Medicine and Health Sciences Commons^™

The Recovery Index Of Oxygen Saturation From Orthostatic Syncope In Patients With Spinal Cord Injury, David S. Liu, Alice M. K. Wong, Shih-Ching Chen, Kang-Ping Lin, Chien-Hung Lai, Walter H. Chang

Rehabilitation Practice and Science

Orthostatic hypotension (OH) is a common clinical problem for patients with spinal cord injury (SCI) at the cervical or high thoracic level when they move from the supine position to the upright position. Patients with severe SCI frequently suffer from symptoms of OH during head-up tilt, ranging from slight lightheadedness to full syncope. Tilt-table training is commonly used in clinical physiotherapy to overcome OH syncope, but this also relies on carefully manual control of the tilt angle and training time by the therapist during training. Up till now, it still has no method to estimate the recovery process of OH …

Combining Therapeutic Ultrasound And Breast Massage For Plugged Ducts: Three Casereports, Yu-Chun Lee, Xiu-Yong Hong, Chin-Teng Chung, Wei-Chih Chen, Hui-Mi Liu, Si-Wa Chan

Rehabilitation Practice and Science

Plugged ducts are a common problem during lactation. They often occur when the breast is not emptied properly, or when there is local pressure on the breast. Plugged ducts usually occur three to four weeks postpartum. Symptoms include a sensitive lump with well-defined margins in the breast. There may be pain and tenderness in the affected area, although this is not necessarily accompanied by systemic symptoms such as high-grade fever. Milk flow can be blocked and sometimes a tiny white spot can be seen at the opening of the mammary duct on the nipple. Without treatment, plugged ducts can lead …

The Impact Of Left Hemisphere Stroke On Force Control With Familiar And Novel Objects: Neuroanatomic Substrates And Relationship To Apraxia, Amanda M. Dawson, Laura J. Buxbaum, Susan V. Duff

Physical Therapy Faculty Articles and Research

Fingertip force scaling for lifting objects frequently occurs in anticipation of finger contact. An ongoing question concerns the types of memories that are used to inform predictive control. Object-specific information such as weight may be stored and retrieved when previously encountered objects are lifted again. Alternatively, visual size and shape cues may provide estimates of object density each time objects are encountered. We reasoned that differences in performance with familiar versus novel objects would provide support for the former possibility. Anticipatory force production with both familiar and novel objects was assessed in six left hemisphere stroke patients, two of whom …

Reliability Of Measuring Abductor Hallucis Muscle Parameters Using Two Different Diagnostic Ultrasound Machines, Wayne A. Hing, Keith Rome, Alyse F. M. Cameron

Wayne Hing

Background: Diagnostic ultrasound provides a method of analysing soft tissue structures of the musculoskeletal system effectively and reliably. The aim of this study was to evaluate within and between session reliability of measuring muscle dorso-plantar thickness, medio-lateral length and cross-sectional area, of the abductor hallucis muscle using two different ultrasound machines, a higher end Philips HD11 Ultrasound machine and clinically orientated Chison 8300 Deluxe Digital Portable Ultrasound System.

Methods: The abductor hallucis muscle of both the left and right feet of thirty asymptomatic participants was imaged and then measured using both ultrasound machines. Interclass correlation coefficients (ICC) with 95% confidence …

Clinically Applicable Paper: Land-Based Versus Pool-Based Exercise For People Awaiting Joint Replacement Surgery Of The Hip Or Knee: Results Of A Randomized Controlled Trial, Cheryl Rudisile-Smith, Marissa Loosli, Jason Brumitt

Faculty Publications - College of Physical Therapy

Landbased versus pool-based exercise for people awaiting joint replacement surgery of the hip or knee: results of a randomized controlled trial

Observation Of Amounts Of Movement Practice Provided During Stroke Rehabilitation, Catherine E. Lang, Jillian R. Macdonald, Darcy S. Reisman, Lara Boyd, Teresa Jacobson Kimberley, Sheila M. Schindler-Ivens, T. George Hornby, Sandy A. Ross, Patricia L. Scheets

Physical Therapy Faculty Research and Publications

Objective

To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

Design

Observational survey of stroke therapy sessions.

