Medicine and Health Sciences Commons^™

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 …

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 …

Measurement Of Illness Perception And Behaviour Along A Continuum Of Symptomatic Knee Osteoarthritis: A Transdisciplinary Approach, Clayon B. Hamilton

Electronic Thesis and Dissertation Repository

Objectives: A multifactorial approach is recommended for the identification/diagnosis, prognosis, and treatment of pain in knee osteoarthritis (OA). One aspect of this approach includes illness perception and behaviour. The purpose of this thesis was to investigate the measurement of illness perception and behaviour along a continuum of symptomatic knee OA, starting from the early symptoms of knee OA.

Methods: Three studies were conducted to fulfill this purpose. The first study was a scoping review that applied an interpretative analysis to validated measures that had been used to assess people with knee pain and/or knee OA. Second was the construct validation …

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 …

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 …

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 …

Assessment Of Physical Performance In Adolescents Of Varying Body Weight, Nicholas Dalonzo, Nicole Liquori, Nicole Savarese

Dissertations, Theses, and Capstone Projects

Fifty-one healthy adolescents of both gender without any neuromuscular, musculoskeletal or cardiopulmonary disorders and between the ages of 12 and 17 with a mean age of 14.09 years (SD: 1.45 years) were recruited to participate in the 6-minute walk test. Several measurements such as height, weight and leg length were taken before testing, along with heart rate, blood pressure and oxygen saturation (SPO2) before, after and 10 minutes post 6-minute walk test. Walk distance was also quantified and used as an outcome measure. The adolescents were divided into two groups prior to statistical testing. The first group was classified as …

Participants' Perceptions Of Factors In Preventing Falls, Rajvinder K. Bains, Jaclyn A. Fok, Nadine M. Marcelo, Tamara Vileshina

Dissertations, Masters Theses, Capstones, and Culminating Projects

Falls pose a serious threat to older adults, often resulting in physical, emotional, and financial consequences. The use of multifactorial fall prevention programs has provided community-dwelling older adults with strategies to decrease the risk of falling. Outcomes for these programs are measured in terms of such factors as fear of falling, balance and self-efficacy. One outcome of fall prevention programs that is less well understood is what the older adults themselves perceive as most beneficial. For this program evaluation project, five women participated in semi-structured interviews to understand which aspects of a multifactorial fall prevention program they found to be …

The Immediate Effects Of Cervicothoracic Manipulation Versus Stretching On Upper Trapezius Pressure Pain Thresholds And Range Of Motion In Individuals Without Neck Pain, Kevin Carr, Morgan King, Erin Oelklaus, Brendan Parry

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Myofascial pain may be considered one of the most common clinical findings in patients with neck pain (NP). Motor aspects of myofascial pain include disturbed motor function and muscle weakness secondary to motor inhibition, muscle stiffness, and restricted range of motion (ROM). Currently, it is unclear which interventions may have the greatest immediate impact on pressure pain sensitivity and ROM. Several studies have demonstrated improved pressure pain thresholds (PPT) after cervical manipulation; however, it is not clear if manipulation targeted to the cervicothoracic (CT) junction will have a similar effect. Others recommend stretching as a method to …

Comparing Usability And Variance Of Low- And High Technology Approaches To Gait Analysis In Health Adults, John Mcconnell, Brian Silverman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to compare the usability, reliability, and objectivity of four tools that represented varying gait analysis technologies used in clinical practice and/or research. Low technology clinical tools included the Gait Abnormality Rating Scale (GARS-M) and the Rancho Los Amigos Observational Gait Analysis (Rancho OGA). High technology tools included the GAITRiteÒ computerized walkway, and the APDM Mobility LabÔ wearable sensor system.

Subjects: 74 healthy adults ages 18-41 years (mean = 24.82, SD = 4.39) 33 males and 40 females.

