Physiotherapy Commons^™

Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

Cardiovascular Effects Of Exercise And Use Of Abdominal Binder In Patients Of Parkinson’S Disease With Orthostatic Hypotension, Faizan Ahmed

Electronic Thesis and Dissertation Repository

Orthostatic hypotension (OH) is a common manifestation of autonomic dysfunction in Parkinson’s Disease. It can adversely affect a patient’s functional capacity, exercise tolerance and quality of life, while increasing the risk of falls, cerebrovascular disease and overall mortality. Use of an abdominal binder (AB) can help counter OH; however, this has not been sufficiently studied in patients with Parkinson’s Disease (PwPD). Moreover, the hemodynamic effects of upper and lower extremity exercise are unclear in PwPD with OH. Although OH can impair the cerebral circulation, the consequences on the cerebral hemodynamics of wearing an AB or performing exercise are unknown in …

Joint Protection Programs For People With Hand Arthritis, Pavlos Bobos

Electronic Thesis and Dissertation Repository

The fact that Joint Protection Programs (JPP) can reduce pain and improve function is based on small, but definitive Randomized Controlled Trials (RCTs), conducted in the 1980s. However, changes over time in the nature of hand use, the rapid expansion of technology, and improvements in our understanding of health literacy mean that these programs are now outdated. Further, problems with adherence to JPP are well documented. The purpose of this thesis was 1) to conduct a scoping review to map all the available evidence around joint protection programs in published and unpublished studies 2) to evaluate the effectiveness of joint …

Effect Of Unilateral Lower-Limb Amputation On Intact Limb Biomechanics: A Systematic Review, Amanda Boyd

Master's Theses

The United States will perform 30,000-40,000 amputations this year (Ertl et al., 2019). As a common medical intervention, there is extensive research regarding rehabilitation strategies and post-operative care. Many studies have explored the effects of the affected limb and prosthetic intervention yet have neglected that of the contralateral limb (De Asha et al., 2014; Jones et al., 2006; Winter & Sienko, 1988). Studies have reported an increase in secondary musculoskeletal conditions among unilateral lower-limb amputees, particularly in the intact limb, indicating the need for additional research (Gailey et al., 2008). The purpose of this systematic review was to investigate the …

Therapeutic Interventions For Managing Diabetic Shoulder, Sanaa A. Alsubheen

Electronic Thesis and Dissertation Repository

Shoulder pain is a common complaint of diabetic patients that causes motion limitations and functional disability. Adhesive capsulitis (AC) is the most common disabling shoulder disorder. There is no optimal non-surgical treatment for managing AC in diabetic patients. Furthermore, the impact of diabetes on shoulder recovery and factors predicting shoulder function following shoulder arthroplasty is not well investigated.

Purpose and Methods

The main purpose of this thesis was to inform clinical practice about the best intervention for managing AC in diabetic patients, and to assess the impact of diabetes on functional outcomes after shoulder arthroplasty, with the following objectives: 1) …

Physical Therapy Nontreatment Events With Primary Physical Therapist, Stephen Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Physical therapy improves prognosis reduces stay and is generally helpful in aiding recovery from a wide range of ailments. Nontreatment rates occur for multiple reasons and are also related to the personalities of physical therapists.

Methods: We used data from a research project involving physical therapy at an acute care facility in our community. Our study focused on the retrospectively determined primary physical therapist for each patient. We used the chi-squared tests to compare nontreatment rates between days of the week and disease type and the reasons for nontreatment events. Repeated-measure models were used to evaluate the effect of …

The Symbiome Project: An Exploratory Investigation Of The Biological, Psychological, And Social Mechanisms That Contribute To The Transition From Acute To Chronic Musculoskeletal Pain, Joshua Y. Lee

Electronic Thesis and Dissertation Repository

This dissertation presents the initial findings of the SYMBIOME project; which attempts to combine the objective and subjective aspects of musculoskeletal pain to develop a prognostic clinical phenotype. Chapter 2 presents a moderator analysis of functional outcomes (pain interference and pain severity). Psychosocial moderators can affect the relationship between biomarkers and pain. For pain severity, TNF-α, TGF-β1, and CRP were moderated by employment status, pre-existing psychopathology, and sex. For pain interference, IL-1β, cortisol, TGF-β1, CRP, and IL-6 were moderated by pre-existing pain, peri-traumatic fear, region of injury, and peri-traumatic stress. Chapter 3 presents a latent growth curve analysis in determining …

Assessment Of Intrinsic Hand Neuromuscular Physiology, Philemon Tsang

Electronic Thesis and Dissertation Repository

Alterations to the peripheral nervous system and neuromuscular physiology may impact hand function in a typical or clinical population, such as individuals with ulnar neuropathy. The mechanisms that influence these positive and negative changes are still not well understood. The three studies within my thesis aim to validate the reliability of decomposition-based quantitative electromyography (DQEMG) measurements and explore the changes in intrinsic hand neuromuscular physiology in a typical aging population and individuals recovering from a surgical intervention for severe ulnar neuropathy.

