Medicine and Health Sciences Commons^™

Hip Muscle Function In Individuals With Chronic Ankle Instability, Lindsay Carroll

Electronic Theses and Dissertations

Purpose: Hip muscle function has been reported to be altered in individuals with chronic ankle instability (CAI). The purpose of this study was (1) to determine whether the single leg squat test (SLST) could be used to detect differences in proximal muscle activation between individuals with and without CAI and (2) to determine if there was a difference in maximum isometric body weight normalized torque output of the hip lateral rotators, extensors, and abductors between individuals with and without CAI.

Subjects: Forty-eight subjects (14 males, 34 females; median age = 22.00 years, interquartile range (IQR) = 1.00; median height = …

Consideration Of Executive Functioning For Physiotherapy Rehabilitation: Studies Of Physiotherapists’ Knowledge, Normative Data, And A Practice Application, Nicole A. Guitar

Electronic Thesis and Dissertation Repository

Executive functioning (EF) refers to cognitive abilities involved in decision-making and self-regulation and can be impaired in many patients referred for physiotherapy, including older adults and people living with chronic pain. This dissertation aimed to determine what physiotherapists understood about EF, to summarize normative data for application in physiotherapy practice, and to provide an assessment of feasibility for studying EF impairments in people living with chronic pain. Study one surveyed what physiotherapists understood about EF as a concept, what EF assessments they used, and if this was influenced by their primary area of practice. Respondents (N = 262) subjectively reported …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Safe Patient Handling, Aubrey Graves

Honors College Theses

Introduction: Nursing is a high-risk occupation for musculoskeletal injuries due to the strenuous activity of patient handling. These tasks include, assisting a patient in bed, moving a patient from the bed to a wheelchair, and assisting with walking. These work-related tasks can create a large amount of stress on the body, especially the back if proper technique is not utilized and/or if excessive loads are applied. The purpose of this study is to examine if teaching proper body mechanics and the dangers of not performing the tasks properly is an effective way of reducing musculoskeletal injuries.

Methods: The NUR 202 …

Effects On Adherence And Comprehension With Video Demonstration Support Versus Traditional Home Exercise Programs: Culminating Project, Emily E. Morales

Department of Occupational Therapy Entry-Level Capstone Projects

This culminating project examines the need for video-supported home exercise programs (HEP) in outpatient hand therapy clinics in South Jersey by developing a YouTube channel. This YouTube channel will consist of HEPs for common upper extremity diagnoses including proper demonstration of each exercise and clear concise written instructions within a playlist correlating to diagnosis. Advance clinical skill in hand therapy is the main goal for this capstone project. An analysis was completed evaluating adherence and comprehension when clients are prescribed traditional HEP to HEP supported by a video demonstration. The ultimate goal of this project was to establish an easily …

Lower Extremity Power And Movement Velocity In Competitive Older Athletes, Becca D. Jordre

Dissertations and Theses

Older adults are a rapidly growing population which house a subset of older athletes who regularly engage in sport competition. The physical health and risk factors of this competitive older athlete population have been largely overlooked by healthcare providers and researchers and are poorly understood. Older athletes exhibit distinctly different measures of physical performance which require unique thresholds to identify health-related risk factors. While lower extremity power and movement velocity have been identified as valuable measures of physical performance and fall risk in community-dwelling older adults this relationship has not been explored in competitive older athletes. One method for analyzing …

Central Sensitization, Muscle Function, And Knee Kinematics In Females With Patellofemoral Pain, Kemery Jean Sigmund

Theses and Dissertations

Context: Females with patellofemoral pain (PFP) are at higher risk, have higher rates, and experience worse long-term outcomes than males. Structural and functional changes have been observed in pain networks and neuromuscular systems in individuals with PFP. Central sensitization describes dysfunctional pain modulation which could lead to altered neuromuscular control. Evidence examining relationships between central sensitization and muscle function in PFP is lacking.

Objective: The purpose of this study is to determine whether females with PFP exhibit signs of central sensitization compared to pain-free females. Then, after grouping each individual based on her quantitative sensory test results into a centrally …

Femoroacetabular Impingement Syndrome: Evaluating Postoperative Rehabilitation Progress And Return To Sport Readiness, Trevor A. Day

Electronic Thesis and Dissertation Repository

Femoroacetabular impingement syndrome (FAIS) is a common cause of non-arthritic hip pain and reduced physical activity in active young adults. It is defined as a motion-related disorder of the hip with a triad of symptoms, clinical signs, and imaging findings that represents symptomatic premature contact between the proximal femur and the acetabulum. There are two anatomical morphologies that can cause FAIS, cam, and pincer, and is a challenging clinical pathology. Patients typically undergo hip arthroscopy to repair damage to the joint and recess the bone causing the impingement. These procedures can result in positive outcomes for the patient, like reduced …

