Medicine and Health Sciences Commons^™

Musculoskeletal Imaging Education In A Doctor Of Physical Therapy Program, William Chaz Sak-Ocbina, Rebecca Lancaster, Travis Muraoka, Robert Boyles

Physical Therapy Research Symposium

Title: Musculoskeletal Imaging Education in a Doctor of Physical Therapy Program

Authors: Rebecca Lancaster, SPT¹; Chaz Sak-Ocbina, SPT¹; Travis Muraoka, SPT¹; Robert Boyles, PT, DSc, OCS, FAAOMPT¹

Affiliation: 1. The School of Physical Therapy, University of Puget Sound

Purpose: Physical Therapists (PTs) are commonly referred to as the musculoskeletal experts in the medical field. As direct access laws have passed, PTs now must demonstrate appropriate clinical decision making and select suitable patients to refer for imaging services. Evidence suggests that, with adequate imaging education, PTs decrease imaging and overall health care costs compared …

Effects Of Desensitization On Pain Distribution And Normalization Of Somatosensation In A Patient With Quadrilateral Complex Regional Pain Syndrome, Lisa Cook, Kristen Dullen, Jacob Hoffman, Megan Vento, Roger Allen

Physical Therapy Research Symposium

Background and Purpose:

Complex regional pain syndrome (CRPS) is a chronic condition affecting at least one extremity that can develop after injury, involving allodynia, constant limb pain, and hyperpathic autonomic and somatic symptoms.¹ One essential CRPS treatment is somatosensory desensitization (SD), yet efficacy evidence remains limited.² This study aimed to assess changes in pain distribution and intensity in treated and untreated limbs, as well as possible somatosensory normalization of proximal non-painful limb regions, after 10 weeks of SD.

Case Description:

The 54 y.o. male patient had an incomplete C5 SCI. Prior to SD, the patient experienced constant searing …

The Influence Of A Supine Kicking Intervention On Infants With Down Syndrome Compared To Typically Developing Infants, Kara Schimke, Bryana Pardo, Kaylee Redmann, Kimberly Mahoney, Julia Looper

Physical Therapy Research Symposium

Title: The Influence of a Supine Kicking Intervention on Infants with Down Syndrome Compared to Typically Developing Infants

Authors: Kara Schimke, SPT¹; Bryana Pardo, SPT¹; Kaylee Redmann, SPT¹; Kimberly Mahoney, SPT¹; Julia Looper, PT, PhD¹

Affiliation(s): 1. School of Physical Therapy, University of Puget Sound

Purpose: Without intervention, infants with Down syndrome (DS) initiate walking one year later than their typically developing peers (TD). Supine kicking is an essential foundation for the development of walking due to similarities between the movement patterns. The purpose of this study was to investigate the …

Balance-Related Outcome Measures Of Acquired Brain Injury Patients In A Student-Led Onsite Physical Therapy Clinic: A Retrospective Records Review, Lauren M. Wilson, Corey R. Kaleshnik, Parke K. Humphrey, Ann M. Wilson

Physical Therapy Research Symposium

Title: Balance-Related Outcome Measures of Acquired Brain Injury Patients in a Student-Led Onsite Physical Therapy Clinic: A Retrospective Records Review

Authors: Parke Humphrey, SPT; Corey Kaleshnik, SPT; Lauren Wilson, SPT; Ann Wilson, PT, MEd, GCS

Affiliation(s): 1. Physical Therapy Program, University of Puget Sound

Purpose: Individuals with Acquired Brain Injury (ABI) often have balance impairments. Interventions targeting these impairments may improve balance and thus increase overall societal participation. The purpose of this review was to identify the types of balance-related outcome measures used to assess balance impairments in patients with ABI in a student-led onsite physical therapy clinic.

Subjects: 13 …

Effectiveness Of Spinal Manipulation In The Treatment Of Non-Musculoskeletal Disorders: A Systematic Review, Aynsley Muller Spt, Elizabeth Murphy Spt, Sarah Brownstein Spt, Robert Boyles Pt, Dsc

Physical Therapy Research Symposium

Purpose: Perform a systematic review to determine if spinal manipulation (SM) is an effective treatment for non-musculoskeletal disorders.