Setting

Seven inpatient and outpatient rehabilitation sites.

Participants

We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

Interventions

Not applicable.

Main Outcome Measures

We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were …

The Effect Of Early Contextual Learning On Student Physical Therapists’ Self-Perceived Level Of Clinical Preparedness, Kevin E. Brueilly, T. Kirk Nelson, Tamara Gravano, Penny G. Kroll

Physical Therapy Faculty Research

Context: Students in health care often describe their feelings of self-inadequacy in clinical skills and report these feelings abate with experience.

Objective: To determine whether early contextual learning experiences can improve entry-level student physical therapists’ self-perceived level of clinical preparedness.

Design: A pair-wise comparison of pre vs. post intervention. Survey of students self-perceived level of clinical preparedness before and after a series of three planned small group contextual learning experiences involving the assessment of actual hospital patients.

Setting: Academic institution and associated medical center

Participants: Thirty-nine first-year student cohort in the 10th month of a 36-month entry-level Doctor of Physical …

Adding Gabapentin To A Multimodal Regimen Does Not Reduce Acute Pain, Opioid Consumption Or Chronic Pain After Total Hip Arthroplasty, H. Clarke, S. Pereira, D. Kennedy

PT Faculty Publications

Background: Gabapentin (GPN) is effective in reducing post-operative pain and opioid consumption, but its effects with regional anesthesia for total hip arthroplasty (THA) are not known. We designed this study to determine whether (1) gabapentin administration reduces pain and opioid use after THA using a multimodal analgesic regimen including spinal anesthesia; (2) pre-operative administration of gabapentin is more effective than post-operative administration. Methods: After REB approval and informed consent, 126 patients were enrolled in a double-blinded, randomized-controlled study. Patients received acetaminophen 1 g per os (p.o.), celecoxib 400 mg p.o. and dexamethasone 8 mg intravenously, 1-2 h pre-operatively. Patients were …

Evaluation Of The Effect Of Patient Education On Rates Of Falls In Older Hospital Patients: Description Of A Randomised Controlled Trial, Anne-Marie Hill, Keith Hill, Sandra Brauer, David Oliver, Tammy Hoffmann, Christopher Beer, Steven Mcphail, Terry P. Haines

Tammy Hoffmann

Background: Accidental falls by older patients in hospital are one of the most commonly reported adverse events. Falls after discharge are also common. These falls have enormous physical, psychological and social consequences for older patients, including serious physical injury and reduced quality of life, and are also a source of substantial cost to health systems worldwide. There have been a limited number of randomised controlled trials, mainly using multifactorial interventions, aiming to prevent older people falling whilst inpatients. Trials to date have produced conflicting results and recent meta-analyses highlight that there is still insufficient evidence to clearly identify which interventions …

What Education Do Stroke Patients Receive In Australian Hospitals?, Tammy Hoffmann, Tammy Cochrane

Tammy Hoffmann

Objective: This study evaluated the educational practices of staff working in acute stroke wards in Australian hospitals, including the coordination and methods of patient education provision, postdischarge education and support services available, and the education and support services that health professionals would like to provide.

Methods: Health professionals who worked in acute stroke wards in Australian hospitals were surveyed about the stroke education practices of staff in their ward. Thirty-four hospitals returned a completed questionnaire via email or fax.

Results: Verbal communication and written materials were the most frequently used methods of information provision. Twenty-three (67.6%) wards developed their own …

Handbook On Sensitive Practice For Health Care Practitioners: Lessons From Adult Survivors Of Childhood Sexual Abuse, Candice L. Schachter, Carol Stalker, Eli Teram, Gerri C. Lasiuk, Alanna Danilkewich

Lyle S. Hallman Social Work Faculty Publications

This handbook is the culmination of a multiphase, multidisciplinary research project that used grounded theory and participatory action research to illuminate ways that healthcare providers can work sensitively (in a trauma-informed way) with adult survivors of childhood sexual abuse.

