Medicine and Health Sciences Commons^™

Use Of Core Stabilization Exercise And Medical Exercise Therapy In The Treatment Of A Patient With Chronic Post Partum Low Back Pain: A Case Report, Zachary Chaloner, Kirsten Buchanan

Case Report Posters

Low back pain and lumbar hyper-mobility are common during and after pregnancy. Chronic postpartum low back pain (LBP) can be difficult to manage. Core stabilization exercises (CSE) have been shown to improve function and reduce pain in patients with chronic LBP due to lumbar instability. Medical Exercise Therapy (MET) has shown good outcomes in reducing pain in patients with LBP but has not been thoroughly investigated in the treatment of chronic post partum LBP. There is limited research reporting the use of a combined treatment protocol utilizing CSE and MET in the treatment of chronic LBP in postpartum women. The …

Multimodal Physical Therapy Management Of A Patient With Unilateral Neglect Post-Stroke In An Outpatient Setting: A Case Report, Meghan Riley

Case Report Papers

Background and Purpose: Unilateral neglect (ULN) syndrome negatively affects recovery post-stroke and is often associated with falls, longer stays in rehabilitation, and the need for more assistance at discharge. Typical physical therapy treatments include voluntary trunk rotation, visual scanning exercises, mirror therapy, hemispheric activation, sensory awareness training, and lower extremity loading but the efficacy of these treatments is still unclear. The purpose of this case report is to describe multimodal physical therapy (PT) management that includes common PT interventions to alleviate symptoms of ULN and report upon the outcomes of the various treatment methods for rehabilitation of neglect during functional …

Acute Care Outcome Measures In A Patient Status-Post Right Total Knee Arthroplasty (Tka) Following A Left Tka Staged Five Weeks Apart: A Case Report, Stephanie Sanderson

Case Report Papers

Background and Purpose: Total knee arthroplasty (TKA) is one of the most frequently performed orthopedic procedures in the U.S. Thousands of people undergo TKA every year in hopes of improving their functional abilities and reducing their pain levels. The purpose of this case report was to document acute care outcome measures in a patient who underwent bilateral TKA staged five weeks apart and to assess the possible implications that a short staging period might have on the patient’s ability to recover. Case Description: The patient was a 58-year-old male who following a left TKA underwent a right TKA, secondary to …

A Progressive Physical Therapy Plan Of Care For A Patient With Charcot-Marie-Tooth Disease Following Myocardial Infarction: A Case Report, Paige Blasco

Case Report Papers

Background and Purpose: Charcot-Marie-Tooth disease (CMT) is a neuromuscular disease that leads to distal muscle atrophy, weakness, and sensory loss. Myocardial infarction (MI) is often a result of coronary artery disease, which has an incidence rate of 34.6% in men over 80. While rehabilitation practices for CMT and MI have been described separately, there is a paucity of research investigating physical therapy (PT) interventions for patients who have both health conditions. The purpose of this case report was to investigate the PT management of a patient with CMT following an acute MI in the acute and sub-acute care settings. Case …

Clinical Reasoning And Intervention Selection For A Patient With Lower Extremity Weakness Following Acute Alcoholic Polyneuropathy: A Case Report, Sarah Uzel

Case Report Papers

Background and Purpose: Acute alcoholic polyneuropathy (AAP) can present with a variety of symptoms including paresthesia and paralysis. There is little literature relating to physical therapy management and interventions for a patient with AAP. It is unclear what constitutes the best medical management and physical therapy practices for these patients. The purpose of this case report was to describe the clinical reasoning behind interventions selected for a patient with AAP in the acute setting. Case Description: The patient was a 33 year old male, who was diagnosed with AAP after two days in acute care. Intervention during the first two …

Evaluation And Treatment Of A Patient Diagnosed With Adhesive Capsulitis Classified As A Derangement Using The Mckenzie Method: A Case Report, Ashley Bowser

Case Report Papers

Background/Purpose: The McKenzie Method of mechanical diagnosis and therapy (MDT) is supported in the literature as a valid and reliable approach to spine injuries. It can also be applied to the peripheral joints, but has not been explored through research to the same extent. This method sub-classifies an injury based on tissue response to mechanical loading and repeated motion testing with repeated motions identified during testing used to guide treatment. The purpose of this report is to demonstrate the assessment, intervention, and clinical outcomes of a patient classified as having a shoulder derangement using MDT methodology. Case Description: The patient …

Strength And Balance Exercises To Improve Functional Outcomes And Mobility For A Patient With Parkinson’S Disease And Co-Morbidities: A Case Report, Nicholas Lasarso

