Medicine and Health Sciences Commons^™

Age-Related Modifications To The Magnitude And Periodicity Of Neuromuscular Noise, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Background: Evaluation of task related outcomes within geriatric and fall-prone populations is essential not only for identification of neuromuscular deficits, but also for effective implementation of fall prevention strategies. As most tasks and activities of daily living are performed at submaximal force levels, restoration of muscle strength often does not produce the expected benefit in functional capacity. However, it is known that muscular control plays a key role in the performance of functional tasks, but it remains unclear to what degree muscular control and the associated neuromuscular noise (NmN) is age-related, particularly in the lower-extremities.

Objectives: The aim of this …

Obesity And Physical Function In Rural Women Who Enroll In A Lifestyle Modification Intervention For Reducing Blood Pressure, Patricia A. Hageman, Carol H. Pullen, Paul J. Dizona, Kristin Schmidt, Linda S. Boeckner

Journal Articles: Physical Therapy

Purpose: Rural women have high prevalence of obesity and prehypertension. Obesity, if associated with poor physical function, may have implications for applying activity guidelines for women volunteering for lifestyle modification. This study examined associations of body mass index (BMI) and percent body fat with measures of 1-mile walk time, post-walk perceived exertion, and 10-repetition chair stands in rural women ages 40-69.

Methods: Cross-sectional baseline data were collected using standardized methods from 289 rural women with prehypertension who volunteered for a lifestyle clinical trial for reducing blood pressure. ANOVAs and linear regression were used for analysis.

Results: With exception of the …

Treatment For Cervicobrachial Pain Syndrome; A Comparison Of Direct And Indirect Manual Therapies, Brianna Palmer

Critically Appraised Topics (CAT)

An appraisal was made on a randomized controlled trial by Allison et al, which compared direct and indirect manual therapies for treating cervicobrachial pain syndrome. The direct therapy group (NT) received neural mobilizations, and the indirect therapy group (AT) received joint mobilizations for the glenohumeral joint and thoracic spine.

Per the Northwick Park Questionnaire and the Short Form-McGill Pain Questionnaire, decreases in pain were statistically significant for both groups from pre-assessment to post-assessment, but not between groups. When using the Visual Analog Scale, a statistically significant improvement was found for both groups over the treatment period, though only the NT …

Home-Based Multidisciplinary Rehabilitation Following Hip Fracture Surgery: What Is The Evidence?, Kathleen Donohue, Richelle Hoevenaars, Jocelyn Mceachern, Erica Zeman, Saurabh Mehta

Physical Therapy Faculty Research

Objective. To determine the effects of multidisciplinary home rehabilitation (MHR) on functional and quality of life (QOL) outcomes following hip fracture surgery.

Methods. Systematic review methodology suggested by Cochrane Collaboration was adopted. Reviewers independently searched the literature, selected the studies, extracted data, and performed critical appraisal of studies. Summary of the results of included studies was provided.

Results. Five studies were included. Over the short-term, functional status and lower extremity strength were better in the MHR group compared to the no treatment group (NT). Over the long-term, the MHR group showed greater improvements in balance confidence, functional …

Can The Upper Limb Tension Test 1 (Ultt1) Stand Alone In Diagnosing Median Nerve Compression In Adult Patients With Carpal Tunnel Syndrome (Cts)?, Brianna Palmer

Critically Appraised Topics (CAT)

An appraisal was made on a validity study by Vanti et al, regarding the upper limb neurodynamic test 1 (ULTT1) for diagnosing carpal tunnel syndrome (CTS). The selected paper included current patients at an occupational medicine clinic with suspected CTS and referral for nerve conduction study (NCS).

Using Wainner’s Criteria to indicate a positive ULTT1, calculated sensitivity was 0.9167 and specificity was 0.150. In limiting criteria for a positive test by requiring provocation of 1^st-3^rd digits only, the sensitivity decreased to 0.5417, however specificity increased to 0.70.

