Medicine and Health Sciences Commons^™

Utilization Of Postural Control Training To Improve Gait Symmetry And Walking Ability In A Patient Following A Lacunar Stroke: A Case Report, Hannah C. Wilder, Amy J. Litterini

Case Report Posters

Alteration in gait is one of the most noted impairments following stroke. Improving walking ability is one of the most common goals amongst patients with stroke undergoing rehabilitation. Current literature describes visual and proprioceptive feedback and task-oriented training as effective in improving gait speed, mechanics, strength, and balance following stroke. Based on the research, postural control training may improve walking ability following stroke. The purpose of this case report is to outline physical therapy rehabilitation that utilized postural control training, task-oriented training, and visual feedback to improve walking ability and functional capacity in a patient following a lacunar stroke affecting …

Restoring Gait And Functional Mobility For A Patient With An Ischemic Stroke Through Physical Therapy: A Case Report, Colleen Kelly

Case Report Posters

During an ischemic stroke, blood flow is impeded due to blocked artery. Stroke is the 5^th leading cause of death and the primary cause of disability and dependency in adults in the United States. Patient age and stroke severity, size, and location are strong predictors in prognosis. Stroke rehabilitation during the first three months can reduce mortality. The purpose of this case report is to provide physical therapy management strategies used during an inpatient stay for a patient who experienced an ischemic stroke.

Restoring Gait And Functional Mobility For A Patient With An Ischemic Stroke Through Physical Therapy: A Case Report, Colleen Kelly

Case Report Papers

Stroke is the primary cause of disability and care dependency in adults in the United States. Research has found that the risk of mortality post stroke can be greatly reduced through stroke rehabilitation. The purpose of this case report is to provide a framework of physical therapy rehabilitation that facilitated functional mobility and gait in a patient who experienced a stroke. The patient was a 50-year old male who was admitted to an inpatient rehabilitation hospital for physical therapy following a left middle cerebral artery ischemic stroke four days prior. The patient received three weeks of physical therapy after displaying …

Physical Therapy Management Of A Patient With Chronic Knee Pain: A Case Report, Mohamed Elsaid

Case Report Posters

Knee pain affects approximately 25% of adults, and as a result limits functional mobility and may induce participation restrictions. Risk factors may contribute to knee pain, with osteoarthritis (OA) being the most prevalent cause in individuals 50 years and older. The rate of knee replacement surgery among individuals 65 and older has increased by approximately eight fold from 1979-2002. Physical Therapy (PT) is a nonsurgical option that offers individuals relief. The purpose of this case report is to review the PT treatment and management for a patient with chronic knee pain, and use evidence based interventions, such as therapeutic exercises, …

Early Utilization Of The 6-Minute Walk Test (6mwt) In An Active Patient After Cardiac Surgery - A Case Report, Christian Boucher, Kirsten Buchanan

Case Report Posters

Coronary artery disease affects more than 13 million Americans. A sub-population of these patients, despite exercising regularly, can develop cardiac disease. The 6-Minute Walk Test (6MWT) is a functional outcome measure that is easy to implement and has been used across multiple populations. There is limited literature that has investigated the use of the 6MWT on post-operative day one (POD1) after cardiac surgery. Patients participating in self motivated exercise programs prior to surgery are found to excel with early utilization of the 6MWT. For this active sub-population the 6MWT on POD1 may be a more specific and sensitive outcome measure. …

Subacute Physical Therapy Management For Abnormalities Of Gait And Mobility Following An Acute Accident With Farm Equipment: A Case Report, Maria Stern

Case Report Posters

Workers in the agricultural industry experience 243 injuries per day that result in lost work time, with five percent of these resulting in permanent impairments. Functional decline can occur as a result of prolonged hospitalizations. Endurance and strength of the lower extremities, mobility, and tolerance for ambulation are decreased in this population. Physical therapy (PT) interventions can target these impairments to improve functional ability. The purpose of this case report is to describe the PT management used in a subacute setting to improve functional ability, mobility, and gait in a patient who experienced deconditioning due to prolonged hospitalization following an …

Profiles Of Fatigue Severity And Variability Among Adolescents And Young Adults With Cerebral Palsy, Laura K. Brunton, Doreen J. Bartlett

Physical Therapy Publications

Background: Individuals with cerebral palsy (CP) experience progressive changes in functional status with the development of secondary impairments such as fatigue. Detailed accounts of the fatigue experience in CP are lacking.

