Medicine and Health Sciences Commons^™

In-Season Rehabilitation Program Using Blood Flow Restriction With Therapy For Two Decathletes With Patellar Tendinopathy: A Case Report, Tyler Cuddeford, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background and Purpose: Patellar tendinopathy is an overuse injury experienced primarily by athletes; especially athletes who participate in sports that involve frequent jumping. Therapeutic exercise is the primary conservative treatment for patients with this condition. However, some patients with patellar tendinopathy may be unable to tolerate the loading that occurs during exercise. The use of blood flow restriction (BFR) therapy for patients with patellar tendinopathy may allow the athlete to exercise with a lower load while still experiencing the physiological benefits associated with training at a higher intensity. The purpose of this case report was to detail the outcomes from …

Pattern Of Recovery And Outcomes Of Patient Reported Physical Function And Pain Interference After Ankle Fusion: A Retrospective Cohort Study, Jessica M. Kohring, Jeff Houck, Irvin Oh, Adolf S. Flemister, John P. Keptz, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: Research on outcomes after ankle fusion focuses on basic activities of daily living, fusion rates, and gait parameters. Little has been reported on the patient’s perspective after surgery. The purpose of this study was to determine the change in patient reported physical function and pain interference after ankle fusion surgery to guide patient expectations and improve provider communication.

Methods: This was a retrospective review of prospectively collected patient reported outcome measurement information system (PROMIS) data in 88 ankle arthrodesis procedures performed from May 2015 to March 2018. The PROMIS Physical function (PF) and pain interference (PI) measures were collected …

O-Season Training Habits And Bmi, Not Preseason Jump Measures, Are Associated With Time-Loss Injury In Female Collegiate Soccer Players, Jason Brumitt, Alma Mattocks, Amy Engilis, Jill A. Sikkema, Jeremy Loew

Faculty Publications - College of Physical Therapy

The primary purpose of this study was to determine the effectiveness of the standing long jump (SLJ) and the single-leg hop (SLH) tests to discriminate lower quadrant (low back and lower extremities) injury occurrence in female collegiate soccer players. The secondary purpose of this study was to determine associations between injury and o-season training habits or anthropometric measures. SLJ, SLH, and anthropometric measures were collected during a preseason screening clinic. Each subject completed a questionnaire providing demographic information and o-season training habits. Each athlete performed three SLJ and three SLH per leg. SLJ and SLH scores were not associated with …

Changes In Tendon Thickness Only Occurs In Patients With Achilles Tendinopathy, Sarah Garner, Kelsey Harnar, Jesus Soltero Plaza, Kevin Coriano, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

A previous George Fox Study examined the effect of a heavy load eccentric exercise program for patients with achilles tendinopathy (AT) to test the hypothesis of improved outcomes and decreased tendon thickness.

Screening And Addressing Fatigue Symptoms In Patients With Orthopedic Problems Using The Promis Fatigue Scale, Breanna Becker, Karina Kreider, Hannah Lawrence, Kayla Winter, Caleb Zimmerman, Jeff Houck, Li-Zandre Philbrook

Student-Faculty Research - College of Physical Therapy

In the primary care setting, fatigue is a common complaint, outnumbered only by cough. 41.9% of patients in an outpatient physical therapy setting reported unacceptable fatigue. Fatigue scores are weakly correlated to physical function and pain interference (using Patient Reported Outcome Measurement Information Systems [PROMIS]). Therefore, detecting fatigue and addressing it directly is necessary.

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

Student-Faculty Research - College of Physical Therapy

Purpose: To compare strength gains of the supraspinatus and external rotators, and changes in tendon size of the supraspinatus after performing sidelying external rotation (ER) exercise with or without BFR.

Falls Risk Screening In Community-Dwelling Older Adults, Austyn Byasse, Kevin Joines, Rachel Cundy, Carlos Navia, Virginia Edwards, Rachel Lineback, Cindy Zablotny, Theresa Raudsepp

Student-Faculty Research - College of Physical Therapy

Purpose: To determine a way to reduce clinician burden in the identification of individuals at risk for falls.

Qualitative Analysis Of Reflective Narratives Of Physical Therapy Students Attempting To Implement Biopsychosocial Approaches To Care, Ricardo Gonzalez, Sari Harris, Justin Lee, Patrick Mcmahon, Rebecca Wezensky, Jeff Houck, Daniel Kang, Kevin Sellars

Student-Faculty Research - College of Physical Therapy

Purpose: To examine the learning process of physical therapy students attempting to apply BPS principles to clinical treatment during both an initial training period under mentorship, and during clinical rotations.

