Medicine and Health Sciences Commons^™

Neuromotor Changes In Participants With A Concussion History Can Be Detected With A Custom Smartphone App, Christopher K. Rhea, Masahiro Yamada, Nikita A. Kuznetsov, Jason T. Jakiela, Chanel T. Lojacono, Scott E. Ross, F. J. Haran, Jason M. Bailie, W. Geoffrey Wright

Moss-Magee Rehabilitation Papers

Neuromotor dysfunction after a concussion is common, but balance tests used to assess neuromotor dysfunction are typically subjective. Current objective balance tests are either cost- or space-prohibitive, or utilize a static balance protocol, which may mask neuromotor dysfunction due to the simplicity of the task. To address this gap, our team developed an Android-based smartphone app (portable and cost-effective) that uses the sensors in the device (objective) to record movement profiles during a stepping-in-place task (dynamic movement). The purpose of this study was to examine the extent to which our custom smartphone app and protocol could discriminate neuromotor behavior between …

Comparison Of Clinical And Biomechanical Characteristics Between Individuals With Lower Limb Amputation With And Without Lower Back Pain: A Systematic Review And Meta-Analysis, Szu-Ping Lee, Shawn Farrokhi, Jenny A. Kent, Jason Ciccotelli, Lung-Chang Chien, Jo Armour Smith

Physical Therapy Faculty Articles and Research

Background

Lower back pain is a debilitating condition common to individuals with lower limb amputation. It is unclear what risk factors contribute to the development of back pain. This study systematically reviewed and analyzed the available evidence regarding the clinical and biomechanical differences between individuals with amputation, with and without lower back pain.

Methods

A literature search was conducted in PubMed, Web of Science, Scopus, and CINAHL databases in November 2020 and repeated in June 2021 and June 2022. Studies were included if they reported comparisons of demographic, anthropometric, biomechanical, and other clinical variables between participants with and without LBP. …

The Traumatic Injuries Distress Scale: Manual And Questionnaire, David Walton

Physical Therapy Publications

No abstract provided.

Bone–Patellar Tendon–Bone Autograft Harvest Prolongs Extensor Latency During Gait 2 Yr After Aclr, Naoaki Ito, Jacob J. Capin, Ashutosh Khandha, Thomas S. Buchanan, Karin Grävare Silbernagel, Lynn Snyder-Mackler

Physical Therapy Faculty Research and Publications

Purpose

Bone–patellar tendon–bone (BPTB) graft harvest for anterior cruciate ligament reconstruction alters patellar tendon properties, which inflict poor quadriceps neuromuscular function. BPTB autografts are associated with higher rates of posttraumatic osteoarthritis, which in turn is associated with pathological gait. The purpose of this study was to investigate the latency between the time of peak quadriceps activity and the peak knee flexion moment during gait, between those with BPTB grafts (n = 23) and other graft types (hamstring autograft or allografts, n = 54), 5 ± 2 months and 2 yr (25 ± 3 months) after anterior cruciate ligament reconstruction. …

Single Muscle Fibre Contractile Function With Ageing, Gregory J. Grosicki, Carlos S. Zepeda, Christopher W. Sundberg

Physical Therapy Faculty Research and Publications

Ageing is accompanied by decrements in the size and function of skeletal muscle that compromise independence and quality of life in older adults. Developing therapeutic strategies to ameliorate these changes is critical but requires an in-depth mechanistic understanding of the underlying physiology. Over the past 25 years, studies on the contractile mechanics of isolated human muscle fibres have been instrumental in facilitating our understanding of the cellular mechanisms contributing to age-related skeletal muscle dysfunction. The purpose of this review is to characterize the changes that occur in single muscle fibre size and contractile function with ageing and identify key areas …

Reliability Of Accelerometer-Based Reaction Time Tests, Jacob Hepp, Warner Rhodes, Jordan Walton, Rahul Soangra, Brent Harper

