Physical Therapy Commons^™

Predicting Walking Ability And Prosthetic Candidacy Following Lower Extremity Amputation; An Updated Systematic Review And Treatment Pathway, Scott Love, Carolyn Dias-Karch, Bianca Saragusti, Rebekah Langrek, Kayla Aponte, Rebecca Miro, Michael Jason Highsmith

Physical Therapy Collection

Background: There is not a clear compilation of existing literature that determines walking ability and prosthetic candidacy following lower extremity amputation (LEA). There is no multi-disciplinary instrument or patient centric decision-making protocol accepted that can predict walking ability and prosthetic candidacy nor support a treatment pathway. It is important to determine these factors to better assist clinicians in determining a patient’s MFCL K-level to assist with the delivery of proper prosthetic componentry. Medicare Functional Classification Level (MFCL) K-level is a 0 to 4-point scale of functional level for those with limb loss. The purpose of this systematic literature review …

The Reliability Of The Gnrb® Knee Arthrometer In Measuring Acl Stiffness And Laxity: Implications For Clinical Use And Clinical Trial Design., Kayla M. Smith, Nicole Miller, Steve Laslovich

Physical Therapy Collection

BACKGROUND: Stability of the knee is dependent on multiple factors including integrity of the anterior cruciate ligament (ACL). Greater knee joint laxity appears to negatively affect dynamic joint function and therefore reliable and valid measures of ACL stiffness and laxity are clinically valuable.

PURPOSE: The aim of this study was to investigate the reliability of the GENOUROB, (GNRB®) knee arthrometer device in measuring both stiffness and laxity of the ACL, and to provide information on sample size calculation for future clinical trials.

STUDY DESIGN: Cross-sectional test-retest study.

METHOD: Twelve healthy student participants (age 24-30 years; 6 females and 6 …

Recommendations For Optimizing Cardiac Ischemia Detection For Physical Therapy Practice: Research Review, Stacey Pirtle, Germaine Ferreira

Physical Therapy Collection

Purpose: The purpose of this study is to guide physical therapists in recognizing ischemia using electrocardiogram strips during graded exercise stress testing using methods other than relying on ST segment deviation for cardiac ischemia detection.

Methods: A literature review of the English-language literature published between 1975 to 2022 on the detection and prediction accuracy of ECG abnormalities on cardiac ischemia during GXT was conducted using PubMed and CINAHL. Inclusion criteria included studies utilizing 12-lead ECG monitoring while performing GXT for the detection of cardiac ischemia. Exclusion criteria included studies that did not utilize GXT or ECG for detection of cardiac …

Assessing Ground Reaction Forces And Degenerative Changes Of Sound Limb In Unilateral Lower Extremity Amputees: A Systematic Review, Kira Donnelly, Colin Davis, Nicole Liotta, Angela Perkins, Vibhor Agrawal, Michael Jason Highsmith, Scott Michael Love

Physical Therapy Collection

Abstract Background: There is a rising number of individuals undergoing lower extremity amputation (LEA) and is associated with increased risk of comorbidities. Osteoarthritis (OA) and Degenerative Joint Disease (DJD) are conditions that cause reduction in an individual’s function, independence, and quality of life.

Research Design: A search of multiple databases using terms associated with possible functional declines as evidenced by the International Classification of Functioning, Disability and Health (ICF), followed by assessment of evidence using the PEDro scoring method will be conducted. Multiple reviewers will screen, sort, rate and extract data from articles.

Methods: A computer-aided literature search of PubMed, …

Clinical Reasoning Readiness And Confidence Of Dpt Students With Pt Interventions Using Telehealth, Derrick F. Campbell, Jean-Michel Brismee, Brad Allen, Troy L. Hooper, Tony A. Domenech, Kathleen Manella

Physical Therapy Collection

Telehealth service-delivery content has an emerging footprint on entry-level physical therapy programs. This study evaluated clinical reasoning readiness and confidence in third-year DPT students during clinical experiences with and without telehealth.

Students’ clinical reasoning readiness and confidence were determined using the Physical Therapist Self-Efficacy (PTSE) score, self-confidence rating treating patients, and final APTA Clinical Performance Instrument (CPI) clinical reasoning and summative ratings.

