Biomechanics Commons^™

Research Roundup From The Research Committee, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

With the expectations of accountability by consumers and third party payors for the efficacy of physical therapy practice, there has been a significant increase in the push to develop outcome measures in rehabilitation. One type of these measures, patient-reported outcome measures (PROs), are becoming increasingly more common in clinical practice. The American Physical Therapy Association’s Guide to Physical Therapist Practice 3rd edition includes outcomes assessment as an integral part of the Patient and Client Management model, and delineates that appropriate tests and measures depend upon established psychometric properties of the measurement.1 The Section on Research formed the Evidence Database to …

Research Round-Up: Manual Muscle Testing, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

Manual muscle testing was developed in response to the need to assess muscle strength losses during the polio outbreak in early part of the 20th century. The development of this original method is credited to Wilhelmine Wright and Robert W. Lovett, MD. Wright presented this method in 1912 in the Boston Medical Surgical Journal, and Lovett expanded the description of the testing method in 1916 in the Journal of the American Medical Association. The development of quantifying muscle strength by rating force generated against external resistance was an important development in objectifying assessment methods of the time.

Today, manual muscle …

Oncology Section Edge Task Force On Breast Cancer Outcomes: A Systematic Review Of Outcome Measures For Functional Mobility, Mary Insana Fisher, Jeannette Lee, Claire Davies, Hannah Geyer, Genevieve Colon, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Breast cancer treatments in women with breast cancer often result in physical impairments that lead to activity limitations and participation restrictions. These limitations and restrictions manifest in impaired functional mobility skills that may impact survivorship. Thus, evaluation of functional mobility is an important part of survivorship care.

Purpose: To identify functional mobility outcome measures that possess strong psychometric properties and are clinically useful for examination of women treated for breast cancer.

Methods: Multiple electronic databases were searched for articles published after 1995. Studies were included if they reported psychometric properties, used clinically feasible methods, were performed on adults, and …

The Effects Of Home-Based Pilates In Healthy College-Age Females, Betsy Donahoe-Fillmore, Mary Insana Fisher, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: To quantify and determine the effects of Pilates on core endurance, hamstring flexibility, balance, body composition/mass and perceived stress level in healthy college age females.

Study Design: Randomized controlled trial design.

Background: Emerging research on the Pilates technique is inconclusive regarding benefits to core endurance, flexibility, balance, body mass, and perceived stress.

Methods and Measures: Female college students (n=57; 18-35 years old) were randomly assigned to a Pilates group, who exercised at home with a DVD, or a control group who did not engage in Pilates practice. Core endurance, hamstring flexibility, balance, body composition and stress measurements were taken …

Effects Of Yoga On Arm Volume Among Women With Breast Cancer Related Lymphedema: A Pilot Study, Mary Insana Fisher, Betsy Donahoe-Fillmore, Laura Leach, Colleen O'Malley, Cheryl Paeplow, Tess Prescott, Harold L. Merriman

Physical Therapy Faculty Publications

Lymphedema affects 3–58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3×/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at …

The Importance Of Managing Psychosocial Health: A Case Study, Mary Insana Fisher, Harold L. Merriman

Physical Therapy Faculty Publications

Managing the physical aspects of lymphedema requires an individual to be committed to daily treatment of this chronic condition. Performing manual lymph drainage, using compression bandaging or compression garments, exercising, and caring for the skin all take time and a high level of dedication. This commitment to self-care can be emotionally and psychologically exhausting.

When coupled with other emotional stressors in a patient’s life, successful treatment of lymphedema is challenging. We present a case demonstrating how the physical and psychological aspects of care interplay, and, when well-managed, can positively affect the outcome.

Breast Cancer Edge Task Force Outcomes - Clinical Measures Of Strength And Muscular Endurance: A Systematic Review, Mary Insana Fisher, Claire Davies, Christine Beuthin, Genevieve Colon, Brittany Zoll, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Muscular strength deficits are a common morbidity following treatment for breast cancer. Accurate assessment of strength and muscular endurance following breast cancer treatments is essential in identifying deficits and planning rehabilitation strategies.

