Medicine and Health Sciences Commons^™

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 …

Effects Of Two Exercise Programs On Neck Proprioception In Patients With Chronic Neck Pain: A Preliminary Randomized Clinical Trial, Leila Rahnama, Mark Daniel Geil

Faculty and Research Publications

Background: The purpose of this study was to compare the effects of specific neck muscle training and general neck-shoulder exercises on neck proprioception, pain, and disability in patients with chronic non-specific neck pain. Methods: Twenty-five patients with chronic non-specific neck pain were recruited into this preliminary single-blinded randomized clinical trial. They were randomly assigned to either a specific neck exercise (n = 13, mean aged 24 years) or a general neck exercise group (n = 12, mean aged 25 years). Specific neck exercises included eye-head coordination and isometric deep neck muscle exercises. General neck exercises included neck and shoulder free …

Implementation Of Increased Physical Therapy Intensity For Improving Walking After Stroke: Walk 'N Watch Protocol For A Multisite Stepped-Wedge Cluster-Randomized Controlled Trial, Sue Peters, Shannon B Lim, Mark T Bayley, Krista Best, Louise A Connell, Hélène Corriveau, Sarah J Donkers, Sean P Dukelow, Tara D Klassen, Marie-Hélène Milot, Brodie M Sakakibara, Lisa Sheehy, Hubert Wong, Jennifer Yao, Janice J Eng

Physical Therapy Publications

RATIONALE: Clinical practice guidelines support structured, progressive protocols for improving walking after stroke. Yet, practice is slow to change, evidenced by the little amount of walking activity in stroke rehabilitation units. Our recent study (n = 75) found that a structured, progressive protocol integrated with typical daily physical therapy improved walking and quality-of-life measures over usual care. Research therapists progressed the intensity of exercise by using heart rate and step counters worn by the participants with stroke during therapy. To have the greatest impact, our next step is to undertake an implementation trial to change practice across stroke units where …

Higher Intensity Walking Improves Global Cognition During Inpatient Rehabilitation: A Secondary Analysis Of A Randomized Control Trial, Sue Peters, Keith R Lohse, Tara D Klassen, Teresa Liu-Ambrose, Sean P Dukelow, Mark T Bayley, Michael D Hill, Sepideh Pooyania, Jennifer Yao, Janice J Eng

Physical Therapy Publications

Cognitive deficits are common poststroke. Cognitive rehabilitation is typically used to improve cognitive deficits. It is unknown whether higher doses of exercise to promote motor recovery influence cognitive outcomes. Our recent trial, Determining Optimal Post-Stroke Exercise (DOSE), shows more than double the steps and aerobic minutes can be achieved during inpatient rehabilitation versus usual care, and translates to improved long-term walking outcomes. Thus, the secondary analysis aim was to determine the effect of the DOSE protocol on cognitive outcomes over 1-year poststroke. The DOSE protocol progressively increased step number and aerobic minutes during inpatient stroke rehabilitation over 20 sessions. The …

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 …

Association Of Disease Outcomes With Physical Activity In Multiple Sclerosis: A Cross-Sectional Study, Trinh L T Huynh, Stephanie L Silveira, Brenda Jeng, Robert W Motl

Journal Articles

UNLABELLED: Purpose/Objective Research: This study examined combinations of disease outcomes (i.e., walking, cognition, and symptoms) as correlates of physical activity subgroups (insufficiently active vs. sufficiently active) in persons with multiple sclerosis (MS).

RESEARCH METHOD/DESIGN: This study included 213 participants who completed walking and cognitive function tests and self-report measures of symptoms and physical activity. Multivariate analysis of variance and discriminant function analysis identified combinations of MS outcomes associated with physical activity.

RESULTS: The sample had a mean age of 49.6 years (

CONCLUSION/IMPLICATIONS: The findings identified walking endurance and limitations, processing speed, depression, and fatigue as primary correlates of physical …

The Use Of Mobility And Medication On Patient’S Perception Of Pain In Hospitalized Patients With Chronic Back Pain Benchmark Study, Katherine E. Zaske Merenda Mrs., Katherine Merenda

MSN Capstone Projects

According to Boss & Huether, twenty-nine percent of Americans have been diagnosed with chronic low back pain (CLBP). This pain can affect every part of their lives leading to lost wages and decreased quality of life. CLBP is an issue experienced by many hospitalized patients. These patients may not be able to mitigate their pain as they normally would due to safety protocols in hospital settings. Exercise or mobility has been shown to decrease a person’s perception of pain. The importance of exercise and mobility in a hospital setting to help decrease a patient’s perception of pain needs further research. …

