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Cory Christiansen, PT PhD

Title: EC GRECC Investigator; Professor, Physical Therapy

Contact: cory.christiansen@cuanschutz.edu

University of Colorado webpage

Personal Statement
Dr. Christiansen is an Associate Professor in the Physical Therapy Program. His research focuses on applying rehabilitation science to optimize functional movement outcomes for older adults with a variety of health conditions. Clinical areas of focus for Dr. Christiansen include rehabilitation after total joint arthroplasty and lower limb amputation. He teaches within the Doctor of Physical Therapy and Rehabilitation Science programs, with expertise in Movement Science.

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Research Interest

My research is focused on optimizing physical health and life participation outcomes for older adult patient populations with a variety of chronic health conditions. I have been PI or co-I for several randomized controlled rehabilitation studies concentrated on exercise studies and physical activity analysis for a variety of older adult populations, including most recent focus on patients with lower limb amputation. These studies have involved interventions to promote both functional activity and quality of movement, especially related to chronic health and movement behaviors. I have recently led the completion of two pilot studies examining physical activity behavior-change intervention, one for patients recovering from total knee arthroplasty and one for patients with dysvascular lower limb amputation.

See Dr. Christiansen's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials.

The following images visualize Dr. Christiansen's work. The word cloud is drawn from publication titles. The research collaboration map shows research relationships (click the image to enlarge):

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Grants & Funding

Transfemoral osseointegrated prosthesis limb load symmetry training (TOPLOAD)

Role: Co-PI
This randomized controlled trial will
1) determine the feasibility of a 40-week limb-load biofeedback training intervention,
2) determine if there is an intervention signal of efficacy, and
3) identify functional movement priorities for people with transfemoral osseointegrated prostheses.

Walking Exercise Sustainability Through Telehealth for Veterans with Lower-Limb Amputation

Role: PI
Despite recent advances in physical rehabilitation, Veterans with lower-limb amputation have poor long-term outcomes, including severely limited functional capacity and high levels of disability. Such poor outcomes are compounded by a lack of exercise participation over time, even with lower-limb prostheses.
There is a clear need to advance current rehabilitation strategies to promote sustained exercise following lower-limb amputation. Our study will determine the efficacy of a walking exercise self-management program to achieve sustained exercise participation. The 18-month intervention on helping Veterans reduce habitual sedentary behavior through a remote exercise behavior-change intervention includes multiple clinical disciplines, a novel individualized exercise self-management training, and peer support.
This innovative approach shifts the conventional rehabilitation paradigm to target life-long exercise sustainability and remove an underlying cause of disability for Veterans with lower-limb amputation.
Funder: Veterans Affairs
NIH website

Study in Parkinson disease of exercise Phase III clinical trial: SPARX3

Role: Site-PI
The study goal is to establish the efficacy of high-intensity endurance exercise as first-line therapy for recently diagnosed people with Parkinson's disease (PD).

Optimizing Physical Activity Outcomes for Veterans After Total Knee Arthroplasty

Role: PI; Co-I: Jennifer Stevens-Lapsley
While total knee arthroplasty improves the pain and disability associated with knee osteoarthritis, physical activity levels after total knee arthroplasty remain at low levels and are nearly unchanged from before surgery. Such low physical activity may account for problems seen in Veterans with total knee arthroplasty, including long-term disability, secondary health problems, and high levels of healthcare use.
There is a clear need to advance current rehabilitation strategies to address chronic low physical activity after total knee arthroplasty. Our proposed study will assess the efficacy of using physical activity behavior-change telerehabilitation for improving physical activity outcomes. The three-month intervention focuses on changing habitual behaviors through remote video telerehabilitation sessions between Veterans and physical therapists.
This innovative approach shifts the paradigm of conventional rehabilitation to specifically target poor physical activity behaviors underlying physical disability for Veterans with total knee arthroplasty.
Funder: Veterans Affairs
NIH website
Recruiting ↠ The study Optimizing Physical Activity Outcomes for Veterans After Total Knee Arthroplasty (ART) is recruiting research subjects, click to learn more.
Publications of note:
— Improving Physical Activity Through Adjunct Telerehabilitation Following Total Knee Arthroplasty: Randomized Controlled Trial Protocol

Optimizing Gait Rehabilitation for Veterans with Non-Traumatic Lower Limb Amputation

