Medicine and Health Sciences Commons^™

The Effects Of A Novel Therapeutic Intervention In Diabetic Peripheral Neuropathy Patients, Adel M. Alshahrani

Loma Linda University Electronic Theses, Dissertations & Projects

Diabetes mellitus (DM) is a common disorder affecting individuals in the United States and in the world. The prevalence of DM has increased noticeably over the last three decades with an estimated 380 million people currently diagnosed with this disease. DM is associated with numerous systemic complications that affect the retina, heart, brain, kidneys, and nerves. The most common complication of DM is diabetic peripheral neuropathy. Diabetic peripheral neuropathy causes reduced sensation, reflexes, proprioception, and strength in lower limbs that leads to balance problems. Various manual therapy techniques have not approached a pilot study for the efficacy of a manual …

The Effect Of Cervical Muscle Fatigue On Postural Stability During Immersion Virtual Reality, Mazen M. Alqahtani

Loma Linda University Electronic Theses, Dissertations & Projects

The visual system is part of the nervous system that enables an individual to scan their environment and assess distance to and from objects. The information captured form our navigating environment is communicated to the brain, which in turn makes the decision on how we respond to spatial orientation. This is particularly useful in helping with balance and determining direction of movement. Our posture and visual stability rely heavily on an efficient and processing of visual, vestibular, and proprioception afferent input. Erroneous sensory information from defective sensory organs may cause a person to experience feelings of lightheadedness, spinning and whirling …

Effect Of Tactile Feedback On Reducing Body Sway In Elderly, Faris Shuleih Alshammari

Loma Linda University Electronic Theses, Dissertations & Projects

Context: Body sway increases in the elderly due to normal aging and a high incidence of disease such as diabetes. Increased body sway is associated with an elevated risk of falling. Falling is one of the major causes of morbidity and mortality in the elderly. Objectives: The purpose of this study was to examine the effect of 6 minutes training of tactile feedback (novel intervention) compared to visual feedback on body sway in the elderly with or without diabetes to develop a new technique for balance training. Design: A single blinded randomized controlled trial. Setting: Loma Linda University, Loma Linda, …

Effect Of Tai Chi Exercise Combined With Mental Imagery In Improving Balance, Abdulrahman Alsubiheen

Loma Linda University Electronic Theses, Dissertations & Projects

Background: One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects feet sensation and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Methods: Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 50-80 years of age were recruited. All subjects in both groups attended a Yang style of TC class, two sessions per week for 8 weeks. Each session was one hour long. Measures …

Muscle Dynamics As The Result Of Whole Body Vibration And Plyometrics, Richard Jeremy Hubbard

Loma Linda University Electronic Theses, Dissertations & Projects

BACKGROUND: Whole body (WBV) vibration and plyometrics are common training techniques which increase strength, blood flow, force and power. The effects these techniques have on sedentary population is unknown. It is our aim to assess the effectiveness of WBV and plyometrics on sedentary population. SUBJECTS: Three groups of nine sedentary subjects were assigned to either the control group (C), jumping only group (J), or jumping with vibration group (JV). METHODS AND PROCEDURES: Measurements included: jump height (Myotest or Vertec), velocity, force, blood lactates, gastrocnemius and quadriceps strength, and exertion (RPE). Subjects were measured at the first, seventh, and eighteenth visits. …

Nutrition Students’ Perception Of Osce & Its Effect On Perceived Readiness To Clinical Placement, Elaf Farahat

Loma Linda University Electronic Theses, Dissertations & Projects

Objective: Explore nutrition and dietetic students’ perception of the educational value of Objective Structured Clinical Examinations (OSCE) and to examine the change in their perceived readiness to practice after completing three OSCEs.

Participants: Students from the Schools of Public Health (SPH) and Allied Health Professions (SAHP) enrolled in Medical Nutrition Therapy course, mean age 26.6±5.4 years, 95% females (n=37).

