Medicine and Health Sciences Commons^™

Creating A University-Based Performing Arts Clinic: Challenges And Lessons, Carissa Limtiaco, Alan Savanapridi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fine artists performing at the collegiate level are at a high risk for developing performance related musculoskeletal injuries due to the unique physical demands and repetitive nature of their movements. Previous research has reported incidence rates as high as 81% and 62% for student dancers and musicians respectively. Despite the high injury rates, research has shown that student performers underreport injuries and are reluctant to seek medical management from health professionals due to unhealthy beliefs and attitudes often held by this population as well as the lack of specialized healthcare. The goal of the UNLV College of Fine Arts (CFA) …

Developing A Physical Therapy Initial Evaluation Screening Tool For A Multidisciplinary Clinic For Adults With Down Syndrome, Isabella Russell, Alvin Lacap, Francis Lacap

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Down syndrome (Ds) is a chromosomal condition that can result in intellectual disability, as well as structural or functional disorders impacting the nervous, cardiovascular, and musculoskeletal systems. As individuals with Ds age, they can have an increased number of comorbidities that impact their health. Physical therapy can play an important role in managing many of the comorbidities adults with Ds have. Therefore, there is an increased need for physical therapists to efficiently screen, evaluate and treat adults with Ds. The purpose of this work is to create an Initial Evaluation Screening Tool and Patient Intake Form for physical therapists …

Effects Of A 12-Week Remote Exercise Program On Balance In Adults With Down Syndrome, Kayla Kotake, Sherwin Cadiao, Nicole Kaes, Jayston Prudencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis Individuals with Down syndrome (Ds) tend to have deficits in balance and postural control, which negatively affects their ability to perform physical activities safely and independently. Previous research has shown that exercise can improve balance in people with Ds, however, most studies looked at balance in children with Ds. As the average life expectancy for people with Ds has increased, there is a need for research investigating balance in adults with Ds. Also, there is a need to increase exercise opportunities (eg, remote exercise programs) for adults with Ds, as physical inactivity and sedentary behavior are prevalent among individuals …

Association Between Rural Background And Physical Therapist Practice Location, Caitlin Parker, Jace-Anne Sharp

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis To examine the association between physical therapists’ rural background and their decision to practice in a rural setting. We hypothesized that years of rural upbringing and size of hometown would be related to rural practice. Number of Subjects 257 physical therapists who graduated from one of two physical therapy programs in the Western United States between 2000 and 2020. Materials and Methods A survey was emailed to 19 physical therapy schools consisting of questions regarding participants’ background, demographics, and job history. We collected total number of years of practice and total years of rural practice. Length of practice varied, …

The Effects Of Exercise Training On Gait In Adults With Down Syndrome, Anna Lois Aquino, Sandra Daugherty, Alex Palko

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Down syndrome (Ds) is a genetic disorder in which the individual carries an extra copy of chromosome 21 resulting in mental and physical disabilities and risk of major health conditions. A high prevalence of gait pattern dysfunction occurs in adults with Ds due to muscle hypotonia, ligamentous laxity, joint hypermobility, and altered development of musculoskeletal structure, which often lead to increased falls and fear of falling. The purpose of this study is to investigate the differences in kinematic and spatiotemporal gait parameters between adults with Ds and age-matched controls, as well as studying the effects of a 12-week Ds-specific …

Exploring Treatment Targets To Mitigate Fear Of Falling Activity Avoidance Behavior In Parkinson's Disease And Older Adults, John Vincent Rider

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fear of falling (FOF) is a significant concern among individuals with Parkinson’s disease (PD) and older adults in general. This FOF can lead to avoidance behavior resulting in activity restriction. Some level of fear of falling avoidance behavior (FFAB) may be protective (adaptive) and decrease the likelihood of falls, especially among individuals with physical limitations and high fall risk. However, excessive (maladaptive) avoidance behavior may lead to downstream consequences such as further physical and psychological decline and an increased likelihood of falls, especially when there is a disparity between the FFAB and physiological fall risk. While poor physical functioning, disease …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Patient And Facility Perceptions On The Feasibility Of A Student-Run Pro-Bono Back-School For Uninsured Patients With Low Back Pain, Javier Ascanio-Pellon, Sofia Cruz, Lauren Liebert, Trevor Pacuk

