Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Dr. Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

Barriers And Facilitators To Enhance Interprofessional Education For Rehabilitation Science Graduate Students, Mary A. Riopel, Kimberly Wynarczuk, Taylor Grube

The Qualitative Report

Interprofessional education (IPE) aims to develop healthcare practitioners who work effectively in teams, demonstrate strong communication skills, respect others, and have a working knowledge of the roles and responsibilities of other professionals. Of identified research to date, it is unclear what students perceive as important for effective IPE delivery and learning. The purpose of this study was to identify graduate students' perceptions of facilitators and barriers to learning interprofessional practice using phenomenology. Three semi-structured focus groups were conducted including athletic training, occupational therapy, or speech-language pathology students and the transcripts were analyzed using thematic analysis. Four themes emerged about IPE …

The Clinical Value Of Oculomotor Assessments Across The Continuum Of Concussion, Dillon Richards

Electronic Thesis and Dissertation Repository

Concussions are complex conditions that are difficult to manage medically. Variations in symptom presentation, intricate neurophysiological processes, and the availability of a variety of possible assessment tools may contribute to this complexity. Clinicians must use a broad approach, employing both subjective symptom assessment and objective assessments to confirm a diagnosis and/or monitor progression and recovery. Oculomotor function after concussion may be an important indicator of injury, given the interconnectedness of oculomotor function, vestibulo-ocular and visual systems, and even cognition. Oculomotor function may be assessed objectively or indirectly using patient-reported symptom checklists as part of subjective assessments. One way of objectively …

Effects Of Quadruped Movement In An Individual With Chronic Stroke: A Case Study, Maureen Romanow Pascal, Emily Connell, Alyssa Pratti, Kristina Russell

Student Research Poster Presentations 2022

Background/Purpose: Neuromuscular dysfunction encompasses a wide variety of conditions that impact proper muscle functioning. One common condition resulting in neuromuscular dysfunction is a cerebrovascular accident (CVA) which can disrupt sensory, motor, visual and language systems. The resulting combination of impairments can cause limitations in activity performance and restrict participation across domains. In addition, muscle weakness is widely recognized as a major contributing factor to decline in function. Literature is showing that rehabilitation programs focusing on development of core strength with emphasis on repetition, intensity and novelty are critical for recovery of motor function. The purpose of this research was to …

The Fit-For-Purpose Model: Conceptualizing And Managing Chronic Nonspecific Low Back Pain As An Information Problem, Benedict M. Wand, Aidan G. Cashin, James H. Mcauley, Matthew K. Bagg, Gemma M. Orange, G. Lorimer Moseley

Physiotherapy Papers and Journal Articles

Chronic nonspecific low back pain (CNSLBP) is a complex and multifaceted problem. The following Perspective Piece tries to help make sense of this complexity by describing a model for the development and maintenance of persistent low back pain that integrates modifiable factors across the biopsychosocial spectrum. The Fit-for-Purpose model (FFPM) posits the view that chronic nonspecific low back pain represents a state in which the person in pain holds strong and relatively intransient internal models of an immutably damaged, fragile, and unhealthy back, and information that supports these models is more available and trustworthy than information that counters them. This …

Femoroacetabular Impingement Syndrome: Evaluating Postoperative Rehabilitation Progress And Return To Sport Readiness, Trevor A. Day

Electronic Thesis and Dissertation Repository

Femoroacetabular impingement syndrome (FAIS) is a common cause of non-arthritic hip pain and reduced physical activity in active young adults. It is defined as a motion-related disorder of the hip with a triad of symptoms, clinical signs, and imaging findings that represents symptomatic premature contact between the proximal femur and the acetabulum. There are two anatomical morphologies that can cause FAIS, cam, and pincer, and is a challenging clinical pathology. Patients typically undergo hip arthroscopy to repair damage to the joint and recess the bone causing the impingement. These procedures can result in positive outcomes for the patient, like reduced …

The Efficacy Of Resistance Training In Addition To Usual Care For Adults With Acute Burn Injury: A Randomised Controlled Trial, Paul M. Gittings, Benedict M. Wand, Dana A. Hince, Tiffany L. Grisbrook, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