Subjects: Four studies from peer-reviewed journals that met inclusion/exclusion criteria were reviewed.

Materials & Methods: Pubmed, PEDro, Chiropractic Literature, CINAHL, Cochrane were searched between March and April 2014. In order to assess methodological quality, three raters applied the PEDro scale to included studies.

Results: The initial search yielded 2,324 articles covering 45 non-musculoskeletal conditions. Four randomized control trials (RCTs), met inclusion criteria. The conditions covered included: inner ear infection, infantile colic, asthma, and chronic obstructive pulmonary disease. Pedro scores ranged from 6-8, …

Salutogenesis: Implications For Maintaining A Psychologically Informed Physical Therapy Practice, Maximillian Gorchels Spt, Thomas Molyneux-Elliot Spt, Christina Phillips Spt, Danny Mcmillian Pt

Physical Therapy Research Symposium

Pathogenesis, the study of disease origins and causes, looks retrospectively at how to eliminate illnesses once they occur and has been the prevalent approach in Western medicine. Salutogenesis, by comparison, is the study of health origins and causes and looks prospectively at how to create health. There are many psychosocial instruments used to measure the personal factors that influence salutogenesis. However, the salutogenic model has rarely been studied in physical therapy settings, even though physical therapy educators and researchers are currently describing the importance of a psychologically informed practice.

Twenty-five psychological constructs within the salutogenic model were evaluated for this …

Neuromuscular Electrical Stimulation (Nmes) On The Tibialis Anterior Muscle And The Effects On Strength And Gait Mechanics On Stroke Patients: A Systematic Review., Katherine Chan Spt, Rachel Milhem Spt, Casey Hampton Spt

Physical Therapy Research Symposium

Purpose: To establish the effects of neuromuscular electrical stimulation (NMES) on the tibialis anterior muscle (TA) on chronic stroke patients in order to improve gait mechanics.

Subjects: 6

Materials & Methods: A systematic search of Pubmed, PEDro, CINAHL, and Cochrane Library was conducted to identify all pertinent randomized control trials (RCTs). RCTs that met the inclusion criteria were then assessed using the 11-point PEDro scale. Studies were assessed by two raters, and articles that scored 6 or above were accepted for review.

Results: The initial search yielded 34 articles: 21 were pulled for data extraction, six met selected inclusion and …

Effect Of Early Mobilization Programs In The Intensive Care Unit (Icu). A Review Of Systematic Reviews, Rondamarie Smith, Stephanie Pelham, Nicholas Higa, Ann M. Wilson

Physical Therapy Research Symposium

Title: Effect of Early Mobilization Programs in the Intensive Care Unit (ICU). A Review of Systematic Reviews

Authors: Nicholas C. Higa, SPT1; Stephanie J. Pelham, SPT1; Rondamarie B. Smith, SPT1; Ann Wilson, PT, M.Ed., GCS.1

Affiliation(s): 1. Physical Therapy Program, University of Puget Sound;

Purpose: To determine the effect of early mobilization on reducing the side effects associated with prolonged bed rest of patients in the ICU.

Materials & Methods: CINAHL, The Cochrane Library, PEDro and PubMed were searched between April 2015 to August 2015 to identify systematic reviews published from 2000 to 2015 with the keywords “ambulation,” “critical care,” …

Clinical Pain Scale Compendium, Tiffany M. Crow, Nicholas J. Pilch, James P. Aiken

Physical Therapy Research Symposium

Title: Clinical Pain Scale Compendium

Authors: James Aiken, SPT1, Tiffany Crow, SPT1, Nicholas Pilch, SPT1

Affiliation(s): 1. Physical Therapy Program, University of Puget Sound

Theory:

Pain is one of the pivotal aspects of a healthcare examination. Clinicians cannot measure pain objectively, and thus, we can only obtain a subjective report of the patient’s experience. However, the human experience of pain can be measured beyond merely its intensity. The purpose of this compendium is to present a range of pain aspects; the who, what, where, when, and how much of pain measurement. This is accomplished with the following domains: affective, beliefs, …

The Immediate Effects Of Kinesio Taping Versus Thoracic Manipulation In Subjects With Mechanical Neck Pain: A Pilot Study, Ashley Rojan, Brynn Blickenstaff, Jenae Perman, Bob Boyles

Physical Therapy Research Symposium

Title: The Immediate Effects of Kinesio Taping Versus Thoracic Manipulation in Subjects with Mechanical Neck Pain: A Pilot Study.

Authors: Brynn A. Blickenstaff, SPT¹; Jenae L. Perman, SPT¹; Ashley N. Rojan, ATC, AT/L, SPT¹; Dr. Robert E. Boyles, PT, DSc, OCS, FAAOMPT¹.

Affiliation(s): 1. Physical Therapy Program, University of Puget Sound.

Purpose: The purpose of this study was to compare the short-term effects of thoracic spine thrust manipulation and exercise (TSM-EX), cervical spine Kinesio Taping and exercise (KT-EX), and exercise only in subjects with mechanical neck pain (MNP).

Subjects: Eleven participants who …

Ability To Maintain A 0.22 M/Sec Gait Speed As Directed By An Auditory Metronome In Adults, Brady Christoph, Stacey Mccutchan, Samantha Mcdaniel

Physical Therapy Research Symposium

Purpose: To determine if healthy adults can maintain a slow gait speed after a seven-day training period of metronome guidance.

Subjects: Twenty students age 18-45 years.

Materials/Methods: The cadence of each participant was determined while walking on a treadmill at 0.22m/sec and individual metronomes were set accordingly. Participants walked along a pre-determined path and Gait­Rite mat (measuring cadence and velocity) with and without metronome guidance. This was repeated after a seven-day training period that consisted of walking with the metronome 10 minutes/day over five of the seven days.

Results: No significant visit effect for cadence (P=0.41) or velocity (P=0.47). Both …

Arm Positioning And Walking Styles Of Children During First 5 Months Of Independent Walking, Bernadette Schrempf, Julia Looper Phd, Pt, Lauren Poole, Alison Gunselman, Katrina Brett

Physical Therapy Research Symposium

Title: ARM POSITIONING AND WALKING STYLE OF CHILDREN DURING FIRST 5 MONTHS OF

INDEPENDENT WALKING

Authors: Poole, Lauren; Brett, Katrina; Gunselman, Alison; Schrempf, Bernadette; Looper, Julia

Affiliation: Physical Therapy, University of Puget Sound, Tacoma, WA, United States.

Purpose: Arm position during initial independent walking (IW) affects upper trunk biomechanics with gait. Arm positioning plays a role in forward propulsion and in maintaining upright position. Previous research has not established time lines or percentages of time spent in each arm position as IW progresses in typically developing infants. This study describes arm positioning across the initial 5 months of IW in …

The Impact Of Electrical Stimulation And Exercise On Independent Static Standing Balance, Denise A. Gyselinck Spt, Jennifer R. Briant Spt, Elizabeth L. Goldstein Spt

Physical Therapy Research Symposium

Purpose: Maintaining balance requires a complex integration of input from multiple sensory systems. Studies have shown positive effects of using transcutaneous electrical stimulation (TENS) and neuromuscular electrical stimulation (NMES) to enhance somatosensory feedback and muscular strength associated with balance. The purpose of this study is to examine the effects of electrical stimulation on independent standing balance during single leg stance (SLS) using either NMES with exercise, TENS with exercise, or exercise alone.

Subjects: Fourteen subjects were recruited through a convenience sample on the University of Puget Sound campus.

Methods: Randomized control trial. Subjects participated in this study …

Determining Leg Dominance Using The Unipedal Stance Test (Upst), Sheree Reed, Nia Jennings, Jordan Nakamura, Ann Wilson

Physical Therapy Research Symposium

Purpose: To determine whether the kicking leg or stance leg as determined by the Ball Kicking test results in a longer unipedal stance time as determined by the UPST.