Muscle-Specific Contributions To Lower Extremity Net Joint Moments While Squatting With Different External Loads, Kristof Kipp, Hoon Kim, William I. Wolf

Exercise Science Faculty Research and Publications

The purpose of this study was to determine muscle-specific contributions to lower extremity net joint moments (NJMs) during squats with different external loads. Nine healthy subjects performed sets of the back squat exercise with 0, 25, 50, and 75% of body mass as an added external load. Motion capture and force plate data were used to calculate NJMs and to estimate individual muscle forces via static optimization. Individual muscle forces were multiplied by their respective moment arms to calculate the resulting muscle-specific joint moment. Statistical parametric mapping (α = 0.05) was used to determine load-dependent changes in the time series …

Physical Activity Interventions In Children With Juvenile Idiopathic Arthritis: A Systematic Review Of Randomized Controlled Trials, Maura D. Iversen, Marie Andre, Johan Von Heideken

Physical Therapy Faculty Publications

Introduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.

Materials and methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and …

Perceived Exercise Habits Of Individuals With Parkinson’S Disease Living In The Community, Jordana Lockwich, Kate Schwartzkopf-Phifer, Camille L. Skubik-Peplaski, Richard D. Andreatta, Patrick H. Kitzman

Communication Sciences and Disorders Faculty Publications

Context

Exercise has been shown to improve gait in individuals with Parkinson’s disease (PD). Stepping practice at higher intensity levels has been suggested as a beneficial treatment option to improve gait in the neurological population. Unfortunately, this mode is poorly understood and underutilized within the PD population. Information on what individuals with PD are doing for exercise would be beneficial to help tailor exercise programs to improve gait and provide exercise options in the community for intensity-based exercise.

Objective

To investigate the current exercise habits of individuals living with PD in the community aimed at improving walking and to understand …

Integrating Survivors Of Stroke Into Exercise‐Based Cardiac Rehabilitation Improves Endurance And Functional Strength, Elizabeth Wherley Regan Dpt, Ph.D., Reed Handlery, Jill Campbell Stewart, Joseph Lee Pearson Ms,Drph, Sarah Wilcox Phd, Stacy L. Fritz Phd, Pt

Faculty Publications

Background

Cardiac rehabilitation (CR) is a structured exercise program prevalent in the United States for people with cardiovascular disease that has been shown to increase cardiovascular endurance and improve quality of life. Despite similar cardiovascular risk factors, stroke is not among the covered diagnoses for CR. The purpose of this study was to examine the participant impact of integrating survivors of stroke into the exercise portion of an existing hospital‐based CR program through measures of physical function and other health impacts and through qualitative evaluation of participant perception.

Methods and Results

Subacute and chronic survivors of stroke were integrated into …

The Efficacy Of Resistance Training In Addition To Usual Care For Adults With Acute Burn Injury: A Randomised Controlled Trial, Paul M. Gittings, Benedict M. Wand, Dana A. Hince, Tiffany L. Grisbrook, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

Resistance training immediately after a burn injury has not been investigated previously. This randomised, controlled trial assessed the impact of resistance training on quality of life plus a number of physical, functional and safety outcomes in adults with a burn injury. Patients were randomly assigned to receive, in addition to standard physiotherapy, four weeks of high intensity resistance training (RTG) or sham resistance training (CG) three days per week, commenced within 72h of the burn injury. Outcome data was collected at six weeks, three and six months after burn injury. Quality of life at 6 months was the primary endpoint. …

Identifying Participants With Knee Osteoarthritis Likely To Benefit From Physical Therapy Education And Exercise: A Hypothesis-Generating Study, So Tanaka, Tomohiko Nishigami, Benedict Martin Wand, Tasha R. Stanton, Akira Mibu, Masami Tokunaga, Takaaki Yoshimoto, Takahiro Ushida

Physiotherapy Papers and Journal Articles

Background: The purpose of this investigation was to undertake a hypothesis generating study to identify candidate variables that characterize people with knee osteoarthritis who are most likely to experience a positive response to exercise.

