Medicine and Health Sciences Commons^™

Students' Attitudes, Beliefs And Perceptions Surrounding 2slgbtqia + Health Education And Inclusiveness In Canadian Physiotherapy Programs, Codie A Primeau, Holly T Philpott, Kyle Vader, Janelle Unger, Christina Y Le, Trevor B Birmingham, Joy C Macdermid

Physical Therapy Publications

BACKGROUND: Patients who identify as 2SLGBTQIA + report negative experiences with physiotherapy. The objectives were to evaluate student attitudes, beliefs and perceptions related to 2SLGBTQIA + health education and working with individuals who identify as 2SLGBTQIA + in entry-level physiotherapy programs in Canada and to evaluate physiotherapy program inclusiveness towards 2SLGBTQIA + persons.

METHODS: We completed a nationwide, cross-sectional survey of physiotherapy students from Canadian institutions. We recruited students via email and social media from August-December 2021. Frequency results are presented with percentages. Logistic regression models (odds ratios [OR], 95%CI) were used to evaluate associations between demographics and training hours …

Knowledge, Behaviours, And Training Related To 2slgbtqia+ Health Education Amongst Entry-Level Physiotherapy Students In Canada: Results Of A Nationwide, Cross-Sectional Survey, Codie A Primeau, Holly T Philpott, Kyle Vader, Janelle Unger, Christina Y Le, Trevor B Birmingham, Joy C Macdermid

Physical Therapy Publications

BACKGROUND: Individuals who identify as 2SLGBTQIA+ report worse health outcomes than heterosexual/cisgender counterparts, in part due to poor experiences with healthcare professionals. This may stem from inadequate 2SLGBTQIA+ health and inclusiveness training in health professional student education. The purpose of the study was to evaluate knowledge, behaviours, and training related to 2SLGBTQIA+ health education and inclusiveness for entry-level physiotherapy students in Canada.

METHODS: We conducted a nationwide, cross-sectional survey with physiotherapy students from accredited Canadian physiotherapy programs. We administered the survey through Qualtrics and recruited students through targeted recruitment emails and social media posts on Twitter and Instagram between August …

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 …

Survey Of Confidence And Knowledge To Manage Patellofemoral Pain In Readers Versus Nonreaders Of The Physical Therapy Clinical Practice Guideline, Richard W. Willy, Lisa T. Hoglund, Neal R. Glaviano, Lori A. Bolgla, David M. Bazett-Jones

Department of Physical Therapy Faculty Papers

Objectives: To compare beliefs of physical therapists (PTs) who read the clinical practice guideline (CPG) for the management of individuals with patellofemoral pain (PFP) to those who have not read the CPG.

Design: Cross-sectional study.

Setting: Online survey.

Participants: 494 currently licensed/registered PTs or physiotherapists.

Main Outcome Measures: Respondents answered Likert-based or open-ended questions regarding the diagnosis, prognosis, risk factors, and management of individuals with PFP, as well as confidence for managing individuals with PFP, especially the ability to identify beneficial and non-beneficial interventions. We dichotomized responses into participants who read (READERS) and did not read (NonREADERS) the CPG.

Results: …

Functional Reach Test, Single-Leg Stance Test, And Tinetti Performance-Oriented Mobility Assessment For The Prediction Of Falls In Older Adults: A Systematic Review, Humberto Omaña, Kari Bezaire, Kyla Brady, Jayme Davies, Nancy Louwagie, Sean Power, Sydney Santin, Susan W. Hunter

Physical Therapy Publications

OBJECTIVE: The authors sought to systematically review the existing literature on the falls-related diagnostic test properties of the Functional Reach Test (FRT), single-leg stance test (SLST), and Tinetti Performance-Oriented Mobility Assessment (POMA) in older adults across settings and patient populations.

METHODS: The PubMed, EMBASE, and CINAHL databases were searched (inception-July 2020). Inclusion criteria were participants aged 60 years or more, prospectively recorded falls, and the reporting of falls-related predictive validity. Manuscripts not published in English were excluded. Methodological quality of reporting was assessed using the Tooth Scale.