This study was effective in defining the inclusion criteria for …

Contributions Of The Kölliker-Fuse Nucleus To Coordination Of Breathing And Swallowing, Joshua M. Bonis, Suzanne E. Neumueller, K. L. Krause, Lawrence Pan, Matthew R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Herein we compare the effects of perturbations in the Kölliker–Fuse nucleus (KFN) and the lateral (LPBN) and medial (MPBN) parabrachial nuclei on the coordination of breathing and swallowing. Cannula was chronically implanted in goats through which ibotenic acid (IA) was injected while awake. Swallows in late expiration (E) always reset while swallows in early inspiration (I) never reset the respiratory rhythm. Before cannula implantation, all other E and I swallows did not reset the respiratory rhythm, and had small effects on E and I duration and tidal volume (V_T). However, after cannula implantation in the MPBN and …

Ferreira Named Chair Of Physical Therapy, Becky St. Clair

Lake Union Herald

No abstract provided.

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 …

Changes In Hemodynamic Responses In Chronic Stroke Survivors Do Not Affect Fmri Signal Detection In A Block Experimental Design, Nutta-On Promjunyakul, Brian D. Schmit, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

The use of canonical functions to model BOLD-fMRI data in people post-stroke may lead to inaccurate descriptions of task-related brain activity. The purpose of this study was to determine whether the spatiotemporal profile of hemodynamic responses (HDRs) obtained from stroke survivors during an event-related experiment could be used to develop individualized HDR functions that would enhance BOLD-fMRI signal detection in block experiments. Our long term goal was to use this information to develop individualized HDR functions for stroke survivors that could be used to analyze brain activity associated with locomotor-like movements. We also aimed to examine the reproducibility of HDRs …

Integrating Best Evidence Into Practice: Outcomes Of A Community-Based 12-Week Exercise And Education Intervention In Women With Cancer, Betsy J. Becker, Katherine J. Jones, Patricia A. Hageman, Ruth Vangerpen

Posters and Presentations: Physical Therapy

Objective

Cancer-related fatigue is the most commonly reported side effect of cancer treatment, affecting 70-100% of patients and current literature suggests exercise is an important component of managing this side effect. The specific objective of this project was to evaluate the effectiveness of a 12-week evidence-based cancer exercise and education intervention on outcomes of fatigue, pain, depression, sleep disturbance and quality of life for women with cancer; the intervention was delivered by an interprofessional team in a medically-based wellness center.

Methods

The team was led by a physical therapist and included medical and radiation oncologists, general surgeons, nurses and cancer …

Chhs July E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, College Of Health & Human Services, Western Kentucky University

College of Health & Human Services Publications

No abstract provided.

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 …

Has The Foundation For Physical Therapy Advanced The Body Of Knowledge?, Sheila Schindler-Ivens, Jan Struhar, Martha G. Jermé

Physical Therapy Faculty Research and Publications

No abstract provided.

Lower Extremity Functional Tests And Risk Of Injury In Division Iii Collegiate Athletes, Jason Brumitt, Bryan C. Heiderscheit, Robert C. Manske, Paul E. Niemuth, Mitchell J. Rauh

Faculty Publications - College of Physical Therapy

Purpose/Background: Functional tests have been used primarily to assess an athlete’s fitness or readiness to return to sport. The purpose of this prospective cohort study was to determine the ability of the standing long jump (SLJ) test, the single-leg hop (SLH) for distance test, and the lower extremity functional test (LEFT) as preseason screening tools to identify collegiate athletes who may be at increased risk for a time-loss sports-related low back or lower extremity injury.

