A Pilot Study To Investigate Concerns In Patients Undergoing Neck Dissection Surgery, Daniel Sundar Raj Arulananda Doss

Electronic Thesis and Dissertation Repository

Abstract:

This study investigates concerns in patients undergoing neck dissection surgery. Forty patients were recruited at Pre-surgery, Discharge and 1-month Post-surgery. The Patient Concerns Inventory - Level of Importance questionnaire (PCI-LOI), Shoulder Pain and Disability Index (SPADI), Neck Dissection Impairment Index (NDII) and the University of Washington - Quality of Life questionnaire (UWQOL) were used.

The study identified "Anxiety" at Pre-surgery and "Appearance" at Discharge and 1-month Post-surgery as the important patient concerns. Patients’ concerns were found to change over time. Support for cross-sectional convergent validity of the PCI-LOI was evidenced by significant correlations between the PCI-LOI and the UWQOL …

Grip Strength, Multimorbidity, And Disability, Amy M. Yorke

Dissertations

The presence of two or more chronic health conditions, also known as multimorbidity, is one of the most prevalent health disorders experienced by adults. Adults with multimorbidity and functional limitations represent clinical and financial challenges to the current health care system. The purpose of this three-paper dissertation is to examine the relationship between grip strength, multimorbidity, and the prediction of disability in adults. Data from the 2008 Health and Retirement Study (HRS), a nationally representative, longitudinal study completed on Americans age 50 years and over, are used for the dissertation.

The objective of the first paper is to investigate the …

Inter-Rater Reliability Of Lumbar Segmental Instability Tests And The Subclassification, Faisal Mohammad Alyazedi

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: This study investigated the inter-rater reliability of three structural end-range lumbar segmental instability tests with the highest positive Likelihood Ratio against flexion-extension radiographs, and three functional mid-range clinical tests that predict the success of lumbar stabilization exercises in patients with recurrent or chronic low back pain (R/CLBP). It also investigated the reliability of lumbar segmental instability subclassification as: Functional, Structural and Combined Instability. Method: 40 adult with R/CLBP patients (30 men and 10 women), 18 to 80 years of age, underwent repeated measurements of specific clinical tests for structural or functional lumbar segmental instability. Results: Other than the Lack …

Examining The Shift In Occupational Identity After A Brain Injury, Mikelle Bryson-Campbell

Electronic Thesis and Dissertation Repository

Occupational identity is defined by Kielhofner (2002) as a sense of who we are as an occupational being, based on our past, current, and future occupational roles. When a life disruption occurs such as a brain injury (BI) and the disruption impacts the ability to conduct an occupation deemed meaningful an important process of transition occurs (Muenchberger, Kendall, & Neal, 2008). In turn occupational identity may shift to reflect the current health and economic status of the individual and what occupations are judged as meaningful.

The current study examined the shift in occupational identity in BI survivors in a two …

In Vitro Manual Therapy And Biorobotic Simulation Of Glenohumeral Joint Mobilization Techniques, Hunter Johnson Smith

Theses and Dissertations (ETD)

Physical therapists (PT) employ mobilization techniques for restoring range of motion to joints. Few studies have attempted to quantify the biomechanics of manual therapy on the glenohumeral (GH) joint. The objectives of this study were to develop an in vitro protocol to determine the biomechanical effects of joint mobilization on the GH joint, and to then simulate these mobilizations in the University of Tennessee Health Science Center (UTHSC) Joint Implant Biomechanics Laboratory’s Robotic Testing Platform (RTP).

The GH joint is an incredibly shallow socket joint. This gives the joint an unusually large range of motion (ROM) compared to other ball …

Short Term Sensory And Vascular Responses To Physical Agent Modalities And Exercise In Healthy Volunteers And Patients With Distal Radius Fracture., Shaguftha Shaik

Electronic Thesis and Dissertation Repository

Currently, there is weak evidence on the effectiveness of different rehabilitation regimens following distal radius fracture (DRF). This thesis evaluated sensory and vascular effects of exercise, thermal and ultrasound interventions that can be used in the mobilization phase (cast removal) after DRF.

