Digital Commons Network^™

Extensor Hallucis Longus Focal Dystonia In A Patient With Parkinson’S Disease: A Case Study, Jessika Truax, Linda Bobo, Keilea Sumrall

Clinical Practice in Athletic Training

Introduction: Parkinson’s Disease (PD) is a common neurodegenerative disorder that affects a person’s ability to produce dopamine and control motion of the body. PD affects 1% of people over the age of 65, but the disease can occur earlier and later in life. The uncontrollable movement of any body part involved with PD is referred to as a tremor. Pathophysiology of PD causes the thalamus to have a decreased activation of the frontal cortex, thus decreased motor activity. Patients commonly have dystonia mostly in the foot resulting in striatal toe. Optional pain relief is a tenotomy of the extensor hallicus …

Sacroiliac Dysfunction In A Middle-Aged Female Runner: A Case Study, Blair Bradshaw

Clinical Practice in Athletic Training

Introduction: Research has indicated an increased prevalence of low back pain (LBP) due to SIJ dysfunction, with some reports suggesting it is the main source of pain in 15- 30% of cases. Women are more prone to incidence of SIJ pain due to a wider, more uneven, less curved, and posteriorly rotated sacrum. Additionally, women have increased mobility at the SIJ which increases stress and shear loading. Repetitive loading such as running can further contribute to SIJ dysfunction. Research suggests that female runners with SIJ pain had common biomechanical patterns putting them at more risk for injury including decreased knee …

Breaking Barriers: Disparities Among Minority Collegiate Athletes In Concussion Reporting, Josette Villanueva, Melissa Long

Clinical Practice in Athletic Training

Introduction: Concussions are a serious concern in sports medicine because of their potential long-term effects on cognitive and neurological health. However, many athletes, especially those from minority groups, hesitate to report symptoms due to fears of being sidelined, pressure to keep playing, and challenges like limited access to education, language barriers, and distrust in healthcare systems. The objective of this study was to investigate the barriers to concussion reporting among Division I collegiate athletes, with a particular focus on demographic differences, particularly racial and ethnic disparities. The goal was to identify key factors that hinder self-reporting and to propose strategies …

Overcoming Thoracic Outlet Syndrome In A Young Athlete: A Case Study, Cormia Lewis, Christina Fry, Mark Knoblauch, Layci Harrison

Clinical Practice in Athletic Training

Introduction: Thoracic Outlet Syndrome (TOS) is a rare and complex condition caused by the compression of neurovascular structures in the thoracic outlet. TOS is estimated to affect 3 to 80 individuals per 1,000,000 annually, with neurogenic TOS accounting for approximately 95% of cases. Athletes who perform repetitive overhead motions are at higher risk due to increased stress on the brachial plexus. Diagnosis can be challenging as symptoms such as pain, numbness, and weakness, often mimic other conditions such as nerve entrapment or tendon pathologies. Treatment for TOS typically begins with a conservative approach, including postural correction and strengthening, activity modification, …

Athletic Trainers’ Motivations For And Satisfaction With Transition To The Physician Practice Setting, Abigail G. Overstreet, Nicolette A. Harris, Cailee E. Welch Bacon

Clinical Practice in Athletic Training

An increasing number of athletic trainers are transitioning from traditional settings, such as secondary schools, colleges, universities, and professional sports, to physician practice. Although research suggests athletic trainers may be changing settings in search of better working conditions, little is known about their motivations for and satisfaction with the setting transition. The objective of this research was to explore athletic trainers’ motivations for and satisfaction with transition to the physician practice setting. A qualitative design was used to collect and interpret data. Eleven certified athletic trainers (6 women, 5 men; age 1⁄4 38.5 6 10.0 years) who transitioned from a …

Improving Entry-Level Athletic Training Student Confidence In Emergency Care: A Pilot Study, Michele Pye, Cade Watts, John Hunt, Kimberly Pritchard

