Minnesota Musculoskeletal and Occupational Performance Research (MnMOR) Lab

Current

Role: Principal Investigator

Dr. McGee earned a bachelor’s degree in Biology and Psychology in 1998 from the University of Northern Iowa, and a Master’s of Science in Occupational Therapy from the University of Minnesota in 2000. He has worked as an occupational therapy clinician at several respected organizations including the Iowa Health System, the University of Iowa Hospitals and Clinics, HealthPartners, and Twin Cities Orthopedics. In 2006, he earned specialty credentials in upper limb rehabilitation (CHT) from the Hand Therapy Certification Commission. His love for research and commitment to advancing the science of occupational therapy led him to pursue a PhD in Rehabilitation Science from the University of Minnesota. After completing his PhD in 2014, he accepted a faculty position in the Department of Occupational Therapy at the University of Minnesota and subsequently founded this lab. Dr. McGee’s research focuses broadly on improving the health and occupational performance of persons with conditions that affect the musculoskeletal structures of the arm. Specifically, it focuses on studying the mechanisms and effects of occupational therapy interventions and the measurement tools used by occupational therapists for these populations. His lab is an “academic” research lab where there is a heavy emphasis on research mentorship in addition to promoting the science of occupational therapy.   

Karin Burbach, MS, OTR/L, CHT

Role: PhD Advisee

Project Title: Thumb Proprioception in Surgical Thumb Carpometacarpal Arthroplasty

Karin has been an OT for 24 years and earned her Master's in Occupational Therapy from Washington University in St. Louis in 1999. She completed a Master's Certificate Program in Hand and Upper Quarter Rehabilitation at Drexel University in Philadelphia in 2004 and became a Certified Hand Therapist in 2005.  After working in hand therapy in Washington, DC at the National Rehabilitation Hospital/Regional Rehab for 3 years, she moved to Phoenix, AZ, where she worked for Desert Hand Therapy as a staff therapist and clinic manager for almost 11 years.  In 2016, she continued her work in Minnesota with Park Nicollet/TRIA as a CHT and supervisor.  Karin has a special interest in complex hand trauma, tendon injuries, thumb carpometacarpal osteoarthritis, and advanced orthotic fabrication.  She is currently enrolled as a Rehabilitation Science PhD student, working in Dr. Corey McGee's lab at the UMN.  

Halil Ibrahim Ergen, PhD, MS, PT  

Project: Test-Retest Reliability and Precision of the Inter-Metacarpal Distance Method for Measuring Joint Position Sense in Adults with Non-Operative Thumb Carpometacarpal Osteoarthritis 

Dr. Ergen earned a bachelor's degree in physiotherapy and rehabilitation from Gazi University-Türkiye in 2013. After working as a pediatric physiotherapist for 3 years, he went to a university where he will be a lecturer for 6 years. He has a Master of Science degree (2015) and a doctoral degree (2021) in occupational therapy from Hacettepe University-Türkiye. Both theses were about hand therapy. He has 9 years of clinical experience in hand rehabilitation and has been working as an assistant professor for 1.5 years at Gaziantep University-Türkiye. He is currently at the University of Minnesota for a year as a research scholar (postdoctoral researcher) to carry out his research with Dr. McGee. In his leisure time, he enjoys spending time with his family, traveling, hiking, exercising, and exploring Minnesota.

Kasey Bartyzal, OTD Student, UMN

Role: Occupational Therapy Doctoral Research Capstone Advisee and UMN A-PReP Scholar

Project: Self-reported Centralized Pain Symptomology is Linked to Worse Disability and Pain Severity in Adults with Thumb Carpometacarpal Osteoarthritis.

Kasey is a doctoral Occupational Therapy student interested in upper extremity rehabilitation following complex neuromusculoskeletal injuries, burn trauma, and limb loss. She also has an interest in holistic rehabilitation programs for individuals living with persistent pain from musculoskeletal conditions. Her doctoral capstone research examines centralized pain in relation to carpometacarpal osteoarthritis, aiming to better understand how centrally mediated pain is associated with symptoms and functional outcomes among patients with CMC OA. Kasey is from southern Minnesota and received her Bachelor's degree from the University of Minnesota Twin Cities, where she is currently pursuing her OTD. She has worked as a research assistant in pediatric endocrinology, neuromuscular, health psychology, and neuroscience laboratories before starting graduate school. In her free time, Kasey enjoys spending time with friends and family, traveling, rollerblading, visiting local breweries, and hiking in our National Parks.