Purpose: This study describes the severity and variability of fatigue in CP using the Fatigue Impact and Severity Self-Assessment.

Methods: This was a descriptive cross-sectional study surveying 130 (61 males) individuals (mean age 18 years, 11 months; SD four years, six months) with CP. Analyses comprised comparisons between two groups (Gross Motor Function Classification System (GMFCS) I and II-V), frequency counts and proportions.

Results: Significant differences exist between GMFCS …

Use Of Functional Strengthening, Balance Training, And Stretching In The Treatment Of A Patient Following A T11-L5 Spinal Fusion: A Case Report, Anna Sidloski, Brian T. Swanson

Case Report Posters

There is abundant evidence available regarding treatment approaches for patients suffering from low back pain (LBP), but limited research focusing on physical therapy (PT) treatment status post-multilevel spinal fusion with postural impairments. The purpose of this case report is to describe the management and functional improvement of a patient s/p spinal fusion with severe postural impairments, elevated fall risk, and high levels of back pain.

Physical Therapy And Cognitive Behavioral Therapy In A Patient With Multiple Co-Morbidities – A Case Report, Jeanine Manubay, Kirsten Buchanan

Case Report Posters

Traditional physical therapy (PT) interventions can be challenging to implement in the complex patient with multiple comorbidities. Cognitive behavioral therapy (CBT) is a behavioral therapy technique used to change obstructive behaviors and improve functional and emotional health. CBT has shown positive outcomes in patients with cancer and elderly patients with depression, but has not been studied in conjunction with PT in medically complex patients. The purpose of this case report was to document the utilization and outcomes of CBT along with traditional physical therapy for a medically complex patient diagnosed with end stage renal disease and multiple co-morbidities.

Physical Therapy And Cognitive Behavioral Therapy In A Patient With Multiple Co-Morbidities – A Case Report, Jeanine Manubay

Case Report Papers

Background and Purpose: Cognitive behavioral therapy (CBT) is grounded in the premise that by altering a patient’s negative thought processes, one can improve functional and emotional health. When multiple co-morbidities limit traditional physical therapy interventions, CBT may be a consideration. While CBT has shown benefits in patients with cancer and others, there is a lack of research investigating its effectiveness in conjunction with physical therapy (PT) in the medically complex patient. The purpose of this case report was to document the outcomes of CBT along with traditional PT for a medically complex patient diagnosed with end stage renal disease and …

Use Of Functional Strengthening, Balance Training, And Stretching In The Treatment Of A Patient Following A T11-L5 Spinal Fusion: A Case Report, Anna Sidloski

Case Report Papers

Background and Purpose: Lumbar spinal fusion surgery has been utilized to manage levels of low back pain and instability. However, pain often persists post-operatively. Evidence supports the use of Transverse Abdominis recruitment in patients with LBP. Research demonstrates strengthening the hip musculature may allow for improved outcomes for those who experience LBP. There is limited research focusing on lower extremity strengthening, flexibility, and balance training in a patient following a T11-L5 spinal fusion. Case Description: The patient was a 68-year-old male presenting to physical therapy eight weeks’ status post T11-L5 spinal fusion with ~45 degrees forward-flexed posture, weak lower extremity …

A Comprehensive Physical Therapy Program For Adult-Onset Dystonia: A Case Report, Karissa Wells, Kirsten Buchanan

Case Report Posters

Dystonia can present with symptoms of involuntary muscle contractions, resting tremors, and diminished muscular control. Patients with dystonia can present similarly to patients with Parkinson’s disease due to the association with the basal ganglia. While there is significant research on physical therapy (PT) interventions for patients with Parkinson’s disease there is limited research on the PT evaluation and treatment of patients with dystonia. The purpose of this case report was to describe a comprehensive PT regimen, based on Parkinson’s disease research, for a patient diagnosed with adult-onset dystonia.