Student Scholar Symposium Abstracts and Posters

Concussions are traumatic brain injuries that affect the function of the brain. One of the primary symptoms of a concussion is a lack of reaction time. The people that are most susceptible to concussions are athletes; Laker’s (2011) study found that 135,000 patients that suffer concussions from playing sports are expected to be hospitalized each year, with football making up 75% of concussions at high school and college levels. Honda et al. (2018) suggested reaction time as an important biomarker of concussion. Laboratory camera-based motion capture data, while reliable, is not a realistic tool to use outside of a laboratory …

Multi-Disciplinary Biopsychosocial Approach In Low Back Pain Benchmark Study, Liza Beth Cocanougher Short Rn, Ms

MSN Capstone Projects

Low back pain (LBP) is the third most common reason people seek care in America and is the primary reason for missed work days. Working in a pain clinic for eight years and managing research studies directed toward improving low back pain in patients was the motivation for choosing the evidence based intervention in this population. The health care professionals (HCP) in the pain clinic usually have a conversation with the patients who have acute or subacute onset of LBP about their disease and give them a written handout with exercises and ask them to perform these exercises at home. …

Reliability And Validity Of Inertial Sensor Assisted Reaction Time Measurement Tools Among Healthy Young Adults, Brent Harper, Michael Shiraishi, Rahul Soangra

Physical Therapy Faculty Articles and Research

The assessment of movement reaction time (RT) as a sideline assessment is a valuable biomarker for mild TBI or concussion. However, such assessments require controlled laboratory environments, which may not be feasible for sideline testing during a game. Body-worn wearable devices are advantageous as being cost-effective, easy to don and use, wirelessly transmit data, and ensure unhindered movement performance. This study aimed to develop a Drop-stick Test System (DTS) with a wireless inertial sensor and confirm its reliability for different standing conditions (Foam versus No Foam) and task types (Single versus Dual), and postures (Standing versus sitting). Fourteen healthy young …

Effects Of Treadmill Interventions On Infants With Developmental Delays Presenting With Mild And Severe Impairments: A Case Series, Eric Nguyen Spt, Nicolle Gerchak Spt

Physical Therapy Research Symposium

Background: Physical development delays can severely limit a child’s ability to explore and learn about their environment. Evidence supports that this exploration promotes a child’s development in cognition, language acquisition, social skills, and further physical skills. Thus, interventions that target and improve early mobility can be highly valuable to a child’s life. Treadmill training in infants with developmental delays has shown to be an effective intervention in moving infants toward earlier independent walking and improved gross motor function.

Purpose: This study aims to explore the potential benefits of an established treadmill training program in infants with varying degrees of motor …

Covid Restrictions Did Not Decrease Physical Activity In Community-Dwelling Older Adults, Jillian Stoewer Spt, Cara Filce Spt, Holly J. Roberts Pt, Phd, Gcs, Ncs

Physical Therapy Research Symposium

Background

Understanding the long-term impacts of COVID-19-related stay-at-home orders on physical activity can help clinicians prepare for consequences that may impact their patient populations.

Purpose

This study examined effects of the 2020 COVID-19 stay-at-home orders on physical activity levels in community-dwelling older adults including the number of hours they spent walking outside of the home and working/volunteering in the community.

Methods

Eighty-nine participants completed a monthly Physical Activity Scale for the Elderly (PASE) for 10 months. One-way repeated measures ANOVAs with post hoc analyses were calculated to determine differences among PASE scores, PASE item 2 scores, and work/volunteer hours at …

Kinematic And Kinetic Gait Characteristics In People With Patellofemoral Pain: A Systematic Review And Meta-Analysis, Harvi Hart Dr.

Physical Therapy Publications

Abstract

Background

Patellofemoral pain (PFP) is a prevalent knee condition with many proposed biomechanically orientated etiological factors and treatments.

Objective

We aimed to systematically review and synthesize the evidence for biomechanical variables (spatiotemporal, kinematic, kinetic) during walking and running in people with PFP compared with pain-free controls, and determine if biomechanical variables contribute to the development of PFP.

Design

Systematic review and meta-analysis.

Data sources

We searched Medline, CINAHL, SPORTDiscus, Embase, and Web of Science from inception to October 2021.