Do Generic Health And Population Norm Based Outcomes Adequately Detect Change In Patients Attending Outpatient Physical Therapy?, Li-Zandre Philbrook, Jeff Houck, Jonah Koski, Kyle Johnston, Kyle Sumida, Ben Wagar

Student-Faculty Research - College of Physical Therapy

The purpose was to determine the ability of Patient Reported Outcome Measurement Information (PROMIS) Pain Interference (PI), Physical Function (PF), Fatigue, and Self-Efficacy of Symptom Management (SE) scales to detect change and outcomes compared to population norms at discharge from an outpatient orthopedic clinic.

Can Cue Location Influence Postural Sway Control In A Post-Concussion Syndrome Case?, Andrew J. Meszaros, Alyssa Carey, Robin Dorociak, Erik Cronrath, Farah Makani, Monica Martinez

Student-Faculty Research - College of Physical Therapy

Center for Disease Control reports the following as fall risk factors: lower extremity weakness, vision problems, and difficulty maintaining balance during walking. Greatest predictor for a fall, is prior fall within the last year. Injury from a fall leads to: fear of falls, inactivity, atrophy, higher risk for falls. Kouzake and Masani (2008) indicated that improvements in postural sway are attributed to light touch increasing proprioception, rather than through mechanical support. Examples of light touch-enhanced proprioceptive feedback: walls and assistive walking devices. Successful strategy in bimanual tasks?

Validity Of The Paper Pull Test For Strength In Patients With Hallux Valgus, Taylor Eckel, Alex Hughes, Jaymee Kau, Jessica Lumba, Kristen Omohundro, Kara Oshiro, Jeff Houck, Marcey Keefer Hutchison

Student-Faculty Research - College of Physical Therapy

Hallux valgus (HV) is a progressive deformity affecting the foot and big toe and it most commonly affects middle to older aged females. This study explores the validity of the paper pull test to assess the strength and function and utilizes PROMIS scores to assess the relationship between biological and pyschosocial factors in patients with HV.

Role Of Patient-Reported Outcome Measures On Predicting Outcome Of Bunion Surgery, Ashlee Macdonald, Jeff Houck, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: Prior studies have suggested preoperative patient-reported outcome scores could predict patients who would achieve a clinically meaningful improvement with hallux valgus surgery. Our goal was to determine bunionectomyspecific thresholds using Patient-Reported Outcomes Measurement Information System (PROMIS) values to predict patients who would or would not benefit from bunion surgery.

Methods: PROMIS physical function (PF), pain interference (PI), and depression assessments were prospectively collected. Forty-two patients were included in the study. Using preoperative and final follow-up visit scores, minimally clinically important differences (MCID), receiver operating characteristic (ROC) curves, and area under the curve (AUC) analyses were performed to determine if …

Is There A Difference In Outcomes Between Patients Who Received A Double Or Triple Arthrodesis For Hindfoot Arthritis?, Amanda H. Holleran, Judith F. Baumhauer, Jeff Houck, Daniel Homeier, Adolph S. Flemister, John P. Ketz, Benedict F. Digiovanni, Irvin Oh

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Triple arthrodesis has historically been considered the standard of treatment for arthritis of the hindfoot with or without deformity. The complications of this surgery including non-union, malunion, nerve injury, infection and wound healing problems can occur at any of the three joints. Double arthrodesis is capable of producing a similar reduction in degrees of motion and correction of foot deformity but may also cause less patient morbidity in regard to these complications due to one less joint being incorporated into the fusion procedure. What is unknown is the patient reported outcomes, specifically physical function (PF) and pain interference (PI) …

What Is The Responsiveness And Quality Of Life “Utility” For Promis Outcomes In Foot And Ankle Patients Following Physical Therapy?, Christopher G. Neville, Judith F. Baumhauer, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Patients with foot and ankle conditions have been shown to demonstrate improvement in their generic outcomes using the Patient Reported Outcome Measurement Information System (PROMIS). However, the responsiveness to change and the impact change may have on quality of life has not been explored following non-operative care with physical therapy. The effect size (ES) is an assessment of the magnitude of change while the impact of change in physical function can be assed with quality of life utility scores. Therefore, the purpose of this analysis was to investigate the responsiveness of the PROMIS physical function (PF) scale on changes …

Do Patients Judge Success Of Treatment And Patient Acceptable Symptom State Based On Current Self-Reported Health Status?, Ryan Jacobson, Daniel Kang, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Value-based care models call for better interpretation of patient-reported outcomes. Patients may reference health status differently when appraising if an intervention was successful versus if their current state is acceptable. The purpose of this study was to determine the association between success of treatment (SOT), patient acceptable symptom state (PASS), and PROMIS measure T-scores, following a single primary care physical therapy encounter.

