Medicine and Health Sciences Commons^™

Optimal Interventions To Address Drop Foot And Increase Gait Speed In Stroke Populations, Christopher Tran, Tommy Ngo, Dana Hazlett, Ethan Jung, Faris Alshammari

San Marcos, Summer 2020

Background: The mechanism of stroke or cerebral vascular accident (CVA) is an interruption of blood flow to the brain, which can result in many different neuromuscular impairments including drop foot. There is limited research focusing on comparative interventions for gait improvement in early stroke.

Purpose: The purpose of this study was to review the various physical thereapy interventions to benefit patients with drop foot following a single stroke.

Methods: A comprehensive systematic search was conducted within the PubMed and ProQuest databases. This study examined papers assessing conventional physical therapy for stroke patients with drop foot who had their 1st stroke …

Remedying Healthcare Disparities Affecting The Black Community, Savonna Reed

San Marcos, Summer 2020

The purpose of this literature review is to determine how black communities are being impacted by racial/social determinants of cardiovascular health, and to investigate potential healthcare solutions to eliminate these disparities.

As physical therapists, we commonly treat patients following lumbar spinal fusion surgery. Post-op outcomes have been found to be impacted by racial disparities in decision making in whether care providers offer surgical care, differences in access to care due to socioeconomic barriers, and differences in attitudes towards surgical care among ethnic groups.

Review of current literature has revealed that more research should be done to establish ways of remedying …

The Effectiveness Of Home Health Physical Therapy Following Diagnosis Of Acute Respiratory Failure Secondary To Covid-19: A Case Report, Desiree Lyall, Maura Owens

San Marcos, Summer 2020

The purpose of this case study is to describe the effects of home health physical therapy involving gait training, respiratory exercises, disease process education and rehabilitation exercises for strength, endurance and balance in the treatment of a 73 year-old, male patient with a diagnosis of acute respirtory failure secondary to Covid-19.

For a patient with a diagnosis of acute respiratory failure secondary to Covid-19 diagnosis home health physical therapy was an effective treatment option to facilitate return to prior level of function. This case study supports previous research and recommended treatment guidelines for the effectiveness of gait training, respiratory exercises, …

The Effectiveness Of Heart Rate Variability Biofeedback In Conjunction With Traditional Treatment For Thoracic Outlet Syndrome In A 25-Year-Old Female: A Case Report, Sepehr Rezaei

San Marcos, Summer 2020

Introduction: Thoracic outlet syndrome (TOS) is a complex condition that causes pain, tingling sensation, hypesthesia, muscle atrophy, weakness, and edematous changes in the upper quadrant (UQ) and down upper extremity (UE). ^3,7,8,16,17 TOS is due to compression of neurovascular bundles in the interscalene triangle, costoclavicular space, and under pectoralis minor and caused by trauma, congenital malformations such as a cervical rib, and abnormal/poor postures from muscle imbalances.^3,7,8,16,17 Interventions for TOS can consist of correcting posture by addressing muscle imbalance, decreasing tone and muscle tightness and rib mobilization, and in rare cases, rib resection. ^{3,7,8,13,16,17} However, there is limited research …

Analysis Of Physical Therapy Interventions Vs. Kinesio Taping For Relieving Low Back Pain, Amanda Orr

San Marcos, Summer 2020

Introduction/Background: This topic focuses on the utilization of kinesio taping (KT) to assist with decreasing pain in the low back. According to Shipton, low back pain has gone up by more than 50% since 1990. These factors are attributed to smoking, obesity, sedentary occupations, and to low socioeconomic status.Globally, in 2016, it is said that low back pain contributed 57.6 years to disability and the prevalence peaks around the ages of 35-55 years according to the World Health Organization.

Purpose: The purpose of this literature review is to compare research articles between KT with physical therapy interventions as compared …

The Health Benefits Of Visual Art Activities In The Geriatric Population, Melody Au-Yeung, Abraham Avila, Jason Bandong, Hy Ia, Naureen Imam, Kayla Wilcox

San Marcos, Spring 2020

Purpose: The purpose of this poster presentation is to assess the efficacy of visual art therapy on the physical and mental health of the geriatric population.

