Medicine and Health Sciences Commons^™

Hybrid Diffuse Optical Techniques For Continuous Hemodynamic Measurement In Gastrocnemius During Plantar Flexion Exercise, Brad Henry, Mingjun Zhao, Yu Shang, Tim L. Uhl, D. Travis Thomas, Eleftherios S. Xenos, Sibu P. Saha, Guoqiang Yu

Physical Therapy Faculty Publications

Occlusion calibrations and gating techniques have been recently applied by our laboratory for continuous and absolute diffuse optical measurements of foreann muscle hemodynamics during handgrip exercises. The translation of these techniques from the foreann to the lower limb is the goal of this study as various diseases preferentially affect muscles in the lower extremity. This study adapted a hybrid near-infrared spectroscopy and diffuse correlation spectroscopy system with a gating algorithm to continuously quantify hemodynamic responses of medial gastrocnemius during plantar flexion exercises in 10 healthy subjects. The outcomes from optical measurement include oxy-, deoxy-, and total hemoglobin poncentrations, blood oxygen …

Reliability Of 3-Dimensional Measures Of Single-Leg Cross Drop Landing Across 3 Different Institutions: Implications For Multicenter Biomechanical And Epidemiological Research On Acl Injury Prevention, Christopher A. Dicesare, Nathaniel A. Bates, Kim D. Barber Foss, Staci M. Thomas, Samuel C. Wordeman, Dai Sugimoto, Benjamin D. Roewer, Jennifer M. Medina Mckeon, Stephanie Di Stasi, Brian W. Noehren, Kevin R. Ford, Adam W. Kiefer, Timothy E. Hewett, Gregory D. Myer

Physical Therapy Faculty Publications

Background: Anterior cruciate ligament (ACL) injuries are physically and financially devastating but affect a relatively small percentage of the population. Prospective identification of risk factors for ACL injury necessitates a large sample size; therefore, study of this injury would benefit from a multicenter approach.

Purpose: To determine the reliability of kinematic and kinetic measures of a single-leg cross drop task across 3 institutions.

Study Design: Controlled laboratory study.

Methods: Twenty-five female high school volleyball players participated in this study. Three-dimensional motion data of each participant performing the single-leg cross drop were collected at 3 institutions over a period of 4 …

Sustained Isometric Shoulder Contraction On Muscular Strength And Endurance: A Randomized Clinical Trial, Natalie L. Myers, Jenny L. Toonstra, Jacob S. Smith, Cooper A. Padgett, Tim L. Uhl

Physical Therapy Faculty Publications

BACKGROUND: The Advanced Throwers Ten Exercise Program incorporates sustained isometric contractions in conjunction with dynamic shoulder movements. It has been suggested that incorporating isometric holds may facilitate greater increases in muscular strength and endurance. However, no objective evidence currently exists to support this claim.

HYPOTHESIS/PURPOSE: The purpose of this research was to compare the effects of a sustained muscle contraction resistive training program (Advanced Throwers Ten Program) to a more traditional exercise training protocol to determine if increases in shoulder muscular strength and endurance occur in an otherwise healthy population. It was hypothesized that utilizing a sustained isometric …

Examining Older Adults' Perceptions Of Usability And Acceptability Of Remote Monitoring Systems To Manage Chronic Heart Failure, Lorraine S. Evangelista, Debra K. Moser, Jung-Ah Lee, Alison A. Moore, Hassan Ghasemzadeh, Majid Sarrafzadeh, Carol M. Mangione

Nursing Faculty Publications

Objective: This study was conducted to evaluate the feasibility, usability, and acceptability of using remote monitoring systems (RMS) in monitoring health status (e.g., vital signs, symptom distress) in older adults (≥ 55) with chronic heart failure (HF). Method: Twenty-one patients (52.4% women, mean age 73.1 ± 9.3) were trained to measure and transmit health data with an RMS. Data transmissions were tracked for 12 weeks. Results: All participants initiated use of RMS within 1 week; 71%, 14%, and 14% of patients transmitted daily health data 100%, ≥ 75%, and < 75% of the time, respectively, for 12 weeks. Overall usability and acceptability of the RMS were 4.08 ± 0.634 and 4.10 ± 0.563, respectively (when scored on a range of 1-5, where 1 = strongly disagree and 5 = strongly agree). Discussion: Findings show …