UNLV Theses, Dissertations, Professional Papers, and Capstones

A. Background of Knowledge: Nevada ranks 8th highest in uninsured population in the United States. People who are uninsured may be more affected by low back pain (LBP) than their insured counterparts. Volunteers in Medicine of Southern Nevada (VMSN), a non-profit organization, serves uninsured people in Nevada. VMSN partnered with UNLV Physical Therapy (UNLVPT) to provide a back-school for patients. UNLVPT proposed a service-learning model to provide both education and treatment for VMSN patients with LBP. B. Purpose: The purpose of this community-based research project is to create and implement a student-run pro-bono back-school for uninsured individuals with LBP in …

Brain Volumes And Dual-Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jon Basterrechea, Daniel Krist, Caitlin Moreland, Morgan Wise

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. Objective: To examine associations between brain volumes, dual task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. Methods: We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual task performance, and measures of gait and balance. Results: Greater cognitive function and combined dual task effect (DTE) is associated with smaller brain volumes. In contrast, greater motor DTE is associated with larger …

Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Dosage, Mode, And Timing Of Acute Care Physical Therapy: A Scoping Review, Brendan Acosta, Bradley Goins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Aims and Objectives: 1) To synthesize available evidence for mode, dosage, and timing of physical therapy in the acute care hospital setting. 2) To report the evidence about the effects of mode, dosage, and timing of physical therapy in the acute care hospital setting on LOS, associated costs, and PT-related outcomes. Background: Hospital based physical therapy quality depends on providing evidence-based interventions, however, the research regarding dosage, mode, and timing of physical therapy in the acute care hospital setting has not been synthesized for patient populations except for total joint arthroplasties or patients in the ICU. Design: A systematic search …

Fall Prevention Service-Learning Project, Alexis Mansoor, Kendra Morrison, Jeremy Nordfelt, Cheng Yang Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The purpose of this service-learning project was to: 1) reduce falls in the Las Vegas, Nevada community by implementing the Stepping On fall prevention program and 2) to investigate the effect of planning and implementing a service learning project (SLP) on physical therapy (PT) students’ education and professional development. Description: Under the supervision of our advisor, we planned and organized this SLP, became certified leaders of Stepping On, recruited and screened older adults using the STEADI fall risk screening tool, and facilitated the program at a local community hospital. We facilitated group discussion and instructed the exercises outlined in …

The Effectiveness Of Implementing A Collegiate Dance Clinic At The University Of Nevada, Las Vegas, Quinn Williams, Kristin Allman, Matthew Mcarthur, Ryan Yim

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screenings are commonly employed in athletics to identify deficits in performance with the goal of providing interventions to decrease injury risk; however, their utilization is uncommon in collegiate dance programs. Therefore, the purpose of this service learning project was to address the needs of the University of Nevada, Las Vegas (UNLV) dance program through implementation of an injury screening and prevention clinic for collegiate-level dancers. Four second year Doctor of Physical Therapy students (SPTs) supervised by a clinical faculty member with dance medicine expertise researched, developed, and provided screenings to identify increased risk for dance-specific injuries, and education to decrease …

Partnering With The Nevada Physical Therapy Association To Improve Pt/Pta Engagement, Rachel Cooklin, Joshua Cooper, Madison Luna

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The American Physical Therapy Association (APTA) is the professional organization that represents Physical Therapy and exists to promote the needs of society by advocating access and availability of all Physical Therapy services. The Nevada Physical Therapy Association (NVPTA) is a chapter of the APTA that represents the Physical Therapy profession in Nevada. In 2017, only 38.9% of licensed Physical Therapists (PTs) and 7.9% of licensed Physical Therapy Assistants (PTAs) practicing in Nevada were members of the NVPTA. Objective: The purpose of this service-learning project was to explore membership trends in the NVPTA, explore why membership amongst PTAs is low, …

Rural Or Underserved Practice Interest Among Doctor Of Physical Therapy Students. Do Clinical Education Experiences Change Opinions?, Brandon Godin, Trenton Poulson, Mac Neil Moresca, Tyler Satoshige

