Jennifer Stevens-Lapsley PT, PhD

Title: Associate Director for Research; Professor, Physical Medicine & Rehabilitation; Physical Therapy Program

Contact: jennifer.stevens-lapsley@cuanschutz.edu | jennifer.stevens-lapsley@va.gov

University of Colorado webpage

Personal Statement
My clinical research focuses on identifying, integrating and advancing innovative evidence-based medicine rehabilitation solutions for older adults through highly effective research methods and partnerships. My research uses a multifaceted approach to evaluate intervention strategies designed to enhance the effectiveness of rehabilitation in older adult patient populations. I have served as a clinician in various settings with an emphasis on patients following knee and hip arthroplasty. As such, I have 20 years of clinical research experience in patients with osteoarthritis planning joint arthroplasty. More specifically, I have participated in the design, implementation, and publication of studies exploring whether innovative surgical and rehabilitation strategies improve physical function (e.g. NIH R01 HD065900, NIH R03 AR054538, NIH K23 AG029978, and NIH R01 AG056585). More recently, I have worked closely with interdisciplinary teams focused on medically-complex patients in different settings (inpatient, home health, skilled nursing facilities) and have developed new lines of research involving these older adult populations (NIH R01 NR016209, VA RR&D I21 RX002054, VA RR&D I01 RX001978).

Research Interest

A very important part of my contributions to science include serving as a research mentor to PhD students, post-doctoral fellows, PT faculty, and DPT students. Evidence of mentoring excellence is supported by a track record of trainees securing academic appointments, combined with mentoring awards, and mentored grants. My PhD and post-doctoral fellow trainees have all secured academic appointments and have demonstrated a track record of productivity (publications, presentations, grants, etc). In recognition of my mentoring, I received the Outstanding Research Mentor Award for the Clinical Science Program (2009), and the University of Colorado Excellence in Doctoral Mentoring Award (2016).

Grants & Funding

Multicomponent Telerehabilitation to Engage Veterans in Effective Self-Management of Complex Health Conditions

Role: PI
Medically complex older Veterans are at greater risk for progressive declines in physical function, lower quality of life, and increasing care needs. Additionally, older Veterans experience social isolation and loneliness and have low levels of physical activity. 
While the Veterans Health Administration has established programs to address rehabilitation needs, these programs tend to be diagnosis-focused, lack self-management approaches, include low-intensity rehabilitation, and typically require in-person attendance. 
A MultiComponent TeleRehabilitation (MCTR) program that provides high-intensity rehabilitation and self-management interventions, social support, and telehealth and technology support may be more effective in improving and sustaining physical function for older Veterans with complex health conditions. 
Therefore, this project is designed to determine whether the MCTR program improves strength and physical function more effectively than traditional interventions.
Funder: Veterans Affairs
NIH website

Intensive Rehabilitation Research Grant Writing Workshops in the United States (TIGRR)

Role: Co-I with Edelle Field-Fote
With the aging of our population and growing numbers of persons with disability, rehabilitation research is increasingly essential. However, rehabilitation researcher lags behind other areas of biomedical research. 
We propose a vibrant and intensive year-long program to strengthen the rehabilitation research workforce.
Funder: Eunice Kennedy Shriver National Institute of Child Health & Human Development

Gait Speed Screening Initiative: To Identify Older Adults with Lower Functional Status at Risk of Falls.

Role: Co-I; PI: Hillary Lum
This initiative will implement gait speed measurements as a 6th vital sign at UCH Seniors Clinics to refer patients to appropriate exercise and rehabilitation interventions to prevent adverse events (falls, ER visits, hospitalizations). 
Funder: University of Colorado Hospital

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

Role: PI; Co-I: Cory Christiansen
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

Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities

This study seeks to provide large-scale, foundational evidence that high-intensity rehabilitation is effective and be systematically implemented to improve functional outcomes for patients admitted to skilled nursing facilities following hospitalization. 
Additionally, this study will generate a descriptive overview of factors that predict implementation success while informing effective implementation strategies for future skilled nursing facilities innovation. 
Overall, this study is a critical step in advancing clinical practice to establish high-intensity rehabilitation as an effective standard of care in skilled nursing facilities to shift current treatment away from low-intensity, conservative interventions.
Funder: National Institute on Aging
NIH website