Description: The potential impact of art therapy on cognition and dementia is a growing field of research in the rehabilitative world. Some researchers have found support for certain mediums, such as ceramic painting, while others have explored multimodal treatment programs that integrate art into physical activities. Combining physical activity with an arts and crafts program could posit a significant impact on ADL function and quality of life in older adults. As a …

Case Report: Effects Of Therapeutic Exercise On A Patient With Metastatic Osteosarcoma And Pathological Fracture, Jessica Phung, Sarah Mathew

San Marcos, Spring 2020

Purpose: The purpose of this case report is to demonstrate how conditioning exercise for patients with active metastatic neoplasms can improve quality of life (QoL) after a pathological fracture of lumbar vertebrae. Spinal metastasis, in this case from breast cancer, is primarily asymptomatic, and therefore, difficult to detect during early stages. Detection and diagnosis usually occur after initial manifestation of a pathological fracture leading to debilitating effects. Complications with metastatic bone cancer and surgical contraindications may bring patients into outpatient physical therapy to address the pathological fractures and QoL for patients.

Case Description & Methods: The patient is a 44-year …

A Case Study On The Effects Of Functional Exercises In Improving Quality Of Life (Qol) In A Patient Diagnosed With Glioblastoma Multiforme (Gbm), Kathy Nguyen, Savonna Reed, Sepehr Rezaei, Vanessa Rindge-Silvas, Brianne Bozzella

San Marcos, Fall 2019

Background and Purpose: The estimated prevalence of primary brain tumors in the US population is 14 per 100,000. GBM accounts for 50% of primary central nerve tumors in people older than 15 years old. Approximately 12,820 deaths each year are due to primary and nervous system tumors. There is limited research on the optimal interventions and effects of physical therapy on individuals diagnosed with GBM.¹ The purpose of this case report was to determine which aspects of the International Classification of Functioning, Disability, and Health model are the most important to consider during physical rehabilitation and possible interventions that …

What Is Congenital Talipes Equinovarus?, Cornelia Lieb-Lundell

San Marcos, Fall 2019

An estimated 80% of clubfoot cases occur in low to middle-income countries. Incidence of clubfoot is estimated to be 1-1.5 per 1000 births, and male to female occurrence is 3:1. (1) Left untreated, this congenital anomaly becomes a “neglected clubfoot” and can result in lifelong hardships including limited ambulation related to gait deviations, pain, foot deformities and an inability to wear shoes. Without treatment, this health condition can lead to functional limitations with limited independence in activities of daily living and participation restrictions within the family and community related to decreased mobility. (2)

The intervention presented is the main components …

Weight-Bearing Interventions To Decrease Spasticity And Improve Gait In Stroke Patients: A Case Report, Melin Nguyen, Shelby Peterson, Jessika Sun, Irene Taing, Faris Alshammari

San Marcos, Fall 2019

The purpose of this case report was to determine the success of weight-bearing interventions on spasticity reduction and improved gait patterns in a 61 year-old-male patient recovering from a chronic left hemorrhagic CVA. The patient’s primary impairments included right upper and lower extremity spasticity, circumduction gait, weakness and decreased range of motion of right extremities.

The interventions included in this patient’s treatment program included standing calf stretches, toe raises, ankle range of motion and gait training for 1 hour once a week for 4 weeks. This case report supports the application of weight-bearing through the paretic limb, which has been …

The Effect Of Aquatic Interventions In Combination With Early Start Physical Therapy Services On Gross Motor Development In A Male Child With Down Syndrome, Roxanne Mueller

San Marcos, Fall 2019

Introduction: Aquatic therapy has been used in various patient populations as a modality to facilitate motor control and manage tonicity.^1-3 Despite the variety of literature addressing individuals with Down syndrome (DS) and aquatic therapy, there has been little described about the effects of aquatic therapy on early gross motor development in children with DS.

Purpose: The purpose of this case study is to examine whether aquatic physical therapy interventions combined with early start physical therapy influence gross motor developmental delay in a child with DS.

