Rehabilitation and Therapy Commons^™

Properties And Applications Of Sensory Outcome Measures In Carpal Tunnel Syndrome, Derek Km Cheung

Electronic Thesis and Dissertation Repository

This thesis aimed to determine the psychometric properties and applications of sensory threshold tools and outcome measures in patients with Carpal Tunnel Syndrome (CTS). The first chapter is a psychometric study that defines clinically important difference (CID), construct validity and responsiveness of touch and vibration threshold tools and in the Symptoms Severity Scale (SSS). The study found the CID for the PSSD and for the SSS was 0.15g/mm² and 0.50 respectively. The study also found that the Vibrometer was more representative of hand function and responsive compared PSSD. The second objective of this thesis was to determine the feasibility …

Predicting Risk For Adverse Outcomes Following Distal Radius Fracture, Saurabh Mehta Phd

Physical Therapy Faculty Research

Some individuals remain at risk for adverse outcomes such as chronic wrist/hand pain, falls, and fall-related osteoporotic fractures after distal radius fracture (DRF) remain. This thesis includes five studies that were conducted to establish prediction rules or assessing the risk of these adverse outcomes following DRF.

The first manuscript outlines a theoretical framework (RACE - Reducing pain, Activating, Cognitive reshaping, Empowering) for managing the risk of adverse outcomes, mainly chronic pain, in individuals with DRF. The RACE is one of the first frameworks to suggest a risk-based management approach for individuals with DRF.

The Patient-Rated Wrist Evaluation (PRWE) is a …

Skin Cell Proliferation Stimulated By Microneedles, Horst Liebl, Luther C. Kloth

Physical Therapy Faculty Research and Publications

A classical wound may be defined as a disruption of tissue integrity. Wounds, caused by trauma from accidents or surgery, that close via secondary intention rely on the biological phases of healing, i.e., hemostasis, inflammation, proliferation, and remodeling (HIPR). Depending on the wound type and severity, the inflammation phase begins immediately after injury and may last for an average of 7–14 days. Concurrent with the inflammation phase or slightly delayed, cell proliferation is stimulated followed by the activation of the remodeling (maturation) phase. The latter phase can last as long as 1 year or more, and the final healed state …

Physical Therapy Following Shoulder Rotator Cuff Repair, Ravindiran Appunni

Electronic Thesis and Dissertation Repository

ABSTRACT

Introduction

Rotator cuff (RC) tears are one of the common causes of pain and disability in the upper extremity. Currently there are no fixed guidelines for choosing testing positions for shoulder range of motion measurement. Optimal rehabilitation following RC repair is yet to be defined.

Purpose and Method

The purpose was to inform about postoperative Physical therapy following rotator cuff repair, with the following objectives:

• To systematically review the content of clinical research, which addresses various physical therapy programs.
• To describe validity and responsiveness of different testing positions for goniometric measurement of shoulder active external rotation.
• To pilot test …

Use Of Item Response Analysis To Investigate Measurement Properties And Clinical Validity Of Data For The Dynamic Gait Index, Yi-Po Chiu, Stacy L. Fritz, Kathye E. Light, Craig A. Velozo

Yi-Po Chiu

Background and Purpose. The Dynamic Gait Index (DGI) is a standardized clinical assessment that aids in evaluating a subject’s ability to modify gait in response to changing demands. The purpose of this study was to use Rasch measurement theory to examine whether the DGI rating scale meets suggested psychometric guidelines, whether the hierarchical order of DGI tasks is consistent with a clinically logical testing procedure, and whether the DGI represents a unidimensional construct. Subjects. Subjects were 84 community-dwelling male veterans (age range=64–88 years; mean±SD=75±6.47 years). Methods. Data were retrieved retrospectively from the participants’ clinical records. The Rasch measurement model with …

Feasibility Of Electromyography-Triggered Neuromuscular Stimulation As An Adjunct To Constraint-Induced Movement Therapy, Stacy L. Fritz, Yi-Po Chiu, Matthew P. Malcolm, Tara S. Patterson, Kathye E. Light