Role: PI
The population of older Veterans with non-traumatic lower limb amputation is growing. Following lower limb amputation, asymmetrical movements persist during walking and likely contribute to disabling sequelae, including secondary pain conditions, poor gait efficiency, impaired physical function, and compromised skin integrity of the residual limb.
The proposed study seeks to address chronic gait asymmetry by evaluating the efficacy of two error-manipulation gait training programs to improve gait symmetry for Veterans with non-traumatic lower limb amputation. Additionally, this study will assess the potential of error-manipulation training programs to strengthen secondary measures of disability and residual limb skin health.
Ultimately, the proposed study aims to improve conventional prosthetic rehabilitation for Veterans with non-traumatic amputation through gait training programs based on motor learning principles, resulting in improved gait symmetry and lower incidence of long-term disability after non-traumatic lower limb amputation.
Funder: Veterans Affairs
NIH website
Recruiting ↠ The study Optimizing gait rehabilitation for Veterans with non-traumatic lower limb amputation (GEM) is recruiting research subjects, click to learn more.
Publications of note:
— Error-manipulation Gait Training for Veterans with Non-traumatic Lower Limb Amputation: A Randomized Controlled Trial Protocol

Improving health self-management using walking biobehavioral intervention for people with dysvascular lower limb amputation

Role: PI
Sedentary lifestyles and high levels of disability are relevant public and personal health issues resulting from the chronic comorbid condition of dysvascular lower limb amputation.
This study examines the use of an evidence-based walking biobehavioral intervention to increase physical activity after dysvascular amputation.
The proposed intervention leverages successes in conventional prosthetic rehabilitation while addressing the complex health conditions and chronic sedentary behaviors that underlie dysvascular amputation, with the ultimate goal of improved physical activity self-management to minimize disability.
Funder: National Institute of Nursing Research
NIH website
Recruiting ↠ This study is recruiting research subjects, click to learn more.

Movement pattern biofeedback training after total knee arthroplasty

Role: Co-I; PI: Jennifer Stevens-Lapsley
In the next two decades, there may be a significant increase in total knee arthroplasty surgeries. Yet innovative rehabilitation techniques are still needed to optimize long-term physical function.
This study has a high potential to change current rehabilitation practices for TKA. Implementing movement pattern training can be easily implemented in clinical settings. Furthermore, the study also has the unique opportunity to improve patient outcomes after TKA by reducing subsequent problems due to compensatory overuse of the opposite knee.
Funder: National Institute on Aging
NIH website
Publications of note:
— Multimodal conservative management of arthrofibrosis after total knee arthroplasty compared to manipulation under anesthesia: a feasibility study with retrospective cohort comparison
— Movement Pattern Biofeedback Training after Total Knee Arthroplasty: Randomized Clinical Trial Protocol
— The Impact of Home Health Physical Therapy on Medicare Beneficiaries with a Primary Diagnosis of Dementia

Engaging Medically Complex Veterans in Tele-Rehabilitation Using a Biobehavioral Approach: A Pilot Study of Feasibly and Acceptability

Role: Co-I; PI: Jennifer Stevens-Lapsley
Medically complex older Veterans are a vulnerable patient population with reduced access to care (i.e., rural living and limited transportation). This population is also at risk for physical function deficits, physical inactivity, and social isolation.
Telerehabilitation is a potentially effective and scalable approach for providing rehabilitation services to medically complex older Veterans with limited care access. This study will determine the feasibility, acceptability, and safety of a multicomponent telerehabilitation program strategically designed to address the physical function deficits and social isolation often experienced by older Veterans.
Study findings will have an immediate clinical impact as they will guide the implementation of safe and effective telerehabilitation strategies for medically complex older Veterans who lack access to standard in-person rehabilitation services.
Funder: Veterans Affairs
NIH website