Methods: A total of 193 Division III athletes from 15 university teams (110 females, age 19.1 ± 1.1 y; 83 males, age 19.5 ± 1.3 …

The Effects Of Practice On The Concurrent Performance Of A Speech And Postural Task In Persons With Parkinson Disease And Healthy Controls, K. Bo Foreman, Stuart Sondrup, Christopher Dromey, Eon Jarvis, Shawn Nissen, Leland E. Dibble

Faculty Publications

Purpose. Persons with Parkinson disease (PD) demonstrate deficits in motor learning as well as bidirectional interference (the performance of one task concurrently interferes with the performance of another task) during dual-task performance. Few studies have examined the practice dosages necessary for behavioral change in rehabilitation relevant tasks. Therefore, to compare the effects of age and PD on motor learning during dual-task performance, this pilot study examined persons with PD as well as neurologically healthy participants during concurrent performance of postural and speaking tasks. Methods. Seven persons with PD and 7 healthy age-matched and 10 healthy young control subjects …

Pilot Comparative Effectiveness Study Of Surface Perturbation Treadmill Training To Prevent Falls In Older Adults, Jon D. Lurie, Alexandra B. Zagaria, Dawna M. Pidgeon, Judith L. Forman, Kevin Spratt

Dartmouth Scholarship

Falls are the leading cause of fatal and non-fatal injuries among older adults. Exercise programs appear to reduce fall risk, but the optimal type, frequency, and duration of exercise is unknown. External perturbations such as tripping and slipping are a major contributor to falls, and task-specific perturbation training to enhance dynamic stability has emerged as a promising approach to modifying fall risk. The purpose of this pilot study was 1) to determine the feasibility of conducting a large pragmatic randomized trial comparing a multidimensional exercise program inclusive of the surface perturbation treadmill training (SPTT) to multidimensional exercise alone (Standard PT); …

Applying Principles Of Motor Learning And Control To Upper Extremity Rehabilitation, Lisa M. Muratori, Eric M. Lamberg, Lori Quinn, Susan V. Duff

Physical Therapy Faculty Articles and Research

The purpose of this article is to provide a brief review of the principles of motor control and learning. Different models of motor control from historical to contemporary are presented with emphasis on the Systems model. Concepts of motor learning including skill acquisition, measurement of learning, and methods to promote skill acquisition by examining the many facets of practice scheduling and use of feedback are provided. A fictional client case is introduced and threaded throughout the article to facilitate understanding of these concepts and how they can be applied to clinical practice.

Intensive Goal-Directed Treatments In Enriched Environments Augments Patient Outcomes Post-Stroke, Blake A. Kandah, Michael A. Klonowski, Ryan M. Pelo, Nicole M. Williams, Raquel V. Santiago, Christopher K. Thompson, Kristan A. Leech, Carey L. Holleran, Abigail L. Leddy, T. George Hornby

GW Research Days 2013

Objective: Previous research indicates that patients post-stroke, average 400-800 steps within physical therapy sessions and demonstrate heart rate values of 24-35% of HR Max. This dosage and intensity is inadequate to promote neuroplastic changes and maximize recovery. The goal of this study was to quantify and examine the amount of high-intensity stepping practice that was delivered within an Acute Inpatient Rehabilitation (AIR) setting for individuals with sub-acute stroke.

Methods: 14 patients with a diagnosis of sub-acute stroke were admitted to AIR. Standardized outcomes included the 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), the Berg Balance Scale (BBS) and the …

Effects Of Hemodialysis Therapy On Sit-To-Walk Characteristics In End Stage Renal Disease Patients, Rahul Soangra, Thurmon Lockhart, John Lach, Emaad M. Abdel-Rahman

Physical Therapy Faculty Articles and Research

Patients with end stage renal diseases (ESRD) undergoing hemodialysis (HD) have high morbidity and mortality due to multiple causes; one of which is dramatically higher fall rates than the general population. In spite of the multiple efforts aiming to decrease the high mortality and improve quality of life in ESRD patients, limited success has been achieved. If adequate interventions for fall prevention are to be achieved, the functional and mobility mechanisms consistent with falls in this population must be understood. Human movements such as sit-to-walk (STW) tasks are clinically significant, and analysis of these movements provides a meaningful evaluation of …

