graduate researchers in our lab.”
“I want our students to apply what they learn in this lab to their lives and studies,” Noehren continued. “As scientists, we are all driven by discoveries that will lead to the next set of questions. Life’s like that, too. You never know quite where the road is going to turn. That’s what makes research and science great. It’s like writing and solving your own mystery novel.”