Filiz Dikmen, OTD Student, UMN 

Role: Occupational Therapy Doctoral Research Capstone Advisee 

Project: The Relationship Between Kinesiophobia, Pain Severity, and Disability in Persons with Thumb Carpometacarpal Osteoarthritis

Filiz is a doctoral student in the Occupational Therapy Program researching kinesiophobia in relation to carpometacarpal osteoarthritis. The goal of this research is to better understand how fear of movement is associated with disability and sensorimotor performance in patients with CMC OA. Filiz is from Belle Plaine, MN, and received her Bachelor of Arts in psychology from the University of St. Thomas. She is pursuing her OTD at the University of Minnesota Twin Cities. In her free time, she enjoys spending time with family, traveling, trying new restaurants, and riding her Peloton bike.

Past 

Leah Johnson, PhD, MA, OTR/L

Role: PhD Advisee

Project: Upper Extremity Biomechanics During Manual Wheelchair Propulsion: A Systematic Review and Analysis of Push Rim Positioning and Training Effects

Leah has a bachelor's degree in biomedical engineering, with a specialization in biomechanics and rehabilitation and a global health minor, a master of arts in occupational therapy, and a PhD in rehabilitation science with a graduate minor in public health. She is currently an Associate Study Director at BRIGHT Research Partners.

Karl Dischinger, OTD, OTR/L  

Role: Occupational Therapy Doctoral Research Capstone Advisee 

Project: Reliability and Precision of the Palmar Abduction Intermetacarpal Distance Method in Persons with Thumb Carpometacarpal Osteoarthritis.

Roman Kudin, OTD, OTR/L 

Role: Occupational Therapy Doctoral Research Capstone Advisee

Project: Test-Retest Reliability and Precision of GripAble, A Multi-Purpose Exergaming Device

Grace Allison, Undergraduate Kinesiology Student, UMN 

Role: Undergraduate Research Opportunities Program (UROP) Student, U of MN

Project: Relationship between thumb dexterity and strength deficits and self-reported disability in persons with thumb Osteoarthritis.

Kennedy VanderLoop Undergraduate Kinesiology Student, UMN

Role: Undergraduate Research Opportunities Program (UROP) Student, UMN

Project: Relationship between thumb proprioception deficits and self-reported disability

Clinical Partners

Ed Wu, MD

Department of Orthopedic Surgery, Medical School, UMN

Ashley Enke, OTD, OTR/L, CHT

MHealth-Fairview, Minneapolis, MN

Ashley Enke is an occupational therapist and certified hand therapist at M Health Fairview in Minneapolis, MN. She has been a research interventionist on several of Dr. McGee's studies including one assessing the effectiveness of a dynamic stability program for the treatment of thumb carpometacarpal osteoarthritis, and another evaluating the effectiveness of graded motor imagery in reducing the risk of complex regional pain syndrome in women with distal radius fractures. In addition to her clinical and research roles, Ashley is an adjunct clinical mentor for the hand therapy fellowship at M Health Fairview and a fieldwork educator. Ashley earned a doctoral degree in occupational therapy from Creighton University in 2017. She completed a hand therapy fellowship through Fairview and the University of Minnesota in 2019, and became a certified hand therapist in 2021.

Jenny Johnson, MS, OTR/L, CHT

MHealth-Fairview, Minneapolis, MN

Jenny works for the M Health Fairview Hand Center at the Clinics and Surgery Center in Minneapolis.  She earned her MS in OT in 2010 from the University of Wisconsin - Madison.  She completed a hand therapy fellowship in 2017 through Fairview Hand Center and the University of Minnesota. She became a certified hand therapist in 2019. She works with patients with non-operative and post-operative conditions of the upper extremity and has collaborated in various clinical research projects.

Virginia O’Brien, OTD, OTR/L, CHT

UWHealth, Madison, WI

Dr. O’Brien is an active clinical researcher and has presented on the topic of dynamic stability of the thumb nationally and internationally, as well as numerous courses and workshops on multiple topics related to evidence-informed intervention for the upper limb. She is a published author in Hand, Journal of Hand Therapy, and the Year Book of Hand and Upper Limb Surgery since 2012. She continues in clinical and biomechanical research centered in the care of the painful thumb and wrist injuries. She is a fulltime clinician and the clinical coordinator of the an AOTA accredited Hand Therapy Fellowship at UW Health Hospitals and Clinics, Madison WI, USA.