Purpose: The purpose of this systematic review was to identify strength and muscular endurance outcome measures for use with women treated for breast cancer that possess strong psychometric properties and are clinically useful.

Methods: Multiple electronic databases were searched between February and June 2013. Included studies of tools used to assess strength and muscular endurance met the following criteria: reported psychometric properties, clinically feasible methods, adults (preferably …

Test Items In The Complete And Short Forms Of The Bot-2 That Contribute Substantially To Motor Performance Assessments In Typically Developing Children 6-10 Years Of Age, Kadi Carmosino, Ashley Grzeszczak, Kaylie Mcmurray, Ali Olivo, Bo Slutz, Brittany Zoll, Betsy Donahoe-Fillmore, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: Determine the magnitude of association between individual subtest items of the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), and the respective total subtest scores and to review items on the BOT-2 Short Form.

Background: The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), is a test used to measure gross motor proficiency in both typically developing children and children with developmental disabilities between the ages of four and twenty-one. The BOT-2 Short Form consists of fourteen test items proportionally selected from the subtests of the Complete Form. It can be used as a screening tool and takes less …

Oncology Section Task Force On Breast Cancer Outcomes: An Introduction To The Edge Task Force And Clinical Measures Of Upper Extremity Function, Pamela K. Levangie, Mary Insana Fisher

Physical Therapy Faculty Publications

With the proliferation of outcome measures in the literature, many of which lack documentation of sufficient psychometric properties to justify use, it is difficult to document patient change or demonstrate effectiveness of interventions. The goal of the Section on Research’s EDGE (Evaluation Database to Guide Effectiveness) Task Force is to facilitate identification of valid and reliable tests and measures that reflect clinically important outcomes and are responsive to change for standard use across selected patient groups. This paper lays the groundwork for understanding the work of the Oncology Section’s Breast Cancer EDGE Task Force on clinical measures of shoulder function …

Oncology Section Task Force On Breast Cancer Outcomes: Scapular Assessment, Mary Insana Fisher, Pamela K. Levangie

Physical Therapy Faculty Publications

Background: Functional deficits and changes in scapular mechanics following breast cancer (BC) treatments have been documented. Scapular assessment is important when examining the shoulder in survivors of breast cancer to document the need for or effectiveness of physical therapy intervention. The Oncology Section Task Force on Breast Cancer Outcomes sought to identify scapular examination tools that can be recommended for routine use in individuals treated for BC.

Methods: A systematic review of the literature on scapular measures was conducted. Relevant studies were examined for psychometric properties and clinical usefulness. Each method was given a recommendation score based on the Breast …

A Home-Based Exercise Program For The Foot And Ankle To Improve Balance, Muscle Performance And Flexibility In Community Dwelling Older Adults: A Pilot Study, Laurel Long, Kurt Jackson, Lloyd L. Laubach

Physical Therapy Faculty Publications

Background and purpose: Strength and range of motion of the foot and ankle have been shown to be related to measures of balance and fall risk in older adults. The primary purpose of this pilot investigation was to evaluate the feasibility of a 6-week home-based exercise program focusing on the foot and ankle and any associated changes in balance, muscle performance and range of motion in older adults. Methods: This single-group repeated measures study involved a convenience sample of 21 healthy communitydwelling older adults age 60-90. Nineteen participants completed all phases of the testing and training. The intervention was a …

Effects Of Footstrike On Low Back Posture, Shock Attenuation, And Comfort In Running, Traci L. Delgado, Emilia Kubera-Shelton, Robert R. Robb, Robbin Hickman, Harvey Wallmann, Janet Dufek

Interdisciplinary Research Scholarship Day

To determine if a change from rearfoot strike (RFS) to forefoot strike (FFS) would change lumbar lordosis, influence shock attenuation, or change comfort levels in healthy recreational/experienced runners.

A Comparison Of Upper Extremity Function Between Female Breast Cancer Survivors And Healthy Controls: Typical Self-Report Of Function, Motion, Strength, And Muscular Endurance, Mary Insana Fisher

Physical Therapy Faculty Publications

Many women who have experienced breast cancer (BC) report continued impairments in upper extremity (UE) function beyond the time required for normal healing after surgical treatment. Most research supporting this has not made comparisons between survivors of breast cancer (BCS) to a sample of healthy women. This lack of comparison to a healthy cohort prevents an understanding of whether continued deficits in UE function are due to normal aging or the BC treatment.