DPT students providing PT interventions using telehealth reported lower clinical reasoning self-efficacy (PTSE) when compared to traditional service-delivery. Confidence treating using telehealth was greater at the initial visit compared to subsequent visits, suggesting a lack of student readiness …

Lower Extremity And Trunk Electromyographic Muscle Activity During Performance Of The Y-Balance Test On Stable And Unstable Surfaces., Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

Background: The Star Excursion Balance Test (SEBT) has been used as a rehabilitation exercise. To improve its efficacy, efficiency, and method variations, the Y-Balance Test (YBT) with anterior (A), posterolateral (PL), and posteromedial (PM) directions of the SEBT has been recommended. Electromyographic activity has been reported to change when the same task is performed on various surfaces.

Hypothesis/Purpose: To compare the EMG activity of trunk and LE muscles during the performance of the YBT on stable and unstable surfaces.

Study Design: Cross-Sectional study.

Methods: Healthy adults with no history of chronic ankle instability were recruited for the study. …

Admission Variables Predict Success In A Hybrid-Online Physical Therapist Education Program, Evan M. Pucillo, Rossniel Marinas, Christine Salmon, Vibhor Agrawal

Physical Therapy Collection

Purpose: Screening student applicants can be a valuable measure for hybrid-online Doctor of Physical Therapy (DPT) programs.Institutions embrace a wide variety of measurements that drive admissions decisions. However, uncertainties exist regarding the most accurate admission predictors of academic outcomes, especially among hybrid-online DPT programs. The purpose of this study was to examine predictive relationships between applicants’ admission variables and program grade point average and National Physical Therapy Examination (NPTE) performance in a cohort of entry-level hybrid-online DPT students. Methods: A retrospective cohort design and convenience sampling method was used across two entry-level hybrid-online DPT programs in the Southeastern US. Hybrid-online …

Physical Therapy Interventions And Outcomes In A Patient With Transfemoral Amputation Following Sound Side Total Knee Arthroplasty: A Case Report, Scott Love, Debra Gray, Jenna Yent, Michael Jason Highsmith

Physical Therapy Collection

Background: Following a transfemoral amputation (TFA), osteoarthritis (OA) on the sound limb may occur secondary to overuse. Potential causative factors include gait abnormalities, increased knee load, and performing hopping activities without a prosthesis. Unilateral TFA patients may require a total knee arthroplasty (TKA) to improve function.

Case Description and Methods: A 56-year-old male with a TFA who was diagnosed with left knee OA and was classified as a limited community ambulator underwent a TKA to restore function. The purpose of this case report is to determine the benefits of standard physical therapy (PT) augmented by a high intensity, whole-body …

Prevalence Of Soccer Heading In Middle School American Youth Club Soccer Players, Pedro Gonzalez-Cabrera, Mohan Ganesan, Julie Jameson, Deanna M. Hughes

Physical Therapy Collection

The purpose of this study was to evaluate the prevalence of soccer heading during a season in a youth soccer club competitive team

Heading events were recorded real time using a recording datasheet for a single team and their opponent teams during the 2014 season of a youth soccer league. Position on the field at the time of the heading event was also documented.

Mean heading events were 35.5 events/match. A paired sample t-test showed no statistically significant difference between observed team and opponent teams. Mean standardized assessment of concussion (SAC) score for the observed soccer team was 24.9±2.6 (out …

Use Of Smartphone Technology To Promote Knowledge Of Home Safety, Bonnie L. Rogulj

Physical Therapy Collection

This brief article describes the use of smartphone panoramic 360-degree imaging technology to educate patients on home safety. By positioning "hot spots" on images of the home environment, a visual tool for patient education was created to illustrate safety hazards in the home.

Trunk And Lower Extremity Muscle Activity During The Y Balance Test In Healthy Adults, Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

Y balance test kit^TM (YBT) is used to measure dynamic balance. YBT is an instrumented version of the Star Excursion Balance test that has Anterior (A), Posteromedial (PM), and Posterolateral (PL) directions. PURPOSE: To determine electromyographic (EMG) activity of the trunk and lower extremity (LE) muscles during YBT performance. METHODS: Surface EMG was collected on 10 males and 10 females healthy adults for the erector spinae (ES), external oblique (EOB), and rectus abdominis (RA) for both ipsilateral (i) and contralateral (c) sides of the stance leg, and gluteus medius (GMED), gluteus maximus (GMAX), Rectus Femoris (RF), Vastus Lateralis (VL), …

The Importance Of Cognitive Screening To Promote Clinical Decision-Making Skills, Bonnie L. Rogulj

Physical Therapy Collection

Description:

Research has revealed decreased cognitive function to be associated with mobility deficits and increased fall risk. The role of the physical therapist as the "Movement Specialist" of the patient-centered team should include screening for cognitive dysfunction in an effort to promote clinical decision-making and early intervention.

