Medicine and Health Sciences Commons^™

Freezing Of Gait: Mechanisms, Mechanics, And Management, Peter S. Myers

Arts & Sciences Electronic Theses and Dissertations

Parkinson disease (PD) is a neurodegenerative disease with multiple motor and non-motor symptoms, including postural instability, gait impairments, and cognitive deficits. More than 50% of individuals with PD experience a symptom called freezing of gait (FOG), described as a transient inability to take another step forward. Individuals with PD who experience FOG (freezers) have further postural, gait, and cognitive impairments compared to individuals with PD without FOG (non-freezers). While degeneration of the dopaminergic neurons in the substantia nigra is accepted as the primary etiology of the disease, research shows that the disease has a global impact on the brain, accounting …

Early Career Physical Therapy Faculty Networking And Scholarly Productivity: A Mixed-Methods Study, Betsy J. Becker

Theses & Dissertations

While it is well-known that physical therapist (PT) faculty must retain a scholarly agenda, few report being activity engaged and many programs have low scholarly dissemination. There is evidence that knowledge of the make-up of a faculty network leads to improved performance and innovation. The purpose of this explanatory sequential mixed methods study was to explore agency (behaviors and perspectives about career advancement) and the professional network structure and composition of early career PT faculty as they relate to scholarly activity. This dissertation research study included 50 early career faculty who worked in accredited entry-level physical therapy programs.

The quantitative …

The Effects Of Exercise On The Cognitive Function Of Patients With Alzheimer’S Disease, Amanda Savitski

Honors Theses

Alzheimer’s disease (AD) is America’s most common neurodegenerative disease affecting over 5.4 million Americans (Fernández et al., 2017). A literature review was completed to assess the possible relation between physical activity and the progression of AD. Articles were collected from various peer-reviewed, published journals using the available databases of Western Michigan University library which included PubMed, ClinicalTrials.gov, and the National Institute of Health (NIH). Keywords used for the database searches included “Alzheimer”, “Alzheimer’s Disease”, “neurodegeneration”, “aging brain”, “exercise”, and “physical activity”. Based upon the literature reviewed, aerobic exercise appears to slow the progression of AD and possibly reverses it slightly …

Shoulder-Specific Patient Reported Outcome Measures For Use In Patients With Head And Neck Cancer:An Assessment Of Reliability, Construct Validity, And Overall Appropriateness Of Test Score Interpretation Using Rasch Analysis, Melissa Michelle Eden

Department of Physical Therapy Student Theses, Dissertations and Capstones

Context: Medical management for head and neck cancer (HNC) often includes neck dissection surgery, a side effect of which is shoulder dysfunction. There is no consensus for which patient-reported outcome measure (PRO) is most appropriate to quantify shoulder dysfunction in this population.

Objective: The aims of this research study were to: (1) use Rasch methodologies to assess construct validity and overall appropriateness of test score interpretation of Disability of the Arm, Shoulder and Hand (DASH), QuickDASH, Shoulder Pain and Disability Index (SPADI) and Neck Dissection Impairment Index (NDII) in the HNC population; (2) determine appropriateness of use of University of …

The Effect Of Patterned Sensory Enhancement On Balance And Ambulation In Persons Diagnosed With Parkinson’S Disease, Brittany Barko

Masters Theses

One rehabilitation protocol effective in delaying the symptoms of Parkinson’s Disease (PD) is Lee Silverman Voice Training BIG (LSVT BIG), comprising pre-gait exercises and gait training. This study seeks to determine if combining Patterned Sensory Enhancement (PSE), a music therapy intervention, with LSVT BIG will improve quality of movement. During physical therapy sessions with three participants, a music therapist adapted the PSE stimuli to support each patient’s motor needs, which were then recorded on CD and sent with patients to exercise with at home. Results showed improved balance and ambulation comparing pre- and post- measures of the BERG balance scale …

Understanding The Process Of Recovery From Critical Illness From The Patient Perspective: A Constructivist Grounded Theory, Tania Larsen

Electronic Thesis and Dissertation Repository

Critical illness creates long-term physical, psychological and cognitive deficits that negatively impact quality of life, persisting well beyond hospital discharge. The purpose of this constructivist grounded theory study is to understand and develop theoretical propositions on factors that patient’s perceive influence the process of recovery from critical illness in order to inform more comprehensive patient care management strategies.