Methods

• This thesis includes 3 studies. The first study compared responses to Immersion in Cold water Evaluation (ICE) in the DRF and uninjured hands. Skin blood flow (Sbf), skin temperature (temp.) and sensory perception thresholds (sPT) at 2000Hz for A –beta fibres and at 5 Hz for C fibres were obtained before, immediately after ICE and 10 min …

Effect Of Fluid Loss Following Hemodialysis On Tibialis Anterior Muscle Strength In People With End-Stage Renal Disease, Anuradha Sawant

Electronic Thesis and Dissertation Repository

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the effect of fluid loss following hemodialysis (HD) on tibialis anterior (TA) strength in participants with end-stage renal disease. Issues concerning measures of skeletal muscle hydration and efficacy of exercise as an anabolic intervention were also addressed.

METHODS: Data from published literature were combined in a meta-analysis to establish efficacy of exercise in participants on HD. Three clinical studies were undertaken using data acquired from healthy volunteers and participants on HD. Hydration of the calf muscles was estimated using bioelectrical impedance spectroscopy (BIS) [extracellular (ECF) and intracellular (ICF) fluid] …

Prognosis And Movement Patterns In Patients After Rotator Cuff Repair, Jayaprakash Raman

Electronic Thesis and Dissertation Repository

Rotator cuff repairs are done in patients who failed to achieve functional improvement with conservative management for rotator cuff tears. This thesis focuses on prognostic factors that predict outcomes after rotator cuff repair (RCR) and change in functional range of motion (ROM) and muscle endurance before and after RCR. A meta-analysis was performed to statistically analyze all available evidence in the literature concerning prognostic factors that determine outcome after RCR. Based on this study, several factors were identified that had significant and moderate effects on outcomes after RCR. Two prospective studies were conducted to analyze change in functional ROM and …

Tibial Tubercle Transfer To Correct Bilateral Patellar Tendinopathy In A Collegiate Football Player, Andrew D. Hamstra

Boise State University Theses and Dissertations

Objective: To present a case of a competitive football player with chronic patellar tendinopathy and the associated bilateral tibial tubercle transfer surgeries performed leading to the reduction of pain and return to participation.

Background: A 19 year-old male football athlete (height= 187.96 cm, mass= 112.037 kg) presented with chronic patellar tendinopathy that began in his high school career and continued to worsen with the increased physical demands associated with participation in collegiate sport.

Differential Diagnosis: Chondromalacia patella and Osgood Schlatters disease.

Treatment: After nonsurgical intervention resulted in no decrease of pain, bilateral tibial tubercle transfer surgery was conducted to correct …

Short Term Treatment Effectiveness And Long Term Prognosis In Patients With Lateral Epicondylosis/Tennis Elbow, Pritika Gogia

Electronic Thesis and Dissertation Repository

This thesis investigated the short term and long term outcomes of patients who underwent treatment for lateral epicondylosis (LE). The first manuscript compared the immediate effects of counterforce brace versus kinesiotaping on pain free grip during a repetitive upper extremity reaching task in thirty patients (n=30) with LE. The study found kinesiotape to be superior over bracing as it not only improved immediate pain free grip strength by 17.5% but also maintained this during activity as compared to brace which had a smaller improvement of 9.3%. The second manuscript determined the extent of work disability/limitations experienced by patients (n=32) following …

The Effect Of Balance Training With An Innovative Approach Compared To Traditional Balance Exercises, Brian Curtis Waite

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the use of an X Box 360 KinectTM game as a modality for improving balance. Specifically, this study explores the use of the Target Kick mini game on Kinect SportsTM as a tool for VR rehabilitation. Subjects (N=18, age 23.3 ±2.87 yrs, mass 71.83 ±15.25 kg, height 168.4 ±7.79 cm) with no lower extremity injury were randomly placed into three groups (X Box n = 6, Traditional n = 6, and Control n = 6). The X Box (XBOX) group performed ten minutes of balance training by playing an X Box game …

Sleep-Wake Cycle Assessment In Type 2 Diabetes And Salivary Melatonin Correlates, Paula Regina Aguiar Cavalcanti

Loma Linda University Electronic Theses, Dissertations & Projects

p=.047). Additionally, there were significant inverse relationships between melatonin collected at two hours before bed time and latency (ρ=-.87; p=.001), wake after sleep onset (ρ =-.69; p=.02) and nocturnal activity (ρ =-.67; p=.03). Latency was inversely correlated with melatonin collected at bed time (ρ =-.69; p=.02). These findings suggest that T2DM presents disturbances in the homeostatic and circadian drives, mainly characterized by less consistency across days of the daily circadian signal, higher rhythm fragmentation and lower rhythm amplitude. In addition to the lower melatonin levels, the decrease in the amplitude of the activity rhythm may also be involved in circadian …