Methods: One hundred and fifty participants with knee osteoarthritis participated in this observational, longitudinal study. All participants received a standard exercise intervention that consisted of 20-min sessions two to three times a week for three months. The classification and regression tree methodology (CART) was used to develop prediction of positive clinical outcome. Positive pain and disability outcomes (dependent variables) were defined as an improvement in pain …

Effects Of Goal Type And Reinforcement Type On Self-Reported Domain-Specific Walking Among Inactive Adults: 2×2 Factorial Randomized Controlled Trial, Mindy L. Mcentee, Alison Cantley, Emily Foreman, Vincent Berardi, Christine B. Phillips, Jane C. Hurley, Melbourne F. Hovell, Steven Hooker, Marc A. Adams

Psychology Faculty Articles and Research

Background: WalkIT Arizona was a 2×2 factorial trial examining the effects of goal type (adaptive versus static) and reinforcement type (immediate versus delayed) to increase moderate to vigorous physical activity (MVPA) among insufficiently active adults. The 12-month intervention combined mobile health (mHealth) technology with behavioral strategies to test scalable population-health approaches to increasing MVPA. Self-reported physical activity provided domain-specific information to help contextualize the intervention effects.

Objective: The aim of this study was to report on the secondary outcomes of self-reported walking for transportation and leisure over the course of the 12-month WalkIT intervention.

Methods: A total of …

Potential Benefits Of Physical Therapy For Individuals With Amyotrophic Lateral Sclerosis, Rebecca Soito

Senior Honors Projects

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects the nerve cells in the brain and spinal cord. ALS is associated with progressive motor deficits and paralysis of the muscles that control limb movement, swallowing, and breathing. As ALS progresses, the muscles responsible for fine and gross motor functions are affected and motor skills decline. Typical life expectancy of people with ALS is 2-5 years after symptom onset. The most common cause of death for individuals with ALS is respiratory failure. There is no current curative treatment for ALS but symptoms can be managed through multidisciplinary care. The …

High Supervised Resistance Training In Elderly Women: The Role Of Supervision Ratio, Denis Cesar Leite Vieira, Dahan Da Cunha Nascimento, Vitor Tajra, Tatiane Gomes Teixeira, Darlan Lopes De Farias, Ramires Tibana, Alessandro Oliveira Silva, Thiago Santos Rosa, Milton Rocha Moraes, Fabrício Azevedo Voltarelli, James W. Navalta, Jonato Prestes

Kinesiology and Nutrition Sciences Faculty Publications

The objective of this study was to compare the effects of very high supervision (VHS-RT) versus high supervision (HS-RT) ratio resistance training (RT) on irisin, brain-derived neurotrophic factor (BNDF), muscle strength, functional capacity, and body composition in elderly women. Participants performed daily undulating periodized RT over 16 weeks with two different supervision ratios: VHS-RT at 1:2 (supervisor/subject) or HS-RT at 1:5. Serum was used to analyze brain derived neurotropic factor (BDNF) and irisin by enzyme-linked immunosorbent assay (ELISA). Body composition was evaluated by dual-energy X-ray absorptiometry, while functional capacity was evaluated using the Six-minute walk test, and Timed Up and …

The Impact Of Exercise In Spaceflight And Microgravity Environments, William Bybee

Mahurin Honors College Capstone Experience/Thesis Projects

Since mankind’s first spaceflight, a significant barricade in reaching distant planets has been the damaging effects of microgravity upon the human body. Effects range from loss in bone mineral density and severe muscle atrophy to autoimmune disorders. The most effective countermeasure of these effects to date is exercise. Implementation of exercise in microgravity is not an easy task, so various specialized equipment must be utilized to effectively administer it. Even with this equipment, exercise as it is currently used does not entirely prevent body systems from undergoing detrimental changes. New modalities and implementations are currently being investigated that may significantly …

Blood Flow Restriction Training For The Rotator Cuff: A Randomized Controlled Trial, Jason Brumitt, Marcey Keefer Hutchison, Daniel Kang, Zach Klemmer, Mike Stroud, Edward Cheng, Neil Patrick Cayanan, Sheldon Shishido

Faculty Publications - College of Physical Therapy

Context: Blood flow restriction (BFR) training utilizes a tourniquet, applied to the proximal portion of one or more extremities, to occlude blood flow during exercise. Significant gains in strength and cross-sectional area can be achieved in muscles, both distal and proximal to BFR cuff application. Purpose: To compare strength gains of the rotator cuff and changes in tendon size in subjects who performed side-lying external-rotation exercise with or without BFR. Methods: Forty-six subjects (mean age 25.0 [2.2] y) were randomized to either a BFR + exercise group or to the exercise-only group. Subjects performed 4 sets of the exercise (30/15/15/15 …