Reduced Voluntary Running Performance Is Associated With Impaired Coordination As A Result Of Muscle Satellite Cell Depletion In Adult Mice, Janna R. Jackson, Tyler J. Kirby, Christopher S. Fry, Robin L. Cooper, John J. Mccarthy, Charlotte A. Peterson, Esther E. Dupont-Versteegden

Physical Therapy Faculty Publications

BACKGROUND: Satellite cells, or muscle stem cells, have been thought to be responsible for all muscle plasticity, but recent studies using genetically modified mouse models that allow for the conditional ablation of satellite cells have challenged this dogma. Results have confirmed the absolute requirement of satellite cells for muscle regeneration but surprisingly also showed that they are not required for adult muscle growth. While the function of satellite cells in muscle growth and regeneration is becoming better defined, their role in the response to aerobic activity remains largely unexplored. The purpose of the current study was to assess the …

Reliability Of Isometric And Eccentric Isokinetic Shoulder External Rotation, Brianna M. Papotto, Thomas Rice, Terry Malone, Timothy Butterfield, Tim L. Uhl

Physical Therapy Faculty Publications

CONTEXT: Shoulder external rotators are challenged eccentrically throughout the deceleration phase of throwing which is thought to contribute to overuse injuries. In order to evaluate the effectiveness of intervention programs as well as identify deficits, reliable and responsive measures of isometric and eccentric shoulder external rotation are necessary. Previously, isometric measures have primarily tested a single position and eccentric measures have not been found to have high reliability.

OBJECTIVE: To examine the between day reliability of multiple angle isometric and dynamic eccentric isokinetic testing of shoulder external rotation.

DESIGN: Repeated measures Participants: 10 healthy subjects (age: 30 ± 12 years, …

A Prospective Analysis Of Factors Associated With Decreased Physical Activity In Patients With Cirrhosis Undergoing Transplant Evaluation, Anna Christina Dela Cruz, Valery Vilchez, Sooyeon Kim, Benjamin Barnes, Abhishek Ravinuthala, Anthony Zanni, Roberto Galuppo, Achuthan Sourianarayanane, Trushar Patel, Erin Colleen Maynard, Malay B. Shah, Michael F. Daily, Timothy L. Uhl, Karyn A. Esser, Roberto Gedaly

Internal Medicine Faculty Publications

BACKGROUND: Physical activity has been associated with improved recovery time after transplantation. Handgrip strength has been related to post-transplant outcomes.

AIM: To evaluate predictors of physical activity and grip strength in cirrhotic patients undergoing liver transplant evaluation.

METHODS: Single center, prospective analysis.

RESULTS: A hundred patients were evaluated (54% male, mean age 53 ± 9). Common etiologies of liver disease were non-alcoholic hepatitis (27%), hepatitis C (22%), and alcoholic liver disease (21%). Mean MELD score was 13.5. Forty one percent had a history of smoking. Ninety-three patients completed the International Physical Activity Questionnaire. The median total physical activity score of …

Residual Impact Of Previous Injury On Musculoskeletal Characteristics In Special Forces Operators, Jeffrey J. Parr, Nicholas C. Clark, John P. Abt, Julie Y. Kresta, Karen A. Keenan, Shawn F Kane, Scott M. Lephart

Physical Therapy Faculty Publications

Background: Musculoskeletal injuries are a significant burden to United States Army Special Operations Forces. The advanced tactical skill level and physical training required of Army Special Operators highlights the need to optimize musculoskeletal characteristics to reduce the likelihood of suffering a recurrent injury.

Purpose: To identify the residual impact of previous injury on musculoskeletal characteristics.

Study Design: Cross-sectional study; Level of evidence, 3.