Case Description: The patient is a 31-month-old boy with diagnosis of …

The Effects Of Dry Needling In The Management Of Sub-Acromial Impingement Syndrome: A Case Report, Kaitlyn Radice, Lindsey Bramlette, Kristin Fenstermaker

Miami, Fall 2019

The purpose of this study was to evaluate the effectivness of dry needling to an active trigger point in the anterior deltoid musculature in conjunction with physical therapy. This case study presents a 77-year-old male with traumatic pull into flexion injury. In addition to being given RTC and postural musculature strengthening exercises, PROM, joint mobilization, and soft tissue mobilization, dry needling was performed at week 2 and week 4 of treatment.

From this case study, we can conclude that TrP-DN to an active TrPin the anterior deltoid can yield statistically significant improvements in ROM, strength, pain, and functional abilities when …

Treatment Of Phantom Limb Pain And Knee Flexion Contracture Due To Transtibial Amputation: A Case Study, Kristin Smead, Donna Leigel

Miami, Fall 2019

This case study evaluated the effectiveness of a combination of visual mirror therapy for phantom limb pain desensitization in conjunction with a physical therapy regimen of therapeutic exercise, short-wave diathermy, and gait training in a 66-year-old male with left lower extremity amputation.

Through a combination of mirror therapy, short-wave diathermy over the hamstring musculature, and therapeutic exercise, the patient displayed an overall improvement in left lower limb knee flexion contracture and a reduction in perceived phantom limb pain.The patient can now tolerate full weight bearing through this extremity from an improved fit of the prosthesis socket. Throughout the course of …

Physical Therapy Management Of Stress Urinary Incontinence In The Pediatric Population: A Case Study, Debra Dy, Maureen Egizii

Miami, Fall 2019

The purpose of this study was to determine if external pelvic floor examination and treatment can be an effective, non-invasive intervention for urinary incontinence in the pediatric population. The case study examines the effectiveness of exercise therapy for an 11-year-old female with pelvic floor dysfunction. This case demonstrates that pelvic floor strengthening exercises can help to resolve incontinence symptoms without the implementation of internal examination or treatment. Although commonly used to address incontinence in adults, pelvic floor physical therapy may also be an effective, non-invasive intervention option for children who are experiencing urinary incontinence.

Rehabilitation Modifications For A Patient With Parkinson’S Disease Following A Suspected Case Of Gilbert’S Syndrome: A Case Study, Jason Bandong, Hy Ia, Naureen Imam, Kayla Wilcox, Travis Dennis

San Marcos, Summer 2019

The purpose of this case study was to assess the effects of core stabilization exercises, balance training, agility ladder step drills, fine motor, and dual-task training in the treatment of a high-functioning, 55-year-old, male patient with a history of Parkinson’s Disease and suspected Gilbert’s Syndrome.

This treatment program delivered for 1 hour once per week over 4 weeks led to mild improvements in activity limitations with the most notable being able to button a shirt with decreased time and assistance. The patient also exhibited mild improvement in body structure/function impairments with decreased loss of balance as evident during tandem walking …

Case Study: Effects Of Psychosocial Factors On A Geriatric Patient With Guillain Barré Syndrome, Keane Evangelista, Mary Pent Hunter, Jessica Phung, Aum Tejani, Lee Anne H. Robotta

San Marcos, Summer 2019

The purpose of this case report is to determine how a change in intrinsic motivation and environmental factors help physical and functional improvements in a 77-year-old male patient with Guillain Barré Syndrome (GBS) in the geriatric population. Interventions to promote this change included patient education about lifestyle choices along with endurance and balance exercises.

Patient psychological state, community access, and general education about interventions/dosing had an effect on the patient's participation in his prescribed HEP. His comorbidities hindered his overall progress over the course of his treatment and should be addressed to improve patient outcomes. Activities that were more salient …

Power Up With Parkinson's: A Case Report, Sean Ekekwe, Anne H. Boddy

St. Augustine, Fall 2018

The purpose of this study is to highlight the use of power training in a patient with low back pain and Parkinson’s disease.

Power training demonstrated a more significant change in gait speed, mobility, and function compared to other phases in rehabilitation. After power training was implemented at visit 11, there was a dramatic increase gait speed with the 10-meter walk test, a reduction in Oswestry Disability Index score (ODI), and a decrease in Timed Up and Go (TUG) time. The increase in 10 MWT gait speed and reduction in ODI and TUG score were greater than their MDC values …

Core Stabilization And Pelvic Motility Training For A 28-Week Pregnant Female With Low Back Pain And Sciatic Nerve Pain, Jenna Belser, Anne H. Boddy

St. Augustine, Fall 2018

The purpose of this case study is to determine the effects of core stabilization and pelvis mobility training for a 28-week pregnant female to improve function and decrease pain.