The presentation will discuss cognitive changes associated with aging to improve understanding of normal aging, mild and major neurocognitive disorder. The presentation will identify tools commonly used for cognitive screening and assist participants in the selection process. Participants will analyze sample screening findings necessary for clinical decision-making skills. The presentation will recognize the …

Gender-Specific Differences Of Normative Values Of Pelvic Floor Muscle Function In Healthy Adults Population: An Observational Analytical Study, Iman Akef Khowailed, Heather Disney, Haneul Lee

Physical Therapy Collection

The quantitative evaluation of pelvic floor muscle (PFM) function is of great value for the diagnosis and treatment of female pelvic floor dysfunction (FPFD; Gachon et al. 2019). The demographics and the prevalence of pelvic floor dysfunction are well understood but there are no data on the normative values of PFM function and the preventive measures needed to serve this population (Jundt, Peschers, and Kentenich 2015).

A total of 200 healthy adults, including 71 males and 129 females participated in this observational analytical study. Subjects were included in the study if they were healthy females or males aged 20–45.

Bladder …

Pandemic Sparks Innovation In Virtual Care Education, Bonnie L. Rogulj

Physical Therapy Collection

As a result of COVID-19 the physical therapy profession has required increased use of technology to manage patients and clients Telerehabilitation has allowed PTs to provide cost-effective services to patients and clients at a distance. This article describes an effort to create a series of interactive virtual activities related to the cervical spine and upper extremities for novice students enrolled in the Applied Anatomy course (see example below). It also explores important considerations for educators when utilizing technology to teach physical therapy telemedicine skills.

Spreading Encouragement To Seniors In A Pandemic, Bonnie L. Rogulj, Lashia Hicks

Physical Therapy Collection

This brief note describes a "virtual calendar" project created by students of the University of St. Augustine for Health Sciences. The calendar of images and poetry was shared with older adult community members to reduce loneliness and increase mental health and wellness in this population during the COVID-19 pandemic.

Utilization Of A Double Robot To Promote Critical Thinking By Novice Student Physical Therapists, Bonnie L. Rogulj, Mechelle Roy, Megan Dickerson

Physical Therapy Collection

This presentation discusses the clinical significance of the utilization of a double robot during a simulated telehealth session by novice student physical therapists to develop critical thinking skills. We demonstrate how to create a simulated telehealth session utilizing a double robot to promote critical thinking by novice student physical therapists. Finally, the limitations for virtual healthcare simulation are addressed as well as strategies for successful outcomes in the development of critical thinking skills.

Psychometric Properties Of Segmental Assessment Of Trunk Control In Infants And Toddlers With Down Syndrome., Megan Flores, Katy Mitchell, Christina Bickley, Carolyn P. Da Silva

Physical Therapy Collection

Purpose: This study investigated infants and toddlers with Down syndrome (DS) to determine: reliability of the Segmental Assessment of Trunk Control (SATCo), concurrent validity of the SATCo with the Gross Motor Function Measure (GMFM), and whether age and SATCo score predict GMFM score.

Methods: Eighteen infants and toddlers with DS were tested on the SATCo by 2 physical therapist (PT) raters. One PT rater administered the GMFM. After 2 weeks, PT raters rescored their recorded SATCo sessions. A third PT rater also scored the SATCo videos.

Results: Interrater reliability of the SATCo was moderate to good and …

Relationship Between Movement Quality, Functional Ambulation Status, And Spatiotemporal Gait Parameters In Children With Myelomeningocele., Megan Flores, Kathleen Manella, Elizabeth Ardolino

Physical Therapy Collection

Aims: We investigated relationships among the Pediatric Neuromuscular Recovery Scale (Peds NRS), modified Hoffer Scale, and spatiotemporal gait parameters in children with myelomeningocele (MMC).

Methods: 21 children with MMC, age 5.3 years (SD = 2.6), were assessed by three clinicians using the Peds NRS and modified Hoffer Scale. In eight children, gait parameters were also measured.

Results: The Peds NRS summary score demonstrated good correlation with modified Hoffer Scale score (r = -0.64, p = 0.002) that accounted for 41% of variation in summary score. Six Peds NRS seated/standing items exhibited good relationships with modified Hoffer Scale …

“But I’Ve Always Lived Here”: Evidence Informed Analysis On Aging In Place, Roxanne Mueller, Allison Paris, Holly Olsen, Lindsey Valentine, Chris Childers

Physical Therapy Collection

Purpose: The purpose of this poster/presentation is to provide an exploration and analysis of aging in place. To ensure the success of the older adult to remain in their home it is essential to determine and meet the changing needs of the aging population in a way that preserves lifelong health and wellness.

