Rehabilitation and Therapy Commons^™

Chronic Lower Back Pain: A Maladaptive Perceptions Model, Benedict M. Wand

Physiotherapy Conference Papers

High quality evidence suggests that current approaches to the management of CLBP show only limited effectiveness; one explanation of this finding is that current models of management are misdirected or incomplete. This talk proposes a model of CLBP underpinned by data on the psychological contributors to the LBP experience and recent evidence of neuroplastic changes in the brains of people with CLBP (see below). The model suggests that maladaptive cognitive perception about the nature of the back problem and future consequences drive behaviours that might bring about maladaptive neuroplastic changes. These central nervous system changes may enhance sensitivity, influence normal …

Moving In An Environment Of Induced Sensory-Motor Incongruence Does Not Influence Pain Sensitivity In Healthy Volunteers: A Randomised Within-Subject Cross-Over Experiment, Benedict M. Wand, Lareina Szpak, Pamela George, Max Bulsara, Neil E. O'Connell, G Lorimer Moseley

Physiotherapy Conference Papers

A mismatch between the brain's motor control and sensory systems has been suggested as one mechanism whereby maladaptive neuroplastic changes contribute to the experience of chronic pain. Several studies have investigated this hypothesis by artificially inducing a state of sensory-motor incongruence using mirrors. The data to date appear to suggest that creating an environment of sensori-motor incongruence induces various sensory changes and feeling of peculiarity, however the effect on pain is less clear. The aim of this study was to test the hypothesis that healthy participants would demonstrate reduced pain thresholds and report greater intensity of pain in a condition …

Treatment-Based Classification Of Low Back Pain – Who Are The Unclear Classifications?, T R. Stanton, J M. Fritz, A T. Apeldoorn, Benedict M. Wand, M J. Hancock

Physiotherapy Conference Papers

A recent focus in low back pain research has been to identify patient subgroups that respond best to certain treatments. To integrate these subgroup findings into a useable form, a treatment-based classification algorithm for LBP was created.^1,2 To allow the algorithm to be comprehensive – eg, provide a classification for all patients – additional criteria are provided to assist therapists’ decisions for patients who do not clearly meet a treatment subgroup (unclear classifications).

Recent research found that approximately 34% of patients will receive unclear classifications using the algorithm.³ It has also been shown that the reliability of the …

Functional Changes In The Primary Somatosensory Cortex In Complex Regional Pain Syndrome (Crps): A Systematic Review, Flavia Di Pietro, Tasha R. Stanton, Luke Parkitny, James H. Mccauley, Martin Lotze, Benedict M. Wand, G Lorimer Moseley

Physiotherapy Conference Papers

The brain plays a key role in CRPS. A widely-studied brain region in pain research is the primary somatosensory cortex (S1), a somatotopic map of our body’s surface which functionally reorganises in pain [1]. Changes in the S1 representation of the CRPS-affected body part have contributed to new CRPS treatments, e.g. graded motor imagery. This systematic review and meta-analysis aimed to determine whether CRPS is associated with: a) a change in the size of the S1 representation of the affected body part; b) altered S1 activity, in terms of activation levels and latency of responses.

Low Back Pain-Related Beliefs And Self-Reported Practice Behaviours Among Final-Year Cross-Discipline Health Students, A Briggs, H Slater, A Smith, A Parkin-Smith, K Watkins, Benedict Wand, J Chua

Physiotherapy Conference Papers

No abstract provided.

Discovering Which Experiences Physiotherapy Students Identify As Learning Facilitators In Practical Laboratories: An Action Research Project, J Francis-Coad, A Hill

Physiotherapy Conference Papers

Purpose: Students enrolled in courses that focus on patient contact participate in practical laboratories to learn clinical skills but this can be challenging in a pre-clinical environment. A simulated case based format using role play in small groups is commonly undertaken. Students may find it difficult to actively engage in learning and effective role playing without prior clinical experience. The aim of this study was to discover what type of experiences facilitated student learning in practical laboratory sessions.

Method: Design: Action research study.

Participants: Thirty two undergraduate second year physiotherapy students who were engaging in practical laboratories.