Eligibility criteria for selecting studies

All study designs (prospective, case–control [± interventional component, provided pre-intervention data were reported for both …

Quantifying Physical Resilience In Ageing Using Measurement Instruments: A Scoping Review, Sue Peters, Theodore D Cosco, Dawn C Mackey, Gurkaran S Sarohia, Jeffrey Leong, Andrew Wister

Physical Therapy Publications

Purpose: The capacity to recover motor function with pathology or age-related decline is termed physical resilience. It is unknown what outcome domains are captured with existing measurement instruments. Thus, this scoping review aimed to identify measurement instruments for physical resilience, identify research gaps, and make recommendations for future research. Methods: Articles were included from the search when their subject matter included the term resilience in relation to the physical health of older adults. Data on physical resilience measurement instruments were extracted using the outcome domains: body function or structure, activity and participation, and societal impact. Results: The majority of the …

From Zoom To The Clinic: Unique Student Challenges In Physical Therapy Clinical Education, Amy Both, Jaclyn Catherine Carson, Matthew B. Garber, Heather Marie Mack, Nicole M. Sleddens

Posters and Presentations: Physical Therapy

While the abrupt shift in PT education (PTE) brought on by the pandemic created opportunities for educational innovation, it also brought relational separation and fragmented learning due to lockdowns, social distancing, face masks, and communication limited to virtual platforms. Academic programs increased use of virtual learning, rearranged curriculum, reduced lab and simulated learning time, and provided fewer, if any, opportunities for service learning and patient contact. Clinic sites paused clinic education experiences or hosted fewer students to maintain social distancing and limit disease exposure. As PTE returns to more typical curricular schedules and practices, it is important to be aware …

Effectiveness Of Simulation-Based Learning Compared To Integrated Clinical Experience In Development Of Dpt Students’ Clinical Decision-Making Skills, Derrick F. Campbell Pt, Dpt, Sc.D, Kristy Demers, Masoor Alameri, Fabian Bizama

Education Collection

Background: Simulation-based learning has a significant footprint on entry-level physical therapy programs. Students’ clinical decision-making (CDM) skills development through simulation-based learning (SBL) format when compared to the Integrated Clinical Experience (ICE) remains unknown. Self-efficacy of Clinical and CDM skills tool measures clinical skills, clinical decision-making, and total self-efficacy of clinical and CDM skills.2 A need to evaluate the effectiveness of simulation-based learning compared to ICE in development of CDM skills

Purpose: The purpose of this study was to compare the effectiveness of simulation-based learning and the Integrated Clinical Experience (ICE) in the development of DPT student clinical decision-making skills as …

Immediate Vs Delayed Feedback In A Progressive Musculoskeletal E-Module Case For Clinical Reasoning Development, Megan Frazee, Krista Gipson, Elizabeth Lyden, Stephanie Langel

Posters and Presentations: Physical Therapy

PURPOSE: Educators are responsible for developing clinical reasoning skills in Physical Therapy (PT) students. Simulated virtual experiences allow specific skills, such as clinical reasoning, to be learned and tested (Holdsworth, 2016). PT students prefer a combination of learning from e-modules and lecture formats (Gardner, 2016). Feedback is a critical component for consolidated learning; however, there is no consensus on the best timing of feedback (Schute, 2008). The purpose was to evaluate the impact of immediate versus delayed feedback through an e-module in PT students' accuracy in identifying the primary hypothesis, severity and irritability level for a virtual patient case. The …

Developing A Rapid Assessment Program For Student Success In Clinical Education, Nicole M. Sleddens, Betsy J. Becker, Grace Johnson, Joseph F. Norman

Posters and Presentations: Physical Therapy

Successful management of the struggling student in the clinic relies heavily on the early identification of clinical performance deficits. CIs who directly observe student performance, actions and behaviors should aim for early and precise identification of difficulties, which should lead to initial discussions with the student. If the student's struggles require involvement from the educational institution, the CI should promptly contact and collaborate with the DCE. Early communication with the DCE is beneficial, as they can provide support for CIs overwhelmed by the difficulties that accompany working with a challenging student. The DCE provides guidance on determining the depth of …

