Medicine and Health Sciences Commons^™

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). …

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 …

Neuromuscular Adaptions Following A Daily Strengthening Exercise In Individuals With Rotator Cuff Related Shoulder Pain: A Pilot Case-Control Study, Amee L. Seitz, Lisa A. Podlecki, Emily R. Melton, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: The goal of therapeutic exercise is to facilitate a neuromuscular response by increasing or decreasing muscular activity in order to reduce pain and improve function. It is not clear what dosage of exercise will create a neuromuscular response.

Purpose: The purpose of this study was to assess the effects following a three-week home program of a daily single exercise, the prone horizontal abduction exercise (PHA), on neuromuscular impairments of motor control as measured by scapular muscle EMG amplitudes, strength, and secondarily outcomes of self-reported pain and function between individuals with and without subacromial pain syndrome.

Study Design: Prospective Case-Control, …

Conservative Treatment For Patients With Suspected Slap Tears: A Case Series, Stephanie D. Moore-Reed, Kelley A. Seekins, W. Ben Kibler, Aaron D. Sciascia, Timothy L. Uhl

Physical Therapy Faculty Publications

Objective: Outcome following non-operative management of superior labral anterior to posterior (SLAP) lesions has been under reported with little empirical data demonstrating the effectiveness of conservative treatment. Material and Methods: 10 patients, 5 matched pairs, presenting with symptoms consistent with a SLAP lesion performed a standardized phased rehabilitation program completing patient reported outcome (PRO) and pain measures before and following rehabilitation. Physical therapy notes and home exercise logs were reviewed and all exercises were recorded and coded using the phased rehabilitation protocol as a guide. At followup, patients were divided into two groups; responders and non-responders to treatment based on …

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 …

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 …

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 …

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 …

The Role Of Rehabilitation Following Autologous Chondrocyte Implantation: A Retrospective Chart Review, Jenny L. Toonstra, Jennifer Sebert Howard, Timothy L. Uhl, Robert A. English, Carl G. Mattacola

Physical Therapy Faculty Publications

PURPOSE/BACKGROUND: Clinical outcomes following autologous chondrocyte implantation (ACI) are influenced by multiple factors, including patient demographics, lesion characteristics, quality of the surgical repair, and post-operative rehabilitation. However, it is currently unknown what specific characteristics of rehabilitation have the greatest influence on clinical outcomes following ACI. The purpose of this study was to conduct a retrospective chart review of patients undergoing ACI with the intent to describe this patient population's demographics, clinical outcomes, and rehabilitation practices. This study aimed to assess the consistency of the documentation process relative to post-operative rehabilitation in order to provide information and guide initiatives for improving …