Semi-structured interviews were conducted with 17 participants admitted to an ICU. All interviews were audio-recorded and transcribed verbatim. Data collection and analysis occurred concurrently using the constant comparative method. Data were analysed initially with line-by-line coding, then focused coding. Initial codes were …

Validity And Reliability Of The Clinician Rated Drop Vertical Jump Scale In Patients Following Anterior Cruciate Ligament Reconstruction, Morgan Jennings

Electronic Thesis and Dissertation Repository

The purpose of this study was to evaluate the validity and reliability of the Clinician Rated Drop Vertical Jump Scale (CR-DVJS) in a population of patients following anterior cruciate ligament reconstruction (ACLR). Patients completed two drop vertical jump tasks at 6 and/or 12-months post-operative. One task was recorded using a motion capture system. Four individuals of varying clinical experience served as raters for the CR-DVJS. Rater scores of valgus collapse did not correlate strongly with motion capture measures of knee abduction moment or angle. However, CR-DVJS scores of trunk and knee flexion did demonstrate an association with 3D measures of …

Functional And Skeletal Muscle Impairments In Progressive Diabetic Ckd, Daniel Bittel

Arts & Sciences Electronic Theses and Dissertations

1-in-3 persons with type 2 diabetes (T2DM) develop chronic kidney disease (CKD), which is characterized by progressive renal dysfunction leading to end-stage renal disease. In response to elevated blood glucose and systemic inflammation of diabetes, a process of active thickening of the renal glomerular basement membrane ensues with concomitant damage to the structural supports (podocytes) of the kidneyճ filtration barrier. This results in impaired renal filtration. The metabolic sequelea of T2DM and CKD also, synergistically, alter skeletal muscleճ degradative pathways, satellite cell function (muscle reparative cells), and mitochondrial health (muscle energetic machinery) -- resulting in muscle breakdown, poor muscle quality, …

Effects Of Resistance Exercise On Postprandial Metabolism In Obese Men With Prediabetes, Adam Bittel

Arts & Sciences Electronic Theses and Dissertations

Prediabetes is a metabolic condition defined by elevated fasting (impaired fasting glucose (IFG)) and/or postprandial (impaired glucose tolerance (IGT)) glucose. Prediabetes affects nearly 86 million adults in the United States, with most (up to 70%) progressing to type 2 diabetes within as little as one year. Recent studies have indicated that elevated post-prandial glycemia and hypertriglyceridemia are early indicators of prediabetes, and are major risk factors for complications of prediabetes, including cardiovascular disease (CVD), stroke, elevated blood pressure, and obesity. Resistance exercise is a central component of exercise recommendations for individuals with type 2 diabetes and prediabetes, but the effect …

Change In Bone Mineral Density Among High Frequency Apheresis Blood Donors, Walter Bialkowski

Dissertations (1934 -)

Exposure to citrate anticoagulant during apheresis blood donation induces significant decreases in serum ionized calcium with subsequent perturbations to parathyroid hormone, vitamin D, and markers of bone remodeling. Cross-sectional studies of bone mineral density (BMD) among apheresis donors exhibit conflicting results. Resolving the potential impact of the highest apheresis donation frequency represents a significant knowledge gap in ensuring adequate protections for volunteer apheresis blood donors. ALTRUYST (NCT02655055) was a randomized, longitudinal, controlled clinical trial designed to determine if repeated exposure to citrate through apheresis donation reduces BMD. Male donors, 18-65 years of age with no more than five previous apheresis …

Well-Being And Readiness To Change Among Career Firefighters, Elizabeth R. Feinauer

Morehead State Theses and Dissertations

A thesis presented to the faculty of the College of Science, Morehead State University in partial fulfillment of the requirements for the Degree Master of Arts by Elizabeth R. Feinauer on June 12, 2018.