Orthopaedic Physical Therapy Residency And Fellowship Program Mentoring Structure: A Survey Of Program Directors, Darren Q. Calley, Kirk R. Bentzen, Megan Frazee, Matthew D. Haberl

Posters and Presentations: Physical Therapy

Purpose/Hypothesis: Mentoring is a required component of physical therapy residency and fellowship training, and a primary reason applicants pursue training in these programs. Resources outlining core competencies for effective mentoring, mentor and mentee characteristics, and recommendations for effective mentoring have been described. However, little is known about the timing, structure, and process of how mentoring and feedback is implemented across residency and fellowship programs. The purpose of this study was to better understand the structure, timing, and delivery of mentoring and the role mentors and program directors (PDs) play in orthopaedic physical therapy residency and fellowship programs. A secondary purpose …

Bruce Protocol Test Affects Postural Stability In Healthy Young Adults, Andreas Germanos, Tessa Heiberg, Annie Jeon, Emi Heisterkamp, Hao Giang, Jessica Cota, Laura Corona, Thomas Loi, Vincent Bovino, Shayce Cordero, Sunny Kim, Michael Shiraishi, Rahul Soangra

Physical Therapy Faculty Articles and Research

Maintaining balance is key in avoiding falls and injury. However, little is known on how increased cardiac activity may affect postural stability. This study investigated if increase in cardiac activity to 85% maximal heart rate (HR) when exercising with standard Bruce Protocol Test (BPT) influence postural sway. Ten young adults were tested for three postural stances, quiet bilateral standing with i) eyes open, ii) eyes closed, and iii) tandem stance, before and after performing the BPT. Resting Heart Rate (HR) and HR variability along with standard postural sway parameters like sway velocity, sway area, turn index, and power frequency in …

The Reliability Of The Gnrb® Knee Arthrometer In Measuring Acl Stiffness And Laxity: Implications For Clinical Use And Clinical Trial Design., Kayla M. Smith, Nicole Miller, Steve Laslovich

Physical Therapy Collection

BACKGROUND: Stability of the knee is dependent on multiple factors including integrity of the anterior cruciate ligament (ACL). Greater knee joint laxity appears to negatively affect dynamic joint function and therefore reliable and valid measures of ACL stiffness and laxity are clinically valuable.

PURPOSE: The aim of this study was to investigate the reliability of the GENOUROB, (GNRB®) knee arthrometer device in measuring both stiffness and laxity of the ACL, and to provide information on sample size calculation for future clinical trials.

STUDY DESIGN: Cross-sectional test-retest study.

METHOD: Twelve healthy student participants (age 24-30 years; 6 females and 6 …

A Systematic Review Of Chronic Pain Mechanism Differential Assessment Strategies For Physical Therapy, Kate Hovde Spt, Kenny Li Dpt, Kylie Wong Bs, Roger Allen Phd, Pt

Physical Therapy Research Symposium

Background

Recently, the International Association for the Study of Pain (IASP) redefined pain, the American Physical Therapy Association proposed pain education guidelines, and a new pain mechanism category (PMC) was defined as “nociplastic pain”. IASP defines three PMCs - nociceptive, neuroplastic, and nociplastic.

Purpose

Identify current clinical assessment strategies for differentiating between nociceptive, neuropathic, and nociplastic chronic pain, feasible for implementation by physical therapists (PTs).

Methods

In 2020, investigators independently searched databases for studies evaluating assessment methods differentiating “nociceptive,” “neuropathic,” “central,” “mixed pain” and “central sensitization,” with follow-up on “nociplastic pain”. A qualitative systematic review was performed utilizing defined inclusion …

Motivational Characteristics And Fulfillment Of Psychological Needs Among Physically Active Undergraduate Students, Rohan Cobb-Ozanne Spt, Kayla Renee Withers Spt, Danny Mcmillian Pt, Dsc

Physical Therapy Research Symposium

Background: Physical activity (PA) guidelines describe positive correlations between PA and health outcomes. Self-determination theory (SDT) was used to identify motivational factors crucial to a physically active lifestyle.