The Use Of Manual Therapy In The Treatment Of A Patient With Chronic Low Back Pain And Sciatica: A Case Report, Elia N. Darazi

Case Report Posters

Low back pain (LBP) is the second most common cause of disability in adults with total costs estimated to be between $100 and $200 billion annually on the US economy. The prevalence of chronic LBP rose significantly over a 14-year interval (1992 to 2006), from 3.9% to 10.2%. Treatment of LBP may be conservative or surgical, with conservative being the mainstream initial treatment before a consideration of a surgical option. A surgical option is usually recommended when there is evidence of worsening nerve damage. In a physical therapy (PT) outpatient setting, chronic LBP is one of the most common conditions …

Combining Physical Therapy And Podiatry For A Patient With Plantar Fasciitis: A Case Report, Kathleen Barnes, Kirsten Buchanan

Case Report Posters

One million cases of plantar fasciitis (PF) are reported annually in the United States. Studies have separately investigated the effectiveness of physical therapy (PT) interventions as well as steroid injections from podiatry – but not in conjunction with each other. There is a lack of research investigating an interdisciplinary approach utilizing PT and podiatry for PF. This case report investigated an interdisciplinary approach combining physical therapy and podiatry utilizing steroid injections in the treatment of a patient with plantar fasciitis.

Application Of Manual Therapy Utilizing Maitland Principles In The Rehabilitation Of A Patient Following Rotator Cuff Repair, Kehinde Aderibigbe, Brian T. Swanson

Case Report Posters

In the United States, more than 500,000 rotator cuff repairs and shoulder arthroscopies are performed annually. Following surgery, physical therapy (PT) often utilizes various manual therapy (MT) and therapeutic exercise (TE) interventions. Post-operatively, accessory joint mobilizations (AJM) help to prevent adhesions and may decrease excitability of central nociceptive pathways. However, there is no consensus about the most appropriate postoperative utilization and timing of MT following surgery. Maitland describes a framework for clinical decision making that is patient-centric and focuses on frequent reassessment to guide the application of manual therapy. In this framework, comparable signs are identified at initial evaluation, and …

Restoration Of Functional Mobility For A Young Adult Patient Following A Severe Motor Vehicle Accident: A Case Report, Zachary Mercier

Case Report Posters

Over 50 million people world-wide experience non-fatal injuries, and 1.2 million people die as a result of motor vehicle accidents (MVA) annually. Unintentional injury, including MVA, was the leading cause of death in females age 15-24 in 2014. Higher intensity therapy can result in greater gains in functional mobility in rehabilitation settings. Skilled nursing facilities typically care of older patients, but younger patients can also benefit. The purpose of this case report was to document a young adult patient’s response to skilled physical therapy interventions with the goal of returning the patient to prior level of function.

Physical Therapy Intervention For A Patient With Temporomandibular Joint Dysfunction Caused By Two Traumatic Events: A Case Study, Elyse Detweiler

Case Report Posters

Temporomandibular disorders (TMD) are a collection of pathoanatomical dysfunctions of the temporomandibular joint (TMJ) and are associated with a variety of symptoms throughout the head and neck. There is a severe lack of supportive evidence for physical therapy management used in the conservative and/or post-surgical treatment of TMD. The dental profession provides much of the current literature on TMD but is limited in conservative and surgical interventions. Research has shown arthrocentesis to be a beneficial procedure to perform initially; long-term outcomes for pain and functional impairments were comparable with conservative treatment. The purpose of this case report is to provide …

Manual And Exercise Therapy For The Treatment Of Chronic Costochondritis In A Male Office Worker: A Case Report, John Livecchi

Case Report Posters

For some patients, the use of techniques that typically comprise a physical therapy (PT) treatment plan for costochondritis, such as high-velocity low-amplitude (HVLA) manipulation, can be intolerable due to pain or even contraindicated because of other comorbidities. This case report describes the successful treatment of a patient with chronic costochondritis utilizing gentler, more conservative manual therapy techniques than those that are typically used in PT management of the condition.

