Mitigating Risk Factors For Disease Progression In Patients With Varus Gonarthrosis, Angelo Boulougouris

Electronic Thesis and Dissertation Repository

Knee osteoarthritis (OA) is a leading cause of disability worldwide. Its growing burden is related to an aging population, obesity and physical inactivity. The progression of knee OA involves both biomechanical and systemic mechanisms. Known risk factors that might be altered through interventions include lower limb alignment, the distribution of loads across the knee during walking, body composition and muscular strength. The overall purpose of this thesis was to evaluate the effects of multi-modal, rehabilitative and surgical interventions that target different risk factors for disease progression in patients with medial compartment knee OA and varus mal-alignment (varus gonarthrosis). The thesis …

Investigating The Effects Of Custom Made Orthotics On Brain Forms: A Pilot Study, Lindsay Carey

Electronic Thesis and Dissertation Repository

OBJECTIVES: To determine (1) the feasibility of this novel approach and technique of recording brain activity, wirelessly and continuously, during human gait, and (2) if custom made orthotics will alter the brain activity patterns recorded. METHODS: Gait trials were performed on 16 participants walking with and without orthotic devices in their shoes while simultaneously collecting EEG data through the Emotiv wireless neuroheadset. RESULTS: The Emotiv neuroheadset was capable of detecting changes in brain activity between the two gait trials. The differences in brain activity identified between conditions were not statistically significant. CONCLUSION: The findings suggest the Emotiv EEG device is …

A Pilot Study To Investigate Concerns In Patients Undergoing Neck Dissection Surgery, Daniel Sundar Raj Arulananda Doss

Electronic Thesis and Dissertation Repository

Abstract:

This study investigates concerns in patients undergoing neck dissection surgery. Forty patients were recruited at Pre-surgery, Discharge and 1-month Post-surgery. The Patient Concerns Inventory - Level of Importance questionnaire (PCI-LOI), Shoulder Pain and Disability Index (SPADI), Neck Dissection Impairment Index (NDII) and the University of Washington - Quality of Life questionnaire (UWQOL) were used.

The study identified "Anxiety" at Pre-surgery and "Appearance" at Discharge and 1-month Post-surgery as the important patient concerns. Patients’ concerns were found to change over time. Support for cross-sectional convergent validity of the PCI-LOI was evidenced by significant correlations between the PCI-LOI and the UWQOL …

Effects Of Thoracic Spinal Manipulative Therapy On Thoracic Spine And Shoulder Kinematics, Thoracic Spine Flexion/Extension Excursion, And Pressure Pain Sensitivity In Patients With Subacromial Pain Syndrome, Joseph Kardouni

Theses and Dissertations

EFFECTS OF THORACIC SPINAL MANIPULATIVE THERAPY ON THORACIC SPINE AND SHOULDER KINEMATICS, THORACIC SPINE FLEXION/EXTENSION EXCURSION, AND PRESSURE PAIN SENSITIVITY IN PATIENTS WITH SUBACROMIAL PAIN SYNDROME By Joseph R. Kardouni, Ph.D., PT A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, at Virginia Commonwealth University. Virginia Commonwealth University, 2013. Major Director: Lori A. Michener, PhD, PT, ATC, Professor, Department of Physical Therapy In patients with shoulder pain, the use of manual therapy directed at the spine and shoulder have been reported to provide superior outcomes to exercise based interventions or usual care without …

The Impact Of Cognitive Behavior Techniques On The Vocational Identity Of Persons With Disabilities Receiving Ssi/Ssdi Benefits, James Joseph Quinn

Graduate Theses and Dissertations

This study examines the effects of Cognitive Behavior Therapy (CBT) on the vocational identity, self-efficacy, and vocational satisfaction of persons with disabilities receiving SSI/SSDI. This study was carefully planned to help persons with disabilities obtain employment. A review of the relevant literature was used to determine the need for the study and to support the study. Forty participants, all were enrolled into a vocational rehabilitation program were selected for the study. Threats to internal and external validity were taken into consideration and controlled for. They received CBT as a treatment intervention to change their beliefs and irrational thoughts about the …

Potential Benefits And Withdrawal Effects Of Cranial Nerve Non-Invasive Neuromodulation On Functional Mobility For Individuals With Traumatic Brain Injury, Kati P. Liegl

Theses and Dissertations

Objective: Document and describe benefits and withdrawal effects of the Cranial Nerve Non-Invasive Neuromodulation (CN-NINM) intervention.