Data …

Is Pilates An Effective Treatment For Improving Functional Disability And Pain In Patients With Nonspecific Low Back Pain?, Koren V. Fleming

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Pilates an effective treatment for improving functional disability and pain in patients with nonspecific low back pain?”

STUDY DESIGN: Review of three English language primary studies, two of which were published in 2006 and the other in 2009.

DATA SOURCES: Three single-blind randomized control trials comparing the Pilates method of treatment to a control group that did not receive Pilates intervention were found using PubMed and EBSCOhost databases.

OUTCOMES MEASURED: Each of the studies had patients participate in Pilates sessions for six to seven weeks. …

A Systematic Review Of Sensorimotor Function During Adolescence: A Developmental Stage Of Increased Motor Awkwardness?, Catherine C. Quatman-Yates, Carmen Quatman, Andrew Mezsaros, Mark V. Paterno, Timothy E. Hewett

Faculty Publications - College of Physical Therapy

No abstract provided.

Turf, Team, And Town: A Geriatric Interprofessional Education Program, Nancy Macrae

Occupational Therapy Faculty Publications

Describes the Interprofessional Geriatric Education Program (IGEP) at the University of New England (U.S.). This course involves collaboration among health care students and faculty, including dental, occupational therapy, physician assistant, and physical therapy programs, and is focused on treatment for and feedback from elderly patients, who serve as “teachers” for students in the program.

Impact Of Yoga On Low Back Pain And Function: A Systematic Review And Meta-Analysis, Amy Sawyer, Sarah K. Martinez, Gordon L. Warren

Physical Therapy Faculty Publications

An estimated 70% of people will experience low back pain at some point in their lives, and recurrence rates can be as high as 85%. Recent studies suggest that yoga – a widely practiced physical/mental discipline – may relieve back pain and reduce functional disability. The objective of this study was to conduct a systematic review and meta-analysis of the existing research on the effects of yoga on chronic low back pain and function. Our literature search began April 2011 and continued through October 2011. Cochrane, PubMed, CINAHL, Embase, ProQuest Dissertations and Theses, Google Scholar, and Clinicaltrials.gov databases were searched …

Service Learning In Higher Education Exercise Science Programs, Wendy Bjerke

All PTHMS Faculty Publications

Introduction: Service learning (SL) describes teaching methods that incorporate student service activities with specific learning objectives. SL has been applied to allied health higher education programs.

Purpose: To determine the applicability of SL to exercise science courses. SL data associated with an undergraduate course in exercise physiology serving a local fire department is examined.

Aging, Aerobic Activity And Interhemispheric Communication, Keith M. Mcgregor, Kenneth M. Heilman, Joe R. Nocera, Carolynn Patten, Todd M. Manini, Bruce Crosson, Andrew Butler

Physical Therapy Faculty Publications

Recent studies have shown that during unimanual motor tasks, aging adults show bilateral recruitment of primary motor cortex (M1), while younger adults show a suppression of the ipsilateral motor cortex. Additional work has indicated that increased bilateral M1 recruitment in older adults may be deleterious when performing some motor tasks. However, higher levels of physical fitness are associated with improved dexterity and fitness may mitigate the loss of both inhibitory and excitatory communication in aging adults. The goal of this study was to assess dexterity and interhemispheric motor communication in physically fit and sedentary middle-age (40–60 years) right handed participants …

Reflection In Physical Therapy Practice: A Phenomenological Inquiry Into Oral And Written Narratives, Mary S. Knab

Educational Studies Dissertations

In today’s healthcare system, physical therapists treat an increasingly complex and diverse patient population and face rapidly expanding knowledge, technologies, and evidence for the care they provide. They also face demands for increased efficiency and improved outcomes. Reflection, espoused for its ability to help clinicians convert experience into learning and new knowledge, is widely viewed as being critical to sound clinical practice. There is, however, limited research and little consensus regarding what reflection looks like in the day-to-day practice of physical therapists. This phenomenological inquiry aims to identify the essence of reflection as experienced by physical therapists in clinical practice. …

