Medicine and Health Sciences Commons^™

Breast Injury During Sport Participation, Laura J. Smith, Tamara Eichelberger, Elizabeth Miller, Edward J Kane

Athletic Training Collection

A recent study found that almost half (47.9%), of female college athletes participating in basketball, soccer, volleyball and softball (n = 194) suffered a breast injury during their college career with less than 10% reporting their injury to health personnel with only 2.1% receiving treatment ^[1]. Breast injury in female athletes is under-reported and is lacking a much-needed level of awareness in sport. If there is a void in awareness of breast injuries and in reporting breast injuries, preventive measures as well as any potential sequela from the injury will not be given the necessary attention.

Preseason Y Balance Test Scores Are Not Associated With Noncontact Time-Loss Lower Quadrant Injury In Male Collegiate Basketball Players, Jason Brumitt, Kyle Nelson, Duane Duey, Matthew Jeppson, Luke Hammer

Faculty Publications - College of Physical Therapy

The Y-Balance Test-Lower Quarter has shown promise as a screening tool for identifying athletes at risk of injury. Subsequent studies, utilizing heterogeneous populations or different operational definitions of injury, have presented equivocal findings. Therefore, studies evaluating the efficacy of the Y-Balance Test to discriminate injury risk in a homogeneous population is warranted. One-hundred sixty-nine male (mean age 19.9 + 1.5 y) collegiate basketball players were recruited during 2 consecutive seasons (2016–2017/2017–2018). Athletes completed the Y-Balance testing protocol at the start of each preseason. Athletic trainers tracked noncontact time-loss lower quadrant injuries over the course of the season. Receiver operator characteristic …

Acute Progressive Neurological Decline In An Elderly Man, Troy Burley, Michael Ross, Ryan Elliott, Michael Tall

Articles & Book Chapters

The patient was an 88-year-old man referred to a physical therapist by his primary care physician for a 1-week history of severe neck pain of insidious onset. Based upon the history and physical examination, the physical therapist concluded that the patient’s neck pain was mechanical in nature. Initial physical therapist intervention included cervical taping, cervical collar use and instruction in home exercise. At his follow-up visit 4 days after his initial physical therapy visit, the patient reported no improvement. The patient’s son, who accompanied him to this visit, also reported that his father had a recent onset of fever and …

Subacute Physical Rehabilitation For A Young Adult With A Hypoxic Brain Injury Resulting In Severe Myoclonic Movements And Ataxia: A Case Report, Chelsea Vandriel

Case Report Papers

Background and Purpose: An acquired brain injury is an injury to the brain that is not hereditary, congenital, degenerative in nature or induced by birth. Hypoxic/anoxic ischemic brain injuries (HIBI) result from global lack of oxygen to the brain from events such as drowning, choking, and cardiac or respiratory arrest. Limited research has been done regarding physical therapy (PT) interventions to improve functional mobility, gait, and tolerance to activity in an inpatient rehabilitation facility (IRF) with this patient population. Thus, the purpose of this case report is to provide PT interventions that were utilized in an IRF setting for a …

The Treatment Of Pes Anserine Syndrome Using Acl Injury Prevention Exercises: A Case Report, Stephanie Chau

Case Report Papers

Background and Purpose: Pes anserine syndrome is the term that encompasses both pes anserine bursitis and pes anserine tendonitis. The exact incidence of pes anserine syndrome is unknown. However, the etiology has been hypothesized to be due to poor biomechanics and overuse. Treatment protocols with targeted exercises for rehabilitation of pes anserine syndrome have not been well documented. ACL injury prevention programs have been shown to significantly decrease ACL injuries by addressing proper hip, knee, and ankle alignment and biomechanics. It was postulated that utilization of an ACL injury prevention program could also be an effective strategy in addressing the …

Restoring Functional Mobility In An Adult Patient Secondary To Subtrochanteric Femur Fracture Surgical Repair: A Case Report, Brittany Gray

Case Report Papers

Background and Purpose: Femur fractures lead to significant functional deficits resulting in major healthcare expenses. This case report accounts the outcomes of skilled physical therapy interventions for treatment of an intramedullary nail fixation of a subtrochanteric fracture. The purpose of this case report was to demonstrate the use of physical therapy in regaining strength, range of motion, and improving gait and balance deficits post femur fracture. The combination of the patient’s age, mechanism of injury, post-surgical complications, and delayed full weight bearing status make this case distinctive in nature. Case Description: The patient was a 47-year-old male who presented to …