Background: Neuromodulation techniques can be used for the treatment of many diagnoses and conditions. Many current neuromodulation techniques have or can have negative consequences such as high cost, risk of surgical complications or infections, effects not lasting without the drug or stimulation presence, and need for medical experts' direct oversight. A new rehabilitation intervention called CN-NINM may eliminate these negative factors, making it a promising tool for clinicians and participants. CN-NINM combines targeted training activities with mild, portable, electrical stimulation of the tongue to …

Grip Strength, Multimorbidity, And Disability, Amy M. Yorke

Dissertations

The presence of two or more chronic health conditions, also known as multimorbidity, is one of the most prevalent health disorders experienced by adults. Adults with multimorbidity and functional limitations represent clinical and financial challenges to the current health care system. The purpose of this three-paper dissertation is to examine the relationship between grip strength, multimorbidity, and the prediction of disability in adults. Data from the 2008 Health and Retirement Study (HRS), a nationally representative, longitudinal study completed on Americans age 50 years and over, are used for the dissertation.

The objective of the first paper is to investigate the …

Feasibility And Preliminary Outcomes From A Pilot Study Of The Smile Curriculum For Mother-Infant Co-Occupational Engagement And Maternal Self-Efficacy, Emily Whitlock

Theses and Dissertations

OBJECTIVE: To report on the feasibility and preliminary outcomes from a pilot study of the SMILE curriculum, a new educational program designed to enhance the mother-infant relationship by focusing on improvement of co-occupational engagement within daily routines.

METHOD: Six mothers, each with an infant diagnosed with special medical needs who received services in a local birth-to-three program, participated in an exploratory design study. Each mother was assigned to a SMILE curriculum intervention group or a waiting-list control group. Mothers were evaluated pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP-SE) Scale for measurement of maternal self-efficacy and the Center …

Inter-Rater Reliability Of Lumbar Segmental Instability Tests And The Subclassification, Faisal Mohammad Alyazedi

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: This study investigated the inter-rater reliability of three structural end-range lumbar segmental instability tests with the highest positive Likelihood Ratio against flexion-extension radiographs, and three functional mid-range clinical tests that predict the success of lumbar stabilization exercises in patients with recurrent or chronic low back pain (R/CLBP). It also investigated the reliability of lumbar segmental instability subclassification as: Functional, Structural and Combined Instability. Method: 40 adult with R/CLBP patients (30 men and 10 women), 18 to 80 years of age, underwent repeated measurements of specific clinical tests for structural or functional lumbar segmental instability. Results: Other than the Lack …

The Effect Of Perceived Parental Style On Hispanic Adults Receiving Outpatient Substance Abuse Treatment In South Texas, Elizabeth C. Palacios

Theses and Dissertations - UTB/UTPA

Hirschi's (1969) Social Control Theory proposes that parental relationships serve as a shielding factor and has positive impact in the decreasing delinquency (i.e. substance use/abuse) in young people. This theory provides a framework for understanding substance use/abuse in young adult populations. Other factors including gender, cultural influences, family composition and birth order were also examined in this study. The Drug Abuse Screening Test - 20 (Skinner, 1982), the Parental Authority Questionnaire (Buri, 1991), and a demographic scale were utilized in a population of 182 adults in outpatient substance abuse treatment centers in South Texas, Texas Gulf Coast and areas in …

Examining The Shift In Occupational Identity After A Brain Injury, Mikelle Bryson-Campbell

Electronic Thesis and Dissertation Repository

Occupational identity is defined by Kielhofner (2002) as a sense of who we are as an occupational being, based on our past, current, and future occupational roles. When a life disruption occurs such as a brain injury (BI) and the disruption impacts the ability to conduct an occupation deemed meaningful an important process of transition occurs (Muenchberger, Kendall, & Neal, 2008). In turn occupational identity may shift to reflect the current health and economic status of the individual and what occupations are judged as meaningful.

The current study examined the shift in occupational identity in BI survivors in a two …

Re-Cognizing Power In The Culture Of Dementia Care Knowledge, Ryan T. Deforge

Electronic Thesis and Dissertation Repository

In light of increasing system demands, system regulations, and constrained resources, those living and working with dementia in the long-term care sector are vulnerable to oppressive care practices. This is true so long as our understanding of how social power affects the ways in which dementia care knowledge is created, shared, and enacted remains limited. Based on prolonged field observations and on informal and formal interviews with care recipients, family members, and staff, the aim of this critical qualitative research was to examine the culture of dementia care knowledge in two sites: a specialized dementia care unit in a long-term …

In Vitro Manual Therapy And Biorobotic Simulation Of Glenohumeral Joint Mobilization Techniques, Hunter Johnson Smith

Theses and Dissertations (ETD)

Physical therapists (PT) employ mobilization techniques for restoring range of motion to joints. Few studies have attempted to quantify the biomechanics of manual therapy on the glenohumeral (GH) joint. The objectives of this study were to develop an in vitro protocol to determine the biomechanical effects of joint mobilization on the GH joint, and to then simulate these mobilizations in the University of Tennessee Health Science Center (UTHSC) Joint Implant Biomechanics Laboratory’s Robotic Testing Platform (RTP).

The GH joint is an incredibly shallow socket joint. This gives the joint an unusually large range of motion (ROM) compared to other ball …

Understanding Turnover Propensity Via Affective Beliefs, Adam Bradshaw

Theses and Dissertations

Three latent variable models examined relationships among neuroticism, situation-specific affective beliefs, and turnover propensity and were evaluated with Structural Equation Modeling to determine model fit. Results provided additional insight into how affective belief systems relate to turnover propensity reinforcing and expanding upon previous research by Binning, Bradshaw, LeBreton, and Scheier (2010) as the Correlated Antecedents and the Mediated Antecedents Models fit the data as proposed. Neuroticism and situation-specific affective beliefs continue to play distinguishable roles in explaining turnover propensity. Research by Binning et al. (2010) and the present study make it increasingly clear that understanding how affective belief systems relate …

Short Term Sensory And Vascular Responses To Physical Agent Modalities And Exercise In Healthy Volunteers And Patients With Distal Radius Fracture., Shaguftha Shaik

Electronic Thesis and Dissertation Repository

Currently, there is weak evidence on the effectiveness of different rehabilitation regimens following distal radius fracture (DRF). This thesis evaluated sensory and vascular effects of exercise, thermal and ultrasound interventions that can be used in the mobilization phase (cast removal) after DRF.

Methods

• This thesis includes 3 studies. The first study compared responses to Immersion in Cold water Evaluation (ICE) in the DRF and uninjured hands. Skin blood flow (Sbf), skin temperature (temp.) and sensory perception thresholds (sPT) at 2000Hz for A –beta fibres and at 5 Hz for C fibres were obtained before, immediately after ICE and 10 min …

Effect Of Fluid Loss Following Hemodialysis On Tibialis Anterior Muscle Strength In People With End-Stage Renal Disease, Anuradha Sawant

Electronic Thesis and Dissertation Repository

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the effect of fluid loss following hemodialysis (HD) on tibialis anterior (TA) strength in participants with end-stage renal disease. Issues concerning measures of skeletal muscle hydration and efficacy of exercise as an anabolic intervention were also addressed.

METHODS: Data from published literature were combined in a meta-analysis to establish efficacy of exercise in participants on HD. Three clinical studies were undertaken using data acquired from healthy volunteers and participants on HD. Hydration of the calf muscles was estimated using bioelectrical impedance spectroscopy (BIS) [extracellular (ECF) and intracellular (ICF) fluid] …

A Randomized Controlled Trial Comparing Arthroscopic Surgery To Conservative Management Of Femoroacetabular Impingement, Heather C. Klaus

Electronic Thesis and Dissertation Repository

OBJECTIVE: To determine whether patients with femoroacetabular impingement (FAI) who undergo arthroscopic hip surgery experience similar outcomes at two years post-operative with respect to physical function, pain, and health related quality of life, compared to similar patients who receive conservative management, including medication and physiotherapy. This thesis is an interim analysis of ten participants who are six-months post-randomization. METHODS: Participants were randomized to either operative treatment (6) or conservative treatment (4), and completed general and region specific quality of life questionnaires, including the Hip Outcome Score (HOS), Lower Extremity Functional Scale (LEFS), Modified Harris Hip Score (MHHS), Non-Arthritic Hip Score …

Prognosis And Movement Patterns In Patients After Rotator Cuff Repair, Jayaprakash Raman

Electronic Thesis and Dissertation Repository

Rotator cuff repairs are done in patients who failed to achieve functional improvement with conservative management for rotator cuff tears. This thesis focuses on prognostic factors that predict outcomes after rotator cuff repair (RCR) and change in functional range of motion (ROM) and muscle endurance before and after RCR. A meta-analysis was performed to statistically analyze all available evidence in the literature concerning prognostic factors that determine outcome after RCR. Based on this study, several factors were identified that had significant and moderate effects on outcomes after RCR. Two prospective studies were conducted to analyze change in functional ROM and …

The Effects Of Virtual Rehabilitation Following Acquired Brain Injury: A Feasibility Study, Taylor L. Randall

Electronic Thesis and Dissertation Repository

Increasingly the Nintendo Wii has been cited as an adjunctive tool for physical rehabilitation among healthy young and older adults, and among diverse range of patient populations (e.g., Parkinson’s disease, Cerebral Palsy, and Down syndrome) in clinical settings. However, evidence supporting the implementation of Wii-habilitation in community settings remains limited. The present study evaluates the feasibility of a 4-week community based exercise program using the Nintendo Wii™; as a tool for improving balance in individuals with Acquired Brain Injury (ABI) several years post injury. This study also evaluates whether use of the Wii™ in this context may lead to clinically …

Investigating Immersive Augmented Reality As A Rehabilitation Tool For Parkinson Disease, Danielle M. Bell Boucher

Electronic Thesis and Dissertation Repository

Physical rehabilitation programs are often prescribed in an effort to maintain range of motion, and to adapt strategies for managing the debilitating symptoms of Parkinson disease (PD) in everyday life. An emerging trend to overcome the limitations of traditional rehabilitation is the use of virtual reality technologies. IThe goal of the present study was to determine the feasibility of augmented reality technology (IAR) in a rehabilitative setting. Three IAR environments were designed and a corresponding task was completed in each one. Not surprisingly, the control group generally performed better than the PD group on the tasks. All participants typically performed …

Tibial Tubercle Transfer To Correct Bilateral Patellar Tendinopathy In A Collegiate Football Player, Andrew D. Hamstra

Boise State University Theses and Dissertations

Objective: To present a case of a competitive football player with chronic patellar tendinopathy and the associated bilateral tibial tubercle transfer surgeries performed leading to the reduction of pain and return to participation.

Background: A 19 year-old male football athlete (height= 187.96 cm, mass= 112.037 kg) presented with chronic patellar tendinopathy that began in his high school career and continued to worsen with the increased physical demands associated with participation in collegiate sport.

Differential Diagnosis: Chondromalacia patella and Osgood Schlatters disease.

Treatment: After nonsurgical intervention resulted in no decrease of pain, bilateral tibial tubercle transfer surgery was conducted to correct …

Short Term Treatment Effectiveness And Long Term Prognosis In Patients With Lateral Epicondylosis/Tennis Elbow, Pritika Gogia

Electronic Thesis and Dissertation Repository

This thesis investigated the short term and long term outcomes of patients who underwent treatment for lateral epicondylosis (LE). The first manuscript compared the immediate effects of counterforce brace versus kinesiotaping on pain free grip during a repetitive upper extremity reaching task in thirty patients (n=30) with LE. The study found kinesiotape to be superior over bracing as it not only improved immediate pain free grip strength by 17.5% but also maintained this during activity as compared to brace which had a smaller improvement of 9.3%. The second manuscript determined the extent of work disability/limitations experienced by patients (n=32) following …

Therapeutic Guide To Intellectual Disability And Special Populations, Robert Spencer Ashmun

Chancellor’s Honors Program Projects

No abstract provided.