Improving Rehabilitation for Veterans After Total Knee Arthroplasty Using Individualized Recovery Trajectories

Role: PI; Co-I: Michael Bade
This study will examine the impact of a new clinical decision-support tool for rehabilitation after total knee arthroplasty (TKA). Typically, TKA rehabilitation is generic. Most patients receive the same dose and type of rehabilitation, despite the diversity of patients who undergo TKA. 
Our clinical support decision tool helps physical therapists tailor rehabilitation treatments and dosages to the individual needs, goals, and preferences of Veterans recovering from TKA. This study can potentially improve Veterans’ functional recovery after TKA while reducing the average number of physical therapy visits Veterans attend after surgery by tailoring rehabilitation dosage based on need. 
The clinical support decision tool will ensure the Veterans Health Administration (VHA) has the resources and capacity to provide adequate rehabilitation to every Veteran seeking TKA in the VHA system. Physical therapists using the clinical decision support tool can improve outcomes and access for other patient populations in the future.
Funder: Veterans Affairs
NIH website

Optimizing Physical Activity Outcomes for Veterans After Total Knee Arthroplasty

Role: Co-I; PI: Cory Christiansen
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. 
Investigator: Cory Christiansen
Funder: Veterans Affairs
NIH website
Publications of note:
— Improving Physical Activity Through Adjunct Telerehabilitation Following Total Knee Arthroplasty: Randomized Controlled Trial Protocol

Novel Strategies for Personalized Clinical Decisions in Knee Arthroplasty

Role: PI; Co-I: Michael Bade
The proposed research is relevant to public health because total knee arthroplasty (TKA) is the most common inpatient elective surgery, with approximately 700,000 procedures performed each year. 
We propose to develop and implement a clinical decision tool for shared decision-making — Personalized Reference Charts (PRCS) — to facilitate personalized approaches to care. We believe our research will contribute to AHRQ's mission by supplying knowledge that will enhance individual clinical decision-making, increase resource utilization efficiency, and improve the quality of care surrounding TKA surgery in a learning healthcare system.
Funder: Agency for Healthcare Research and Quality
NIH website
Publications of note:
— Person-Centered Care and Physical Therapy: A “People-Like-Me” Approach
— "This is not negotiable. You need to do this…": A directed content analysis of decision making in rehabilitation after knee arthroplasty

Combining Testosterone and Exercise to Improve Function Post Hip Fracture

Role: Co-I; PI: Ellen Binder
This clinical trial will evaluate whether adding an anabolic hormone stimulus to exercise results in improved functional outcomes after hip fracture in older women when compared with exercise alone.
Funder: National Institute on Agin
NIH website

Improving Function in Older Veterans with Hospital-associated Deconditioning

This study focuses on a prevalent and understudied problem for older Veterans: functional decline following acute hospitalization. Our proposed intervention will be applied in the immediate post-hospitalization period to lessen the effects of deconditioning for older Veterans and improve home and community mobility. 
The intervention also has the potential to reduce the utilization of high-cost, long-term healthcare options such as formal in-home caregivers or institutionalization within the Veterans Health Administration System. 
Funder: Veterans Affairs
NIH website
Publications of note:
— Public Health Impact of Frailty: Role of Physical Therapists

Improving Rehabilitation Outcomes After Total Hip Arthroplasty

In the next two decades, there may be a significant increase in total hip arthroplasty (THA) surgeries. Innovative rehabilitation techniques are needed to optimize long-term physical function. 
This study has a high potential to change current rehabilitation practice for THA in Veterans where implementing functional strength integration rehabilitation strategies can be designed for clinical settings. 
Funder: Veterans Affairs
NIH website
Publications of note:
— Trunk movement compensation identified by inertial measurement units is associated with deficits with physical performance, muscle strength and functional capacity in people with hip osteoarthritis
— Incorporating Specific Functional Strength Integration Techniques to Improve Functional Performance for Veterans After Total Hip Arthroplasty: Protocol for a Randomized Clinical Trial
— Simulated Hip Abductor Strengthening Reduces Peak Joint Contact Forces in Patients with Total Hip Arthroplasty
— The Impact of Hip Implant Alignment on Muscle and Joint Loading during Dynamic Activities

Movement pattern biofeedback training after total knee arthroplasty

Role: PI; Co-I: Cory Christiansen & Michael Bade
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