Yi-Po Chiu

Background and Purpose. The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT). Case Description. The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient's weaker arm for one half of the CIMT training hours. Outcomes. The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements …

Extreme Levels Of Noise Constitute A Key Neuromuscular Deficit In The Elderly, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Fluctuations during isometric force production tasks occur due to the inability of musculature to generate purely constant submaximal forces and are considered to be an estimation of neuromuscular noise. The human sensori-motor system regulates complex interactions between multiple afferent and efferent systems, which results in variability during functional task performance. Since muscles are the only active component of the motor system, it therefore seems reasonable that neuromuscular noise plays a key role in governing variability during both standing and walking. Seventy elderly women (including 34 fallers) performed multiple repetitions of isometric force production, quiet standing and walking tasks. No relationship …

Proposal For A Clinic Based Model Of Physical Therapist Consultation In A Geriatric Outpatient Clinic, Rania Karim, Patricia A. Higgins, Thomas R. Hornick

Physical Therapy Faculty Research

Purpose: The purpose of this article is to describe the role of a certified geriatric physical therapist (PT) in a geriatric outpatient clinic.

Methods: This pilot study used a model in which a geriatric certified doctor of physical therapy (DPT) provided consultations one afternoon a week for patients in the Outpatient Geriatric Clinic at the Louis Stokes Cleveland Veterans Affairs Medical Center (VAMC). Data collection included reason for referral, DPT’s interventions, and clinicians’ and patients’ perceptions.

Results: Over 7 months, the DPT consulted on 25 male patients ranging from 65 to 91 years, with a mean age …

Influence Of Knee Flexion Angle And Age On Triceps Surae Muscle Fatigue During Heel Raises, Kim Hébert-Losier, Anthony G. Schneiders, José A. García, S. John Sullivan, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

Hébert-Losier, K, Schneiders, AG, García, JA, Sullivan, SJ, and Simoneau, GG. Influence of knee flexion angle and age on triceps surae muscle fatigue during heel raises. J Strength Cond Res 26(11): 3134–3147, 2012—The triceps surae (TS) muscle-tendon unit is 1 of the most commonly injured in elite and recreational athletes, with a high prevalence in middle-aged adults. The performance of maximal numbers of unilateral heel raises is used to assess, train, and rehabilitate TS endurance and conventionally prescribed in 0° knee flexion (KF) for the gastrocnemius and 45° for the soleus (SOL). However, the extent of muscle selectivity conferred through …

Neuromagnetic Activity In The Cerebral Cortex Is Modulated By Locomotor-Like Movements Produced During Pedaling, Sheila M. Schindler-Ivens, Ruth M. Swedler, Brian Schmit, Sylvain Baillet

Physical Therapy Faculty Research and Publications

No abstract provided.

Effective Mentoring In Physical Therapy : Approaches For Residency Training, Anne E. O'Donnell

Department of Physical Therapy Student Theses, Dissertations and Capstones

PURPOSE: This study aimed to investigate how physical therapy mentors instill clinical judgment and competence during residency training. The researcher investigated effective mentoring behaviors and techniques in physical therapy residency training. SUBJECTS: Participants included physical therapy residency faculty, physical therapy residents currently enrolled in U.S. residency programs credentialed by the American Physical Therapy Association (APTA), and resident graduates (ie, within the past 2 years) from APTA programs. METHOD: A quantitative survey design was used to gain information about effective mentoring behaviors and techniques of physical therapy residency faculty who foster clinical expertise in physical therapy residents. Two online surveys were …

Physical Therapy News, Volume 2, Issue 1, College Of Health Professions

Physical Therapy News

No abstract provided.

The Development And Testing Of The Continuity Assessment Record And Evaluation (Care) Item Set: Final Report On Care Item Set And Current Assessment Comparisons: Volume 3 Of 3, Barbara Gage, Ann Deutsch, Laura Smith, Carole Schwartz, Jessica Ross, Laurie Coots, Karen Reilly, Judith Hazard Abbate, Kate Shamsuddin, Benjamin Silver, Christopher Murtagh, Margaret Stineman, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

No abstract provided.