Case Report Papers

Background and Purpose: Parkinson’s disease (PD) is a movement disorder that can lead to declines in function and falls. As a common age-related neurological diagnosis, PD is most often accompanied by other co-morbidities. The purpose of this case report is to document the physical therapy management of a patient presenting with PD and other co-morbidities. This case report looks at the outcomes of strength and balance exercises on the patient’s impairments, mobility and overall function. Case Description: The 69 year-old male patient presented with a history of PD, Lyme disease, osteoarthritis, peripheral neuropathy (PN) and exposure to Agent Orange. He …

Use Of Core Stabilization Exercise And Medical Exercise Therapy In The Treatment Of A Patient With Chronic Post Partum Low Back Pain: A Case Report, Zachary Chaloner

Case Report Papers

Background and Purpose: Low back pain and lumbar hyper-mobility are common during and after pregnancy. Postpartum low back laxity can contribute to LBP and can become chronic if not addressed. Core stabilization exercises (CSE) have been shown to improve function and reduce pain in patients with nonspecific chronic low back pain due to lumbar instability. Additionally, Medical Exercise Therapy (MET) has shown good outcomes in reducing pain in patients with LBP but has not been thoroughly investigated in the treatment of chronic post partum LBP. There is limited research reporting the use of a combined treatment protocol utilizing CSE and …

A Task Oriented Approach For A Patient With Chronic Effects Of Stroke: A Case Report, Sarah Richardson

Case Report Papers

Background and Purpose: Stroke is the leading cause of serious long-term disability for American adults. Most stroke survivors receive physical therapy (PT), and task-oriented rehabilitation is one novel approach known to benefit stroke survivors. The purpose of this case report is to illustrate the outcomes of a task-oriented approach to PT interventions on a patient >12 months post stroke. The unique aims were to 1) outline possible benefits in function from repetitive task-oriented training techniques and 2) document outcomes of a patient who had received PT services >12 months post stroke. Case Description: The patient was an 82 year-old female …

Rehabilitation And Cancer Survivorship, Matthew Denning, Samantha Fisk, Alyssa Grigware, Mary Leopold, Erika Lopez, Margaret Masiak, Sebastian Stoltzfus, Ashley Tomaswick

Disease Prevention and Health Promotion Resources

Presentation given at Central Maine Medical Center on December 4, 2015, to build awareness of the role of rehabilitation services in cancer survivor management and discuss strategies to address existing needs. This presentation was based on a project undertaken to determine which physical distress screening tools are most appropriate to trigger a wellness or rehabilitation referral when it is warranted for a survivor. The use of effective screening tools will assist in directing cancer survivors, who experience physical and emotional burdens caused by the disease and subsequent treatment, to access services that will continue to improve their overall quality of …

A Three-Week Intensive Pediatric Physical Therapy Plan Of Care For A Child With Spastic Quadriplegia Cerebral Palsy: A Case Report, Brandie Schmierer, Kirsten Buchanan

Case Report Posters

The benefits of physical therapy (PT) on gross motor function and general strength in children with spastic quadriplegia cerebral palsy (CP) are well documented. There have been no firm conclusions that have determined the optimal duration and intensity of PT interventions for patients with spastic quadriplegia CP. CP occurs as a result of a brain injury associated with birth. Worldwide the prevalence of CP was 1.5 to 3.0 per 1,000 live births in 2009. Previous research demonstrated that PT intervention in children with CP improved gross motor function and strength, decreased the assistance required for mobility, and decreased step length …

Acute Care Outcome Measures In A Patient Status-Post Right Total Knee Arthroplasty (Tka) Following A Left Tka Staged Five Weeks Apart: A Case Report, Stephanie Sanderson

Case Report Posters

Total knee arthroplasty (TKA) is one of the most frequently performed orthopedic procedures in the U.S. Osteoarthritis (OA) is the most common reason for a total knee arthroplasty. Cartilage and bone is removed from the distal end of the femur and proximal end of the tibia and is replaced with metal alloy components that recreate the joint surface. Some evidence suggests that staging bilateral TKA within three months of each other may increase the patient’s risk for mortality and complications. The purpose of this case report was to document acute care outcome measures in a patient who underwent bilateral TKA …

Evaluation And Treatment Of A Patient Diagnosed With Adhesive Capsulitis Classified As A Derangement Using The Mckenzie Method: A Case Report, Ashley Bowser, Brian T. Swanson