The research identified nine Principles of Sensitive Practice: respect, rapport, taking time, sharing information and control, respecting boundaries, fostering mutual learning, understanding non-linear healing and demonstrating an understanding of trauma to patients. Specific guidelines were developed for a wide variety of issues pertinent to clinical practice such as, removal of clothing, touch, responding to disclosures of abuse, managing triggers among others. …

Use Of Aquatic Therapy/Core Stabilization And A Multi-Disciplinary Treatment For A Patient With Chronic Low Back Pain: A Case Report, Jesse Elis

Physical Therapy Scholarly Projects

Background and Purpose: This case report describes the use of two different conservative treatment approaches on a patient suffering from chronic nonspecific low back pain. The case report illustrates the difference between aquatic therapy/core stabilization, which focuses on the biological aspect of the injury, and multi-disciplinary treatment, which treats the injury on a biopsychosocial level.

Case description: The patient was a 32-year old man that suffered two disc herniations from lifting a large box at work. After the injury, the patient received conservative treatments 3 months prior to this specific case report. Neurological deficits were present and the patient had …

Outpatient Physical Therapy Management Of A Patient Who Is Status Post Right Lunate: Open Reduction Internal Fixation With Hardware Removal: A Case Report, Jaime Garness

Physical Therapy Scholarly Projects

Background and Purpose: This case report follows a 20 year old male through his five week out patient rehabilitation for an open reduction internal fixation (ORIF) pinning of his right lunate and subsequent hardware removal following a motor vehicle accident. The patient presented with pain, decreased strength and range of motion of his right wrist. A deficit was also identified in his right shoulder stemming from decreased use of his right upper extremity. The reason for this case study is to look into benefits of physical therapy interventions as well as their functional outcomes.

Interventions: Patient warmed up on …

Respiratory-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Spinal cord injury can affect normal breathing. The level of your injury will determine the effect it will have. It can be different for everyone. For example, the higher the level of your injury, the more complications you may face. Good pulmonary care can assist in keeping you healthy after your spinal cord injury.

Normal

The process of breathing (or respiration) is a two-step process: taking in air (inspiration) and exhaling the waste products. The process of taking in air (inhalation) is an active process, requiring the use of many muscles, while the process of exhaling is a passive …

A Randomized Trial Comparing Digital Video Disc With Written Delivery Of Falls Prevention Education For Older Patients In Hospital, Anne-Marie Hill, Steven Mcphail, Tammy Hoffman, Keith Hill, David Oliver, Christopher Beer, Sandra Brauer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Objectives: To compare the effectiveness of a digital video disc (DVD) with that of a written workbook delivering falls prevention education to older hospital patients on self-perceived risk of falls, perception of falls epidemiology, knowledge of prevention strategies, and motivation and confidence to engage in self-protective strategies. To compare the effect of receiving either education approach versus no education on patients' perception of falls epidemiology.

Design: Randomized trial (DVD vs workbook) with additional quasi-experimental control group.

Settings: Geriatric, medical, and orthopedic wards in Perth and Brisbane, Australia.

