Medicine and Health Sciences Commons^™

Addition Of Hip Exercises To Treatment Of Patellofemoral Pain Syndrome: A Meta-Analysis, Kimberly Morelli, Maria Carrelli, Maria Nunez, Carolina A. Smith, Gordon L. Warren

Physical Therapy Faculty Publications

AIM: To determine if the addition of hip-strengthening exercises decreases pain and improves function in patients with patellofemoral pain syndrome.

METHODS: The authors completed a systematic review searching eight databases (i.e. , PubMed, Cochrane, CINHAL, MEDLINE, SportsDiscus, EMBASE, APTA Hooked on Evidence, and PEDro). Two independent reviewers screened and excluded studies if they did not meet the following inclusion criteria: subjects had a primary diagnosis of patellofemoral pain syndrome (PFPS), intervention group included hip-strengthening exercises, control group included a traditional physical therapy intervention, study included outcome measures of pain and/or function, study used a randomized controlled trial design, PEDro score …

Functional Organization And Restoration Of The Brain Motor-Execution Network After Stroke And Rehabilitation, Sahil Bajaj, Andrew Butler, Daniel Drake, Mukesh Dhamala

Physics and Astronomy Faculty Publications

Multiple cortical areas of the human brain motor system interact coherently in the low frequency range (<0.1 Hz), even in the absence of explicit tasks. Following stroke, cortical interactions are functionally disturbed. How these interactions are affected and how the functional organization is regained from rehabilitative treatments as people begin to recover motor behaviors has not been systematically studied. We recorded the intrinsic functional magnetic resonance imaging (fMRI) signals from 30 participants: 17 young healthy controls and 13 aged stroke survivors. Stroke participants underwent mental practice (MP) or both mental practice and physical therapy (MP+PT) within 14–51 days following stroke. We investigated the network activity of five core areas in the motor-execution network, consisting of the left primary motor area (LM1), the right primary motor area (RM1), the left pre-motor cortex (LPMC), the right pre-motor cortex (RPMC) and the supplementary motor area (SMA). We discovered that (i) the network activity dominated in the frequency range 0.06–0.08 Hz for all the regions, and for both able-bodied and stroke participants (ii) the causal information flow between the regions: LM1 and SMA, RPMC and SMA, RPMC and LM1, SMA and RM1, SMA and LPMC, was reduced significantly for stroke survivors (iii) the flow did not increase significantly after MP alone and (iv) the flow among the regions during MP+PT increased significantly. We also found that sensation and motor scores were significantly higher and correlated with directed functional connectivity measures when the stroke-survivors underwent MP+PT but not MP alone. The findings provide evidence that a combination of mental practice and physical therapy can be an effective means of treatment for stroke survivors to recover or regain the strength of motor behaviors, and that the spectra of causal information flow can be used as a reliable biomarker for evaluating rehabilitation in stroke survivors.

Randomized, Placebo-Controlled, Double-Blind Pilot Study Of D-Cycloserine In Chronic Stroke, Andrew Butler, Justiss Kallos, Stephen N. Housley, Michelle Laplaca, Stephen F. Traynelis, Stephen L. Wolf

Physical Therapy Faculty Publications

Stroke is a leading cause of death and disability in the USA. Up to 60% of patients do not fully recover despite intensive physical therapy treatment.N-Methyl-D-aspartate receptors(NMDA-R) have been shown to play a role in synaptic plasticitywhen activated. D-Cycloserine promotes NMDA receptor function by binding to receptors with unoccupied glycine sites. These receptors are involved in learning and memory.We hypothesized thatD-cycloserine,when combined with robotic-assisted physiotherapy (RAP), would result in greater gains compared with placebo + RAP in stroke survivors. Participants (𝑛 = 14) were randomized to Dcycloserine plus RAP or placebo plus RAP. Functional, cognitive, and quality-of-life measures were used …

Randomized, Placebo-Controlled, Double-Blind Pilot Study Of D-Cycloserine In Chronic Stroke, Andrew Butler, Justiss Kallos, Stephen N. Housley, Michelle Laplaca, Stephen F. Traynelis, Stephen L. Wolf

Physical Therapy Faculty Publications

Stroke is a leading cause of death and disability in the USA. Up to 60% of patients do not fully recover despite intensive physical therapy treatment. N-Methyl-D-aspartate receptors (NMDA-R) have been shown to play a role in synaptic plasticity when activated. D-Cycloserine promotes NMDA receptor function by binding to receptors with unoccupied glycine sites. These receptors are involved in learning and memory. We hypothesized that D-cycloserine, when combined with robotic-assisted physiotherapy (RAP), would result in greater gains compared with placebo + RAP in stroke survivors. Participants (n=14) were randomized to D-cycloserine plus RAP or placebo plus RAP. Functional, …

Effect Of A Home-Based Virtual Reality Intervention For Children With Cerebral Palsy Using Super Pop Vr Evaluation Metrics: A Feasibility Study, Yuping Chen, Sergio Garcia-Vergara, Ayanna M. Howard