Purpose: Identify and analyze how motivational characteristics, fulfillment of psychological needs, and individual experiences/beliefs influence PA.

Methods: Participants defined as moderately to vigorously physically active by the International Physical Activity Questionnaire were recruited using nominated sampling and public advertising. Motivational characteristics and psychological needs were assessed using SDT, Motives for Physical Activities Measure – Revised (MPAM-R), and The Basic Psychological Need Satisfaction and Frustration Scale – General (BPNSF). Semi-structured interviews were recorded …

Pain Catastrophizing, Pain Intensity And Perceived Injustice Do Not Predict Hrv In Acute Pain, Jacqueline Diulio Spt, Hailey Kettel Spt, Karin Steere Dpt, Phd

Physical Therapy Research Symposium

BACKGROUND: The nature of chronic pain conditions is well documented, with systemic biological, psychological and social factors interacting in an emergent fashion. Autonomic nervous system dysregulation, reflected as decreased heart rate variability (HRV), is suggested to be a biomarker of systemic dysfunction. Previous research has demonstrated correlations between numerous chronic pain disorders and diminished HRV.

PURPOSE: To determine the relationship between pain and HRV in the acute phase of pain, and to examine the predictive value of psychosocial variables on HRV. This study is meant to enhance our sense of how early in the pain experience decreased HRV may occur. …

Pne – Lots Of Talk, Superficial Results, Aidan Keller, Michael Ray, Taylor Baugher

Honors Projects

Objective: A narrative review (NR) of meta-analyses (MA) and systematic reviews (SR) that assess the effectiveness or efficacy of pain neuroscience education (PNE) on various outcome measures in individuals with chronic musculoskeletal (MSK) pain. Methods: This was a mixed methodology review involving systematic searches across 4 databases (PubMed, ScienceDirect, CENTRAL (Cochrane), and Google Scholar). Inclusion criteria stipulated MAs and SRs that assessed the effectiveness or efficacy of PNE on CP population. Quantitative eligibility criteria included randomized controlled trials (RCTs), adults (18+ years of age), English or Spanish speaking individuals, and reporting of chronic pain (persistent or recurrent pain lasting ≥ …

Student Wellness During Curriculum Implementation Of A Lifestyle Medicine Approach Within The Social-Ecological Model: A Longitudinal Study., Betsy J. Becker, Tessa Wells, Kathleen G. Volkman, Nicole M. Sleddens, Teresa Cochran

Posters and Presentations: Physical Therapy

Purpose

The student-life experience is an ideal time to implement lifelong wellness behaviors needed for the professional role. The ongoing effects of the COVID pandemic have amplified the need for Doctor of Physical Therapy (DPT) educational programs to train an emerging workforce that can, through personal wellness, withstand the stressors of personal and professional lives. The study purpose is to: a) evaluate the change in student wellness from matriculation to mid-program to completion after implementation of a curriculum based on a lifestyle medicine approach within the Social-Ecological Model, and b) compare student wellness between cohorts that matriculated before and during …

Student Wellness During Curriculum Implementation Of A Lifestyle Medicine Approach Within The Social-Ecological Model: A Longitudinal Study, Betsy J. Becker, Anne Skinner, Tessa Wells, Kathleen G. Volkman, Nicole M. Sleddens, Teresa Cochran

Posters and Presentations: Physical Therapy

Purpose

The student-life experience is an ideal time to implement lifelong wellness behaviors needed for the professional role. The ongoing effects of the COVID pandemic have amplified the need for Doctor of Physical Therapy (DPT) educational programs to train an emerging workforce that can, through personal wellness, withstand the stressors of personal and professional lives. The study purpose is to: a) evaluate the change in student wellness from matriculation to mid-program to completion after implementation of a curriculum based on a lifestyle medicine approach within the Social-Ecological Model, and b) compare student wellness between cohorts that matriculated before and during …

Recommendations For Optimizing Cardiac Ischemia Detection For Physical Therapy Practice: Research Review, Stacey Pirtle, Germaine Ferreira

Physical Therapy Collection

Purpose: The purpose of this study is to guide physical therapists in recognizing ischemia using electrocardiogram strips during graded exercise stress testing using methods other than relying on ST segment deviation for cardiac ischemia detection.