Participants: One hundred (n=51 DVD, n=49 workbook) hospital inpatients aged 60 and older …

A Return To Running Program For The Postpartum Client: A Case Report, Jason Brumitt

Faculty Publications - College of Physical Therapy

The purpose of this case report is to present a return to running program for a postpartum client who had delivered via cesarean section. The client, a 29-year-old female health care professional who was 8 months postcesarean section, was referred to physical therapy for a return to running exercise program. The client had three live births during a 30-month time period (February 2004 to August 2006). During her last labor she underwent an emergency cesarean section because of a low fetal heart rate. Since her surgery the client had not participated in an exercise routine. Following an 8-week training program …

Clinical Report: Land-Based Versus Pool-Based Exercise For People Awaiting Joint Replacement Surgery Of The Hip Or Knee: Results Of A Randomized Controlled Trial, C. Rudisile-Smith, M. Loosli, J. Brumitt

Faculty Publications - College of Physical Therapy

Background: Individuals with either knee or hip osteoarthritis are at risk of experiencing pain and developing functional limitations (Bennell 2005). In many cases, to alleviate pain and improve one's quality of life, an individual may require a total joint replacement. Despite advances in surgical technique and joint replacement hardware, surgical procedures are not without risk. Conservative treatments, including therapeutic exercise programmes, may improve a patient's status while avoiding the potential risks associated with surgery (pain, medication utilisation, long bouts of rehabilitation, and/ or death). Researchers have demonstrated that some patients may experience improvements in pain and functional abilities after participating …

Table Of Contents-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Table of Contents for entire Spinal Cord Injury Manual.

(31 pages, 445Kb)

Acute Physical Therapy Management Of Pediatric Patient With Traumatic Brain Injury, Michelle Holt

Physical Therapy Scholarly Projects

Background and Purpose: Traumatic brain injury can cause many deficits including decreased balance and coordination. The purpose of this case report is to describe the interventions used and subsequent outcomes for a pediatric patient following traumatic brain injury in the acute care setting. Also, this case report serves to describe the methods and tools used in a hospital that is not equipped with pediatric-specific equipment or utilities.

Case Description: This paper describes the four-day inpatient physical therapy management of a six-year-old female who fell from a horse and sustained a left open depressed frontal skull fracture with an underlying subdural …

Status Post Rotator Cuff Repair With Interrupted Therapy And Comorbidities: A Case Report, Whitney Lesnau

Physical Therapy Scholarly Projects

Background & Purpose: The purpose of this case study is to describe the plan of care that was completed despite interruption from multiple complications. Interrupted therapy has not been explored in research even though it is something physical therapists encounter often.

Case Description: This 45-year-old patient went through a right rotator cuff repair surgery followed by physical therapy to regain functional use of her shoulder. Her therapy was interrupted twice; first by her mother’s heart condition and then by her own neurological condition.

Intervention: The main component of treatment with this patient was range of motion exercises including passive, active-assistive, …

A Comparative Analysis Of Two Gait Training Approaches For Individuals With Transtibial Amputation, Nannette Wright Hyland

Seton Hall University Dissertations and Theses (ETDs)

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Applying Classification And Decision Rule To Predict Outcome Of Whiplash In An Ambulatory Patient Recovering From Incomplete Spinal Cord Trauma, Emmanuel Yung

All PTHMS Faculty Publications

It is not known whether a clinical prediction rule or a whiplash associated disorder (WAD) classification may be applied effectively in a second traumatic event to predict the outcome in a patient recovering from cord trauma. Therefore, the purpose of this case was to apply a decision rule and a whiplash classification to predict the outcome of a second traumatic event in a recovering incomplete spinal cord injured (SCI) patient who was ambulatory.

The Effects Of Ultrasound Transducer Velocity On Intramuscular Tissue Temperature Across A Treatment Site, Pamela Liceralde

UNLV Theses, Dissertations, Professional Papers, and Capstones

This purpose of this study was twofold: to determine whether ultrasound transducer velocity affected tissue temperature increase, and whether heating was uniform across the treatment site. Thermocouples were inserted 2.5cm below the skin surface at the center, edge of the ERA, and the edge of the treatment site that was the size of two times the soundhead. Each subject received three 10-minute treatments at each speed, letting tissue temperature return to baseline between treatments.

Repeated measures factorial ANOVA revealed no significant differences in the speed of application and no interaction between speed and location. However, the location of the thermocouples …