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The Supine Moving Apprehension Test—Reliability And Validity Among Healthy Individuals And Patients With Anterior Shoulder Instability, Alon Rabin, Ofir Chechik, Margie K. Olds, Timothy L. Uhl, Efi Kazum, Adin Deutsch, Eran Citron, Tal Cohen, Oleg Dolkart, Assaf Bibas, Eran Maman Jan 2023

The Supine Moving Apprehension Test—Reliability And Validity Among Healthy Individuals And Patients With Anterior Shoulder Instability, Alon Rabin, Ofir Chechik, Margie K. Olds, Timothy L. Uhl, Efi Kazum, Adin Deutsch, Eran Citron, Tal Cohen, Oleg Dolkart, Assaf Bibas, Eran Maman

Physical Therapy Faculty Publications

Background: Performance-based tests for patients with anterior shoulder dislocation are lacking. This study determined the reliability and validity of the supine moving apprehension test designed to assess the ability to control anterior instability loads. Methods: Thirty-six participants were recruited (18 healthy individuals, and 18 patients following anterior shoulder dislocation). Healthy participants performed the supine moving apprehension test on 2 separate occasions to determine test-retest reliability. Patients completed the supine moving apprehension test and the Western Ontario Shoulder Instability index before and 6 months after surgical stabilization of their shoulder. The presence of anterior apprehension was also documented post-operatively. Results: The …


Nonoperative Management Of Shoulder Instability, Margie K. Olds, Timothy L. Uhl Jan 2023

Nonoperative Management Of Shoulder Instability, Margie K. Olds, Timothy L. Uhl

Physical Therapy Faculty Publications

Non-operative management following a shoulder dislocation or subluxation remains a challenging and complex task. Accurate diagnosis of the condition, and shared decision-making regarding operative and non-operative management, as well as timing of return to play is required. This clinical concept paper introduces a shoulder instability framework that addresses these fundamental clinical dilemmas. Valid clinical prognostic tools which can predict recurrent shoulder instability are reviewed. The process of shared decision-making within the realm of shoulder instability is also presented. Finally, a framework for progressive rehabilitation that addresses deficits in motor control, strength, and endurance in scapula and shoulder musculature is presented …


Effect Of Pitching Restrictions And Mound Distance On Youth Baseball Pitch Counts., Hailey Mair, Nicholas A Kenney, Timothy L Uhl, L Robert Ullery, Robert G Hosey Jul 2022

Effect Of Pitching Restrictions And Mound Distance On Youth Baseball Pitch Counts., Hailey Mair, Nicholas A Kenney, Timothy L Uhl, L Robert Ullery, Robert G Hosey

Physical Therapy Faculty Publications

BACKGROUND: Studies have shown that higher pitch counts are directly related to a greater incidence of elbow and shoulder pain among youth baseball pitchers.

PURPOSE/HYPOTHESIS: The purpose of this study was to examine the effect of different pitching restriction rules on the number of pitches thrown in youth baseball leagues. We hypothesized that more pitches would be thrown in leagues with inning restrictions versus leagues with pitch count restrictions as well as in leagues with a longer mound distance (from pitching mound to home plate).

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: Pitch count data were collected for …


Acute Kidney Injury Contributes To Worse Physical And Quality Of Life Outcomes In Survivors Of Critical Illness, Kirby P. Mayer, Victor M. Ortiz-Soriano, Alborz Kalantar, Joshua Lambert, Peter E. Morris, Javier A. Neyra Apr 2022

Acute Kidney Injury Contributes To Worse Physical And Quality Of Life Outcomes In Survivors Of Critical Illness, Kirby P. Mayer, Victor M. Ortiz-Soriano, Alborz Kalantar, Joshua Lambert, Peter E. Morris, Javier A. Neyra

Physical Therapy Faculty Publications

Objectives: Survivors of critical illness and acute kidney injury (AKI) are at risk of increased morbidity. The purpose of this study was to compare physical, emotional, and cognitive health in survivors of critical illness with and without AKI.