Organic Photovoltaics: A Charge Transfer Perspective In The Study Of Donor-Acceptor Pairs, Marco Olguin

Open Access Theses & Dissertations

The present research involves the study of donor-acceptor (D/A) dyad complexes from a charge transfer energy perspective. The aim is to provide insight and predictive understanding into the charge transfer processes of the molecular-level components in donor-acceptor based organic solar cells using computational methods to describe photochemical processes at the quantum mechanical level within the Density Functional Theory (DFT) approximation. Predictive understanding is anchored in reproducing experimental results, wherein the present work a perturbative excited-state DFT method is described in detail and shown to give CT energies in excellent agreement with benchmark experimental data. With an accurate excited state method …

Low Back Pain With Psoas Tightness, Trevor Northagen

Physical Therapy Scholarly Projects

Background and Purpose

Low back pain is a prevalent healthcare issue which has a number of causes. There are many types of treatment with varying levels of success. The psoas is a back muscle which may undergo changes in a patient with back pain. Treatment may have to be modified if changes are seen in the psoas.

Case Description

A 66 year-old woman reported low back and right hip pain, as well as right-sided abdominal pain around a surgical incision. The physical therapy examination revealed adhered scar tissue around the incision, psoas muscle tightness, as well as low back and …

Influence Of Foot Position On Lower Extremity Muscle Activation, Casey Darling

Physical Therapy Scholarly Projects

The anterior cruciate ligament (ACL) in the knee is often sprained or torn in injuries resulting from jumping, cutting, or hyperextension of the knee. When the knee is put under a valgus, varus, or rotatory stress it can put strain on the ACL. Lower extremity motor control can help control the amount of varus and valgus stress on the knee. Lower extremity muscle control is involved with preventing this stress and resulting injuries. This study was performed to determine whether the position of the foot (neutral, supination, and pronation) has an effect on lower extremity muscle activity during single-leg squats. …

Effect Of Frontal Plane Foot Position On Lower Extremity Muscle Activation And Limb Positioning In A Single Leg Squat, Marissa N. Laddusaw

Physical Therapy Scholarly Projects

Purpose/Background: This goal of this study was to reach a bottom up understanding of ACL injury occurrence. Subtalar position during single leg stance may affect the muscles associated with the knee joint and promote ACL injury. The muscle activity of six muscles of the leg, thigh, and hip were analyzed during a single leg squat with the foot on surfaces of 10 degrees decline, five degrees decline, neutral, and 5 degrees incline, and 10 degrees incline.

Methods: Seventeen healthy participants between the ages of 18 and 30 performed five rhythmically timed repetitions of single leg squats on surfaces of 10 …

Low Dose Ct Vs Plain Abdominal Radiography For The Investigation Of The Acute Abdomen, Long K. Nguyen, Daniel D. Wong, Daniel M. Fatovich, Justin M. Yeung, Jennifer Persaud, Christopher J. Wood, David De Vos, Richard M. Mendelson

Physiotherapy Papers and Journal Articles

Background: To compare low-dose abdominal computed tomography (LDCT) with plain abdominal radiography (AR) in the primary investigation of acute abdominal pain to determine if there is a difference in diagnostic yield, the number of additional investigations required and hospital length of stay (LOS).

Methods: This randomized controlled trial was approved by the institutional review board, and informed consent was obtained. Patients presenting to the emergency department with an acute abdomen and who would normally be investigated with AR were randomized to either AR or LDCT. The estimated radiation dose of the LDCT protocol was 2–3 mSv compared to 1.1 mSv …

Tibial Acceleration In Male And Female Distance Runners In Reduced Body Weight Conditions, Brendan J. Rickert

PTHMS Graduate Research

Seventy-two percent of all stress fractures in athletes come from running, which can cause an immediate cessation of training. Additionally, fifty percent of all stress fractures occur in the distal end of the tibia. One way to keep the athlete moving without slowing down the healing process is using an unloader treadmill (TM) in a rehabilitation setting. The purpose of this study was to investigate relationship between the level of body weight (BW) unloading in an Anti-Gravity Treadmill and tibial acceleration. Fifteen collegiate cross-country team runners (Gender: 9 males, 6 females; Age: 20.4 ± 2.4 years; Weight 60.1 ± 12.6 …