Methods: A literature review of the English-language literature published between 1975 to 2022 on the detection and prediction accuracy of ECG abnormalities on cardiac ischemia during GXT was conducted using PubMed and CINAHL. Inclusion criteria included studies utilizing 12-lead ECG monitoring while performing GXT for the detection of cardiac ischemia. Exclusion criteria included studies that did not utilize GXT or ECG for detection of cardiac …

The Effects On Gait Of 4-Wheeled Walker Use In People With Alzheimer's Disease Dementia And Gait Impairment: A Pilot Study, Humberto Omaña, Edward Madou, Susan W. Hunter

Physical Therapy Publications

In people with dementia, provision of mobility aids is standard treatment for those with impaired gait. However, mobility aid use is independently associated with increased falls risk. In this short communication, gait velocity and stride time variability were recorded in eleven adults with Alzheimer's disease dementia. Three conditions were tested: single-task (no aid), walking with a walker, and dual-task (walker use and counting backwards) under both a straight path and Figure-of-8 walking configuration. Gait velocity increased when using a walker compared to no aid in the Figure-of-8 walking configuration. Walker use improved gait in simple walking, but benefits diminished upon …

Assessing Ground Reaction Forces And Degenerative Changes Of Sound Limb In Unilateral Lower Extremity Amputees: A Systematic Review, Kira Donnelly, Colin Davis, Nicole Liotta, Angela Perkins, Vibhor Agrawal, Michael Jason Highsmith, Scott Michael Love

Physical Therapy Collection

Abstract Background: There is a rising number of individuals undergoing lower extremity amputation (LEA) and is associated with increased risk of comorbidities. Osteoarthritis (OA) and Degenerative Joint Disease (DJD) are conditions that cause reduction in an individual’s function, independence, and quality of life.

Research Design: A search of multiple databases using terms associated with possible functional declines as evidenced by the International Classification of Functioning, Disability and Health (ICF), followed by assessment of evidence using the PEDro scoring method will be conducted. Multiple reviewers will screen, sort, rate and extract data from articles.

Methods: A computer-aided literature search of PubMed, …

A Proposed Value Metric To Quantify Value In Outpatient Therapy, Bryan Bourcier Dpt, Scs, Thomas Ruediger Dpt, Ocs, Scs, Alexandra Bond Dpt

Other Specialties

ABSTRACT

Study Design: Case report

Objectives: The purpose of this study is to report the steps towards developing a single number Value Metric that represents both the quality and cost of clinical care for outpatient therapy that can be used in real time.

Background: As healthcare continues to move towards value-based and risk-based reimbursement, it is imperative that leaders in outpatient therapy settings understand and can quantify the value of the services that therapists provide.

Methods and Measures: This study proposes a Value Metric to quantify value in outpatient therapy using existing quality and cost data. The Value Metric was …

Knee Joint Biomechanics During Gait Improve From 3 To 6 Months After Anterior Cruciate Ligament Reconstruction, Kelsey Neal, Jack R. Williams, Abdulmajeed Alfayyadh, Jacob J. Capin, Ashutosh Khandha, Kurt Manal, Lynn Snyder-Mackler, Thomas S. Buchanan

Physical Therapy Faculty Research and Publications

Gait alterations after anterior cruciate ligament reconstruction (ACLR) are commonly reported and have been linked to posttraumatic osteoarthritis development. While knee gait alterations have been studied at several time points after ACLR, little is known about how these biomechanical variables change earlier than 6 months after surgery, nor is much known about how they differ over the entire stance phase of gait. The purpose of this study was to examine knee gait biomechanical variables over their entire movement pattern through stance at both 3 and 6 months after ACLR and to study the progression of interlimb asymmetry between the two …