Physical Therapy/Occupational Therapy And Applied Behavior Analysis Forming An Interdisciplinary Bridge For Positive Patient Outcomes, Rachel Ann Vaughn

Honors College Theses

Physical therapy, Occupational therapy, and Applied Behavior Analysis work within the pediatric population and are used to help children reach milestones throughout their development. This survey is meant to assess the amount of interdisciplinary collaboration that is occurring within these disciplines. The research team believes that this interdisciplinary collaboration could be beneficial to the pediatric population, but understands that this survey is a baseline and needs further research. Through a survey, there were 29 total participants, 22 PT/OT and 7 ABA therapists. The survey showed evidence of ABA techniques being used within PT and OT sessions for betterment of the …

Visuomotor Adaptation During Asymmetric Walking, Charles Napoli

Masters Theses

Necessary for effective ambulation, head stability affords optimal conditions for the perception of visual information during dynamic tasks. This maintenance of head-in-space equilibrium is achieved, in part, by the attenuation of the high frequency impact shock resulting from ground contact. While a great deal of experimentation has been done on the matter during steady state locomotion, little is known about how head stability or dynamic visual acuity is maintained during asymmetric walking.

In this study, fifteen participants were instructed to walk on a split-belt treadmill for ten minutes while verbally reporting the orientation of a randomized Landolt-C optotype that was …

Physical Therapy And Occupational Therapy Well-Being, Jenna Pilkington, Dara Musher-Eizenman, Cindi Baum, Elizabeth Emley

Honors Projects

There is a lack of research in the professions of physical therapy and occupational therapy. To be more specific, the areas of stress and burnout have been topics of research within the healthcare field for medical physicians and nurses, but currently there is little research looking at stress and burnout for physical therapists and occupational therapists. (Anderson 2015; Berry 2019). The current study aims to look at the emotional connections between patients and professions, along with the related emotional stress experienced by these professionals. A survey was administered to 59 physical therapists and occupational therapists for the purpose to give …

The Impact Of Intraneural Facilitation Therapy On Diabetic Peripheral Neuropathy, Kyan Zhra-Sahba Alnajafi

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Intraneural facilitation (INF) has shown clinical success, and significant improvements have been found in a recent pilot study. This study aims to investigate further these effects on DMT2 subjects suffering from DPN. Objective: The purpose of this study is to explore the effects of INF on subjects suffering from DPN impacting blood flow, sensation, balance, gait, pain, and quality of life.

Methods: Twenty-eight subjects between 50-75 years old with T2DM and below ankle moderate-severe DPN, were randomly assigned into two groups (N=17 INF, N=11 sham). All blinded subjects went through 9 therapy visits, and blinded assessing …

Chronic Pain Following Musculoskeletal Injuries: Where Do Familial Factors, Depression, And Distress Fit In?, Shirin Modarresi

Electronic Thesis and Dissertation Repository

Background: Currently, there is a paucity of effective therapeutic options for chronic pain. A better understanding of the factors that can contribute to chronic pain development and maintenance can lead to more informed prevention and management strategies.

Purpose: The driving force for this thesis comes from the biopsychosocial model of pain. The main purpose was to investigate the contribution of various psychosocial factors to chronic pain with the following objectives: 1) to systematically review the literature on the existence of a familial sub-type of complex regional pain syndrome (fCRPS); 2) CRPS can follow injuries such as distal radius fractures (DRFs), …

A Transformative Journey: The Lived Experience Of Healthcare Learners Participating In Pain Management Education, Zoe A. Leyland

Electronic Thesis and Dissertation Repository

There is little emphasis on pain management education for healthcare providers. In September 2019, the Master of Clinical Science (MClSc) program in Advanced Healthcare Practice at Western University in London, Ontario introduced a new, “Interprofessional Pain Management” (IPM) field. The program follows a competency-based framework, and the learners are all practicing healthcare providers with a special interest in pain. Part of the purpose of this thesis is to describe the process of development and implementation. The objective is to provide educators and healthcare providers an in-depth look at how the pain education is experienced. This includes exploring the lived experience …

Creation Of A Virtual Interface For Stress-Trauma Investigations Through Open World Navigation: An Exploration Of Tolerability And Physiological Reactions, Michael J. Lukacs

Electronic Thesis and Dissertation Repository

It is estimated that as many as 50% of people suffering from Whiplash Associated Disorders (WAD) may experience chronic alterations of their activities of daily living as much as 1-year post injury. Despite their burden, there is little to evidence to suggest why some people may be more likely to acquire WAD or develop chronic symptomology. Additionally, the link between biomechanical forces at the time of impact and symptom development or recovery is poor. As a result, interest in alternative theories such as stress system reactivity have received interest in recent literature, but empirical methods to test them has been …