Clinical Practice in Athletic Training

Introduction: Immediate and emergency care is essential to athletic training education and clinical practice. Athletic training students (ATS) may have limited exposure to emergencies during their clinical experiences, which can undermine their confidence. AT educators can improve ATS confidence and clinical reasoning using a simulation-based, learner-centered SNAPPS approach. SNAPPS consists of Summarizing the history and findings, Narrowing and Analyzing the differential diagnoses, Probing peers about uncertainties or confusion, Planning management, and Selecting case-related knowledge gaps for self-directed learning. This empowers students to control the learning environment while adding realism to encounters. The purpose of this pilot study was to determine …

Trust, Culture, And Conversation: How Athletic Training Leaders Navigate High-Stakes Interactions, Nicole A. Wilkins, Ashley B. Thrasher, Ericka P. Zimmerman

Clinical Practice in Athletic Training

Introduction: Engaging in difficult conversations is central to leadership growth and requires sustained effort to refine and strengthen these skills. Leaders not only need to navigate the complexities of their role within an organization, but also the intersectionality of interpersonal dynamics, emotional intelligence, structural hierarchies, and the nuanced environments that influence how communication occurs. Furthermore, leaders must adapt to role expectations that shift across clinical, academic, and administrative contexts, adjusting their approach to engaging in conversations based on these complexities. As part of a larger research project examining difficult conversations, this portion of the study explored how leaders in athletic …

Integrating Wearable Technologies Into Athletic Training: Bridging Innovation And Clinical Practice, Michael Douglas

Clinical Practice in Athletic Training

Athletic training is entering a transformative period driven by the convergence of wearable technologies, artificial intelligence (AI), and advanced biomechanical modeling. Historically, wearable technology in sport was primarily used for performance tracking, including workload monitoring, heart rate assessment, and movement quantification. However, advances in sensor accuracy and data analytics have expanded the clinical relevance of wearable systems, allowing athletic trainers to monitor fatigue markers, movement asymmetry, and neuromuscular control patterns that inform injury risk and rehabilitation progression. Wearable sensor technologies provide objective data that can support clinical decision-making when integrated with traditional evaluation methods.¹Despite these advancements, wearable technologies present persistent …

Performance On The Timed Single-Leg Step-Down Test Is Correlated With Hip And Knee Biomechanics As Measured By 3d Markerless Motion Capture, Ghislain Aminake, Anthony Drazick, Christ Focht, Chloe Roy, Emily Clark, Savannah Knighton, Edward Austin, Jeremy Burnham

Clinical Practice in Athletic Training

Introduction: The timed single-leg step-down (SLSD) test is widely used in clinical and sports settings to assess lower extremity function and injury risk, yet the specific biomechanical determinants of performance on this test remain poorly understood. The purpose of this study is to investigate the relationship between performance on the timed SLSD test and hip and knee biomechanics captured by a markerless 3-D motion-analysis system. Methods: Twenty (20) healthy high school athletes with no recent history of lower extremity injury completed a 60-second timed single leg step down test. The number of quality SLSD repetitions (REPS) constituted their SLSD score. …

Recurrent Lateral Patellar Dislocation After Mpfl Repair With Subsequent Tibial Tubercle Anteromedialization And Concomiant Mpfl Reconstruction, Jacob Hardy, Anthony Thomas Drazick, Joshua Pratt, Jeremy M. Burnham

Clinical Practice in Athletic Training

Introduction: Patellar instability is a common knee pathology, particularly among adolescents and young adults, with reported incidence rates ranging from 7 to 77 per 100,000 person-years. Following an initial patellar dislocation, recurrence rates have been reported as high as 86%, particularly in patients with underlying anatomic risk factors. Identification of the multifactorial contributors to patellar instability is critical to guide appropriate management and prevent recurrent episodes. Common pathoanatomic factors associated with recurrent instability include trochlear dysplasia, patella alta, lateralized tibial tubercle, coronal or torsional malalignment, and abnormal patellar shift. This case report describes a patient who presented with a chronic …

Educational Implications Of Vestibular And Oculomotor Impairments In School Aged Children, Ellie Davenport

Graduate Teacher Education

This paper examined how vestibular and oculomotor dysfunction contributed to learning difficulties in children in grades K-12. This topic was selected due to both the association between physiological function and better academic performance and the researcher's personal interest in sport-based vestibular training as a possible intervention for children. Research sought to identify patterns among students with poor physiological function and to examine the outcomes of interventions targeting the vestibular and oculomotor systems. Understanding the implications of impaired physiological function is critical, as every day at school, children are expected to read, write, track information, and stay attentive, all skills that …

