Medicine and Health Sciences Commons^™

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 …

Altered Achilles Tendon Morphology In Individuals With Chronic Post-Stroke Hemiparesis: A Case Report, Jing Nong Liang, Kai-Yu Ho

Physical Therapy Faculty Publications

Background: Individuals post-stroke walk slowly and with more effort, which puts them at higher risks for falls. The slow walking speed results from insufficient propulsive forces generated by the paretic leg. Current rehabilitative efforts to improve walking function target increasing propulsive forces, but overlook the muscle-tendon unit. Case presentations: Two individuals with chronic post-stroke hemiparesis are presented. In both individuals post-stroke, paretic ankle plantarflexors presented with increased muscle tone. Gait kinetics revealed asymmetric propulsive forces, specifically, insufficient propulsive forces by the paretic legs, consistent with previous literature. Sonography revealed increased thickness of paretic Achilles tendon at the calcaneal insertion, in …

Reaching The Peak, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

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 …

A Quantitative Comparison Of Arm Activity Between Women With Breast Cancer And Healthy, Mary Insana Fisher, Claire 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 …

Validity Of The Body Scan Scanner® And Structure Sensor To Measure Limb Volume In Healthy Adults, Mary Insana Fisher, Michaela Claire Viola, Noah James Brueckner, Madison Elizabeth Wolfe, Rachel Lynn Kremer

Physical Therapy Faculty Publications

Purpose/Hypothesis: Secondary lymphedema is a chronic condition that can develop in approximately 30 percent of women treated for breast cancer. It is important to measure limb volume changes for early detection of lymphedema, when it is possible to reverse the swelling (stage 1). Common clinical measures carry concerns of infection control (water displacement), are time consuming (truncated cone calculation using circumferential measures), or expensive (perometry). Use of a portable 3D scanner addresses these concerns, but the validity is unknown. The purpose of this phase I study is to investigate the validity of the Body Scan Scanner to measure limb volume …

Characterizing Intersection Variability Of Butterfly Diagram In Post-Stroke Gait Using Kernel Density Estimation, Yun Ju Lee, Jing Nong Liang

Physical Therapy Faculty Publications

ackground:Center of pressure (COP) trajectory during treadmill walking have been commonly presented usingthe butterfly diagram to describe gait characteristics in neurologically intact and impaired individuals. However,due to the large amount of displayed information, the butterfly diagram is not an efficient solution to visualizelocomotor variability.Purpose:The purpose of this study was to evaluate post-stroke locomotor variability by applying Kernel densityestimation (KDE) on the intersections of the butterfly diagram, and to compare KDE derived metrics withconventional metrics of gait symmetry and variability.Methods:Bilateral toe-off(TO) and initial contact (IC) points of the butterfly diagram were determined to cal-culate the COP symmetry index and the intersections …

Comparison Of Upper Extremity Function In Women With And Women Without A History Of Breast Cancer, Mary Insana Fisher, Gilson Capilouto, Terry Malone, Heather Bush, Timothy L. Uhl

Physical Therapy Faculty Publications

Design: This was an observational cross-sectional study.

Methods: Women who were diagnosed with breast cancer and had a mean post–surgical treatment time of 51 months (range = 12–336 months) were compared with women who did not have breast cancer (CTRL group). Self-reported upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and shoulder range of motion, strength, and muscular endurance were measured. Participants were divided into 3 groups: breast cancer involving the nondominant limb (BC-ND), breast cancer involving the dominant limb (BC-DOM), and CTRL.

Results: A total of 59 women in the CTRL group, 23 …

Cancer Rehabilitation Publications (2008–2018) With A Focus On Physical Function: A Scoping Review, Shana Harrington, Nicole L. Stout, Elizabeth Hile, Mary Insana Fisher, Melissa Eden, Victoria Marchese, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Cancer rehabilitation research has accelerated over the last decade. However, closer examination of the published literature reveals that the majority of this work has focused on psychological interventions and cognitive and behavioral therapies. Recent initiatives have aggregated expert consensus around research priorities, highlighting a dearth in research regarding measurement of and interventions for physical function. Increasingly loud calls for the need to address the myriad of physical functional impairments that develop in people living with and beyond cancer have been published in the literature. A detailed survey of the landscape of published research has not been reported to our …

