Digital Commons Network^™

Shoulder Pain And Subsequent Loss Of Function In Hemiplegic Patients, Kari A. Goetz

Physical Therapy Scholarly Projects

Hemiplegia, caused by a stroke, is one of the most common disorders in which physical therapists are extensively involved in the rehabilitation process. When a stroke occurs, there is damage to the higher centers of the central nervous system resulting in neurologic, unilateral impairment or hemiplegia. The upper extremity is frequently involved and many patients complain of pain, particularly in the shoulder. Etiology and treatment of hemiplegic shoulder pain (HSP) is a challenging symptom that interferes with progressive rehabilitation and the overall quality of life of many patients.

The purpose of this study was to discuss HSP and the subsequent …

Fetal Alcohol Syndrome: Physical Therapy Implications And Treatment Strategies, Mary L. Emerson

Physical Therapy Scholarly Projects

Fetal Alcohol Syndrome (FAS) describes physical and neurological (motor, cognitive, and behavioral) deficits that result from maternal alcohol intake during pregnancy. FAS is the leading cause of mental retardation and birth defects in the U.S., ahead of spina bifida, fragile X syndrome, and down's syndrome. The incidence of FAS increased more than three-fold from 1979 to 1992; this increasing incidence rate, enhances the importance of the Physical Therapists' role in early recognition and intervention of FAS. A review of current F AS research studies, reveals a need for additional resource information on FAS, regarding implications for Physical Therapy and possible …

The Adverse Effects Of Long-Term Corticosteroid Use, Jennifer Ann. Johnston

Physical Therapy Scholarly Projects

Corticosteroids are an often prescribed anti-inflammatory medication. They are used to treat disease processes of every system of the body. Those disease processes or procedures for which corticosteroids are often prescribed are cancer, bone marrow transplants, collagenous diseases (systemic lupus erythematosus), rheumatoid arthritis, leukemia, and anemia.

However, despite the therapeutic benefits of corticosteroids, many adverse effects are possible. Gastrointestinal difficulties, steroid myopathy, hyperglycemia, osteoporosis, impaired cellular immunity, decreased neuropsychological functioning, and avascular necrosis are just a few of the possible adverse effects.

Patients receiving corticosteroids will often be seen by physical therapists for either their primary or secondary diagnoses. Physical …

The Lateral Scapular Slide Test: Is It Valid In Detecting Glenohumeral Impingement Syndrome?, Denise G. Litchfield

Physical Therapy Scholarly Projects

Recent literature has focused on instability of the scapulothoracic joint and on resulting scapular positions. Weakness of the scapular musculature can allow the scapula to slide laterally, leading to abnormal glenohumeral biomechanics and to subsequent shoulder pathology. Kibler1 has described the lateral scapular slide test (LSST) as a method of measuring lateral translation of the scapula. A significant difference between right and left scapular positions, as indicated by a discrepancy of greater than one centimeter side-to-side, may indicate functional scapulothoracic instability. The purpose of this study was to evaluate validity of the LSST, measured in two positions. Modified LSST measurements …

The Use Of Ergogenic Aids In Athletes, Sheri L. Mounteer

Physical Therapy Scholarly Projects

Ergogenic aids are substances purported to enhance athletic performance or improve exercise capacity. The use of ergogenic aids in sports is very widespread. It is common for a physical therapist working in a sports clinic to have patients that are either considering using or using ergogenic aids. Use of these aids by patients being treated might affect the patients' response to treatment. Therapists should be able to recognize the signs of ergogenic aid abuse in individuals under their care, and they should be aware of the side effects of these aids. It is also important for therapists to be able …

Musicians And Performance Related Injuries To The Hand, Leona Pang

Physical Therapy Scholarly Projects

Musicians spend a great amount of energy and time preparing for auditions, competitions, performances, and recitals. The process of developing techniques and learning musical pieces requires practice sessions filled with long hours of repeating musical passages and awkward upper extremity positions. Performance related injuries often result from these conditions. Injuries include joint disorders, musculotendinous disorders, muscle cramps and pain disorders, neurological disorders, and focal dystonia or occupational palsy disorders. Pain, numbness, tingling, muscle cramping, and motor dysfunctions are associated symptoms. If symptoms are ignored and intense performance is continued, the musician can experience tissue damage and permanent loss of function. …