Low back pain during pregnancy is a common occurrence that affects a majority of the population.¹ Over the five treatment sessions, the patient was able to tolerate a full ten-hour work shift and sleep through the night. She also showed improvements in muscle strength and flexibility. As seen in non-pregnant females, the patient was able to have a decrease in pain and improvement in function with these techniques.⁴

Fsm Restores Activity To Trapezius For 67 Y.O. Male, Marilyn Miller, Carolyn R. Mcmakin

San Marcos, Fall 2018

One session of frequency specific microcurrent (FSM) restored voluntary function and muscle definition for a 67 y. o. male DIY enthusiast after 18 mos of disuse.

Service Learning For Balance And Activity Promotion In The Older Adult, Christine Mary Childers

San Marcos, Summer 2018

Barr and Wong¹ challenged faculty to provide creative and innovative ways of teaching meaningful content related to care of the older adult population.¹ Service learning combines community service with learning objectives and reflection, meeting academic and community needs.² Service learning helps students manage the complex care of the older adult stroke population³ and intergenerational programs benefit both generations.⁴ The purpose of this study was to explore and compare student ideas and thoughts regarding balance and activity promotion in the older adult, both with and without a service learning opportunity Falls are a leading concern with …

External Load On The Hemi-Paretic Lower Limb With Task-Oriented Training To Improve Gait Post Right Aca Stroke, Jacob France, Lindsey Perry

St. Augustine, Fall 2018

The purpose of this case report is to describe the treatment of a 77-year-old male post-stroke with the application of an external load to the paretic lower limb in conjunction with task-oriented training to improve gait.

Strength, balance, gait speed, and functional tasks all improved over the course of physical therapy. At the end of 2 weeks, the patient exceeded the minimal detectable change (MDC) for the TUG (2.9 sec) and achieved the minimal clinically important difference (MCID) for the FIM (22 points).^4-5 Although the MCID is not established for the Modified Ashworth Scale (MAS), the patient experienced improvements …

Are You Ready To Get High? High Repetition Exercise For Radial Nerve Palsy, Tayler Adams, Matthew L. Daugherty

St. Augustine, Fall 2018

Research suggests the need for early surgical nerve exploration for secondary radial nerve palsy based upon a 75% recovery rate with early exploration.⁵ In using typical conservative management plus high-repetition movement, the patient in this case report was able to avoid surgery for radial nerve exploration, attain complete recovery within 4 months of his initial injury, and fully return to work and daily function.

This case report offers the possibility of high-repetition movement being a beneficial treatment intervention. This is a simple, low-cost treatment and can be accomplished by the patient at home as part of a home exercise …

A Different Instructional Model To Improve Student Learning Outcomes In Gross And Applied Anatomy For Physical Therapy Students, Cherie Peters-Brinkerhof, Christine Mary Childers

San Marcos, Fall 2018

Teaching and learning anatomy in a DPT program poses a challenge to students and faculty because of the volume of material needed as foundational information for a PT curriculum. The aim of this study was to determine if a round-robin model of instruction in anatomy and applied anatomy labs, is more effective to meet the course learning objectives compared to a more traditional, separate class instruction.

Guiding Questions:

1. What were the faculty and students’ perception of the teaching method used for anatomy and applied anatomy?

2. What were the faculty's perceptions of the students’ understanding of the material presented? …

Effects Of Weight Shifting And Heel Lift On Gait, Posture, And Balance In An Elderly Female With Backward Disequilibrium: A Case Report, Gilissa T. Schjang, Evan M. Pucillo

St. Augustine, Fall 2018

The purpose of this case report is to investigate how weight shifts and a heel lift affects a patient's center of mass in respect to their base of support to improve posture, balance, and gait which will aid in decreasing falls.

The patient demonstrated functional improvements by reducing the amount of assistance required from a caregiver for transfers and gait. Improvements in balance will allow the patient to sit on the toilet and edge of bed for toileting and dressing more independently.

