Rehabilitation and Therapy Commons^™

Clinical Effects Of Botulinum Toxin On Spasticity Management In Children With Cerebral Palsy, En-Shiuan Wu, Chia-Ling Chen, Alice M.K. Wong, Ching-Kai Wong, Jun-Xiao Chen, Shin-Ming Lo

Rehabilitation Practice and Science

Botulinum toxin type A (BTA) has treated spasticity in cerebral palsy (CP) in recent years. This study investigated both the clinical effects and gait improvements of BTA on spasticity management in children with CP.Twenty-nine children with spastic CP (2-10 years old) were recruited into this study. All subjects received complete clinical assessments, video recording and functional assessments before and 1-3 months after BTA treatment. A questionnaire was employed for the evaluation of parents’ subjective satisfaction. Clinical assessments included muscle tone and joint range of motion (ROM) of bilateral lower limbs. ROMs, including dynamic (R1) and static (R2), were measured by …

Assessing Intervention Effects In A School-Based Nutrition Intervention Trial: Which Analytic Model Is Most Powerful?, Jessica B. Janega, David M. Murray, Sherri P. Varnell, Jonathan L. Blitstein, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and posttest. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs addressing dietary outcomes. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect (σΔ) from adjustments for both fixed and time-varying covariates and correlations over time. These estimates will allow other researchers to use these variables to plan their studies by estimating a priori detectable differences and sample size requirements for any of the four analytic options. These methods …

A Closer Look At Development Of Self-Awareness And Compensatory Strategy Use In Adults With Traumatic Brain Injury, Melissa A. Byrne

Masters Theses

My study investigates the development of self-awareness and use of compensatory strategies in eight adults with traumatic brain injuries using the Awareness Questionnaire (AQ) and three additional questions of descriptive nature. This study also examines whether or not the severity of brain injury (mild, moderate, severe) impacts the development of self-awareness. In addition, the spouses' perceptions of client awareness are compared to the relatives' to determine existence of potential variance.

Results indicate that while there is no significant difference in self-awareness_ between the mild and moderate groups, the severe group significantly varies from both the mild and moderate groups. Also, …

Relationship Of Urinary Incontinence To Hysterectomy And Episiotomy, Elizabeth Oakley, Debra Buchtel, Rachel Atanosian, A. Lynn Millar

Faculty Publications

BACKGROUND: Urinary incontinence (UI) is a problem that affects women of all ages. Research has identified many risk factors for the development of UI but is inconclusive regarding the relationship between episiotomy and hysterectomy and the development of UI symptoms. Physical therapists are emerging as primary care providers which increases the importance of attention to and knowledge of risk factors facilitate timely screening and care for women at risk or who have UI signs and symptoms. PURPOSE: The purpose of this study was to examine the relationship between episiotomy and hysterectomy and incidence of urinary incontinence. SUBJECTS: The subjects included …

The Effectiveness Of Personal Data Assistants In Improving Daily Function Of Adults With Mild Traumatic Brain Injury, Connie Lee Budiwarman

Masters Theses

This study evaluated the effectiveness of using Personal Data Assistants to help with memory and/or organizational difficulties with adult patients who had survived mild Traumatic Brain Injury. Utilizing an AB single subject design method with a training period, one subject ultimately completed the study. The study demonstrated mixed results. Through the use of daily record sheets, the subject reported improvement in three areas of daily function but reported negative improvement in three areas of daily function. This study suggests, but does not completely support, the potential use of Personal Data Assistants with patients with Traumatic Brain Injury.

Retraining Balance Using Task-Focussed Work-Stations, Nancy Low Choy

Nancy Low Choy

Extract:

This chapter aims to:
Present a task-oriented approach to retraining balance and mobility using workstations as an effective mode of delivering tailored interventions to individual or small groups of residents or community-based elders who are: frail aged; elders who ambulate with supervision within residential care facilities; or elders who are independently ambulant in the community.