Pre- And Post-Operative Comparison Of Kinematic Data In Ambulatory Patients With Cerebral Palsy, Douglas A. Miller, Matthew J. Vanderkooi

Masters Theses

Computerized three-dimensional gait analysis effectively supplements clinical examination by objectively assessing dynamic gait abnormalities and surgical outcomes. The purpose of this research was to assess the ambulatory outcomes of corrective surgery performed on children with spastic cerebral palsy by comparing pre- and post-operative kinematic data. It was hypothesized that post-operative data would be significantly improved compared to pre-operative values. Clinical examination and computerized gait analysis were performed pre-operatively and six to eighteen months following corrective surgery. Gait analysis included video taping of gait and recording of three-dimensional joint motion, synchronized force plate, and dynamic EMG data. The three patients (average …

Rural Elderly People's Attitudes And Perceptions About Home Modifications And Assistive Devices, Christine M. Abbott

MUSC Theses and Dissertations

Occupational therapists frequently recommend home modifications and assistive devices to help elderly people remain as safe and independent as possible. Elderly people, however, do not always follow through with such recommendations resulting in unsatisfactory outcomes of occupational therapy. The purpose of this qualitative study was to examine elderly people's attitudes towards home modifications and assistive devices and to determine what they perceived as the barriers and facilitators to using home modifications and assistive devices. Two focus groups were conducted with elderly people in rural Missouri. The main attitudes were (a) determination; (b) positivism, such as feeling fortunate and encouraged; and …

Rehabilitation Treatment Following Total Shoulder Arthroplasty, Debbie Aarhus

Physical Therapy Scholarly Projects

The shoulder is a very complex joint in the human body and, therefore, is easily injured and/or damaged. When conservative methods (pain reducing modalities, exercise, or medication) to treat the injury fail, an alternative method of treatment could be a total shoulder arthroplasty. Corrective surgery alone, however, is not enough. A rehabilitation program involving range of motion and strengthening exercises is fundamental in the successful return of function at the shoulder.

The purpose of this literature review is to provide an overview of shoulder anatomy, surgical procedures of total shoulder arthroplasty, rehabilitation protocols, and outcomes. The information gained from this …

A Review Of Shoulder Impingement Syndrome, Jodee Backhaus

Physical Therapy Scholarly Projects

Shoulder impingement syndrome (IS) is one of the most common shoulder problems seen today in the orthopaedic clinical setting. Patients exhibit symptoms of pain and discomfort due to pathomechanics of increasing pressure under the acromion. Factors related to IS include degeneration of the rotator cuff, vascular insufficiency of the supraspinatus, glenohumeral instability, muscle imbalances, bursitis, and bony impingement.

Impingement syndrome is most often classified as an overuse syndrome, although it can occur from a traumatic episode such as a blow to the shoulder or a fall. The population most affected are those in occupations that require a high number of …

A Review Of Juvenile Rheumatoid Arthritis, Jill C. Ballan

Physical Therapy Scholarly Projects

Juvenile rheumatoid arthritis (JRA) is the most common pediatric rheumatoid disease in North America. and a principle cause of childhood disability. The disease course is unremitting in up to a quarter of the children with JRA, and a small percentage will grow-up with severe functional disabilities.. Physical and occupational therapy, along with prescribed drug and orthopedic provisions, are important in the management of JRA. The therapists, and other medical professionals involved, work toward the following goals: decreasing joint inflammation, relieving pain, achieving or maintaining an optimal level of function, and educating the patient and family on the disease course and …

Isokinetic Ratios Of Concentric And Eccentric Work Production Of Internal And External Rotators In A Simulated Throwing Pattern, Deane M. Chinen

Physical Therapy Scholarly Projects

Shoulder internal and external rotators have been the focus of several isokinetic studies. However, an examination of muscular work in a functional pattern has not been investigated. Therefore, the purpose of this study was twofold: 1) to establish normative ratios of concentric to eccentric work of internal and external shoulder rotators respectively, and 2) to provide information on the balance of strength in shoulder rotators during a simulated throwing pattern.