Blood Flow Restriction Exercise: A Systematic Review Of The Literature, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Blood flow restriction training is quickly gaining popularity in the United States. However, it is not without controversy. While there are many reported health benefits, there are equally as many risks. Most concerning is the lack of industry standardizations regarding cuff size and pressure. There is no required training to implement blood flow restriction training, which can be problematic when people with little knowledge practice this type of exercise. When blood flow is restricted, there is an impact on the cardiovascular system, nervous system, and muscular system. Damage can be done when blood flow is restricted with too much pressure …

Response Shift After A 4-Week Multimodal Intervention For Chronic Ankle Instability, Cameron J. Powden, Matthew C. Hoch, Beth E. Jamali, Johanna M. Hoch

Rehabilitation Sciences Faculty Publications

Context The accurate evaluation of self-reported changes in function throughout the rehabilitation process is important for determining patient progression. Currently, how a response shift (RS) may affect the accuracy of self-reported functional assessment in a population with chronic ankle instability (CAI) is unknown.

Objective To examine the RS in individuals with CAI after a 4-week multimodal rehabilitation program.

Design Controlled laboratory study.

Setting Laboratory.

Patients or Other Participants Twenty adults (5 men, 15 women; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at …

A 6-Week Hip Muscle Strengthening And Lumbopelvic-Hip Core Stabilization Program To Improve Pain, Function, And Quality Of Life In Persons With Patellofemoral Osteoarthritis: A Feasibility Pilot Study., Lisa T. Hoglund, Laura Pontiggia, John D. Kelly

Department of Physical Therapy Faculty Papers

Background: Patellofemoral joint (PFJ) osteoarthritis (OA) is prevalent in middle-aged and older adults. Despite this, there are minimal studies which have examined conservative interventions for PFJ OA. Weakness of proximal lower extremity muscles is associated with PFJ OA. It is unknown if a hip muscle strengthening and lumbopelvic-hip core stabilization program will improve symptoms and function in persons with PFJ OA. This study examined the feasibility and impact of a 6-week hip muscle strengthening and core stabilization program on pain, symptoms, physical performance, peak muscle torques, and quality of life in persons with PFJ OA.

Methods: Ten females with PFJ …

Systemic Exercise-Induced Hypoalgesia Following Isometric Exercise Reduces Conditioned Pain Modulation, Ali Alsouhibani, Henrik Bjarke Vaegter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Objective

Physically active individuals show greater conditioned pain modulation (CPM) compared with less active individuals. Understanding the effects of acute exercise on CPM may allow for a more targeted use of exercise in the management of pain. This study investigated the effects of acute isometric exercise on CPM. In addition, the between-session and within-session reliability of CPM was investigated.

Design

Experimental, randomized crossover study.

Setting

Laboratory at Marquette University.

Subjects

Thirty healthy adults (19.3±1.5 years, 15 males).

Methods

Subjects underwent CPM testing before and after isometric exercise (knee extension, 30% maximum voluntary contraction for three minutes) and quiet rest in …

Feasibility And Preliminary Outcomes Of A Standardized Exercise Program In Adults With Down Syndrome: A Pilot Study, Megan Flores, Kristen Barta, Martha Sneary, Germaine Ferreira, Elizabeth Ardolino

Physical Therapy Collection

Purpose/ Hypothesis: Youth with Down Syndrome (DS) have limited participation in physical activity. When compared to their typically developing peers, adults with DS display decreased functional mobility and strength. Exercise has shown to improve the physical fitness, overall health, and quality of life in people with DS. The Lee Silverman Voice Treatment (LSVT® BIG) is an effective treatment approach designed for patients with Parkinson’s disease. The core components of LSVT® BIG include large amplitude movements, sensory calibration, high intensity, and maximum effort while performing the daily exercises. Due to hypotonicity associated with DS, these individuals typically display kyphotic posture, shortened …

Can Foot Exercises And Going Barefoot Improve Function, Muscle Size, Foot Pressure During Walking And Qualitative Reports Of Function In People With Flat Foot?, Marcey Keefer Hutchison, Robin Dorociak, Alison Modafferi, Shanna Howland, Angela Foster, Jean Jarbath, Brenden Thompson, Tyler Whited, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Specific exercises to train foot muscles for barefoot running (i.e. doming seated[DS] and standing[DSt]) and post foot and ankle injury (i.e. seated plantar flexion and inversion[SPFI]) are common. Exercise programs specifically for the foot claim improvement in foot posture (foot posture index [FPI]) and foot strength. However, rigorous assessment of foot function as a result of exercise is lacking (i.e. foot posture, strength, and plantar pressure). Further, no studies specifically address patients with flat foot. The purpose of this case series study was to assess the immediate effects of an 8-week foot exercise and barefoot weight bearing program on …

Overwhelming Research And Clinical Evidence Of Exercise Medicine Efficacy In Cancer Management—Translation Into Practice Is The Challenge Before Us, Robert Newton

Research outputs 2014 to 2021

The paper “Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement”1 is very timely. As the authors have convincingly demonstrated, rigorous clinical and research evidence support something of which most medical and allied health professionals are cognizant: the benefit of physical activity and exercise for people with cancer.