Provide an outline of workstations that illustrate varying levels of challenge but address the multiple aspects of balance and mobility that need to be considered while retraining balance and mobility in elders.

© Copyright Elsevier Limited, 2004

A Theoretical Framework For The Assessment And Treatment Of Balance And Mobility Deficits, Nancy Low Choy

Nancy Low Choy

Extract:

This chapter aims to:
Review the theoretical elements that contribute to balance and mobility as a basis for assessing balance and mobility in the elderly, and presenting a tailored but multidimensional approach to assessing and retraining balance and mobility deficits in the elderly.

Describe a process of assessing balance and mobility in the elderly that uses observational and problem-solving skills while analysing balance and mobility tasks, identifies and measures impairments, and monitors progress and outcomes for elders of varying functional motor ability.

© Copyright Elsevier Limited, 2004

Impact And Influences On Caregiver Outcomes At One Year Post-Stroke, Lorraine N. Smith, John Norrie, Susan M. Kerr, Maggie Lawrence, Peter Langhorne, Kennedy R. Lees

Dr. Maggie Lawrence

Four outcome measures of carer stress and coping at one year post-stroke were identified: carer general health, anxiety, depression and perception of stress. Each outcome was assessed using valid and reliable instruments. In addition, we collected demographic data from both carers and patients which could reasonably be expected to influence carer stress and coping (e.g. age, deprivation levels) as well as information specific to the caring role. Results: Carers were found to be more anxious than previously reported. Neither satisfaction with caring nor the adoption of helpful coping strategies were associated with positive carer outcomes but, nevertheless, carers were not …

Visual-Motor Integration Skills Impact On Handwriting, Amber M. Kapnick

Masters Theses

The purpose of this study was to evaluate if a visual-motor integration intervention improved handwriting legibility and visual-motor integration in first grade students as measured by the Minnesota Handwriting Test (MHT) and the Developmental Test of Visual-Motor Integration (VMI). Intervention was based on sensory-motor learning theories. Sixty-six children from four first grade classrooms in a suburban elementary school were randomly assigned to an intervention or a control condition. The intervention group received eight weeks of visual-motor integration training twice a week for 30 minute sessions. The control group received regular academic instruction. All children were tested on the Minnesota Handwriting …

Normal Values Of Balance Tests In Women Aged 20 - 80, Rosemary Isles, Nancy Low Choy, Marie Steers, Jennifer Nitz

Nancy Low Choy

Objectives:
To determine normal values for four commonly used clinical functional balance tests from community-dwelling women aged 20 to 80 and to identify any significant decline due to aging.

Design:
A cross-sectional study was undertaken to provide normative values for four clinical balance tests across 6 decade cohorts.

Setting:
The Betty Byrne-Henderson Center for Women and Aging, Royal Womens' Hospital, Brisbane, Australia.

Participants:
Four hundred fifty-six community-dwelling, independently ambulant women with no obvious neurological or musculoskeletal-related disability, aged 20 to 80, were randomly recruited from a large metropolitan region.

Measurements:
The clinical balance measures/tests were the Timed Up and Go …

Spousal Congruence On Disability, Pain, And Spouse Responses To Pain, Annmarie Cano, Ayna B. Johansen, Michael Geisser

Psychology Faculty Research Publications

We examined congruence between chronic pain patients and their spouses on their reports of patient pain severity, patient disability, and spouse responses to pain. Patients reported that they were more physically and psychosocially disabled than their spouses reported them to be. However, spouses reported that the patients’ pain was more severe than patients reported. Depressive disorders in the patient and gender interacted with patient–spouse ratings. For physical and psychosocial disability, depressed patient couples reported significantly larger differences in disability ratings than nondepressed patient couples. In addition, female patients’ disability was rated as more severe by the female patients than by …

The Understanding And Utilization Of Occupational Therapy Services By Medical Doctors In Acute Hospital Settings, Naina Jamani