Methods: Retrospective cohort study of adult (≥ 18 years old) survivors of critical illness due to sepsis and/or acute respiratory failure who attended follow-up in a specialized ICU Recovery Clinic. Outcomes were evaluated during 3-month visit and comprised validated tests for evaluation of physical function, muscle strength, cognitive and emotional health, and self-reported health-related quality of life (HRQOL). Descriptive statistics …


Highly-Individualized Physical Therapy Instruction Beyond The Clinic Using Wearable Inertial Sensors, Samir A. Rawashdeh, Ella Reimann, Timothy L. Uhl Jan 2022

Highly-Individualized Physical Therapy Instruction Beyond The Clinic Using Wearable Inertial Sensors, Samir A. Rawashdeh, Ella Reimann, Timothy L. Uhl

Physical Therapy Faculty Publications

Musculoskeletal conditions, often requiring rehabilitation, affect one-third of the U.S. population annually. This paper presents rehabilitation assistive technology that includes body-worn motion sensors and a mobile application that extends the reach of a physical rehabilitation specialist beyond the clinic to ensure that home exercises are performed with the same precision as under clinical supervision. Assisted by a specialist in the clinic, the wearable sensors and user interface developed allow the capture of individualized exercises unique to the patient’s physical abilities. Beyond the clinical setting, the system can assist patients by providing real-time corrective feedback to repeat these exercises through a …


Bending The Elbow During Shoulder Flexion Facilitates Greater Scapular Upward Rotation And A More Favorable Scapular Muscle Activation Pattern, Alon Rabin, Brakha R. Tabi, Timothy L. Uhl, Zvi Kozol Jan 2022

Bending The Elbow During Shoulder Flexion Facilitates Greater Scapular Upward Rotation And A More Favorable Scapular Muscle Activation Pattern, Alon Rabin, Brakha R. Tabi, Timothy L. Uhl, Zvi Kozol

Physical Therapy Faculty Publications

Context: Decreased scapular upward rotation (UR) and diminished activation of the serratus anterior (SA) and lower trapezius (LT) are often observed among patients with subacromial impingement syndrome. Maintaining the elbow fully flexed during shoulder flexion may limit glenohumeral motion due to passive insufficiency of the triceps brachii and therefore facilitate greater scapular UR and increased scapular muscle activation. Objectives: To compare scapular UR, SA, upper trapezius (UT), middle trapezius, and LT activation levels between shoulder flexion with the elbow extended (Flexion-EE) to shoulder flexion with the elbow fully flexed (Flexion-EF). This study hypothesized that Flexion-EF would result in …


International Physical Therapists Consensus On Clinical Descriptors For Diagnosing Rotator Cuff Related Shoulder Pain: A Delphi Study., Néstor Requejo-Salinas, Jeremy Lewis, Lori A Michener, Roy La Touche, Rubén Fernández-Matías, Juan Tercero-Lucas, Paula Rezende Camargo, Marcus Bateman, Filip Struyf, Jean-Sébastien Roy, Anju Jaggi, Timothy Uhl, Leanne Bisset, Craig A Wassinger, Robert Donatelli, Melina Nevoeiro Haik, Enrique Lluch-Girbés Jan 2022

International Physical Therapists Consensus On Clinical Descriptors For Diagnosing Rotator Cuff Related Shoulder Pain: A Delphi Study., Néstor Requejo-Salinas, Jeremy Lewis, Lori A Michener, Roy La Touche, Rubén Fernández-Matías, Juan Tercero-Lucas, Paula Rezende Camargo, Marcus Bateman, Filip Struyf, Jean-Sébastien Roy, Anju Jaggi, Timothy Uhl, Leanne Bisset, Craig A Wassinger, Robert Donatelli, Melina Nevoeiro Haik, Enrique Lluch-Girbés

Physical Therapy Faculty Publications

BACKGROUND: There is a lack of standardized criteria for diagnosing rotator cuff related shoulder pain (RCRSP).

OBJECTIVE: To identify the most relevant clinical descriptors for diagnosing RCRSP.

METHODS: A Delphi study was conducted through use of an international physical therapists expert panel. A 3-round Delphi survey involving an international panel of physical therapists experts with extensive clinical, teaching, and research experience was conducted. A search query was performed in Web of Science, along with a manual search, to find the experts. The first round was composed of items obtained from a previous pilot Delphi study along with new items proposed …


Efficacy Of Power Training To Improve Physical Function In Individuals Diagnosed With Frailty And Chronic Disease: A Meta-Analysis, Alexander B. Sklivas, Lauren E. Robinson, Timothy L. Uhl, Esther E. Dupont-Versteegden, Kirby P. Mayer Jan 2022

Efficacy Of Power Training To Improve Physical Function In Individuals Diagnosed With Frailty And Chronic Disease: A Meta-Analysis, Alexander B. Sklivas, Lauren E. Robinson, Timothy L. Uhl, Esther E. Dupont-Versteegden, Kirby P. Mayer