What Maximum Ankle Torque Is Appropriate For Training Patients With Non-Insertional Achilles Tendinopathy?, Tyler Cuddeford, Jeff Houck, Derek Palmer, Jason Beilstein, Jordan Visser

Faculty Publications - College of Physical Therapy

Background and Purpose: The capacity of the Achilles tendon during a 1-repetition eccentric maximum contraction is largely unknown. This study examined the maximum ankle torque during a concentric/ eccentric heel raise/lowering task and while running in healthy individuals and participants with chronic Achilles tendinopathy. These findings were applied to a 10-week training program for a patient with chronic Achilles tendinopathy.

Methods: A total of 13 subjects (9 healthy and 4 with Achilles tendinopathy) participated in this study. Subjects were asked to perform a maximum eccentric contraction wearing a weighted vest while collecting 3-dimensional biomechanical variables. Subjects also ran along an …

Can Foot Exercises Alter Foot Posture, Strength, And Walking Foot Pressure Patterns In People With Severe Flat Foot?, Jeff Houck, Lacey Seidl, Austin Montgomery, Joshua Keefer, Miranda Walker

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Muscle training muscle control for barefoot running (i.e. doming seated[DS] and standing[DSt]) and post foot and ankle injury (i.e. seated plantar flexion and inversion[SPFI]) are common. Although studies demonstrated improvement in foot posture (validated foot posture index [FPI]) immediately following a 4-week exercise program this was not assessed in people with flatfoot. Also, more rigorous assessment of foot function is lacking (i.e. foot posture, strength, and plantar pressure during walking). There is clearly a need for more rigorous clinical data on the effect of foot exercises. The purpose of this pilot study was to assess the immediate effect of …

Manual Therapy And Exercise In Treatment Of Patients With Cervical Radiculopathy: A Protocol For A Case Series, Andrew E. Didricksen Spt, Justin Y. Higa Spt, Daniel T. Kobayashi Spt, Robert Boyles

Physical Therapy Research Symposium

Study Design: Manual therapy and exercise in the treatment of patients with cervical radiculopathy: A protocol for a case series.

Background: Cervical radiculopathy (CR) most commonly originates from space occupying lesions, resulting in upper extremity radicular pain. Numerous physical therapy interventions are available for treating CR symptoms, however present practice patterns incorporate the application of a combination of interventions with inconclusive or mixed results. Clinical practice guidelines advocate for the utilization of thoracic manipulation to treat CR.

Objectives: It is hypothesized that the use of specific manual therapy techniques combined with exercise will have a positive effect on CR as …

E For Everyone: Strategic Plan, Lindsay Calcaterra, Kaela Fischer, Kelley Flahaven, Megan Witherow Quarles, Maria Stern, Christina Tilton

Physical Therapy Administration

‘E for Everyone’ is an innovative and unique inclusion program that equalizes the playing field among all people with and without disabilities by creating opportunities to build synergistic relationships through teamwork, fun, and physical activity. Created during the Fall 2016 semester of the course Physical Therapy Administration, this strategic plan summarizes the program.

Effects Of Laryngeal Restriction On Pharyngeal Peristalsis And Biomechanics: Clinical Implications, Rita Shaker, Patrick Sanvanson, Gokulakrishnan Balasubramanian, Mark Kern, Ashley Wuerl, Allison Hyngstrom

Physical Therapy Faculty Research and Publications

To date, rehabilitative exercises aimed at strengthening the pharyngeal muscles have not been developed due to the inability to successfully overload and fatigue these muscles during their contraction, a necessary requirement for strength training. The purpose of this study was to test the hypothesis that applying resistance against anterosuperior movement of the hyolaryngeal complex will overload the pharyngeal muscles and by repetitive swallowing will result in their fatigue manifested by a reduction in pharyngeal peristaltic amplitude. Studies were done in two groups. In group 1 studies 15 healthy subjects (age: 42 ± 14 yr, 11 females) were studied to determine …