The purpose of this research was to compare quality of life (QOL) and UE function among long term breast cancer survivors and similar aged women without cancer. …

Whole-Body Vibration Improves Functional Mobility, Flexibility, And Relative Risk For Falling In The Assisted Living Elderly: A Case Series, Christina Garrity, Harold L. Merriman, C. Jayne Brahler

Physical Therapy Faculty Publications

Study design: A randomized double blind repeated measures, case series study of whole body vibration (WBV) in the assisted living elderly.

Background: A single exposure to WBV has been shown to have benefit with respect to muscle activity, strength, balance, and power in some studies while other studies have found no benefit. Its overall effectiveness is unknown due to the conflicting findings reported in the literature.

Case description: Six subjects (5 female, 1 male; mean age = 85.4) in an assisted living community volunteered to participate. Subjects were exposed to a single bout of WBV at 0, 2, 20, and …

Effects Of Head Position And Head-Supported Mass On Nerve Function Of The Flexor Carpi Radialis Muscle In Healthy Individuals, Bethany Lauren Shivers

Graduate Theses and Dissertations

Long-term exposure to head-supported mass (HSM) has been linked with spinal degeneration including foraminal stenosis and disc deterioration. Anecdotally, HSM has also been linked to neck and arm pain and muscle atrophy, but nerve function has not been tested specifically. The combined effect of various head positions and HSM may be sufficient to compress the nerve root in aviators and Soldiers during job performance, potentially leading to short- and long-term neuromuscular effects. The Hoffmann (H) reflex, a well-established measure of nerve function, has shown to be sensitive to changes in nerve root space which occurs with different head positions. This …

Digital And Clinical Refractometers Are Valid Instruments For The Measure Of Hydration Status, A. J. Niemann, S. W. Yeargin, L. E. Eberman, H. M. Mata, H. A. Adams, D. J. Dziedzicki

Symposium 2012

Although some instruments have been validated for clinical measure of hydration status, new and currently invalid instruments are available for purchase and clinical use. Athletic trainers commonly use these instruments to assess hydration status for weight checks and body mass loss charts due to their ease of use. However, the validity of these popular instruments has not yet been established.

Systematically Controlling For The Influence Of Age, Sex, Hertz And Time Post-Whole-Body Vibration Exposure On Four Measures Of Physical Performance In Community-Dwelling Older Adults: A Randomized Cross-Over Study, Harold L. Merriman, C. Jayne Brahler, Kurt Jackson

Physical Therapy Faculty Publications

Though popular, there is little agreement on what whole-body vibration (WBV) parameters will optimize performance. This study aimed to clarify the effects of age, sex, hertz, and time on four physical function indicators in community-dwelling older adults (N = 32). Participants were exposed to 2 minutes WBV per session at either 2 Hz or 26 Hz, and outcome measures were recorded at 2-, 20-, and 40-minute post-WBV. Timed get-up-and-go and chair sit-and-reach performances improved post-WBV for both sexes, were significantly different between 2 Hz and 26 Hz treatments (P ≤ 0.05), and showed statistically significant interactions between age and gender …

Knee Range Of Motion: Reliability And Agreement Of 3 Measurement Methods, Paul G. Peters, Michael A. Herbenick, Philip A. Anloague, Ronald J. Markert, L. Joseph Rubino

Physical Therapy Faculty Publications

We conducted a study to compare 3 methods of measuring knee range of motion: visual estimation by physicians, hand goniometry by physical therapists, and radiographic goniometry. We hypothesized that reliability would be high within and across all techniques. We found intrarater and interrater reliability to be satisfactory for visual estimation, hand goniometry, and radiographic goniometry. Interrater reliability across methods did not agree satisfactorily. Between-methods differences in estimating knee range of motion may result from variations in technique among physicians and physical therapists.