Neurorecovery Network Provides Standardization Of Locomotor Training For Persons With Incomplete Spinal Cord Injury, Sarah A. Morrison, Gail F. Forrest, Gail F. Forrest, Leslie R. Vanhiel, Michele Davé, Denise D'Urso

Sarah Morrison, PT, MBA, MHA

The Effect Of Early Contextual Learning On Student Physical Therapists’ Self-Perceived Level Of Clinical Preparedness, Kevin E. Brueilly, T. Kirk Nelson, Tamara Gravano, Penny G. Kroll

Penny G. Kroll

Context: Students in health care often describe their feelings of self-inadequacy in clinical skills and report these feelings abate with experience.

Objective: To determine whether early contextual learning experiences can improve entry-level student physical therapists’ self-perceived level of clinical preparedness.

Design: A pair-wise comparison of pre vs. post intervention. Survey of students self-perceived level of clinical preparedness before and after a series of three planned small group contextual learning experiences involving the assessment of actual hospital patients.

Setting: Academic institution and associated medical center

Participants: Thirty-nine first-year student cohort in the 10th month of a 36-month entry-level Doctor of Physical …

Central Somatosensory Changes And Altered Muscle Synergies In Subjects With Anterior Cruciate Ligament Deficiency, Carol Courtney, Rose Marie Rine, Penny G. Kroll

Penny G. Kroll

To clarify the mechanisms of compensation in subjects with anterior cruciate ligament deficiency (ACL-D), we examined proprioception, quadriceps strength, somatosensory evoked potentials (SEPs) and muscle responses during gait in varied combinations of speed and incline. Seventeen subjects with ACL-D were grouped by functional level and report of giving way. Seven subjects without ACL-D served as a control sample for muscle response measures. ACL-D subjects with quadriceps weakness experienced giving way and could not resume sport activities. Those without weakness fell into one of two groups: (1) copers, who had full return to previous activity and no giving way despite proprioceptive …

Optimizing Physical Function Following Distal Radius Fracture, Siamak Bashardoust Tajali

Electronic Thesis and Dissertation Repository

Distal Radius Fracture (DRF) is one of the most frequent of all human bone fractures. Wrist and/or finger range of motion (ROM) and grip strength are standard outcome measures used by clinicians to evaluate recovery after a hand injury. ROM is considered to be an important component of joint mobility and relates to measures of functional impairment and disability. Impaired wrist and hand ROM are related to a decrease in grip strength, grasp ability, fine manipulation, and hand function. The relationship between ROM and other physical impairments as they relate to patient-rated outcomes after DRF have not been well identified. …

The Development And Testing Of The Continuity Assessment Record And Evaluation (Care) Item Set: Final Report On Reliability Testing, Volume 2 Of 3, Barbara Gage, Laura Smith, Jessica Ross, Laurie Coots, Tracy Kline, Kate Shamsuddin, Karen Reilly, Judith Hazard Abbate, Zachariah Gage-Croll, Anne Deutsch, Trudy Mallinson

Clinical Research and Leadership Faculty Publications

No abstract provided.

The Development And Testing Of The Continuity Assessment Record And Evaluation (Care) Item Set, Volume 1 Of 3, Barbara Gage, Roberta Constantine, Jyoti Aggarwal, Melissa Morley, Vera Kurlantzick, Shulamit Bernard, Dianne Munevar, Megan Garrity, Laura Smith, Dan Barch, Anne Deutsch, Trudy Mallinson, Linda Ehrlich-Jones

Clinical Research and Leadership Faculty Publications

No abstract provided.