Twenty-seven subjects without shoulder pathology were tested on the KINCOM isokinetic dynamometer. The statistics for the whole group revealed 55% more concentric internal rotation work in relation to eccentric external …

Crossing The Language Barrier In Physical Therapy Practice, Nancy Ann Feist

Physical Therapy Scholarly Projects

Physical therapists provide health care services to a diverse range of patient populations. Members of these populations may differ in language or culture from the therapists who treat them. If a language barrier is present, vital communication is lost, and there is interference with the implementation of effective physical therapy.

Options in overcoming language barriers include a language assistance department, a bilingual staff directory, a telephone interpreter service, and an outside interpreter. Limitations of these options exist that can lead to ineffective treatment.

This project makes one further option available. This option is translated written material and audiotapes. This project …

An Electromyographic And Goniometric Analysis Of The Lower Extremity During Stair Climbing With And Without The Use Of Ez-Steps® In An Elderly Population, Staci L. Fethkenher

Physical Therapy Scholarly Projects

Purpose: EZ-StepsTM is a device that fits into an existing stairwell which decreases the height, or rise, of each step by half. The purpose of this study was to determine if there is a difference in lower extremity muscle activity and knee joint range of motion (ROM) during stair climbing with and without the use of EZ-StepsTM in an elderly population.

Methods: Eight healthy, elderly (aged 65-89 years) male and female subjects volunteered for the study. Surface electromyography (sEMG) was used to assess muscle activity in four lower extremity muscles during stair climbing standard steps and steps installed with EZ-StepsTM. …

Physical Therapy Techniques For Treating Patients With Traumatic Brain Injury (Tbi), Daren M. Flolo

Physical Therapy Scholarly Projects

Traumatic brain injury (TBI) can be devastating. Survivors of TBI and their families face complex needs that challenge physical therapists. To respond to this challenge, physical therapists need specific knowledge in regard to epidemiology, etiology, specialized treatment techniques, and the impact of the TBI on patients and their families.

With improvements in medical technology, the number of children and adults surviving brain injuries has increased. Many of these survivors require specialized training to improve impairments as a result of their injuries.

Physical therapists play a vital role in the evaluation and treatment of the patient with traumatic brain injury. In …

The Role Of Fascia In The Musculoskeletal System, Lori Folkers

Physical Therapy Scholarly Projects

The function of fascia in the human body is poorly understood. This anatomical structure has not been given the clinical significance it may deserve. The purpose of this literature review is to provide a physiological explanation for physical therapy techniques that manipulate fascia. The review is designed to facilitate an understanding of the role of fascia in the' musculoskeletal system.

Physical therapists may deal with musculoskeletal system pathologies on a daily basis. In order for the therapist to utilize soft-tissue techniques, it is necessary to have a working knowledge of the involved structures. Anatomical material is presented to define the …

Nutrition In Rehabilitation, John D. Jr. Haywood

Physical Therapy Scholarly Projects

Diet has been implicated as a risk factor in atherosclerotic cardiovascular diseases, cancer, diabetes, osteoporosis, obesity, high blood pressure and chronic liver and kidney diseases. These diseases include almost all of the most common non-traumatic causes of death in the United States. It has been suggested that many physicians do not have the opportunity for specific training in nutrition while in medical school. Many studies have shown that patients admitted to a hospital are at risk of malnutrition and that this risk will increase as length of hospital stay increases. Other studies suggested nutritional deficiencies may result in delayed wound …

A Review Of The Causes And Treatment Of Low Back Pain During Pregnancy, Dana Krenzel

Physical Therapy Scholarly Projects

Pregnancy is a time of great musculoskeletal change for a woman. Complaints of low back pain are a very common occurrence at this time. Many women regard this type of pain as a normal adjunct to pregnancy. However, most types of low back pain related to pregnancy are either treatable or avoidable. Mechanical, hormonal, and vascular factors may all contribute to low back pain. Differentiation of these different causes of low back pain is crucial to providing the patient with effective intervention plans. Physical therapists can provide evaluation, treatment, and low back pain management techniques to the expectant mother. Exercise, …

Gait Analysis For The Enhancement Of Aka Gait Patterns, Krista Lausen

Physical Therapy Scholarly Projects

The amputation of a body part is both a physically and psychologically traumatic event for an individual. There are a number of gait deviations that often occur when a person has had a lower extremity amputation, especially when that amputation is above the knee. The entire locomotor mechanism of the body is altered by this change. The person must then adjust ahd relearn how to accommodate for the loss.