Sponsored Projects

Current

Title: Prevalence of Observed Thumb Metacarpophalangeal (MP) Collapse by Occupational and Physical Therapists: A Pilot Study.

Principal Investigator: Nicole Hoover

Co-investigators: Corey McGee, Jay Kapellusch

Synopsis. Thumb Osteoarthritis (OA) incidence is increasing, with many hand therapists reporting that nearly a quarter of their caseload is for thumb pain10. The kinetic chain is important in maintaining neutral position of the metacarpal on the trapezium and the first phalanx on the metacarpal head. In that, postural faults increase stress on stabilizing ligaments of the thumb joints, which increases risk of joint degradation and injury. Metacarpophalangeal (MP) joint collapse or hyperextension during pinch causes increased loading on the dorsal aspect of the joint, which results in instability and reduced force output. Hand therapists are well-positioned to treat postural faults of the thumb, but best management practices have not been established. This study will determine the prevalence of MP collapse based on expert observation, which will contribute to understanding this condition’s impact to justify conservative management strategies and further research efforts.

Founding Source: American Hand Therapy Foundation

Interrater and Test-retest Reliability and Precision of Measures of Thumb Sensorimotor Function in Adults with Thumb Carpometacarpal Osteoarthritis (#710966)

Synopsis: Thumb carpometacarpal (CMC1) osteoarthritis (OA) is a highly prevalent and most disabling form of hand OA. It is characterized by pain and thumb sensorimotor changes that are often treated through multimodal interventions provided by rehabilitation therapists. Treatment response is measured via a variety of sensorimotor assessments, many of which do not have established psychometrics in CMC1 OA. One aim of our lab is to develop robust measures that inform treatment and evaluate rehabilitation intervention outcomes for persons with upper limb dysfunction. We expect to realize this goal through establishing the validity, reliability and precision of tools which evaluate several domains of sensory and motor function in CMC1 OA. We will make concurrent progress toward all project aims via cross-sectional and cohort observational “psychometric” designs. Specifically, we will enroll 100 patients with CMC1 OA who will attend two measurement sessions that are two weeks apart. Throughout these sessions, we will assess the test-retest reliability, inter-rater reliability, precision, and validity of 9 sensorimotor outcome measures and explore related secondary questions. This project is foundational to the future study of a novel sensorimotor rehabilitation intervention in CMC1 OA. If efficacious, disease progression and disability might be moderated.

Principal Investigator: Corey McGee 
Funding Sources: University of Minnesota, Office of the Vice President for Research

Past

Title: Novel multi-sensing seat cover system for prevention of sitting-related pressure injuries in individuals with Alzheimer’s disease or related dementias (1R41AG080965-01)  

Synopsis: 

The proposed project will develop a sensor system that is placed between a person and their sitting surface to help caregivers of people with Alzheimer’s disease and related dementia (AD/ADRD) identify external risk factors that lead to pressure injuries during prolonged sitting. The sensors will identify pressure, shear, and microclimate factors directly between a person at the seat interface. Early detection helps caregivers and clinicians take action to mitigate the risk, especially important for people with AD/ADRD who may not recognize the risk or who may experience apathy. The sensors will be integrated with an existing robust software platform that displays information in a meaningful way to the caregiver in real-time. The resulting efforts will translate to improved caregiver efficacy and reduced pressure injury risk.

Principal Investigator: Rob Wudlick
Site Principal Investigator: Corey McGee

Funding Source: NIH

Title: Mechanisms of a Dynamic Stability Protocol for Persons with Thumb Osteoarthritis (KL2TR002492)