Shared Steps To Independence: Qualitative Exploration Of A 4:1 Collaborative Pediatric Clinical Education Model, Kathryn E. Sawyer, Megan B. Flores, Elizabeth M. Ardolino

Internet Journal of Allied Health Sciences and Practice

Purpose: As demand for pediatric clinical placements increases, innovative supervision models are needed to expand capacity while supporting student learning. Grounded in situated learning and Communities of Practice theory, a 4:1 collaborative clinical education model was designed with four students to one clinical instructor (CI). This study explored how participation in this 4:1 collaborative pediatric clinical education model influenced physical therapy students’ learning, professional identity development, and clinical practice. Method: A qualitative study using a social constructivist paradigm was conducted. Nine Doctor of Physical Therapy students who completed a 4:1 collaborative pediatric clinical placement participated in semi-structured interviews immediately following …

Effects Of Mindfulness-Based Intervention On Stress And Anxiety In Doctor Of Physical Therapy Students: A Prospective Cohort Design, Kelli J. Brizzolara, Kathy Shirley

Internet Journal of Allied Health Sciences and Practice

Purpose: The demanding nature of physical therapist (PT) education often leads students to experience very high stress levels, which can negatively impact both their academic performance and overall wellbeing. Mindfulness-based intervention programs have been used to decrease stress and anxiety in the general population. However, there is limited evidence of their use with Doctor of Physical Therapy (DPT) students. The purpose of this study was to explore the impact of a brief mindfulness-based intervention on stress and anxiety in DPT students. Methods: Thirty-seven DPT students completed an 8-week mindfulness program, including daily individual mindfulness sessions (10 minutes) and …

Telerehabilitation Program In Rural South India: A Mixed-Method Analysis Of The Shared-Decision Making Process, Sylvia Langlois, Caroline Eagles, Dinesh Krishna, Navamani Venkatachalapathy, Tim Bressmann, Franzina Coutinho

Internet Journal of Allied Health Sciences and Practice

Purpose: Shared decision making (SDM) in health care teams involves partnering with the patient and family to consider treatment options, prioritizing their values and preferences while collaboratively determining the best care plan. Previous research on SDM in rural South India has only focused on adult populations receiving in-person care. This study aimed to understand parent perception of the SDM approach implemented in telerehabilitation services offered by Amar Seva Sangam Ayikudy to children with disabilities in a rural Southern Indian setting. Methods: A convergent parallel mixed-methods design was utilized. Quantitative data was collected from 187 participants using a SDM measure …

Agreement Of Chatgpt With Clinical Practice Guidelines For Knee Osteoarthritis Treatment, Alessandra N. Garcia, Brian Neville, Bradley Myers, Lori Leineke, Karlyn Green

Internet Journal of Allied Health Sciences and Practice

Purpose: This cross-sectional study evaluated whether Chat Generative Pre-Trained Transformer (ChatGPT) GPT-3.5 and GPT-4O provide treatment information consistent with high-quality clinical practice guidelines (CPGs) for knee osteoarthritis (OA). Methods: High-quality CPGs published in the past decade were identified via PubMed and PEDro, with the search updated on November 11, 2024. Guidelines were appraised using the AGREE II tool. GPT-3.5 and GPT-4O were queried with common treatment-related questions, and their responses were compared to CPG recommendations. Two independent reviewers conducted a thematic content analysis of GPT-3.5 and GPT-4O responses using a deductive–inductive codebook, iteratively refined through consensus, to identify major themes/subthemes, …

The Effect Of Debriefing Following A Computer-Based Low-Fidelity Simulation On The Self-Efficacy Of Health Professions Students: A Randomized Cross-Over Control Study, Matthew Mills, Enrico Gandolfi, Richard E. Ferdig, Kimberly Peer