Evaluating A Concern For Falling Among People With A Lower Extremity Amputation, Kristin Elizabeth Nugent

Electronic Thesis and Dissertation Repository

The purpose of these studies was to evaluate a concern for falling (CFF) among people with a lower extremity amputation (PLEA). Study 1 evaluated relative and absolute test-retest reliability of five standardized scales which have not been previously evaluated among PLEA. Twenty-two participants completed Study 1, an online survey that was administered twice. Study 2 assessed the inter-relationship of the multiple dimensions in a CFF using nine standardized scales of measurement and open-ended questions, and the association on quality of life (QOL). Forty-eight participants completed Study 2, a onetime online survey. Study 1 provided support for the reliable use of …

Movement Patterns During Functional Activities In People With Chronic Low Back Pain, Quenten Lowell Hooker

Arts & Sciences Electronic Theses and Dissertations

People with chronic LBP display an altered movement pattern where the lumbar spine moves more readily than other joints that can contribute to the activity. The pattern is of particular clinical relevance because across multiple studies the magnitude of altered pattern is associated with LBP and function. One session of motor skill training (MST) during functional activities can improve the altered pattern. However, of the few studies investigating MST for people with LBP, none have examined the short-term or long-term effects of MST on the altered pattern. Additionally, no study has systematically examined if person-specific characteristics moderate the altered pattern …

The Psychosocial And Physical Effects Of Therapeutic Horseback Riding For Children With Cerebral Palsy, Karen M. Pratt

Electronic Thesis and Dissertation Repository

Background: Participation in specialized adapted activities such as therapeutic horseback riding (THR) is critical for children with cerebral palsy (CP) as they are at increased risk for lower habitual physical activity levels, social exclusion and mental health conditions. The benefits of THR for children CP are unclear despite positive anecdotal evidence. Purpose: The aim of the study is to explore the effects of THR participation for children with CP across multiple domains of health (psychological, social and physical) from the children themselves. Specifically, this study explored overall wellbeing including mental health, perceived independence, social inclusion and presence of fatigue and …

Functional Performance Testing In Ice Hockey: The Role Of The Single Leg, Medial Countermovement Jump, Anthony S. Donskov

Electronic Thesis and Dissertation Repository

Due to the physical nature of the game, injuries are common in ice hockey. Injury rates have been difficult to interpret due to the inconsistencies in the definitions of injury and athlete exposure. Consensus statements on injury definitions have been developed for sports such as soccer and rugby but have not been established in ice hockey. Furthermore, many different off-ice tests are performed, but a hockey-specific performance test has not been promoted. Accordingly, the objective for this thesis was to investigate injury rates, injury definition, athlete exposure and injury type in men’s ice hockey, and providing information on a practical …

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills

Doctoral Dissertations

Phantom limb pain is a chronic pain condition that negatively impacts the lives of over half of amputees, and results in considerable morbidity. Currently, there is no gold standard for treatment for phantom limb pain. However, a frequently used intervention is the use of mirror visual feedback, in which the amputee watches the reflection of the adjacent non-amputated limb move and exercise. In the last few decades, mindfulness-based interventions have been increasingly used with individuals living with different types of chronic pain. This study attempts to discover if the addition of a mindfulness-based intervention, such as guided meditation, will augment …

The Effects Of The Mckenzie Method And Strengthening/Stabilization Exercises In Patients With Chronic Nonspecific Low Back Pain., Lufei Harder

Honors College Theses

Background & objective: Low back pain is a frequent problem that the majority of people will face at some point in their lifetime. Exercise has been advocated as an effective treatment for chronic nonspecific low back pain; however, there is a lack of consensus on the best form of exercise treatment. This review was designed to compare the effectiveness of the McKenzie Method against stabilization/strengthening exercises in patients with chronic nonspecific low back pain.

Methods: A literature review examining McKenzie and stabilization exercises for chronic nonspecific low back pain were identified from three databases.

