Physical Therapy Commons^™

Creating A University-Based Performing Arts Clinic: Challenges And Lessons, Carissa Limtiaco, Alan Savanapridi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fine artists performing at the collegiate level are at a high risk for developing performance related musculoskeletal injuries due to the unique physical demands and repetitive nature of their movements. Previous research has reported incidence rates as high as 81% and 62% for student dancers and musicians respectively. Despite the high injury rates, research has shown that student performers underreport injuries and are reluctant to seek medical management from health professionals due to unhealthy beliefs and attitudes often held by this population as well as the lack of specialized healthcare. The goal of the UNLV College of Fine Arts (CFA) …

Effects Of Postural Load Perturbations On The Stroke-Impaired Spinal Circuitry, Jose Galvez, Linh Thi My Nguyen, Brandon Yee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective Transitioning from supported sitting position to standing activities requires coordinated interactions among postural muscles with appropriate reflexive responses to adapt to an increase in postural loading. Previous studies have found the failure to accommodate the challenge of increased postural loads in the stroke-impaired nervous system. In this study, we examined the H-reflex in response to different magnitudes of loads under static postural conditions, and compared the responses directly between individuals with a stroke-impaired nervous system and those with a non-neurologically impaired nervous system. We tested the hypothesis that the reflex amplitude would increase with increased load during standing in …

Developing A Physical Therapy Initial Evaluation Screening Tool For A Multidisciplinary Clinic For Adults With Down Syndrome, Isabella Russell, Alvin Lacap, Francis Lacap

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Down syndrome (Ds) is a chromosomal condition that can result in intellectual disability, as well as structural or functional disorders impacting the nervous, cardiovascular, and musculoskeletal systems. As individuals with Ds age, they can have an increased number of comorbidities that impact their health. Physical therapy can play an important role in managing many of the comorbidities adults with Ds have. Therefore, there is an increased need for physical therapists to efficiently screen, evaluate and treat adults with Ds. The purpose of this work is to create an Initial Evaluation Screening Tool and Patient Intake Form for physical therapists …

Analyzing Equity Within The University Of Nevada, Las Vegas Physical Therapy Program Admissions Process, Rebecca Altman, Savanna Cathey, Michelle Dedmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose The purpose of this study was to analyze the admissions process of the University of Nevada Las Vegas Physical Therapy (UNLVPT) program through the lens of racial equity. Methods A retrospective cohort of UNLVPT applicants between 2014-2019 was obtained from the physical therapy centralized admissions system and the UNLVPT admissions office. Applicant and application characteristics were compared by racial group. Results: Our sample included 2937 total applicants with 212 (7.2%) that were admitted and matriculated into the program. Applicants identified as 49% White, 24% Asian, 13% multiracial, 6% Hispanic, 2% Black, 0.2% American Indian, and 6% did not report …

The Psychometric Properties Of The Modified Fear Of Falling Avoidance Behavior Questionnaire In Parkinson’S Disease And Older Adults, Billy La, Arturo Aldaco, Ashley Haller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/purpose: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ), developed in 2011 to measure fear of falling avoidance behavior, has good evidence for reliability and validity. However, a recently modified version (mFFABQ) is theorized to be easier to understand for those completing the questionnaire because the Likert responses are more logical in completing the item stem. The purpose of this study was to examine the test-retest reliability and construct validity of the mFFABQ in adults with Parkinson’s Disease (PD) and older adults aged 60-90 years. Methods: Thirty-nine participants (age 72.21 ± 9.5; 29 men, 10 women) diagnosed with PD (diagnosis …

Effects Of A 12-Week Remote Exercise Program On Balance In Adults With Down Syndrome, Kayla Kotake, Sherwin Cadiao, Nicole Kaes, Jayston Prudencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis Individuals with Down syndrome (Ds) tend to have deficits in balance and postural control, which negatively affects their ability to perform physical activities safely and independently. Previous research has shown that exercise can improve balance in people with Ds, however, most studies looked at balance in children with Ds. As the average life expectancy for people with Ds has increased, there is a need for research investigating balance in adults with Ds. Also, there is a need to increase exercise opportunities (eg, remote exercise programs) for adults with Ds, as physical inactivity and sedentary behavior are prevalent among individuals …

Utilization And Perception Of Peer-Support After Lower Limb Loss In The United States: Potential Benefits On Mobility Outcomes, Moriah Maluotoga, Roopkiran Thind

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Limb loss is a life-changing event that significantly impacts patients’ functioning as well as psychosocial well-being. Psychosocial support in the form of amputee peer-support is widely recognized as beneficial to individuals after lower limb loss (LLL). However, there is currently a lack of research on the utilization of peer-support after LLL and its perceived benefits to function. The purpose of this cross-sectional study was to examine and quantify participants’ experiences with peer-support after LLL, and how peer-support experience is associated with mobility outcomes. We hypothesized that participants with LLL would express generally positive experiences with peer-support and that it …

Association Between Rural Background And Physical Therapist Practice Location, Caitlin Parker, Jace-Anne Sharp

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis To examine the association between physical therapists’ rural background and their decision to practice in a rural setting. We hypothesized that years of rural upbringing and size of hometown would be related to rural practice. Number of Subjects 257 physical therapists who graduated from one of two physical therapy programs in the Western United States between 2000 and 2020. Materials and Methods A survey was emailed to 19 physical therapy schools consisting of questions regarding participants’ background, demographics, and job history. We collected total number of years of practice and total years of rural practice. Length of practice varied, …

The Effects Of Exercise Training On Gait In Adults With Down Syndrome, Anna Lois Aquino, Sandra Daugherty, Alex Palko

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Down syndrome (Ds) is a genetic disorder in which the individual carries an extra copy of chromosome 21 resulting in mental and physical disabilities and risk of major health conditions. A high prevalence of gait pattern dysfunction occurs in adults with Ds due to muscle hypotonia, ligamentous laxity, joint hypermobility, and altered development of musculoskeletal structure, which often lead to increased falls and fear of falling. The purpose of this study is to investigate the differences in kinematic and spatiotemporal gait parameters between adults with Ds and age-matched controls, as well as studying the effects of a 12-week Ds-specific …

Implementation Of 2d Running Gait Analysis In Orthopedic Physical Therapy Clinics, Justin Rasavage, Tristan Trumbull, Melissa Goo-Tam, Micah Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Despite 2D motion analysis being deemed valid and reliable in assessing gait deviations in runners, current use of video-based motion analysis among orthopedic physical therapists is not prevalent. Purpose/Hypothesis: To investigate clinician-perceived effectiveness, adherence, and barriers of using a 2D running gait analysis protocol for patients with running-related injuries. Study Design: Survey Methods: Thirty outpatient physical therapy clinics were contacted to assess interest in participation. The participating therapists were trained on 2D running gait analysis protocol and given a running gait checklist. We used Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to assess the implementation process by collecting …

Anatomy Academy Service-Learning Project: Attacking The Epidemic Of Childhood Obesity, Kelsey Kjer, Rosedaveia Howell, Brennan Kitchen, Francesca Schutte

UNLV Theses, Dissertations, Professional Papers, and Capstones

The World Health Organization has classified childhood obesity as one of the most serious public health concerns in the world. Obesity is known to have detrimental health consequences and be a risk for comorbidities. On top of the consequences of obesity already seen in young children at school, a lack of health education interventions in many elementary schools remains a significant health disparity. Anatomy Academy (AA) is a seven-week curriculum designed to educate children about their bodies and the importance of gaining and maintaining a healthy lifestyle. The purpose of this service-learning project was to educate elementary school students in …

Lumbopelvic Biomechanics And Muscle Performance In Individuals With Unilateral Transfemoral Amputation: Implications For Lower Back Pain, Jason Ciccotelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

Many people with lower extremity amputation (LEA) experience lower back pain (LBP). The amount of pain they experienced can be debilitating and severely interferes with activities of daily living. Previous studies have explored LBP in populations without LEA, and the evidence is also growing within the limb loss population. However, the mechanism for the high prevalence of LBP after LEA remains unclear. The lower back muscles, specifically the multifidi muscles, play an important role in stabilization of the spine during motion, and LBP has been associated with decreased mobility in patient populations, but the degree of dysfunction in the spinal …

Stepping On - Virtual Fall Prevention For Older Adults, Sean Conners, Tyler Greener, Kaitlyn Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Three student learners in a doctoral physical therapy program completed a service-based learning project dedicated to reducing falls in the elderly. The program, called Stepping On, is a fall prevention initiative supported by the Wisconsin Institute for Healthy Aging (WIHA) whose goal is to identify risk factors for falls in the older population and provide exercises and recommendations to reduce falls. The eleven volunteer participants in this student learners’ Stepping On program completed online fall prevention classes and provided feedback at the completion of the program. Participants reported being more conscientious while walking and noted improved balance and flexibility.

Development Of A Multifactorial Virtual Fall Prevention Tool For Community Dwelling Older Women, Eduardo Gutierrez, Jacob James Nogra, Carol Sparks, Bradley Voels

UNLV Theses, Dissertations, Professional Papers, and Capstones

Falls are the leading causes of injury-related death in adults over the age of 65, with women sustaining more than twice the rate of fall-related fractures as men. Reduced access to in-person falls prevention programs during the COVID-19 pandemic created a need for a user-friendly guide to existing online fall prevention resources targeted at this vulnerable population. The first aim of this study was to create and make widely available a website with evidence-based resources that address a range of modifiable fall risk factors, and the second was to test its feasibility in a convenience sample of older women. The …

Effects Of Patellofemoral Pain On Central Activation And Function Of The Gluteus Medius Muscle In Physically Active Females, Michelle Samuel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patellofemoral pain (PFP) is the most common knee injury among runners, military personnel, adolescents and recreationally active persons. PFP commonly presents as diffuse pain across the anterior knee that increases with activities such as running, squatting, and walking up and down stairs. Nearly 75% of patients with PFP either alter or completely stop physical activity as a result of the pain. There are numerous mechanisms that contribute to PFP symptoms; such as muscle weakness, abnormal joint mechanics and abnormal joint stress, which make it difficult to successfully treat. In addition, PFP may lead to patellofemoral joint (PFJ) osteoarthritis, a debilitating …

Increasing Utilization Of Otago Fall Prevention Program By Nevada Physical Therapists: A Service-Learning Project, Jared Apostol, Erica Mooy Brown, Danielle Uptain

UNLV Theses, Dissertations, Professional Papers, and Capstones

Otago is an evidence-based program that is designed to reduce falls in community dwelling older adults by individualizing an exercise program with three key components: strength, balance, and a walking program. Unfortunately, Nevada clinicians do not utilize the program frequently or entirely with patients in outpatient and/or home health physical therapy. Evidence shows it reduces fall risk, but it has barriers to implementation in the United States. The barriers to integration are primarily due to the plan of care that stems from a 12-month timeframe and several phone call appointments which does not fit well in the American healthcare system. …

Perceived Value Of Acute Care Physical Therapy, Juliana Amenta, Andrew Falcinelli, Erin Heenan, Hannah Kendall

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/Significance/Objective: Although there is some research regarding physical therapy in the acute hospital setting, much of it is focused on the role physical therapists play with specific patient populations or diagnoses. By understanding more about how physical therapy services can add value in the acute hospital, their skills could be better utilized to maximize benefit for both individual patients and the hospital. The purpose of this study was to investigate the perceived value that physical therapists bring to the acute care hospital from the perspective of both physical therapists and their supervisors in Southern Nevada.

Methods: This study used an …

Direction Of Attentional Focus In Prosthetic Training: Current Practice And Potential For Improving Motor Learning In Individuals With Lower Limb Loss, Alexander Bonczyk, Maria Katrina Tillada Dimapilis, Sarah Partridge, Samantha Ruiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting.

Methods: Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age=50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience=10 years, range=4-21 years) during …

Essential Tools For Sustainability Of A Student-Led, Pro-Bono Back School, Cory Brown, Rosalie Gutierrez, Jennifer Montes, Rondale Scruggs

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: In 2018, University of Nevada Las Vegas Doctor of Physical Therapy (DPT) students and faculty, in cooperation with a community partner, created a student-led pro bono Back School to address a gap in healthcare for underinsured individuals with low back pain in Southern Nevada. To support the sustainability of the Back School, the authors of this paper set out to develop a student club to recruit and train DPT students to volunteer in the program using a specifically designed electronic training manual. Overall, the aim was to encourage students to join the new club's leadership team to prepare future …

Diagnostic Ultrasound As A Reliable Tool To Measure Multifidus Thickness, Katherine Shigemoto, Valeria Garcia Arteaga, Jessie Peterson, Nathan Gentry

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Lower back pain (LBP) is a recurrent issue in the general population, though it is generally seen 2-3 times more frequently in those who undergo transfemoral amputations, being considered worse than phantom limb or residual pain. It is suggested that LBP is more common in those who have a transfemoral amputation than those who have a transtibial amputation. Research thus far has seemed to focus on identifying links between unilateral amputation and LBP rather than bilateral.

The multifidus muscle is the most important dynamic stabilizer of the lumbar spine, accounting for two- thirds of lower lumbar segmental stability. A …

Effects Of A Remote Exercise Intervention On Aerobic Endurance In Individuals With Down Syndrome, Andrew Murata, Elena Wolf, Jonathan Crimm, Benjamin Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Down syndrome (Ds) or Trisomy 21 is a common genetic birth condition, and those with Ds typically display decreased cardiorespiratory fitness compared to those without Ds, potentially leading to an increased risk for cardiovascular conditions and mortality. Low cardiorespiratory fitness is partially caused by low physical activity levels in this population. The COVID-19 pandemic caused community-based activity programs to shut down, as individuals with Ds are at increased risk for COVID-19 hospitalization and death. Thus, it was vital to explore alternatives of in-person exercise during the pandemic. The purpose of this study was to investigate the effects of a …

Walking With Poles Improves Step Length Of Simulated Prosthetic Gait, Marissa Elquist, Daniel Perez, Jonathan Garcia, Brady Owens

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with lower limb loss often demonstrate gait deviations which cause instability and asymmetry. Walking with poles has been shown to improve stride length and stability in older adult and other patient populations. The enhanced arm involvement in bipedal walking with poles has the potential to facilitate interlimb coordination among arms and legs, and therefore is likely to improve prosthetic gait. The purpose of this study was to examine the effect of walking poles on temporal gait parameters and the center of mass (COM) displacement during prosthetic and simulated prosthetic gait. It was hypothesized that walking with poles would improve …

The Effects Of A Telehealth Exercise Intervention On Balance In Adults With Down Syndrome, Mark Barton, Kristina Guerrero, Andrew Martinez, Alexandria Umagat

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: People with Down syndrome (Ds) often present with balance deficits, which compromise their safety during daily activity. While evidence shows that exercise can improve balance in the Ds population, it is unclear if a telehealth method will elicit similar benefits. We aimed to examine the effects of a virtual exercise program on balance in adults with Ds.

Methods: Twenty participants completed a 12-week telehealth exercise program based on the Mann Method. Balance testing took place before and after the intervention, which included: Timed Up and Go (TUG), Modified Clinical Test of Sensory Interaction in Balance (MCTSIB), Frailty and Injuries: …

Brain And Spinal Cord Adaptations Associated With Patellofemoral Pain: A Systematic Review And Meta-Analysis, Kara Meske, Savanna Budge Huerta, Austin Madriaga, Derrick Nguyenton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To evaluate the evidence for altered cortical and spinal cord functions in individuals with patellofemoral pain (PFP).

Methods: We conducted a comprehensive search of databases to appraise and analyze the studies published prior to December 10, 2021 that examined spinal reflex excitability measured using Hoffmann reflex (H-reflex) amplitudes, corticospinal excitability measured using transcranial magnetic stimulation (TMS)-elicited motor evoked potential (MEP) amplitudes, motor threshold (MT), or stimulus-response (SR) curves, cortical reorganization assessed using TMS cortical mapping or structural magnetic resonance imaging (MRI), or functional changes of the brain assessed using functional MRI (fMRI) in individuals with PFP.

Results: Eight studies …

Physical Therapy Alumni Rural Employment Assessment, Karen Aleyda Santos, Nikkita Jacob Crozier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction and Purpose: The University of Nevada, Las Vegas Doctor of Physical Therapy program (UNLVPT) encourages rural and underserved employment by requiring students to complete one clinical experience in either a rural or underserved setting. Students who participate in rural clinical experiences may be more likely to practice in rural settings. UNLVPT also assesses rural interest level during each student’s education. The purpose of this study was to determine if relationship exists between students’ pre- or post-clinical experience rural interest level and their practice location within the first two years after graduation. We hypothesized that an interest in rural practice …

Factors Predicting Fear Of Falling Avoidance Behavior In Parkinsonisms, Kameron Eckard, Franjo Vukojevic, Ryan Hammar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in potentially mitigable downstream consequences.

Objective: Determine the characteristics of individuals with parkinsonisms most associated with FFAB.

Methods: A retrospective, cross-sectional study was conducted from medical records data of 142 patients with parkinsonisms. These data included: demographics (age, sex), disease characteristics (Movement Disorders Society – Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III), years since diagnosis), fall history (number of fall injuries in previous year), and gait and balance function (five times sit to stand, MiniBESTest, Timed Up and Go (TUG), dual-task TUG, ten-meter walk test …

Efficacy And Benefits Of Providing A Screening Clinic For Performing Arts Students, Shaun Bean, Joanna Centeno, Elizabeth Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

In past years, University of Nevada, Las Vegas physical therapy students (UNLVPT) have provided UNLV dance students with screening clinics, injury evaluations, and treatment sessions to help address their need for direct and specialized services. Through this project, UNLVPT has worked to help reduce injury risk in dancers and provided treatment and rehabilitation for injuries that have occurred. Due to the COVID-19 pandemic, our group was unable to treat dancers in person over the course of the 2020-2021 school year. In response to these limitations, we worked to reformat our screening process to make it practical in a virtual setting. …

Effects Of A 12-Week Telehealth Exercise Intervention On Gait Speed And Gait Deviations In Adults With Down Syndrome, Robert Lum, Taylor Souza, Christopher Roys, Daniel Stopka

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Down syndrome (Ds) is associated with impairments affecting overall motor development including gait pattern and speed. Research on the effects of exercise on adults with Ds is lacking. The purpose of this study is to evaluate the effects of a 12-week telehealth exercise program on gait impairments in adults with Ds.

Methods: Twenty participants performed a 12-week telehealth exercise program based upon a diagnosis-specific procedure developed by Sarah Mann, PT, DPT. Gait deviations were assessed with the Ranchos Los Amigos Observational Gait Analysis. Comfortable gait speed was evaluated with the 4-meter walk test.

Results: Improvements in comfortable gait speed …

Quality Assurance Of Service Learning Back School, Eric Bashaw, Vu Pham, Tyler Parvin, Ryan Pauly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Project Execution: Back School: During the 2019-20 academic year, two University of Nevada, Las Vegas Physical Therapy (UNLVPT) core faculty members, along with eight doctor of physical therapy students, provided three student-led, pro-bono back school classes at Volunteers in Medicine of Southern Nevada (VMSN). Each back school class consisted of two, 2-hour sessions where participants were screened for red flags, educated on pain management strategies and common causes of back pain, and given an individual home exercise program. Quality Assurance Surveys: Patient’s and VMSN staff were all given questions in the form of Likert-scale and open-ended questions via printed handouts …

Is Decreased Trunk Flexion Angle A Contributing Factor To Patellofemoral Joint Loading In Runners With Patellofemoral Pain?, Christine Duvall, Zachary Clark, Tavin Fox, Caitlin Howden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Reduced trunk flexion during running is theorized to be a contributing factor of elevated patellofemoral joint (PFJ) stress in runners with patellofemoral pain (PFP); thus, the primary purpose of this research study was to determine if runners with PFP would exhibit differences in PFJ stress and trunk flexion angle during running as compared to pain-free runners across three speeds. We hypothesized that runners with PFP would exhibit higher PFJ stress and decreased trunk flexion while running compared to the pain- free runners. Number of Subjects: 7 runners with PFP and 5 similar pain-free control runners. Materials/Methods: Kinematics and kinetics …