Subjects: Forty-two healthy subjects (13 male, 29 female, mean age 26) with no history of lower limb pathology or balance impairments.

Materials and Methods: Subjects completed the Ball Kicking test and three trials of the UPST in a single session.

Results: UPST times were compared between the best trials of the stance and kicking legs with a significant difference found. Fifty percent of participants (21/42) maintained longer single limb stance times …

The Effectiveness Of Desensitization Therapy For Individuals With Complex Regional Pain Syndrome: A Systematic Review, Lauryn M. Helmers, Kira L. Donnelly, Olivia M. Verberne, Roger J. Allen

Physical Therapy Research Symposium

Authors: Kira L, Donnelly, SPT; Lauryn M. Helmers, SPT; Olivia M. Verberne, SPT; Roger J. Allen, PT, PhD

Title: The Effectiveness of Desensitization Therapy for Individuals with Complex Regional Pain Syndrome: A Systematic Review

Purpose: Systematically review evidence supporting the use of desensitization therapy to treat Complex Regional Pain Syndrome (CRPS).

Subjects: This systematic review evaluated 10 studies from peer-reviewed journals fitting research criteria.

Materials/Methods: Databases were searched between Mar and Aug of 2014 with the following search terms: complex regional pain syndrome, CRPS, allodynia, desensitization, neuropathic pain, physical therapy, tactile desensitization, pressure desensitization, hydrotherapy, physiotherapy, capsaicin and somatosensory.

Results: …

Hippotherapy As A Tool For Improving Motor Skills, Postural Stability, And Self Confidence In Cerebral Palsy And Multiple Sclerosis, Sarah A. Long

Sound Neuroscience: An Undergraduate Neuroscience Journal

Hippotherapy utilizes the three dimensional movement of the horse to improve balance, strength, coordination, and postural symmetry in those with cerebral palsy, multiple sclerosis, or related neuromuscular disorders. The forward, side-to-side, and rotational movement of the horse provides the rider with different sensory cues to help improve gait. While this therapy is a passive exercise for the patient, the individual must engage the core muscles to sit upright along with making small corrections due to the constant movement of the horse to help with postural stability and strengthening. Ultimately, understanding how affected brain areas lead to symptoms in those with …

Latent Modulation Of Neuropathic Pain Intensity Via Hypothalamus-Pituitary-Thyroid Axis Of Psychogenic Stress, Roger J. Allen

All Faculty Scholarship

Background: In patients with complex regional pain syndrome (CRPS) delayed pain flares consistently occur ten days following salient psychogenic stress episodes. Timing of latent flares suggests pain modulation via hypothalamus-pituitary-thyroid (HPT) axis hormones.

Objective: To determine if thyroxine (T₄) may modulate latent stress-related neuropathic pain flare intensity, temporal relationships between daily stress, serum T₄ levels, and perceived pain intensity in patients with CRPS were investigated.

Patients and Methods: Daily, for ten weeks, three patients with type I CRPS and no thyroid pathology Hx provided blood samples for T₄ assay and ratings of stress and pain. Measures …

The Relationship Between Dynamic Balance And Isokinetic Ankle Strength In Female College Athletes, Nika Evans

Summer Research

Conflicting results have been found between dynamic balance and isokinetic ankle strength. PURPOSE: To investigate the relationships between ankle strength and dynamic balance. METHOD: 15 healthy female Division III varsity athletes (INSERT DEMOGRAPHIC DATA) were tested on a Cybex NORM isokinetic dynamometer performing maximal ankle plantar and dorsiflexion. Dynamic balance was assessed using the SEBT. Isokinetic strength was assessed through 8 maximal contractions of plantar and dorsiflexion at 60, 120, and 180º/s with a 60 second rest period between each velocity set. Pearson’s correlations were used to assess the relationship between the dynamic balance score and peak torque at each …