Methods: Mixed-method sequential exploratory design. Three focus group discussions (11 participants) were conducted as part of the qualitative phase to elicit themes related to perception of OSCE as an education tool. In the quantitative phase, a pre-post test design …

Cortical Mechanisms Of Human Pelvic Floor Muscle Synergies, Skulpan Asavasopon

Loma Linda University Electronic Theses, Dissertations & Projects

The human pelvic floor is an anatomically, functionally, and morphologically complex region that is associated with many disorders such as chronic prostatitis/pelvic pain syndrome (CPPS), chronic low back pain, and urinary incontinence. The purpose of this dissertation was to explore the cortical mechanisms that underlie human pelvic floor muscle synergies. Our first original experiment involved the study of 20 healthy male controls who were instructed to perform a variety of muscle tasks presumed to be associated with pelvic floor muscle synergies. Surface electromyography (EMG) method was used to detect timing onsets, as well as activation patterns of the pelvic floor, …

Effect Of 17Β Estradiol & Foot Strike Patterns On Physiological & Biomechanical Changes In Runners, Iman Akef Khowailed

Loma Linda University Electronic Theses, Dissertations & Projects

It is well established that female runners are at a significantly increased risk of incurring injuries when compared to their male counterparts. Gender-specific factors such as anatomical, hormonal, and altered neuromuscular activation patterns have been implicated as causative factors. An association have been observed between hormonal fluctuation and ACL injury risk indicating potentially hormonal effect on both passive and dynamic knee stabilizer.

A growing contingency believes that we were designed with all we need in our feet to be able to run with minimal shoes that mimic barefoot running striking pattern. Habitual barefoot runners tend to FFS, compared to habitually …

Humor's Effect On Short-Term Memory In Older Adults: An Innovative Wellness Paradigm, Gurinder Singh Bains

Loma Linda University Electronic Theses, Dissertations & Projects

Context: With ageing, the detrimental effects of stress can impair the ability to learn and sustain memory. Humor and the associated mirthful laughter can reduce stress by decreasing the hormone cortisol. Chronic release of cortisol can damage hippocampal neurons leading to impairment of learning and memory. Objectives: To examine the effect of watching a humor video on short term memory in older adults. Design: A randomized, controlled trial. Setting: Loma Linda University, Loma Linda, CA. Participants: 30 subjects: 20 normal healthy, older adults, 11 males and 9 females; 10 Type 2 Diabetic older adults, 6 males and 4 females. Intervention: …

Screening For Torticollis And Plagiocephaly: The Role Of The Pediatrician, Lisa Ann Change-Yee Hwang

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine the effects of providing a standardized screening examination to a group of attending and resident physicians on the rate of torticollis and plagiocephaly diagnoses, the age at time of diagnosis, and the attitudes and practice patterns of the physicians. All subjects were given a standardized screening procedure by verbal instruction and handout, and also completed a pre-­‐ and post-­‐intervention questionnaire, which assessed the 􀂕􀂗􀂄􀂌􀂇􀂅􀂖􀂕􀇯􀀃 practice regarding the diagnosis and management of torticollis and plagiocephaly. A retrospective chart review was conducted to ascertain the changes in frequency and mean age of patients diagnosed …

Effect Of Monophasic Pulsed Current On The Treatment Of Plantar Fasciitis, Abdullah Alotaibi

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Plantar fasciitis (PF) is one of the most common soft tissue disorders that causes inferior heel and rear foot pain. Monophasic pulsed current (MPC) is a method of electrical stimulation (ES) clinically used to promote and accelerate wound healing processes. The aim of this prospective clinical trial was to investigate the effect of MPC and MPC coupled with plantar fascia specific stretching exercises (SE) in the treatment of PF. Methods: Forty four participants (twenty- two subjects were women; 22 were men with a mean age of 49 ± 10.6 years) diagnosed with PF were randomly allocated to receive MPC …

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 …

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 …

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 …

Stress, Depression, Quality Of Life, And Language Recovery In Constraint Induced Aphasia Therapy (Ciat), Brian Sharp

Loma Linda University Electronic Theses, Dissertations & Projects

Traditional aphasia treatment approaches focus initially on restoration of language, but quickly move to use of alternative modes of communication when progress is slow. Constraint Induced Aphasia Therapy (CIAT), a more intensive form of treatment, is based on the concept of frequent, long sessions and forced use of the impaired language system. Prior to the present study, the relationship between CIAT and stress had not been explored; therefore, this study compared cortisol stress levels and improvement of language skills in two groups of subjects, all of whom presented with expressive aphasia. Ten subjects participated in CIAT, and received 10 days …

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 …

The Efficacy Of Melodic Based Communication Therapy For Eliciting Speech In Nonverbal Children With Autism, Givona A. Sandiford

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this dissertation is to compare the efficacy of Melodic Based Communication Therapy (MBCT) to traditional speech and language therapy for eliciting speech in nonverbal children with autism. Efficacy was assessed by number of: verbalizations, correct words, words reported by parent, and imitative attempts. Additionally it examines the effect of exposure to MBCT on social language abilities as measured by score on the Pragmatic Language Skills Inventory (PLSI); the effect of age on the response to treatment, and the predictors of overall effectiveness of treatment.