Internet Journal of Allied Health Sciences and Practice

Purpose: Simulations have been increasingly used in health science education to supplement clinical experience. There is evidence of the benefits of high-fidelity simulation (HFS) with debriefing, but HFS is costly and time-intensive to administer. Low-fidelity simulation (LFS) has been proposed as an alternative that is easier to scale and more cost-effective; however, the evidence surrounding its impact on students is mixed, possibly because debriefing is frequently omitted in LFS. Methods: A randomized experimental mixed methods cross-over control study was performed to evaluate the impact of a structured debriefing session following an interactive computer-based low-fidelity simulation on the self-efficacy and anxiety …

What Numbers Don't Tell Us: Can Sociodemographic Factors Identify Grit, Resilience, And Imposter Phenomenon In Hybrid Doctor Of Physical Therapy Students?, Benton Lindaman, Marlena Calo, Brandon Ness, James Smoliga, Moyo B. Tillery, Suzanne Trotter, Liana Wooten, Shefali Christopher

Internet Journal of Allied Health Sciences and Practice

Purpose: To determine whether routinely collected sociodemographic admissions criteria (e.g., first-generation status, race, government assistance, youth employment) could serve as proxies for non-cognitive traits such as grit, resilience, and imposter phenomenon in hybrid Doctor of Physical Therapy (DPT) students. Method: A descriptive, cross-sectional survey was conducted among first-year students (N=100) across three accelerated, hybrid DPT programs. Students completed validated instruments measuring grit (Grit-O), general resilience (Brief Resilience Scale), academic resilience (Academic Resilience Scale), and imposter phenomenon (Clance Imposter Phenomenon Scale) during their first semester. Sociodemographic data were obtained from admissions applications. Between-group comparisons were analyzed using independent t-tests and …

The Effect Of A Mindfulness-Based Program On Musculoskeletal Pain And Function, Christine Conroy, Kent E. Irwin, Paige Dougherty, Teresa Elliott-Burke

Internet Journal of Allied Health Sciences and Practice

Purpose: Mindfulness-based Stress Reduction (MBSR) is a structured therapeutic tool that was developed in the 1980s by Kabat-Zinn and colleagues. Mindfulness-based interventions (MBIs) have been developed based on the fundamental principles of MBSR and are an emerging area of research. These programs are used to decrease pain levels and kinesiophobia in patients with chronic disease and pain. The purpose of this case study is to describe the effects of MBIs on function and pain for a middle-aged patient, two-month post-proximal humerus fracture. Method: A 53-year-old woman presented status post closed fracture of the proximal right humerus resulting from a …

The Phases Of Variation In Physiotherapy Management Of Organophosphate Poisoning Patients: A Case Series, Manish P. Shukla, Sachin A. Chaudhary, Hemant Deshpande, Nikita Gupta

Internet Journal of Allied Health Sciences and Practice

Purpose: Organophosphate (OP) poisoning presents a significant challenge in healthcare, with varying severities requiring adaptive management strategies. This case series examines the physiotherapy management of three patients with different levels of OP poisoning severity: mild, moderate and severe. The study highlights the crucial role of physiotherapy in the multidisciplinary care of OP poisoning patients and demonstrates the need for phase-specific interventions tailored to individual patient needs. Method: The severe case required prolonged mechanical ventilation and intensive care, with physiotherapy progressing from passive techniques to active mobilization over 15 days. The moderate case showed faster recovery, allowing for earlier initiation of …

Firearm Violence Prevention: Analysis Of Physical Therapy Political Action Committee Financial Contributions And Congressional Voting, Kim D. Dao, Edward P. Mulligan, Michael Siegel, Liana Wooten

Internet Journal of Allied Health Sciences and Practice

Purpose. The American Physical Therapy Association (APTA) declared firearm violence a public health crisis in 2019. This investigation aimed to understand relationships between the amount of APTA political action committee (PTPAC) donations received by a federal candidate and (1) their voting records on FV prevention legislation; and (2) their voting records on other APTA-supported legislation. Methods. Data pertaining to the identification and amount of PTPAC donations to federal Congressional candidates during the 2020 and 2022 election cycles were gathered from the public resource, Open Secrets. Public voting records were compiled on firearm and other APTA-supported legislation. Results. 222 candidates received …

