Medicine and Health Sciences Commons^™

Timed Wheelchair Ambulation Of Children Aged 11-17 Years And Their Perceptions Of Their Function, Karen Feuerstein, Susan Fisher, Kristy Van Zee

Masters Theses

Problem. Little data is available to aid physical therapists in writing functional wheelchair velocity goals. Purpose. This study begins to establish baseline data on wheelchair velocity. The authors hypothesize that there will be a significant relationship between a child's perceived function and their wheelchair velocity over a given distance. Methods. One female and 10 male community manual wheelchair users aged 11-17 completed 3 time trials of 150 feet on carpet with 1 minute rest between trials. Following the WRAT-R reading screen, the subjects completed a questionnaire about wheelchair function in the community. Results. A two-tailed significance test of the correlation …

The Effect Of Family Participation On The Outcome Of Patients With Traumatic Brain Injury In Rehabilitation, Grant Middleton, Brett Ransom

Masters Theses

The purpose of this study was to explore the relationship between physical therapists' perceptions and institutional policies relating to family participation in rehabilitation and rehabilitation outcome of patients with traumatic brain injury. Utilizing surveys, we collected information about institutional policy from institutions that were members of the Commission for Accreditation of Rehabilitation Facilities (CARF) in the Midwestern United States. Thirteen institutional surveys provided usable Functional Independence Measure (FIM) scores for patients rehabilitated in 1993, which were used as the outcome measure. The therapists' perceptions survey (n = 104) gathered data about the belief of physical therapists relating to family involvement …

Effectiveness Of An Interdisciplinary Chronic Low Back Pain Program Based On Return To Work Outcome, John R. Bromfield, Deborah A. Knowles, Stacie M. Schoenberg

Masters Theses

The purpose of this study was to determine the effectiveness of a Midwestern Hospital's Interdisciplinary Outpatient Chronic Low Back Pain program. Rate of return to work was selected as the outcome measure for effectiveness. For purposes of discussion, the percentage of patients who were compliant with home exercise, who were involved in a vocational rehabilitation program, and who consulted a physician since discharge were analyzed. There were 118 male and female subjects, average age of 43; who successfully completed the 8 week chronic low back pain program between 1992 and 1994. Subjects were then sent questionnaires at 1, 3, 6, …

Investigating Use Of The Transdisciplinary Approach In The Public School System: Assessment Of The Interaction Between The Physical Therapist And The Regular Education Teacher, Jennifer C. Bunker, Jennifer M. Wolffis

Masters Theses

The purpose of our research was to determine the extent that physical therapists utilize components of the transdisciplinary approach in their interaction with regular education teachers when working with children kindergarten through sixth grade who participate in regular education classes. 325 surveys were distributed to physical therapists in the Midwest region of the United States who work in a school environment. 46% of the surveys were returned and met our inclusion criteria. Our results showed that 28.7% of the respondents indicated use of the transdisciplinary approach. 41% of the respondents reported presence of a written philosophy. 9% of the therapists …

Functional Independence Measurement Scale: Analysis Of Variables To Determine Predictability To Stroke Patient's Discharge Site, Joseph A. Cloud, Daren C. Johnson, Tricia A. Lauinger

Masters Theses

The purpose was to define subsets of variables that are found within the Functional Independence Measurement (FIM) scale that demonstrate a high predictability to right cerebral vascular accident (CVA) patient's discharge site, including home, foster home, and skilled nursing facility. The researchers wanted to find if gait, along with other subsets, has a high prediction to discharge site than overall FIM admission and discharge scores together and separately.; Gait did not show a higher prediction to discharge site compared with subsets of FIM variables and overall FIM admission and discharge scores, together and separately. However, other subsets were found to …

The Effects Of Relative Frequency Of Knowledge Of Results On Brain Injured And Neurologically Normal Individuals Learning A Linear Positioning Task, Deborah M. Thomas