An Examination Of Executive Function, Mild Cognitive Impairment And Fall Risk In Community Dwelling Older Adults, Jennifer A. Blackwood

Dissertations

The aim of this three-paper dissertation was to examine the relationship between fall risk, executive function (EF) and mild cognitive impairment (MCI) in community dwelling older adults. Papers one and two describe how mild changes in cognition influence performance on four measures of fall risk, the Five Times Sit to Stand Test (FTSTS), usual gait speed, the Timed Up and Go (TUG) test, and the Activities Specific Balance Confidence Scale (ABC) in a group of community dwelling older adults. The third paper describes if participation in a progressively challenging domain specific computerized cognitive training intervention influenced performance on measures of …

Anterior Cruciate Ligament Elasticity And Force For Knee Flexion During The Menstrual Cycle In Women, Haneul Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Numerous studies have been conducted on changes of knee ligament laxity during the menstrual cycle (MC) since there are more injuries in certain phases. Some researchers believe that since estrogen receptor β exists in ligaments and tendons in the knee, estrogen may modulate towards a state of laxity. However, increased tissue temperature also observed during the MC can predispose ligament and tendon laxness. The number of women using oral contraceptive pills (OCP) has constantly increased in the United States. This exogenous source of synthetic forms of steroid hormones prevents ovulation by maintaining more consistent daily hormone levels than occurs. Since …

Anterior Cervical Decompression And Fusion On Neck Range Of Motion, Pain And Function: A Prospective Analysis, Kate Addis, Jason Longhurst, Bree-Lyn Vom Steeg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Summary of background data: Intractable cervical radiculopathy secondary to stenosis or herniated nucleus pulposus is commonly treated with an anterior cervical decompression and fusion procedure (ACDF). However, there is little evidence in the literature that demonstrates the impact such surgery has on long term range of motion outcomes

Study Design: Prospective, non--‐experimental.

Objective: The objective of this study was to compare cervical range of motion and patient reported outcomes in patients before and after a 1, 2 or 3 level ACDF.

Patient Sample: 46 patients.

Methods: Patients undergoing an ACDF for cervical radiculopathy had their cervical range …

Reliability And Validity Of The Ne1 Wound Assessment Tool (Wat), Stephanie Coon, Faustina Tran, Melinda Vicencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current literature indicates a lack of reliability and validity of existing pressure ulcer (PrU) staging systems. This prompted the development of the N.E. One Can Stage (NEOCS). Recently this tool was modified and renamed, the NE1 Wound Assessment Tool (NE1 WAT). The purpose of this study is to test the reliability and validity of the NE1 WAT.

Subjects:

A sample of convenience of nine physical therapists (PTs) and 11 nurses (RNs) with PrU staging as part of their routine work duties were included in this study.

Methods:

A written exam was administered and consisted of assessment questions …

The Acute Effects Of Upper Extremity Stretching On Throwing Velocity In Untrained Baseball Throwers, Ashley Delobel, Lanisa Harveson, Jason Melton, Michael Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to examine the effects of static and proprioceptive neuromuscular facilitation (PNF) stretching of shoulder internal rotators on throwing velocity as compared to a typical dynamic warm-up.

Subjects: 27 male untrained throwers (mean age = 25.1 years old, SD =2.4) with basic knowledge of throwing mechanics.

Methods:The study was conducted over a series of three sessions with at least one week between each session. During each session, subjects warmed-up, threw 10 pitches, were randomly assigned to one of three separate stretching protocols, and then threw 10 more pitches.The three protocols were static stretching, …

Modern Technology And An Aging Population: Can The Use Of The Wii Fit Gaming System Improve Functional Balance In Community Dwelling Seniors?, Curtis N. Phillips

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Seniors are a growing segment of the population of the United States. By 2030 they will make up nearly 20% of the general population. Senior citizens face many health challenges as they age. Injury due to falling is a major concern for many in this age group. Research shows that approximately one third of seniors will fall each year. Injuries that result from falls have been identified as the number one cause of accidental death in this age group each year. While falls have been studied by researchers for a number of years, and some progress has been made in …

Effects Of Footstrike Pattern On Low Back Posture, Shock Attenuation, And Comfort During Running, Traci L. Delgado, Emilia Kubera-Shelton, Robert R. Robb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Barefoot running (BF) is popular in the running community. Biomechanical changes occur with BF, especially when initial contact changes from rearfoot strike (RFS) to forefoot strike (FFS). In addition, changes in lumbar spine range of motion (ROM), particularly involving lumbar lordosis, have been associated with increased low back pain (LBP). However it is not known how changing from RFS to FFS affects lumbar lordosis or LBP. Thus, the purpose of this study was to determine if a change from RFS to FFS would change lumbar lordosis, and/or decrease shock attenuation, and/or change comfort levels in healthy recreational/experienced runners.