Masters Theses

The purpose of this study was to determine what medical doctors working in the Canadian healthcare system know about occupational therapy, and if this understanding of occupational therapy is deemed valuable by the rate of referrals generated by these practitioners. This study will examine the relationship between physician's knowledge level and referrals to occupational therapy. The study instrument was a survey that consisted of eight questions, seven multiple choice and one open-ended response. The study took approximately five minutes to complete. A total of forty surveys were distributed at three different acute hospital settings. A total of fourteen or thirty-five …

Influence Of Varied, Controlled Distances From The Crank Axis On Peak Physiological Responses During Arm Crank Ergometry, Thomas L. Miller, Carl G. Mattacola, Mayra C. Santiago

Physical Therapy Faculty Publications

The purpose of the study was to determine the influence of varied, controlled distances from the crank axis during arm crank ergometry (ACE) on peak physiological responses and physical work capacity (PWC). Physiological responses to ACE were evaluated using three controlled distances from the crank axis based on 0°, 15°, and 30° from full extension in the elbow while at the furthest point in the crank rotation. Eleven adult, able-bodied women (age = 24.5 ± 4.7 yrs) performed graded maximal ACE tests at each of three distances from the crank axis. Data were analyzed for differences in peak physiological responses …

Orthopedic Treatment Outcomes And Physical Therapists' Orthopedic Clinical Specialist Status, Karin Granberg

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Orthopedic Clinical Specialist (OCS) certification has been available since 1989, however, no prospective studies exist demonstrating better patient outcomes with OCS certification. The purpose of this study was to prospectively explore if there are differences in effectiveness as measured by health, work status and patient satisfaction; efficiency, as measured by visits, treatment duration, number of treatment codes and cost; value (unit of functional improvement per dollar charged), and utilization (unit of functional improvement per visit) depending on OCS status of PTs working in orthopedic outpatient settings.

Subjects. Six PTs with OCS certification and 11 PTs without …

The Effectiveness Of A Physical Therapy Intervention For Children With Hypotonia And Flatfeet, Charmayne G. Ross

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to determine the effectiveness of physical therapy using Cascade orthotics and an exercise program for children with hypotonia and flatfeet. Subjects: Thirty-seven children, aged 18 months to 5 years, who demonstrated developmental delays and hypotonia with flatfoot dysfunction, participated in this study. Methods: Three groups (control, orthotic, and orthotic-exercise) were studied. The orthotic- exercise group practiced bilateral heel lifts besides wearing the orthoses. An arch index was used to assess the width of the medial longitudinal arch (MLA) pre/post interventions. Gait parameters (velocity, step-length, single-limb support, and cadence) were assessed four times in …

Diabetes: The Interrelationship Between Vascular, Nervous Systems And Avandia, Salameh Bweir

Loma Linda University Electronic Theses, Dissertations & Projects

Diabetes Mellitus has been linked to vascular and neurological impairments. The purpose of this study was to assess the relationship between vascular endothelial dysfunction, autonomic and somatic nervous systems impairment in diabetic patients. These studies also evaluated the effects of rosiglitazone (Avandia) on the vascular, autonomic, and somatic nervous systems.

Fourteen diabetic subjects and fourteen control subjects (age matched) participated in three series of experiments. Using Whitney volume plesythmography to assess post occlusion blood flow in the subject’s forearm did assessment of vascular endothelial function. Evaluating skin blood flow, orthostatic tolerance, heart rate, and thermal responses under thermal and postural …

Skills For The Job Of Living: Why You Need An Ot On Your Team, Laura Greiss Hess

Laura Greiss Hess

Test-Retest Reliability Of Temporal And Spatial Gait Characteristics Measured With An Instrumented Walkway System (Gaitrite)., Cornelis J T Van Uden, Marcus P Besser

