Medicine and Health Sciences Commons^™

Development, Validation And Application Of A New Fornix Template For Studies Of Aging And Preclinical Alzheimer's Disease, Christopher A. Brown, Nathan F. Johnson, Amelia J. Anderson-Mooney, Gregory A. Jicha, Leslie M. Shaw, John Q. Trojanowski, Linda J. Van Eldik, Frederick A. Schmitt, Charles D. Smith, Brian T. Gold

Physical Therapy Faculty Publications

We developed a merged younger-older adult template of the fornix and demonstrated its utility for studies of aging and preclinical Alzheimer's disease (AD). In Experiment 1, probabilistic tractography was used to reconstruct the fornix in younger and older adults and successful streamlines were then averaged to create a merged template in standard space. The new template includes the majority of the fornix from the hippocampal formation to the subcallosal region and the thalamus/hypothalamus. In Experiment 2, the merged template was validated as an appropriate measure for studies of aging, with comparisons against manual tracing measures indicating identical spatial coverage in …

Wearable Imu For Shoulder Injury Prevention In Overhead Sports, Samir A. Rawashdeh, Derek A. Rafeldt, Timothy L. Uhl

Physical Therapy Faculty Publications

Body-worn inertial sensors have enabled motion capture outside of the laboratory setting. In this work, an inertial measurement unit was attached to the upper arm to track and discriminate between shoulder motion gestures in order to help prevent shoulder over-use injuries in athletics through real-time preventative feedback. We present a detection and classification approach that can be used to count the number of times certain motion gestures occur. The application presented involves tracking baseball throws and volleyball serves, which are common overhead movements that can lead to shoulder and elbow overuse injuries. Eleven subjects are recruited to collect training, testing, …

Do Scapular Kinematics Alter During The Performance Of The Scapular Assistance Test And Scapular Retraction Test: A Pilot Study, W. Ben Kibler, Thomas J. Cunningham, Natalie L. Myers, Timothy L. Uhl

Physical Therapy Faculty Publications

Objective: To describe to what degree and in what plane biomechanical alterations occur during the performance of the Scapular Retraction test (SRT) and Scapular Assistance Test (SAT).

Design: Laboratory Pilot Study

Participants: Eight symptomatic and 7 asymptomatic subjects were instrumented with electromagnetic sensors.

Main Outcome Measures: The SRT and SAT were performed with the scapula stabilized and unstabilized. The scapular kinematic variables of posterior tilt, internal rotation, upward rotation, protraction, and elevation were measured during both tests.

Results: Descriptive analysis of scapular kinematics suggested that posterior tilt was primarily increased during both clinical tests in both groups. Both groups decreased …

Neuromuscular Alterations After Ankle Sprains: An Animal Model To Establish Causal Links After Injury, Lindsey K. Lepley, Patrick O. Mckeon, Shane G. Fitzpatrick, Catherine L. Beckemeyer, Timothy L. Uhl, Timothy A. Butterfield

Physical Therapy Faculty Publications

Context: The mechanisms that contribute to the development of chronic ankle instability are not understood. Investigators have developed a hypothetical model in which neuromuscular alterations that stem from damaged ankle ligaments are thought to affect periarticular and proximal muscle activity. However, the retrospective nature of these studies does not allow a causal link to be established.

Objective: To assess temporal alterations in the activity of 2 periarticular muscles of the rat ankle and 2 proximal muscles of the rat hind limb after an ankle sprain.

Design: Controlled laboratory study.

Setting: Laboratory.

Patients or Other Participants: …

Walking Performance Is Positively Correlated To Calf Muscle Fiber Size In Peripheral Artery Disease Subjects, But Fibers Show Aberrant Mitophagy: An Observational Study, Sarah H. White, Mary M. Mcdermott, Robert L. Sufit, Kate Kosmac, Alex W. Bugg, Marta Gonzalez-Freire, Luigi Ferrucci, Lu Tian, Lihui Zhao, Ying Gao, Melina R. Kibbe, Michael H. Criqui, Christiaan Leeuwenburgh, Charlotte A. Peterson

Physical Therapy Faculty Publications

Background: Patients with lower extremity peripheral artery disease (PAD) have decreased mobility, which is not fully explained by impaired blood supply to the lower limb. Additionally, reports are conflicted regarding fiber type distribution patterns in PAD, but agree that skeletal muscle mitochondrial respiration is impaired.