Effect Of Adding Stretching Techniques To Standardized Intervention On Nonspecific Mechanical Neck Pain, Saad S. Alfawaz

Loma Linda University Electronic Theses, Dissertations & Projects

Mechanical neck pain is becoming one of the leading causes of musculoskeletal disorders in the general adult population. Mobilization intervention is considered one of the most effective therapeutic techniques to treat non-specific neck pain. The purpose of this study was to investigate the benefit of adding stretching exercises as part of a rehabilitation program for patients with non-specific mechanical neck pain. Methods: Thirty-eight subjects with non-specific neck pain for at least 2 weeks with mean± SD age 30.9±8.1 years and body mass index (BMI) 26.8±6.7 kg/m2 participated in the study. Participants were randomly assigned to either the combined intervention (passive …

Investigating The Effects Of Trans-Spinal Direct Current Stimulation On The Expression Of Nkcc1 In Mice, Pasindu Weliwaththage

Student Theses

Trans-spinal direct current stimulation (tsDCS) is a non-invasive powerful tool demonstrated to positively affect behavior and motor function. tsDCS is a neuromodulatory technique capable of altering spinal and cortical excitability and even regain motor function after complete motor paralysis (Cortes et at, 2017). tsDCS causes immediate and long-term effects in spinal excitability (Ahmed, 2011, 2013; Ahmed and Wieraszko, 2012; Cogiamanian et al., 2011, 2012). Studies have been conducted on both healthy and injured subjects. The ultimate goal is to ameliorate the devastating effects of Spinal Cord Injury. Though researchers have been successful in improving motor function, the molecular basis of …

Patellofemoral Joint Stress During Uphill And Downhill Running In Healthy, Theresa French, Brooks Klein, Young Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Subjects: Twenty recreational runners participated (mean age of 24.9 years). Methods: Kinematics and kinetics of the trunk and lower extremity were obtained at 3 conditions: level, 6° uphill, and 6° downhill, at a speed of 2.3 m/s. PFJ stress was determined using a biomechanical model that incorporates knee flexion angle and knee extensor moment as subject-specific input variables. The model output consisted of PFJ reaction force, PFJ stress, and PFJ contact area. One-way ANOVAs with repeated measures and post-hoc t-tests with a Bonferroni adjustment were used to compare outcome variables across the 3 conditions. Results: Peak PFJ stress during downhill …

The Moderation Effect Of Bdnf Genotype And Self-Reported Habitual Physical Activity Levels On Age Of Onset, Disease Progression, And Postural Instability In Parkinson's, Kyle Johnson, Danielle Salgo, Jessica Zorn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Brain-derived neurotrophic factor (BDNF) levels have been reported to play an important role in driving neuroprotection in people with neurologic disorders, and levels of BDNF are known to increase in response to physical activity. Moreover, the level of BDNF produced is also affected by BDNF genotype. It is not known, however, whether one’s BDNF genotype interacts with physical activity throughout life to affect a neuroprotective response in people with Parkinson’s disease (PD). Therefore, the purpose of this study was to determine if BDNF genotype interacts with lifetime self-reported physical activity levels to affect disease severity and progression …

The Influence Of Socioeconomic Factors On Fear Of Falling And Mobility Outcomes After Lower Limb Loss: A Preliminary Study, Tyler Chin, Heather Fox, Juan Gutierrez Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with …

Successful Patient Participation In Acute Hospital Physical Therapy, Jesse Kim, Joseph Fertitta, Patrick Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Research has demonstrated that physical therapy plays a crucial role in patient recovery in the acute hospital setting. Despite known benefits, scheduled sessions do not always occur and are called nontreatment (NT) events. Reported NT ranges from 15% to 26% of scheduled sessions. Previous studies have found an association between NT and patient diagnosis as well as between NT and day of the week on which treatment was scheduled. Identifying additional factors that affect NT is important if therapists and administrators are to make improvements. The purpose of this study is to determine if an association exists between physical …

Investigation Of The Cardiovascular Endurance Of Dance Majors, Arnold Huang, Ali Ross, Kelsey Taelour, Geneva Winters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: College dancers have demonstrated low levels of cardiovascular endurance compared to other athletes, which could be one of the factors that leads to more fatigue and injuries during performance. The effects of an education session on cardiovascular endurance and on college dancers’ attitudes towards cardiovascular exercise outside of dance class have not been previously studied. Purpose: The purpose of this study was to use the accelerated three-minute step test to compare lower level and upper level college dancers’ cardiovascular endurance before and 2 months after an education session emphasizing fitness and exercise. Additionally, assessed were the dancers’ attitudes towards …

