Physical Therapy Commons^™

Incorporation Of Balance And Vestibular Exercises In A 45-Year-Old Female With Bell’S Palsy: A Case Report, Kelsey Andersson, Erica Kiernan

St. Augustine, Fall 2018

The purpose of this case report is to determine the effectiveness of balance and vestibular exercises in conjunction with facial strengthening exercises on a patient with Bell’s palsy.

By incorporating vestibular exercises into the patient’s therapy sessions, she was able to demonstrate improved single leg stance and self-reported decrease in onset of symptoms with a progression of vestibular exercises. Facial muscle strengthening exercises demonstrated significant improvements in eye closure and smiling but she exhibited little changes in facial symmetry, strength and self-perceived function. The patient reported she was starting to drive and participate in more social events by the 4th …

Effects Of Trigger Point Dry Needling In Conjunction With Intramuscular Electrical Stimulation For A Patient With Lumbar Radiculopathy: A Case Report, Mayur Patel, Todd Bourgeois

St. Augustine, Fall 2018

The purpose of this case was to see the benefits of Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for the treatment of lumbar radiculopathy regarding the range of motion, strength, sensation, reduction of pain, improve functional ability, and quality of life.

Traditional interventions for this diagnosis include strengthening exercises, modalities such as transcutaneous electrical stimulation, and even surgery as a last resort. There is limited research available regarding Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for lumbar radiculopathy.⁴ This case report supports the idea that this physical therapy treatment intervention has positive outcomes …

Sara Plus And Task Specific Training In A Patient With Anoxic Encephalopathy, Olivia Levi, Erica Kiernan

St. Augustine, Fall 2018

The purpose of this case report is to describe the benefits of using a task-specific approach and the SARA plus to improve balance and gait in a patient with anoxic encephalopathy.

This case demonstrated the positive results of incorporating repetitive, task-specific, and early use of the SARA plus for gait training. With these interventions, the patient was able to ambulate 25 ft and transfer from sit to stand with the use of a rolling walker and minimum assistance. He was also able to maintain static sitting balance for 32 seconds independently and reach 17 inches outside of his base of …

Scapulothoracic Mobility And Strengthening After A Posterior Capsular Reconstruction Of The Glenohumeral Joint With An Allograft: A Case Report, Kris Saunders, David Kempfert

St. Augustine, Fall 2018

The purpose of this case report is to emphasize the importance of scapular mobility and strengthening exercises in rehabilitation protocols for patients after a posterior capsular reconstruction surgery of the glenohumeral joint.

The objective outcomes by week three are displayed in Table 1.0. The patient was discharged after nine visits over a period of three weeks. During the final session, the patient was able to perform standing shoulder abduction to 90 degrees with a one-pound dumbbell pain-free. The patient was able to reach into a shelf at 120 degrees of shoulder flexion with a pain scale rating of 2/10. He …

Anti-Gravity Treadmill Training With 19-Year-Old Soccer Player Status Post-Leukemia, Britni Barber, Lisa Chase

St. Augustine, Fall 2018

The purpose of this case report was to describe the effects of anti-gravity treadmill training, in addition to standard treatment protocol, on endurance performance in a 19-year-old female collegiate soccer player following chemotherapy treatment for leukemia.

Physical therapy rehabilitation of patients who are experiencing chemotherapy-related fatigue may benefit from anti-gravity treadmill training. This case report not only identifies a successful outcoming using such intervention but also introduces a more aggressive approach to treatment for a patient whose goals included going back to play division one sports. The patient was not only able to reach her goals of being able to …

Conservative Therapy Of Patient With Dyspareunia In A Post-Menopausal State With Co-Morbidities Including Previous Breast Cancer And Valve Replacement: A Case Report, D. Ditoro, M. Mason-Cover, C. Hazelton, Annie Burke-Doe, Marilyn Miller

San Marcos, Fall 2018

Dyspareunia is defined as persistent pain in the vaginal area before, during, or after sexual intercourse.^1,2 The etiology is uncertain in the medical literature, but evidence proposes that pain and dysfunction of pelvic floor muscles (PFM) can contribute to dyspareunia and other forms of chronic pelvic pain.^1,2 The information contained in this case report is clinically relevant because it presents evidence that dyspareunia can be treated safely with physical therapy techniques on a patient with a complex medical history.

Computerized Dynamic Posturography Testing In Concussion: A Systematic Review, Ashlynn Aoki, Whitney Peterson, Cameron Prins, Holly Roberts

Physical Therapy Research Symposium

Title: Computerized Dynamic Posturography Testing in Concussion: A Systematic Review

Purpose/Hypothesis: Computerized dynamic posturography (CDP) has been utilized within research and clinical practice for assessment of sensory deficits following concussion. However, it is unclear if current evidence on psychometric properties supports its use. The purpose of this systematic review is to compile evidence on psychometric properties of CDP for individuals following concussion.

Number/Subjects: 7 research articles including 1239 participants that met inclusion criteria.

