Medicine and Health Sciences Commons^™

A Review Of Juvenile Rheumatoid Arthritis, Jill C. Ballan

Physical Therapy Scholarly Projects

Juvenile rheumatoid arthritis (JRA) is the most common pediatric rheumatoid disease in North America. and a principle cause of childhood disability. The disease course is unremitting in up to a quarter of the children with JRA, and a small percentage will grow-up with severe functional disabilities.. Physical and occupational therapy, along with prescribed drug and orthopedic provisions, are important in the management of JRA. The therapists, and other medical professionals involved, work toward the following goals: decreasing joint inflammation, relieving pain, achieving or maintaining an optimal level of function, and educating the patient and family on the disease course and …

Isokinetic Ratios Of Concentric And Eccentric Work Production Of Internal And External Rotators In A Simulated Throwing Pattern, Deane M. Chinen

Physical Therapy Scholarly Projects

Shoulder internal and external rotators have been the focus of several isokinetic studies. However, an examination of muscular work in a functional pattern has not been investigated. Therefore, the purpose of this study was twofold: 1) to establish normative ratios of concentric to eccentric work of internal and external shoulder rotators respectively, and 2) to provide information on the balance of strength in shoulder rotators during a simulated throwing pattern.

Twenty-seven subjects without shoulder pathology were tested on the KINCOM isokinetic dynamometer. The statistics for the whole group revealed 55% more concentric internal rotation work in relation to eccentric external …

The Effect Of Intraarticular Injection Of Morphine Following Knee Arthroscopy, Chandel Dietz

Physical Therapy Scholarly Projects

Postoperative pam IS common following knee arthroscopy and has been typically controlled with opioids, the most popular of which is morphine. Morphine has been traditionally administered by intramuscular, intravenous, or epidural injections. These methods of administering morphine have been very effective in producing prolonged analgesia; however, they have also produce negative central nervous system side effects.

Recent research has suggested administering morphine via intraarticular injections to provide postoperative analgesia without the central nervous system side effects. However, there is little evidence to suggest that this method is effective. Therefore, the purposes of this randomized, double-blinded study were to 1) investigate …

The Role Of Fascia In The Musculoskeletal System, Lori Folkers

Physical Therapy Scholarly Projects

The function of fascia in the human body is poorly understood. This anatomical structure has not been given the clinical significance it may deserve. The purpose of this literature review is to provide a physiological explanation for physical therapy techniques that manipulate fascia. The review is designed to facilitate an understanding of the role of fascia in the' musculoskeletal system.

Physical therapists may deal with musculoskeletal system pathologies on a daily basis. In order for the therapist to utilize soft-tissue techniques, it is necessary to have a working knowledge of the involved structures. Anatomical material is presented to define the …

Physical Therapy Techniques For Treating Patients With Traumatic Brain Injury (Tbi), Daren M. Flolo

Physical Therapy Scholarly Projects

Traumatic brain injury (TBI) can be devastating. Survivors of TBI and their families face complex needs that challenge physical therapists. To respond to this challenge, physical therapists need specific knowledge in regard to epidemiology, etiology, specialized treatment techniques, and the impact of the TBI on patients and their families.

With improvements in medical technology, the number of children and adults surviving brain injuries has increased. Many of these survivors require specialized training to improve impairments as a result of their injuries.

Physical therapists play a vital role in the evaluation and treatment of the patient with traumatic brain injury. In …

Functional Electrical Stimulation As A Treatment For Spinal Cord Injuries, Gail Garrett

Physical Therapy Scholarly Projects

Injury of the spinal cord resulting in quadriplegia or paraplegia IS one of the most devastating conditions a person can experience. The majority of these individuals that suffer from a spinal cord injury are young males. The inability to ambulate is generally a major concern for these patients, but there are also degenerative and deconditioning effects of the spinal cord injury which may lead to devastating secondary complications that must be addressed.

