Medicine and Health Sciences Commons^™

Improving Access To Mainehealth Care At Home, Amanda Kunkel, Mhcah Intake Department, Mhcah Scheduling Department, Mhcah Clinical Leadership Team

Operational Transformation

It is known that there are capacity limitations at MaineHealth Care at Home caused by a decrease in staffing. This leads to limited availability of home health services to patients in the community and can also contribute to increased length of stay for patients in acute care hospitals. MaineHealth Care at Home needs a way to measure current capacity to accept referrals and improved systems for communicating with referral sources.

Short-Term Benefits From Manual Therapy As An Adjunct Treatment For Persistent Postural-Perceptual Dizziness Symptoms: A Preliminary Prospective Case Series, Brent A. Harper, Larry Steinbeck

Physical Therapy Faculty Articles and Research

Persistent dizziness and balance deficits are common, often with unknown etiology. Persistent Postural-Perceptual Dizziness (3PD) is a relatively new diagnosis with symptoms that may include dizziness, unsteadiness, or non-vertiginous dizziness and be persistent the majority of time over a minimum of 90 days. The purpose of this case series was to investigate short-term outcomes of reducing dizziness symptoms using a manual therapy intervention focused on restoring mobility in the fascia using a pragmatically applied biomechanical approach, the Fascial Manipulation^® method (FM^®), in patients with 3PD. The preliminary prospective case series consisted of twelve (n = 12) patients …

Augmenting Hand And Arm Function For Persons With Hemiparesis, Brooke Stein, Susan Duff, Alison Mckenzie, Bailey Advincula, Isaac An, Annie Jeon, Casey Mcwilliam, Will Potter, Virginia Ruano, Paulina Vokulich, Audrey Howell, Rahul Soangra

Student Scholar Symposium Abstracts and Posters

Background. Hand and arm dysfunction due to neural disorders significantly influences quality of life. Activity-based training has been found to improve function. These improvements could be augmented with transcutaneous spinal cord stimulation (tSCS) due to the modulatory effect it has on spinal and supraspinal networks. Objective. The primary aim is to determine if a 4-week training program will improve hand and arm function. The secondary aim is to determine if the addition of tSCS to a second 4-week training session will further improve function. Design. This is a pre-posttest, controlled trial for persons 10-75 years of age, >6 months post …

Structural Sensorimotor Adaptations In Young Adults With Low Back Pain, Isaac Chrisman, Jo Armour Smith, Rongwen Tain, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer

Student Scholar Symposium Abstracts and Posters

Chronic low back pain (CLBP) is the largest cause of disability worldwide. There is evidence for regional structural brain adaptation in CLBP. Most studies have investigated middle-aged adults and show decreased grey matter density in pain processing regions. It is not clear if these adaptations are evident early in the lifespan of individuals with CLBP. The purpose of the study was to compare sensorimotor gray matter density in young adults with a history of CLBP with back-healthy controls. 53 young adults with a greater than 1-year history of CLBP and 29 young adults with no history of LBP participated. Clinical …

Spatiotemporal Gait Parameter Consistency Across Two Days Of Treadmill Walking In Stroke Survivors, Alejandro Aguirre Ramirez, Samantha N. Jeffcoat, Natalia Sanchez, Andrian Kuch

Student Scholar Symposium Abstracts and Posters

Retraining impaired gait is essential in post-stroke recovery. This project aims to determine between day variability of spatiotemporal gait measures in treadmill walking post-stroke to differentiate between changes due to the intervention and measurement errors due to between day test-retest variability. Six individuals post-stroke performed a two-minute walk test at a self-selected speed (SSS) for two consecutive days. SSS was assessed through the six-minute walk test. Reflective markers were placed on anatomical landmarks (van den Bogert et al. 2013). The heel markers were used for step detection. We calculated spatiotemporal parameters: stride length, stride time, step length, stance time, and …

Enhancing Post-Injury Rehabilitation: A Focus On Prehabilitation For Athletes, Kariya Jennings, Kyanne Crockarell, Rishi Gulati, Mallory Rae, Dakota Hill, Deborah Edmondson

Physical Therapy Student Research

No abstract provided.