Description: The global trend of population aging is on the continual rise due to longer life expectancy and lower fertility rates.¹ It is predicted that by the year 2036 one in every four individuals will be a senior citizen. In some areas, the availability of …

Can Treadmill Training With Musical Cueing In Individuals With Progressive Parkinson’S Disease Improve Ambulation?, Kristen Barta, Derrick F. Campbell, Sharon Dunnivan-Mitchell Pt, Dpt

Physical Therapy Collection

The purpose of this study was to measure the effectiveness of a specialized musical composition in combination with treadmill training to impact gait parameters and balance in people with progressive Parkinson’s disease (PD). Incorporation of auditory stimulation, typically via metronome, to improve movement has been successfully used in rehabilitation for decades. Treadmill training, also frequently used in treatment of PD, has shown short- and long-term improvements in stride length, cadence, stance and swing phase. Music assisted therapy utilizing expertly designed musical composition, known as informed composition, has recently become available for use in rehabilitation in collaboration with music therapists. Combination …

Learning Strategies And Academic Difficulty In Physical And Occupational Therapy Online Education, Evan M. Pucillo, Erica J. Kiernan

Physical Therapy Collection

The purpose of this study was to explore the Learning and Study Strategies Inventory (LASSI) in relation to hybrid-online clinical neuroscience course outcomes in occupational therapy (OT) and physical therapy (PT) students. OT and PT students self-administered the LASSI during the Spring of 2019. N=34 students (14 OT; 20 PT) completed the LASSI. The scales of Information Processing (r = -0.43; p

Improvements In Physical Functional Performance Test 10 (Pfp-10) In An Amputee Following Contralateral Total Knee Arthroplasty, Scott Love, Rebekah Langreck, Payton Mcwilliams, Jenna Yent, Michael Jason Highsmith

Physical Therapy Collection

Introduction: Due to abnormal gait patterns in patients with lower extremity amputation (LEA), it has been hypothesized that this population experiences early onset of osteoarthritis (OA) of sound side limb causing pain and impaired function which may lead to surgical intervention.

Purpose: The purpose of this case report is to present a transfemoral LEA who received sound limb total knee arthroplasty (TKA). Just prior to and immediately following surgery, there is a time period where a person with LEA can experience a decrease in physical functional performance and become dependent on assistance for daily activities. Case

Description: The patient …

Psychometric Properties Of Segmental Assessment Of Trunk Control In Infants And Toddlers With Down Syndrome, Megan Flores, Katy Mitchell, Carolyn Da Silva, Christina Bickley

Physical Therapy Collection

Purpose/Hypothesis: The purpose of this study was to investigate infants and toddlers with Down Syndrome (DS) to determine: 1) interrater, intrarater, and live versus video reliability of the Segmental Assessment of Trunk Control (SATCo), 2) concurrent validity of the SATCo with the Gross Motor Function Measure (GMFM), and 3) whether a model of staggered entry with age and SATCo score predicts GMFM score.

Number of Subjects: 18 children with DS between 6 to 23 months (mean = 13.67, SD = 5.31) participated. Materials and Methods: The SATCo is a dichotomous scale to assess 7 discrete levels of trunk control in …

Experiencing Ipe: A Framework Integrating Ipec Standards In Multi-Disciplinary Education, Norman C. Belleza, Maureen Johnson

Physical Therapy Collection

Course Overview

This workshop creates an immersive experience demonstrating the effectiveness using the IPEC framework with IPE-based activities and shares outcome measures for integration into respective educational curricula. A gap exists in health-science programs regarding the effects of IPE. Novel activities include a multi-disciplinary experience of an escape room, chart review, and simulation vignettes. After the workshop, attendees will have tools to build an IPE framework in their respective programs.