Methods: Subjects were instructed to walk at a self-selected speed for two minutes …

Patient No-Show For Outpatient Physical Therapy: A National Survey, James Bokinskie, Payton Johnson, Trevor Mahoney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Patients who fail to show for scheduled medical appointments (no-show) create a cascade of issues for the health care system, the provider, and themselves. No-show can affect clinical productivity, cost and quality of care, and treatment outcomes. There is an overwhelming lack of research on no-show as it relates to outpatient physical therapy in the United States. The purposes of this study were to report national no-show rates, describe the presence and characteristics of no-show policies, determine the relationship of these policies and other demographic information to no-show rates, and describe the most commonly perceived reasons for no-show.

Methods: …

Comparing Functional Motor Control And Gait Parameters In Children With Autism To Those Of Age-Matched Peers Who Are Typically Developing, Patricia Stevenson, Samantha Novotny, Jillian May, Christopher Ancell

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare motor performance of children with Autism Spectrum Disorder (ASD) to that of age-matched peers who are typically developing (TD) on motor control tasks plus symmetry and variability of gait parameters across four walking conditions. A sample of convenience of children with ASD (n=6) and peers who are TD (n=6) were recruited. Motor control was assessed using initiation and completion times on the Timed Up and Go (TUG) test. Gait parameters were collected using a computerized walkway under four trial conditions: 1) walking at self-selected velocity (SSV); 2) walking during a tray-carrying task …

A Qualitative Examination Of Optimal Professional Traits Of Physical Therapists. – An Exploratory Investigation, Nicholas G. Wood

Honors College Theses

Physical therapists are constantly searching for aspects of their professional practice to improve, in order to enhance interactions with patients, eventually leading to a more successful practice (Resnek & Jensen, 2003). Although this is the case, limited research has been found which has examined optimal qualities of physical therapists from neither a qualitative perspective, nor based upon their location. Thus, the purpose of this study is to use a qualitative approach to describe optimal qualities necessary for a successful physical therapy practice. In addition, this study aims to determine if therapists practicing in a rural community describe different qualities than …

Take 2 Steps And Call Me In The Morning: Prescribing Physical Activity Through Primary Care, Emily Knight

Electronic Thesis and Dissertation Repository

Objectives: Physical activity guidelines for older adults target high-intensity activities (i.e. increasing exercise), with less attention on low-intensity activities (i.e. reducing/interrupting sedentary behaviours) to improve health. Mobile health (mHealth) holds promise for engaging patients in self-management of chronic diseases. The purpose of this research was to prescribe physical activity of various intensities (i.e. sedentary through exercise) in primary care paired with mHealth for self-management.

Methods: 60 older adults (55-75yr) were randomly assigned to four groups: one control, and three receiving mHealth kits plus prescription for a specific intensity of physical activity (exercise, sedentary or both). Clinical measures (anthropometrics, …

Outcomes Of A Comprehensive Physical Therapy Treatment Program For A 22-Year-Old Patient With Migraine Without Aura, Chronic Migraine, And Cervicogenic Type Headache: A Case Report, Katrina L. Koltz

All Capstone Projects

Background and Purpose: The purpose of this case report is to describe the interventions and outcomes of a comprehensive physical therapy (PT) treatment program that emphasized addressing musculoskeletal deficits and increasing neuromuscular control, which was theorized to decrease headache (HA) symptoms for a patient with overlapping HA diagnoses.

Case Description: The subject was a 22-year-old Caucasian female with an 8-year history of migraine without aura, chronic migraine, and cervicogenic type headaches. A comprehensive PT program was implemented to address subject’s musculoskeletal deficits, neurological impairments, and functional limitations. Assessments were performed at initial evaluation and two weeks later at re-assessment. Outcome …

Clinical Decision-Making For Discharge Recommendations For A 63 Year Old Male With Foot Drop Status Post Great Toe Amputation: A Case Report, Sigmund Ku

All Capstone Projects

Background and Purpose: Making a discharge recommendation from an acute care setting involves many factors and a coordinated team effort, and discharging a patient to an inappropriate setting can have adverse effects. Physical therapists have shown to be able to make appropriate and accurate discharge recommendations. The purpose of this case report is to apply a model of discharge decision making and analyze the results in the case of an older adult male with foot drop status post great toe amputation.