Methods: To test the hypothesis that reduced muscle fiber oxidative activity and type I distribution are negatively associated with walking performance in PAD, calf muscle biopsies from non-PAD (n = 7) and PAD participants (n = 26) were analyzed immunohistochemically for fiber type and size, oxidative activity, markers of autophagy, and capillary density. Data were …

Cellular And Morphological Alterations In The Vastus Lateralis Muscle As The Result Of Acl Injury And Reconstruction, Brian W. Noehren, Anders H. Andersen, Peter A. Hardy, Darren L. Johnson, Mary Lloyd Ireland, Katherine L. Thompson, Bruce Damon

Physical Therapy Faculty Publications

Background: Individuals who have had an anterior cruciate ligament (ACL) tear and reconstruction continue to experience substantial knee extensor strength loss despite months of physical therapy. Identification of the alterations in muscle morphology and cellular composition are needed to understand potential mechanisms of muscle strength loss, initially as the result of the injury and subsequently from surgery and rehabilitation.

Methods: We performed diffusion tensor imaging-magnetic resonance imaging and analyzed muscle biopsies from the vastus lateralis of both the affected and unaffected limbs before surgery and again from the reconstructed limb following the completion of rehabilitation. Immunohistochemistry was done to determine …

Cycle Training Modulates Satellite Cell And Transcriptional Responses To A Bout Of Resistance Exercise, Kevin A. Murach, R. Grace Walton, Christopher S. Fry, Sami L. Michaelis, Jason S. Groshong, Brian S. Finlin, Philip A. Kern, Charlotte A. Peterson

Physical Therapy Faculty Publications

This investigation evaluated whether moderate‐intensity cycle ergometer training affects satellite cell and molecular responses to acute maximal concentric/eccentric resistance exercise in middle‐aged women. Baseline and 72 h postresistance exercise vastus lateralis biopsies were obtained from seven healthy middle‐aged women (56 ± 5 years, BMI 26 ± 1, VO_2max 27 ± 4) before and after 12 weeks of cycle training. Myosin heavy chain (MyHC) I‐ and II‐associated satellite cell density and cross‐sectional area was determined via immunohistochemistry. Expression of 93 genes representative of the muscle‐remodeling environment was also measured via NanoString. Overall fiber size increased ~20% with cycle training ( …

Living With Traumatic Brain Injury In A Rural Setting: Supports And Barriers Across The Continuum Of Care, Anne L. Harrison, Elizabeth G. Hunter, Heather Thomas, Paige Bordy, Erin Stokes, Patrick H. Kitzman

Physical Therapy Faculty Publications

Purpose: Traumatic brain injury (TBI) is prevalent in Kentucky and comes with a high cost in care and quality of life for individuals and caregivers affected. Many people living with the condition of TBI have unmet needs. Research among people living with TBI in rural areas is limited. The purposes of this study were to (1) increase understanding of the lived experience of people with TBI and caregivers in rural regions of Kentucky across the continuum of their care and (2) provide their perspectives on barriers and facilitators of optimal function and well-being.

Methods: A qualitative descriptive interview study was …

Adherence Of Individuals In Upper Extremity Rehabilitation: A Qualitative Study, Enrique V. Smith-Forbes, Dana M. Howell, Jason Willoughby, Hilary Armstrong, Donald G. Pitts, Timothy L. Uhl

Physical Therapy Faculty Publications

OBJECTIVE: To describe the rehabilitation experiences, expectations, and treatment adherence of patients receiving upper extremity (UE) rehabilitation who demonstrated discrepancy between functional gains and overall improvement.

DESIGN: Qualitative (phenomenologic) interviews and analysis.

SETTING: Outpatient UE rehabilitation.