Neuromuscular Adaptations Following Slope Walking In Individuals Post-Stroke, Eric Akoopie, Brooke Conway Kleven, Trisha Koch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The excitability of the H-reflex pathway in the non-impaired nervous system can be augmented by altering the different parameters of a walking task, specifically slope. We sought to examine the adaptations in soleus H-reflex excitability and foot force control following an acute bout of upslope or downslope treadmill walking in people post-stroke compared to those who are non- impaired. Methods: We recruited 12 individuals with chronic post-stroke hemiparesis and 9 age-similar non- neurologically impaired individuals. Each subject was tested over 2 sessions separated by at least 7 days. For each session, subjects walked at a self-selected walking speed on …

Immediate Effects Of Cervical Spine Thrust Joint Manipulation On Gait Parameters In Individuals With Neck Pain, Marc Anthony D. Albano, Emily Blok, Beau Gronert, Ryan Masuda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypotheses: 1. To investigate for any change in gait parameters in individuals with neck pain while walking with different functional neck conditions immediately following cervical thrust joint manipulation (TJM) versus a sham intervention. 2. To investigate any association between Global Rating of Change (GROC) scores and gait parameters immediately following cervical thrust joint manipulation versus a sham intervention. The hypotheses were that, a) cervical TJM would have an immediate effect on gait parameters during walking with the neck in at least one of three conditions (neutral, flexion/extension and rotation) among individuals with neck pain; and b) higher scores on the …

The Effect Of Standardized Photodocumentation On Coding Of Pressure Injuries, Brandon Bales, Alex Preciado, Angela Sandoval

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure injuries (PI) are prevalent and costly for hospitals. Hospitals implement different practices to accurately document PIs ranging from pen and paper to photodocumentation in electronic medical records (EMRs). In some instances, PIs that have been documented are not coded for billing and reporting. The purpose of this study is to determine if different documentation practices affect the number of coded PIs. Methods: Counts of coded PIs were collected from 2011- 2017 from two hospitals: a 500-bed acute care hospital (ACH) and a 42-bed acute rehabilitation hospital (ARH). A series of PI documentation practices were implemented over …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes Of Paraspinal Muscle Performance After Lumbar Multifidus Intramuscular Fine Wire Electrode Insertion, Anthony Duong, Vincent Dinglasan, Russell Totten

UNLV Theses, Dissertations, Professional Papers, and Capstones

STUDY DESIGN: Case control study. BACKGROUND: Recurrent low back pain (RLBP) is associated with paraspinal muscle dysfunction. Intramuscular electromyography (EMG) is a common tool for studying activation of the deep lumbar paraspinal muscles such as multifidi muscles, but it is currently currently unclear how muscle performance and activation are affected by the pain and micro-injury associated with intramuscular fine-wire electrode (IFWE) insertion and how it interacts with the presence of RLBP. OBJECTIVES: The purpose of this study was to examine how IFWE insertion into the lumbar multifidus affects paraspinal muscle strength and endurance in subjects with and without RLBP. METHODS: …

Reliability And Validity Of Using A Mobile Application To Asses Knee Valgus In Healthy And Post-Anterior Cruciate Ligament Reconstruction Participants, Brenda Benson Deaver, Tyrel Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To examine the reliability and validity of using a movement analysis application (MAA) to measure knee valgus angle during three functional activities used to assess return-to-sport after ACL reconstruction (ACLR). Design: Reliability and validity study Setting: University laboratory Participants: Twelve ACLR participants with a non-contact mechanism of injury and 20 healthy individuals. Independent Variables: Each subject performed single-leg drop landing, single-leg hop, and 90º cut with simultaneous 3-dimensional (3D) motion capture and video recording in the frontal plane on an iPad. Main Outcome Measures: Peak knee valgus angle during the landing phase of each task was measured using a …

Effects Of Two High-Frequency Physical Therapy Programs On Balance, Gait, Fatigue, And Quality Of Life In People With Multiple Sclerosis, Min Liu

Theses & Dissertations

Multiple sclerosis (MS) is an inflammatory disease involving the inflammation and demyelination in both brain and spinal cord. MS typically affects people in early adulthood in the range of 20-40 years old, and most patients with MS experience symptoms on a daily basis, such as walking difficulties, balance impairment, and fatigue, which can be disabling and impact the Quality of Life (QOL).