Postural Control In Young Adults With And Without Recurrent Back Pain: Influence Of Symptom Characteristics, Rachel Berns

Student Scholar Symposium Abstracts and Posters

Many individuals with low back pain (LBP) experience episodic symptoms. During symptomatic episodes, individuals with LBP have delayed trunk muscle activation during anticipated postural perturbations, though it's unclear if these postural control changes persist between symptomatic episodes. This study examined anticipatory postural muscle activation in adults with and without recurrent LBP to determine the influence of muscle fatigue and typical symptom characteristics on trunk muscle activation. 55 young adults with a greater than one-year history of recurrent LBP and 30 young adults with no history of LBP were recruited. Electromyography electrodes were placed on their thoracic and lumbar paraspinals, external …

Increasing Social Inclusion And Engagement Of Exercise For Individuals With Spinal Cord Injuries: A Universal Resource Development For Wellness Facilities, Alexa Hall

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Individuals with spinal cord injuries (SCIs) are 1.5 times more likely to disengage in exercise one-year post-injury despite 80% of these individuals agreeing that exercise is critical to their overall health and quality of life (Baehr. Et al., 2022). A needs assessment was conducted on why the lack of engagement in exercise exists for individuals with SCIs within fitness facilities to identify barriers preventing participation. A quality improvement program called the Spinal Cord Injury Wellness Toolkit was created based off these findings and implemented at the MUSC Wellness Center. 14 individuals with SCIs participated at wellness center; REDCap surveys were …

Exploring The Interplay Between Physical Activity Wellness, Social Networks, And Academic Performance In Pt Students, Grace C. Johnson, Kellie Gossman, Tessa Wells, Betsy J. Becker

Posters and Presentations: Physical Therapy

Purpose

Recognizing the intersection of peer influence, physical activity, student wellness, and academic performance, this study aims to provide insights that can inform educational practices and promote success among future physical therapist (PT) students. The study's purpose is to investigate the associations between students' physical activity wellness scores, their social networks, and academic performance within the school environment. The research questions are (1) Do students tend to form friendships with classmates who exhibit similar physical activity wellness scores and student achievement? and (2) How do the Exercise Factor scores of PT students align with published normative values?

Subjects: 124 students …

From Textbooks To Clinical Practice: Selecting And Implementing Outcomes Measures In Stroke Rehabilitation, Stacie Mae Larreau Christensen, Monica Dial

Posters and Presentations: Physical Therapy

No abstract provided.

Blood Flow Restriction Therapy: A Review Of Physiology, Clinical Application, And Guidelines For Implementation, Nathan Schuliger

Senior Honors Theses

Blood flow restriction (BFR) therapy is an emerging clinical modality utilizing the metabolic stress of a hypoxic state to induce hypertrophic and strength adaptations in a manner allowing for reduced external loading. BFR has a variety of applications in rehabilitation settings, showing great potential for patients seeking the benefits of high intensity training without the associated degrees of mechanical stress. This literature review details the proposed mechanisms of BFR, along with various clinical applications of BFR including active and aerobic BFR. Concerns and contraindications for BFR usage are discussed regarding certain clinical populations, with risk stratification recommendations provided. Current BFR …

Designing Effective E-Learning Modules: Exploring Best Practices In Module Navigation, Stacie Mae Larreau Christensen, Lukas Pohlmann, Elizabeth Lyden, Elizabeth L. Beam, Stephanie Langel

Posters and Presentations: Physical Therapy

No abstract provided.