Materials/Methods: Relevant studies published between 1980 and September 2018 extracted from the following electronic databases: PubMed, CINAHL, SPORTDiscus, ScienceDirect, Cochrane Library, ProQuest Central, and PEDro. Additional resources …

Implications Of Direct Access To Physical Therapy In A Global Health Context, Coty Hogue, Mercedes Friend, Holly Roberts

Physical Therapy Research Symposium

The purpose of this study was to examine the implications of direct access in a global health setting through the process of medical screening during physical therapy (PT) examinations in rural Guatemala. Six patients (5%) presented with signs and symptoms requiring follow-up medical care or when medical follow-up was unavailable, modification of physical therapy intervention. The role of physical therapists (PTs) in the delivery of health care is expanding. PTs practicing abroad must be prepared for the unique health needs of medically underserved populations. Additionally, as direct access to physical therapy services becomes increasingly common in the United States, clinicians …

Physical Therapy Implications Of Zika And Microcephaly In Latin America, Acacia Dyer, Miriam Janove, Holly Roberts

Physical Therapy Research Symposium

Purpose: The purpose of this project is to:

• describe the history and etiology of the Zika virus as well as relationship of gestational Zika infection to incidence of microcephaly.
• describe clinical manifestations and useful physical therapy treatments of microcephaly.

Description

• Lit Review: A systematic literature review was performed in PubMed and CINAHL. Two researchers reviewed the sources screening in articles with relevance for evaluation and treatment of infants and children with microcephaly. Articles relevant to the link between Zika and microcephaly were also included in the review.
• Case Studies: During 03/11/18 - 03/16/18 in the Zacapa region of Guatemala, three …

Common Experiences And Beliefs Among Highly Active Individuals, Amy Luong, Aaron Hall, Danny Mcmillian

Physical Therapy Research Symposium

The purpose of this study was to identify and analyze how motivational characteristics, fulfillment of psychological needs, and individual experiences and beliefs play a role in influencing individuals’ motivation for physical activity. Validated questionnaires, including the International Physical Activity Questionnaires (IPAQ), Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), and Motives for Physical Activities Measure Revised (MPAM-R) were used along with a narrative approach via recorded interviews to elucidate the experiences of highly active middle-aged adults. Videos were created to capture “movement stories” that combined footage of participants doing the physical activities they enjoyed along with pieces of their interviews. …

Exploration Of A Novel Approach To Measure Brain Smudging In Dancers, Connor Mickelson, Morgan Cooke, Mercedes Friend, Laura Shellooe

Physical Therapy Research Symposium

Objective

Obtain baseline accuracy measurements of right/left discrimination in actively performing dancers without performance-inhibiting injuries.

Purpose

Gather data that can be used in future studies to expand understanding of brain smudging in dancers.

Methods

This study is a prognostic cohort study. This study will involve participant use of a simple iPad application to do the left and right discrimination test that is suggested to give information on brain reorganization, or brain smudging

Research Problem

The specific physical, mental, and emotional demands of dancers’ careers put constant strain on their bodies to perform at the level required and can lead to …

Swallow Strength Training Exercise For Elderly: A Health Maintenance Need, D. Agrawal, Mark Kern, F. Edeani, Gokulakrishnan Balasubramanian, Allison S. Hyngstrom, Patrick Sanvanson, Rita Shaker

Physical Therapy Faculty Research and Publications

Background: Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty‐ and age‐related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly. Methods: A total of 28 volunteers (75 + 7 years; 17 females) with no complaint of dysphagia were studied using video fluoroscopy …

Stability Of The Gross Motor Function Classification System, Manual Ability Classification System, And Communication Function Classification System., Robert J Palisano, Lisa Avery, Jan Willem Gorter, Barbara Galuppi, Sarah Westcott Mccoy

Physical Therapy Publications

AIM: To determine the stability of the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) over 1-year and 2-year intervals using a process for consensus classification between parents and therapists.

METHOD: Participants were 664 children with cerebral palsy (CP), 18 months to 12 years of age, one of their parents, and 90 therapists. Consensus between parents and therapists on level of function was ≥92% for the GMFCS, MACS, and CFCS. A linearly weighted kappa coefficient of ≥0.75 was the criterion for stability.

RESULTS: Kappa coefficients varied from 0.76 to 0.88 for …

Emotional Exhaustion, Depersonalization, And Feelings Of Decreased Personal Accomplishment Oh My: What Message Are We Sending To Our Students?, Nikki Sleddens, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE:

The purpose of this presentation is to address the issue of burnout amongst PTs through the lens that addressing this issue in our profession may very well be the first step in building resilience in the academic and clinical environments.