Inpatient Rehabilitation Of A 99-Year-Old Patient Following A High-Impact Unstable Pelvic Ring Fracture: A Case Report, Julia Pratt

Case Report Papers

Background: Unstable pelvic ring fractures (PRF) seldom occur in isolated injuries. Most pelvic fractures are caused by motor vehicle accidents (MVA) concurrently with multiple traumas. PRF have an extremely high mortality rate, ranging from 20-50%. When patients suffer multiple traumas including a pelvic fracture, their mortality rate increases by 10%, and their ability to return home after treatment decreases by 33%. The purpose of this case report was to describe the outcomes of physical therapy (PT) interventions for a nonagenarian patient following an unstable PRF. Case Description: A 99 year-old male suffered a high impact unstable PRF in addition to …

The Use Of Medical Therapeutic Yoga On A Patient With Adhesive Capsulitis: A Case Report, Cameron Vallie

Case Report Papers

Background and Purpose: Shoulder pain is the third most common site of musculoskeletal pain leading to substantial financial burden for patients. Adhesive capsulitis (AC) is a disabling condition defined by a progressive loss of upper extremity (UE) range of motion (ROM) and leading to limitations in functional mobility. The purpose of this case report is to investigate the implementation of medical therapeutic yoga (MTY) in combination with manual therapy and therapeutic exercise in the treatment of a patient with AC. Case Description: The patient was a 51-year-old female with left shoulder AC and associated deficits in ROM, strength, and functional …

Conservative Management Of A Complete Rupture Of The Long Head Of The Biceps: A Case Report, Ali Woller

Case Report Papers

Background/Purpose: The long head of the biceps plays an important role stabilizing the shoulder. Most of the current literature supports surgical intervention following a complete rupture, but there is little evidence that supports conservative management. Due to a lack of evidence supporting conservative management of a complete rupture of the long head of the biceps, the purpose of this case study was to evaluate the progress this patient made over a six-week period with outpatient physical therapy addressing his impairments resulting from his injury. Case Description: The patient was a 51-year-old male with a confirmed diagnosis of a complete rupture …

A 6 Week Balance And Gait Training Program Using The Alterg For A Patient With Cervical Myelopathy After Spinal Decompression Surgery: A Case Report, Palak Patel

Case Report Papers

Background and Purpose: Spinal stenosis is the narrowing of the spinal canal, which can cause radicular symptoms due to compression of the spinal cord. About 80% of patients over 70 years old have some level of stenosis. Patients with severe types of cervical stenosis may require operative management which includes spinal decompression and fusion. In this case report the AlterG was used to perform a balance and gait training program for a patient who had significant loss of strength and functional mobility after spinal decompression surgery. Case Description: The patient was an 83-year-old male who was a retired farmer that …

Comprehensive Physical Therapy Management Of A Patient With Decreased Shoulder Function And A History Of Breast, Lung, And Oral Cancer: A Case Report, Andrew Chongaway

Case Report Papers

Background: Cancer treatments can have late effects on the musculoskeletal, cardiopulmonary, nervous, and integumentary systems. This case report describes comprehensive physical therapy (PT) management of decreased shoulder function for a patient with a history of breast, lung, and tongue cancers treated with surgery, chemotherapy, and radiation. Case Description: The patient was a 71-year-old female referred to outpatient PT for right shoulder and neck pain with the goals to reduce pain and increase functional mobility. Past history included local cancer treatment occurred to the right upper quadrant for multiple cancers. Outcome measures included the Upper Extremity Functional Scale (UEFS), the Numeric …

A Barefoot Running Program For A College Lacrosse Player With Chronic Exertional Compartment Syndrome: A Case Report, Erica Mazzarelli

Case Report Papers

Background and Purpose: Although barefoot running has been investigated for anterior and lateral exertional compartment syndrome, a specific barefoot running program aimed at altering running mechanics has not been determined for posterior exertional compartment syndrome for a college lacrosse player. The purpose of this case report was to examine the effects of adopting a forefoot running pattern through a barefoot running program in a 20-year-old college lacrosse player with posterior chronic exertional compartment syndrome (CECS) in conjunction with a comprehensive physical therapy program. Case description: The patient was a 20-year-old female college lacrosse player who presented to physical therapy with …