The purpose of the first study was to determine the test-retest reliability of near-fibre (NF) jiggle, a measure of …

Clinical And Neurophysiological Effects Of Dry Needling On Individuals With Chronic Ankle Instability, Jennifer Mullins

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are generally considered innocuous injuries; however, as many as 74% of patients will develop chronic symptoms. 1-3 Chronic ankle instability (CAI) is defined by a history of ankle sprain accompanied by ongoing bouts of giving way, residual ankle sprain symptoms, and a decrease in patient-perceived function. As understanding of sensorimotor deficits in individuals with CAI have advanced, treatment strategies have evolved to include a robust focus on balance training to mitigate dynamic and static postural control impairments exhibited in individuals with CAI. A problem arises as these improvements have not been conclusively linked to a decrease in CAI. …

Influences Of Functional And Psychological Factors On Biomechanics Following An Anterior Cruciate Ligament (Acl) Reconstruction, Chelsey Roe

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to return to sport (RTS) test batteries following primary anterior cruciate ligament reconstruction (ACLR) (Aim 1) and define recovery in athletes from 4-9 months after ACLR across three domains: 1) psychological recovery and biomechanics (Aim 2), 2) rehabilitation quantity and biomechanics (Aim 3), and 3) functional performance and biomechanics (Aim 4). Ultimately, the results of this research would quantify recovery following ACLR in athletes with a desire to RTS and identify objective criteria throughout rehabilitation prior to RTS.

Participants: Twenty-two post-ACLR athletes 17 females, 8 males, …

Clinical Measurements Of The Posterior Shoulder Endurance Test (Pset), Neil A. Evans

Theses and Dissertations--Rehabilitation Sciences

Of the intrinsic factors responsible for non-traumatic shoulder pain, muscular endurance is often not measured by rehabilitation professionals due to the lack of available shoulder endurance measures. Measurement properties of the PSET have not been adequately assessed in previous studies. The purpose of this dissertation was to develop the clinical measurement properties of the Posterior Shoulder Endurance Test (PSET) so that it might be used as a clinical measure of shoulder muscular endurance.

Electromyography (EMG) offers the ability to identify which muscles in the posterior shoulder girdle are fatiguing during the PSET. Surface EMG of upper trapezius (UT), middle trapezius …

Differential Effects Of Reduced Foot Sole Sensitivity And Nerve Conduction Velocity On Postural Control And Functional Gait, Kelsey D. Lewis

Electronic Theses and Dissertations

INTRODUCTION: Peripheral neuropathy is characterized by a loss of foot sole sensitivity and slowed nerve conduction velocity. Individuals with peripheral neuropathy have decreased postural control ability and functional gait performance. No research was found that differentiated the effects of the main symptoms of peripheral neuropathy on postural control and functional gait. PURPOSE: The purpose of this study was to assess the differential effects of reduced foot sole sensitivity and slowed nerve conduction velocity on postural control and functional gait. METHODS: Two main clinical symptoms, H-index and foot sole sensitivity were evaluated among 35 participants. Outcome variables are the center of …

Understanding Falls In People With Intellectual Disability In Western Australia, Portia Ho

Theses

Adults with intellectual disability (ID) experience earlier age-related changes, compared with other age-matched populations, but concurrently their life expectancy is increasing. Falls often result in serious injuries and reduced health-related quality of life, however there is limited research regarding falls in older adults with ID. The purpose of this research was to investigate falls among community dwelling older adults with ID, including the epidemiology, risk factors and experiences when engaging with health services after a fall.

A meta-analysis of the incidence and prevalence of falls in adults with ID was initially conducted to inform the research aims. Prospective research was …

Outcomes Of Resistance Exercise Training In Adults With Acute Burn Injury, Paul M. Gittings

Theses

Decreased quality-of-life and impairments in physical function, muscle strength and muscle volume are known complications of a burn injury. As such, rehabilitation is an important aspect of the burn care journey. Rehabilitation of burn injury is currently hampered by a lack of tools to reliably measure muscle strength and lower limb function, as well as an incomplete understanding of the effect of resistance training after a burn injury. Specifically, there is currently no data on the safety or efficacy of resistance training immediately after a burn injury.

The series of studies presented in this thesis aimed to: 1) systematically review …