Physical Therapy Faculty Publications

Muscle power training with emphasis on high-velocity of concentric movement improves physical functionality in healthy older adults, and, maybe superior to traditional exercise programs. Power training may also be advantageous for patients with acute and chronic illnesses, as well as frail individuals. To determine the efficacy of power training compared with traditional resistance training on physical function outcomes in individuals diagnosed with frailty, acute illness or chronic disease. PubMed (MEDLINE), CINAHL, PEDro, Web of Science, and Google Scholar. (1) at least one study group receives muscle power training of randomized controlled trial (RCT) (2) study participants diagnosed as prefrail, frail …


Regaining Motion Among Patients With Shoulder Pathology - Are All Exercises Equal?, Alon Rabin, Eran Maman, Oleg Dolkart, Efi Kazum, Zvi Kozol, Timothy L. Uhl, Ofir Chechik Dec 2021

Regaining Motion Among Patients With Shoulder Pathology - Are All Exercises Equal?, Alon Rabin, Eran Maman, Oleg Dolkart, Efi Kazum, Zvi Kozol, Timothy L. Uhl, Ofir Chechik

Physical Therapy Faculty Publications

Background: Little information exists to guide the choice of exercise for regaining shoulder range of motion (ROM). The purpose of this study was to compare the maximal ROM reached, pain and difficulty associated with 4 commonly prescribed exercises.

Methods: Forty (9 females) patients with various shoulder disorders and a limited flexion ROM performed 4 exercises for regaining shoulder flexion ROM in a randomized order. Exercises included the self-assisted flexion, forward bow, table slide and rope-and-pulley. Participants were videotaped while performing all exercises and the maximal flexion angle reached during each exercise was recorded using Kinovea motion analysis freeware (Kinovea 0.8.15). …


Deletion Of Sa Β-Gal+ Cells Using Senolytics Improves Muscle Regeneration In Old Mice, Cory M. Dungan, Kevin A. Murach, Christopher J. Zdunek, Zuo Jian Tang, Georgia L. Vonlehmden, Camille R. Brightwell, Zachary Hettinger, Davis A. Englund, Zheng Liu, Christopher S. Fry, Antonio Filareto, Michael Franti, Charlotte A. Peterson Dec 2021

Deletion Of Sa Β-Gal+ Cells Using Senolytics Improves Muscle Regeneration In Old Mice, Cory M. Dungan, Kevin A. Murach, Christopher J. Zdunek, Zuo Jian Tang, Georgia L. Vonlehmden, Camille R. Brightwell, Zachary Hettinger, Davis A. Englund, Zheng Liu, Christopher S. Fry, Antonio Filareto, Michael Franti, Charlotte A. Peterson

Physical Therapy Faculty Publications

Systemic deletion of senescent cells leads to robust improvements in cognitive, cardiovascular, and whole-body metabolism, but their role in tissue reparative processes is incompletely understood. We hypothesized that senolytic drugs would enhance regeneration in aged skeletal muscle. Young (3 months) and old (20 months) male C57Bl/6J mice were administered the senolytics dasatinib (5 mg/kg) and quercetin (50 mg/kg) or vehicle bi-weekly for 4 months. Tibialis anterior (TA) was then injected with 1.2% BaCl2 or PBS 7- or 28 days prior to euthanization. Senescence-associated β-Galactosidase positive (SA β-Gal+) cell abundance was low in muscle from both young and old mice …


The Intra- And Inter-Rater Reliability Of An Arm Care Screening Tool In High School Baseball Coaches, Kyle A. Matsel, Stephanie N. Brown, Matthew C. Hoch, Robert J. Butler, Philip M. Westgate, Terry R. Malone, Timothy L. Uhl Dec 2021

The Intra- And Inter-Rater Reliability Of An Arm Care Screening Tool In High School Baseball Coaches, Kyle A. Matsel, Stephanie N. Brown, Matthew C. Hoch, Robert J. Butler, Philip M. Westgate, Terry R. Malone, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: Preseason movement screening can identify modifiable risk factors, deterioration of function, and potential for injury in baseball players. Limited resources and time intensive testing procedures prevent high school coaches from accurately performing frequent movement screens on their players.

Purpose: To establish the intra-rater and inter-rater reliability of a novel arm care screening tool based on the concepts of the Functional Movement Screen (FMS™) and Selective Functional Movement Assessment (SFMA™) in high school coaches.

Study Design: Methodological intra- and inter-rater reliability study.