Methods: …

Land-Based Exercise And Its Effect On Quality Of Life Outcomes In Patients With Knee Osteoarthritis: A Systematic Review, Cody R. Buckner, Lindsay C. Martin, Michael L. Soukup

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The purpose of this systematic review was to examine effectiveness of land-based exercise interventions for improving quality of life (QOL) of individuals with symptomatic knee osteoarthritis.

Methods: A systematic search included PubMed, CINAHL, Scopus, Academic Search Premier, and the Cochrane Database of Systematic Reviews. Inclusion criteria included land-based exercise interventions aimed to improve lower extremity strength and QOL, published since 2000. Exclusion criteria included OA of joints other than the knee, and aquatic-based and surgical interventions. Studies were evaluated using a modified version of the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) methodology score.

Results: Level of …

Test-Retest Reliability And Responsiveness Of Gaze Stability And Dynamic Visual Acuity In High School And College Football Players, Denise Kaufman, Mallory Puckett, Mitchell Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: The purpose of this study was to establish reliability and responsiveness of the active dynamic visual acuity test (DVAT) at speeds of 150 to 200 degrees per second (deg/sec) and the gaze stabilization test (GST) in high school and college football players.

Design: Reliability design

Setting, Participants, Main Outcome Measures: A total of 50 high school and college football athletes completed vestibulo-ocular reflex testing using the DVAT and GST in the yaw (horizontal) and pitch (vertical) planes on two separate occasions within 14 days.

Results: Test-retest reliability for the DVAT was good in yaw, Intraclass Correlation Coefficient (ICC) (3,3) …

Using Over-The-Counter Ear Filters As A Treatment To Improve Dizziness And Balance In Patients Diagnosed With A Traumatic Brain, Brandy Sue Whitney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: People diagnosed with a Traumatic Brain Injury (TBI) usually have physical, cognitive, emotional, and sleep deficits. Sensory overload is a common symptom of TBI. One treatment prescribed for sensory overload is over the counter ear filters. Ear filters have shown to decrease sensory input. Could the ear filters have an effect on balance and dizziness without much cost to the patient or the clinic?

Subjects: Patients diagnosed with a mild or moderate brain injury, ages of 18-65 years old. They needed to be medically stable, potential to walk, and have complaints of dizziness and/or balance problems.

Methods: …

Therapeutic Neuroscience Education For Patients With Chronic Low Back Pain And Its Effect On Activity Level, Pain Perception, And Function, Stephen Burton, Amber Domingo, Ryan Spencer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Chronic low back pain (CLBP) is a significant cause of disability and inactivity in the United States. Patients with chronic pain are often symptomatic even in the absence of tissue damage. This is a major reason patients need to be educated about their pain. Cognitions such as fear, anxiety and faulty beliefs may impact the pain experiences and changing cognitions are important in changing pain behavior. If patients understand that the pain they are experiencing may not be a true indication of the health of their tissues, they may experience less fear of their pain, and may be able …

Effects Of Cervical Spine Manipulation On Balance And Joint Proprioception In Asymptomatic Individuals: Plausibility And Pilot Study, Kimberly Drayer, Michael Kauwe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Balance issues are prevalent in all ages of the population and can lead to many debilitating secondary impairments. There are various methods for treating balance problems, one of which is cervical spine manipulation (CSM). It seems to be biologically plausible that CSM would be an effective intervention, as it elicits effects in the same systems that are impaired in people with balance issues: vestibular, visual, and somatosensory.

Objective: The aim of this study is to investigate the immediate differences in balance and proprioception following a CSM in asymptomatic subjects.

Design: An experimental, cross-over study design was used

Methods: …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Russell Gourlie, Spencer Sorensen, Rithea Vong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study is to examine and identify key characteristics of and differences between people with Parkinson’s Disease (PD) who exhibit moderate/high fear of falling avoidance behaviors and those that exhibit low fear of falling avoidance behaviors.