The main purpose of this investigation is to determine if our novel, adaptive, high-frequency physical therapy protocol, compared with the conventional therapeutic exercise protocol, has the potential to improve participants’ dynamic balance, gait, fatigue, and overall QOL based …

Physical Therapy Review Of Best Practices Based On Psychology, Bethany Painter

Honors Projects

Physical therapy is a field that is growing and changing constantly. For so long, it was assumed that physical healing should be the sole focus of physical therapy. While this is an important aspect of the rehabilitation process, there is so much more to it than that. The psychological trauma a person may experience following an injury can be just as challenging, if not more challenging to overcome than the physical repercussions of the injury. For this reason, it is important to take psychological healing into consideration, as well as physical healing when creating best practices for physical therapists. The …

Predicting And Preventing Common Volleyball Injuries With Functional Tests, Madison Marshall

Honors Theses

The purpose of this thesis is to provide a compilation of screening tests best suited for predicting and preventing volleyball’s most common injuries. Research displays a gap in knowledge pertaining to volleyball-specific injury prevention tests. A literary analysis was completed for information regarding; correct volleyball techniques, incorrect techniques that are commonly observed, common injuries resulting from faulty technique, and tests best designed to prevent these injuries. It was found that knees and ankles were the two joints most often injured. These injuries mainly occurred during the landing phase of the jumping-landing sequence. Therefore, ankle and knee injury rates were higher …

Facilitating Emotional Regulation In Adults With Developmental Disabilities Through Person-Centered Play Therapy, Otis Kemutambah

Honors Theses

Adults with developmental disabilities may employ maladaptive behaviors that stem from limited opportunities to interact with their community and non-nurturing interactions within their environment. This literature review explores the effects of play on maladaptive behaviors and provides a rationale that supports the use of PCPT to improve this population’s emotional regulation skills. More specifically, the sources indicate that activities containing exercise and games, improves the emotional regulation skills of this population. Based on the presented information, created cost effective activities will potentially improve these skills amongst adults with developmental disabilities. These activities that adhere to PCPT are basketball, water basketball, …

Patients Attitudes On Alternative Approaches To Chronic Pain Management, Morgan Beede

Thinking Matters Symposium Archive

The topic of chronic pain and pain management continues to be heavily discussed by healthcare providers today. In the state of Maine, the recent limit on Opioid prescriptions raised questions regarding sustainable and alternative, long-term treatment options for patients. Many patients suffering from chronic pain are now tapering off their prescriptions and seeking alternative treatment options such as acupuncture, herbal remedies/supplements, massage, mind-body techniques, and yoga. This qualitative study was designed to explore patients attitudes on alternative treatment approaches. Seven individuals who suffer from chronic pain participated in interviews exploring their journey toward pain relief. The findings from this study …

Therapeutic Riding And Psychological Health In Older Adults, Alyssa Pattison, Craig Ashford

Thinking Matters Symposium Archive

This project explores the available quantitative and qualitative research to see if there is a link between therapeutic horseback riding and the reduction in symptoms of depression in older adults. Currently, there is a gap in evidence based research surrounding older populations with depression and therapeutic riding. However, research gathered on adolescents and adults suggest that therapeutic riding may alleviate depressive symptoms in persons over 65 years of age. Studies included in this project reveal groups of themes. The first is assessments, tools and evaluations. The second is animal assisted therapy, equine assisted therapy, therapeutic riding, and the barn environment. …

Treatment Interventions For Medial Tibial Stress Syndrome, Nathan Cook, Alexa Srolovitz

Thinking Matters Symposium Archive

Medial Tibial Stress Syndrome (MTSS) or more commonly referred to as “shin splints” is characterized as an overuse or repetitive stress injury that causes vague pain over and around the tibia. Researchers are yet to determine a definitive cause though numerous risk factors have been noted. They are as follows; over training,type of surface, poor footwear, muscular imbalances at the ankle, over tight or weak triceps surae muscles, imbalances at the thoracolumbar complex, other muscular imbalances and BMI above 30. Rehabilitation and treatment interventions often call for a pause in training entirely or at the very least an immediate scaling …