METHODS AND/OR DESCRIPTION:

Physical therapy student well-being is a priority for academic institutions. Yet, are we, as academic and clinical faculty, who are responsible for promoting student well-being, “well” ourselves? Could burnout of our academic and clinical faculty impact our student’s wellness? Burnout is a syndrome described as emotional exhaustion, depersonalization, and feelings of decreased personal accomplishment. All effects …

Experience Of Robotic Exoskeleton Use At Four Spinal Cord Injury Model Systems Centers, Allen W. Heinemann, Arun Jayaraman, Chaithanya K. Mummidisetty, Jamal Spraggins, Daniel Pinto, Susan Charlifue, Candy Tefertiller, Heather B. Taylor, Shuo-Hsiu Chang, Argyrios Stampas, Catherine L. Furbish, Edelle C. Field-Fote

Physical Therapy Faculty Research and Publications

Background and Purpose: Refinement of robotic exoskeletons for overground walking is progressing rapidly. We describe clinicians' experiences, evaluations, and training strategies using robotic exoskeletons in spinal cord injury rehabilitation and wellness settings and describe clinicians' perceptions of exoskeleton benefits and risks and developments that would enhance utility.

Methods: We convened focus groups at 4 spinal cord injury model system centers. A court reporter took verbatim notes and provided a transcript. Research staff used a thematic coding approach to summarize discussions.

Results: Thirty clinicians participated in focus groups. They reported using exoskeletons primarily in outpatient and wellness settings; 1 center used …

A Collaborative Approach To Decision Making Through Developmental Monitoring To Provide Individualized Services For Children With Cerebral Palsy., Doreen J Bartlett, Sarah W Mccoy, Lisa A Chiarello, Lisa Avery, Barbara Galuppi, On Track Study Team

Physical Therapy Publications

In this Perspective, we suggest a process to improve physical and occupational therapists’ and families’ collaboration to provide appropriate, efficient, and effective evidence-based services to improve motor function, self-care performance, and participation in family and recreation activities for children with cerebral palsy (CP). This process is informed by 2 multisite prospective cohort studies (Move & PLAY and On Track). The heterogeneity of children with CP is described, limiting the utility of evidence from randomized controlled trials and systematic reviews to inform service planning for children with CP. An evidence-based alternative using prospective cohort studies that produce knowledge of determinants of …

Locomotor Adaptations To Prolonged Step-By-Step Frontal Plane Trunk Perturbations In Young Adults, Eric R. Walker, Allison S. Hyngstrom, Tanya Onushko, Brian D. Schmit

Physical Therapy Faculty Research and Publications

The purpose of this study was to quantify the magnitude and time course of dynamic balance control adaptations to prolonged step-by-step frontal plane forces applied to the trunk during walking. Healthy young participants (n = 10, 5 female) walked on an instrumented split-belt treadmill while an external cable-driven device applied frontal plane forces to the trunk. Two types of forces were applied: 1) forces which accentuated COM movement in the frontal plane (destabilizing) and 2) forces which resisted COM movement in the frontal plane (stabilizing). We quantified dynamic balance control using frontal plane measures of (1) the extent of center …

Lean Mass Mediates The Relation Between Temporal Summation Of Pain And Sex In Young Healthy Adults, Abdulaziz Awali, Ali Alsouhibani, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Background

Previous studies have shown that women experience greater temporal summation (TS) of pain than men using a repetitive thermal stimulus. These studies, however, did not individualize the thermal stimulus to each subject’s thermal pain sensitivity. The aim of this study was to investigate sex differences in TS using an individualized protocol and potential mediators that have been shown to influence TS including physical activity and body composition.

Methods

Fifty young healthy men and women (21 men) participated in the study. Subjects completed TS testing on the right forearm using a repetitive thermal stimulus at a temperature that the subject …

Utility Of Fms To Understand Injury Incidence In Sports: Current Perspectives, Meghan Warren, Monica Lininger, Nicole Chimera, Craig Smith

Articles & Book Chapters

The Functional Movement Screen (FMS) is a popular movement screen used by rehabilitation, as well as strength and conditioning, professionals. The FMS, like other movement screens, identifies movement dysfunction in those at risk of, but not currently experiencing, signs or symptoms of a musculoskeletal injury. Seven movement patterns comprise the FMS, which was designed to screen fundamental movement requiring a balance between stability and mobility. The 7 movement patterns are summed to a composite FMS score. For an instrument to have wide applicability and acceptability, there must be high levels of reliability, validity, and accuracy. The FMS is certainly a …

A Framework For Secondary Cognitive And Motor Tasks In Dual-Task Gait Testing In People With Mild Cognitive Impairment., Susan W Hunter, Alison Divine, Courtney Frengopoulos, Manuel Montero Odasso

Physical Therapy Publications

BACKGROUND: Cognition is a key factor in the regulation of normal walking and dual-task gait assessment is an accepted method to evaluate the relationship. The objective of this study was to create a framework for task complexity of concurrent motor and cognitive tasks with gait in people with mild cognitive impairment (MCI).

METHODS: Community-dwelling people with MCI (n = 41, mean age = 76.20 ± 7.65 years) and cognitively normal controls (n = 41, mean age = 72.10 ± 3.80 years) participated in this study. Gait velocity was collected using an instrumented walkway under one single task and six combined …