Methods: Thirty-one male high school baseball players (15.9 years ± 1.06) were independently scored on the Arm Care …


Interprofessional Inconsistencies In The Diagnosis Of Shoulder Instability: Survey Results Of Physicians And Rehabilitation Providers, Constantine P. Nicolozakes, Xinning Li, Timothy L. Uhl, Guido Marra, Nitin B. Jain, Eric J. Perreault, Amee L. Seitz Aug 2021

Interprofessional Inconsistencies In The Diagnosis Of Shoulder Instability: Survey Results Of Physicians And Rehabilitation Providers, Constantine P. Nicolozakes, Xinning Li, Timothy L. Uhl, Guido Marra, Nitin B. Jain, Eric J. Perreault, Amee L. Seitz

Physical Therapy Faculty Publications

Background: Clinicians of many specialties within sports medicine care for athletes with shoulder instability, but successful outcomes are inconsistent. Consistency across specialties in the diagnosis of shoulder instability is critical for care of the athlete, yet the extent of divergence in its diagnosis is unknown.

Hypothesis: Physicians differ from rehabilitation providers in which findings they deem clinically important to differentiate shoulder instability from impingement, and in how they diagnose athlete scenarios with atraumatic shoulder instability.

Study Design: Cross-sectional study.

Methods: Physicians (orthopaedic surgeons, primary care sports medicine physicians) and rehabilitation providers (physical therapists, athletic trainers) were asked via an online …


Myonuclear Transcriptional Dynamics In Response To Exercise Following Satellite Cell Depletion, Yuan Wen, Davis A. Englund, Bailey D. Peck, Kevin A. Murach, John J. Mccarthy, Charlotte A. Peterson Jul 2021

Myonuclear Transcriptional Dynamics In Response To Exercise Following Satellite Cell Depletion, Yuan Wen, Davis A. Englund, Bailey D. Peck, Kevin A. Murach, John J. Mccarthy, Charlotte A. Peterson

Physical Therapy Faculty Publications

Skeletal muscle is composed of post-mitotic myofibers that form a syncytium containing hundreds of myonuclei. Using a progressive exercise training model in the mouse and single nucleus RNA-sequencing (snRNA-seq) for high-resolution characterization of myonuclear transcription, we show myonuclear functional specialization in muscle. After 4 weeks of exercise training, snRNA-seq reveals that resident muscle stem cells, or satellite cells, are activated with acute exercise but demonstrate limited lineage progression while contributing to muscle adaptation. In the absence of satellite cells, a portion of nuclei demonstrates divergent transcriptional dynamics associated with mixed-fate identities compared with satellite cell replete muscles. These data provide …


A Nation-Wide Survey Of High School Baseball Coaches’ Perceptions Indicates Their Arm Care Programs Play A Role In Injury Prevention, Kyle A. Matsel, E. E. Weiss, R. J. Butler, Matthew C. Hoch, Philip M. Westgate, Terry R. Malone, Timothy L. Uhl Jun 2021

A Nation-Wide Survey Of High School Baseball Coaches’ Perceptions Indicates Their Arm Care Programs Play A Role In Injury Prevention, Kyle A. Matsel, E. E. Weiss, R. J. Butler, Matthew C. Hoch, Philip M. Westgate, Terry R. Malone, Timothy L. Uhl

Physical Therapy Faculty Publications

Background
Arm care programs consisting of upper extremity strengthening and stretching have been recommended for injury prevention for pitchers of all ages. There has been no investigation into high school baseball coaches’ usage and perceptions of arm care programs to mitigate physical impairments associated with injuries in baseball players.

Hypothesis/Purpose
The purpose of this study was to investigate the current usage of arm care programs by high school baseball coaches. The primary objective was to determine if coaches use group-based or individualized arm care programs. The secondary objective sought to determine if the use of arm care programs is influenced …


Identifying Risk Factors Of Upper Extremity Injuries In Collegiate Baseball Players: A Pilot Study, Robert Slowik, Christopher Morris, Matthew C. Hoch, Timothy L. Uhl Jun 2021

Identifying Risk Factors Of Upper Extremity Injuries In Collegiate Baseball Players: A Pilot Study, Robert Slowik, Christopher Morris, Matthew C. Hoch, Timothy L. Uhl

Physical Therapy Faculty Publications

Background
Repetitive pitching places tremendous forces on the shoulder and elbow which can lead to upper extremity (UE) or lower extremity (LE) overuse injuries.

Purpose
The purpose of this study was to evaluate pre-season physical measurements in collegiate baseball players and track in-season baseball throwing volume to determine which factors may predict throwing overuse injuries.

Study Design
Retrospective Cohort study.