Participants were 12 nonverbal children with autism ages 5 through 7 randomly assigned …

The Efficacy Of Melodic Based Communication Therapy For Eliciting Speech In Nonverbal Children With Autism, Givona A. Sandiford

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this dissertation is to compare the efficacy of Melodic Based Communication Therapy (MBCT) to traditional speech and language therapy for eliciting speech in nonverbal children with autism. Efficacy was assessed by number of: verbalizations, correct words, words reported by parent, and imitative attempts. Additionally it examines the effect of exposure to MBCT on social language abilities as measured by score on the Pragmatic Language Skills Inventory (PLSI); the effect of age on the response to treatment, and the predictors of overall effectiveness of treatment. Participants were 12 nonverbal children with autism ages 5 through 7 randomly assigned …

Postural Sway, Eeg And Emg Analysis Of Hip And Ankle Muscles During Eight Balance Training Tasks, Yuen Yi Florence Tse

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine postural sway, cortical response and muscle activation of the hip and ankle muscles during eight balance tasks routinely used in sensorimotor training. This was a single group repeated measure study. The postural sway; the power of alpha, beta and sigma wave bands; and the EMG activity of gluteal maximus, gluteal medius, tibialis anterior and medial gastrocnemius were measured in 17 subjects during eight balance tasks with eyes open or closed, feet in tandem or apart and on foam or a firm surface. The results of this study showed that postural sway, EEG …

Co-Diagnosis Frequency Of Peripheral Vestibular Disorders And Physical Therapy, Summer M. San Lucas

Loma Linda University Electronic Theses, Dissertations & Projects

Dizziness is among the most common reasons that people consult a physician. The two most common causes of dizziness related to peripheral vestibular dysfunction are benign paroxysmal positional vertigo (BPPV) and vestibular hypofunction (VH). Physical therapy (PT) is an effective component of the medical management for both conditions. The occurrence rate of concurrent BPPV and VH in the same patient has not been described in the literature. Identifying patients with co-diagnosis of BPPV and VH will allow the PT to construct a proper treatment sequence. We conducted a retrospective chart review of 500 consecutive medical records of Veteran's Administration male …

Effect Of A Single High-Fat Meal And Vitamins On The Circulatory Response To Local Heat In Koreans And Caucasians, Jongeun Yim

Loma Linda University Electronic Theses, Dissertations & Projects

Blood flow mediated by the vascular endothelium plays an important role in removing heat from the skin. Asians who have thrifty genes have impaired endothelial function (EF) due to the westernized high fat (HF) dietary lifestyle. Hypertriglyceridemia (HTG) can produce free radicals which reduces the bioavailability of the endothelium derived relaxing factor, nitric oxide (NO). EF, as measured by the blood flow response (BFR) to heat, occlusion and the free radical concentration after a single HF meal has not been studied in Korean-Asians compared to Caucasians. The purpose of this study was to evaluate baseline and postprandial EF as related …

Delayed Onset Muscle Soreness In People With Diabetes; Biomarkers And Nutritional Supplementation, Hani H. Al-Nakhli

Loma Linda University Electronic Theses, Dissertations & Projects

Exercise is important for controlling hemoglobin A1c, and maintaining proper glycemic control in people with diabetes. Exercise also increases the diabetics overall insulin sensitivity, and decreases their dependency on diabetes medication. However, people with diabetes are faced with metabolic and endothelial impairment, which could result in a prolonged sensation of muscle soreness following exercise. This would make it difficult for these people to sustain exercise regimes. Delayed-onset muscle soreness (DOMS) is a common problem in healthy individuals and in people who have diabetes. DOMS is a painful sensation experienced by individuals who have been recently inactive and then over-exercise. Yet, …

Effects Of Neck Muscle Fatigue On The Vestibulo-Ocular Reflex, Amer Al Saif

Loma Linda University Electronic Theses, Dissertations & Projects

In order to maintain balance, the brain receives and processes input from multiple sensory systems including the visual, vestibular, and somatosensory systems. The information from these systems is sent to the brain where the information is then combined, organized and interpreted. This results in the output of reflexes (vestibulo-ocular reflex [VOR] and vestibulospinal reflex [VSR]). The VOR and the VSR work together with other motor systems to control gaze stability and control whole body equilibrium. Impairment in any of these sensory systems can result in dizziness, loss of balance, and visual instability. While the contributions of the visual, vestibular, and …

Integrating The Development Of Children And Gestalt Therapy, Jennifer J. Thompson

