Physical Measures Core (PMC)

The Physical Measures Core serves as the central resource for Center investigators seeking advice, training, laboratory access, and equipment for valid, sensitive, and reliable measures. The Physical Measures Core provides highly integrated, customized support to investigators supported by our Research Education Component, Pilot/Exploratory Studies Core, Externally Funded Projects, and the larger Duke Community engaged by the Duke Older Americans Independence Center.

AIMS of the Physical Measures Core
  1. Expertise and Consultation: To provide centralized expertise available for consultation on the measurement of reserve and resilience
  2. Development and Standardization: To develop measurement protocols and train personnel in administration and data collection
  3. Innovation and Standardization: To identify gaps in resiliency measures and develop or adapt innovative new measurement approaches across the adult lifespan for related outcomes

Miriam Morey, PhD
Professor of Medicine in the Division of Geriatrics

The general focus of my work is exercise and aging. A number of studies examine how system-wide impairments serve as preclinical indicators of disability and overall decline in the quality of life of older adults. Ongoing studies examine the role of exercise training in attenuation or reversal of functional decline and examination of the effectiveness of different methods of physical activity counseling for home-based exercise.

Katherine S. Hall, PhD
Assistant Professor in the Division of Geriatrics, Duke Pepper Scholar, and Investigator in the Durham VA GRECC

My research is focused on developing evidence-based physical activity interventions for older adults with an eye to preserving functional independence and quality of life. I am particularly interested in developing exercise programs to promote physical and psychological well-being among older veterans with posttraumatic stress disorder (PTSD).


Emerging Discovery/Health Innovation Projects
Co-sponsored with the Duke Institute for Health Innovation

Sheng Luo, PhD (Biostatistics & Bioinformatics)
Accelerometer-based physical activity features and associations with physical function in older adults.

  1. The clinical utility of the information embedded in the rich times-series data captured by accelerometers has been greatly understudied among older adults. Novel approaches to analyzing these data suggest that microscale features of complexity (e.g., active and sedentary bouts) and fragmentation metrics (e.g., transitions between activity and sedentary states) may be linked with measures of health and functional status. We propose to examine the association between novel physical activity features such as complexity and fragmentation, and physical function in 961 participants enrolled in the PALS Longitudinal Cohort Study. Aim 1: Characterize physical activity features (e.g., total volume, time related features, fragmentation metrics, intradaily variability) derived from minute-level actigraphy data and examine the association with physical function at baseline. Aim 2: Explore predictive models of change in physical activity features and changes in physical function over 2 years. This study provides a novel clinical application for wearable accelerometers, and seeks to explore the potential for accelerometry as a non-invasive biomarker of physiologic reserve, aging, and functional health. [PALS Study Description]

Lisa Hobson-Webb, MD (Neurology)
Development of two new tools to measure muscle reserve and function in older adults using electrical impedance myography (EIM) and quantitative muscle ultrasound (QMUS)

  1. Validation of electrical impedance myography (EIM) and quantitative muscle ultrasound (QMUS) as reliable, valid markers of function and muscle mass will provide inexpensive and non-invasive biomarkers for studies in physical resilience and rehabilitation. EIM and QMUS provide direct information about muscle structure and integrity. These two promising technologies offer an inexpensive, non-invasive alternative to BodPod or DEXA methods. This study is mid-way through recruitment. Preliminary data suggest a high correlation of a simple-to-use bioelectrical impedance method with muscle ultrasound and muscle isokinetic testing to examine skeletal muscle quality and function, respectively. Importantly, there were also positive correlations between the bioelectrical impedance device and functional tasks. This is a promising inexpensive and non-invasive method to measure muscle quality and to indicate muscle function potential. [Journal Link]

Jaime Hughes, PhD (Population Health Sciences)
Smart technologies to monitor/modify sleep-activity behaviors in older adults

  1. Project Overview. Smart home technologies are increasingly being used to support older adults’ functional capacity and manage daily health behaviors. However, no existing technologies actively monitor or modify sleep-activity behaviors, thereby missing an opportunity to address these upstream determinants of functional decline during both times of health and recovery. The proposed work aims to develop and evaluate the feasibility of sensor-triggered ecological momentary assessment (EMA) diaries to monitor older adults’ sleep-activity behaviors.

Kevin Caves, ME (Medicine and Biomedical Engineering)
Integrating digital technology in the development of two new tools to measure mobility in older adults

  1. Project Overview. Aim 1: Develop a new activity monitoring device and analysis software to assess and analyze mobility in older adults in inpatient settings. Aim 2: Validate walking velocity measured by the Gaitbox, a compact digital device developed by Dr. Caves that automatically records, stores, and displays walking speed. This project is newly awarded and aims to respond to technology needs identified by Pepper investigators to advance the integration of technology in their work.

Marty Woldorff, PhD (Neuroscience and Neurobiology)
Assessing postoperative neurocognitive resilience in older adults using scalp EEG

  1. This project is testing the feasibility and usability of a LiveAmp EEG Amplifier device in the OR setting. Trajectories of neurocognitive resilience will be examined using resting-state 32-channel EEG collected preoperatively, intraoperatively, and postoperatively in older adults across three funded resiliency-related projects. This project is newly awarded and will enhance our ability to advance innovations in resiliency measurement.

Research Education Component
2020 Awards
Brian Andonian, MD Accelerated metabolic aging in rheumatoid arthritis immune cells and skeletal muscle: A pilot study
Ming-Feng Hsueh, PhD Harness human cartilage repair capability to prevent and reverse osteoarthritis
Daniel C. Parker, MD Identification of biomarkers of cognitive resilience in the Duke Performance Across the LifeSpan (PALS) Study
2018 Awards
Nazema Siddiqui, MD Effects of aging and the urinary microbiome on recurrent urinary tract infections
Corey Simon, DPT, PhD Physical resilience to pain with activity influences among seniors
Tony Sung, MD High intensity interval training to improve pre- and peri-transplant function and outcomes

Pilot/Exploratory Studies Core
2020 Awards
Gurpreet Baht, PhD ApoE: A new target to improve aged bone healing
Elaine Gomez Guevara, PhD Mechanisms underlying variation in primate physiological reserve
Gentzon Hall, MD, PhD Understanding the role of IL-15 signaling in podocyte resilience and survival
Adam DeVore, MD, MHS Resilience after heart transplant or LVAD in patients with advanced heart failure
2018 Awards
David Bartlett, PhD Exercise training to promote resilience in chronic lymphocytic leukemia in older patients by enhancing physical and immunological reserve
Anna Mae Diehl, MD Aging Effects on Hepatocyte Reprogramming and Liver Repair
Charity Oyedeji, MD Focused geriatric assessment and biomarkers to determine physiologic resilience in older adults with sickle cell disease
Mihai Podgoreanu, MD Metabolic modifiers and rehabilitation phenotypes in older adults subjected to extracorporeal support


Pepper researchers have an extraordinary opportunity for collaboration across Medical Center and University departments. These affiliated faculty members currently conduct interdisciplinary research with the Physical Measures Core.

Miriam Morey, PhD
Epidemiology/Exercise Science

Expertise and Access in assessment of:
Physical function: Performance-based and Self-report
Physical activity: Performance-based and Self-report
Services available
Portable telemetric oxygen uptake analyzer (Cosmed)
Activity tracking devices (SAM, Garmin)
Physical performance testing protocols & equipment

Katherine S. Hall, PhD
Exercise Psychology/Behavioral Medicine

Expertise and Access in assessment of:
Psycho-social measures of behavior change
Physical activity: Performance-based and Self-report
Services available
Physical activity/sedentary monitoring (Actigraph)
Activity tracker analytic software (ActiLife)
Physical performance testing protocols & equipment
Psychosocial assessments/Health behavior theories

Amy M. Pastva, PT, MA, PhD
Physical Therapy/Exercise Physiology/Cell-Molecular Physiology/Biology

Expertise and Access in assessment of:
Translational science
Rodent models of disease, rodent exercise – young and aged mice
Cardiovascular and pulmonary fitness and function
Performance-based measures of physical status and function;
Rehabilitation and care transitions for medically complex patients
(acute, outpatient, home health)
Services available
Pulmonary function testing
Portable EKG
Physical status/Function (strength, mobility, cardiovascular, balance)/ Retraining equipment
Muscle physiology
Rodent: Treadmill exercise equipment

Avshalom Caspi, PhD

Expertise and Access in assessment of:
Psychiatric genetics
Mental health and personality
Longitudinal trajectories of mental health and predictors
Services available
Psychosocial measures of stress resilience
Personality assessment
Life-course epidemiology

Cathleen Colón-Emeric, MD, MHS

Expertise and Access in assessment of:
Outcome measurement using administrative datasets and economic analyses
Measures of care delivery
Development of measures of reserve and resilience
Services available
Falls history/Falls risk assessments
Fall prevention strategies

Deborah Gold, PhD

Expertise and Access in assessment of:
Psychosocial factors; Quality of life
Osteoporosis; Chronic illness; Pain
Services available
Measurement of quality of life, pain, psychological well-being, health behavior theories, self-efficacy

Gerda Fillenbaum, PhD

Expertise and Access in assessment of:
Cognitive function; Neuropsychology measures
Health service use; Functional status
Services available
Measurement of functional status, comorbidity, quality of life, cognitive status, ADLs, depression

Heather E. Whitson, MD, MHS

Expertise and Access in assessment of:
Sensorial assessments
Services available
Measurement of sensorial impairments (cognitive, visual, pain, balance)
Comorbidity assessments

Helen Hoenig, MD
Physical Medicine and Rehabilitation

Expertise and Access in assessment of:
Performance-based measures of function using tele-technology
(gait, balance, motor coordination, ADLs)
GPS technology
Clinical measurement of physical, cognitive, I/ADLs
Services available
Functional retraining equipment
Rehabilitation training equipment
Assistive technology/devices

Kevin Caves, BSME
Biomedical Engineer

Expertise and Access in assessment of:
Assistive technology; Technology and design for people with disabilities; Rehabilitation engineering
GPS/Spatial assessments
Design and fabrication of clinical and research tools
Integration of micro controllers and sensors
Software specification and development
Services available
Fabrication facilities (build and prototype custom devices)
3D printers
Assistive technology/devices
Remote monitoring of activities/physical performance
Fabrication of mechanical and electronic devices
Creation of software

S. Nicole Hastings, MD

Expertise and Access in assessment of:
Pharmacotherapy and comorbidity
Health service use
Services available
Assessment of healthcare utilization
Medication exposure/Prescribing practices

Terrie E. Moffitt, PhD

Expertise and Access in assessment of:
Mental health and bio-behavioral risk factors
Longitudinal trajectories of mental health and predictors
Gene-environment interplay and psychological health
Services available
Behavioral genetics
Mental health epidemiology
Psychological assessments

William E. Kraus, MD

Expertise and Access in assessment of:
Cardiopulmonary exercise testing
Metabolic testing (RMR; OGTT, IVGTT)
Anthropometry assessments
Muscle molecular physiology
Integrative physiology
Services available
Body composition (Bod Pod, DXA)
Exercise physiology testing: CPET and strength testing; 6 MW
Metabolic testing (RMR; OGTT; IVGTT; infusion studies)
Physical activity tracking devices (RT3, Actigraph)
Mobile Health devices
Skeletal muscle biopsies
Clinical coordinator time for exercise, drug interaction studies
CV physical exam and EKG


Pastva AM, Hugenschmidt CE, Kitzman DW, Nelson MB, Brenes GA, Reeves GR, Mentz RJ, Whellan DJ, Chen H, Duncan PW. Cognition, Physical Function and Quality-of-Life in Older Patients with Acute Decompensated Heart Failure. J Card Fail. 2021 Mar;27(3):286-294. PMID:32956816 Institutional access PMCID:7914148 Available 3/1/2022

Jarvis LM, Peterson MJ, Caves KM. Development, validity, and reliability of a novel walking speed measurement device: the GaitBox. Gait Posture. 2021 Feb;84:52-57. Journal access PMCID:7902333 Available 2/1/2022

Hall KS, Morey MC, Beckham JC, Bosworth HB, Sloane R, Pieper CF, Pebole MM. Warrior Wellness: A randomized controlled pilot trial of the effects of exercise on physical function and clinical health risk factors in older military veterans with PTSD. J Gerontol A Biol Sci Med Sci. 2020 Oct 15;75(11):2130-2138. PMID:31646339 Open access

Hall KS, Morey MC, Bosworth HB, Beckham JC, Pebole MM, Sloane R, Pieper CF. Pilot randomized controlled trial of exercise training for older veterans with PTSD. J Behav Med. 2020 Aug;43(4):648-659. PMCID:6938572

Hall KS, Hyde ET, Bassett DR, Carlson S, Carnethon M, Ekelund U, Evenson K, Galuska D, Kraus WE, Lee I, Matthews C, Omura J, Paluch A, Thomas W, Fulton J. Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia. Int J Behav Nutr Phys Act. 2020 Jun 20;17(1):78. PMCID:7305604

Fillenbaum GG, Sloane R, Burchett BM, Hall K, Pieper CF, Whitson HE, Colón-Emeric CS. Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample. J Am Med Dir Assoc. 2020 Aug;21(8):1141-1147. Minority Research Publication Minority Research Publication PMCID:7396287

Hall KS, Morey MC, Bosworth HB, Beckham JC, Pebole MM, Sloane R, Pieper CF. Pilot randomized controlled trial of exercise training for older veterans with PTSD. J Behav Med. 2019 Jul 1. PMCID:6938572

Whitson HE, Cohen HJ, Schmader KE, Morey MC, Kuchel G, Colon-Emeric CS. Physical Resilience: Not Simply the Opposite of Frailty. J Am Geriatr Soc. 2018 Mar 25. PMCID:6157007

Hall KS, Cohen HJ, Pieper CF, Fillenbaum GG, Kraus WE, Huffman KM, Cornish M, Shiloh A, Flynn C, Sloane R, Newby LK, Morey MC. Physical performance across the adult lifespan: correlates with age and physical activity. J Gerontol A Biol Sci Med Sci 2017 Apr;72(4):572-578. PMCID:6075535

Whitson HE, Duan-Porter W, Schmader KE, Morey MC, Cohen HJ, Colón-Emeric CS. Physical Resilience in Older Adults: Systematic Review and Development of an Emerging Construct. J Gerontol A Biol Sci Med Sci 2016 Apr;71(4):489-495. PMCID:5014191