PARTICIPANTS: Patients with acute UE injuries (N=10).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURE: Concerns related to UE rehabilitation patients demonstrating discrepancy between outcome measures.

RESULTS: Five key themes emerged from the interviews of patients demonstrating discrepancy in their self-reported patient outcomes: (1) desire to return to normal, (2) initial anticipation of brief recovery, (3) trust of therapist, (4) cannot stop living, and (5) feelings …

Feasibility Of Conducting A Web-Based Survey Of Patient-Reported Outcomes And Rehabilitation Progress, Jennifer S. Howard, Jenny L. Toonstra, Amanda R. Meade, Caitlin E. Whale Conley, Carl G. Mattacola

Physical Therapy Faculty Publications

Background: Web-based surveys provide an efficient means to track clinical outcomes over time without the use of clinician time for additional paperwork. Our purpose was to determine the feasibility of utilizing web-based surveys to capture rehabilitation compliance and clinical outcomes among postoperative orthopedic patients. The study hypotheses were that (a) recruitment rate would be high (> 90%), (b) patients receiving surveys every two weeks would demonstrate higher response rates than patients that receive surveys every four weeks, and (c) response rates would decrease over time.

Methods: The study design involved a longitudinal cohort. Surgical knee patients were recruited for study …

A Literature Review Of Studies Evaluating Rotator Cuff Activation During Early Rehabilitation Exercises For Post-Op Rotator Cuff Repair, Samuel N. Wells, Jodi R. Schilz, Timothy L. Uhl, A. Burke Gurney

Physical Therapy Faculty Publications

Despite the modern advancement of surgical repair equipment and techniques, many rotator cuff repairs do not clinically heal. Prescribed rehabilitative exercises must appropriately load the repaired muscle-tendon complex to promote healing and prevent capsular adhesions without damaging the repair. The clinician must possess an understanding of the anatomy and physiology of the healing rotator cuff, and understand the importance of the plane of movement, speed of the movement, position of the extremity, level of assistance, and type of resistance used. Electromyography (EMG) provides a useful means to determine muscle activation levels during specific exercises. Descriptions of specific exercises and EMG …

Enhancement Of Aging Rat Laryngeal Muscles With Endogenous Growth Factor Treatment, Joseph C. Stemple, Richard D. Andreatta, Tanya S. Seward, Vrushali Angadi, Maria Dietrich, Colleen A. Mcmullen

Physical Therapy Faculty Publications

Clinical evidence suggests that laryngeal muscle dysfunction is associated with human aging. Studies in animal models have reported morphological changes consistent with denervation in laryngeal muscles with age. Life‐long laryngeal muscle activity relies on cytoskeletal integrity and nerve–muscle communication at the neuromuscular junction (NMJ). It is thought that neurotrophins enhance neuromuscular transmission by increasing neurotransmitter release. We hypothesized that treatment with neurotrophin 4 (NTF4) would modify the morphology and functional innervation of aging rat laryngeal muscles. Fifty‐six Fischer 344xBrown Norway rats (6‐ and 30‐mo age groups) were used to evaluate to determine if NTF4, given systemically (n = 32) …

Specificity Of The Minimal Clinically Important Difference Of The Quick Disabilities Of The Arm Shoulder And Hand (Qdash) For Distal Upper Extremity Conditions, Enrique V. Smith-Forbes, Dana M. Howell, Jason Willoughby, Donald G. Pitts, Timothy L. Uhl

Physical Therapy Faculty Publications

Retrospective cohort design. The minimal clinically important difference (MCID) for the quick Disabilities of the Arm, Shoulder and Hand (QDASH) has been established using a pool of multiple conditions, and only exclusively for the shoulder. Understanding diagnoses-specific threshold change values can enhance the clinical decision-making process. Before and after QDASH scores for 406 participants with conditions of surgical distal radius fracture, non-surgical lateral epicondylitis, and surgical carpal tunnel release were obtained. The external anchor administered at each fourth visit was a 15-point global rating of change scale. The test-retest reliability of the QDASH was moderate for all diagnoses: intraclass correlation …