The Sympathetic And Clinical Effects Of Dry Needling To The Thoracolumbar Junction Multifidi: A Randomized Controlled Trial, Nicole Clark, Cheryl J. Hill, Joshua Cleland, Thomas Massie, Shane Koppenhaver

Internet Journal of Allied Health Sciences and Practice

Purpose: The primary aim of this study was to investigate the neurophysiological effects of dry needling (DN) to the thoracolumbar junction multifidi when compared with a placebo. The secondary objective was to determine if there is a relationship between post-treatment pain and disability and the magnitude of sympathetic nervous system activity. Methods: Participants were eligible if they had low back pain, limited flexibility in at least one hamstring, and had not previously received DN. Participants completed the Numeric Pain Rating Scale and Oswestry Disability Index, underwent pressure pain threshold testing, and were randomized to a DN or sham …

Staying Strong In Practice: Reducing Musculoskeletal Risks In Dentistry, Leslie Hovda Dpt

Metro Denver Dental Society Articulator Magazine

Dentistry’s physical demands and static postures put providers at high risk for musculoskeletal disorders (MSDs), especially in the back, neck, shoulders and wrists. This article Dr. Leslie Hovda, outlines practical ways to reduce strain through proper equipment use, posture optimization and preventive self-care. Applying the “MEDS” approach: mindfulness, exercise, diet, and sleep, can extend career longevity for dental professionals.

Assessment Of Rotator Cuff External Rotation: Isometric Vs. Isotonic Testing Modes, Luca Maestroni, Filippo Beretta, Fabio Civera, Paolo Artina, Marco Cuniberti, Francesco Bettariga, Anthony Turner

Research outputs 2022 to 2026

Objectives: To assess intra-session reliability of isometric and isotonic shoulder external rotation (ER) strength tests and to compare their outcomes. Methods: Thirty-eight healthy subjects (19 females; 19 males; 25.7 ± 6.0 years; 175 ± 9 cm; 70.3 ± 11.4 kg) completed a shoulder ER strength assessment including Prone and Standing ER Isometric tests and Seated 5 repetition maximum (RM) ER tests. Normality was checked with the Shapiro–Wilk test. Reliability was assessed using the CV and ICC (3, k, 95% CI). Linear mixed models examined sex and dominance effects. Correlations and multiple regression tested associations between tests (p < 0.05). Results: All tests performed displayed “excellent” reliability scores (CV from 1.9 to 3.1% and ICC from 0.970 to 0.994). No significant effect of dominance was observed in any strength test. Males showed significantly higher values than females in both Prone (3.8% higher, p < 0.001) and Standing (2.7% higher, p = 0.003) isometric ER strength tests. Prone and Standing isometric tests were moderately correlated (r = 0.62, 95% CI [0.46, 0.74], p < 0.001). A regression model explained 52.4% of the variance in Seated 5 RM ER strength (R² = 0.524, …

Effect Of A 6-Week Structured Exercise Intervention On Tnf-Α During The Chronic Recovery Phase Of A Burn Injury Compared To Regular Daily Activities: A Pilot Randomised Cross-Over Trial, Tyler Jerome Osborne, Grant Rowe, Dale W. Edgar, Mark Fear, Fiona M. Wood, Timothy Fairchild, Brook Galna, Pippa Kenworthy, Brad Wall

Research outputs 2022 to 2026

Background: Burn injury induces a prolonged inflammatory response that may contribute to long-term metabolic dysfunction. Exercise is known to reduce inflammation in various clinical populations; however, its effect on chronic post-burn inflammation remains unclear. This crossover trial investigated the impact of a 6-week exercise intervention on tumour necrosis factor-alpha (TNF-α) in adults with non-severe burns sustained more than one year prior. Methods: Twenty-one participants were randomised to complete either a 6-week exercise program or a control period first, separated by a 4-week washout. The exercise program comprised three supervised sessions per week of combined resistance and cardiovascular training. Primary (TNF-α) …

Improving Equity Within The Holistic Admission Process Through Race-Neutral Holistic Review: A Before And After Cross-Sectional Study, Megan Eikenberry, Kylie Scott, Jaime González, Josh Subialka, Lacey Frankland, Patrice Ayala, Mark Kargela, Byron Russell

Physical Therapy Faculty Publications

Introduction: The US Physical therapist (PT) workforce lacks racial and ethnic diversity, which may contribute to health disparities. Holistic review (HR) admission methods may improve workforce diversity by evaluating applicants' academic metrics, experiences, and personal attributes. Holistic review processes must adapt following the 2023 Supreme Court ruling prohibiting race-based admission criteria.