Correlation Enhanced Distribution Adaptation For Prediction Of Fall Risk, Ziqi Guo, Teresa Wu, Thurmon Lockhart, Rahul Soangra, Hyunsoo Yoon

Physical Therapy Faculty Articles and Research

With technological advancements in diagnostic imaging, smart sensing, and wearables, a multitude of heterogeneous sources or modalities are available to proactively monitor the health of the elderly. Due to the increasing risks of falls among older adults, an early diagnosis tool is crucial to prevent future falls. However, during the early stage of diagnosis, there is often limited or no labeled data (expert-confirmed diagnostic information) available in the target domain (new cohort) to determine the proper treatment for older adults. Instead, there are multiple related but non-identical domain data with labels from the existing cohort or different institutions. Integrating different …

In Vivo Behavior Of The Soleus Muscle During Various Activities In Persons Post-Stroke, Madison Swaney, Molly Carter, Mitchell Mckinley, Joshua Nelson, Robin Dorociak, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

Current protocols for post stroke populations consists of inconsistent and outdated interventions that target less functional strength training through heavier and slower movements. Current research displays a 90/10 principle displaying the tendon as the primary power absorber and generator during ballistic and cyclic movements, supported by a primarily isometric muscle activation. Power generation is key for walking. High angular velocity needed during the gait cycle to be able to produce and absorb power rapidly. Ballistic training requires the perfect tradeoff between speed and force to generate and train populations targeting power absorption and output with greater tendon activity. Therefore, current …

Is Sway-Referenced Haptic Assistance Sensitive To Perceptual Context, Andrew Meszaros, Robin Dorociack, Peter Jang, Tanner Lehr, Bayli Mohl

Student-Faculty Research - College of Physical Therapy

Falls account for >$50 billion of medical spending in 2015 (CDC). Real-time haptic feedback shows promise at reducing static standing COM sway (Meszaros, 2019). Pilot data variability suggests that some haptic-wearers ‘over-correct’ (unnecessarily reducing available degrees of freedom), when haptic correction is perceived as ‘a mistake. Does over-correction reduce multi-segment control and impair sway stability (Hsu, Scholz, et al. 2007)?

Implementing Pt In Pediatric Primary Care, Juliann Fronius, Scout Cai, Courtney Hoffman, Carlee Martin, Joel Wiley, Chris Yuen, Ryan Jacobson

Student-Faculty Research - College of Physical Therapy

Patients are referred to PT everyday, but referrals can delay care. Early care is preferred, but getting to the right healthcare provider at the right time is ideal. Upstream PT improves patient care and clinician experience. Purpose: Implement PT within pediatric primary care.

Imu And Markerless Technology In Gait Analysis: Clinical Lessons, Jessa Barendse, Trevor Nannini, Joanna Zuckerman, Tess Swake, Robin Dorociak, Peter Jang, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

- Haptic feedback refers to the external vibratory cue that is activated by data picked up by the haptic device, Inertial Measurement Unit (IMU) (Figure 1), which senses joint position.

- Position-driven haptic touch input can modify movement in real-time (Meszaros, 2019)

- Original goal: to reduce knee hyperextension during gait using a popliteal fossa tactor driven by an IMU-based angle sensor (Sagemotion)

-Concerns arose on the validity of IMU/tactor and markerless motion analysis ❏ Are these algorithm-based data technologies clinic-ready?

- Does Sagemotion IMU fire the tactor at the actual knee angle selected in its software?

- Can markerless …

Hamstring Tendons Don’T Lie #Eccentricsdontexist, Alec Espinoza, Chris Garcia, Enoch Ho, Ian Rousseau, Joel Centeno, Robin Dorociak, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

Research done on the plantarflexor MTU have shown the degree of achilles tendon and muscle fascicle shortening/stretching is specific to demands of the activity. To expand on this principle, we wanted to explore if a similar relationship exists with the Biceps Femoris MTU. We predict that the biceps femoris (long head) muscle tendon unit (MTU) will behave similarly to the Achilles tendon complex exhibiting the 80/20 principle during dynamic activities (jogging, walking) and the muscle fascicle will lengthen more than the MTU during stationary exercise (Nordic hamstring curls, Romanian deadlifts).

Fatigue Changes Biomechanical Variables In Drop Vertical Jump Performance In Competitive Basketball Players, Isabella Bruno, Caroline Linardos, Michala Rennels, Kristina Williams, Robin Dorociak, Jaydee Romick, Jason Brumitt

Student-Faculty Research - College of Physical Therapy

The drop vertical jump (DVJ) has been used as a tool to identify athletes at risk for injury. Initial studies have suggested an association between biomechanical variables and injury (1); however, subsequent research has demonstrated no relationship (2-4). Evaluating variables in fatigued athletes may help clinicians identify athletes at risk. Advances in motion capture technology now allow for assessment of variables after a fatigue protocol.

Factors Affecting Peak Effort In Max Effort Tests, Amanda Pardue, Michael Forster, Taylor Kopecky, Zoralei Dayley, Jeff Houck, Rebecca Dobler

Student-Faculty Research - College of Physical Therapy

Challenging older adults to execute peak effort functional tests is not common. A peak effort test pushes patients to the point of not sustaining the task. The Wingate test is a peak effort test that measures the amount of revolutions per second a participant can perform over 30s. Older adults with knee osteoarthritis (OA) may regulate their effort during the Wingate. Alternatively, high exertion during the Wingate test may yield high value in influencing attitudes related to pain and aging. The purpose of this study was to develop themes of what influences peak effort during the Wingate test in participants …

Effect Of Perturbation-Based Balance Training On Fall Risk And Fear Of Falls In Community-Dwelling Older Adults – A Pilot Study, Lindsey Kelly, Casey Kostecki, Garrett Markham, Conner Morris, Trevor Strem, Lyndsay Strutzenberger, Gabe Haberly

Student-Faculty Research - College of Physical Therapy

Falls are a major health concern among adults ≥65 years as it is the leading cause of injury and injury related death in the United States. Perturbation-based training (PBT) has been shown to reduce rate of falls by 50% and 24 slips has been shown to be optimal. It is unknown whether falls reduction would be greater with one session or spread out over multiple sessions. The purpose of this study was to determine the effects of PBT dosage (12 slips over 2 sessions vs. 24 slips in one session) on falls incidence, fear of falling, and reactive stepping in …

Does The Size-Weight Illusion Exist During Deadlift?, Dakota Kerbow, Luke Mallory, Robin Dorociak, Peter Jang, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

Purpose:

to assess whether the SWI exists during deadlift (whole body loading), and identify the mechanical factors that explain or overcome the illusion

Changes In Quadriceps Strength In Recreationally Active Individuals Using Single-Limb Or Double-Limb Blood Flow Restriction, Brogan Boen, Logan Cockrell, Olivia Aho, Taylor Bryant, Bethany Nguyen, Jason Brumitt

Student-Faculty Research - College of Physical Therapy

Blood flow restriction training utilizes a tourniquet system to occlude arterial and venous flow while one performs exercises. This training strategy allows one to exercise using loads at a lower percentage of 1RM while experiencing physiological change similar to those achieved when training at a higher percentage of 1RM.

Identifying The Effects Of Function-Based Exercise On Postural Stability And Gait In Patients With Parkinson’S Disease, Kasey Markell, Rahul Soangra

Student Scholar Symposium Abstracts and Posters

This project seeks to identify a correlation between consistent, functional exercise and posture, balance, stability and gait in patients with Parkinson’s Disease (PD). PD is a neurodegenerative disease that decreases levels of dopamine in the Basal Ganglia of the brain, resulting in symptoms such as excessive freezing or erratic, involuntary movements, ultimately affecting a person’s ability to ambulate safely and independently. This study consisted of three main approaches to build a firm base of knowledge for this field of research. The first component was to test the limits of stability in healthy individuals for a baseline comparison to people with …

Multi-Site Identification And Generalization Of Clusters Of Walking Behaviors In Individuals With Chronic Stroke And Neurotypical Controls, Natalia Sanchez, Nicolas Schweighofer, Sara J. Mulroy, Ryan T. Roemmich, Tricia M. Kesar, Gelsy Torres-Oviedo, Beth E. Fisher, James M. Finley, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Background