Physical Therapy Faculty Publications

Objective. The purpose of this pilot study was to determine whether Super Pop VR, a low-cost virtual reality (VR) system, was a feasible system for documenting improvement in children with cerebral palsy (CP) and whether a home-based VR intervention was effective. Methods. Three children with CP participated in this study and received an 8-week VR intervention (30 minutes × 5 sessions/week) using the commercial EyeToy Play VR system. Reaching kinematics measured by Super Pop VR and two fine motor tools (Bruininks-Oseretsky Test of Motor Proficiency second edition, BOT-2, and Pediatric Motor Activity Log, PMAL) were tested before, mid, and after …

Low Intensity, High Frequency Vibration Training To Improve Musculoskeletal Function In A Mouse Model Of Duchenne Muscular Dystrophy, Susan A. Novotny, Tara L. Mader, Angela G. Greising, Angela S. Lin, Robert Guldberg, Gordon L. Warren, Dawn A. Lowe

Physical Therapy Faculty Publications

The objective of the study was to determine if low intensity, high frequency vibration training impacted the musculoskeletal system in a mouse model of Duchenne muscular dystrophy, relative to healthy mice. Three-week old wildtype (n = 26) and mdx mice (n = 22) were randomized to non-vibrated or vibrated (45 Hz and 0.6 g, 15 min/d, 5 d/wk) groups. In vivo and ex vivo contractile function of the anterior crural and extensor digitorum longus muscles, respectively, were assessed following 8 wks of vibration. Mdx mice were injected 5 and 1 days prior to sacrifice with Calcein and Xylenol, respectively. Muscles …

Pni Biomarkers And Health Outcomes In College Women, Shih-Yu Lee, Mugdha Vasireddi, Yuping Chen, Yong Tai Wang, Julia Hilliard

Physical Therapy Faculty Publications

Sleep disturbance has been found to trigger a stress response with a subsequent activation of the psychoneuroimmunological (PNI) pathway associated with adverse health outcomes. This study aimed to assess the association among selected PNI biomarkers, sleep disturbances, and adverse health outcomes (depressive symptoms, physical symptoms). A stratified, quota sample (14 poor sleepers and 15 good sleepers) was drawn from a pool of healthy college women from a larger scale of study. The participants reported their sleep, stress, depressive, and physical symptoms. Wrist actigraphy was used to collect objective sleep data, and the Enzyme-Linked ImmunoSorbent Assay was used to assess PNI …

Game Analysis, Validation, And Potential Application Of Eyetoy Play And Play 2 To Upper-Extremity Rehabilitation, Yuping Chen, Michelle Caldwell, Erica Dickerhoof, Anastasia Hall, Bryan Odakura, Kimberly Morelli, Hsin-Chen Fanchiang

Physical Therapy Faculty Publications

Objective. To describe and analyze the potential use of games in the commercially available EyeToy Play and EyeToy Play 2 on required/targeted training skills and feedback provided for clinical application. Methods. A summary table including all games was created. Two movement experts naïve to the software validated required/targeted training skills and feedback for 10 randomly selected games. Ten healthy school-aged children played to further validate the required/targeted training skills. Results. All but two (muscular and cardiovascular endurance) had excellent agreement in required/targeted training skills, and there was 100% agreement on feedback. Children’s performance in required/targeted training skills (number of unilateral …

The Impact Of Body-Scaled Information On Grasping Action In Toddlers With And Without Down Syndrome, Yuping Chen, Allison Mitch, Kristen Chafin, Rachel Sargent

Physical Therapy Faculty Publications

Background and purpose: Studies of adults and typically developing (TD) children find the number of hands and fingers used to grasp an object is influenced by the relationship between object size and hand size. Children with Down syndrome (DS) between 3 and 11 years have shown no differences in number of hands (1 or 2 hands) used to grasp different sized objects compared to TD children when the object size was body-scaled. The purpose of this study was to examine whether body-scaled information affected the number of hands and fingers used to grasp different sized objects in toddlers with and …

Impact Of Yoga On Low Back Pain And Function: A Systematic Review And Meta-Analysis, Amy Sawyer, Sarah K. Martinez, Gordon L. Warren

Physical Therapy Faculty Publications

An estimated 70% of people will experience low back pain at some point in their lives, and recurrence rates can be as high as 85%. Recent studies suggest that yoga – a widely practiced physical/mental discipline – may relieve back pain and reduce functional disability. The objective of this study was to conduct a systematic review and meta-analysis of the existing research on the effects of yoga on chronic low back pain and function. Our literature search began April 2011 and continued through October 2011. Cochrane, PubMed, CINAHL, Embase, ProQuest Dissertations and Theses, Google Scholar, and Clinicaltrials.gov databases were searched …

Aging, Aerobic Activity And Interhemispheric Communication, Keith M. Mcgregor, Kenneth M. Heilman, Joe R. Nocera, Carolynn Patten, Todd M. Manini, Bruce Crosson, Andrew Butler