Resistance training immediately after a burn injury has not been investigated previously. This randomised, controlled trial assessed the impact of resistance training on quality of life plus a number of physical, functional and safety outcomes in adults with a burn injury. Patients were randomly assigned to receive, in addition to standard physiotherapy, four weeks of high intensity resistance training (RTG) or sham resistance training (CG) three days per week, commenced within 72h of the burn injury. Outcome data was collected at six weeks, three and six months after burn injury. Quality of life at 6 months was the primary endpoint. …

Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

Cardiovascular Effects Of Exercise And Use Of Abdominal Binder In Patients Of Parkinson’S Disease With Orthostatic Hypotension, Faizan Ahmed

Electronic Thesis and Dissertation Repository

Orthostatic hypotension (OH) is a common manifestation of autonomic dysfunction in Parkinson’s Disease. It can adversely affect a patient’s functional capacity, exercise tolerance and quality of life, while increasing the risk of falls, cerebrovascular disease and overall mortality. Use of an abdominal binder (AB) can help counter OH; however, this has not been sufficiently studied in patients with Parkinson’s Disease (PwPD). Moreover, the hemodynamic effects of upper and lower extremity exercise are unclear in PwPD with OH. Although OH can impair the cerebral circulation, the consequences on the cerebral hemodynamics of wearing an AB or performing exercise are unknown in …

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …

The Nature And Consistency Of Exercise Reporting In Rehabilitation Following Rotator Cuff Repair, Dinesh Balachandran

Electronic Thesis and Dissertation Repository

Abstract

Purpose:

Rotator cuff repair is conventional surgery, and postoperative rehabilitation programs are routine. Optimization and implementation of evidence-based exercise are dependent on comprehensive reporting of intervention content and dosage. The purpose of this study is to examine the content and consistency of reporting of postoperative exercise programs following arthroscopic rotator cuff repairs.

Methods:

Keyword search of PUBMED, EMBASE, Scopus, SPORTDiscuss, AMED, CINAHL, and Cochrane were performed from January 1950 to March 2019. All the studies that discussed rehabilitation following rotator cuff repairs of human adults were included. A Proforma Consensus on Exercise Reporting Template (CERT) assessment form was used …

Quantifying The Outcomes Of A Virtual Reality (Vr)-Based Gamified Neck Rehabilitation, Shahan Salim

Electronic Thesis and Dissertation Repository

Neck pain is a major global public health concern and adds a significant financial burden to both the healthcare system as well as people suffering from it. Additionally, it presents measurement and evaluation challenges for clinicians as well as adherence challenges and treatment barriers for the patients. We have developed a virtual reality (VR)-based video game that can be used to capture outcomes that may aid in the assessment and treatment of neck pain. We investigated: (i) performance metrics of overall accuracy, accuracy based on movement difficulty, duration, and total envelope of movement; (ii) stability across sessions; (iii) accuracy across …

Hip And Trunk Muscle Activity During The Star Excursion Balance Test In Healthy Adults, Kunal Bhanot, Navpreet Kaur, Lori Thein Brody, Jennifer Bridges, David C. Berry, Joshua J. Ode

Physical Therapy Collection

CONTEXT: Dynamic balance is a measure of core stability. Deficits in the dynamic balance have been related to injuries in the athletic populations. The Star Excursion Balance Test (SEBT) is suggested to measure and improve dynamic balance when used as a rehabilitative tool.

OBJECTIVE: To determine the electromyographic activity of the hip and the trunk muscles during the SEBT.

DESIGN: Descriptive.

SETTING: University campus.

PARTICIPANTS: Twenty-two healthy adults (11 males and 11 females; 23.3 [3.8] y, 170.3 [7.6] cm, 67.8 [10.3] kg, and 15.1% [5.0%] body fat).

