Mark Geil, PhD

O&P Almanac introduces individuals who have undertaken O&P-focused research projects. Here, you will get to know colleagues and healthcare professionals who have carried out studies and gathered quantitative and/ or qualitative data related to orthotics and prosthetics, and find out what it takes to become an O&P researcher.

MARK GEIL, PhD, RECENTLY concluded a long line of research in collaboration with Children’s Healthcare of Atlanta (CHOA) on prosthetic prescription protocols for children with limb loss requiring a knee component. The project started in the late 1990s when Geil, who is currently professor and interim associate dean for research

Caption and operations at Wellstar College of Health and Human Services, Kennesaw State University (KSU), first learned that CHOA was achieving positive results when providing children with a working prosthetic knee much earlier than standardly advised.

“Since then, we’ve collected 3D-instrumented motion analysis on children walking with and without locked knees, on younger children crawling with and without a knee, and most recently in a multisite study on children in what we call the ‘early knee’ protocol compared to children in the traditional prescription protocol,” says Geil. The results have consistently shown that children who receive a knee earlier develop more normal gait patterns at an earlier age and also are afforded opportunities to meet other developmental milestones at more normative ages.

“We’re seeing this research start to find its way into medical textbooks, and we believe it’s actually changing the accepted protocols at multiple facilities,” Geil says. “It’s a distinct pleasure to see the research we conduct in our labs not only make it into the world in scientific publications, but also have a direct and meaningful impact on the development of children around the country.”

Geil decided to pursue a career in biomedical engineering back when he was in high school, during a career day. “I was already drawn to engineering because I enjoyed building things and taking them apart, and did well in science and mathematics,” he says. “But when I learned there was a discipline within engineering so focused on directly helping people, I was all in.” He went on to earn his bachelor’s degree in mechanical engineering from North Carolina State University in 1993.

While pursuing his doctorate in biomedical engineering at Ohio State University, he took an O&P class designed for the medical students. In the hospital where the course was taught, “I learned about energy-storing prosthetic feet, which at the time were relatively new, and learned that gait lab-based research was giving unclear messages about their effectiveness. I set to find out why and have been working in O&P ever since—over 25 years now.”

During those two and a half decades, Geil participated in many studies designed to benefit O&P patients, including a plethora of pediatric studies. One of his often cited plagiocephaly studies investigates results in infants who use cranial remolding orthoses designed with a noninvasive laser shape digitizer.

Today, as associate dean at KSU, Geil is responsible for facilitation and oversight of faculty and student research. He assists with grant proposals, collaboration development, and public awareness of the work being carried out at Wellstar College of Health and Human Services. He also is responsible for the college’s facilities and operations.

Geil and his research team are currently focusing on the role of cognitive bias in gait, particularly with respect to O&P devices. “We have one line of research on confirmation bias, studying the possibility that people who are given an advanced, computerized device, or maybe just an expensive device, might alter their feedback—or even their motion—just because they expect the device to perform better, regardless of the device’s actual function. We have some fascinating results already,” he says. Subjects given a standard knee orthosis who were led to believe it had dynamic microprocessor control very highly favored the device’s stability and function, according to Geil, even though they did not actually walk any differently with it.

Geil’s team also is studying children with idiopathic toe walking. “We’ve developed a strong team of international collaborators and, with each study, are closing in on finally identifying the etiologies of the condition.”

Looking to the future, Geil plans to expand his work on cognitive biases, “because I think it undergirds all the research we do on advanced devices, and the future will undoubtedly hold more and more technological advancements,” he says. “I’m also invested in continuing our work with idiopathic toe walking until we find a cause and can

develop tailored treatments, instead of just trying to treat the symptoms.”

Geil also plans to continue collaborating with orthotists and prosthetists in the years to come. “As an engineer, I recognize the importance of the clinician in the research process, which is why I’ve worked so closely with clinicians on all of my research projects,” he says. “I’ve had lots of ideas for research projects that don’t resonate with clinicians, so I don’t pursue them. I believe research that involves clinicians will always be more clinically applicable.”

In addition to his research responsibilities, Geil is proud of his work in O&P education—in particular, helping to launch the O&P master’s program at Georgia Tech two decades ago. “In the summer of 1999, I first learned of discussions among the engineering faculty at Georgia Tech regarding the future need for advanced degrees in O&P,” he recalls. Because he was conducting research in the area, Geil became involved and wrote the proposal to the Georgia Board of Regents for what became the world’s first entry-level master of science degree program in O&P.

“We started the program in 2002, and it quickly became a leading model in how to elevate education to the master’s level, how to infuse research into O&P curricula, and how to balance clinical skills with advanced engineering concepts,” he says. Eventually, the accreditation model used nationwide moved to the master’s level. Most recently, after administrative changes, the Georgia Tech program found a new home at Kennesaw State University. (See “Education Upgrades” in the September issue of O&P Almanac.) “I’m teaching a clinical gait analysis class to the first class of 24 students this semester, and it feels just like old times.”

Outside of his day job, Geil has a unique part-time gig: He works in Atlanta’s booming movie and TV industry. “I’m a blur in the background of movies like ‘Avengers: Endgame’ and the ‘Hunger Games’ series,” he says. “I should be making an appearance on the upcoming season of ‘Stranger Things,’ and I even played a cadaver on a show called ‘The Resident.’”

In his spare time, Geil spends time with his wife and three daughters. “This year, we welcomed our first grandchild, who is just delightful,” he says. During the pandemic, Geil and his wife purchased an RV, and they have spent time traveling to state and national parks.

But the travel will have to fit within his current work responsibilities, as Geil plans to spend many more professional years studying pediatric outcomes. “It’s a challenging population with which to conduct research, which might be why it’s understudied in O&P, but that just motivates me more,” he says. “I consistently find that we don’t give kids enough credit for what they’re naturally capable of when we plan for components and rehabilitation.”

Mark Geil, PhD, has been involved in dozens of important published studies, including the following: • Geil, M.D., Safaeepour, Z.,

Giavedoni, B., Coulter, C.P.

“Walking Kinematics in Young

Children With Limb Loss

Using Early Versus Traditional

Prosthetic Knee Prescription

Protocols.” PLoS ONE, 2020; 15(4): e0231401. PMID: 32275734

PMCID: PMC7147787. https://doi. org/10.1371/journal.pone.0231401 • Balsamo, B., Geil, M.D., Ellis,

R., Wu, J. “Confirmation Bias

Affects User Perception of Knee Braces.” Journal of

Biomechanics, 2018; 75: 164-170.

PMID: 29724537. https://doi. org/10.1016/j.jbiomech.2018.04.028 • Fanchiang, H., Geil, M.D., Wu, J., Ajisafe, T., Chen, Y. “The Effects of Walking Surface on the Gait Pattern of Children With Idiopathic Toe Walking.” Journal of Child Neurology, 2016; 31(7): 858-863. • Plank, L.H., Giavedoni, B., Lombardo, J.R., Geil, M.D, Reisner, A. “Comparison of Infant Head Shape Changes in Deformational Plagiocephaly Following Treatment With a Cranial Remolding Orthosis Using a Noninvasive Laser Shape Digitizer.” Journal of Craniofacial Surgery, 2006; 17(6), 1084-1091.