RESULTS: Of 1071 studies reviewed, 21 met the inclusion criteria (12 POMA, 8 …

Front-Loading Of Anatomy Content Has No Effect On Long-Term Anatomy Knowledge Retention Among Physical Therapy Students: A Prospective Cohort Study., Amy H. Amabile, Kim Nixon-Cave, Larry J. Georgetti, Ashley C. Sims

Department of Physical Therapy Faculty Papers

BACKGROUND: Information learned over a longer period of time has been shown to result in better long-term knowledge retention than information learned over a shorter period of time. In order to address multiple curricular goals, the timing and spacing of anatomy content within the Doctor of Physical Therapy (DPT) program at our institution recently changed from a very spaced to a very compressed format. The purpose of the present study was to assess differences in anatomy knowledge retention that might have been impacted by this change. The research hypothesis was that students receiving spaced instruction would have significantly better anatomy …

Development, Reliability And Validity Of The Safe Use Of Mobility Aids Checklist (Sumac) For 4-Wheeled Walker Use In People Living With Dementia., Susan W. Hunter, Alison Divine, Humberto Omana, Ed Madou, Jeffrey Holmes

Physical Therapy Publications

BACKGROUND: Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change.

METHODS: Healthcare professionals (HCP) experienced in rehabilitation of …

The Experiences Of Physical Rehabilitation In Individuals With Spinal Cord Injuries: A Qualitative Thematic Synthesis., Janelle Unger, Hardeep Singh, Avril Mansfield, Sander L Hitzig, Erica Lenton, Kristin E Musselman

Physical Therapy Publications

PURPOSE: The purpose of this thematic synthesis review was to identify and synthesise published qualitative research on the perspectives of individuals with spinal cord injuries with respect to physical rehabilitation interventions.

MATERIALS AND METHODS: The peer-reviewed literature was searched across seven databases and identified abstracts were independently screened by two reviewers. A thematic synthesis methodology was used to code and synthesise the results from the included studies.

RESULTS: In total, 7233 abstracts were identified; 31 articles were selected for inclusion, representing 26 physical rehabilitation interventions. The methodological quality of studies was moderate (Standards for Reporting Qualitative Research mean ± standard …

Hip And Trunk Muscle Activity During The Star Excursion Balance Test In Healthy Adults, Kunal Bhanot, Navpreet Kaur, Lori Thein Brody, Jennifer Bridges, David C. Berry, Joshua J. Ode

Physical Therapy Collection

CONTEXT: Dynamic balance is a measure of core stability. Deficits in the dynamic balance have been related to injuries in the athletic populations. The Star Excursion Balance Test (SEBT) is suggested to measure and improve dynamic balance when used as a rehabilitative tool.

OBJECTIVE: To determine the electromyographic activity of the hip and the trunk muscles during the SEBT.

DESIGN: Descriptive.

SETTING: University campus.

PARTICIPANTS: Twenty-two healthy adults (11 males and 11 females; 23.3 [3.8] y, 170.3 [7.6] cm, 67.8 [10.3] kg, and 15.1% [5.0%] body fat).

INTERVENTION: Surface electromyographic data were collected on …

Cognition Predicts Mobility Change In Lower Extremity Amputees Between Discharge From Rehabilitation And 4-Month Follow-Up: A Prospective Cohort Study., Susan W. Hunter, Pavlos Bobos, Courtney Frengopoulos, Austin Macpherson, Ricardo Viana, Michael W Payne

Physical Therapy Publications

OBJECTIVES: To assess (1) the effect of task (single and dual task), time (discharge and 4mo), and their interaction for mobility; (2) task prioritization during dual-task testing; and (3) the association between cognition on change in mobility between discharge from rehabilitation and 4 months' follow-up.

DESIGN: Prospective cohort study.

SETTING: Rehabilitation hospital.

PARTICIPANTS: People with lower extremity amputations (N=22) were consecutively recruited at discharge from an inpatient prosthetic rehabilitation program.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Gait velocity and the L Test of Functional Mobility, single and dual task (serial subtractions by 3), were the primary outcomes. Montreal Cognitive Assessment …

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 …

The Use Of Neuromuscular Electrical Simulation In Glenohumeral Unidirectional Instability When An Exercise-Based Approach Has Failed: A Case Study, Kunal Bhanot, Navpreet Kaur, J Butler

Physical Therapy Collection

Purpose of this case study was to report the role of neuromuscular electrical stimulation (NMES) to restore strength and normal motion in a patient with unidirectional shoulder instability or glenohumeral internal rotation deficit (GIRD).

A Collaborative Approach To Decision Making Through Developmental Monitoring To Provide Individualized Services For Children With Cerebral Palsy., Doreen J Bartlett, Sarah W Mccoy, Lisa A Chiarello, Lisa Avery, Barbara Galuppi, On Track Study Team

Physical Therapy Publications

In this Perspective, we suggest a process to improve physical and occupational therapists’ and families’ collaboration to provide appropriate, efficient, and effective evidence-based services to improve motor function, self-care performance, and participation in family and recreation activities for children with cerebral palsy (CP). This process is informed by 2 multisite prospective cohort studies (Move & PLAY and On Track). The heterogeneity of children with CP is described, limiting the utility of evidence from randomized controlled trials and systematic reviews to inform service planning for children with CP. An evidence-based alternative using prospective cohort studies that produce knowledge of determinants of …

The High-Level Mobility Assessment Tool (Himat) In Myotonic Dystrophy Type 2: A Case Report, Kim B. Smith, Evan M. Pucillo

Physical Therapy Collection

Myotonic dystrophy type 2 (DM2) is a progressive muscular dystrophy with multi-system manifestations and can affect functional mobility, gait, and balance. Currently, there are few reports of functional outcome measures in this population. This case describes the change in function detected by the High-level Mobility Assessment Tool (HiMAT) and 30-second Chair Stand Test (CST) in a high-functioning adult female with DM2 after physical therapy treatment. The patient’s chief complaint was muscular pain and fatigue that affected activities of daily living (ADLs). Multimodal physical therapy focused on neuromuscular re-education, balance and strength training, patient education, and moderate cardiorespiratory training. Improvements were …

Shared Decision-Making As Experienced By Rehabilitation Students On An International Service-Learning Trip: A Phenomenological Investigation, Mary Zadnik, Suzanne Trotter, Thomas Werner

Occupational Therapy Collection

The value of service-learning has been well documented in medical and allied health education (Abedini, Gruppen, Kolars, & Kumagai, 2012; Ekelman, Dal Bello-Haas, Bazyk, & Bazyk, 2003; Pechak, Gonzalez, Summers, & Capshaw, 2013; Pechak & Thompson, 2009; Ryan-Krause, 2016). Several studies have been conducted looking at cultural experiences and clinical reasoning (Corbett & Fickert, 2009; Sheppard & Landry, 2015; Nouvet, Chan & Schwartz, 2016). What has not been well-examined though is the concept of shared decision-making by those engaged in service-learning. The purpose of this phenomenological investigation (i.e. study) was to identify how occupational therapy (OT) and physical therapy (PT) …

Manual Physical Therapy And Cervical Joint Position Training For Cervicogenic Dizziness Following Whiplash-Associated Disorder: A Case Report, Melanie Friedman, Kayla Smith

Physical Therapy Collection

Background and Purpose Whiplash is defined as an acceleration-deceleration injury to the neck, which may lead to a variety of immediate and/or prolonged symptoms collectively known as whiplash-associated disorder (WAD). Cervicogenic dizziness is one possible sequalae that may arise from dysfunction within the structures of the cervical spine, disrupting the flow of sensory and proprioceptive feedback. The purpose of this case report is to demonstrate the efficacy of combining manual physical therapy and cervical joint position training on a patient with cervicogenic dizziness status-post motor vehicle accident (MVA).

Case Description A 28-year-old female with a history of MVA and chief …

The Impact Of Body-Weight Supported Locomotor Training In A Toddler With Gmfcs Level V Cerebral Palsy: A Case Study, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

BACKGROUND AND PURPOSE: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) level 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 locomotor training (BWSLT) 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 study was to explore the impact of a 6-week BWSLT intervention on postural control, gross motor function, and quality of life in a young child with cerebral palsy in GMFCS level …

Disability And Physical Therapy Services In Rural Nicaragua: A Pilot Study, Evan M. Pucillo, Edward C. O'Bryan

Physical Therapy Collection

The World Health Organization (WHO) estimates that 15% of the world’s population is living with disability, a large majority of which can be found in developing nations. Previous studies in Nicaragua have investigated the perceptions of disability among caregivers and noted limited access to rehabilitative services. However, the general knowledge and perceptions of physical therapy services in Nicaragua remains unclear. As a result, this pilot study sought to explore the local knowledge and perceptions of disability and physical therapy services and to characterize the sample from a remote area of northwestern Nicaragua. Participants were recruited using convenience sampling during multidisciplinary …

Blood Flow Restriction Training For Chronic Quadriceps Weakness And Atrophy: A Case Report, Tobi Baldwin, Fred Baldwin

Physical Therapy Collection

Background and purpose

The high load and intensity of traditional strength training may not always be appropriate or beneficial for certain patient populations such as the elderly or those with orthopedic injuries. In these cases blood flow restriction training with light resistance has been shown to be effective method of increasing strength and hypertrophy. However, what if traditional strength training is tolerated but not effective for an individual? The purpose of this case report is to describe the use of blood flow restriction training in a recreationally active male who was fully functional but continued with chronic unilateral quadriceps weakness …

Effect Of Stable And Unstable Surfaces On The Serratus Anterior Muscle Activation In A Kinetic-Chain Exercise Among Healthy Adults, Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

PURPOSE/HYPOTHESIS: The stabilizing action of the serratus anterior (SA) muscle is vital in maintaining proper scapulothoracic rhythm.^1,2 Poor activation of SA muscle could lead to many shoulder dysfunctions.^1,3 This warrants for exercises that are best to activate the SA muscle. Kinetic-chain recruitment during exercises has demonstrated increased SA activation due to the myofascial connections between various segments of the body.^4–6 Variation of surfaces during an exercise has been shown to alter the muscle recruitment patterns.^7–9 The primary purpose of this study was to determine if the unstable surface can influence SA muscle activity during the kinetic …

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 …

Interrelationships Of Functional Status And Health Conditions In Children With Cerebral Palsy: A Descriptive Study., Doreen Bartlett, Emily Dyszuk, Barbara Galuppi, Jan Willem Gorter

Physical Therapy Publications

PURPOSE: To examine the relationship among the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS) in children with cerebral palsy (CP) and to determine the average number and effect of health conditions.

METHODS: Participants were 671 children with CP aged 2 to 12 years from Canada and the United States. Cross-tabulation of functional classifications and averages were computed for the number and impact of health conditions and comparisons among groups.

RESULTS: A total of 78 of the 125 possible classification combinations were recorded. Most frequent were GMFCS I, MACS …

Gross Motor Outcomes After Dynamic Weight-Bearing In 2 Children With Trunk Hypotonia: A Case Series, Elizabeth Ardolino, Megan Flores, Kathleen Manella

Physical Therapy Collection

NTRODUCTION:

Children with trunk hypotonia may have limited ability to maintain an upright weight-bearing position, resulting in decreased postural control and a delay in achieving gross motor milestones.

PURPOSE:

The purpose of this case series is to report the effect of a home-based dynamic standing program on postural control and gross motor activity in 2 children with trunk hypotonia.

DESCRIPTIONS:

Child 1 (aged 24 months, Gross Motor Function Classification Scale Level IV) and Child 2 (aged 21 months, Gross Motor Function Classification Scale Level V) participated in a standing program using the Upsee harness at home 3 days per week …

The Effects Of Spinal Mobilizations, Manual Stretching, And Exercises In The Treatment Of Testicular Pain: A Case Report, Kunal Bhanot, Navpreet Kaur, R Chambers

Physical Therapy Collection

The purpose of this case report was to describe the PT management in relieving testicular pain related to genitofemoral nerve entrapment.