Methods: Isokinetic strength of the knee, shoulder, and back and flexibility of the shoulder and hamstrings were assessed as part of a comprehensive human performance protocol, and self-reported musculoskeletal injury history was obtained. Subjects were stratified based …

Increasing Ball Velocity In The Overhead Athlete: A Meta-Analysis Of Randomized Controlled Trials, Natalie L. Myers, Aaron D. Sciascia, Philip M. Westgate, William B. Kibler, Tim L. Uhl

Physical Therapy Faculty Publications

Overhead athletes routinely search for ways to improve sport performance, and one component of performance is ball velocity. The purpose of this meta-analysis was to investigate the effect of different strengthening interventions on ball and serve velocity. A comprehensive literature search with pre-set inclusion and exclusion criteria from 1970 to 2014 was conducted. Eligible studies were randomized control trials including the mean and SDs of both pretest and posttest ball velocities in both the experimental and the control groups. The outcome of interest was ball/serve velocity in baseball, tennis, or softball athletes. Level 2 evidence or higher was investigated …

Reliability Of Strength And Performance Testing Measures And Their Ability To Differentiate Persons With And Without Shoulder Symptoms, Aaron Sciascia, Tim L. Uhl

Physical Therapy Faculty Publications

BACKGROUND: Upper extremity physical performance measures exist but none have been universally accepted as the primary means of gauging readiness to return to activity following rehabilitation. Few reports have described reliability and/or differences in outcome with physical performance measures between individuals with and without shoulder symptoms.

HYPOTHESES/PURPOSE: The purpose of this study was to establish the reliability of traditional upper extremity strength testing and the CKCUEST in persons with and without shoulder symptoms as well as to determine if the testing maneuvers could discriminate between individuals with and without shoulder symptoms. The authors hypothesized that strength and physical …

Do Three Different Passive Assessments Of Quadriceps Spasticity Relate To The Functional Activity Of Walking For Children Diagnosed With Cerebral Palsy?, Hank White, Tim L. Uhl, Sam Augsburger

Physical Therapy Faculty Publications

A stiff-knee gait pattern is frequently associated with several impairments including quadriceps spasticity in children diagnosed with cerebral palsy (CP). The relationship of clinical measures of quadriceps spasticity and the stiff-knee gait pattern in children diagnosed with CP has not been well established. Therefore, the purpose of this study was to determine the ability of clinical measures of quadriceps spasticity (modified Ashworth scale [MAS], Ely tests, and pendulum test) to categorize a stiff-knee gait pattern in children with CP. Children were categorized as having a stiff-knee gait pattern based on kinematic and EMG gait data. Results of a logistic regression …

Less Is More: The Physiological Basis For Tapering In Endurance, Strength, And Power Athletes, Kevin A. Murach, James R. Bagley

Physical Therapy Faculty Publications

Taper, or reduced-volume training, improves competition performance across a broad spectrum of exercise modes and populations. This article aims to highlight the physiological mechanisms, namely in skeletal muscle, by which taper improves performance and provide a practical literature-based rationale for implementing taper in varied athletic disciplines. Special attention will be paid to strength- and power-oriented athletes as taper is under-studied and often overlooked in these populations. Tapering can best be summarized by the adage “less is more” because maintained intensity and reduced volume prior to competition yields significant performance benefits.

Assessment Of Accelerometers For Measuring Upper-Extremity Physical Activity, Elizabeth Lawinger, Timothy L. Uhl, Mark Abel, Srinath Kamineni

Physical Therapy Faculty Publications

Objective: The overarching goal of this study was to examine the use of triaxial accelerometers in measuring upper-extremity motions to monitor upper-extremity-exercise compliance. There were multiple questions investigated, but the primary objective was to investigate the correlation between visually observed arm motions and triaxial accelerometer activity counts to establish fundamental activity counts for the upper extremity.

Study Design: Cross-sectional, basic research.

Setting: Clinical laboratory.

Participants: Thirty healthy individuals age 26 ± 6 y, body mass 24 ± 3 kg, and height 1.68 ± 0.09 m volunteered.

Intervention: Participants performed 3 series of tasks: activities of …

Arm Dominance Does Not Influence Measures Of Scapular Muscle Strength And Endurance In Healthy Individuals, Joseph M. Day, Heather M. Bush, Arthur J. Nitz, Tim L. Uhl

Physical Therapy Faculty Publications

BACKGROUND PURPOSE: Scapular muscle performance is potentially influenced by arm dominance. The purpose of this study was to investigate the effect of arm dominance on clinical measures of scapulohumeral muscle strength and endurance.
METHODS: Thirty-two healthy individuals between the ages of 30 and 65 years were recruited to participate. Scapular muscle strength of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) were recorded with a hand held dynamometer. One scapulohumeral isometric muscle endurance task was performed in prone. The order of testing (strength and endurance) was randomized for each individual. Dominant to …

Role Of Mitochondria In Regulating Microrna Activity And Its Relevance To The Central Nervous System, Wang-Xia Wang, Joe E. Springer

Physical Medicine and Rehabilitation Faculty Publications

No abstract provided.

Descriptive Analysis Of Common Functional Limitations Identified By Patients With Shoulder Pain, Enrique V. Smith-Forbes, Stephanie D. Moore-Reed, Philip M. Westgate, W. Ben Kibler, Timothy L. Uhl

Physical Therapy Faculty Publications

Context: Recent establishment of G-codes by the US government requires therapists to report function limitations at initial evaluation. Limited information exists specific to the most common limitations in patients with shoulder pain.

Objective: To describe the most commonly expressed shoulder limitations with activities and their severity/level of impairment from a patient’s perspective on the initial evaluation.

Design: Descriptive.

Setting: Patients reporting pain with overhead activity and seeking medical attention from one orthopedic surgeon were recruited as part of a cohort study.

Patients: 176 with shoulder superior labral tear from anterior to posterior (SLAP), subacromial impingement, …

Immune Function And Muscle Adaptations To Resistance Exercise In Older Adults: Study Protocol For A Randomized Controlled Trial Of A Nutritional Supplement, Richard A. Dennis, Usha Ponnappan, Ralph L. Kodell, Kimberly K. Garner, Christopher M. Parkes, Melinda M. Bopp, Kalpana P. Padala, Charlotte A. Peterson, Prasad R. Padala, Dennis H. Sullivan

Physical Therapy Faculty Publications

BACKGROUND: Immune function may influence the ability of older adults to maintain or improve muscle mass, strength, and function during aging. Thus, nutritional supplementation that supports the immune system could complement resistance exercise as an intervention for age-associated muscle loss. The current study will determine the relationship between immune function and exercise training outcomes for older adults who consume a nutritional supplement or placebo during resistance training and post-training follow-up. The supplement was chosen due to evidence suggesting its ingredients [arginine (Arg), glutamine (Gln), and β-hydroxy β-methylbutyrate (HMB)] can improve immune function, promote muscle growth, and counteract muscle loss. …

Mitochondria-Associated Micrornas In Rat Hippocampus Following Traumatic Brain Injury, Wang-Xia Wang, Nishant P. Visavadiya, Jignesh D. Pandya, Peter T. Nelson, Patrick G. Sullivan, Joe E. Springer

Sanders-Brown Center on Aging Faculty Publications

Traumatic brain injury (TBI) is a major cause of death and disability. However, the molecular events contributing to the pathogenesis are not well understood. Mitochondria serve as the powerhouse of cells, respond to cellular demands and stressors, and play an essential role in cell signaling, differentiation, and survival. There is clear evidence of compromised mitochondrial function following TBI; however, the underlying mechanisms and consequences are not clear. MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate gene expression post-transcriptionally, and function as important mediators of neuronal development, synaptic plasticity, and neurodegeneration. Several miRNAs show altered expression following TBI; however, the …

Comparison Of Transcutaneous Electrical Nerve Stimulation And Cryotherapy For Increasing Quadriceps Activation In Patients With Knee Pathologies, Conrad M. Gabler, Adam S. Lepley, Timothy L. Uhl, Carl G. Mattacola

Physical Therapy Faculty Publications

Proper neuromuscular activation of the quadriceps muscle is essential for maintaining quadriceps strength and lower extremity function. Quadriceps activation failure is a common characteristic observed in patients with knee pathologies, and it is defined as an inability to voluntarily activate the entire alpha motor neuron pool innervating the quadriceps. One of the more popular techniques used to assess quadriceps activation is the superimposed burst (SIB) technique. The SIB technique is a force-based technique which uses a supramaximal, percutaneous electrical stimulation to activate all of the motor units in the quadriceps during a maximal, voluntary isometric contraction of the quadriceps. Central …

Inducible Depletion Of Satellite Cells In Adult, Sedentary Mice Impairs Muscle Regenerative Capacity Without Affecting Sarcopenia, Christopher S. Fry, Jonah D. Lee, Jyothi Mula, Tyler J. Kirby, Janna R. Jackson, Fujun Liu, Lin Yang, Christopher L. Mendias, Esther E. Dupont-Versteegden, John J. Mccarthy, Charlotte A. Peterson

Physical Therapy Faculty Publications

A key determinant of geriatric frailty is sarcopenia, the age-associated loss of skeletal muscle mass and strength. Although the etiology of sarcopenia is unknown, the correlation during aging between the loss of activity of satellite cells, which are endogenous muscle stem cells, and impaired muscle regenerative capacity has led to the hypothesis that the loss of satellite cell activity is also a cause of sarcopenia. We tested this hypothesis in male sedentary mice by experimentally depleting satellite cells in young adult animals to a degree sufficient to impair regeneration throughout the rest of their lives. A detailed analysis of multiple …

Biomechanical Analysis Of Race Walking Compared To Normal Walking And Running Gait, Jaclyn D. Norberg

Theses and Dissertations--Kinesiology and Health Promotion

Human locomotion is phenomenon that is extraordinarily complex. It is evident that a complete description of locomotion involves consideration of kinematics, kinetics, and muscle activity of the extremities in all of their various movements. Race walking (RW) is a form of upright locomotion that differs from normal walking and running by its form dictated by the International Amateur Athletics Federation (IAAF). Despite the similarities to both normal walking (NW) and running (RU), RW has not been the subject of equally intensive investigations.

This study explores the comprehensive biomechanics of race walking and how it compares to NW and RU. A …

Exploration Of Factors Associated With Patient Adherence In Upper Extremity Rehabilitation: A Mixed-Methods Embedded Design, Enrique V. Smith-Forbes

Theses and Dissertations--Rehabilitation Sciences

Adherence is considered a prerequisite for the success of exercise programs for musculoskeletal disorders. The negative effects of non-adherence to exercise recommendations impact the cost of care, and also treatment effectiveness, treatment duration, the therapeutic relationship, waiting times, the efficiency of personnel and use of equipment. Adherence to therapeutic exercise intervention is a multifaceted problem.

The World Health Organization (WHO) established the multidimensional adherence model (MAM). The MAM describes five interactive dimensions (socioeconomic, healthcare team and system, condition-related, therapy-related, and patient-related factors) that have an effect on patient adherence.

The first purpose of this dissertation was to explore the MAM …

"Bent But Not Broken": A Mixed Methods Study Of Mothering During Chemotherapy For Breast Cancer, Julie A. Baltisberger

Theses and Dissertations--Rehabilitation Sciences

Breast cancer is the most common cancer diagnosis of women, with an estimated 232,670 new cases in 2014. With 89.2% of breast cancer patients surviving five years or longer, studies are needed to investigate the long-term impact of breast cancer on women and families (National Cancer Institute, 2014).

The purpose of this study was to examine, using a mixed methods approach, the impact of chemotherapy on mothering occupations for patients diagnosed with breast cancer. Thirty-one women (mean age=39.6, SD=5.79), with breast cancer of any stage, who were currently undergoing chemotherapy and had at least one child under the age of …

The Effects Of Spinal Manipulative Therapy On Isokinetic Strength And Postactivation Potentiation, Grant D. Sanders

Theses and Dissertations--Kinesiology and Health Promotion

Spinal manipulative therapy (SMT) is a therapeutic procedure employed by various healthcare practitioners for alleviating acute and chronic musculoskeletal complaints. This form of treatment is also delivered to enhance the performance and augment the rehabilitation of athletes. However, despite research findings alleging the strength-modulating effects of SMT alongside numerous professional athletes’ positive anecdotal claims concerning its results, the physiological processes to explain its effects remain largely unexplained. Therefore, the purpose of this work was to investigate the effects of SMT in a college-aged sample population with two experiments.

The first study examined the effect of SMT targeting the lumbosacral region …