Improving Environmental Capacities For Health Promotion In Support Settings For People With Intellectual Disabilities: Inclusive Design Of The Dihasid Tool, Kristel Vlot-Van Anrooij, Thessa I. M. Hilgenkamp, Geraline L. Leusink, Anneke Van Der Cruijsen, Henk Jansen, Jenneken Naaldenberg, Koos Van Der Velden

Physical Therapy Faculty Publications

People with intellectual disabilities (ID) have unhealthier lifestyles than the general population. To sustainably improve their lifestyle and health status, a whole-system approach to creating healthy environments is crucial. To gain insight into how support for physical activity and healthy nutrition can be embedded in a setting, asset mapping can be helpful. Asset mapping involves creating a bottom–up overview of promoting and protective factors for health. However, there is no asset mapping tool available for ID support settings. This study aims to develop an asset mapping tool in collaboration with people with ID to gain insight into assets for healthy …

You Say “Goodbye,” And I Say, “Hello, Hello, Hello.”, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

Validity And Reliability Of Three-Dimensional Imaging To Measure Limb Volume: A Systematic Review, Rachel Kremer, Madison Elizabeth Wolfe, Noah James Brueckner, Michaela Claire Viola, Mary Insana Fisher

Physical Therapy Faculty Publications

Introduction: Approximately 30% of women treated for breast cancer will develop lymphedema, yet early identification can prevent this occurrence. It is important to accurately and efficiently measure limb volume to identify pre-clinical lymphedema. Three-dimensional (3 D) imaging is emerging as a potential method to meet the need for accuracy and efficiency. The purpose of this review was to evaluate the psychometrics of 3 D imaging to measure limb volume.

Methods: A systematic search of 4 databases was conducted for articles using 3 D imaging to measure limb volume. Articles were included that compared 3 D imaging to water displacement using …

Updated Poster Presentation Abstract (N = 58) From 2020 Combined Sections Meeting Of The American Physical Therapy Association: How Well Do Clinical Walking Measures Predict Natural Walking Behavior In Parkinson Disease?, James T. Cavanaugh, Cristina Colon-Semenza, Tammy Deangelis, Ryan P. Duncan, Daniel Fulford, Martha Hessler, Michael Lavalley, Timothy Nordahl, Lisa Quintiliani, Kerri S. Rawson, Marie Saint-Hilaire, Cathi A. Thomas, Jenna A. Zajac, Gammon M. Earhart, Terry D. Ellis

Physical Therapy Faculty Publications

Declines in the amount and intensity of natural walking behavior in people with Parkinson disease (PD) may precede declines in motor behavior, gait, and balance. Physical interventions targeting walking behavior in PD may have the greatest impact on slowing the progression of disability. Despite a lack of supporting evidence, however, clinicians may be more likely to rely on quick performance measures of walking speed, capacity, and balance to make inferences about a patient’s walking health, rather than direct measures of natural walking behavior. Our primary purpose, therefore, was to examine the extent to which clinical walking measures might predict natural …

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 …

Non-Thrust Cervical Manipulations Reduce Short-Term Pain And Decrease Systolic Blood Pressure During Intervention In Mechanical Neck Pain: A Randomized Clinical Trial, Emmanuel Yung, Cheongeun Oh, Michael Wong, Jason K. Grimes, Erica M. Barton, Muhammad I. Ali, Allison Breakey

Physical Therapy Faculty Publications

Objectives: To evaluate the association of resting blood pressure with pain response and evaluate the cardiovascular effects of anterior-to-posterior [AP] versus lateral [LAT] techniques of cervical spine non-thrust manipulation [NTM].

Methods: Forty-three (23 females) participants with non-chronic neck pain (mean age 29.00 ± SD 9.09 years) randomly received AP or LAT NTM to the cervical spine. Blood pressure and heart rate were measured before, during, and after the intervention. Disability and pain were measured pre- and post-intervention.