A Comparison Of Two Pelvic Floor Muscle Training Programs In Females With Stress Urinary Incontinence: A Pilot Study, Betsy Donahoe-Fillmore, Wendy Chorny, C. Jayne Brahler, Ashley Ingley, Jennifer Kennedy, Valerie Osterfeld

Physical Therapy Faculty Publications

Background: Stress urinary incontinence (SUI) is a condition affecting millions of Americans. Few studies have assessed the benefits of different exercises involved in pelvic floor muscle training (PFMT). Purposte: The purpose of this study was to compare the effects of a traditional PFMT program to an assisted pelvic floor muscle training (APFMT) program that included contraction of hip musculature.

Investigating The Associations Between Core Strength, Postural Control And Fine Motor Performance In Children, Rachel Burnett, Nicole Cornett, Gina Rekart, Betsy Donahoe-Fillmore, C. Jayne Brahler, Susan Aebker, Megan Kreill

Physical Therapy Faculty Publications

Study design: Quantitative design including statistical analysis.

Objectives: The objective of this study was to determine if there is an association between core strength, postural control, fine motor precision and integration, specifically in typical children in the first and third grades, ages 6-10. The secondary purpose of this study was to determine if there was an association between BMI and fine and gross motor ability in this same population.

Background: The relationship between core strength, postural control and fine motor skills in children is not well understood. The assumption that trunk stability and control are necessary for the maturation of …

The Power Of Empowerment: An Icf-Based Model To Improve Self-Efficacy And Upper Extremity Function Of Survivors Of Breast Cancer, Mary Insana Fisher, Dana Howell

Physical Therapy Faculty Publications

Breast cancer is one of the most frequently diagnosed cancers among women. Breast cancer treatments often negatively impact the function of the arm, and quality of life and upper extremity function does not always return to a prediagnosis level. Survivors of breast cancer may also experience feelings of diminished self-efficacy related to functional deficits resulting from their physical limitations. The International Classification of Functioning (ICF) provides a framework for rehabilitation practitioners to address physical and psychological impairments, activity limitations, and participation restrictions. Patient outcomes may be improved by fostering self-efficacy through empowerment. This paper explores how the ICF model and …

Electromyographic Analysis Of Trunk Muscle Activation During A Throwing Pattern Following Rotator Cuff Mobilization, Aubrey L. Doede

CMC Senior Theses

Correct muscular activation of the body segments during an overhand throw is achieved when movement originates in the larger and more proximal legs and trunk and moves sequentially to the smaller, distal segments of the shoulder and arm. This sequence permits angular velocity to transfer progressively through the throw as part of an open kinetic chain. The athlete can summate angular velocity and segmental forces only if he is able to create a separation between the body segments during the movement pattern, and this separation is thus essential to effective segmental sequencing for activation of the trunk muscles to occur …

Peer-Led Team Learning: A Prospective Method For Increasing Critical Thinking In Undergraduate Science Courses, Ian J. Quitadamo, C. Jayne Brahler, Gregory J. Crouch

Physical Therapy Faculty Publications

This study examined the impact of peer-led team learning (PLTL) on critical thinking gains in science and math courses at a research university in the Pacific Northwest.

Chronic Elbow Dislocation Treated With Open Reduction And Lateral Ulnar Collateral Ligament Reconstruction, Louis Joseph Rubino, Michael A. Herbenick, Ryan P. Finnan, Philip A. Anloague

Physical Therapy Faculty Publications

In the United States, chronic unreduced elbow dislocations are rare injuries. We report the successful short-term outcome of a chronic elbow dislocation treated with open reduction and lateral ulnar collateral ligament reconstruction using a split semitendinosus allograft in a figure-of-8 technique without use of hinged external fixation. The authors have obtained the patient’s written informed consent for print and electronic publication of the case report.

High Dietary Fat Intake Is Not Associated With High Levels Of Circulating Lipoproteins Or Total Cholesterol, C. Jayne Brahler, C. Wilson, Janine Baer

Physical Therapy Faculty Publications

The objective of this study was to determine the association between dietary intake of fats, waist to hip ratio (WHR), body mass index (BMI), and blood lipoproteins and total cholesterol (TC) using food frequency data in one group of apparently healthy, urban African American women and their daughters (n = 110). Subjects were fasted when blood was drawn, waist and hip circumferences and body weight and height were measured, and WHR and BMI were calculated.