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Recent Publications

2023

Gaffney BMM, Davis-Wilson HC, Awad ME, Tracy J, Melton DH, Lev G, Stoneback JW, Christiansen CL. Daily steps and stepping cadence increase one-year following prosthesis osseointegration in people with lower-limb amputation. Disabil Rehabil. 2023 Apr 19:1-6. doi: 10.1080/09638288.2023.2200036. Epub ahead of print.
PMID: 37073780.
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Davis-Wilson HC, Christiansen CL, Gaffney BMM, Lev G, Enabulele E, Hoyt C, Stoneback JW. Changes in lower extremity joint moments one-year following osseointegration in individuals with Transfemoral lower-limb amputation: A case series. Clin Biomech (Bristol, Avon). 2023 Mar 27;104:105948. doi: 10.1016/j.clinbiomech.2023.105948. Epub ahead of print.
PMID: 37043833.
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Mañago MM, Cohen ET, Cameron MH, Christiansen CL, Bade M. Reliability, Validity, and Responsiveness of the Patient-Specific Functional Scale for Measuring Mobility-Related Goals in People With Multiple Sclerosis. J Neurol Phys Ther. 2023 Mar 8. doi: 10.1097/NPT.0000000000000439. Epub ahead of print.
PMID: 36897202.
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2022

Davis-Wilson HC, Christiansen CL, Gaffney BMM, Lev G, Enabulele E, Stoneback JW. Improvements in disability and function in people with lower-limb amputation one year after prosthesis osseointegration. Prosthet Orthot Int. 2022 Dec 27. doi: 10.1097/PXR.0000000000000200. Epub ahead of print. PMID: .
PMID: 36701203.
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Gaffney BMM, Davis-Wilson HC, Christiansen CL, Awad ME, Lev G, Tracy J, Stoneback JW. Osseointegrated prostheses improve balance and balance confidence in individuals with unilateral transfemoral limb loss. Gait Posture. 2022 Dec 13;100:132-138. doi: 10.1016/j.gaitpost.2022.12.011. Epub ahead of print.
PMID: 36521257.
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Patterson CG, Joslin E, Gil AB, Spigle W, Nemet T, Chahine L, Christiansen CL, Melanson E, Kohrt WM, Mancini M, Josbeno D, Balfany K, Griffith G, Dunlap MK, Lamotte G, Suttman E, Larson D, Branson C, McKee KE, Goelz L, Poon C, Tilley B, Kang UJ, Tansey MG, Luthra N, Tanner CM, Haus JM, Fantuzzi G, McFarland NR, Gonzalez-Latapi P, Foroud T, Motl R, Schwarzschild MA, Simuni T, Marek K, Naito A, Lungu C, Corcos DM; SPARX3-PSG Investigators. Study in Parkinson's disease of exercise phase 3 (SPARX3): study protocol for a randomized controlled trial. Trials. 2022 Oct 6;23(1):855. doi: 10.1186/s13063-022-06703-0. PMCID: PMC9535216.
PMID: 36203214.
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Kline PW, Davis-Wilson HC, So NF, Fields TT, Christiansen CL. Feasibility of repeated session error-augmentation gait training for people with nontraumatic transtibial amputation. Prosthet Orthot Int. 2022 Aug 25. doi: 10.1097/PXR.0000000000000181. Epub ahead of print.
PMID: 36037273.
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Anderson CB, Fatone S, Mañago MM, Swink LA, Hager ER, Kittelson AJ, Christiansen CL, Magnusson DM. Improving shared decision-making for prosthetic care: a qualitative needs assessment of prosthetists and new lower-limb prosthesis users. Prosthet Orthot Int. 2022 May 25. doi: 10.1097/PXR.0000000000000142. Epub ahead of print.
PMID: 35622457.
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Anderson CB, Kittelson AJ, Wurdeman SR, Miller MJ, Stoneback JW, Christiansen CL, Magnusson DM. Understanding decision-making in prosthetic rehabilitation by prosthetists and people with lower limb amputation: a qualitative study. Disabil Rehabil. 2022 Apr 7:1-10. doi: 10.1080/09638288.2022.2037745. Epub ahead of print.
PMID: 35389313.
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Miller MJ, Hoffman RM, Swink LA, Barnes DE, Christiansen CL. Post-amputation cognitive impairment is related to worse perceived physical function among middle age and older prosthesis users. Arch Phys Med Rehabil. 2022 Feb 3:S0003-9993(22)00022-3. doi: 10.1016/j.apmr.2021.12.025. Epub ahead of print.
PMID: 35123974.
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Kline PW, Christiansen CL, Judd DL, Mañago MM. Clinical utility of the Trendelenburg Test in people with multiple sclerosis. Physiother Theory Pract. 2022 Jan 24:1-8. doi: 10.1080/09593985.2022.2030446. Epub ahead of print.
PMID: 35073816.
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2021

Mañago MM, Swink LA, Hager ER, Gisbert R, Earhart GM, Christiansen CL, Schenkman M. The Impact of COVID-19 on Community-Based Exercise Classes for People with Parkinson Disease. Phys Ther. 2021 Aug 27:pzab203. doi: 10.1093/ptj/pzab203. Epub ahead of print.
PMID: 34473303.
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Kline PW, So N, Fields T, Juarez-Colunga E, Christiansen CL. Error-Manipulation Gait Training for Veterans with Non-Traumatic Lower Limb Amputation: A Randomized Controlled Trial Protocol. Phys Ther. 2021 Aug 9:pzab192. doi: 10.1093/ptj/pzab192. Epub ahead of print.
PMID: 34379777.
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Christensen JC, Quammen DL, Rigby JH, Christiansen CL, Stevens-Lapsley JE. Trunk movement compensation identified by inertial measurement units is associated with deficits in physical performance, muscle strength and functional capacity in people with hip osteoarthritis. Clin Biomech (Bristol, Avon). 2021 Jul 21;88:105436. doi: 10.1016/j.clinbiomech.2021.105436. Epub ahead of print.
PMID: 34364100.
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Mañago MM, Kline PW, Harris-Love MO, Christiansen CL. The Validity of the Single-Leg Heel Raise Test in People With Multiple Sclerosis: A Cross-Sectional Study. Front Neurol. 2021 Jul 21;12:650297. doi: 10.3389/fneur.2021.650297. PMCID: PMC8333614.
PMID: 34354656.
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Kline PW, Christiansen CL, Hager ER, Alvarez E, Mañago MM. Movement compensations during a step ascent task are associated with stair climbing performance in people with multiple sclerosis. Gait Posture. 2021 Apr 15;87:27-32. doi: 10.1016/j.gaitpost.2021.04.022. Epub ahead of print.
PMID: 33878510.
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Anderson CB, Wurdeman SR, Miller MJ, Christiansen CL, Kittelson AJ. Development of a physical mobility prediction model to guide prosthetic rehabilitation. J Dev Behav Pediatr. 2021 Apr 5. doi: 10.1097/PXR.0000000000000001. Epub ahead of print.
PMID: 33840752.
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Miller MJ, Mealer ML, Cook PF, Kittleson AJ, Christiansen CL. Psychometric Assessment of the Connor-Davidson Resilience Scale for People With Lower-Limb Amputation. Phys Ther. 2021 Jan 9:pzab002. doi: 10.1093/ptj/pzab002. Epub ahead of print.
PMID: 33421074.
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2020

Miller MJ, Blankenship JM, Kline PW, Melanson EL, Christiansen CL. Patterns of Sitting, Standing, and Stepping After Lower Limb Amputation. Phys Ther. 2020 Dec 17:pzaa212. doi: 10.1093/ptj/pzaa212. Epub ahead of print.
PMID: 33336706.
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Miller MJ, Cook PF, Magnusson DM, Morris MA, Blatchford PJ, Schenkman ML, Christiansen CL. Self-Efficacy and Social Support are Associated with Disability for Ambulatory Prosthesis Users After Lower-Limb Amputation. PM R. 2020 Aug 10. doi: 10.1002/pmrj.12464. Epub ahead of print.
PMID: 32926546.
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Miller MJ, Morris MA, Magnusson DM, Putnam K, Cook PF, Schenkman ML, Christiansen CL. Psychosocial Factors Influence Physical Activity after Dysvascular Amputation: A Convergent Mixed-Methods Study. PM R. 2020 Aug 10. doi: 10.1002/pmrj.12466. Epub ahead of print.
PMID: 32936512.
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Christensen JC, Kline PW, Murray AM, Christiansen CL. Movement asymmetry during low and high demand mobility tasks after dysvascular transtibial amputation [published online ahead of print, 2020 Jul 7]. Clin Biomech (Bristol, Avon). 2020;80:105102. doi:10.1016/j.clinbiomech.2020.105102
PMID: 32768801.
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Kline PW, Murray AM, Miller MJ, So N, Fields T, Christiansen CL. Step length symmetry adaptation to split-belt treadmill walking after acquired non-traumatic transtibial amputation. Gait Posture. 2020 Jul; 80:162-167.
PMID: 32516682.
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