This literature review will discuss specific causes of certain gait deviations to determine whether the deviation is due to a musculoskeletal deficit or habit pattern on the part of the patient …

Balance Exercise For Fall Prevention In The Elderly, Lorrina Mcclellan

Physical Therapy Scholarly Projects

Falls are a very common and serious problem in the elderly population. Individuals who fall may suffer from physical trauma, psychological problems, and possible death. In the past, falls were thought to be an unavoidable occurrence that accompanied aging. Research has .recently identified risk factors that may predict those who are at risk for falling. By recognizing and then modifying these risk factors, potential falls may be prevented. Examples of risk factors that occur with aging include visual impairments, vestibular decline, deterioration of muscle strength, decrease in joint flexibility, and the loss of sensation. Natural biological declines may have profound …

Meniscal Substitution: A Literature Review, Kerry L. Muir

Physical Therapy Scholarly Projects

With the increased awareness that meniscectomy results in degenerative changes in the knee joint, research is now aimed at substituting the meniscus that had been previously removed. Surgical attempts at replacing the meniscus include the use of autografts, allografts, and artificial synthetic prosthesis.

This paper will review the available literature regarding each type of meniscal substitute. Surgical procedures, results, and considerations relating to the different substitutes will be examined.

While studies indicate that meniscal transplantation is technically feasible, the long-term results are unknown. More research is necessary to determine if meniscal substitutes can survive for a prolonged time and function …

The Effects Of Botulinum Toxin Injections On Function In Patients With Spasticity, Leann Pippen

Physical Therapy Scholarly Projects

Spasticity can be one of the most challenging problems for patients with neurologic conditions such as cerebral palsy, spinal cord injuries, cerebrovascular accidents, multiple sclerosis, traumatic brain injuries, etc. It can lead to a wide variety of problems including decreased mobility, decreased quality of movement, interference with normal postural reactions, interference with functional activities, and pressure sores. Therefore, the medical community has focused on effective treatments for spasticity which do not produce overwhelming weakness, spasticity, paralysis, fatigue, and/or muscle atrophy. Since the late 1970's, the use of botulinum toxin (BTX-A) injections to decrease spasticity has been investigated.

The purpose of …

A Review Of Bell's Palsy, Jodi Spicer

Physical Therapy Scholarly Projects

Bell's Palsy is an acute unilateral weakness or paralysis of the facial muscles resulting from peripheral facial nerve dysfunction. Bell's Palsy is the most common cause of unilateral facial weakness. Since idiopathic facial paralysis was first diagnosed, several treatment options have been tried in an effort to influence early and full recovery. The role of physical therapy in the treatment of Bell's Palsy is to exercise the muscle in an attempt to keep the denervated muscle healthy while the injured axons regenerate and reinnervate the muscle. The natural course of Bell's Palsy is a spontaneous return of function in 71 …

The Effect Of Intraarticular Injection Of Morphine Following Knee Arthroscopy, Chandel Dietz

Physical Therapy Scholarly Projects

Postoperative pam IS common following knee arthroscopy and has been typically controlled with opioids, the most popular of which is morphine. Morphine has been traditionally administered by intramuscular, intravenous, or epidural injections. These methods of administering morphine have been very effective in producing prolonged analgesia; however, they have also produce negative central nervous system side effects.