Review of literature: Holistic review criteria are program-specific and align with institutional and programmatic goals. While HR is shown to improve student body diversity, most PT education programs heavily emphasize academic metrics, which may disadvantage racial and ethnic minority (REM) applicants from acceptance. This study examines the racial and …

Co-Occurring Vocal Symptoms In Speech-Language Pathologists: A Survey Study, Dawn M. Stanley

Journal of Human Services: Training, Research, and Practice

Vocal symptoms among speech-language pathologists (SLPs) are often overlooked in occupational voice research. In a profession where voice is the primary tool, SLPs usually neglect the instrument they ask others to protect. Vocal symptoms may arise due to high vocal demands in clinical and educational settings. Despite their expertise in communication disorders, SLPs remain an understudied population in vocal health. This study surveyed 202 SLPs to examine the experiences of vocal symptoms during clinical practice. Results indicated that SLPs reported co-occurrences of vocal effort and vocal fatigue 29 (22%) which can interfere with vocal quality when treating patients.

Social Skill Program Development For Adults With Intellectual And Developmental Disabilities, Clayton Stapert

Capstone Projects

This doctoral capstone experience (DCE) was completed at the Center for Disability Services (CDS) and focused on developing and implementing a social skills program for adults with intellectual and developmental disabilities (IDD). Many existing social skills programs focus on general or work-related skills, but there is a need for programs that help individuals apply social skills during real-life community activities. This project aimed to address that gap by creating a structured, occupation-based program within an adult day skill-building day center.

The program included education, group discussion, role-playing, and community outings to help participants practice skills such as interacting with cashiers, …

Stroke Increases Motor Output Variability During Maximal Voluntary Isometric Contractions Of Knee Extensor Muscles In Adults, Zhilun Zhou, Stephanie Christine Wolfe, Brian Schmit, Matthew J. Durand, Sandra Hunter, Allison Hyngstrom

Physical Therapy Faculty Research and Publications

Greater motor output variability (MOV, inconsistency and unsteadiness) during submaximal tasks post stroke is associated with poorer motor performance. However, little is known about MOV during maximal tasks and relationships with clinical measures of motor performance among stroke survivors. This study determined inconsistency (across discrete attempts) and unsteadiness (within a single attempt) during knee extension maximal voluntary isometric contractions (MVICs) in stroke survivors and neurotypical controls. Forty-three stroke survivors (28 female) and 31 age-matched neurotypical controls (15 female) performed a minimum of five knee extension MVICs with paretic and non-paretic legs (stroke) or dominant leg (controls). Inconsistency was calculated as …

Clinical Characteristics Of Patients With Lower Extremity Amputation During Inpatient Rehabilitation And Its Predictors For Home Discharge, Se Won Lee, Duke Shen, Ning Cao

HCA Healthcare Journal of Medicine

Background

Lower limb amputations significantly impair the mobility and activities of daily living (ADLs) and frequently require inpatient rehabilitation with opioid analgesics to control pain. Large-scale studies of clinical characteristics specific to rehabilitation outcomes after lower limb amputations are limited in the current literature. Identifying the associations between specific clinical characteristics and opioid analgesic use with home versus non-home discharge can help improve care for patients undergoing inpatient rehabilitation after lower-limb amputations.

Methods

In this retrospective study, we examined 1611 patients from 58 inpatient rehabilitation units who underwent transfemoral or transtibial amputations between January 2021 and December 2022, identified using …

A Scarring Experience: Pelvic Floor Rehabilitation As A Palliative Approach In Colorectal Cancer Survivorship, Aryan Dowlatshahi, Mary Garcia, Leanne Jackson

Cancer Survivorship Research Retreat

This is a case study and discussion of pelvic floor rehabilitation in its palliative utility specifically for colorectal cancer survivorship which will be presented at the MD Anderson Survivorship Research Retreat conference.