Description of Content

Interprofessional education (IPE) elicits better quality behaviors amongst team players promoting improved patient safety and patient outcomes. However, there is a gap in multi-disciplinary health-science academic and …

Educational Model Integrating Ipec Collaborative Practice Competencies Across Multiple Disciplines, Norman C. Belleza, Maureen Johnson

Physical Therapy Collection

Purpose

The purpose of this project was to design an educational model that integrates the Interprofessional Education Collaborative (IPEC) Collaborative Practice Competency Domains into the curriculum across multiple disciplines. A faculty team from physical therapy (PT), occupational therapy (OT), medicine, and physician’s assistant (PA) programs, collaborated to create an introductory interprofessional education (IPE) framework and course module series. Currently, there are limited studies in rehabilitation education programs demonstrating the effectiveness of IPE-based activities on student outcomes. The proposed framework employs a series of novel educational activities including a multi-disciplinary escape room and scavenger hunt experience, chart review, and interprofessional (IP) …

Muscle Activation Patterns During Movement Attempts In Children With Acquired Spinal Cord Injury: Neurophysiological Assessment Of Residual Motor Function Below The Level Of Lesion., Darryn A Atkinson, Laura Mendez, Natalie Goodrich, Sevda C Aslan, Beatrice Ugiliweneza, Andrea L Behrman

Physical Therapy Collection

Introduction: Characterization of residual neuromotor capacity after spinal cord injury (SCI) is challenging. The current gold standard for measurement of sensorimotor function after SCI, the International Society for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam, seeks to determine isolated intentional muscle activation, however many individuals with SCI exhibit intentional movements and muscle activation patterns which are not confined to specific joint or muscle. Further, isolated muscle activation is a feature of the neuromuscular system that emerges during development, and thus may not be an appropriate measurement standard for children younger than 6.

Methods: We utilized neurophysiological assessment …

Femoral Retrotorsion As The Source Of Sacroiliac Symptoms – A Case Report, Catherine Patla, Kristin Hernandez

Physical Therapy Collection

The presence of femoral retrotorsion limits the ability to functionally utilize internal rotation IR of the hip. Postures which require the internal rotation of the hip can place more stress on the sacroiliac SI area as a compensation. This case report highlights a patient s self management of the SI symptoms by avoiding the postural positions requiring internal rotation. Retrospective analysis shows a significantly higher correlation of femoral retroversion (57%) in patients with these pain descriptors versus asymptomatic patients in whom the incidence of retroversion is only 5-15% (Prather 2019). The purpose of this case report is to demonstrate that …

Decreased Mobility Of Cuboid Rotation As The Source Of Achilles Tendinopathy--A Case Report, Catherine Patla, Kristin Hernandez

Physical Therapy Collection

Joint mobility is necessary for adequate function of musculature. Internal rotation of the cuboid functions to allow midtarsal and hindfoot pronation in weight bearing. Inability of the cuboid to internally rotate limits mid tarsal pronation, which limits contraction of the gastroc soleus on weight bearing, ultimately contributing to muscle/tendon stress. The continued stress on the contractile structure leads to a tendinopathy which results in limited functional use with pain of the gastroc/soleus. The purpose of this case report is to outline the successful treatment of a patient with this clinical presentation.

Simulation Enhances Soft Skills Among Inter-Professionals Participating In An International Service-Learning Experience To A Resource-Limited Country, Suzanne Trotter, Sharon Dunnivan-Mitchell

Physical Therapy Collection

Introduction: Soft skills are the hallmark of a master healthcare provider. One of the most effective ways to teach soft skills to healthcare providers is through service-learning. Evidence suggests that adding simulation as part of a service-learning team’s pre-departure training (PDT) will better prepare them to resolve ethical and cultural dilemmas often encountered in resource-limited countries, plus facilitate soft skills. We hypothesized that simulation could improve soft skills of physical and occupational therapy students and clinicians providing rehabilitation services on a one-week service-learning experience in Guatemala.

Methods: A convenience sample of 21 physical and occupational therapy students and …

Hip And Trunk Muscle Activity During The Star Excursion Balance Test In Healthy Adults, Kunal Bhanot, Navpreet Kaur, Lori Thein Brody, Jennifer Bridges, David C. Berry, Joshua J. Ode

Physical Therapy Collection

CONTEXT: Dynamic balance is a measure of core stability. Deficits in the dynamic balance have been related to injuries in the athletic populations. The Star Excursion Balance Test (SEBT) is suggested to measure and improve dynamic balance when used as a rehabilitative tool.

OBJECTIVE: To determine the electromyographic activity of the hip and the trunk muscles during the SEBT.

DESIGN: Descriptive.

SETTING: University campus.

PARTICIPANTS: Twenty-two healthy adults (11 males and 11 females; 23.3 [3.8] y, 170.3 [7.6] cm, 67.8 [10.3] kg, and 15.1% [5.0%] body fat).

INTERVENTION: Surface electromyographic data were collected on …