Masters Theses

Twelve normal and 12 brain injured subjects aged 18-56 years learned a linear positioning task involving moving a slide to a target position while blind folded. During the acquisition phase, feedback was provided as 33%, 67% or 100% KR. Immediate (10 minute) and delayed (24 hour) retention tests were performed without feedback. ANOVAs were used to compare the effects of feedback frequency. At the acquisition and immediate retention phases, the normal group performed with significantly less error than the brain injured group. This trend continued in the delayed retention test, but was not significant. Both groups performed best in the …

In Vitro Effects Of Two Silver Electrodes On Select Wound Pathogens, Linda Jean Laatsch-Lybeck, Poh Chye Ong, Luther C. Kloth

Physical Therapy Faculty Research and Publications

The use of electrical current to promote wound healing is well documented. However, little is understood about the effects of micro-amperage direct current (μADC) on growth of wound pathogens. The purpose of this project was to investigate the antibacterial effects of a silver wire/silver nylon electrode carrying μADC in vitro on several Gram positive and Gram negative bacteria. The current was delivered via silver wire and silver nylon electrodes at an amplitude of 100 μA for a 30-minute duration in an in vitro system. Results demonstrated that only silver wire carrying current inhibited bacterial growth around …

Employer Perceptions Of Entry-Level Master's Degree Physical Therapy Graduate's Ability To Practice In A Direct Access Environment, Michele Allen, Matthew J. Duley, Jamie J. Eltzroth

Masters Theses

The purpose of this study was to determine if employers in physical therapy outpatient facilities believed entry-level Master's degree graduates were adequately prepared to practice in a direct access environment. Three-hundred surveys were sent to employers in facilities in Michigan, Illinois, and Ohio. A Likert Scale was utilized to determine opinions regarding physical therapy skills a new graduate may have after graduating from an entry-level Master's degree program. Analysis of variance was used to determine differences in opinion based on skill and employer categorization. Results indicated that employers did not believe physical therapy graduates have adequate skills to recognize diagnoses …

The Effects Of Partial Unweighting On Hemiplegic Gait, Natasha A. Creaser, Michael W. Jones

Masters Theses

This study investigated the effects of 30% body weight support on gait in two individuals with hemiplegia secondary to stroke. Two subjects with right hemiplegia were tested. Each completed four trials, two full weight bearing and two unweighted 30%, in random order. Each trial consisted of walking six meters on a treadmill at the subjects' self-selected speed. Temporal distance data were collected via Stride Analyzer footswitches. Subjects were also videotaped from the side during all trials. We expected velocity, cadence, stride length, uninvolved limb swing time, and involved limb stance time to increase with unweighting. Subjects 1's results agreed only …

An Overview Of Multidirectional Instability Of The Shoulder, Troy Ivesdal

Physical Therapy Scholarly Projects

Multidirectional instability (MOl) of the shoulder is an increasingly recognized clinical entity to physical therapists, yet it remains poorly defined and not fully understood. The clinical importance of correct diagnosis is necessary for rehabilitation and surgical procedures. The purpose of this paper is to address the issue of MOl and its importance in the field of physical therapy.

General anatomy will be presented with attention given to biomechanics which may lead to this pathology. Etiological factors will be discussed including symptoms and proper diagnostic procedures for instability. Finally, treatment of multidirectional instability will be reviewed with a focus on proprioceptive …

The Effects Of Repeat Testing On Performance Scores Utilizing The Isostation B-200, Stephanie D. Kyes

Physical Therapy Scholarly Projects

The purpose of this experimental study was twofold: 1) to determine if there was a significant increase in performance, or learning effect, between the first and second test sessions on the Isostation B-200 for normal subjects, and 2) if so, was there a specific percentage of increase that can be attributed as a learning effect for each age, gender, or activity level.