Case Report Posters

The McKenzie Method of mechanical diagnosis and therapy (MDT) is supported in the literature as a valid and reliable approach to spine injuries. It can also be applied to the peripheral joints, but has not been explored through research to the same extent. A previous case series detailed the use of MDT in the shoulder; however, the application of MDT in the treatment of adhesive capsulitis has not been previously reported in the literature. The purpose of this report is to demonstrate the assessment, intervention, and clinical outcomes of a patient diagnosed with adhesive capsulitis, who was classified as having …

Primary Care Fall Risk Assessment For Elderly West Virginians, Vivian M. Minkemeyer, Matt Meriweather, Franklin D. Shuler, Saurabh P. Mehta, Zain N. Qazi

Orthopaedics

West Virginia is ranked second nationally for the percent of its population .65 years of age. The elderly are especially susceptible to falls with fall risk increasing as age increases. Because falls are the number one cause of injury-related morbidity and mortality in the West Virginia elderly, evaluation of fall risk is a critical component of the patient evaluation in the primary care setting. We therefore highlight fall risk assessments that require no specialized equipment or training and can easily be completed at an established office visit. High quality clinical practice guidelines supported by the American Geriatric Society recommend yearly …

A Review Of Transcranial Magnetic Stimulation And Multimodal Neuroimaging To Characterize Post-Stroke Neuroplasticity, Angela M. Auriat, Jason L. Neva, Sue Peters, Lara A. Boyd

Physical Therapy Publications

Following stroke, the brain undergoes various stages of recovery where the central nervous system can reorganize neural circuitry (neuroplasticity) both spontaneously and with the aid of behavioral rehabilitation and non-invasive brain stimulation. Multiple neuroimaging techniques can characterize common structural and functional stroke-related deficits, and importantly, help predict recovery of function. Diffusion tensor imaging (DTI) typically reveals increased overall diffusivity throughout the brain following stroke, and is capable of indexing the extent of white matter damage. Magnetic resonance spectroscopy (MRS) provides an index of metabolic changes in surviving neural tissue after stroke, serving as a marker of brain function. The neural …

Faculty And Student Perceptions Of A Physical Therapy Professional Behavior Mentoring Program, Ethel Frese, Cheryl Cavallo, Kelly Hawthorne, Ginge Kettenback, Barbara Yemm

Internet Journal of Allied Health Sciences and Practice

Purpose: Mentoring is a process and a relationship between a novice and an expert that fosters intellectual, personal, and professional growth. The purposes and scope of this article are to describe 1) the structured professional development component of a comprehensive mentoring program for students in a physical therapy program; and 2) the perceptions of faculty and students regarding this mentoring program. Method: Faculty and students completed electronic questionnaires developed specifically for each group. Results: Return rate was 54.50% (N=286) for physical therapist students and 100% (N=18) for physical therapy faculty. Student positive ratings regarding the mentoring program exceeded 89.00%. Additionally, …

Inter-Rater Reliability Of The Mckenzie System Of Mechanical Diagnosis And Therapy In The Examination Of The Knee, Sean Willis

Electronic Thesis and Dissertation Repository

Objective: The purpose of this thesis was to investigate the inter-rater reliability of the McKenzie System of Mechanical Diagnosis and Therapy (MDT) when classifying patients with musculoskeletal knee pain using clinical vignettes. Methods: This study was divided into two phases. First, ten clinicians experienced in the use of MDT were randomly recruited to write a total of 60 clinical vignettes based upon the initial assessment of past patients with knee pain. Second, six different MDT raters were recruited to rate 53 selected vignettes and reliability was determined using Fleiss Kappa. Results: There was “substantial agreement” among six MDT raters …

Effect Of Early Mobilization Programs In The Intensive Care Unit (Icu). A Review Of Systematic Reviews, Rondamarie Smith, Stephanie Pelham, Nicholas Higa, Ann M. Wilson

Physical Therapy Research Symposium

Title: Effect of Early Mobilization Programs in the Intensive Care Unit (ICU). A Review of Systematic Reviews

Authors: Nicholas C. Higa, SPT1; Stephanie J. Pelham, SPT1; Rondamarie B. Smith, SPT1; Ann Wilson, PT, M.Ed., GCS.1

Affiliation(s): 1. Physical Therapy Program, University of Puget Sound;

Purpose: To determine the effect of early mobilization on reducing the side effects associated with prolonged bed rest of patients in the ICU.