Department of Physical Therapy Faculty Papers

BACKGROUND: The purpose of this study was to determine the test-retest reliability of temporal and spatial gait measurements over a one-week period as measured using an instrumented walkway system (GAITRite). METHODS: Subjects were tested on two occasions one week apart. Measurements were made at preferred and fast walking speeds using the GAITRite system. Measurements tested included walking speed, step length, stride length, base of support, step time, stride time, swing time, stance time, single and double support times, and toe in-toe out angle. RESULTS: Twenty-one healthy subjects participated in this study. The group consisted of 12 men and 9 women, …

Test-Retest Reliability Of Temporal And Spatial Gait Characteristics Measured With An Instrumented Walkway System (Gaitrite®), Cornelius J.T. Van Uden, Marcus P. Besser

Department of Physical Therapy Faculty Papers

Background
The purpose of this study was to determine the test-retest reliability of temporal and spatial gait measurements over a one-week period as measured using an instrumented walkway system (GAITRite®).

Methods
Subjects were tested on two occasions one week apart. Measurements were made at preferred and fast walking speeds using the GAITRite® system. Measurements tested included walking speed, step length, stride length, base of support, step time, stride time, swing time, stance time, single and double support times, and toe in-toe out angle.

Results
Twenty-one healthy subjects participated in this study. The group consisted of 12 men and 9 women, …

A System For Monitoring Pressures And Spinal Curvature In Spinally Injured People Immobilised On A Spinal Raft, Ruairí De Fréin, Eoin Flinn, Ted Burke

Articles

We present a system designed to study the pressure at various ‘hot spots’ on the back of the body and the deformation of the spine experienced by a patient when strapped to a spinal board, and the potential alleviation of both by the addition of an inflatable “spinal raft” (or other similar device). In measuring pressure we devised a system of air-filled sacks interfaced with a PC. Each sack, placed under a particular key point on the body, is inflated until its faces just begin to separate and a switch thereby opens. The pressure reading is then captured and displayed …

Informal Carers’ Experience Of Caring For Stroke Survivors, Lorraine M. Smith, Maggie Lawrence, Susan M. Kerr, Peter Langhorne, Kennedy R. Lees

Dr. Maggie Lawrence

Stroke is the third most common cause of death in industrialized countries and a major cause of adult disability. However, the burden of caring for stroke survivors usually rests with family members who have neither chosen nor volunteered for the role of ‘carer’. This paper reports on a study which aimed to describe the experience of caring for a stroke survivor at one year after stroke in Scotland.

A Comparison Of Hip Versus Ankle Exercises In Elders And The Influence On Balance And Gait, Laura Z. Gras, Pamela Levangie, Mary (Tina) Goodwin-Segal, Deborah A. Lawrence

All PTHMS Faculty Publications

Purpose: Reductions in hip and ankle strength and range of motion (ROM) in elderly subjects have been associated with decreased functional mobility and risk of falls. The purpose of this research was to determine if short duration hip or ankle interventions designed to increase ROM and strength could improve ROM and strength of those joints, as well as improve balance and gait outcomes. Methods: Well elderly volunteers recruited from retirement communities and a senior citizen center were randomly assigned to a hip or ankle intervention group. Both groups performed a home exercise program (HEP) of stretching 5 days a week …

Impact Of Service Learning On Physical Therapist Students' Knowledge Of And Attitudes Toward Older Adults And On Their Critical Thinking Ability, Janna Beling

Service Learning, General

As the number and proportion of elderly people rapidly increase in the next few decades, there will be increased demands for physical therapists to work with older clients. Although the availability of physical therapists to work with elderly people will be determined, in part, by their personal preferences,¹ most physical therapists will be routinely required to work with elderly clients and clients' aging family members.² In order to provide effective services, it is imperative that physical therapist students possess adequate knowledge about the aging process and recognize the individuality of older clients, as well as their capacity for …

Qtc Is Associated With Obesity And Physical Activity Level For African American Females, C. Jayne Brahler