Functional electrical stimulation (FES) has been the subject of much research concerning the rehabilitation for patients with spinal cord injury. Functional electrical stimulation is a way to activate …

Shoulder Pain And Subsequent Loss Of Function In Hemiplegic Patients, Kari A. Goetz

Physical Therapy Scholarly Projects

Hemiplegia, caused by a stroke, is one of the most common disorders in which physical therapists are extensively involved in the rehabilitation process. When a stroke occurs, there is damage to the higher centers of the central nervous system resulting in neurologic, unilateral impairment or hemiplegia. The upper extremity is frequently involved and many patients complain of pain, particularly in the shoulder. Etiology and treatment of hemiplegic shoulder pain (HSP) is a challenging symptom that interferes with progressive rehabilitation and the overall quality of life of many patients.

The purpose of this study was to discuss HSP and the subsequent …

Nutrition In Rehabilitation, John D. Jr. Haywood

Physical Therapy Scholarly Projects

Diet has been implicated as a risk factor in atherosclerotic cardiovascular diseases, cancer, diabetes, osteoporosis, obesity, high blood pressure and chronic liver and kidney diseases. These diseases include almost all of the most common non-traumatic causes of death in the United States. It has been suggested that many physicians do not have the opportunity for specific training in nutrition while in medical school. Many studies have shown that patients admitted to a hospital are at risk of malnutrition and that this risk will increase as length of hospital stay increases. Other studies suggested nutritional deficiencies may result in delayed wound …

Concentric And Eccentric Isokinetic Normative Ratio Values Of The Quadriceps Muscle In Asymptomatic Knee Subjects, Donna Ho

Physical Therapy Scholarly Projects

Technological advances in isokinetic devices allow the clinician to objectively assess and rehabilitate injuries using concentric and eccentric contractions at different speeds. The purpose of this research project is to establish concentric and eccentric normative ratio values of the quadriceps muscle on the Kinetic Communicator (Kin-Com, Chattecx Corp., Chattanooga, TN) dynamometer. A sample of 19 females and 12 males aged 20-38 (mean for females = 24.32 ± 3.87, mean for males = 27.67 ± 5.80) were tested on the KinCom for maximum concentric and eccentric torque values during knee extension using a 70° range of motion at 90 and 1200/sec. …

Patellofemoral Joint Mechanics And Their Clinical Relevance, William S. Hokanson

Physical Therapy Scholarly Projects

Patellofemoral joint dysfunction is a common ailment affecting one in four of the general population and 30% of the athletic population. Patellofemoral dysfunction may stem from a number of different clinical diagnoses. The most common of these is chondromalacia patella. The term chondromalacia patella, however, refers only to a softening or fissuring of the retropatellar surface of the patella and cannot be used to diagnose all patellofemoral pain. Clinical diagnosis is sometimes very difficult because these patients present with a number of vague and nonspecific signs and symptoms.

The purpose of this literature review is to offer a clear, concise …

Cardiac Rehabilitation: Patient Recall Of Exercise Guidelines And Implications For Physical Therapists, Mary Jones

Physical Therapy Scholarly Projects

The efficacy of a cardiac rehabilitation program depends on adequate patient compliance. Patients with coronary heart disease and those recovering from heart surgery may have a successful recovery from acute episodes of myocardial infarction or following operation. It must be recognized that they may require long-term supervision and support. The purpose of this study was to identify if diagnosis of myocardial infarction or heart surgery was a determinant of compliance with exercise guidelines once a patient has graduated from a level II cardiac rehabilitation program. A retrospective chart audit was performed for the years 1991-1994. A data sheet was used …

A Review Of The Causes And Treatment Of Low Back Pain During Pregnancy, Dana Krenzel

Physical Therapy Scholarly Projects

Pregnancy is a time of great musculoskeletal change for a woman. Complaints of low back pain are a very common occurrence at this time. Many women regard this type of pain as a normal adjunct to pregnancy. However, most types of low back pain related to pregnancy are either treatable or avoidable. Mechanical, hormonal, and vascular factors may all contribute to low back pain. Differentiation of these different causes of low back pain is crucial to providing the patient with effective intervention plans. Physical therapists can provide evaluation, treatment, and low back pain management techniques to the expectant mother. Exercise, …

A Wrist And Cervical Screening Of Grand Forks City Employees: A Pilot Study, William D. Jr. Kukuk

Physical Therapy Scholarly Projects

Cumulative Trauma Disorders (CTDs) developed at work are caused by repetitive movements or sustained postures. Carpal Tunnel Syndrome (CTS) and Cervical Radiculopathy (CR) are both CTDs resulting from repetitive wrist movements and sustained cervical postures respectively. Although both conditions can present with similar symptoms in the exact same hand and finger location, there has been no research comparing the prevalence of CTS and CR symptoms in a given population.