The Special Care Nursery, Linda Kahn-D’Angelo, Yvette Blanchard, Beth Mcmanus

Physical Therapy Faculty Publications

Providing services to high-risk infants and their families in the neonatal intensive care unit is a complex subspecialty of pediatric physical therapy requiring knowledge and skills beyond the competencies for entry into practice. The newborns in the neonatal intensive care unit (NICU) are among the most fragile patients that physical therapists will treat, and detrimental effects can occur as the result of routine caregiving procedures. Pediatric physical therapists (PTs) need advanced education in areas such as early fetal and infant development; infant neurobehavior; family responses to having a sick newborn; the environment of the NICU, physiologic assessment and monitoring; newborn …

Fatigue In Cerebral Palsy: A Critical Review., Laura Kristine Brunton, Charles L Rice

Physical Therapy Publications

Objective: Fatigue contributes to the deterioration or cessation of walking ability in adults with cerebral palsy (CP). However, conflict exists as to its role. Studies involving functional tasks reported increased, and earlier onset of, fatigue in CP whereas laboratory studies have reported individuals with CP to be more fatigue resistant than their peers.

Methods: A critical review of the literature related to fatigue in CP was conducted.

Results: This review describes factors that contribute to the observed fatigue resistance in laboratory tasks and how a decreased force-production in CP can result in higher energy expenditure to perform the same amount …

Plasticity Of Corticospinal Neural Control After Locomotor Training In Human Spinal Cord Injury, Maria Knikou

Publications and Research

Spinal lesions substantially impair ambulation, occur generally in young and otherwise healthy individuals, and result in devastating effects on quality of life. Restoration of locomotion after damage to the spinal cord is challenging because axons of the damaged neurons do not regenerate spontaneously. Body-weight-supported treadmill training (BWSTT) is a therapeutic approach in which a person with a spinal cord injury (SCI) steps on a motorized treadmill while some body weight is removed through an upper body harness. BWSTT improves temporal gait parameters, muscle activation patterns, and clinical outcome measures in persons with SCI. These changes are likely the result of …

Charcot Foot Ulceration, Katelin Sievert

Physical Therapy Scholarly Projects

This case report follows the treatment of a 64 year old male with a Charcot foot ulceration of the right foot. The study was conducted to assess the outcome of wound care to the stage three pressure ulcer and the use of a Total Contact Cast (TCC) in the treatment of the Charcot foot ulceration, as well as to present more awareness to the medical field on Charcot foot pathology and diagnosis. The study was conducted over a 16 week time period. After 15 sessions with the patient, the results showed that wound care, the use of a TCC, and …

Fiber Type And Cross-Sectional Area Characteristics In Hindlimb Muscles Of The Long-Lived Ames Dwarf Mouse, David Farder

Physical Therapy Scholarly Projects

Background: Aging is associated with sarcopenia and a change of composition in muscle fibers. Ames dwarf mice have been found to have a decreased susceptibility to the deleterious effects of the aging process, when compared to a normal mouse counterpart. This study looks at the muscle composition of the Ames dwarf mouse compared to the normal mouse by analyzing two muscles, extensor digitorum longus (EDL) and soleus (Sol).

Methods: Researchers harvested hind limb muscles from Ames dwarf mice and normal mice. The fours muscles were EDL, Sol, Gastrocnemius/Plantaris, and tibialis anterior (TA). EDL and Sol were sliced and stained with …

Effect Of Frontal Plane Foot Position On Lower Extremity Muscle Activation And Limb Positioning In A Single Leg Squat, Elizabeth J. Kornkven

Physical Therapy Scholarly Projects

Purpose/Background: Foot positioning during a single leg landing may affect the muscles above the ankle joint and promote positions of increased vulnerability to ACL injury. The purpose of the study was to analyze muscle activity of six muscles in the lower extremity during completion of a single leg squat on the subject’s dominant leg with the subtalar joint in 5 different positions.