Twenty-two subjects (8 men, 14 women) with no prior history or treatment for low back pain were utilized in this study. All subjects were tested in two positions. First, in an upright standing position and second, in twenty …

A Review Of Spinal Rom Measurement Tools, Dawn Kamihara

Physical Therapy Scholarly Projects

Physical therapists rely on measurements to communicate with one another, establish patient status, predict treatment response, document treatment efficacy, and claim scientific credibility for the profession. Therefore, the quality of measurements should be of great concern to physical therapists and, hence, therapists should be able to examine the quality of measurement tools they are using critically. A variety of measurement tools are being utilized in physical therapy to quantify spinal mobility; however, there is no clarity as to which of the tools are optimal. In particular, the spinal range of motion measurement tools will be examined because of the high …

A Historical Perspective Of Medical Care Coverage In The United States, Rhonda Noyes

Physical Therapy Scholarly Projects

Reimbursement of medical services by third-party payers is becoming more contingent upon the effectiveness of services at an affordable cost. The push for cost containment brings about the need for the health care professional to have a sound understanding of medical care coverage to provide quality services at an affordable price.

The present coverage of medical care in the united States is largely dependent upon medical benefits offered by employers. In order to understand current trends in medical care coverage and the reliance on employer based coverage, this independent study explores the origins and development of the current medical care …

Multiple Sclerosis: A Literature Review, Jody E. Price

Physical Therapy Scholarly Projects

Multiple Sclerosis (MS), a demyelinating disease of the Central Nervous System (CNS), is the most common cause of nontraumatic disability affecting young adults in the United States. The resultant lesions lead to a variety of symptoms which include: weakness, sensory disturbances, visual problems, spasticity, fatigue, and paralysis. There are also a number of psychological and emotional issues that the MS patient must face. The cause of MS remains unknown and the diagnosis is often difficult. The course and severity of the disease varies from patient to patient. There is no known cure or prevention.

Current treatments include drug therapy, physical …

An Emg Analysis Of Closed Kinetic Chain Exercise Versus Open Kinetic Chain Exercise In The Upper Extremity, Bradley J. Neis

Physical Therapy Scholarly Projects

Both closed kinetic chain and open kinetic chain activities are common in rehabilitation involving the lower extremity and the upper extremity. Although closed chain activities are performed regularly in the rehabilitation setting for the upper extremity, there has been little or no research proving that these activities are better, worse, or the same as open chain activities. Therefore, the purpose of this research project was to compare muscle activity in both open and closed chain exercises in the upper extremity and determine if there is a difference in the two forms of exercise. Five healthy subjects without previous shoulder or …

The Role Of Foot Biomechanics In Lower Extremity Pathologies, Don Martin

Physical Therapy Scholarly Projects

Lower extremity pathologies caused by abnormal biomechanics of the subtalar joint are commonly seen in the health care setting. Certain foot types will predispose an individual to excessive amounts of subtalar joint pronation or supination during gait. Subtalar joint movement is transmitted proximally to the lower extremity during gait and excessive amounts of pronation or supination can lead to altered biomechanics in the lower extremity with development of various lower extremity injuries. The purpose of this study is to analyze the biomechanical events of the subtalar joint of the foot during gait in order to show how abnormalities in these …

The History And Evolution Of Stretching, Jennifer Roberts

Physical Therapy Scholarly Projects

Virtually every athlete engages in some form of stretching before beginning a training routine or competitive event. Stretching is an integral component of endless physical therapy treatment programs for muscle strains, ligament sprains, fibromyalgia protocols, and joint replacements to name a few. However, the physiological effect of stretching and the best method for producing the desired outcome is often questioned by coaches, athletes, and therapists.

The purpose of this paper is to examine the effects of static stretching and ballistic stretching individually and in conjunction with modalities. Muscle physiology, the benefits of flexibility, and the psychological and physiological effects of …

Overview Of The Flaccid Hemiplegic Shoulder Following A Stroke, Tricia R. Pederson

Physical Therapy Scholarly Projects

Stroke may cause long-term disability and impairment in the hemiplegic shoulder. Problems may develop early in the flaccid phase of recovery and complicate the entire rehabilitation process. The etiology and treatment of shoulder complications remains uncertain. Contributing factors include inappropriate handling and positioning, abnormal muscle tone, impaired sensation, and musculoskeletal pathology.

Prevention and treatment of shoulder dysfunction begins with positioning, early range of motion, and education. Physical therapists play an important role in stroke management by administering therapeutic positioning programs, teaching appropriate exercise regimens, and instructing in proper handling techniques.