Loma Linda University Electronic Theses, Dissertations & Projects

There are many theories that have contributed to what we know about the development of children; for instance, theoretical diversity supports the complexities of human nature. A child's developmental level will impact his ability to relate. Gestalt theory supports the child's phenomenological view by focusing on the here-and-now of what is happening in the therapeutic environment. Most of what a child will do is in response to a need or want. The child will work toward fulfilling that need. The child may develop maladaptive ways to fulfill his needs based on the environment in which he lives. Gestalt play therapy …

Virtual Reality Gaming As A Tool For Rehabilitation In Physical Therapy, Abel A. Rendon

Loma Linda University Electronic Theses, Dissertations & Projects

Balance control decreases in the elderly and currently 33 to 50 percent of people over 65 years of age experience a fall each year resulting in ten thousand deaths annually. Many balance‐training programs use expensive equipment and a clinical setting for the training. The need for reliable and low cost tools is essential for fall prevention and rehabilitation of the aging population. Virtual reality gaming is emerging as a solution for this problem. The purpose of the six week study was to determine the effects of virtual reality gaming, specifically the Nintendo Wii Fit Balance Board (WBB), on dynamic balance …

Aerobic Exercise And Bone Turnover In Trained And Untrained Premenopausal Women, Michelle Prowse

Loma Linda University Electronic Theses, Dissertations & Projects

Regular weight-bearing exercise is recommended for healthy young adults to optimize bone mineral density (BMD) (Physical Activity Guidelines Advisory Committee, 2008). BMD alone however, is not a significant predictor of osteoporosis or fracture risk. While bone turnover markers are used clinically to assess efficacy of pharmacological intervention in individuals diagnosed with osteoporosis, they may also have a role in evaluating acute responses to exercise. The purpose of this dissertation was to compare two groups of premenopausal women, those which are sedentary (low fitness) versus those that are well-trained (high fitness), by BMD and bone turnover markers at rest and the …

Effect Of 3-Electrode Electrical Stimulation On Current Delivery And Healing In Chronic Wounds, Hyejin Suh

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic wounds have been an enormous burden on the healthcare system due to their prevalence and the lack of efficacy of current treatment modalities. Over the years, electrical stimulation (ES) has been widely used in the treatment of wounds. Unfortunately, the effectiveness of this treatment is under scrutiny, since many studies have failed to report successive and/or consistent effects of ES on wound healing. This inconsistency may be due to the uneven current produced by the conventional 2-electrode delivery system (2-channel ES) and the reduced resting blood flow resulting from thermally cool treatment rooms. In this study, a new approach …

Response Of Endothelial Cells To Stressors: The Impact Of Aging And Diabetes, Katie Mclellan

Loma Linda University Electronic Theses, Dissertations & Projects

Preliminary research indicates there is some impairment of the endothelial cells to respond to single stressors such as local heat, shear stress, and global heat in older people and people who have diabetes. The response of the skin blood flow to local heat is an indicator of the endothelial cells ability to cope with stress. In addition, factors such as thicker subcutaneous fat and skin moisture may impair the skin’s ability to dissipate heat. For older people and people with diabetes, this endothelial dysfunction may cause an even more diminished response to multiple stressors. However, no studies have examined the …

Is Electrical Stimulation A Predictive Tool For Autonomic Dysfunction In Males With Diabetes?, Susan Dorothy Rand

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine whether electrical stimulation can be used as a predictive tool to assess autonomic dysfunction in males with diabetes. The study was designed to better understand the extent of autonomic nervous system (ANS) dysfunction in the diabetic population.

Controls and patients with diabetes were recruited from the community at large and the Loma Linda University Diabetes Treatment Center and were managed by a physician. Twelve (12) people with diabetes and thirteen (13) control subjects participated. Mean age (years) for people with diabetes was 52.4 +/- 6.1 and 47.2 +/-11.1 for controls (p =0.05). …

Physiological Effects Of Vibration In Select Populations, Colleen S. Maloney-Hinds

Loma Linda University Electronic Theses, Dissertations & Projects

Recently, researchers have demonstrated that Whole Body Vibration results in significant increases in skin blood flow. No study has determined if there is an optimal frequency or duration for optimizing this response. In addition, there is no known mechanism for the increase in skin blood flow. It is hypothesized that nitric oxide (NO) is responsible for the increase in skin blood flow due to its ability to vasodilate the smooth muscle in response to shear stress. Therefore, the purpose of this research was to determine the optimal frequency and duration of vibration and determine if NO is the mechanism for …