The purpose of this study was to identify hand and finger symptoms and correlate the severity of the symptoms with objective measures. Thirty employees of the City of Grand Forks, ND, …

Gait Analysis For The Enhancement Of Aka Gait Patterns, Krista Lausen

Physical Therapy Scholarly Projects

The amputation of a body part is both a physically and psychologically traumatic event for an individual. There are a number of gait deviations that often occur when a person has had a lower extremity amputation, especially when that amputation is above the knee. The entire locomotor mechanism of the body is altered by this change. The person must then adjust ahd relearn how to accommodate for the loss.

This literature review will discuss specific causes of certain gait deviations to determine whether the deviation is due to a musculoskeletal deficit or habit pattern on the part of the patient …

The Lateral Scapular Slide Test: Is It Valid In Detecting Glenohumeral Impingement Syndrome?, Denise G. Litchfield

Physical Therapy Scholarly Projects

Recent literature has focused on instability of the scapulothoracic joint and on resulting scapular positions. Weakness of the scapular musculature can allow the scapula to slide laterally, leading to abnormal glenohumeral biomechanics and to subsequent shoulder pathology. Kibler1 has described the lateral scapular slide test (LSST) as a method of measuring lateral translation of the scapula. A significant difference between right and left scapular positions, as indicated by a discrepancy of greater than one centimeter side-to-side, may indicate functional scapulothoracic instability. The purpose of this study was to evaluate validity of the LSST, measured in two positions. Modified LSST measurements …

An Overview In The Ergonomics Of An Office Computer Workstation, James H. Matetich

Physical Therapy Scholarly Projects

Ergonomics is an applied science concerned with adapting a workplace environment to match the capabilities of a worker and ensure the worker's safety. The study of ergonomics is one of increasing interest to American business. Specifically, the ergonomics of the office computer workstation has come under growing scrutiny due to a tremendous rise in the reported incidence of work related injuries. Workers, in this work environment, appear to be at a greater risk of injuries to the back, neck, shoulder, forearm, wrist, hand, and leg. These injuries, classified as cumulative trauma disorders or CTDs, can be attributed to ergonomic hazards …

A Review Of Treatment Methods For Patients With Patellofemoral Pain, Kristi Minter

Physical Therapy Scholarly Projects

There have been many therapeutic methods proposed for the treatment of patellofemoral pain, but there still remains some question as to which of these options is most beneficial to the patient. There are many steps to follow in order to find the most effective treatment method for an individual suffering from patellofemoral pain syndrome.

This paper is a review of the literature regarding patellofemoral pain syndrome. The paper begins with a discussion of the anatomy of the patellofemoral joint. Etiological factors of this common syndrome are also presented as well as the clinical presentation of this patient population. The focus …

Meniscal Substitution: A Literature Review, Kerry L. Muir

Physical Therapy Scholarly Projects

With the increased awareness that meniscectomy results in degenerative changes in the knee joint, research is now aimed at substituting the meniscus that had been previously removed. Surgical attempts at replacing the meniscus include the use of autografts, allografts, and artificial synthetic prosthesis.

This paper will review the available literature regarding each type of meniscal substitute. Surgical procedures, results, and considerations relating to the different substitutes will be examined.

While studies indicate that meniscal transplantation is technically feasible, the long-term results are unknown. More research is necessary to determine if meniscal substitutes can survive for a prolonged time and function …

An Overview Of The Prescription Of Orthotics For Abnormal Subtalar Joint Pronation, Kari Rafteseth

Physical Therapy Scholarly Projects

The foot and ankle are a complex set of joints that are susceptible to various types of dysfunction, including abnormal subtalar joint pronation. An option for treatment of this problem that may be used is the prescription of orthotics. An orthotic is used to assist the foot in functioning properly and to prevent damage due to malalignment.