Health and Sport Science Faculty Publications

Long QT syndrome (LQTS) is an independent risk factor for cardiovascular or ischemic disease mortality. Obesity as a cause for acquired LQTS in otherwise healthy individuals is rapidly gaining the attention of the scientific community. African American people have a higher incidence of obesity compared to Caucasians, yet race-specific information is not available for their prevalence of LQTS. Chronic physical activity can help reduce the incidence of obesity, yet little is known about the effects of chronic physical activity on acquired LQTS. Subjects in this study were a volunteer sample of African American mothers (21-53 yr, n = 44) and …

Enhancing The Rehabilitation Counseling Process: Understanding The Obstacles To Asian Americans' Utilization Of Services, Roy K. Chen, Song-Jae Jo, Chandra M. Donnell

School of Rehabilitation Services & Counseling Faculty Publications and Presentations

Improving rehabilitation services for Asian Americans with disabilities through the rehabilitation counseling process remains as an ongoing challenge. Despite being the fastest growing ethnic group in the United States, past studies have reported low utilization rates of vocational rehabilitation and mental health services among this population. This article (a) describes Asian American views on disabilities from religious, philosophical, and spiritual perspectives; (b) reviews factors that may contribute to their being underserved in the rehabilitation; (c) discusses the influence of family dynamics on the rehabilitation process; (d) underscores unique employment challenges facing the Asian Immigrant community; and (e) draws out the …

Speech And Occupational Therapy, Laura Greiss Hess, Kerrie Lemons Chitwood

Laura Greiss Hess

Assessing The Most Powerful Analysis Method For School-Based Intervention Studies, Jessica B. Janega, David M. Murray, Sherri P. Varnell, Jonathan L. Blitstein, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and a single posttest, the most common design used in GRTs. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs with alcohol, tobacco, and other drug measures as the outcomes of interest. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect of both adjustments for fixed and time-varying covariates, as well as correlations over time. These estimates will allow other researchers using these variables to plan their studies by …

Management Of Postsurgical Hyperhidrosis With Direct Current And Tap Water, Bernadette T. Gillick, Luther C. Kloth, Andrew John Starsky, Laura Cincinelli-Walker

Physical Therapy Faculty Research and Publications

Background and Purpose. Excessive sweating, known as hyperhidrosis, involves the eccrine sweat glands of the axillae, soles, palms, and/or forehead. The use of iontophoresis to reduce or eliminate excessive sweating has been described since 1952. The purpose of this case report is to describe the use of tap water galvanism (TWG) using direct current (DC) with a patient who had postsurgical hyperhidrosis. Case Description. The patient was a 36-year-old male electrician with traumatic phalangeal amputation and postsurgical development of hyperhidrosis. Tap water galvanism was administered using a DC generator, 2 to 3 times per week for 10 treatments. The patient's …

A Comparison Of Four Electrical Stimulation Types On Staphylococcus Aureus Growth In Vitro, Harold L. Merriman, Chris A. Hegyi, Cheryl R. Albright-Overton, John Carlos Jr., Robert W. Putnam, Janet A. Mulcare

Faculty Publications

We evaluated the efficacy of common electrical stimulation (ES) types on bacterial growth in vitro using clinically relevant conditions. Four types of ES-continuous micro-amperage direct current (μADC), high-voltage pulsed current (HVPC), low-voltage monophasic milliamperage pulsed current (LVMmAPC), and low-voltage biphasic milliamperage pulsed current (LVBmAPC)-were each applied to a separate set of culture plates containing Staphylococcus aureus for 1 h at 37°C on 3 consecutive days. After ES treatment, the zone of inhibition surrounding each electrode was measured. Zone of inhibition measurements showed a significant inhibitory effect for continuous μADC and HVPC (p < 0.05), but not for LVM-mAPC and LVBmAPC. Differences in bacterial growth inhibition were not found for polarity and time. These data suggest that for infected wounds, HVPC and continuous μADC treatments may have an initial bacterial inhibitory effect, which does not significantly change with subsequent treatments.

Su People, Linda Ober, Wanfeng Zhou, David Marc, Kate Gaetano, Margaret Costello, Amy Speach Shires

Syracuse University Magazine

No abstract provided.