Mckenzie Approach To Treating Lumbar Radiculopathy With A Lateral Shift: A Case Report, Carly Theriault

Case Report Papers

Background and Purpose: Pain and dysfunction of the lumbar spine has the highest incidence of any other musculoskeletal condition. LBP is thought to affect 70-85% of people. The purpose of this case report was to implement the McKenzie method, along with manual therapy, strengthening and stretching exercises, modalities, patient education, and an HEP for a patient with lumbar radiculopathy. Case Description: The patient was a 59-year-old male with an eight-year history of LBP. Following his most recent injury, the patient had LBP with pain radiating to the right LE. The patient received PT treatment twice a week for eight weeks. …

Female Athlete Triad: Strategic Plan, Kaitlyn Savard, Carly Theriault, Polina Weinstein, Mayra Zerpa Calderon

Physical Therapy Administration

The following is a blueprint for creating a screening and educational program focused on the Female Athlete Triad. Our program intends to promote awareness, encourage women to take action regarding their health needs, and reduce the stigma surrounding this underdiagnosed and undertreated health issue. Created during the Fall 2018 semester of the Physical Therapy Administration course, this strategic plan contains all values, rationale, and strategies for reaching the target population and addressing this health issue.

Female Athlete Triad: Presentation, Kaitlyn Savard, Carly Theriault, Polina Weinstein, Mayra Zerpa Calderon

Physical Therapy Administration

Presentation created to summarize a strategic plan and screening program focused on the Female Athlete Triad. Program intends to promote awareness, encourage women to take action regarding their health needs, and reduce the stigma surrounding this underdiagnosed and undertreated health issue.

Identifying Trippers And Non-Trippers Based On Knee Kinematics During Obstacle-Free Walking, Lauren C. Benson, Stephen C. Cobb, Allison S. Hyngstrom, Kevin G. Keenan, Jake Luo, Kristian M. O'Connor

Physical Therapy Faculty Research and Publications

Trips are a major cause of falls. Sagittal-plane kinematics affect clearance between the foot and obstacles, however, it is unclear which kinematic measures during obstacle-free walking are associated with avoiding a trip when encountering an obstacle. The purpose of this study was to determine kinematic factors during obstacle-free walking that are related to obstacle avoidance ability. It was expected that successful obstacle avoidance would be associated with greater peak flexion/dorsiflexion and range of motion (ROM), and differences in timing of peak flexion/dorsiflexion during swing of obstacle-free walking for the hip, knee and ankle. Three-dimensional kinematics were recorded as 35 participants …

Functional Mobility For An Elderly Patient With Amyotrophic Lateral Sclerosis: A Case Report, Gianna G. Pezzano

Case Report Papers

Background and Purpose: This case report provides a detailed description of how balance training was incorporated into physical therapy (PT) treatment to reduce fall risk and maintain functional mobility in an elderly patient diagnosed with ALS. Due to lack of research on ALS, and the terminal nature of the disease, clinicians and researchers may benefit from a palliative care PT plan to maintain functional mobility for patients with neurodegenerative diseases. Case Description: An 82-year old female presented to outpatient PT with the diagnosis of ALS, with decreased functional mobility, high fall risk, and left hip/knee pain due to arthritis. She …

Functional Mobility For A Patient With Myelodysplastic Syndrome, Chronic Gvhd, And Corticosteroid Use: A Case Report, Alyssa Deardorff

Case Report Papers

Background: The use of corticosteroids to treat chronic graft-versus-host-disease (cGVHD) is common in oncological treatment. However, the long-term complications of cGVHD and prolonged use of corticosteroids have not been reported in terms of the benefits of physical therapy (PT) interventions. The purpose of this case report was to report the impact of PT interventions for an individual with a cancer diagnosis having received an allogenic-stem cell transplant (allo-SCT) with the long-term complications associated with cGVHD, long-term corticosteroid use, and cancer survivorship. Case Description: The patient was a 73-year-old male diagnosed with Myelodysplastic Syndrome and received an allo-SCT two years prior …