Average daily total fat intakes were 91.46 g and 77.83 g for mothers and daughters, respectively, but average LDL levels of 104.4 g/L and 103.1 …

Functional Electric Stimulation Cycle Ergometry Training Effect On Lower Limb Muscles In Acute Sci Individuals, Timothy J. Demchak, Jon K. Linderman, W. Jerry Mysiw, Rebecca Jackson, Jihong Sunn, Steven T. Devor

Health and Sport Science Faculty Publications

The purpose of this study was to compare three different intervals for a between sets rest period during a common isokinetic knee extension strength-testing protocol of twenty older Brazilian men (66.30 ± 3.92 yrs). The volunteers underwent unilateral knee extension (Biodex System 3) testing to determine their individual isokinetic peak torque at 60, 90, and 120° ·s-1. The contraction speeds and the rest periods between sets (30, 60 and 90 s) were randomly performed in three different days with a minimum rest period of 48 hours. Significant differences between and within sets were analyzed using a One Way Analysis of …

The Effects Of Differing Bicycle Frame Geometry On Muscle Recruitment Strategies And Power During A 30-Second Wingate Anaerobic Test, Patrick Hills-Meyer

Masters Theses

The purpose of this study was to test how changing the bicycle frame geometry; from a shallow frame geometry [seat tube angle (STA) of 72°] to a steep frame geometry (STA of 82°) affected the electromyographic (EMG) signal of the hamstrings [biceps femoris (BF) and semitendinosus (ST) muscles] and the quadriceps [vastus medialis (VM) and vastus lateralis (VL)] and power (max, mean, min, and, % drop) during a Wingate anaerobic test (WAT). To measure the muscle recruitment and power, 12 experienced triathletes were prepped with surface electrodes to measure EMG amplitude and an electrogoniometer to measure knee joint angle while …

The Short-Term Effects Of Grade 1 And 2 Joint Mobilizations On Subject Pain Range Of Motion And Muscle Activity In The Pathological Lumbar Spine, Sean Hanrahan

Human Movement Studies & Special Education Theses & Dissertations

The purpose of this study was to examine the short-term effects of Grades 1 and 2 posteroanterior joint mobilizations (JM) at the pathological lumbar spine on subject pain, range of motion (ROM), and muscle force. All subjects were determined to have sustained mechanical dysfunction of the lumbar spine of less than 48 hours as assessed through a standardized evaluation. Subjects were randomly assigned to a group; the control group received ice and stretching while the experimental group received JM in addition to ice and stretching. The JM's were performed at 3 consecutive lumbar segments surrounding the area of greatest discomfort. …

Neurophysiologic Bases For Abnormal Muscle Coactivation Patterns In Hemiparetic Stroke, Julius P.A. Dewald

Loma Linda University Electronic Theses, Dissertations & Projects

To study disturbed muscle activation patterns in hemiparetic stroke, the EMG activity in spastic-paretic and contralateral elbow muscles of 10 stroke subjects were compared during graded directionally varying voluntary isometric contractions. We observed significant shifts in the peak EMG angle and increases in the angular range of EMG activity in the impaired upper limb. Furthermore, we observed stereotypic coactivation of many muscles acting at the same joint or at different joints across all subjects.

The effect of elbow angle changes on muscle coactivation patterns was studied by examining isometric torque-angle relations under passive and active conditions in 8 stroke subjects. …

Kinesiology Of Knee Flexion Deformity Using Electromyography, Paul J. Roby

Loma Linda University Electronic Theses, Dissertations & Projects

A kinesiological electromyographic study was completed to determine the relative changes in muscle activity as a person walks and stands with different degrees of knee flexion deformity. The ultimate aim was to establish criteria for appropriate preventive and corrective measures relating to knee flexion deformity.

Six different muscles were implanted with wire electrodes. The subjects performed a series of walking and standing experiments with the knee flexed at selected angles by a locking leg brace to simulate knee flexion deformity. The electromyographic action potentials were monitored by analog tapes, oscilloscopes and closed circuit television. The analog tapes were displayed on …