Comprehensive Physical Therapy Treatment Following A Surgical Repair Of A Flexor Hallucis Longus Tendon In A Skateboarder: A Case Report, Joseph Marcil, Kirsten Buchanan

Case Report Posters

Flexor Hallucis Longus (FHL) injuries occur when stress is placed on the great toe. FHL tendinopathies are common in ballet dancers, however, not often seen in skateboarders. The most effective physical therapy (PT) rehabilitation protocol for an FHL tendinopathy and subsequent repair in a skateboarding athlete has not been well documented. The purpose of this case report is to investigate a comprehensive PT protocol, including video feedback after an FHL repair in a skateboarding athlete.

Physical Therapy Management Of A Patient With Chronic Brainstem Stroke Syndrome To Improve Functional Mobility: A Case Report, Kelley Flahaven

Case Report Posters

Strokes are a leading cause of disability, and the fifth leading cause of death in the U.S. Brainstem strokes are much less common and have a higher mortality rate than cortical strokes. Brainstem strokes can lead to physical impairments including gaze palsies, quadriplegia, ataxia, or cranial nerve deficits, which affect balance and safety, decreasing independence. Repetitive task gait training has been shown to create improvements in patients with stroke. Non-specific gait training can have a transfer effect on gait for patients with stroke. There are fewer accounts of brainstem stroke rehabilitation than cortical stroke rehabilitation due to poor prognosis and …

Functional Training In A Patient With Middle Cerebral Artery Stroke With Multiple Comorbidities: A Case Report, Darien Lewis

Case Report Posters

795,000 people experience a stroke yearly, making it the leading cause of long-term disability, costing $34 billion. Strokes affecting the middle cerebral artery (MCA) cause impairments of strength, sensation, coordination, and balance of the contralateral side. Recovery from stroke is affected by premorbid status. Cardiovascular disease causes a majority of strokes. The purpose of this case report is to describe a progressive PT plan of care for a patient following MCA stroke with multiple comorbidities in the skilled nursing setting.

Therapeutic Exercise In The Treatment Of Greater Trochanteric Pain Syndrome S/P Lumbar Discectomy: A Case Report, Sean Jeffrey

Case Report Posters

Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, affecting between 1.8 and 5.6 patients per 1000 annually. Inadequate core stability and gluteal weakness contribute to the probability of developing GTPS. GTPS is more common in patients with coexisting low back pain (LBP). Discectomy is effective in treating LBP pain caused by prolapsed lumbar intervertebral discs, however, it does not correct back muscle function. Lumbar stabilization exercises have demonstrated improved quality of life (QOL) outcomes. As both GTPS and discectomy rehabilitation lack defined treatment guidelines, the purpose of this case report is to describe the physical …

Therapeutic Exercise In The Treatment Of Greater Trochanteric Pain Syndrome S/P Lumbar Discectomy: A Case Report, Sean Jeffrey

Case Report Papers

Background and Purpose: Greater trochanteric pain syndrome (GTPS) is a multifactorial cause of lateral hip pain, affecting between 1.8 and 5.6 patients per 1000 per year. The prevalence of GTPS is more common in patients with coexisting low back pain. Though discectomy is effective in the treatment of prolapsed lumbar intervertebral discs, it does not correct concurrent hip pathology. As GTPS in the setting of discectomy rehabilitation lacks defined treatment guidelines, the purpose of this case report is to display physical therapy (PT) treatment of GTPS in conjunction with simultaneous rehab from lumbar microdiscectomy.
Case Description: A 56-year-old male was …

Adaptations Of Lumbar Biomechanics After Four Weeks Of Running Training With Minimalist Footwear And Technique Guidance: Implications For Running-Related Lower Back Pain, Szu-Ping Lee, Joshua P. Bailey, Jo Armour Smith, Stephanie Barton, David Brown, Talia Joyce

Physical Therapy Faculty Articles and Research

Objectives

To investigate the changes in lumbar kinematic and paraspinal muscle activation before, during, and after a 4-week minimalist running training.

Design

Prospective cohort study.

Setting

University research laboratory.

Participants

Seventeen habitually shod recreational runners who run 10–50 km per week.