Materials & Methods: CINAHL, The Cochrane Library, PEDro and PubMed were searched between April 2015 to August 2015 to identify systematic reviews published from 2000 to 2015 with the keywords “ambulation,” “critical care,” …

Physical Therapy Clinical Instructor Self-Reported Evidence-Based Practice Use, Debra Bierwas, Joan Leafman, Lisa Wallace, Donald Shaw, Steven Fehrer

Internet Journal of Allied Health Sciences and Practice

Introduction: Evidence-based practice is a required component of student physical therapist education. Practice applying the five steps of evidence-based practice to patient care (formulate question, retrieve evidence, appraise evidence, integrate evidence, evaluate outcomes), most effectively performed during clinical education, must occur for students to become proficient. Clinical instructor use of evidence-based practice is essential to assure that student physical therapist practice occurs during clinical education. Purpose: The purpose of this study was to assess self-reported evidence-based practice use by physical therapy clinical instructors and examine whether an association exists between professional characteristics and evidence-based practice use. Methods: This study …

Church Pew Exercise Integrated With Conventional Physical Therapy Following Total Knee Arthroplasty (Tka): Case Report, Randell Gonzales, Jerome Danoff

Internet Journal of Allied Health Sciences and Practice

Background and Purpose: Physical therapy treatment following Total knee Arthroplasty (TKA) consists of a combination of strengthening and range of motion exercises. The exercise technique, church pew exercise (CPE), has been proposed to enhance quadriceps facilitation and improve function. This is a technique that has the patient standing and rocking forward/back. The backward motion is arrested by engagement of the upper calf against a solid object, creating a sudden flexion torque at the knee and a sudden extension torque at the hip. The combination of CPE with standard physical therapy is claimed to provide better quadriceps control and faster walking …

A Description Of Current Curricular Design Models Used In Physical Therapy Clinical Education And Their Relationship To Pass Rates On The National Physical Therapy Examination, Chalee Engelhard, Christine Mccallum

Internet Journal of Allied Health Sciences and Practice

Purpose. The purpose of this study was to develop descriptions and identify commonalities of current clinical education models used in physical therapy programs; then, using this information, to examine differences in first-time and ultimate pass rates among the derived formula from Commission on Accreditation in Physical Therapy Education (CAPTE) accredited programs in 2011-2013. Methods. This mixed methods study captured qualitative and quantitative data from the 204 PT programs located in the United States and Puerto Rico from 2011 to 2013. The data were coded into 11 different clinical education models which represented all programs. The models were then linked to …

A Randomized Clinical Trial To Compare The Effect Of Non Operative Treatment With And Without Autologous Conditioned Plasma (Acp) On Healing And Function In Patients With Achilles Tendon Ruptures, Tyler M. Pratt

Electronic Thesis and Dissertation Repository

The purpose of this study was to determine whether there is evidence to support conducting a larger randomized control trial (RCT) to compare the non-operative treatment of Achilles tendon (AT) ruptures with or without Autologous Conditioned Plasma (ACP®). Twenty-four patients were randomized to receive an ACP® or saline injection within seven days and again at two weeks post-rupture. Tendon healing was longitudinally evaluated using ultrasound (US) and magnetic resonance imaging (MRI). Functional and patient-reported quality of life measures were also assessed. A small sample size limited our ability to detect statistically significant differences. The mean rankings of healing were slightly …

Physical Therapy After Triangular Fibrocartilage Injuries And Ulnar Wrist Pain, Mohamed A. Abdelmegeed

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The ulnar side of the wrist has been referred to as the “black box” of the wrist because of its complex structures and sophisticated anatomy, disorders at this anatomical site have been compared to those of low back pain

Purposes: The purpose of this study was to apply the Brief International Classification of Functioning (ICF) Core Set for Hand Conditions to the physical therapy outcome measures, and to evaluate the contribution of these measures to overall health in subjects with ulnar wrist pain. A secondary purpose was to investigate the effect of wrist orthotics and strengthening exercise on …

Cross-Cultural Adaption And Psychometric Properties Testing Of The Arabic Anterior Knee Pain Scale, Abdullah S. Alshehri

Loma Linda University Electronic Theses, Dissertations & Projects

Patellofemoral pain syndrome (PFP) is a common condition affecting the musculoskeletal system and has a tendency of becoming chronic and is problematic in the affected people. It is the commonest cause of anterior knee pain. In over 2/3 of the patients affected it has been successfully treated through the use of rehabilitation protocols which are designed in pain reduction and returning the functionality to an individual. Many cases of patellofemoral pain syndrome can be avoided only if a clinician can make a pre-diagnosis. Preparation Screening Evaluation testing done by a certified athletic trainer can also help in prevention of this …

Stability Study: A Multicentre Rct Comparing Acl Reconstruction With And Without Lateral Extra-Articular Tenodesis For Individuals At High Risk Of Graft Failure, Christopher Eric Hewison