Subjects: A total of 24 subjects (5 females, 19 males; mean age= 72.2, SD=9.1) participated in this study.

Methods: A cross-sectional design was used to identify descriptive characteristics of subjects with PD associated with moderate/high levels of fear avoidance behavior (MHA) or low levels of fear avoidance (LA) as measured by the Fear of Falling Avoidance-Behavior …

Effect Of Congenital Versus Acquired Varus On Patient-Reported Outcomes After High Tibial Osteotomy, Sherelle T. Solomon

Electronic Thesis and Dissertation Repository

ABSTRACT

Objectives: 1) To determine the inter-rater reliability of tibial bone varus angle (TBVA) measurements. 2) To compare patient-reported outcomes after medial opening wedge high tibial osteotomy (HTO) in patients with congenital versus acquired varus.

Methods: Two raters measured TBVA from preoperative whole-limb standing anteroposterior radiographs (n=74). Patients completed Knee Osteoarthritis Outcome Scores (KOOS) before and 5 years after surgery. The sample was first divided into two groups based on preoperative congenital (TBVA>5°) or acquired (TBVA≤5°) varus, then three groups based on tertiles for TBVA.

Results: Intraclass correlation coefficients (ICC) suggested excellent inter-rater reliability (ICC2,1=0.78; ICC2,2=0.88). Repeated measures analysis …

Benefits Of A Group Exercise Program On A Student With Congenital Hydrocephalus And Multiple Co-Diagnoses, Stephanie Walters

PTHMS Undergraduate Publications

Congenital Hydrocephalus (CH) is a condition at birth where excess cerebral spinal fluid accumulates in the ventricles of the brain due to inadequate drainage, resulting in an increase in intracranial pressure and damage to the surrounding nervous tissue. Although hydrocephalus is successfully treated at birth, a resulting diagnosis of a memory-related learning disorder is common. However, having multiple independent subsequent diagnoses is unique. This report mainly describes a 13 year-old boy who was diagnosed and treated for congenital hydrocephalus at birth and then was subsequently diagnosed with multiple co-morbidities, such as partial agenesis of the Corpus Callosum, Cerebral Palsy with …

Changes In The Dynamics Of Postural And Locomotor Control As A Result Of Varying Task Demands, Kathleen Sherry Thomas

Human Movement Sciences & Special Education Theses & Dissertations

The aim of this study was to examine changes in postural and locomotor control under varying task demands. Three experiments were designed to address the impact that fast walking had on standing posture over time, slow walking had on gait dynamics over time, and the extent to which gait speed interacts with the ability to walk randomly.

For experiment I, the aim was to identify the time course in which postural adaptation occurred while walking at faster than preferred speeds. Postural motion was assessed at specific intervals over a 35-min walking trial. Findings revealed that walking at a faster speed …

Effect Of Passive Vibration On Skin Blood Flow In Good Glycemic Control And Poor Glycemic Control Type 2 Diabetics, Kanikkai Steni Balan Sackiriyas

Loma Linda University Electronic Theses, Dissertations & Projects

Microcirculation regulated by the sympathetic system and vascular endothelium plays a significant role in the homeostasis of temperature and wound healing. Damage to the autonomic nervous system and endothelial system resulting from aging and diabetes decreases the potential of wound healing. Insulin resistance and impaired wound healing associated with type 2 diabetes can lead to diabetic foot ulceration (DFU). Factors such as the increased insulin resistance, impaired wound healing and DFU can increase the risk of amputation in type 2 diabetics (T2D). In research, passive vibration (PV) was effective in increasing skin blood flow (SBF) in healthy individuals as well …

First Rib Mobilization In The Treatment Of Thoracic Outlet Syndrome, Chad C. Boehm

Physical Therapy Scholarly Projects

Background and Purpose: Thoracic outlet syndrome (TOS) is one of the most controversial clinical entities in medicine. It encompasses three related syndromes: compression of the brachial plexus (neurogenic TOS), compression of the subclavian artery or vein (vascular TOS), and a non-specific or disputed type of TOS.s Neurovascular compression may be observed most commonly in the interscalene triangle, but has also been described in the costoclavicular space and subcoracoid space.6 The purpose of this case study is to further explore the efficacy of manual therapy, specifically mobilization of the 1st rib, to relieve the symptoms of a 43 year old …