Recent research has suggested administering morphine via intraarticular injections to provide postoperative analgesia without the central nervous system side effects. However, there is little evidence to suggest that this method is effective. Therefore, the purposes of this randomized, double-blinded study were to 1) investigate …

Applications Of Iontophoresis And Phonophoresis, Craig Hahn

Physical Therapy Scholarly Projects

Many different drugs are used topically for treatment by the medical field. The benefit of some of these drugs can be enhanced by the use of ultrasound (phonophoresis) or electric current (iontophoresis). These methods have been used for many years by such disciplines as ophthalmology, dermatology, dentistry as well as physical therapy. With the inherent risks of blood borne pathogens, these methods are a great alternative to the injection of drugs into the system.

The purpose of this paper is to review the literature regarding iontophoresis and phonophoresis and present the results as a guide for the practicing physical therapist. …

The Effects Of Velocity On Force Production Of The Elbow Flexors During Eccentric Isokinetic Muscle Contraction, Tracie Hildre

Physical Therapy Scholarly Projects

The traditional eccentric force-velocity curve illustrates a continuous increase in muscle force production as velocity increases. Recently, this curve has been scrutinized by some researchers who have found a plateau or decline in eccentric force production at the higher velocities. The purpose of this study was to examine the eccentric isokinetic force-velocity curve of the elbow flexor muscles over a broad range of velocities to observe whether it follows the traditional force-velocity curve.

Fourteen healthy female and six healthy male volunteers were tested using. the Kinetic Communicator Dynamometer at velocities of 30, 60, 90, 120, 150, 180, and 210 degrees …

Concentric And Eccentric Isokinetic Normative Ratio Values Of The Quadriceps Muscle In Asymptomatic Knee Subjects, Donna Ho

Physical Therapy Scholarly Projects

Technological advances in isokinetic devices allow the clinician to objectively assess and rehabilitate injuries using concentric and eccentric contractions at different speeds. The purpose of this research project is to establish concentric and eccentric normative ratio values of the quadriceps muscle on the Kinetic Communicator (Kin-Com, Chattecx Corp., Chattanooga, TN) dynamometer. A sample of 19 females and 12 males aged 20-38 (mean for females = 24.32 ± 3.87, mean for males = 27.67 ± 5.80) were tested on the KinCom for maximum concentric and eccentric torque values during knee extension using a 70° range of motion at 90 and 1200/sec. …

Patellofemoral Joint Mechanics And Their Clinical Relevance, William S. Hokanson

Physical Therapy Scholarly Projects

Patellofemoral joint dysfunction is a common ailment affecting one in four of the general population and 30% of the athletic population. Patellofemoral dysfunction may stem from a number of different clinical diagnoses. The most common of these is chondromalacia patella. The term chondromalacia patella, however, refers only to a softening or fissuring of the retropatellar surface of the patella and cannot be used to diagnose all patellofemoral pain. Clinical diagnosis is sometimes very difficult because these patients present with a number of vague and nonspecific signs and symptoms.

The purpose of this literature review is to offer a clear, concise …

An Electromyographic Study Of Back And Lower Extremity Muscle Activity During Plyopress Exercises, A Squat Lift, And A Vertical Jump, Melissa K. James

Physical Therapy Scholarly Projects

The ongoing research in the evolution of athlete training continues to reveal new principles and training designs which strive to heighten athletic performance and maximize athletic ability. One example of the application of such research is the Plyo Press machine, a patented device used in the Frappier Acceleration Program for athletes. This device was specifically designed to combine strength training with plyometrics to enhance speed and dynamic muscle activity without the excessive low back stress of traditional training methods.

As the Plyo Press has been recently designed and incorporated into training programs, no research has yet been conducted on the …

Cardiac Rehabilitation: Patient Recall Of Exercise Guidelines And Implications For Physical Therapists, Mary Jones

Physical Therapy Scholarly Projects

The efficacy of a cardiac rehabilitation program depends on adequate patient compliance. Patients with coronary heart disease and those recovering from heart surgery may have a successful recovery from acute episodes of myocardial infarction or following operation. It must be recognized that they may require long-term supervision and support. The purpose of this study was to identify if diagnosis of myocardial infarction or heart surgery was a determinant of compliance with exercise guidelines once a patient has graduated from a level II cardiac rehabilitation program. A retrospective chart audit was performed for the years 1991-1994. A data sheet was used …