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: People living in rural and underserved areas are poorly served by our country's healthcare system. The Federal Office of Rural Health Policy reports that approximately 18% of people in the United States live in rural areas. Within the physician and nursing literature the largest reported predictor of rural practice is having a rural background. Mandated rural medical rotations during training have been shown to positively alter interest in rural practice and employment. While nursing and medical students have been thus studied, limited evidence exists for physical therapists. The objective of this study was to determine how rural …

Impact Of Clinician Experience And Positive Language On Subject Expectation Of Cervical Spine Manipulation Effects, Joshua Wood, Jonah Mawae, Stephen Elmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Acute neck pain is a worldwide epidemic that physical therapists treat with cervical spine manipulation (CSM). While the mechanical and neurological effects of CSM are important, it is possible that the patient’s perception of the therapist’s skill level may also play a role in patient outcomes. Along with the patient’s perception of the practitioner, evidence suggests that patient expectation for intervention efficacy may also alter patient outcomes. The implication is that special consideration must be taken when practitioners choose their words when describing both themselves and their interventions. The purpose of this study is to examine if …

The Effect Of Physical Therapy On Patient Self-Reported Outcomes And Perceptions Of Mobility After Lower Extremity Amputations, Gregory Amaya, Rosman Gante, Zachary Meinzer, Abbas Sadrossadat

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The number of people with limb loss is rapidly growing, partly due to an aging society and the prevalence of diabetes. Physical Therapy (PT) has been shown to improve perceived functional outcomes and quality of life in older adults and individuals with diabetes, but it is unclear why certain patients do not receive PT after amputation and whether the beneficial outcomes shown in other populations translate to individuals with limb loss. The purpose of this study was to determine whether receiving PT among patients with limb loss correlates with an improved quality of life, better mobility, and …

Evidence For The Validity Of A Tool For Improved Pressure Ulcer Staging By The Non-Expert In The Live Patient, Janelle Borg, Carrie Johnston, Megan Lucke, Jordan Sinclair

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses.

Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada.

Methods: Subjects assessed 11 wounds on the patients independently. They …

Blended Pedagogy Pathophysiology Course: Effectiveness And Student Satisfaction, Betsy Botsford, Samantha Corn, Alanna Keenan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Evidence supports the effectiveness of computer-assisted instruction (CAI) versus a traditional face-to-face teaching model, but little is known regarding the effectiveness of a blended pedagogy. The purpose of this study is to determine the effectiveness of a blended learning format in a pathophysiology course for entry-level Doctorate of Physical Therapy (DPT) students, to evaluate their level of satisfaction of a podcast formatted course, and to observe changes in cohort performance over time.

Subjects: Five University of Nevada, Las Vegas (UNLV) DPT cohorts (n = 139) participated in the study. Some cohorts were taught in a traditional classroom …

The Effects Of A Progressive Exercise Program On Functional Activity And Quality Of Life For Older Overweight Women With Knee Osteoarthritis, Ty Carlson, Devin Edvalson, Tyler Peck, Brad Robison

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose Osteoarthritis (OA) is a common symptomatic condition experienced by older adults, especially in the overweight population, that affects the knees in particular. This study compares the effectiveness of two progressive exercise protocols (walking and stepping) on function and quality of life in older, overweight women with OA. This study includes self-management training and assesses participant selfperceived efficacy in managing OA.

Subjects This is a quasi-experimental design utilizing 16 women ≥ 50 years of age (60.44 ± 6.04) with a BMI > 25 (34.21 ± 7.28) and radiographic diagnosis of OA in at least one knee.

Methods and Measures …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …

Conceptual Framework Of A Novel Intervention To Improve Mobility In Children With Cerebral Palsy: The Successes And Challenges Of Implementing A Large Amplitude Movement Protocol, Tania Goodwill, Erin Jarrett, Beren Shah, Alanna Stockford

UNLV Theses, Dissertations, Professional Papers, and Capstones

While cerebral palsy remains one of the most common childhood disabilities, clinicians continue to face significant challenges developing effective treatment strategies for the widely variable presentation of motor function impairments associated with cerebral palsy. A large gap exists between current research based evidence and feasible clinical practice. The purpose of this paper is to introduce a novel intervention protocol, explore the theoretical framework behind the protocol and provide insight to clinicians about the successes and challenges faced while pilot testing the intervention. The novel intervention was adapted and implemented by researchers combining a large amplitude movement protocol with the well-researched …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …