Physical Therapy Commons^™

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 …

The Practice Of Dry Needling In Physical Therapy, Sarah A. Robertson

University Honors Theses

This thesis is a systematic review that discusses the current state of the treatment modality of "Dry Needling" in the field of physical therapy. To do this, current studies of the patient outcomes associated with Dry Needling are analyzed and discussed, as well as legislation at both the state and national levels.

High-Intensity Interval Training And Biological Age, Trevor Lohman

Loma Linda University Electronic Theses, Dissertations & Projects

The emergence of valid predictors of biological age has enabled researchers to test the effects of various interventions on biological aging processes. The established virtues of exercise and its effects on health and longevity make it a suitable candidate for investigation. This dissertation reviews the current state of biological age prediction models and presents a trial in which a specific exercise protocol’s ability to modulate biological age is tested. The specific protocol used is a 10X1 high-intensity interval training (HIIT) protocol, 10X1 referring to the quantity and duration of high intensity exercise intervals in each exercise session. The specific biological …

A Long-Term Follow-Up Of The Stability Study: Multicenter Rct Comparing Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis In Individuals At High Risk Of Graft Failure, Katelyn M. Inch

Electronic Thesis and Dissertation Repository

One hundred and ninety-six patients at the Fowler Kennedy Sport Medicine Clinic (FKSMC) undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) were randomized as part of the multi-center STABILITY study to receive either an isolated ACLR or ACLR with a lateral extra-articular tenodesis (LET). The STABILITY study followed these patients up to two years postoperative, and a long-term follow-up protocol was initiated afterwards. Eighty-two patients from this center were seen at three, five and seven years postoperative as part of a long-term follow-up. Our primary outcome was a composite outcome of instability and graft failure. Secondary outcomes included patient-reported outcome measures …

The Clinical Value Of Oculomotor Assessments Across The Continuum Of Concussion, Dillon Richards

Electronic Thesis and Dissertation Repository

Concussions are complex conditions that are difficult to manage medically. Variations in symptom presentation, intricate neurophysiological processes, and the availability of a variety of possible assessment tools may contribute to this complexity. Clinicians must use a broad approach, employing both subjective symptom assessment and objective assessments to confirm a diagnosis and/or monitor progression and recovery. Oculomotor function after concussion may be an important indicator of injury, given the interconnectedness of oculomotor function, vestibulo-ocular and visual systems, and even cognition. Oculomotor function may be assessed objectively or indirectly using patient-reported symptom checklists as part of subjective assessments. One way of objectively …

How Does Exposure To Pelvic Health Content In Entry Level Physical Therapy Curricula Impact Students’ Comfort Level Discussing Sexual Health With Future Patients?, Elizabeth Levay

Graduate Theses, Dissertations, and Capstones

The purpose of this quantitative study was to investigate the relationship between exposure to pelvic health content in physical therapy school curricula and Doctor of Physical Therapy (DPT) students’ comfort levels discussing sexual health issues with future patients. As holistic, autonomous health care providers, physical therapists must be confident in addressing all aspects of health with patients, including sexual health. Lack of attention to patients’ sexual issues may result in aspects of health going unaddressed, leading to poor patient care. The research hypothesis was that increased exposure to pelvic health topics within entry level physical therapy education will improve students’ …

Contributions Of Asymmetry And Instability To Transfer And Retention Following Locomotor Adaptation, Daniel L. Gregory

Doctoral Dissertations

Gait asymmetry resulting from neurological injury is more costly and less stable than healthy gait. Split-belt treadmills, which drive limbs at different speeds, lead to spatial and temporal gait asymmetries, and perturb walking balance, have been used to study locomotor adaptability and learning related to asymmetry and stability. This knowledge may be leveraged to design more effective rehabilitation protocols. In experiment 1, we asked how constraining stride-rates away from preferred during split-belt walking influences learning revealed in a retention test. We found that constraints to stride rate during asymmetric walking uncovered the capacity to leverage redundant degrees-of-freedom for walking control, …

A Mixed Methods Approach To Understanding Common Factors Association With Pain And Functional Outcomes In Musculoskeletal Pain Conditions, Mary Beth Holmes

Educational Studies Dissertations

Healthcare costs continue to rise the provision of value-based care with evidence to support improvement in patient outcomes is essential for service coverage. While physical therapy has proven to be effective for the treatment of painful musculoskeletal conditions ostensibly different treatment approaches have yielded similar results. These findings have led to an exploration of the influence of the features present across all interventions, variables known as the “common factors”, on physical therapy outcomes. Research pertaining to common factors remains in the early stages in physical therapy literature, with studies primarily aimed at defining and exploring singular concepts. Using Wampold’s Contextual …

Adaptation With Injury, Family Role Responsibilities, & Social Support After Distal Radius Fracture (Drf), Hajra Batool

Electronic Thesis and Dissertation Repository

This study is a qualitative interpretive descriptive study aimed at elucidating the impact of distal radius fracture (DRF) on patients' activities of daily living (ADLs), professional and familial duties, and social support during the healing process. The study focuses on fracture healing during the immobilization phase of injury. This study lies in the constructivist paradigm employing the interpretive description method. A total of 20 participants with DRF in casts were recruited by purposeful sampling from the Hand & Upper limb Centre, St. Joseph’s Hospital enrolled and interviewed over the telephone. Data was analyzed by Braun and Clarke’s Thematic Analysis Approach. …

Physical Therapists Clinical Instructors Perceptions, Practices And Experience When Supervising An Underperforming Student In Clinical Education, Ruth Lyons Hansen

Seton Hall University Dissertations and Theses (ETDs)

Physical Therapist (PT) clinical instructors’ (CIs) perceptions, practices, and experiences when supervising an underperforming student.

Background: The experience of supervising an underperforming student (UPS) in clinical education and failure to fail (FTF) are described in health professions such as nursing and medicine but there is little description of it in Physical Therapist (PT) clinical education.

Purpose: To explore the PT clinical instructors’ (CIs) perceptions, practices and experience when supervising an under-performing student, and to determine if failure to fail exists in PT clinical education and if so, what organizational, personal, and demographic factors may be related to it.

Methods: …

Exploring The Inter-Relationship Between Cognitive And Motor Function In People With Lower Limb Amputations, Humberto Adolfo Omaña Moreno

Electronic Thesis and Dissertation Repository

The main objective of the present dissertation was to expand our understanding of the inter-relationship between cognition and mobility in people with lower limb amputations (PLLA). Study 1 systematically reviewed the literature to assess the effects of dual-task testing on the balance and gait of PLLA. A total of twenty-two studies were included. Overall, PLLA demonstrated a disproportionately greater dual-task effect than controls, characterized by increased sway velocity and reduced pace and rhythm, and increased asymmetry when balance or walking was paired with a secondary task. Additionally, the dual-task effect was not influenced by differences in etiology, level of amputation, …

The Investigation Of Prosthetic Rehabilitation Outcomes Following A Lower Limb Amputation In The Oldest Old, Ashvene Sureshkumar

Electronic Thesis and Dissertation Repository

This thesis sought to investigate the changing characteristics of people with lower limb amputations (LLAs) who participate in prosthetic rehabilitation programs and evaluate an under-investigated subgroup; the oldest old (aged 80 years and older). Study 1 included 601 consecutive admissions to a Canadian prosthetic rehabilitation program from 2012 to 2019. Although participant’s age did not increase at admission over time, individuals presented with a higher number of comorbidities each year. Participants were admitted from amputation surgery faster over time. Study 2 assessed functional prosthetic rehabilitation outcomes for the oldest old against participants aged 50 to 79 years old. Despite the …

Advancing The Assessment And Treatment Of Signs And Symptoms Of Parkinson Disease, David Scott May

WUSM Theses and Dissertations – All Programs

People with PD often report signs and symptoms that negatively impact quality of life. Among these are balance difficulties, impaired gait, and FOG. New treatment and assessment strategies for these signs and symptoms are needed, as current techniques are limited. While new treatment and assessment strategies continue to emerge, gaps in knowledge persist. Deep brain stimulation (DBS) has been utilized in many people with PD throughout the 21st century, but it is unknown specifically how subthalamic nucleus deep brain stimulation (STN-DBS) affects balance. Alternative treatment strategies, such as a dental mouthpiece, have also been proposed. While dental mouthpieces have shown …

Assessment Of Postural, Locomotor, And Physical Fitness Status In Individuals With Intellectual And Developmental Disabilities, Alana J. Turner

Theses and Dissertations

Introduction: Postural control and locomotion deficits can be observed during the early years of childhood development and throughout life. For those with disabilities, these deficits can advance past the development years and into adolescence and adulthood while affecting the quality of life and daily activity. Finding interactive rehabilitative activities to delay or limit these deficits is essential for people with disabilities to improve their quality of life, inclusion, and overall movement. Adapted physical activity/sports like badminton and virtual reality could promote improvements in postural and locomotor status for young adults with intellectual and developmental disabilities like cerebral palsy (CP), intellectual …

Association Between Visuomotor Skills And The Effects Of Stroboscopic Vision On Depth Jump Performance, Riley Welch

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

The reactive strength index (RSI) is a popularized method of evaluating depth jump performance. Performance in anticipation of ground impact is influenced by the proprioceptive, vestibular, and visuomotor systems through multisensory integration. The contribution of vision to depth jump performance has been studied through use of stroboscopic goggles, but no study has evaluated which visuomotor skills may be a predictor for DJ performance. The purpose of this investigation was to evaluate the association between visuomotor skills and the effects of stroboscopic vision on DJ performance. Participants consisted of 9 female and 13 male college aged adults. DJ performance was evaluated …

Advancing Type 2 Diabetes As A Condition For Primary Referral To Physiotherapy In Canada, Sarah M. Janssen

Electronic Thesis and Dissertation Repository

Obesity and sedentary lifestyle are increasingly prevalent risk factors for type 2 diabetes (T2D), characterized by high blood glucose levels. Adoption and maintenance of healthy eating, physical activity, and exercise is recommended for lowering blood glucose and weight management. Physiotherapists are experts in prescribing safe, effective exercise to optimize health for people with co-morbid health conditions. However, T2D is not a primary condition for referral to physiotherapy services in Canada. The overall question guiding a series of three related studies was, What is the current education and perspectives of Canadian physiotherapists about their role in managing T2D? Study one surveyed …

Non-Pharmacological Management Of Community Dwelling Individuals With Osteoporosis Or At Risk Of Developing Osteoporosis, Christina Ziebart

Electronic Thesis and Dissertation Repository

Background:

Osteoporosis is a bone disease that increases the risk of fractures. In adults aged 50-65 years, a wrist fracture is usually the first sign of osteoporosis. Fracture risk increases if these individuals are not taught to exercise, eat properly, and/or identify fall risk factors early in their diagnosis.

Methods:

A meta-analysis was conducted to determine whether a home fall hazard identification program could reduce the risk of falls in community dwelling adults and an overview of exercise in individuals with a distal radius fracture (DRF). CINHAL, PubMed, EMBASE, Scopus, and Psych INFO were used to identify articles. A survey …

Assessing The Efficacy Of Physical Prehabilitation On A Total Knee Arthroplasty, Zen S. Miyashiro

University Honors Theses

Prehabilitation is a rather new method of approach to the physical therapy setting in which patients attend therapy sessions to prepare for their upcoming surgery. Researchers hypothesize that if patients enter a procedure with higher levels of strength and function, they will be able to recover from their surgery quicker and more successfully. This literature review assesses different approaches that numerous studies have taken with regards to prehabilitation for patients about to undergo a Total Knee Arthroplasty. Majority of the studies conclude that there needs to be further research done to yield consistent results. Based on what has been done, …