Synopsis: The project’s aims are to 1) describe changes in thumb Carpometacarpal (CMC1) joint stability following an 8-week clinic-based dynamic stability exercise program using computerized tomography (CAT) and 2) to evaluate the agreement between ultrasound and CAT (reference standard) when quantifying thumb CMC stability. For aim 1, we will enroll 30 participants in a prospective pre-post interventional study of an 8-week clinic-based occupational therapy dynamic stability program. The primary outcome will be change in stability (thumb metacarpal subluxation in mm) when forcefully loading the thumb as per CAT from pre-treatment to post-treatment at 9 weeks. For aim 2: the same 30 participants will undergo a one-time ultrasound during baseline assessment. This study is the first to test the sustained biomechanical effects of non-invasive thumb exercises. Should these benefits exist, this will further support exercise as a first-tier intervention. Should ultrasound be a suitable proxy for CAT, therapists/physicians could monitor thumb CMC mechanics in response to treatment without risk of radiation exposure. We anticipate 1) a statistically significant reduction in thumb CMC subluxation at 9 weeks follow up and 2) high agreement between sonographic and CAT measures of thumb stability. This study will lay the foundation for future work and may offer critical support for the use of a non-pharmacological and non-surgical approach as first-line treatment of a highly disabling disease. Future study should include controlled trials where hand function, activity limitation, disease progression, and costs are the outcomes in interest.

Principal Investigator: David Ingbar  

K Trainee: Corey McGee

Sponsoring Organization: NIH

Title: N3C Long COVID Research (RECOVER) (1OT2HL161847-01)  

Synopsis: RECOVER-Adult is the first national, prospective, longitudinal cohort of PASC among US adults. Results of this study are intended to inform public health, spur clinical trials, and expand treatment options.

Principal Investigator: Steve Johnson

Co-Investigator: Corey McGee 

Sponsoring Organization: NIH

Title: Interrater Reliability and Reference Values of the GripAble Device in healthy adults

Synopsis: A new grip strength assessment and treatment device, GripAbleTM is available to rehabilitation therapists for the purpose of enhancing the strength and motor control of persons with neurological and orthopedic conditions affecting the hand.  The device, developed by researchers from Imperial College London, is a lightweight electronic handgrip that interacts wirelessly with a standard PC tablet and enables users to play arm-training games. Given its novelty, unlike the aforementioned dynamometers, GripAbleTM does not yet have strength reference data to use for goal-setting purposes and for measuring response to the grip strength training offered through use of the device. For that reason, we will seek to recruit young and middle aged adults to begin the process of establishing age and sex stratified grip strength norms for this measurement device. 

Principal Investigator: Corey McGee
Sponsoring Organization: GripAble^TM

Title: Graded Motor Imagery for Women at Risk for Developing Type I CRPS Following Closed Treatment of Distal Radius Fractures: A Pilot Randomized Comparative Effectiveness Trial

Synopsis: The project’s aims are to: 1) determine the feasibility of recruiting, enrolling, treating, and following participants and 2) determine if those who participate in a Graded Motor Imagery (GMI) and standard of care (SOC) hand therapy program have differing pain, and function when compared to those who receive only the SOC. We hypothesize 1) that the project will be feasible to carry out on a larger scale and 2) that an early GMI will improve the pain, functional and upper limb sensorimotor outcomes of persons with closed treatment of DRF relative to a standard of care intervention.
Principal Investigator: Corey McGee

Co-Investigator: Ann Van Heest
Sponsoring Organization: American Hand Therapy Foundation

Title: Comparing the Effectiveness of Fatigue Management Programs for People with Multiple Sclerosis NCT03550170

Synopsis: Link to lay summary

Principal Investigator: Matt Plow

Co-Investigator: Corey McGee

Sponsoring Organization: PCORI

Recent Publications

Undergraduate students and entry-level professional students

Dr. McGee mentors promising undergraduate students and OTD students through research activities in the lab and community-based settings. Training varies depending on experience but is inclusive of topics such as data entry, ethical practices in human subjects research, managing flow of participants, protocol development, standardized assessment, and basic statistical analyses. Training for OTD students can occur throughout OTD didactics and/or during a research capstone experience.   

PhD students and Post Docs

Dr. McGee mentors PhD students pursuing the Rehabilitation Science Doctoral Program and Post-Doctoral Fellows. Lab-based training focuses on developing and testing rehabilitation measures, data management, processing, and analysis while training in community-based research focuses on population-level observational studies and intervention development and testing.  For more information on the Rehab Science PhD program follow this link.

OTD/PhD Pathway Students

Dr. McGee is the OT Department Associate Chair for research and was responsible for the development of our OTD to Rehabilitation Science PhD pathways program. In this role, Dr. McGee advises promising OTD students through a degree plan to aid in accelerating progress towards the PhD while pursuing the OTD. For more information on this OTD/PhD pathway, visit the Bridging to the PhD web page.