INTERVENTION: Surface electromyographic data were collected on …

Kinesiophobia And Its Impairment Of Successful Return To Sport After Anterior Cruciate Ligament Injury And Reconstruction, Gabrielle Boulding

Featured Student Work

The rehabilitation of an athlete after an anterior cruciate ligament (ACL) injury includes both physical and psychological barriers. One such psychological barrier is kinesiophobia, more commonly referred to as the fear of reinjury. All individuals experience some level of kinesiophobia, or fear of reinjury, related to the return to sport after ACL injury and reconstruction. Kinesiophobia can have a negative impact on an athlete’s short-term rehabilitation and long-term goals of return to sport. In many cases the fear of reinjury has been found to be one of the key reasons that an athlete does not return to sport or to …

The Tailoring Of National Guidelines For Upper Extremity Post-Stroke Rehabilitation: A Concept In Use., Salem F. Alatawi

Internet Journal of Allied Health Sciences and Practice

Background: In Saudi Arabia, national evidence-based clinical guidelines (NCG) were created based for healthcare interventions. However, clinicians appear to be slow to incorporate the evidence into practice. As a result, there exists a time-gap between the gathering and presentation of evidence for best practice and the use of that evidence by clinicians. It becomes, therefore, imperative to investigate the gap between the research evidence and clinical practice. The knowledge to action (KTA) framework is available to facilitate the implementation of research evidence. This framework incorporates the theory of tailoring, a concept that is intended to create a fit between …

Patient Experiences Of A Physiotherapy-Led Multidisciplinary Rehabilitative Intervention After Successful Treatment For Oesophago-Gastric Cancer, Annemarie Bennett, L. O'Neill, D. Connolly, E. M. Guinan, L. Boland, Suzanne Doyle, J. O'Sullivan, J. V. Reynolds, J. Hussey

Articles

Purpose To qualitatively explore the perceived impact of a 12-week rehabilitative intervention for oesophago-gastric cancer survivors on their physical, mental and social wellbeing. Methods Of the 21 participants who completed the intervention, 19 took part in a semi-structured focus group interview. Four audio-taped focus groups were held, ranging in size from two to eight participants. Focus groups were transcribed and analysed using a descriptive qualitative approach. Results At recruitment, participants were 23.5 ± 15.2 months post-surgery and all had suboptimal fitness levels. Participants reported improvements in their physical capacity and ability to carry out activities of daily living during the …

Grip And Muscle Strength Dynamometry In Acute Burn Injury: Evaluation Of An Updated Assessment Protocol, Paul M. Gittings, Dana A. Hince, Benedict M. Wand, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry.

Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum …

Expert Consensus For Respiratory Physiotherapy Management Of Mechanically Ventilated Adults With Community-Acquired Pneumonia: A Delphi Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Rationale and aims: Patients with community‐acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability in clinical practice and limited research directing best practice for this cohort. This study aimed to determine expert consensus for best physiotherapy practice for invasively ventilated adults with CAP.

Method: A modified Delphi technique involved an international expert panel completing three rounds of an online questionnaire. The initial 35‐statement questionnaire, based on a systematic literature review and survey of current clinical practice, covered physiotherapy assessment and treatment of intubated patients with …

Design And Analysis Of A 3d-Printed, Thermoplastic Elastomer (Tpe) Spring Element For Use In Corrective Hand Orthotics, Kevin Thomas Richardson

Theses and Dissertations--Mechanical Engineering

This thesis proposes an algorithm that determine the geometry of 3D-printed, custom-designed spring element bands made of thermoplastic elastomer (TPE) for use in a wearable orthotic device to aid in the physical therapy of a human hand exhibiting spasticity after stroke. Each finger of the hand is modeled as a mechanical system consisting of a triple-rod pendulum with nonlinear stiffness at each joint and forces applied at the attachment point of each flexor muscle. The system is assumed quasi-static, which leads to a torque balance between the flexor tendons in the hand, joint stiffness and the design force applied to …

Rehabilitation Of An Injured Golden Eagle (Aquila Chrysaetos): A Case Study, Fida Muhammad Khan, Fakhar-I- Abbas, Abu Ul Hassan Faiz

Journal of Bioresource Management

Habitat destruction and anthropogenic activities cause wild birds to migrate towards urban areas in search of food and sometimes nesting in high-roof buildings, where they are caught by local people using different techniques and are further used for hunting or recreational purposes. An injured Golden Eagle (Aquila chrysaetos) was found entangled in bushes near the vicinity of Balkasar Research Complex, Chakwal, Pakistan. After complete physical examination, a wound on the right wing and closed leg fracture was diagnosed. The successful treatment was done by anti-parasitic and anti-bacterial drugs with careful monitoring. Splint was adjusted after aligning the fractured …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Resistance Training For Rehabilitation After Burn Injury: A Systematic Literature Review And Meta-Analysis, P Gittings, T Grisbrook, Dale Edgar, F Wood, B Wand, N O'Connell

Physiotherapy Papers and Journal Articles

Background/aim: Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury.