Perceptual Correlates Of Acoustic Measures Of Vocal Variability, Bree Ann Cumbers

Theses and Dissertations

This study investigated relationships between acoustic measures of vocal variability (pitch sigma, SFF range) and perceptual ratings of vocal variability during a reading task. Fifteen male (19-30 years of age) and nineteen female speakers (20-30 years of age) who were recorded reading the Grandfather Passage provided the stimuli for the listening task. From these samples, 30 were selected as representing a continuum of degrees of vocal variability. Male (N = 15) and female (N = 15) samples were presented to listeners separately. Thirty graduate students in Communication Sciences and Disorders who had a course background in voice supplied the perceptual …

The Effects Of Multiple Sclerosis On Perceived Parenting Roles And Adolescent Coping, Alyssa Coundourides, Kendra Host, Elizabeth Rexroat

Adult

This research project focused on the effects of parental multiple sclerosis (MS) upon parenting roles and family coping. Specifically, the study was implemented to acquire insight into the primary research question: How do parents perceive familial role changes resulting from MS to impact coping of their adolescent children? The study also investigated the role of occupational therapy in assisting parents with MS to facilitate coping in their adolescent children. These concepts were investigated though a mixed methods design, using the Role Checklist to quantitatively assess participants’ roles and values, and a focus group to qualitatively explore participants’ lived experiences of …

Measuring Outcomes Of Rehabilitation Among Persons With Upper Extremity Traumatic Injuries, Jamie Carl Grede

Theses and Dissertations

Grip strength is frequently measured to determine outcomes of rehabilitation among people with upper extremity traumatic injuries (UETIs). UETIs also affect rate of force-production during an isometric grip. However, we do not have a reliable and valid measure for detecting these force changes. The purpose of this study was to determine the validity and responsiveness, i.e. ability to detect change, of the Force-Time Curve (F-T Curve) to determine rate of force production. Twenty people with UETIs undergoing rehabilitation were recruited to participate in this study. Using an electronic Jamar dynamometer, each participant performed three maximal isometric grips, each lasting 10 …

Acoustic Characteristics Of Tense And Lax Vowels Across Sentence Position In Clear Speech, Lindsay Kayne Roesler

Theses and Dissertations

The purpose of this study was to examine the acoustic characteristics of tense and lax vowels across sentence positions in clear speech. Recordings were made of 12 participants reading monosyllabic target words at varying positions within semantically meaningful sentences. Acoustic analysis was completed to determine the effects of Style (clear vs. conversational), Tenseness (tense vs. lax), and Position (sentence-medial vs. sentence-final) on vowel duration, vowel space area, vowel space dispersion, and vowel peripheralization. The results showed speakers had longer durations and expanded vowel spaces in clear speech for both tense and lax vowels. Importantly, the amount of increase was similar …

The Meaning Of Play For Adults From A Reversal Theory Perspective, Linda Lane

Graduate Theses and Dissertations

Play is important to adults' mental creativity and happiness (Marano, 1999), and stress reduction (Apter, 2009a; Baptiste, 1995). Yet play may be considered as trivial behavior that is not appropriate for the adult population. The purpose of the study was to examine how adults describe the concept of play and to determine whether this description reflects their dominant metamotivational state. According to reversal theory, these states are the frames of mind that characterize an individual's motivation at any given point in time (Apter, 1982). An individual tends to be in a more playful (paratelic) state or serious-minded (telic) state depending …

The Effects Of Expiratory Muscle Strength Training On Swallowing And Voice Measures In Healthy Older Adults, Adam Follmer

Theses and Dissertations

This study investigated the effects of a four week expiratory muscle strength training (EMST) exercise program on healthy older adults (65-79 years). The investigators were interested in possible changes to the swallowing and voice production systems, both of which are in the scope of practice for a speech language pathologist. Specific voice variables included maximum phonation time, conversational intensity level, and upper and lower limits of available intensity range. Swallowing variables were related to tongue function and included maximum isometric pressure and mean swallowing pressure. Finally, maximum expiratory pressure was measured as a comparative value to other EMST studies. A …

Cepstral- And Spectral-Based Acoustic Measures Of Normal Voices, Rachel Garrett

Theses and Dissertations

A review of recent literature suggested that cepstral- and spectral-based acoustic measures showed good potential as objective measures of dysphonia for clinical application. However, the small numbers of normal subjects in previous research and wide age ranges prevent a good estimation of the performance of normal speakers of various ages on these measures. Therefore, the purpose of this study was to provide normative data for Long-Term Average spectral- and cepstral-based measures for both men and women in two different age groups to aid clinicians with assessing and treating voice disorders. Sixty participants consisting of fifteen males and fifteen females, ages …