The purpose of this paper is to review methods being …

Occupational Cumulative Trauma Disorders: Prevention And Treatment, Michelle Uyeno

Physical Therapy Scholarly Projects

Cumulative Trauma Disorders (CTDs) consist of a group of musculoskeletal injuries caused by overuse or repetitive strain. The purpose of this Independent Study was to review the literature concerning occupational CTDs, the methods of prevention, and treatment as it related to physical therapy. The most beneficial means of controlling CTDs appear to be taking preventative measures with jobsite analysis and employee education. Treatment is varied and dependent upon the actual diagnosis and causative factor. Therapists may attempt heat or cold modalities, work hardening programs, or manual therapy such as strain-counterstrain. An important aspect to treatment is early intervention. Due to …

Survey Of Pharmacology Education In Entry-Level Physical Therapy Programs, Daniel C. Weaver

Physical Therapy Scholarly Projects

The purpose of this survey research is to document the current status of education in pharmacology in the curriculum of entry-level physical therapy programs. A questionnaire was sent to the 135 entry-level physical therapy programs located in the United States and accredited by the American Physical Therapy Association. The director or faculty member responsible for pharmacology instruction in 96 (71.1 %) of the entry-level physical therapy programs participated in the five-part survey.

The questionnaire results indicate that nearly all of the program respondents (98.9%) incorporate pharmacology content into existing required courses and/or have in his or her curriculum a required …

A Literature Review On Wheelchair Products And Fitting, Lee M. Werchau

Physical Therapy Scholarly Projects

Physical therapists are often involved in wheelchair prescription. An important factor when recommending or prescribing a wheelchair is proper fit. Proper wheelchair fitting is critical when attempting to get maximum independence, normalize tone in spastic or low tone clients, as well as decreasing bony deformities and pressure ulcers. Crucial measurements for wheelchair fitting include backrest height and seat width, depth, and height. To assure ultimate independence an individuals mental competence, ROM in upper extremities, cardiopulmonary health, and coordination must be evaluated prior to prescribing a wheelchair. Options to consider are the type of seat cushion, wheelchair frame, peripherals, and safety. …

Assessment Of Physical Therapy Needs At Third Street Clinic, Susan Wheeldon

Physical Therapy Scholarly Projects

Health care is being provided free of charge at the Third Street Clinic in Grand Forks, North Dakota, for those people who are uninsured or who do not qualify for Medicare or Medicaid. Physical Therapy is not presently offered as a service at the Clinic.

Physical Therapy is part of comprehensive health care. Therapists provide caring and expertise in the areas of neurological rehabilitation, orthopedic/musculoskeletal problems, pediatrics, and work hardening. As volunteers, therapists are involved in providing care at free clinics across the nation.

The Third Street Clinic agreed to have a needs assessment performed to identify those clients who …

Debridement Teaching Aid, Katharine E. Ward

Physical Therapy Scholarly Projects

Physical therapists treat patients with wounds. Debridement is one area of wound care which physical therapists frequently perform. Debridement is a particularly difficult skill to learn in the classroom due to the inability to simulate authentic conditions.

This study is intended to be a debridement teaching aid in the physical therapy classroom and/or the professional setting. Written text discusses the classification, healing, assessment, debridement, and dressing of wounds. Photographs of wounds and wound care clarify the written text.

The purpose of this teaching module is to help students and professional staff feel more comfortable with wound care and debridement upon …

Medical Disease And Low Back Pain: The Physical Therapy Evaluation, Heather Lynn Alderson

Physical Therapy Scholarly Projects

The heightened level of autonomy currently experienced by the profession of physical therapy demands that, in addition to identifying and managing movement dysfunctions of the musculoskeletal system, physical therapists be knowledgeable of signs and symptoms which may indicate medical disease. Individuals who present with low back pain (LBP) are commonly seen in the physical therapy clinic. While most often the source of a patient's LBP is of mechanical musculoskeletal origin, a great number of differential diagnoses classified as medical diseases also exist that are capable of precipitating low back pain. The purpose of this independent study is to: (a) outline …