Relationships Amongst Osteoarthritis Biomarkers, Dynamic Knee Joint Load, And Exercise: Results From A Randomized Controlled Pilot Study, Michael A. Hunt, Courtney L. Pollock, Virginia Byers Kraus, Tore Saxne, Sue Peters, Janet L. Huebner, Eric C. Sayre, Jolanda Cibere

Physical Therapy Publications

Background

Little is known about the relationships of circulating levels of biomarkers of cartilage degradation with biomechanical outcomes relevant to knee osteoarthritis (OA) or biomarker changes following non-pharmacological interventions. The objectives of this exploratory, pilot study were to: 1) examine relationships between biomarkers of articular cartilage degradation and synthesis with measures of knee joint load during walking, and 2) examine changes in these biomarkers following 10 weeks of strengthening exercises.

Methods

Seventeen (8 male, 9 female; 66.1 +/- 11.3 years of age) individuals with radiographically-confirmed medial tibiofemoral OA participated. All participants underwent a baseline testing session where serum and urine …

Planning And Adjustments For The Control Of Reach Extent In A Virtual Environment, Jill Campbell Stewart Pt,Phd, James Gordon, Carolee J. Winstein

Faculty Publications

Background Skilled performance of reach actions includes both anticipatory planning and compensatory adjustments made while moving. The execution of reach actions in a virtual environment (VE) demonstrates similar characteristics to reaches performed in the real-world, however, it is unclear whether the VE itself significantly impacts movement planning or compensatory adjustments. The purpose of this study was to directly compare the use of planning and adjustments to control extent for unconstrained reach actions performed in an immersive VE to those performed in an analogous real-world environment (RWE). Methods Five non-disabled adults (29 ± 5 years) reached with the dominant, right arm …

Introgression Of Brown Norway Cyp4a Genes Onto The Dahl Salt-Sensitive Background Restores Vascular Function In Ss-5Bn Consomic Rats, Kathleen M. Lukaszewicz, John R. Falck, Vijaya L. Manthati, Julian H. Lombard

Physical Therapy Faculty Research and Publications

The present study tested the hypothesis that the Dahl SS (salt-sensitive) rat has vascular dysfunction due, in part, to the up-regulation of the CYP4A/20-HETE (cytochrome P450 ω-hydroxylase 4A)/20-hydroxyeicosatetraenoic acid) system. To assess the role of vascular 20-HETE, SS rats were compared with SS-5^BN consomic rats, carrying CYP4A alleles on chromosome 5 from the normotensive BN (Brown Norway) introgressed on to the SS genetic background. Cerebral arteries from SS-5^BN rats had less CYP4A protein than arteries from SS rats fed either NS (normal-salt, 0.4% NaCl) or HS (high-salt, 4.0% NaCl) diet. ACh (acetylcholine)-induced dilation of MCAs (middle cerebral …

Chhs March 2013 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, College Of Health And Human Services, Western Kentucky University

College of Health & Human Services Publications

No abstract provided.

Missions At Maxwell, Ashleigh Jardine

Lake Union Herald

No abstract provided.

A Pilot Study To Measure Upper Extremity H-Reflexes Following Neuromuscular Electrical Stimulation Therapy After Stroke, Ann M. Stowe, L. Hughes-Zahner, V. K. Barnes, L. L. Herbelin, Sheila M. Schindler-Ivens, B. M. Quaney

Physical Therapy Faculty Research and Publications

Upper extremity (UE) hemiparesis persists after stroke, limiting hand function. Neuromuscular electrical stimulation (NMES) is an effective intervention to improve UE recovery, although the underlying mechanisms are not fully understood. Our objective was to establish a reliable protocol to measure UE agonist–antagonist forearm monosynaptic reflexes in a pilot study to determine if NMES improves wrist function after stroke. We established the between-day reliability of the H-reflex in the extensor carpi radialis longus (ECRL) and flexor carpi radialis (FCR) musculature for individuals with prior stroke (n = 18). The same-day generation of ECRL/FCR H-reflex recruitment curves was well tolerated, regardless of …