Case Description: SF was a 63-year old male with a history of Type II diabetes mellitus, alcohol abuse, and …

Brachial Plexus Injury And Benign Paroxysmal Positional Vertigo Following A Fall: A Case Report, Przemyslaw Ilczyk

All Capstone Projects

Background: In the elderly population, research has shown that impairments of balance and strength are common reasons for falls. Falls constitute one of the main reasons for emergency department and hospital admissions, and are the second most common reason for brachial plexus injury. Another common symptom, after a fall and head trauma incident, is Benign Paroxysmal Positional Vertigo (BPPV). Approximately 50% of subjects with traumatic brain injury complain about positional vertigo. Research shows that traumatic BPPV is commonly misdiagnosed in clinical practice.

Purpose: The purpose of this case report is to present interventions that were used to treat a patient …

Effectiveness Of Conservative Physical Therapy On A 17 Year Old Female Diagnosed With Legg-Calve-Perthes Disease, Bethany Hyde

All Capstone Projects

Background & Purpose: There is currently a lack of research for physical therapy as an intervention in the treatment of Legg-Calve-Perthes Disease. The purpose of this case report is to explore the effectiveness of conservative physical therapy intervention for a 17-year-old female diagnosed with Legg-Calve-Perthes Disease.

Case Description: This case report includes the examination, evaluation, and treatment of a patient with Legg-Calve-Perthes Disease. Interventions focused on increasing strength and range of motion of the left lower extremity, improving balance and proprioception, and the incorporation of functional activities. To measure the effectiveness of the intervention the following examinations where used: Lower …

Physical Therapy Interventions And Functional Outcomes For An 80-Year-Old Female Following Total Knee Replacement And Subsequent Infection: A Case Report, Hailey Corwin

All Capstone Projects

Background and Purpose: The purpose of this case study is to describe the interventions and outcomes of a physical therapy (PT) episode of care in an inpatient skilled nursing facility (SNF) for a subject following a left total knee replacement and subsequent infection.

Case Description: The subject was an 80-year-old Caucasian female who was status post left total knee replacement (TKR) with subsequent infection. The subject presented with left knee pain, limited range of motion (ROM), and impaired function.

Outcomes: Increased active range of motion (AROM) of left knee, increased balance, increased ambulation distance, improved performance on Tinetti-POMA, and increased …

Clinical Decision-Making In Transition To Consultative Physical Therapy Services For A Nine-Year-Old Girl With Spastic Hemiplegic Cerebral Palsy: A Case Report, Gina M. Kelly

All Capstone Projects

Background: Although many pediatric patients with non-progression conditions utilize rehabilitation services, clear pathways towards transitioning away from direct service aren’t adequately addressed in the literature. A number of established frameworks for clinical and ethical decision making can be utilized.

Purpose: The purpose of this case report is to illustrate the application of established frameworks in the literature to a particular case of a nine-year-old female patient with mild spastic hemiplegic cerebral palsy receiving weekly home-based physical therapy services, in which the ultimate decision was to reduce services, highlighting the utility and limitations of such an application.

Case Description: This case …

Implementation Of A Land And Aquatic-Based Physical Therapy Program For A 6-Year-Old Male With Aicardi-Goutieres Syndrome: A Case Report, Kristin A. Cheney

All Capstone Projects

Background & Purpose: There is little research surrounding Aicardi-Goutieres Syndrome (AGS) in all aspects of patient care, including physical therapy. AGS, a rare, early-onset, neurodegenerative disorder, includes symptoms of postnatal microcephaly, spasticity, muscle hypotonia, and developmental delay. The purpose of this study was to examine the effectiveness of a land and aquatic-based physical therapy treatment program for improving functional limitations and balance for a 6 year-old male referred to physical therapy for developmental delay secondary to an onset of AGS.