Three Faces Of Fragile X Syndrome, Cornelia Lieb-Lundell

Physical Therapy Collection

Fragile X Syndrome (FXS) is well known and widely recognized in pediatrics. Less well known is that FXS, as an X-linked disorder of the FMR1 gene, is but one of three impairments that all have a common single-gene genetic basis. These three are labeled Fragile X-associated Disorders (FXD) and are, in turn, a part of a large group of impairments which have a collective name of trinucleotide repeat expansion disorders. Common to all three FXD disorders is that the x-gene carries a characteristic CGG expansion (of the DNA) that can range from 50-+200 (5-45 is normal) with premutation carriers having …

Upsee Daisy! Gross Motor Outcomes After Dynamic Weight Bearing In Two Children With Truncal Hypotonia: A Case Series, Megan Flores, Kathleen Manella, Elizabeth Ardolino

Physical Therapy Collection

PURPOSE: The purpose of this case series was to report the impact of a home-based dynamic standing program on postural control and gross motor activity in two children with truncal hypotonia.

BACKGROUNDS/SIGNIFICANCE: Poor postural control associated with central hypotonia limits a child’s ability to interact with the environment, delaying attainment of developmental milestones such as sitting, crawling, standing and walking. Participation in social interactions with peers and caregivers may be restricted resulting in a decreased quality of life. Supported standing programs are commonly used to ameliorate impairments and optimize function in children with poor postural control. Increased social interactions, …

The Effects Of Closed Kinetic Chain And Endurance Exercises On Reducing Pain In A Child With Ehlers-Danlos Syndrome: A Case Report, Linda Duong, Megan Flores

Physical Therapy Collection

Background and Purpose: Ehlers-Danlos syndrome (EDS) is a connective tissue disorder characterized by joint laxity, chronic pain, and joint instability. Often, children with EDS exhibit polyarthralgia and fatigue as their main symptoms. Although physical therapy is a mainstay of treatment for individuals with EDS, evidence is lacking for specific exercises or treatment strategies for management of pain. The purpose of this case report is to describe the effectiveness of closed kinetic chain and endurance exercises on reducing pain in a child with EDS.

Case Description: The child was a 9 year old girl diagnosed with EDS hypermobility type, and …

Effects Of Manual Therapy And Dry Needling Techniques For Managing Hypertonicity In The Male Pelvic Floor: A Case Report, Amy Jane Porter, Suzanne Trotter, Kristen Barta

Physical Therapy Collection

Background: Dry needling is beneficial for decreasing hypertonicity and improving musculoskeletal dysfunction within various tissues of the body. There is limited research using dry needling for pelvic floor hypertonicity. The purpose of this case report is to describe the effectiveness of a multi-modal intervention utilizing dry needling for a 27-year-old male with a hypertonic pelvic floor.

Study Design: Case study with review of literature.

Case Description: This patient was a 27-year-old Caucasian male with a diagnosis of chronic prostatitis/epididymitis. His primary complaint was pain with prolonged sitting in the right testicle. Treatment consisted of dry needling trigger points, myofascial release, …

Rehabilitation After Glenohumeral Microfracture And Type Ii Slap Repair Surgery: A Case Report, Judson Williams, Eric Chaconas

Physical Therapy Collection

Background and Purpose: There are few rehabilitation protocols for patients who have undergone glenohumeral microfracture procedure. The purpose of this paper is to present a patient case after both glenohumeral microfracture and Type II SLAP repair procedures and present a rehabilitation protocol.

Methods: The patient in this case is a 41-year-old male who had a sudden onset of pain, mechanical catching, and audible popping in his right shoulder, particularly with athletic activities. This patient was seen for 27 treatments and progressed per the presented protocol.

Findings: The overall improvement when combining the sections of the Quick- DASH was 72.96%, the …

Same-Day Physical Therapy Consults In An Outpatient Neuromuscular Disease Physician Clinic, Evan M. Pucillo, Nancy Christensen-Mayer, Shelly D. Poole, Denise M. Whitten, Danielle Freeman, Blake R. Bohe, Brandon R. Swensen, A Gordon Smith, Nicholas E. Johnson

Physical Therapy Collection

Background: Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT) consults within a daily outpatient neuromuscular disease (NMD) physician clinic.

Objective: To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center.

Design: A qualitative assessment and survey of patient satisfaction.

Methods: An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was …