Results: A total of nine articles …

A Vicious Cycle Of Fear Of Falling Avoidance Behavior In Parkinson’S Disease: A Path Analysis, Kameron Jacobson, Nicole Matsunami, Hannah Mccarl, Michelle Regis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal …

Effects Of Altered Somatosensory Input On Lower Limb Mechanics Via Different Shoes And Barefoot Walking In Individuals With Chronic Post-Stroke Hemiparesis, Aaron Abraham Simon, Jynelle Marie Guerrero Arches, Megan Leigh Keohane, Wee Jin Jed Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

[Purpose/Hypothesis] Stroke is a leading cause of disability that results in various neurological deficits. Stroke can cause impaired somatosensory input, which results in decreased balance and gait speed, ultimately increasing fall risks. Therapies to increase somatosensory input have shown promise for people with stroke as well as other neurological populations. However, few studies have systematically investigated varying somatosensory input via different footwear to improve walking in people post-stroke. The purpose of this study was to investigate the effects of altering somatosensory input via different types of footwear (i.e., barefoot, self-selected shoes, and memory foam shoes) on gait kinetics and ankle …

Inter And Intra-Rater Reliability Of Dance Screening Tool, Kathleen Stone, Braden Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Previous literature has indicated that injury rates of ballet and modern dancers are among the highest of any physical activity. These injuries can be detrimental to the athlete and can also result in financial burden for dance companies due to time loss related to injuries. Preventative intervention aimed at those who are most at risk for injury can be effective at reducing the cost associated with lost time due to injury. An effective approach to identifying those most at risk for dance related injuries is to administer a functional movement screen. One such movement screen is the ballet-based Dance Technique …

Am-Pac Basic Mobility Inpatient Short Form (Low Function) Psychometrics/Clinimetrics, Meghan Wonderling, David Miller, Selena Soria

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine whether the Activity Measure for Post-Acute Care® Basic Mobility Inpatient Short Form (Low Function) (6-clicks LF) has increased responsiveness for patients with lower levels of physical function compared to the Activity Measure for Post-Acute Care Basic Mobility Inpatient Short Form (6-clicks). Design: Retrospective cohort study using original scores and simulated scores for assessment of internal responsiveness of the 6-clicks LF compared to the 6-clicks. Simulated 6-clicks and 6-clicks LF scores were created as a hypothetical future AM-PAC® score. Results: We found a statistically significant difference between the 6-clicks and simulated 6-clicks, t=24.8, p < 0.00 [two-tailed]. The effect size was large (d=1.2, r=0.51).There was a statistically significant difference between the 6-clicks LF and simulated 6-clicks LF, t=19.7, p < 0.00 [two-tailed]. The effect size was medium (d=0.91, r=0.41). Finally, for patients with a 6-clicks score in the bottom five-percentile (n=27), we found a statistically significant difference between the 6-clicks and 6-clicks LF, t=11.9, p < 0.00 [two-tailed]. Conclusion: Among patients scoring less than 15, the 6-clicks LF has greater internal responsiveness than the 6-clicks and thus demonstrates that the new low-level questions in the 6-clicks LF better quantify low-level patients’ functional level. Research using non-simulated data should be completed in the future to confirm these findings.

Quality Assurance Of Service Learning Back School, Eric Bashaw, Vu Pham, Tyler Parvin, Ryan Pauly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Project Execution: Back School: During the 2019-20 academic year, two University of Nevada, Las Vegas Physical Therapy (UNLVPT) core faculty members, along with eight doctor of physical therapy students, provided three student-led, pro-bono back school classes at Volunteers in Medicine of Southern Nevada (VMSN). Each back school class consisted of two, 2-hour sessions where participants were screened for red flags, educated on pain management strategies and common causes of back pain, and given an individual home exercise program. Quality Assurance Surveys: Patient’s and VMSN staff were all given questions in the form of Likert-scale and open-ended questions via printed handouts …

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

Stepping On Fall Prevention Project, James P. Gaddi, Jordan T. Bowers, Lea M. K. Fung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Falls are a major problem in the United States among the older adult population and provide opportunity for community outreach via student-led physical therapy projects. Objective: The purpose of this project was to investigate the relationship between fall related outcome measures and questionnaires with the completion of the Stepping On Fall Prevention program along with evaluating the benefits of Physical Therapy student development with participation in service learning projects. Methods: The research quantified the fall risk of 13 participants with assessment of: gait speed (Timed Up and Go), lower extremity strength (30-Second Chair Stand), balance (4-Stage Balance Test), and …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Is Decreased Trunk Flexion Angle A Contributing Factor To Patellofemoral Joint Loading In Runners With Patellofemoral Pain?, Christine Duvall, Zachary Clark, Tavin Fox, Caitlin Howden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Reduced trunk flexion during running is theorized to be a contributing factor of elevated patellofemoral joint (PFJ) stress in runners with patellofemoral pain (PFP); thus, the primary purpose of this research study was to determine if runners with PFP would exhibit differences in PFJ stress and trunk flexion angle during running as compared to pain-free runners across three speeds. We hypothesized that runners with PFP would exhibit higher PFJ stress and decreased trunk flexion while running compared to the pain- free runners. Number of Subjects: 7 runners with PFP and 5 similar pain-free control runners. Materials/Methods: Kinematics and kinetics …