In this literature review, the anatomy and biomechanical function of the subtalar joint are discussed. The structure of the other joints of the foot and ankle are also mentioned. Several etiologies of abnormal pronation are discussed. In addition, changes in structure and function …

Polypharmacy And Physical Therapy In The Geriatric Population, Cathy A. Reuer

Physical Therapy Scholarly Projects

Physical therapists are seeing more and more elderly individuals with acute, chronic, or multiple disease conditions. Many of these conditions are treated with medications. It is common for the geriatric patient to be taking multiple medications. Polypharmacy is a relevant concern for physical therapists as adverse effects are often revealed in the musculoskeletal and central nervous systems. These manifestations can cause adverse effects in evaluation, treatment, and outcomes.

The purpose of this study is to discuss the common non-prescription and prescription medications consumed by the elderly, describe the biologic and physiologic changes that occur with age and how these changes …

Trauma Rehabilitation Of Traumatic Brain Injury: A Physical Therapy Perspective In The Management Of Muscular Complications, Heterotopic Ossification, And Skin Breakdown, Erin N. Sabe

Physical Therapy Scholarly Projects

Traumatic brain injury (TBI) is any combination of focal and/or diffuse central nervous system dysfunction, both immediate and delayed, at the brainstem level and above. The dysfunctions, which, are not developmental or degenerative, are due to the interaction of any external forces and the body, violent movements of the body, infection, toxicity, surgery, and non-age related vascular disorders. In the United States, TBI has reached epidemic proportions and is the leading killer and cause of disability in children and young adults.

The TBI survival rate is increasing due to life-saving technology. Survivors will face extensive rehabilitation services, which have been …

The Relationship Between Vertical Jump Scores And Peak Force Measurements Of An Isokinetic Leg Press, David M. Silkey

Physical Therapy Scholarly Projects

This study evaluated potential correlations between related closed kinematic chain strength measurements on a Kin-Com isokinetic machine and a functional strength test. The correlation between standing vertical jump height and isokinetic leg press measurements were statistically analyzed. The following measurements were obtained from 22 subjects (mean age of 24.4 years): a body weight measurement, a vertical jump score, and the force measurements of an isokinetic leg press at 90°/second on each leg. Pearson correlation coefficients were significant (p < .001) when power quotient scores (vertical jump height multiplied by body weight) were compared to leg press results. However, second-order partial correlation coefficients did not find a significance (p > .005) between vertical jump scores and isokinetic leg press results when weight and gender were considered. A significant difference (p < .001) existed between left leg press and right leg press measures. Although isokinetics are useful for lower extremity assessment, this study found that the isokinetic leg press may not be appropriate in determining functional ability.

A Comparison Study Of Cervical Range Of Motion Between Unilateral Breathers And Bilateral Breathers In Collegiate Swimmers During Freestyle Swimming, Nadine K.M. Takai

Physical Therapy Scholarly Projects

The purpose of this study was to determine if there is a difference in cervical rotation between unilateral breathers and bilateral breathers for freestyle swimmers. The sample consisted of 44 (23 males, 21 females) University of North Dakota Varsity swim team members. Among the swimmers there were 19 bilateral breathers, 21 right unilateral, and 4 left unilateral breathers. The CROM device was the tool used to measure cervical rotation. An ANOVA analysis showed no significant difference in right rotation (p=.6585) and total rotation (p=.0693) for any breathing style, however a significant difference existed for left rotation (p=.0078) between bilateral and …

Sacroiliac Joint: An Overview, Cheryl Walker

Physical Therapy Scholarly Projects

Low back pain is a common cause of limitation in daily activities. Sacroiliac joint (SIJ) dysfunction is often an overlooked cause of low back pain. The biomechanics of the SIJ is not well understood. There is controversy about how much movement is in the joint, but it is generally agreed that movement does occur. There are six ligaments in the SIJ that add to its stability and no muscles that act directly on the joint. SIJ dysfunction can be caused by direct trauma, indirect trauma, pregnancy, or muscle imbalances. Evaluation of the SIJ should include subjective and objective information. The …

Rehabilitation Treatment Following Total Shoulder Arthroplasty, Debbie Aarhus

Physical Therapy Scholarly Projects

The shoulder is a very complex joint in the human body and, therefore, is easily injured and/or damaged. When conservative methods (pain reducing modalities, exercise, or medication) to treat the injury fail, an alternative method of treatment could be a total shoulder arthroplasty. Corrective surgery alone, however, is not enough. A rehabilitation program involving range of motion and strengthening exercises is fundamental in the successful return of function at the shoulder.