How Do Parents Use Health Information With The Aid Of A Knowledge Broker When Living With And Caring For Their Young Children With Cerebral Palsy?, Stephanie E. Lagosky

Electronic Thesis and Dissertation Repository

This research aims to understand how parents use health information (such as those developed from the Move & PLAY study) with the aid of a knowledge broker when living with and caring for young children with cerebral palsy. This research was conducted under a qualitative case study methodology and used questionnaires and in-depth interviews to collect data. Findings include the complexity of both parental use of health information and the desire to use a knowledge broker. A provisional model has been created to help describe information use of parents with young children with cerebral palsy. This provisional model is an …

Systematic Review Of Core Muscle Electromyographic Activity During Physical Fitness Exercises, Jason Martuscello

USF Tampa Graduate Theses and Dissertations

Activating the core muscles through exercise training programs is believed to be important for athletic performance. Considerable attention has been credited to the lumbar multifidus, transverse abdominis, and quadratus lumborum in designing exercise training programs. Numerous core exercise claims and recommendations abound in the fitness and physical therapy communities touting a superior core challenge for these muscles. The plethora of core activation literature with conflicting outcomes has convoluted the process of choosing exercises for an optimal core training approach. Although an abundance of research studies have quantified the muscle activity, collectively, a consensus on the type of exercise that elicits …

Master Thesis: Fibromyalgie, Douleur Et Fasciathérapie, Cyril Dupuis

Cyril Dupuis

Résumé Ce travail porte sur la fasciathérapie appliquée aux douleurs de la fibromyalgie, et tente de répondre à la question « quels sont les effets de la fasciathérapie sur la douleur et ses consé- quences, ainsi que sur le vécu des patients qui souffrent de fibromyalgie ? » Pour cela, j’ai présenté le champ théorique des douleurs chroniques et du syndrome fibromyalgique, ainsi que celui des thérapies s’adressant aux fascias et notamment la fasciathérapie méthode Danis Bois. J’ai abordé cette recherche avec une posture double pour tenter d’appréhender la complexité de la douleur. La première, qualitative, est basée sur des …

Restoring Functional Status: A Long-Term Case Report Of Severe Lung And Ventilatory Muscle Pump Dysfunction Involving Recurrent Bacterial Pneumonias, Dennis Sobush, Linda Jean Laatsch-Lybeck, Randolph J. Lipchik

Physical Therapy Faculty Research and Publications

Background and Purpose: Prolonged mechanical ventilation contributes to immobility and deconditioning making efforts to safely discontinue ventilator support desirable. This case report documents how implementing physical therapy treatment interventions, based on the Guide to Physical Therapist Practice, can help to restore a person’s functional status even after multiple years of mechanical ventilation dependency. Case Description: A patient (female; aged 63 years) with severe restrictive and obstructive ventilatory impairment has survived 34 recurrent pneumonias involving 6 bacterial pathogens while being mechanically ventilated at home. A 3-year study was approved and informed consent obtained for a home exercise program of resistive extremity …

Co-Diagnosis Frequency Of Peripheral Vestibular Disorders And Physical Therapy, Summer M. San Lucas

Loma Linda University Electronic Theses, Dissertations & Projects

Dizziness is among the most common reasons that people consult a physician. The two most common causes of dizziness related to peripheral vestibular dysfunction are benign paroxysmal positional vertigo (BPPV) and vestibular hypofunction (VH). Physical therapy (PT) is an effective component of the medical management for both conditions. The occurrence rate of concurrent BPPV and VH in the same patient has not been described in the literature. Identifying patients with co-diagnosis of BPPV and VH will allow the PT to construct a proper treatment sequence. We conducted a retrospective chart review of 500 consecutive medical records of Veteran's Administration male …

Postural Sway, Eeg And Emg Analysis Of Hip And Ankle Muscles During Eight Balance Training Tasks, Yuen Yi Florence Tse

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine postural sway, cortical response and muscle activation of the hip and ankle muscles during eight balance tasks routinely used in sensorimotor training. This was a single group repeated measure study. The postural sway; the power of alpha, beta and sigma wave bands; and the EMG activity of gluteal maximus, gluteal medius, tibialis anterior and medial gastrocnemius were measured in 17 subjects during eight balance tasks with eyes open or closed, feet in tandem or apart and on foam or a firm surface. The results of this study showed that postural sway, EEG …