Methods: Seventeen healthy males and females (ages 18‐30) performed five single leg squats in five foot positions: neutral, five degrees and ten degrees of declination, and five degrees and ten degrees of inclination. Electromyography data was collected from …

Use Of A Video Game Based Balance Training Intervention On The Balance And Function Of Children With Developmental Disabilities, Gina C. Siconolfi-Morris

Theses and Dissertations--Rehabilitation Sciences

Many children with developmental disabilities (DD) have physical impairments and limitations in their participation. Rehabilitation research often focuses on either physical impairments or participation restrictions, when both need to be investigated. The purposes of these two studies were to evaluate an at home therapist directed video game balance training intervention on balance, gait velocity (GV), hip strength and activities of children with DD. The pilot study was a single-subject non-concurrent multiple baseline design. Balance measures included: weight bearing symmetry; center of pressure area and velocity; time to boundary mean minima and standard deviation; and timed up and go. The participant’s …

Falls And Physical Activity In Persons With Multiple Sclerosis, J. J. Sosnoff, B. M. Sandroff, J. H. Pula, S. M. Morrison, R. W. Motl

Rehabilitation Sciences Faculty Publications

Objectives. To examine the association between fall history and physical activity using an objective measure of physical activity (i.e., accelerometry) in persons with multiple sclerosis.

Design. A community-based sample of 75 ambulatory persons with multiple sclerosis volunteered for the investigation. Participants self-reported fall history in the last year, underwent a neurological exam to determine Expanded Disability Status Scale (EDSS) score, and wore an accelerometer around the waist for 7 consecutive days to determine physical activity.

Results. Overall, 37 persons (49.3% of the sample) reported falling in the last year with 28 of the 37 falling more than once. Persons who …

Cross-Cultural Adaptation And Psychometric Testing Of The Hindi Version Of The Patient-Rated Wrist Evaluation, Saurabh Mehta, Bhavna Mhatre, Joy C. Macdermid, Amita Mehta

Physical Therapy Faculty Research

The purpose of this study was to perform cross-cultural adaptation and Hindi translation of the patient-rated wrist evaluation (PRWE) and assess psychometric properties of the PRWE-Hindi. Cross-cultural adaptation and Hindi translation of the PRWE was performed using standardized guidelines. Intraclass correlation coefficient (ICC) was used for assessing test–retest reliability, and Cronbach’s alpha (CA) was used for assessing the internal consistency of the PRWE-Hindi. Construct validity was assessed by examining the correlations between the PRWE-Hindi and grip strength, wrist range of movements, and self-reported pain and disability. A total of 50 patients with distal radius fracture were recruited and assessed three …

Associations Of Cardiorespiratory Fitness And Fatness With Metabolic Syndrome In Rural Women With Prehypertension., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Linda S. Boeckner, Susan Noble Walker

Journal Articles: Physical Therapy

BACKGROUND: This study investigated the associations of fitness and fatness with metabolic syndrome in rural women, part of a recognized US health disparities group.

METHODS: Fitness, percentage body fat, BMI, and metabolic syndrome criteria were assessed at baseline in 289 rural women with prehypertension, ages 40-69, enrolled in a healthy eating and activity community-based clinical trial for reducing blood pressure.

RESULTS: Ninety (31%) women had metabolic syndrome, of which 70% were obese by BMI (≥30 kg/m²), 100% by percentage body fat (≥30%), and 100% by revised BMI standards (≥25 kg/m²) cited in current literature. Hierarchical logistic regression models, adjusted for …

Investigation Into The Functional Mobility Difference Between Obese And Non-Obese Elderly, Xuefang Wu, Han T. Yeoh, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Obese aging population is increasing in the United States, and obese elderly experience fall twice as frequent as their lean counterparts. However, the mechanisms of older obese adults fall are still not clear. It is not known whether the obese elderly has more functional mobility impairments than their lean counterparts, and consequently have increased risks of falls. It was hypothesized that obese elderly have more functional mobility impairments compared with their healthy weight counterparts. Six lean and six obese community-dwelling elderly participated in the study. “Timed up & go” test was used to quantify the functional mobility for both lean …