Methods
Baseline preseason mobility, strength, endurance, and perception of function were measured in 17 collegiate baseball pitchers. Participants were then followed during the course of the season to collect rate of individual exposure, estimated pitch volume, and rating of perceived …


Icf Linking Of Patient-Reported Therapy Goals For Children With Acquired Upper Extremity Impairment, Jenny M. Dorich, Roger Cornwall, Timothy L. Uhl May 2021

Icf Linking Of Patient-Reported Therapy Goals For Children With Acquired Upper Extremity Impairment, Jenny M. Dorich, Roger Cornwall, Timothy L. Uhl

Physical Therapy Faculty Publications

BACKGROUND: Patient reported outcome measures are used to evaluate hand therapy outcomes. Yet, limited evidence is available regarding the outcomes children desire from hand therapy.

PURPOSE: To determine the desired treatment outcomes of children with acquired upper extremity impairments.

STUDY DESIGN: Descriptive case series METHODS: Two raters independently applied International Classification of Function, Disability and Health (ICF) linking rules to the Canadian Occupational Performance goals of 151 children, age 6-18, receiving occupational therapy for acquired upper extremity impairments. Prevalence of the linked ICF codes was examined using frequency distributions. Kappa and the proportion of positive agreement assessed inter-rater agreement of …


Gait And Balance Changes With Investigational Peripheral Nerve Cell Therapy During Deep Brain Stimulation In People With Parkinson’S Disease, Geetanjali Gera, Zain Guduru, Tritia R. Yamasaki, Julie A. Gurwell, Monica Chau, Anna Krotinger, Frederick A. Schmitt, John T. Slevin, Greg A. Gerhardt, Craig G. Van Horne, Jorge E. Quintero Apr 2021

Gait And Balance Changes With Investigational Peripheral Nerve Cell Therapy During Deep Brain Stimulation In People With Parkinson’S Disease, Geetanjali Gera, Zain Guduru, Tritia R. Yamasaki, Julie A. Gurwell, Monica Chau, Anna Krotinger, Frederick A. Schmitt, John T. Slevin, Greg A. Gerhardt, Craig G. Van Horne, Jorge E. Quintero

Physical Therapy Faculty Publications

Background: The efficacy of deep brain stimulation (DBS) and dopaminergic therapy is known to decrease over time. Hence, a new investigational approach combines implanting autologous injury-activated peripheral nerve grafts (APNG) at the time of bilateral DBS surgery to the globus pallidus interna. Objectives: In a study where APNG was unilaterally implanted into the substantia nigra, we explored the effects on clinical gait and balance assessments over two years in 14 individuals with Parkinson’s disease. Methods: Computerized gait and balance evaluations were performed without medication, and stimulation was in the off state for at least 12 h to best assess the …


Post-Operative Rehabilitation For Scapular Muscle Reattachment: A Case Report, Wendy Burke, W. Ben Kibler, Timothy L. Uhl Apr 2021

Post-Operative Rehabilitation For Scapular Muscle Reattachment: A Case Report, Wendy Burke, W. Ben Kibler, Timothy L. Uhl

Physical Therapy Faculty Publications

Background and Purpose: Scapular muscle detachment is a rare orthopedic problem that has been described in the literature in patients following traumatic events involving traction, direct trauma, or a motor vehicle accident. The purpose of this case report is to describe the post-operative rehabilitation following scapular muscle reattachment surgery. Unique to this case report is the patient's perspective, an orthopedic physical therapist with 25 years of experience.

Case Description: A 47-year-old female physical therapist experienced a traction injury to bilateral upper extremities during a medical procedure resulting in bilateral rhomboid, and bilateral lower trapezius muscles were detached from the medial …


Injury Rates In Major League Baseball During The 2020 Covid-19 Season, Brooks N. Platt, Timothy L. Uhl, Aaron D. Sciascia, Anthony J. Zacharias, Nicole G. Lemaster, Austin V. Stone Mar 2021

Injury Rates In Major League Baseball During The 2020 Covid-19 Season, Brooks N. Platt, Timothy L. Uhl, Aaron D. Sciascia, Anthony J. Zacharias, Nicole G. Lemaster, Austin V. Stone

Physical Therapy Faculty Publications

Background: The 2020 Major League Baseball (MLB) season was drastically altered because of the COVID-19 pandemic. The changes included an extended layoff between March and July as well as a shortened preseason.

Purpose/Hypothesis: To determine the incidence and epidemiology of MLB injuries in the abbreviated 2020 season compared with prior seasons. We hypothesized that there was an increase in the overall injury rate in the 2020 season compared with the 2018-2019 seasons and that it equally affected all body regions.

Study Design: Descriptive epidemiology study.