Physical Therapy Faculty Publications

Recent studies have shown that during unimanual motor tasks, aging adults show bilateral recruitment of primary motor cortex (M1), while younger adults show a suppression of the ipsilateral motor cortex. Additional work has indicated that increased bilateral M1 recruitment in older adults may be deleterious when performing some motor tasks. However, higher levels of physical fitness are associated with improved dexterity and fitness may mitigate the loss of both inhibitory and excitatory communication in aging adults. The goal of this study was to assess dexterity and interhemispheric motor communication in physically fit and sedentary middle-age (40–60 years) right handed participants …

Estrogen Regulates Estrogen Receptors And Antioxidant Gene Expression In Mouse Skeletal Muscle, Kristen A. Baltgalvis, Sarah M. Greising, Gordon L. Warren, Dawn A. Lowe

Physical Therapy Faculty Publications

Background: Estrogens are associated with the loss of skeletal muscle strength in women with age. Ovarian hormone removal by ovariectomy in mice leads to a loss of muscle strength, which is reversed with 17β-estradiol replacement. Aging is also associated with an increase in antioxidant stress, and estrogens can improve antioxidant status via their interaction with estrogen receptors (ER) to regulate antioxidant gene expression. The purpose of this study was to determine if ER and antioxidant gene expression in skeletal muscle are responsive to changes in circulating estradiol, and if ERs regulate antioxidant gene expression in this tissue.

Methodology/Principal Findings: Adult …

Training Effects Of Virtual Reality On Reaching Behaviors In Children With Cerebral Palsy: Case Report, Lin-Ju Kang, Yuping Chen, Wen-Hsu Sung, Tien-Yow Chuang, Shwn-Jan Lee, Mei-Wun Tsai, Suh-Fang Jeng, Ji-Liang Doong

Physical Therapy Faculty Publications

Virtual reality (VR) is a computer technology that artificially generates sensory information in a form that people perceive as real-world objects and events. It has been proposed that VR can improve upper-extremity function in children with cerebral palsy (CP) by decreasing physical disabilities, precisely adjusting the difficulty of task and feedback, enhancing motivation and manipulating perceptual information. The purpose of this study was to investigate the training effects of VR on reaching behavior in a child with CP. This case was a 6-year-old boy with spastic quadriplegic CP who had good cooperation and normal cognition. A single-subject A-B-A design was …

Variable-Frequency-Train Stimulation Of Skeletal Muscle After Spinal Cord Injury, C. Scott Bickel, Jill Slade, Leslie R. Vanhiel, Gordon L. Warren, Gary A. Dudley

Physical Therapy Faculty Publications

Skeletal muscle, after spinal cord injury (SCI), becomes highly susceptible to fatigue. Variable-frequency trains (VFTs) enhance force in fatigued human skeletal muscle of able-bodied (AB) individuals. VFTs do this by taking advantage of the "catch-like" property of skeletal muscle. However, mechanisms responsible for fatigue in AB and SCI subjects may not be the same, and the efficacy of VFT stimulation after SCI is unknown. Accordingly, we tested the hypothesis that VFT stimulation would augment torque-time integral in SCI subjects. The quadriceps femoris muscle was stimulated with constant frequency trains (CFTs) (six 200 s square wave pulses separated by 70 ms) …

Projection Of Supply And Demand Of The Physical Therapy Manpower In Taiwan For The Next Twenty Years: Part I. Current Status And Productivity Of Physical Therapists And Physical Therapist Assistants, Yuping Chen, Hsuei-Chen Lee, Wendy Tzzy-Jinan Wang, Yea-Ru Yang, Shwn-Jen Lee, Huei-Chen Lin, Ray-Yau Wang

Physical Therapy Faculty Publications

Background and purposes: The purposes of this study were 1) to describe the general productivity and productivities in 4 special fields (neurological, orthopedic, pediatric, and cardiopulmonary) of physical therapists (PT) and physical therapist assistants (PTA) in Taiwan, and 2) to explore the association between characteristics of PT/PTA and productivity.

Method: Questionnaire was mailed to the members of all PT and PTA associations in Taiwan. The total mailing number of questionnaire for PT and PTA were 2466 and 1117, respectively. The content of this questionnaire included basic demographic data and information in clinical work. Survey period was between September, 2002 and …

A Comparison Of The Leg Coordination Patterns Of Preterm And Fullterm Infants: A Meta-Analysis, Yuping Chen, Linda Fetters

Physical Therapy Faculty Publications

Background and Purposes: The purposes of this meta-analysis were (1) to investigate the relation between prematurity and the parameters of infant kicking, and (2) to examine to what degree the effect size varies as a function of age, study type, publication type, and country of origin. Methods: Six studies met all the inclusion criteria and were used for this meta-analysis. A r-indicator was used to represent the effect size indicating the difference between low-risk preterm and full term infants and the difference in kinematic variables between high-risk preterm and full term infants. A fixed-effect model was assumed in this study. …