Results: Resting systolic blood pressure (SBP) was significantly associated with average pain reduction two days later on univariate and multivariate analyses (coefficients −0.029 …

Sustained Acoustic Medicine Combined With A Diclofenac Ultrasound Coupling Patch For The Rapid Symptomatic Relief Of Knee Osteoarthritis: Multi-Site Clinical Efficacy Study, Alex Madzia, Chirag Agrawal, Paddy Jarit, Stephanie Petterson, Kevin Plancher, Ralph Ortiz

Physical Therapy Faculty Publications

Background:

Sustained Acoustic Medicine (SAM) is an emerging, non-invasive, non-narcotic, home-use ultrasound therapy for the daily treatment of joint pain. The aim of this multi-site clinical study was to examine the efficacy of long-duration continuous ultrasound combined with a 1% diclofenac ultrasound gel patch in treating pain and improving function in patients with knee osteoarthritis.

Methods:

The Consolidated Standards of Reporting Trials (CONSORT) were followed. Thirty-two (32) patients (18-males, 14-females) 54 years of average age with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence (KL) grade II/III) were enrolled for treatment with the SAM device and diclofenac …

Calcium Pyrophosphate Deposition Disease In The Achilles Tendon, Kai-Yu Ho, Jing Nong Liang

Physical Therapy Faculty Publications

The classic sonographic presentation of calcium pyrophosphate dihydrate crystal deposits in the Achilles tendon is reported.

Characteristics Of Medial-Lateral Postural Control While Exposed To The External Perturbation In Step Initiation, Yun-Ju Lee, Jing Nong Liang, Bing Chen, Alexander S. Aruin

Physical Therapy Faculty Publications

Controllability of posture in the medial-lateral direction is critical for balance maintenance, particularly in step initiation. The objective of the current study was to examine the effects of external perturbation and landing orientation on medial-lateral control stability in step initiation. Eleven young healthy participants stood on the force platform and waited for the instruction of taking a step while experiencing a pendulum perturbation applied at the lateral side of the right shoulder. Eight experimental conditions were conducted by two levels of step side (right or left), two levels of perturbation (with or without), and two levels of landing orientation (forward …

Patellar Tendon Morphology In Trans-Tibial Amputees Utilizing A Prosthesis With A Patellar-Tendon- Bearing Feature, Kai-Yu Ho, Michelle Harty, Jessica Kellogg, Kelly Teter, Szu-Ping Lee, Yu-Jen Chang, Gregory Bashford

Physical Therapy Faculty Publications

A patellar-tendon-bearing (PTB) bar is a common design feature used in the socket of trans-tibial prostheses to place load on the pressure-tolerant tissue. As the patellar tendon in the residual limb is subjected to the perpendicular compressive force not commonly experienced in normal tendons, it is possible for tendon degeneration to occur over time. The purpose of this study was to compare patellar tendon morphology and neovascularity between the residual and intact limbs in trans-tibial amputees and healthy controls. Fifteen unilateral trans-tibial amputees who utilized a prosthesis with a PTB feature and 15 age- and sex- matched controls participated. Sonography …

Test-Retest Reliability And Minimum Detectable Change For Various Frontal Plane Projection Angles During Dynamic Tasks, David M. Werner, Stephanie Di Stasi, Cara L. Lewis, Joaquin Alberto Barrios

Physical Therapy Faculty Publications

Objective: Establish between-day test-retest reliability metrics for 2-dimensional frontal plane projection angles (FPPAs) during the lateral step-down (LSD), single-limb squat (SLS), single-limb landing (SLL), and drop vertical jump (DVJ).

Design: Test-retest reliability study

Setting: University laboratory

Participants: 20 healthy adults (12 female, age = 23.60±1.93 years old, body mass index = 24.26±2.54 kg/m²) were tested on 2 separate occasions 7-14 days apart.