Methods: The MLB transactions database was queried to find players who had been placed on …


Reproducibility And Discriminant Validity Of The Posterior Shoulder Endurance Test In Healthy And Painful Populations, Neil A. Evans, Suzanne Konz, Arthur J. Nitz, Timothy L. Uhl Jan 2021

Reproducibility And Discriminant Validity Of The Posterior Shoulder Endurance Test In Healthy And Painful Populations, Neil A. Evans, Suzanne Konz, Arthur J. Nitz, Timothy L. Uhl

Physical Therapy Faculty Publications

OBJECTIVE: This investigation measured the reproducibility and discriminant validity of the Posterior Shoulder Endurance Test (PSET) on painful and non-painful populations.

DESIGN: Reliability and validity study.

SETTING: Laboratory setting.

PARTICIPANTS: Thirty subjects (male = 11; female = 19).

MAIN OUTCOME MEASURES: Time to failure (TTF) was the primary outcome measure to determine reliability of the PSET. Discriminant validity identified with receiver operator characteristic (ROC) curves utilized TTF separately in men and women since they used different loads.

RESULTS: There were 25/30 subjects (painful = 12; non-painful = 13) tested a second time. ICC, SEM, and MDC90 ranged respectively from 0.77, …


Development, Implementation And Outcomes Of A Quality Assurance System For The Provision Of Continuous Renal Replacement Therapy In The Intensive Care Unit, Eloy F. Ruiz, Victor M. Ortiz-Soriano, Monica Talbott, Bryan A. Klein, Melissa L. Thompson Bastin, Kirby P. Mayer, Emily B. Price, Robert Dorfman, Brandi N. Adams, Lisa J. Fryman, Javier A. Neyra, The University Of Kentucky Crrt Quality Assurance Group Nov 2020

Development, Implementation And Outcomes Of A Quality Assurance System For The Provision Of Continuous Renal Replacement Therapy In The Intensive Care Unit, Eloy F. Ruiz, Victor M. Ortiz-Soriano, Monica Talbott, Bryan A. Klein, Melissa L. Thompson Bastin, Kirby P. Mayer, Emily B. Price, Robert Dorfman, Brandi N. Adams, Lisa J. Fryman, Javier A. Neyra, The University Of Kentucky Crrt Quality Assurance Group

Physical Therapy Faculty Publications

Critically ill patients with requirement of continuous renal replacement therapy (CRRT) represent a growing intensive care unit (ICU) population. Optimal CRRT delivery demands continuous communication between stakeholders, iterative adjustment of therapy, and quality assurance systems. This Quality Improvement (QI) study reports the development, implementation and outcomes of a quality assurance system to support the provision of CRRT in the ICU. This study was carried out at the University of Kentucky Medical Center between September 2016 and June 2019. We implemented a quality assurance system using a step-wise approach based on the (a) assembly of a multidisciplinary team, (b) standardization of …


Acute Skeletal Muscle Wasting And Dysfunction Predict Physical Disability At Hospital Discharge In Patients With Critical Illness, Kirby P. Mayer, Melissa L. Thompson Bastin, Ashley A. Montgomery-Yates, Amy M. Pastva, Esther E. Dupont-Versteegden, Selina M. Parry, Peter E. Morris Nov 2020

Acute Skeletal Muscle Wasting And Dysfunction Predict Physical Disability At Hospital Discharge In Patients With Critical Illness, Kirby P. Mayer, Melissa L. Thompson Bastin, Ashley A. Montgomery-Yates, Amy M. Pastva, Esther E. Dupont-Versteegden, Selina M. Parry, Peter E. Morris

Physical Therapy Faculty Publications

BACKGROUND: Patients surviving critical illness develop muscle weakness and impairments in physical function; however, the relationship between early skeletal muscle alterations and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine whether changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge.

METHODS: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of …


Recovery From Covid-19 And Acute Respiratory Distress Syndrome: The Potential Role Of An Intensive Care Unit Recovery Clinic: A Case Report, Kirby P. Mayer, Jamie L. Sturgill, Anna G. Kalema, Melissa K. Soper, Sherif M. Seif, Evan P. Cassity, Jimmi Hatton Kolpek, Esther E. Dupont-Versteegden, Ashley A. Montgomery-Yates, Peter E. Morris Sep 2020

Recovery From Covid-19 And Acute Respiratory Distress Syndrome: The Potential Role Of An Intensive Care Unit Recovery Clinic: A Case Report, Kirby P. Mayer, Jamie L. Sturgill, Anna G. Kalema, Melissa K. Soper, Sherif M. Seif, Evan P. Cassity, Jimmi Hatton Kolpek, Esther E. Dupont-Versteegden, Ashley A. Montgomery-Yates, Peter E. Morris

Physical Therapy Faculty Publications

Background

In this case report, we describe the trajectory of recovery of a young, healthy patient diagnosed with coronavirus disease 2019 who developed acute respiratory distress syndrome. The purpose of this case report is to highlight the potential role of intensive care unit recovery or follow-up clinics for patients surviving acute hospitalization for coronavirus disease 2019.

Case Presentation

Our patient was a 27-year-old Caucasian woman with a past medical history of asthma transferred from a community hospital to our medical intensive care unit for acute hypoxic respiratory failure due to bilateral pneumonia requiring mechanical ventilation (ratio of arterial oxygen partial …


Cardiorespiratory Fitness Diminishes The Effects Of Age On White Matter Hyperintensity Volume, Nathan F. Johnson, Ahmed A. Bahrani, David K. Powell, Gregory A. Jicha, Brian T. Gold Aug 2020

Cardiorespiratory Fitness Diminishes The Effects Of Age On White Matter Hyperintensity Volume, Nathan F. Johnson, Ahmed A. Bahrani, David K. Powell, Gregory A. Jicha, Brian T. Gold

Physical Therapy Faculty Publications

White matter hyperintensities (WMHs) are among the most commonly observed marker of cerebrovascular disease. Age is a key risk factor for WMH development. Cardiorespiratory fitness (CRF) is associated with increased vessel compliance, but it remains unknown if high CRF affects WMH volume. This study explored the effects of CRF on WMH volume in community-dwelling older adults. We further tested the possibility of an interaction between CRF and age on WMH volume. Participants were 76 adults between the ages of 59 and 77 (mean age = 65.36 years, SD = 3.92) who underwent a maximal graded exercise test and structural brain …


Correlations Of Calf Muscle Macrophage Content With Muscle Properties And Walking Performance In Peripheral Artery Disease, Kate Kosmac, Marta Gonzalez-Freire, Mary M. Mcdermott, Sarah H. White, R. Grace Walton, Robert L. Sufit, Lu Tian, Lingyu Li, Melina R. Kibbe, Michael H Criqui, Jack M. Guralnik, Tamar S. Polonsky, Christiaan Leeuwenburgh, Luigi Ferrucci, Charlotte A. Peterson May 2020

Correlations Of Calf Muscle Macrophage Content With Muscle Properties And Walking Performance In Peripheral Artery Disease, Kate Kosmac, Marta Gonzalez-Freire, Mary M. Mcdermott, Sarah H. White, R. Grace Walton, Robert L. Sufit, Lu Tian, Lingyu Li, Melina R. Kibbe, Michael H Criqui, Jack M. Guralnik, Tamar S. Polonsky, Christiaan Leeuwenburgh, Luigi Ferrucci, Charlotte A. Peterson

Physical Therapy Faculty Publications

Background

Peripheral artery disease (PAD) is a manifestation of atherosclerosis characterized by reduced blood flow to the lower extremities and mobility loss. Preliminary evidence suggests PAD damages skeletal muscle, resulting in muscle impairments that contribute to functional decline. We sought to determine whether PAD is associated with an altered macrophage profile in gastrocnemius muscles and whether muscle macrophage populations are associated with impaired muscle phenotype and walking performance in patients with PAD.

Methods and Results

Macrophages, satellite cells, and extracellular matrix in gastrocnemius muscles from 25 patients with PAD and 7 patients without PAD were quantified using immunohistochemistry. Among patients …


A Quantitative Comparison Of Arm Activity Between Survivors Of Breast Cancer And Healthy Controls: Use Of Accelerometry, Mary Insana Fisher, Claire C. Davies, Timothy L. Uhl Feb 2020

A Quantitative Comparison Of Arm Activity Between Survivors Of Breast Cancer And Healthy Controls: Use Of Accelerometry, Mary Insana Fisher, Claire C. Davies, Timothy L. Uhl

Physical Therapy Faculty Publications

Purpose

Survivors of breast cancer (BC) on the non-dominant side have more persistent deficits than those with cancer on the dominant limb. What is not known is whether those with BC use their involved upper limbs more, less, or at the same level as women without BC. Accelerometer use offers a quantifiable method to measure activity levels of upper limbs. The purpose of this study was to quantify the activity levels of the non-dominant involved limb among survivors of BC and compare these values to their dominant limb, as well as the non-dominant limb of a control group.