Service Learning In Guatemala: Using Qualitative Content Analysis To Explore An Interdisciplinary Learning Experience Among Students In Health Care Professional Programs, Kathleen S. Fries, Donna M. Bowers, Margo Gross, Lenore Frost

Nursing Faculty Publications

What is the experience of interprofessional collaboration as a nursing, occupational, or physical therapy health care student taking part in a weeklong service-learning experience? Interprofessional collaboration among health care professionals yields improved patient outcomes, yet many students in health care programs have limited exposure to interprofessional collaboration in the classroom and in clinical and service-learning experiences. This practice gap implies that students enter their professions without valuing interprofessional collaboration and the impact it has on promoting positive patient outcomes.

The aim of this study was to describe the interprofessional experiences of students in health care professional programs as they collaborated …

Corticospinal Reorganization After Locomotor Training In A Person With Motor Incomplete Paraplegia, Nupur Hajela, Chaithanya K. Mummidisetty, Andrew C. Smith, Maria Knikou

Publications and Research

Activity-dependent plasticity as a result of reorganization of neural circuits is a fundamental characteristic of the central nervous system that occurs simultaneously in multiple sites. In this study, we established the effects of subthreshold transcranial magnetic stimulation (TMS) over the primary motor cortex region on the tibialis anterior (TA) long-latency flexion reflex. Neurophysiological tests were conducted before and after robotic gait training in one person with a motor incomplete spinal cord injury (SCI) while at rest and during robotic-assisted stepping. The TA flexion reflex was evoked following nonnociceptive sural nerve stimulation and was conditioned by TMS at 0.9 TA motor …

Strain And Counterstrain For Structural Integrators, Caryn Pierce

Faculty Publications

Strain and counterstrain (SCS) is an indirect approach to manipulating fascia. In addition to its usefulness as an integration tool, knowledge of the reflexive mechanisms involved in SCS deepens our understanding of how fascia functions to protect vital structures from injury and how unbalanced posture and movement patterns develop after trauma.

Increased Serum And Musculotendinous Fibrogenic Proteins Following Persistent Low-Grade Inflammation In A Rat Model Of Long-Term Upper Extremity Overuse., Helen G L Gao, Paul W Fisher, Alex G Lambi, Christine K Wade, Ann E Barr-Gillespie, Steven N Popoff, Mary F Barbe

Department of Physical Therapy Faculty Papers

We examined the relationship between grip strength declines and muscle-tendon responses induced by long-term performance of a high-repetition, low-force (HRLF) reaching task in rats. We hypothesized that grip strength declines would correlate with inflammation, fibrosis and degradation in flexor digitorum muscles and tendons. Grip strength declined after training, and further in weeks 18 and 24, in reach limbs of HRLF rats. Flexor digitorum tissues of reach limbs showed low-grade increases in inflammatory cytokines: IL-1β after training and in week 18, IL-1α in week 18, TNF-α and IL-6 after training and in week 24, and IL-10 in week 24, with greater …

Core Stabilization Exercise Prescription, Part I: Current Concepts In Assessment And Intervention, Jason Brumitt, J. W. Matheson, Erik P. Meira

Faculty Publications - College of Physical Therapy

Context: Injury to the low back can cause significant pain and dysfunction, which can affect an athlete’s performance and result in time lost from sport. A common conservative treatment is therapeutic core stabilization exercises, which can address pain and musculoskeletal dysfunction in patients with low back pathology.

Evidence Acquisition: MEDLINE and CINAHL were searched (from 1966 to March 2013) to identify relevant research. Keywords and keyword combinations searched included motor control exercise, segmental stabilization, core stabilization, transversus abdominis, multifidi, and low back pain.

Results: There are 2 popular rehabilitation strategies to assess core function and promote core stabilization. Each has …