Older adults with BD or other similar balance disorders are at risk for increased falls.⁵ This case …

Inter-Institutional Collaboration To Benefit Student Learning: A Scenario In Graduate Education, Marilyn Miller, Linda Hill, Nicolas Van Den Heever

San Marcos, Fall 2018

Occupational and Physical Therapists are in a unique role, in which they can assist in the identification and rehabilitation of impairments. The collaboration between UCSD and USAHS is preparing students with the knowledge and skills to assess older persons for driving abilities.

The current content delivery allows the TREDS program to be available to the Gerontology course offering for other USAHS campus locations; and has the potential to be accessed by other institutions of higher education offering courses in Gerontology.

Soft Tissue Mobilization With Movement To Improve Cervical And Shoulder Range Of Motion Post-Thyroidectomy In A 36-Year-Old Male: A Case Report, Sarah Tomes, Megann Schooley

St. Augustine, Fall 2018

The purpose of this case report is to describe the effectiveness of soft tissue mobilization with movement (STMM) to improve cervical and shoulder range of motion status-post thyroidectomy in a 36-year-old male.

When addressing hypertrophic scarring and ROM restrictions after total thyroidectomy, a beneficial myofascial treatment may include STMM. A home program could incorporate STMM or self-myofascial release as well.

Proprioceptive Neuromuscular Facilitation In A Male Wrestler Post Type Ii Slap Lesion Surgical Repair, George Eskander, Matthew L. Daugherty

St. Augustine, Fall 2018

The primary purpose of this case report was to assess the effects of a specific progression of PNF and Rhythmic Stabilization Exercises (RSE) in conjunction with traditional physical therapy for a seventeen-year-old wrestler post Type II SLAP lesion surgical repair.

This case report indicated that the utilization of PNF and RSE is a beneficial component to physical therapy treatment of a seventeen-year-old wrestling athlete with a Type II SLAP lesion surgical repair. Designing a treatment plan with emphasis on PNF and RSE is cost-efficient, as it does not require expensive equipment or additional certifications. Also, physical therapists utilizing PNF and …

Effectiveness Of Stretching And Arch Strengthening In A 10-Year-Old Male With Calcaneal Apophysitis, Hannah Hardesty, Catherine M. Andrea

St. Augustine, Fall 2018

The aim of this case report is to create an independent exercise program to minimize pain while allowing continued participation in recreational activities.

Calcaneal apophysitis is a common condition in children that often results in the cessation of physical activity and participation in social activities, which can have a negative effect on both physical and mental well-being.^2-5 This case demonstrates positive outcomes with the use of static/dynamic stretching combined with arch strengthening in the rehabilitation of a patient with bilateral calcaneal apophysitis without reducing the child’s participation in daily and recreational activities.

Shall We Dance: A Parkinson’S Dance-Based Program, Rebecca Zawodny, Anne H. Boddy

St. Augustine, Fall 2018

This poster presents the implementation of a community-based dance program for individuals diagnosed with Parkinson’s disease.

Dance interventions for individuals with PD are shown to be superior to exercise for improving balance and mobility^5,6,7 thus, effectively addressing both motor as well non-motor symptoms such as depression, fear, anxiety, and declined self-efficacy.^8,9,10 Further positive effects include improved flexibility and coordination7^,11 and forced-use of the senses of sight, sound, and touch to assist with movement and balance.¹² The use of choreography further allows for the rehearsal of movement sequences, new motor skill learning, and improved cognitive functions.^{13 …}

Incorporation Of Balance And Vestibular Exercises In A 45-Year-Old Female With Bell’S Palsy: A Case Report, Kelsey Andersson, Erica Kiernan

St. Augustine, Fall 2018

The purpose of this case report is to determine the effectiveness of balance and vestibular exercises in conjunction with facial strengthening exercises on a patient with Bell’s palsy.

By incorporating vestibular exercises into the patient’s therapy sessions, she was able to demonstrate improved single leg stance and self-reported decrease in onset of symptoms with a progression of vestibular exercises. Facial muscle strengthening exercises demonstrated significant improvements in eye closure and smiling but she exhibited little changes in facial symmetry, strength and self-perceived function. The patient reported she was starting to drive and participate in more social events by the 4th …