Case Description: This case study included a land and aquatic-based physical therapy treatment program focused on neuromuscular re-education, strengthening exercises, …

Effects Of Early Physical Therapy Intervention In The Rehabilitation Of A Total Hip Arthroplasty Revision With An Anterior Approach: Case Report, Jordan Clevy

All Capstone Projects

Advances in medical technology have greatly changed the way surgeons perform surgical procedures. The push by surgeons and their patients for less invasive surgeries has caused surgeons to turn to an anterior approach for total hip arthroplasty and revisions of total hip arthroplasty. The less invasive nature of the anterior approach has led to faster recovery time and less pain. Nearly all total hip arthroplasty and revision patients will receive physical therapy services to guide and assist the patient in a steadfast recovery. This case study explores the results of functional physical therapy interventions on an 80 year old female …

Piecing The Puzzle Together With The Use Of Physical Therapy, Mikayla Pruitt

Honors Projects

For my Honors Project I decided to create a set of exercise cards for children with autism. The front of each card had a picture symbolizing the exercise/activity, and on the back included directions, supplies and tips to complete the activity. The following is a selection of a few exercise cards from each of the four exercise sections, as well as the title card, table of contents cards, information cards, and source cards.

Characterizing Knee Loading Patterns In People Post-Stroke, Stephanie Marrocco

Electronic Thesis and Dissertation Repository

Post-stroke temporal gait asymmetry (TGA) could cause excess loading of the non-paretic leg which may cause musculoskeletal (MSK) issues in the knee. This thesis investigated knee loading during gait and its relationship to TGA post-stroke. Methods: Gait analysis was conducted in nine people post-stroke. Gait was classified as symmetric (TGS) or asymmetric and external knee adduction (KAM) and flexion moments (KFM) were calculated. Participants were compared to healthy older adults (n=109) on KAM and KFM. The proportion of individuals with increased loading was compared between the TGS and TGA groups. Results: Six and four participants exhibited increased loading …

Mirror Therapy For The Lower-Extremities Post-Stroke, Lucas David Crosby

Electronic Thesis and Dissertation Repository

Despite extensive rehabilitation post-stroke gait remains slow, variable and asymmetric. There is a need for simple interventions to improve lower-extremity motor control and walking ability. Mirror therapy is a promising intervention though little attention has focused on its use on the lower-extremities post-stroke. This thesis investigates the feasibility and potential effects of a bilateral lower-extremity mirror therapy intervention (LE-MT) post-stroke. A case series involving three participants, who performed twelve 30 minute sessions of LE-MT over four weeks, is presented. Session duration and number of repetitions completed improved over the course of the intervention indicating LE-MT post-stroke is feasible. Some cases …

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. …

Implications Of Huntington's Disease On Daily Living: An Educational Tool And Guide For Occupational Therapists Treating Individuals With Huntington's Disease, Jacquelin Jones, Megan Thompson

Occupational Therapy Capstones

Huntington’s disease (HD) is a neurodegenerative disease that can cause stress on the individual as well as their family members and caregivers. Due to the rareness of Huntington’s disease (HD), it is common that professionals are often at a loss when treating patients who have it. Dawson et al. (2004) discussed the need for individualized and client-centered care for those individuals diagnosed with HD, as well as providing practical supports for those diagnosed and their families. Furthermore, a major challenge to assessment and intervention is the complexity of the symptoms present with HD. Etchgary (2011) found in her study that …

Patellofemoral Pain Syndrome: A Case Report, Angela Kumm

Physical Therapy Scholarly Projects

Background and purpose. Patellofemoral pain syndrome (PFPS) is a common injury among young female athletes. It is difficult to determine the primary factor that contributes to its development due to the fact that there are multiple causes. Factors influencing the development of PFPS are increased quadriceps (Q) angle, patella alta, abnormal or excessive foot pronation, quadriceps muscle weakness, diminished flexibility of the hamstrings and rectus femoris muscles, malalignment of the femur, weakness of the hips, static and dynamic skeletal malalignment, and altered neuromuscular recruitment strategies.

Case Description. The patient was a young female collegiate track and cross country …