Methods

Participants …


Safety, Feasibility, And Efficacy Of Early Rehabilitation In Patients Requiring Continuous Renal Replacement: A Quality Improvement Study, Kirby P. Mayer, Amanda R. Hornsby, Victor Ortiz Soriano, Timothy C. Lin, Jennifer T. Cunningham, Hanwen Yuan, Caroline E. Hauschild, Peter E. Morris, Javier A. Neyra Jan 2020

Safety, Feasibility, And Efficacy Of Early Rehabilitation In Patients Requiring Continuous Renal Replacement: A Quality Improvement Study, Kirby P. Mayer, Amanda R. Hornsby, Victor Ortiz Soriano, Timothy C. Lin, Jennifer T. Cunningham, Hanwen Yuan, Caroline E. Hauschild, Peter E. Morris, Javier A. Neyra

Physical Therapy Faculty Publications

Introduction: Early rehabilitation in critically ill patients is associated with improved outcomes. Recent research demonstrates that patients requiring continuous renal replacement therapy (CRRT) can safely engage in mobility. The purpose of this study was to assess safety and feasibility of early rehabilitation with focus on mobility in patients requiring CRRT.

Methods: Study design was a mixed methods analysis of a quality improvement protocol. The setting was an intensive care unit (ICU) at a tertiary medical center. Safety was prospectively recorded by incidence of major adverse events including dislodgement of CRRT catheter, accidental extubation, bleeding, and hemodynamic emergency; and minor adverse …


A Comprehensive Rehabilitation Program For Treating Lateral Elbow Tendinopathy, Joseph M. Day, Ann M. Lucado, Timothy L. Uhl Oct 2019

A Comprehensive Rehabilitation Program For Treating Lateral Elbow Tendinopathy, Joseph M. Day, Ann M. Lucado, Timothy L. Uhl

Physical Therapy Faculty Publications

Scapular muscle weakness in patients with lateral elbow tendinopathy is an identified impairment and is part of a multimodal rehabilitation approach. The published literature provides little information regarding specific rehabilitation guidelines that address both the proximal scapular muscle weakness and local elbow/ wrist dysfunctions common in patients with lateral elbow tendinopathy. The purpose of this clinical commentary is to describe a comprehensive rehabilitation strategy for individuals with lateral elbow tendinopathy. This program emphasizes a phased therapeutic strategy that addresses proximal and local dysfunction along the kinetic chain. This clinical protocol is currently being tested for efficacy as part of a …


Non-Fasting High-Density Lipoprotein Is Associated With White Matter Microstructure In Healthy Older Adults, Nathan F. Johnson, Brian T. Gold, Dorothy Ross, Alison L. Bailey, Jody L. Clasey, Vedant Gupta, Steve W. Leung, David K. Powell May 2019

Non-Fasting High-Density Lipoprotein Is Associated With White Matter Microstructure In Healthy Older Adults, Nathan F. Johnson, Brian T. Gold, Dorothy Ross, Alison L. Bailey, Jody L. Clasey, Vedant Gupta, Steve W. Leung, David K. Powell

Physical Therapy Faculty Publications

A growing body of evidence indicates that biomarkers of cardiovascular risk may be related to cerebral health. However, little is known about the role that non-fasting lipoproteins play in assessing age-related declines in a cerebral biomarker sensitive to vascular compromise, white matter (WM) microstructure. High-density lipoprotein cholesterol (HDL-C) is atheroprotective and low-density lipoprotein cholesterol (LDL-C) is a major atherogenic lipoprotein. This study explored the relationships between non-fasting levels of cholesterol and WM microstructure in healthy older adults. A voxelwise and region of interest approach was used to determine the relationship between cholesterol and fractional anisotropy (FA). Participants included 87 older …


Elastic Resistance Effectiveness On Increasing Strength Of Shoulders And Hips, Kelsey J. Picha, Muataz R. Almaddah, Jordan Barker, Tavis Ciochetty, W. Scott Black, Timothy L. Uhl Apr 2019

Elastic Resistance Effectiveness On Increasing Strength Of Shoulders And Hips, Kelsey J. Picha, Muataz R. Almaddah, Jordan Barker, Tavis Ciochetty, W. Scott Black, Timothy L. Uhl

Physical Therapy Faculty Publications

Elastic resistance is a common training method used to gain strength. Currently, progression with elastic resistance is based on the perceived exertion of the exercise or completion of targeted repetitions; exact resistance is typically unknown. This study's objective is to determine if knowledge of load during elastic resistance exercise will increase strength gains during exercises. Participants were randomized into two strength training groups, elastic resistance only and elastic resistance using a load cell (LC) that displays force during exercise. The LC group used a Smart Handle (Patterson Medical Supply, Chicago, IL) to complete all exercises. Each participant completed the same …