Methods: Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and …

Surviving Critical Illness: What Is Next? An Expert Consensus Statement On Physical Rehabilitation After Hospital Discharge, M Major, R Kwakman, M Kho, B Connolly, D Mcwilliams, L Denehy, S Hanekom, S Patman, R Gosselink, C Jones, F Nollett, D Needham, R Engelbert, M Van Der Schaaf

Physiotherapy Papers and Journal Articles

Background: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness?

Methods: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record. A literature review determined five themes, forming the basis for Delphi round one, which was aimed at generating ideas. Statements were drafted and ranked on a 5-point Likert scale in two …

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 …

Development Of A Wearable Mechatronic Elbow Brace For Postoperative Motion Rehabilitation, Anastasiia Kyrylova

Electronic Thesis and Dissertation Repository

This thesis describes the development of a wearable mechatronic brace for upper limb rehabilitation that can be used at any stage of motion training after surgical reconstruction of brachial plexus nerves. The results of the mechanical design and the work completed towards finding the best torque transmission system are presented herein. As part of this mechatronic system, a customized control system was designed, tested and modified. The control strategy was improved by replacing a PID controller with a cascade controller. Although the experiments have shown that the proposed device can be successfully used for muscle training, further assessment of the …

Can The Nintendo Wii Be Used As A More Effective Method Of Rehabilitation Than Traditional Physiotherapy Exercises For Patients With Knee Reconstruction Surgery?, Samantha Snyder

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the Nintendo Wii can be used as a more effective method of rehabilitation than traditional physiotherapy exercises for patients with knee reconstruction surgery?

STUDY DESIGN: Review of three English language primary studies, published after 1999.

DATA SOURCES: Two randomized controlled trials (RCTs) and one case study with no comparison group were found using PubMed. These studies analyzed Nintendo Wii intervention in patients that underwent knee reconstructive surgery in need of rehabilitation.

OUTCOME MEASURED: The outcome measured was improvement in balance through use of the Activity-Specific Balance …

Eccentric Loading Of Triceps Surae Modulates Stretch Shortening Cycle Behaviour - A Possible Therapeutic Mechanism, J Debenham, W Gibson, M Travers, A Campbell, G Allison

Physiotherapy Papers and Journal Articles

Context: Eccentric exercises are increasingly being used to treat lower limb musculoskeletal conditions such as Achilles tendinopathy. Despite widespread clinical application and documented efficacy, mechanisms underpinning clinical benefit remain unclear. Positive adaptations in motor performance are one potential mechanism.

Objective: To investigate how an eccentric loading intervention influences measures of stretch-shortening cycle (SSC) behaviour during a hopping task.

Design: Within subjects repeated measures observational study.

Setting: University motion analysis laboratory.

Participants: Healthy adults. Interventions: A single intervention of 5 sets of 10 eccentric plantarflexion contractions at 6 RM using a commercial seated calf raise machine.

Main outcome measures: Lower limb …

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …

Illusory Touch Temporarily Improves Sensation In Areas Of Chronic Numbness: A Brief Communication, Benedict Martin Wand, Samantha Eve Stephens, Effie Ida Marquita Mangharam, Pamela Jane George, Max Bulsara, Neil Edward O'Connell, G Lorimer Moseley

Physiotherapy Papers and Journal Articles

Background. Creating the visual illusion of touch can improve tactile perception in healthy subjects. Objective. We were interested in seeing if creating the illusion of touch in an insensate area could improve sensation in that area. Methods. Fourteen people with chronic numbness participated in a randomized crossover experiment. The 4 conditions were the following: (a) stimulation over the unaffected limb with mirror visual feedback (experimental condition), (b) stimulation over the affected limb with mirror visual feedback, (c) stimulation over the unaffected limb without mirror visual feedback, and (d) stimulation …

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 …