An Investigation Of Differential Diagnosis Of Patellofemoral Pain Syndromes, Shannon Marie Buckmier

Physical Therapy Scholarly Projects

Dysfunction of the patellofemoral joint has long been a topic of discussion and debate for caregivers of patients with this syndrome. Various diagnosis related to the patellofemoral joint of the knee have been reported. Patellofemoral pain refers to the clinical presentation of pain in the anterior region of the knee. It is one of the most common musculoskeletal complaints in children, adolescents, and adults. It is a major source of pain and dysfunction in both genders, but is more common in females.

The purpose of this literature review is to help distinguish between several differential diagnosis included as part of …

The Continuum Of Care For The Traumatic Brain Injured, Maile M.K. Collado

Physical Therapy Scholarly Projects

Physical therapists play an important role in the rehabilitation and management of the traumatic brain injured (TBI) patient. Physical therapy is accomplished through therapeutic strategies, intervention techniques, and recommendations for placement and discharge. Many times P.T. services are discontinued for various reasons, two of which are loss of reimbursement or the perception that the patient no longer requires P.T. services. Many times, however, services are discontinued due to a lack of awareness of available services.

There is limited research available that follows the TBI patient along the continuum of care towards reintegration into society .. Thus, the purpose of this …

A Literature Review Of The Results Of Traditional Versus Accelerated Anterior Cruciate Ligament (Acl) Rehabilitation In Treatment Following Acl Reconstruction, Cara L. Conway

Physical Therapy Scholarly Projects

In recent years, the rehabilitation of the anterior cruciate ligament (ACL) has undergone changes in its protocol. The changes in ACL rehabilitation protocol are due to clinical observations and trends in ACL rehabilitation across the country. The traditional and presently used accelerated ACL rehabilitation programs are not much different in the activities performed as in the time frames when each activity is permitted.

The main purpose of this literature review is to provide material for clinicians to have accurate and recent knowledge of ACL rehabilitation. This knowledge will allow the clinician to provide the best and most beneficial treatment to …

Delayed Onset Muscle Soreness, Bryan L. Guthmiller

Physical Therapy Scholarly Projects

Delayed-onset muscular soreness (DOMS), the sensation of pain and stiffness in the muscles that occurs from 1-5 days following unaccustomed exercise, can adversely affect muscle performance, both from voluntary reduction of effort and from inherent loss of capacity of the muscles to produce force. This exercise-induced muscle damage causes a response that can be characterized by a cascade of metabolic events. Increased circulating neutrophils and interleukin-1 occurs within 24 hours after the exercise, with skeletal muscle levels remaining elevated for a much longer time. Several theories underlying the physiological mechanisms of DOMS have been proposed. The majority of evidence contradicts …

A Survey: The Documentation Of Manual Therapy, Kimo Danielsen

Physical Therapy Scholarly Projects

Manual therapy, though clinically valuable, lacks published research to support efficacy. The purpose of this project was to survey therapists in the U.S. who use manual therapy · in their clinical practice. Methods: All orthopedic clinical specialists (OCS) in the United States (n=325) as recognized by the American Physical Therapy Association's 1993 Directory of Clinical Specialists were sent a survey that contained questions regarding demographics, frequency of documentation, and items included in documentation. . The information gained through the survey questions were analyzed for descriptive trends. Results: There was a 45% response rate. Majority of the respondents indicated they were …

Comparison Of Pediatric Physical Therapy Service In The Educational Versus Medical Setting With Special Focus On Iep Development, Nicki Christopherson

Physical Therapy Scholarly Projects

The passage of Public Law 94-142, the Education for all Handicapped Children Act, in 1975, has created an increased demand for physical therapists to work with children in the educational setting. The intent of the law is that all individuals have the right to a free, appropriate public education. In order for an individual with a disability to receive an appropriate education, related services, including physical therapy, are provided.

Physical therapy has traditionally been a medical service. In accordance with the law, the services delivered by a physical therapist in the school setting must be educationally related. Service provisions including …