Relieving Low Back Pain And Improving Mobility For An Adult Patient With Progressive Multifocal Leukoencephalopathy: A Case Report, Derek Schwaiger

Case Report Papers

Background and Purpose: Progressive Multifocal Leukoencephalopathy (PML) is a demyelinating disease affecting patients with compromised immune systems. It attacks the central nervous system through white matter plaques that destroy neurons. Plaques form due to the John Cunningham Virus (JCV). There is no approved JCV treatment and thus, no treatment for PML. The purpose of this case report is to examine the physical therapy interventions administered to a patient with PML to address low back pain and functional mobility deficits. Case Description: The patient chosen was a 51-year-old male referred to outpatient physical therapy services with a medical diagnosis of PML. …

Inpatient Physical Therapy Management For A Patient With Chronic Pulmonary Complications Secondary To Multiple Lobectomies: A Case Report, Bayley Archinal

Case Report Papers

Background and Purpose: Bronchiectasis is a disease defined by abnormal dilation of the bronchi from recurrent infections and/or chronic inflammation, which can lead to irreversible lung damage. Based upon severity and patient response to conservative treatment, a lobectomy may be required to resolve their symptoms. Though surgery may provide symptom relief and improve overall quality of life, patients are likely to have long-term pulmonary complications. There are several studies regarding the treatment of patients with pulmonary limitations secondary to a lobectomy. However, there is little to no evidence regarding the long-term treatment of patients who have undergone multiple lobectomies. The …

Anticipatory Postural Adjustments And Spatial Organization Of Motor Cortex: Evidence Of Adaptive Compensations In Healthy Older Adults, Jo Armour Smith, Beth E. Fisher

Physical Therapy Faculty Articles and Research

During anticipated postural perturbations induced by limb movement, the central nervous system generates anticipatory postural adjustments (APAs) in the trunk and hip musculature to minimize disturbances to equilibrium. Age-related changes in functional organization of the nervous system may contribute to changes in APAs in healthy older adults. Here we examined if altered APAs of trunk/hip musculature in older adults are accompanied by changes in the representation of these muscles in motor cortex. Twelve healthy older adults, 5 with a history of falls and 7 nonfallers, were compared with 13 young adults. APAs were assessed during a mediolateral arm raise task …

Fatigue In Adults With Cerebral Palsy: A Three-Year Follow-Up Study., Irene L B Oude Lansink, Patrick G Mcphee, Laura Kristine Brunton, Jan Willem Gorter

Physical Therapy Publications

OBJECTIVES: To describe the course of fatigue over a 3-year follow-up period in adults with cerebral palsy and to investigate the association of known determinants of fatigue (i.e. demographic characteristics and/or body composition) with change in fatigue.

METHODS: Forty-one adults with cerebral palsy from a previous study of fatigue were invited to participate in a follow-up study. Twenty-three adults with cerebral palsy (Gross Motor Function Classification System (GMFCS) levels I-V; mean age 38 years 2 months, standard deviation (SD) 14 years 1 month)) agreed to participate (convenience sample). Fatigue was measured with the Fatigue Impact and Severity Self-Assessment (FISSA, range …

Effect Of Interferential Current In The Management Of Musculoskeletal Pain: A Systematic Review, Ginny Skipper Spt, Sarah Maissy Spt, Roger Allen Phd, Pt

Physical Therapy Research Symposium

Purpose: Interferential current (IFC) is widely used in conjunction with other therapies to manage musculoskeletal pain. While previous systematic reviews have found a lack of studies examining the independent treatment effects of IFC, this study reviews the isolated effects of IFC compared to a control group. The purpose of this study is to determine if IFC is an effective modality for treating musculoskeletal pain.

Number of Subjects: Ten peer-reviewed journal articles, representing a total of 898 participants

Materials/Methods: CINAHL, PubMed, Cochrane Library, PEDro , SportDISCUS and CENTRAL were searched between November 2016 and February 2017 with the following terms: interferential …

Effects Of Pain Neuroscience Education On Physician Assistant Students Understanding Of Pain And Attitudes And Beliefs About Pain., Kory Zimney, Adriaan Louw, Julie Johnson, Suzanne Peppers, Kevin Farrell

Faculty Publications

PURPOSE: Evaluate the effectiveness and efficiency of two different pain neuroscience education (PNE) lectures provided to physician assistant (PA) students. Primary outcomes explored were knowledge of pain and shift in attitudes and beliefs about chronic pain after the lecture.