Effects Of Lift Velocity On Muscle Activation During Leg Extension, Stephen C. Glass

Stephen C Glass

Abstract: It is not known if manipulating velocity within a prescribed resistance training mode will improve muscle activation. Muscle activations of the Rectus Femoris (RF), Vastus Lateralis (VL), Vastus Medialis (VM) and Bicep Femoris (BF) were examined during a leg extension exercise at 3 different velocities on 15 subjects (10men, 5 female, Age = 21.5 ± 1.8 yrs, Height = 171.2 ± 12.5 cm, Mass = 75.5 ± 16.3 kg). Trials of 1 set of 10 repetitions at 60% of 1RM, were performed at 15, 30 and 60º/s. Bipolar surface electrodes were placed over the BF, RF, VL, and VM. …

Rasch Analysis Supports The Use Of The Depression, Anxiety, And Stress Scales To Measure Mood In Groups But Not In Individuals With Chronic Low Back Pain, Luke Parkitny, James Mcauley, David Walton, Leonardo Pena Costa, Kathryn Refshauge, Benedict Wand, Flavia Di Pietro, G Moseley

David Walton

Objective: Chronic pain is a common problem that is associated with mood disorders such as depression. The Depression, Anxiety, and Stress Scales (DASS-21) questionnaire is commonly used to help measure disordered mood. In this study, we used Rasch analysis to analyze the clinimetric properties of the DASS-21 in a chronic low back pain sample. Study Design and Setting: A Rasch analysis was conducted on data collected as a part of a randomized hospital-based placebo-controlled trial. DASS-21 questionnaires were completed by the 154 enrolled participants. Results: The DASS-21 subscales fit the Rasch model. No differential item functioning was detected for age, …

Predictors Of Success To Pass The National Physical Therapy Exam: Is There A Correlation Between Gre/Gpa Scores And Success Rates?, Kelsey Taylor

Undergraduate Honors Theses

The Graduate Record Exam (GRE) is an admission criterion for many different graduate programs including the Doctorate of Physical Therapy (DPT). Upon completion of a DPT program, the National Physical Therapy Exam (NPTE) must be passed with a minimum score of 600 in order to practice as a physical therapist. This study analyzes the relationship between GRE and graduate grade point average (GGPA) and NPTE scores to explore the ability of GRE and GGPA scores to predict NPTE success. Similar studies have been done in the past, but the results vary between studies. GRE, GGPA, and NPTE records were gathered …

Immediate Effects Of High Intensity Training In Children With Cerebral Palsy Gmfcs Levels I-Iii: A Pilot Study, Andrea Blahovec, Andrea Kuiken, Jillian Mears, Heather Riggins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cerebral Palsy is one of the most common causes of motor disability in the U.S., but there is still a lack of consensus for best intervention strategies to improve function and gait efficiency.

Objective: Determine if ambulatory children with CP, exposed to a brief, high intensity training session, will: 1) experience changes in temporal-spatial gait characteristics 2) demonstrate increased gait speed and 3) demonstrate improved gait kinematics.

Design: Five participants walked at preferred and fast speeds over an instrumented walkway followed by a 15-minute intervention. After a short rest, post-intervention walking was completed.

Results: Ten dependent variables were extracted …

Attentional Focus During Balance Training In Idiopathic Parkinson’S Disease (Pd): A Randomized Clinical Trial, Alyssa Davis, Rebecca Hatlevig, Amanda Richards, Leslee Rosenlof

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare the effects of various attentional focus strategies on balance in people with PD. Forty-nine adults with idiopathic PD were randomized into one of four groups (internal focus, external focus, no focus, and control). The three intervention groups participated in a month-long balance program. The outcomes measured were the Sensory Organization Test, Berg Balance Scale, self selected gait velocity, Dynamic Gait Index, Activities-specific Balance Confidence Scale and obstacle course completion time. These outcomes were measured at baseline, post intervention, 2-weeks post intervention, and 8-weeks post intervention. Statistical analyses yielded no significant differences among …