Electronic Thesis and Dissertation Repository

Seventy patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) were randomly assigned to receive ACLR alone or ACLR plus a lateral extra-articular tenodesis (LET). Our primary outcome was Limb Symmetry Index (LSI) calculated using a series of four hop tests at six months postoperative. Secondary outcomes measures included pain, subjective function and isokinetic strength testing. We found no statistically significant difference between the two groups in LSI calculations. We found statistically significant differences favouring the ACLR alone group in quadriceps average power and peak torque symmetry measurements at six-months postoperative when we adjusted for baseline measurements. No other statistically significant …

Shoulder External Rotator Eccentric Training For Subacromial Pain Syndrome, Eric Chaconas

Physical Therapy Collection

Background and Purpose: Rotator cuff weakness has been associated with subacromial pain syndrome (SAPS). The purpose of this study was to determine the effect of eccentric training, isolated to the shoulder external rotators, on strength, strength ratios, range of motion, upper quarter balance, pain, perceived function and global change.

Methods: Forty-Four participants, 19 females (mean age 46), with greater than 3 months of shoulder pain were randomized into two groups. The experimental group performed an external rotator eccentric training exercise (ETER) for three sets of 15 and a scapular retraction exercise, with a resistance band, for 2 sets of 10, …

Reliability Of The Berg Balance Scale As A Clinical Measure Of Balance In Community-Dwelling Older Adults With Mild To Moderate Alzheimer Disease: A Pilot Study, Susan W Muir-Hunter, Laura J. Graham, Manuel Montero Odasso

Physical Therapy Publications

Purpose : To measure test-retest and interrater reliability of the Berg Balance Scale (BBS) in community-dwelling adults with mild to moderate Alzheimer disease (AD).

Method : A sample of 15 adults (mean age 80.20 [SD 5.03] years) with AD performed three balance tests: the BBS, timed up-and-go test (TUG), and Functional Reach Test (FRT). Both relative reliability, using the intra-class correlation coefficient (ICC), and absolute reliability, using standard error of measurement (SEM) and minimal detectable change (MDC95) values, were calculated; Bland-Altman plots were constructed to evaluate inter-tester agreement. The test-retest interval was 1 week.

Results : For the BBS, relative …

Stability Of Isometric Strength Asymmetry And Its Relationship To Sprint And Change-Of-Direction Performance Asymmetry In Division-I Collegiate Athletes, Benjamin H. Gleason

Electronic Theses and Dissertations

The purpose of this dissertation was to evaluate the stability of strength asymmetry over a long-term period (1 year) and investigate the relationship of strength asymmetry to field test performance asymmetry in NCAA division-1 athletes. Isometric mid-thigh pull (IMTP) peak force asymmetry, ground contact time and finish time asymmetries on 10m sprint and 505 agility test performances were also observed. The impact of strength was also investigated in these studies to determine its effect on the magnitude of asymmetry.

In the second study, peak force asymmetry over a one-year period was observed to be a rather volatile quality, with ranges …

A Comparison Of The Scapular Flip Test Between Women With Breast Cancer And Healthy Controls, Mary Insana Fisher, Lucinda Pfalzer, Ellen W. Levy, Shana Harrington, Lynn H. Gerber, Nicole L. Stout

Mary Insana Fisher

Presentation at the World Confederation for Physical Therapy Congress, held May 1-4, 2015, in Singapore. Background: The Scapular Flip test was designed to screen for spinal accessory nerve palsy. The spinal accessory nerve can be damaged in breast cancer surgery and treatment, resulting in scapular dyskinesis and upper limb (UL) impairment in women with breast cancer (BC). This test could be useful to screen for UL impairment in BC. Purpose: The purpose of this study was to describe shoulder impairments as defined by a positive Flip Test in a group of women with BC at baseline, 1-3 months, and 12+ …

Commentary: Considering Educational Perspectives And Their Relevance To Allied Health Professional Education: Using Physical Therapy As An Example, Jennifer Audette, Susan Roush

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this article is to introduce readers to three educational perspectives: progressive, critical, and professional, and explain their relevance to allied health professional education. Faculty in allied health professional education are often solely educated as clinicians and not as teachers, entering academia with limited background in educational theory. Professional organizations and accrediting bodies, however, are highlighting the need for evidence and theory-based pedagogy and practice in educational settings. Method: An overview of three educational perspectives is provided, as is a discussion of their relevance to allied health professional education, using physical therapist education as an example. Conclusion: …