METHODS: A PNE lecture was provided at two separate university PA programs. One program received a two-hour PNE lecture with a case-based example. The other program received a one-hour PNE lecture without the casebased example. Measurement of change for pre and post-test pain knowledge and attitudes and beliefs about chronic pain were recorded.

RESULTS: Students at both universities showed medium effect …

Trunk Control And Gross Motor Outcomes After Body-Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Case Series, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

BACKGROUND AND PURPOSE: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and V present with decreased gross motor function and trunk control that impacts their functional activities and participation in family activities. Research indicates body-weight supported treadmill training (BWSTT) may improve motor control for children with neuromotor disabilities. The toddler years present a window of opportunity for developmental changes. The purpose of this case series was to explore the impact of a 6-week BWSTT intervention on postural control and gross motor function in 3 young children with cerebral palsy in GMFCS levels IV and …

Caregiver Perspectives On Body-Weight Supported Treadmill Training As An Intervention For Young Children With Cerebral Palsy, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

PURPOSE/HYPOTHESIS: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and V present with challenges that impact their functional activities and participation in family activities. The purpose of this study was to examine caregivers’ perspectives on body-weight supported treadmill training (BWSTT) as an intervention for their young children with CP.

NUMBER OF SUBJECTS: Participants included 4 caregivers of children with CP in GMFCS levels IV (n = 2) and V (n = 2) who previously participated in 6 weeks of BWSTT.

MATERIALS/METHODS: Three children diagnosed with CP in GMFCS levels IV and V between the …

Global Health Perspectives In Physical Therapy Education: A Qualitative Report On A Service Learning Experience In Guatemala, Adriana Sandoval, Winter F. Wildt-Bailey, Dr. Holly Roberts Pt, Dpt, Gcs, Ncs

Physical Therapy Research Symposium

Authors: Winter F Wildt-Bailey, SPT; Adriana Sandoval, SPT; Holly J Roberts, PT, DPT, GCS, NCS

Global Health Perspectives in Physical Therapy Education: A Qualitative Report on a Service Learning Experience in Guatemala

Purpose: Doctor of physical therapy (DPT) students at the University of Puget Sound traveled to Zacapa, Guatemala to deliver physical therapy services for 5 days as part of an elective course introducing students to physical therapy and health care delivery from a global health perspective. Participants journaled about their experiences, responding to prompts provided by the course professor/clinical instructor. The purpose of this research was to explore the …

Trunk Control And Gross Motor Outcomes After Body Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Non-Experimental Case Series, Megan Flores, Carolyn P Da Silva

Physical Therapy Collection

OBJECTIVE: To explore the impact of a body weight supported treadmill training (BWSTT) intervention on postural control and gross motor function in three young children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels IV or V.

METHOD: Children (N = 3) between the ages of 2-3 years who were diagnosed with CP classified as GMFCS levels IV and V participated in BWSTT three times per week. The Segmental Assessment of Trunk Control (SATCo) and the gross motor function measure (GMFM-66) were assessed before and after the 6-week intervention.

RESULTS: Final testing revealed …

Diversifying Physical Therapy: Recruitment And Retention Of Under-Represented Minorities To Improve Patient Outcomes, Miriam Janove, Isaac Aguliar, Alex Knapp

Physical Therapy Research Symposium

The American Council of Academic Physical Therapy (ACAPT) has determined that physical therapy (PT) education and practice has fallen short of “representation of the general population”. This lack of diversity compromises access to rehabilitation among under-represented minorities (URM), thus perpetuating the suffering from disease. Using the ACAPT definition of URM, we encompass not only traditional racial and ethnic groups, but also low socioeconomic status, geographically underrepresented, and educationally disadvantaged groups. Lack of resources leads to decreased levels of physical activity, compounded by lack of access to care within URM areas, and has been linked to the perpetuation of sedentary diseases. …

Promis Pain Interference Is Superior Vs Numeric Pain Rating Scale For Pain Assessment In Foot And Ankle Patients, David N. Bernstein, Meghan Kelly, Jeff Houck, John P. Ketz, Samuel Flemister, Benedict F. Digiovanni, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Background: The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).

Methods: Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a …