Main Outcome Measures: Intraclass correlation coefficients (ICC), standard errors of the measurement (SEM), and minimal detectable change (MDC) values across the LSD, SLS, SLL, and DVJ for the following body region variables: trunk, trunk on pelvis, …

Creating An Interprofessional Collaborative Research Opportunity For Physical And Occupational Therapy Students, Anne Fleischer, Mary Insana Fisher, Shirley P. O'Brien

Physical Therapy Faculty Publications

Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the majority of PT and OT programs do not have the other discipline at their university. A challenge exists for the creation of a transparent active learning opportunity promoting interprofessional student engagement when the two professions do not reside in the same university. This case study provides a model for how to feasibly create an interprofessional experience for students in universities that do not include a complementary or collaborative allied health professional …

Impaired H-Reflex Adaptations Following Slope Walking In Individuals With Post-Stroke Hemiparesis, Jing Nong Liang, Yun Ju Lee, Eric Akoopie, Brooke Conway Kleven, Trisha Koch, Kai-Yu Ho

Physical Therapy Faculty Publications

Background and Purpose: Short term adaptations in the Ia afferent-motoneuron pathway, as measured using the H-reflex, in response to altered ground reaction forces (GRFs) applied at the feet during slope walking have been observed in the non-impaired nervous system. The ability of the stroke-impaired nervous system to adapt to altered GRFs have not been examined. The purpose of this study was to examine the acute effects of altered propulsive and braking forces applied at the feet, which naturally occurs when walking on different slopes, on adaptations of the H-reflex pathway in individuals with chronic post-stroke hemiparesis.

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 …

The Effects Of Therapeutic Riding On Social Skills And Sensory Functioning In Children With Autism, Betsy Donahoe-Fillmore, Mary Insana Fisher, Christy Lee, Jordan Bevins, Cristin Carter, Stephanie Dailey, Kelsey Haynes, Allison Richard, Sarah Soboslay

Physical Therapy Faculty Publications

Purpose and Significance: Therapeutic riding (TR) is equine-assisted riding lessons that are adapted for people with a wide variety of impairments and is often used as an adjunct to traditional therapies. Previous research has shown that TR helped to improve sensory functioning, cognition and social skills in children with Autism Spectrum Disorder (ASD) but sessions have typically been for 10-12 weeks. The purpose of this study was to investigate if social skills and sensory functioning improved after only 8 weeks of TR.

Subjects: Children were recruited from a local TR center. Participants included seven children (5M, 2F) with a diagnosis …

Factors Related To Intra-Tendinous Morphology Of Achilles Tendon In Runners, Kai-Yu Ho, Ari Baquet, Yu-Jen Chang, Lung-Chan Chien, Michelle Harty, Gregory Bashford, Kornelia Kulig

Physical Therapy Faculty Publications

The purpose of this study was to determine and explore factors (age, sex, anthropometry, running and injury/pain history, tendon gross morphology, neovascularization, ankle range of motion, and ankle plantarflexor muscle endurance) related to intra-tendinous morphological alterations of the Achilles tendon in runners. An intra-tendinous morphological change was defined as collagen fiber disorganization detected by a low peak spatial frequency radius (PSFR) obtained from spatial frequency analysis (SFA) techniques in sonography. Ninety-one runners (53 males and 38 females; 37.9 ± 11.6 years) with 8.8 ± 7.3 years of running experience participated. Height, weight, and waist and hip circumferences were recorded. Participants …

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 …

Healthcare Students’ Abilities To Translate Interprofessional Education To Collaborative Practice, Sally A. Mccormack Tutt

Physical Therapy Faculty Publications

Interprofessional education is considered the first step to providing students with the knowledge and skill required to participate in interprofessional collaboration. The lingering question in research is if students can take these skills from the classroom to clinical practice. The answer to this question will help guide educators when developing effective IPE training. This quantitative, correlational study aimed to explore if healthcare students that participated in a two-part, case-based interprofessional educational session were able to transfer that skill to their clinical experience. Data was collected from healthcare students in the professions of physical therapy, occupational therapy, and nursing. The participants …

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 …

The Relationship Between Pitching Volume And Arm Soreness In Collegiate Baseball Pitchers, Angel L. Lazu, Shawn D. Love, Timothy A. Butterfield, Robert A. English, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: Excessive baseball pitch volume has been associated with increased risk of injury in adolescents. However, many collegiate athletes report non-time loss injuries over the course of the season. It is unknown how pitch volume throughout a collegiate baseball season affects arm soreness.

Purpose: The primary purpose of this study was to determine the relationship between pitch volume and self-reported arm soreness. A secondary purpose was to determine the relationship between change in pitch volume and change in arm soreness over the course of the season for collegiate baseball pitchers.

Study Design: Prospective Cohort.

Methods: Seven collegiate baseball …

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, …