Clinical Research Senior Scientist
Carolinas Neuromuscular/ALS–MDA Center
Department of Neurology
|2000 – 2004||Clinical Associate Professor of Neurology, University of Wisconsin Medical School|
|1992 - 2000||Clinical Assistant Professor of Neurology, University of Wisconsin Medical School
Research Fellow, University of Wisconsin Medical School
Research Assistant, Metabolic and Lipid Research Laboratory, William S. Middleton Memorial Veterans Hospital (Madison, Wis.)
MPT: University of Wisconsin
MBA: Edgewood College (Madison, Wis.)
PhD: Exercise Physiology, University of Wisconsin,
MA with Thesis: Exercise Physiology, Michigan State University (East Lansing, Mich.)
BA: College of Sport Education, Baghdad University (Baghdad, Iraq)
Motor function in ALS patients is affected early in the course of the disease with loss of fast motor units indicated by earlier loss of isokinetic muscle strength [Figure 1] and balance [Figure 2] during movement before loss of isometric muscle strength measured without muscle movement. Central motor fatigue and peripheral motor fatigue [Figure 3] appear to be dependent upon different aspects of the degeneration occurring in ALS. Central motor fatigue may affect control of fine motor movements, postural control and balance leading to stiffness, spasticity, and falls with subsequent injury. Treatments for central motor fatigue may be confounded by the peripheral motor fatigue resulting from degeneration and remodeling of the motor unit. These changes may occur in the brainstem with bulbar (speech-swallowing) symptoms or in the spinal cord with respiratory-limb symptoms.
Mechanisms of early (isokinetic), balance and motor fatigue, as well as loss of motor stamina (recovery from fatiguing work), require dissection by careful specialized quantitative measurement to allow evaluation of new treatment approaches. Studies of motor and sensory control, motor fatigue and motor stamina in ALS [Figure 4] and other neurological diseases in our Motor Performance Lab will permit comparative evaluation of therapeutic exercise intervention, pharmacologic as well as electrical and magnetic stimulation in the management of these motor deficits.
|Figure 1. Walking Capacity||Figure 2. Balance|
|Figure 3. Motor Fatigue||Figure 4. Motor Stamina|
Miller RG, Brooks BR, Swain-Eng RJ, RC. Basner RC, Carter GT, Casey P, Cohen AB, Dubinsky RM, Forshew D, Jackson CJ, Kasarskis Ed, Procaccini NJ, Sanjak M, Tolin FP. Quality Improvement in Neurology: Amyotrophic Lateral Sclerosis Quality Measures. Neurology; 2013. In press.
Hirsch MA, Sanjak M, Englert D, Iyer S, Quinlan MM, Hirsch H. Parkinson patients as partners in care. Parkinsonism & Related Disorders; 2013 In press.
Butler KA, Kapetanakis VE, Smith BE, Sanjak M, Verheijde JL, Chang YH, Magtibay PM, Magrina JF. Surgeon Fatigue and Postural Stability: Is Robotic Better than Laparoscopic Surgery? J Laparoendosc Adv Surg Tech A, 2013; 23(4):343-346. [PMID: 23410117]
Hirsch MA, Iyer SS, Englert D, Sanjak M. Promoting neuroplasticity through community-basedparticipatory-research (CBPR) exercise in Parkinson’s disease. Neurodegener Dis Manag. 2011; 1(5):365-377. [PMCID: PMC3337755]
Sanjak M, Bravver E, Norton JH, Bockenek WL, Brooks BR. Supported Treadmill Ambulation for Amyotrophic Lateral Sclerosis: A Pilot Study. Arch Phys Med Rehabil. 2010; 91:1920-9. [PMID: 21112435]
Sanjak M, Salachas F, Frija-Orvoen E, Theys P, Hutchinson D, Verheijde J, Pianta T, Stewart H,Brooks BR, Meininger V, Douillet P & Xaliproden [SR57746A] ALS International Study Group. Quality control of vital capacity as a primary outcome measure during a phase lll therapeutic clinical trial in Amyotrophic Lateral Sclerosis. Amyotrophic Lateral Scler, 2010; 11(4):383-8. [PMID: 20192884]
Ward AL, Sanjak M, Duffy K, Bravver E, Williams N, Nichols M, Brooks BR. Power wheelchair prescription, utilization, satisfaction, and cost for patients with amyotrophic lateral sclerosis: preliminary data for evidence based guidelines. Arch Phys Med Rehabil 2010; 91:268-272. [PMID: 20159132]