Methods: Cross-sectional study. Ninety-two patients with musculoskeletal complaints were administered standard SOT and PASS questions, and PROMIS Physical Function, Pain Interference, and Self-Efficacy for Managing Symptoms measures. Association of PASS and SOT was determined using rank biserial …

Validity Of The Paper Pull Test For Strength In Patients With Hallux Valgus, Marcey Keefer Hutchison, Jeff Houck, Jaymee Kau, Kristen E. Omohundro, Alex Hughes, Kara Oshiro, Taylor Eckel

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The purpose of this study was to explore validity of the paper pull test (PPT) to assess hallux flexion strength and function in persons with hallux valgus (HV). The following hypotheses were tested: 1) The PPT is valid for inferring 1st MTP flexion strength and heel rise (HR) performance (e.g. heel height). 2) A specified threshold of force during the PPT can be identified that discriminates patients with HV. 3) Muscle activity (abductor hallucis [AH], flexor hallucis brevis [FHB]), in patients with HV will be distinct from controls across three tasks: 1) PPT, 2) lowering phase of a HR, …

Overall Health And The Influence Of Physical Therapy On Physical Function Following Total Ankle Arthroplasty, Frank E. Diliberto, Daniel H. Aslan, Jeff R. Houck, Bryant S. Ho, Anand M. Vora, Steven L. Haddad

Faculty Publications - College of Physical Therapy

Background: The overall health and the importance of physical therapy for people following total ankle arthroplasty (TAA) have been understudied. Our purpose was to characterize the overall health of patients following TAA, and explore the frequency, influence, and patient-perceived value of physical therapy.

Methods: People who received a TAA participated in this retrospective cohort online survey study. The survey included medical history questions and items from the Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms. Seven PROMIS domains, reflecting the biopsychosocial model of care (physical, mental, social), were included to examine participant overall health status in comparison to the general …

Operative Intervention Does Not Change Pain Perception In Patients With Diabetic Foot Ulcers, Olivia V. Waldman, Stephanie P. Hao, Jeff R. Houck, Nicolette J. Lee, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Researchers investigated pain perception in patients with diabetic foot ulcers (DFUs) by analyzing pre- and postoperative physical function (PF), pain interference (PI), and depression domains of the Patient-Reported Outcome Measurement Information System (PROMIS). They hypothesized that 1) because of painful diabetic peripheral neuropathy (DPN), a majority of patients with DFUs would have high PROMIS PI scores unchanged by operative intervention, and 2) the initially assessed PI, PF, and depression levels would be correlated with final outcomes. Seventy-five percent of patients with DFUs reported pain, most likely because of painful DPN. Those who reported high PI and low PF were likely …

Can Patient-Reported Outcomes Measurement Information System® (Promis) Measures Accurately Enhance Understanding Of Acceptable Symptoms And Functioning In Primary Care?, Ryan Jacobson, Daniel Kang, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Value-based healthcare models will require prioritization of the patient’s voice in their own care toward better outcomes. The Patient-Reported Outcomes Measurement Information System® (PROMIS) gives patients a voice and leads providers to actionable treatments across a broad range of diagnoses. However, better interpretation of PROMIS measures is needed. The purpose of this study was to evaluate the accuracy of PROMIS Physical Function (PF), Self-Efficacy for Managing Symptoms (SE), Pain Interference (PI), Fatigue, and Depression measures to discriminate patient acceptable symptom state (PASS) in primary care, determining if that accuracy is stable over time and/or retained when PROMIS score thresholds …

Preseason Y Balance Test Scores Are Not Associated With A Lower Quadrant Sports Injury In A Heterogeneous Population Of Division Iii Collegiate Athletes, Jason Brumitt, Jill A. Sikkema, Saiko Mair, Cj Zita, Victor Wilson, Jordan Peterson

Faculty Publications - College of Physical Therapy

Functional performance tests, such as the Y Balance Test-Lower Quarter (YBT-LQ), hold promise as screening tools to identify athletes at risk for injury. The ability of the YBT-LQ to discriminate injury risk in Division III collegiate athletes is unknown. The purpose of this study was to determine if preseason YBT-LQ scores are associated with noncontact time-loss lower-quadrant (low back or lower extremities) injury in a heterogeneous population of Division III collegiate athletes. Two hundred and fourteen athletes (females = 104) performed the YBT-LQ test. Preseason YBT-LQ scores, analyzed by the total population, were not associated with noncontact time-loss lower-quadrant injury. …

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 …