The purpose of this literature review is to provide an overview of shoulder anatomy, surgical procedures of total shoulder arthroplasty, rehabilitation protocols, and outcomes. The information gained from this …

Balance Exercise For Fall Prevention In The Elderly, Lorrina Mcclellan

Physical Therapy Scholarly Projects

Falls are a very common and serious problem in the elderly population. Individuals who fall may suffer from physical trauma, psychological problems, and possible death. In the past, falls were thought to be an unavoidable occurrence that accompanied aging. Research has .recently identified risk factors that may predict those who are at risk for falling. By recognizing and then modifying these risk factors, potential falls may be prevented. Examples of risk factors that occur with aging include visual impairments, vestibular decline, deterioration of muscle strength, decrease in joint flexibility, and the loss of sensation. Natural biological declines may have profound …

The Adverse Effects Of Long-Term Corticosteroid Use, Jennifer Ann. Johnston

Physical Therapy Scholarly Projects

Corticosteroids are an often prescribed anti-inflammatory medication. They are used to treat disease processes of every system of the body. Those disease processes or procedures for which corticosteroids are often prescribed are cancer, bone marrow transplants, collagenous diseases (systemic lupus erythematosus), rheumatoid arthritis, leukemia, and anemia.

However, despite the therapeutic benefits of corticosteroids, many adverse effects are possible. Gastrointestinal difficulties, steroid myopathy, hyperglycemia, osteoporosis, impaired cellular immunity, decreased neuropsychological functioning, and avascular necrosis are just a few of the possible adverse effects.

Patients receiving corticosteroids will often be seen by physical therapists for either their primary or secondary diagnoses. Physical …

The Use Of Ergogenic Aids In Athletes, Sheri L. Mounteer

Physical Therapy Scholarly Projects

Ergogenic aids are substances purported to enhance athletic performance or improve exercise capacity. The use of ergogenic aids in sports is very widespread. It is common for a physical therapist working in a sports clinic to have patients that are either considering using or using ergogenic aids. Use of these aids by patients being treated might affect the patients' response to treatment. Therapists should be able to recognize the signs of ergogenic aid abuse in individuals under their care, and they should be aware of the side effects of these aids. It is also important for therapists to be able …

The Effects Of Botulinum Toxin Injections On Function In Patients With Spasticity, Leann Pippen

Physical Therapy Scholarly Projects

Spasticity can be one of the most challenging problems for patients with neurologic conditions such as cerebral palsy, spinal cord injuries, cerebrovascular accidents, multiple sclerosis, traumatic brain injuries, etc. It can lead to a wide variety of problems including decreased mobility, decreased quality of movement, interference with normal postural reactions, interference with functional activities, and pressure sores. Therefore, the medical community has focused on effective treatments for spasticity which do not produce overwhelming weakness, spasticity, paralysis, fatigue, and/or muscle atrophy. Since the late 1970's, the use of botulinum toxin (BTX-A) injections to decrease spasticity has been investigated.

The purpose of …

Musicians And Performance Related Injuries To The Hand, Leona Pang

Physical Therapy Scholarly Projects

Musicians spend a great amount of energy and time preparing for auditions, competitions, performances, and recitals. The process of developing techniques and learning musical pieces requires practice sessions filled with long hours of repeating musical passages and awkward upper extremity positions. Performance related injuries often result from these conditions. Injuries include joint disorders, musculotendinous disorders, muscle cramps and pain disorders, neurological disorders, and focal dystonia or occupational palsy disorders. Pain, numbness, tingling, muscle cramping, and motor dysfunctions are associated symptoms. If symptoms are ignored and intense performance is continued, the musician can experience tissue damage and permanent loss of function. …