Progressing Home Health Rehabilitation Paradigms for Older Adults

This study focuses on a prevalent and understudied problem for older adults: mobility limitations in older adults following acute hospitalization. 
This investigation has a high potential for an immediate clinical impact because it addresses patient mobility in a home setting (rather than a laboratory) and is designed to work within existing Medicare reimbursement guidelines. 
The intervention also has the potential to reduce the utilization of high-cost healthcare options such as re-hospitalizations, nursing home stays, and emergency room visits.
Funder: National Institute of Nursing Research
NIH website
Publications of note:
— Cardiac Rehabilitation in Frail Older Adults With Cardiovascular Disease: A NEW DIAGNOSTIC AND TREATMENT PARADIGM
— Progressive Multicomponent Intervention for Older Adults in Home Health Settings Following Acute Hospitalization: Randomized Clinical Trial Protocol

Recent Publications

2024

Garbin AJ, Devone F, Bayer TA, Stevens-Lapsley J, Abul Y, Singh M, Leeder C, Halladay C, McConeghy KW, Gravenstein S, Rudolph JL. Changes in Physical Function and Physical Therapy Use in Older Veterans Not Infected by CoVID-19 Residing in Community Living Centers During the CoVID-19 Pandemic. J Am Med Dir Assoc. 2024 Jun 27:105120. doi: 10.1016/j.jamda.2024.105120. Epub ahead of print. 
PMID: 38945171.

Stutzbach JA, Hare KS, Gustavson AM, Derlein DL, Kellogg AL, Stevens-Lapsley JE. A Novel Behavioral Intervention to Enhance Physical Activity for Older Veterans in a Skilled Nursing Facility. J Aging Phys Act. 2024 Jun 11:1-12. doi: 10.1123/japa.2022-0412. Epub ahead of print. 
PMID: 38862110.

2023

Churchill L, John Bade M, Koonce RC, Stevens-Lapsley JE, Bandholm T. The past and future of peri-operative interventions to reduce arthrogenic quadriceps muscle inhibition after total knee arthroplasty: A narrative review. Osteoarthr Cartil Open. 2023 Dec 21;6(1):100429. doi: 10.1016/j.ocarto.2023.100429. PMCID: PMC10832271. 
PMID: 38304413.

Judd DL, Cheuy V, Peters A, Graber J, Hinrichs-Kinney L, Forster JE, Christiansen CL, Stevens-Lapsley JE. Incorporating Functional Strength Integration Techniques during Total Hip Arthroplasty Rehabilitation: A Randomized Controlled Trial. Phys Ther. 2023 Dec 15:pzad168. doi: 10.1093/ptj/pzad168. Epub ahead of print. 
PMID: 38102757.

Swink LA, Mealer ML, Miller MJ, Anderson CB, Cook PF, Stevens-Lapsley JE, Christiansen CL. Telehealth Walking Self-Management for Individuals with Amputation: A Qualitative Study of Therapist Perspectives on Adoption. Phys Ther. 2023 Nov 7:pzad155. doi: 10.1093/ptj/pzad155. Epub ahead of print. 
PMID: 37944092.

Stevens-Lapsley J, Hicks GE, Zimney K, Slaven EJ, Manal TJ, Jeffries LM. Research Agenda for Physical Therapy From the American Physical Therapy Association. Phys Ther. 2023 Oct 3;103(10):pzad126. doi: 10.1093/ptj/pzad126. PMCID: PMC10549784. 
PMID: 37712887.

Butera KA, Gustavson AM, Forster JE, Malone D, Stevens-Lapsley JE. Admission Cognition and Function Predict Change in Physical Function Following Skilled Nursing Rehabilitation. J Am Med Dir Assoc. 2023 Oct 17:S1525-8610(23)00799-5. doi: 10.1016/j.jamda.2023.09.011. Epub ahead of print. 
PMID: 37863110.

Rauzi MR, Abbate LM, Lum HD, Cook PF, Stevens-Lapsley JE. Multicomponent telerehabilitation programme for older veterans with multimorbidity: a programme evaluation. BMJ Mil Health. 2023 Sep 14:e002535. doi: 10.1136/military-2023-002535. Epub ahead of print. 
PMID: 37709508.

Rauzi MR, Mealer ML, Abbate LM, Stevens-Lapsley JE, Nearing KA. Older Veterans' Experiences of a Multicomponent Telehealth Program: Qualitative Program Evaluation Study. JMIR Form Res. 2023 Sep 8;7:e46081. doi: 10.2196/46081. 
PMID: 37682595.

Graber J, Churchill L, Struessel T, O'Malley S, Bade M, Stevens-Lapsley J. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty: A Delphi study. J Orthop Sports Phys Ther. 2023 Jul 10:1-28. doi: 10.2519/jospt.2023.11840. Epub ahead of print. 
PMID: 37428802.

Ha DM, Nunnery MA, Klocko RP, Haverhals LM, Bekelman DB, New ML, Randhawa SK, Stevens-Lapsley JE, Studts JL, Prochazka AV, Keith RL. Lung cancer survivors' views on telerehabilitation following curative intent therapy: a formative qualitative study. BMJ Open. 2023 Jun 23;13(6):e073251. doi: 10.1136/bmjopen-2023-073251. 
PMID: 37355268.

Beisheim-Ryan EH, Butera KA, Hinrichs LA, Derlein DL, Malone DJ, Holtrop JS, Forster JE, Diedrich D, Gustavson AM, Stevens-Lapsley JE. Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities: An Effectiveness-Implementation Hybrid Type 1 Clinical Trial Protocol. Phys Ther. 2023 May 31:pzad053. doi: 10.1093/ptj/pzad053. Epub ahead of print. 
PMID: 37255325.

Stevens-Lapsley JE, Derlein D, Churchill L, Falvey JR, Nordon-Craft A, Sullivan WJ, Forster JE, Stutzbach JA, Butera KA, Burke RE, Mangione KK. High-intensity home health physical therapy among older adult Veterans: A randomized controlled trial. J Am Geriatr Soc. 2023 May 24. doi: 10.1111/jgs.18413. Epub ahead of print. 
PMID: 37224397.

Maffiuletti NA, Dirks ML, Stevens-Lapsley J, McNeil CJ. Electrical stimulation for investigating and improving neuromuscular function in vivo: Historical perspective and major advances. J Biomech. 2023 May;152:111582. doi: 10.1016/j.jbiomech.2023.111582. Epub 2023 Apr 11. 
PMID: 37088030.

Rauzi MR, Ridgeway KJ, Wilson MP, Jolley SE, Nordon-Craft A, Stevens-Lapsley JE, Erlandson KM. Rehabilitation Therapy Allocation and Changes in Physical Function Among Patients Hospitalized Due to COVID-19: A Retrospective Cohort Analysis. Phys Ther. 2023 Mar 3;103(3):pzad007. doi: 10.1093/ptj/pzad007. PMCID: PMC10071586. 
PMID: 37172130.

Churchill L, Morrow M, Capin JJ, Jolley SE, Hare K, MaWhinney S, Stevens-Lapsley JE, Erlandson KM. Using Wearable Technology to Quantify Physical Activity Recovery: Secondary Report From the AFTER (App-Facilitated Tele-Rehabilitation) Program for COVID-19 Survivors Randomized Study. JMIR Rehabil Assist Technol. 2023 Mar 20;10:e43436. doi: 10.2196/43436. 
PMID: 36939818.

Garbin AJ, Stevens-Lapsley JE, Gritz RM, Tucker CA, Bade MJ. Long-Term Career Earnings in Academia Might Offset the Opportunity Cost of Full-Time PhD and Postdoctoral Education for Physical Therapists Who Hold a Doctor of Physical Therapy Degree. Phys Ther. 2023 Apr 4;103(4):pzad015. doi: 10.1093/ptj/pzad015. PMCID: PMC10152085. 
PMID: 37128811.

2022

Minick K, Hunter SJ, Capin JJ, Stevens-Lapsley J, Snow G, Woodfield D, Dibblee P, Brennan G. Improved Outcomes Following a Care Guideline Implementation: Part 1 of an Analysis of 12,355 Patients after Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2022 Dec 12:1-26. doi: 10.2519/jospt.2022.11369. Epub ahead of print. 
PMID: 36507694.

Capin JJ, Minick K, Stevens-Lapsley JE, Snow G, Woodfield D, Dibblee P, Brennan G, Hunter SJ. Variation in outcomes and number of visits following care guideline implementation: Part 2 of an Analysis of 12,355 patients after total knee arthroplasty. J Orthop Sports Phys Ther. 2022 Dec 12:1-26. doi: 10.2519/jospt.2022.11370. Epub ahead of print. 
PMID: 36503269.

Graber J, Kittelson A, Juarez-Colunga E, Jin X, Bade M, Stevens-Lapsley J. Comparing "people-like-me" and linear mixed model predictions of functional recovery following knee arthroplasty. J Am Med Inform Assoc. 2022 Jul 28:ocac123. doi: 10.1093/jamia/ocac123. Epub ahead of print. 
PMID: 35903035.

Toth MJ, Savage PD, Voigt TB, Anair BM, Bunn JY, Smith IB, Tourville TW, Blankstein M, Stevens-Lapsley JE, Nelms NJ. Effects of total knee arthroplasty on skeletal muscle structure and function at the cellular, organellar and molecular levels. J Appl Physiol (1985). 2022 Jul 28. doi: 10.1152/japplphysiol.00323.2022. Epub ahead of print. 
PMID: 35900327.

Capin JJ, Jolley SE, Morrow M, Connors M, Hare K, MaWhinney S, Nordon-Craft A, Rauzi M, Flynn S, Stevens-Lapsley JE, Erlandson KM. Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study. BMJ Open. 2022 Jul 26;12(7):e061285. doi: 10.1136/bmjopen-2022-061285. 
PMID: 35882451.

Cheuy VA, Dayton MR, Hogan CA, Graber J, Anair BM, Voigt TB, Nelms NJ, Stevens-Lapsley JE, Toth MJ. Neuromuscular Electrical Stimulation Preserves Muscle Strength Early after Total Knee Arthroplasty: Effects on Muscle Fiber Size. J Orthop Res. 2022 Jul 20. doi: 10.1002/jor.25418. Epub ahead of print. 
PMID: 35856287.

Capin JJ, Bade MJ, Jennings JM, Snyder-Mackler L, Stevens-Lapsley JE. Total Knee Arthroplasty Assessments Should Include Strength and Performance-Based Functional Tests to Complement Range-of-Motion and Patient-Reported Outcome Measures. Phys Ther. 2022 Mar 30:pzac033. doi: 10.1093/ptj/pzac033. Epub ahead of print. 
PMID: 35358318.

Capin JJ, Wilson MP, Hare K, Vempati S, Little CE, McGregor D, Castillo-Mancilla J, Stevens-Lapsley JE, Jolley SE, Erlandson KM. Prospective telehealth analysis of functional performance, frailty, quality of life, and mental health after COVID-19 hospitalization. BMC Geriatr. 2022 Mar 26;22(1):251. doi: 10.1186/s12877-022-02854-6. PMCID: PMC8956362. 
PMID: 35337276.

Huebschmann AG, Glasgow RE, Leavitt IM, Chapman K, Rice JD, Lockhart S, Stevens-Lapsley JE, Reusch JEB, Dunn AL, Regensteiner JG. Integrating a physical activity coaching intervention into diabetes care: a mixed-methods evaluation of a pilot pragmatic trial. Transl Behav Med. 2022 Mar 21:ibac014. doi: 10.1093/tbm/ibac014. Epub ahead of print. 
PMID: 35312788.

Carmichael J, Dennis D, Jennings J, Stevens-Lapsley J, Bade M. Feasibility and initial efficacy of a multimodal swelling intervention after total knee arthroplasty: A prospective pilot study with historical controls. Knee. 2022 Feb 17;35:25-33. doi: 10.1016/j.knee.2022.01.008. Epub ahead of print. 
PMID: 35183923.

Gustavson AM, LeDoux CV, Himawan M, Stevens-Lapsley JE, Nearing KA. Implementation of a rehabilitation model in a Program of All-Inclusive Care for the Elderly (PACE): Preliminary data. J Am Geriatr Soc. 2022 Feb 4. doi: 10.1111/jgs.17674. Epub ahead of print. 
PMID: 35119693.

Presentations (Video, Podcast, etc.

Walking Speed:
The 6th Vital Sign

This video details the value of regular walking speed measurements and how walking speed can be utilized in a clinical setting. Created by:
Alexander Garbin, PT, DPT, PhD
Jennifer Stevens-Lapsley, PT, PhD, FAPTA
Sarah Beck, MD

Watch: Walking Speed: The 6th Vital Sign (5 minutes)