Objectives

Methods

Multi-Site Identification And Generalization Of Clusters Of Walking Behaviors In Individuals With Chronic Stroke And Neurotypical Controls, Natalia Sánchez, Nicolas Schweighofer, Sara J. Mulroy, Ryan T. Roemmich, Trisha M. Keshar, Gelsy Torres-Oviedo, Beth E. Fisher, James M. Finley, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Background

Objectives

Methods

Essential Content For Teaching Implementation Practice In Healthcare: A Mixed-Methods Study Of Teams Offering Capacity-Building Initiatives, Jessica Reszel, Olivia Daub, Jenny Leese, Hanna Augustsson, Danielle Moeske Bellows, Christine E. Cassidy, Beth E. Crowner, Sandra I. Dunn, Lisa B. Goodwin, Alison M. Hoens, Sarah C. Hunter, Elizabeth A. Lynch, Jennifer Moore, Miriam R. Rafferty, Wendy Romney, Dawn Campbell, Dawn Stacey, Implementation Practice Cbi Study Team, Ian D. Graham

Physical Therapy Faculty Publications

Background

Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals’ and teams’ ability to apply implementation science in practice is through training and professional development opportunities (capacity-building initiatives). Although there is an increasing demand for and offerings of implementation practice capacity-building initiatives, there is no universal agreement on what content should be included. In this study we aimed to explore what capacity-building developers and deliverers identify as essential training content …

Integrating Glenohumeral Range Of Motion With Dynamic Postural Control For Early Detection Of Elbow Injury Risk In Collegiate Baseball Pitchers: A Preliminary Prospective Case Series, Brent A. Harper, Luke J. Bailey, Mikayla N. Jones, Joseph Bradley

Physical Therapy Faculty Articles and Research

Introduction: Medial elbow ulnar collateral ligament (UCL) injuries are common in baseball with increased surgical incidence in pitchers. There is no consensus on which modifiable injury risk metrics or performance screening tools to use to identify at risk collegiate baseball pitchers. Current literature on UCL injury risk has focused on local passive glenohumeral rotational motion with limited forays into more global movement patterns. The aim of this study was to assess possible relationships involving UCL injuries and modifiable local and global motor control performance risk factors. Material and Methods: An observational single cohort case series involving 15 collegiate …

Greater Number Of Weekly Stairs Climbed Is Associated With Lower Low Back Pain Prevalence Among Female But Not Male Physical Therapists, Amy H. Amabile, Sharon L. Larson, Lisa T. Hoglund, John P. Guarnieri, Maureen Mcdonald, Madeline R. Reich

Department of Physical Therapy Faculty Papers

INTRODUCTION: Certain cardiovascular health benefits of stair climbing are now widely accepted, but no prior studies have as yet been found linking the quantity of stairs climbed to low back pain (LBP) morbidity. Low back pain is a common musculoskeletal impairment, and research has begun to show an association between LBP and gluteus maximus (GM) weakness. With stair climbing being the activity which most activates GM, the aim of the present research was to assess the relationship between stair ambulation and LBP prevalence. The hypothesis of this cross-sectional study was that individuals with LBP would report a significantly lower numbers …

Does Implementation Of A Lifestyle Medicine Curriculum Affect Student Wellness During Doctor Of Physical Therapy Education?, Betsy J. Becker, Kathleen G. Volkman, Tessa Wells, Nicole M. Sleddens, Teresa Cochran

Posters and Presentations: Physical Therapy

Background

Current healthcare environments amplify the need for educational systems to forge healthy workforces to withstand stressors. Our study examines the effects of embedding a lifestyle medicine curriculum on student wellness in a Doctor of Physical Therapy (DPT) Program, simultaneously preparing students to implement lifestyle medicine with future patients and communities.

Methods

In a DPT program, we implemented a lifestyle medicine curriculum grounded within the Social-Ecological Model. This framework emphasizes student success in the program’s pre-clinical phases, creates a purposeful “ripple effect” threading wellness strategies among peers, patients, and communities, and emphasizes wellness as a clinician over the 32-month curriculum. …