Main outcome measures

During stance phases of running, sagittal lumbar kinematics was recorded using an electrogoniometer, and activities of the lumbar paraspinal muscles were assessed by electromyography. Runners were asked to run at a prescribed speed (3.1 m/s) and a self-selected speed.

Results

For the 3.1 m/s running speed, significant differences were found in the calculated mean lumbar posture …

Use Of The Task-Oriented Approach For Chronic Inflammatory Demyelinating Polyneuropathy: A Case Report, Alison Newell, Amy J. Litterini

Case Report Posters

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an acquired neurological disorder similar to Guillain-Barre Syndrome (GBS) with rare a prevalence of 2-7.7/100,000.7. Etiology and pathogenesis are largely unknown but are thought to be immunological, targeting the myelin of peripheral nerves. Extensive literature exists regarding medical management of CIDP, but limited research exists regarding physical therapy (PT) management for patients with CIDP. Task-Oriented Approach (TOA) is based upon systems theory with influence from motor learning and motor control theories. Systems theory states abnormal movements are related to deficits in one or more system(s) and are comprised of the body’s existing systems’ attempts …

Physical Therapy Intervention For A Patient With Temporomandibular Joint Dysfunction Caused By Two Traumatic Events: A Case Study, Elyse Detweiler

Case Report Papers

Background and Purpose: Temporomandibular disorders (TMD) are pathoanatomical dysfunctions of the temporomandibular joint (TMJ) associated with symptoms throughout the head and neck.Limited information exists regarding conservative physical therapy (PT) and post-surgical management of TMD. The dental profession is the main source of published literature specific to TMD. This paper describes a conservative and post-surgical PT plan of care (POC) for TMD. Case Description: A 32-year old female experienced two separate traumatic events at work resulting in TMD. She was referred to PT after the second assault because of symptoms of severe pain, limited range of motion, and jaw locking. She …

A Comparison Of Multipath And Conventional Neuromuscular Electrical Stimulation, Cody Brian Bremner

Dissertations

Neuromuscular electrical stimulation (NMES) is the use of an electrical current for the purpose of eliciting a muscular response, and these treatments are most often used clinically for the specific purpose of increasing quadriceps strength. It is commonly accepted that the effectiveness of NMES for this purpose is primarily determined by the NMES training intensity. However, spatially limited motor unit recruitment, fatigue and discomfort negatively impact NMES-induced torque, which subsequently reduces NMES training intensities. Due to the importance of NMES training intensity, a substantial amount of research has focused on strategies designed to increase NMES-induced torque production, as well as …

Ot Department News- Issue #1

Department of Occupational Therapy Newsletter

No abstract provided.

Perceptual Variations In Thermoregulation During Exercise In A Hot Environment, William C. Alger

Electronic Theses and Dissertations

ABSTRACT

Professionals are seeking to find ways to prevent exertional heat illness (EHI) in populations working in hot environments as well as populations that are physically active. The purpose of the present study was to evaluate individuals’ ability to accurately perceive core temperature ranges associated with homeothermic and EHI temperatures during exercise. Ten physically active males exercised on a treadmill at a self-selected rate until core temperature reached 39°C. Participants rated perceived core and skin temperature on 100 mm scales each time core temperature increased 0.25˚ C (37.5-39.0˚ C), along with thermal comfort and sweating sensation. During exercise core temperature …

Preseason Jump And Hop Measures In Male Collegiate Basketball Players: An Epidemiologic Report, Jason Brumitt, Amy Engilis, Dale Isaak, Amy Briggs, Alma Mattocks

Faculty Publications - College of Physical Therapy

Background: Injuries are inherent in basketball with lower extremity (LE) injury rates reported as high as 11.6 per 1000 athletic exposures (AEs); many of these injuries result in time loss from sport participation. A recent trend in sports medicine research has been the attempt to identify athletes who may be at risk for injury based on measures of preseason fitness.

Hypothesis/Purpose: The purpose of this prospective cohort study was to determine if the standing long jump (SLJ) and/or the single-leg hop (SLH) for distance functional performance tests (FPT) are associated with non-contact time loss lower quadrant (LQ, defined as lower …