A Novel Approach Toward Concussion Testing, Jorge K. Mercado, Ari Schacter, Danielle Euzent

Student Theses

A concussion is a violent jarring or shaking of the head caused by whiplash or direct impact that results in a disturbance of brain function. Concussions can be mild and brief, as a person may be dazed momentarily or can be more serious, resulting in a loss of consciousness. Underreporting of concussions is prevalent because they are a symptom-based diagnosis, lacking a clinical test. In this study, we investigated the use of VNG testing as a clinical diagnosis of concussions. Looking at the VNG test battery, the previous research cohort found that saccades, gaze, and positional testing are the most …

Acute Response Of A Lower Extremity Mobility Routine On Arom, Sprint Time, And Vertical Jump Height In Flexible And Nonflexible Adults., Flinn Christian

Undergraduate Theses and Capstone Projects

Although previous studies have shown that stretching can increase range of motion and affect performance, the comparison of the effects on flexible and nonflexible adults is not clear. Therefore, the purpose of this study was to determine how flexible and nonflexible adults responded to a lower extremity mobility routine focusing on the hip and ankle joints. A randomized treatment experimental design was used in which subjects had their hip and ankle ranges of motion, lower body flexibility, countermovement vertical jump, and sprint performance assessed. They were then randomly assigned to one of two treatment orders for hip (n=9) or ankle …

Concepts Of Leadership And The Value Of Leadership For Health Care Professionals: Perspectives From Doctor Of Physical Therapy Students, Tara Haj

Dissertations, Theses, and Projects

The complex and rapidly changing environment of health care requires health care professionals with leadership knowledge and skills. Many health professional education programs have recognized the importance of developing the leadership abilities of students studying to be professionals in their field. There is emerging evidence of the need for leadership development for physical therapists, including a set of leadership competencies that has recently been identified by physical therapists. The perspective of Doctor of Physical Therapy (DPT) students regarding leadership and the value of leadership for health care professionals is unknown.

This qualitative phenomenological study utilizing semi-structured interviews was conducted to …

Adaption, Retention, And Readaptation Strategies For Unfamiliar Leka (Lower-Extremity Knee Angles), Leea M. Perry

Honors Capstones

This capstone aimed to look into individuals’ abilities to adapt, retain, and readapt a newly-provided, typically over-exaggerated, goal knee angle for their right leg based upon feedback received and accuracy of examined gait pattern. Research was carried out using individuals aged 18-25, looking at the potential of “learning” per say, a new pattern for their rather instinctual previously formed habits for walking. Knee angle, both baseline and individuals’ attempts at goal angle, were measured with a knee brace worn throughout data collection. Participants for this study were blind in terms of what their goal LEKA (lower-extremity knee angle) was. The …

Barriers To Exercise And Physical Activity - Insight From The Rural Practitioner, Erin G. Tillery

Honors College Theses

Sedentary lifestyles are a growing public health concern. Furthermore, many rural Americans lack adequate access to healthcare resources. When healthcare is sought, the patient-practitioner interactions may serve to influence the patient’s lifestyle choices. The practitioners' exercise and physical activity habits may shape the effectiveness of the patient-practitioners interaction. Here, we explored the potential barriers to exercise and physical activity (PA) in licensed physical and occupational therapists. In addition, we aimed to describe barriers to exercise and PA in individuals with a history of stroke from the perspective of the practitioner. Lastly, how current exercise and physical activity habits influence their …

Intensive, Interprofessional Therapy: A Case Approach, Emma C. Schrotenboer

Honors Theses

This research looks at the impacts of intensive, interprofessional therapy for children with disabilities. There is very little literature currently published on this topic, although what is available generally finds that more intense therapy is more beneficial. The child who was studied was a camper at Adam’s Camp therapy camp, a week-long program that involves six hours of therapy each day with therapists from five different fields. Her progress over the week, as well as her retention of skills several weeks later, were determined by pre- and post-camp surveys sent to the mother and the therapists’ notes from during the …

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 …