Medicine and Health Sciences Commons^™

Neuromuscular Electrical Stimulation And Post-­‐Stroke Glenohumeral Subluxation, Tera Richards, Jason Colon

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

A cerebral vascular accident (CVA) occurs when the blood supply to the brain is interrupted, either because a blood vessel has been occluded or the blood vessel has ruptured. This typically results in hemiplegia or paralysis of the muscles on the side of the body contralateral to the lesion site within the brain.

Effects Of Reducing Fatigue In Muscular Dystrophy Through Physical Activity, Callie Toaso, Alea Brown

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Myopathy is a functional impairment of muscle tissue; muscular dystrophy is a type of myopathy (Rakowicz & Lane, 2004). Muscular dystrophy (MD) consists of progressive muscle weakness and affects limbs and facial muscles. The most common types include Duchenne muscular dystrophy, Fascioscapulohumeral muscular dystrophy (FSHD), and Limb-girdle muscular dystrophy (Mercuri & Muntoni, 2013). One common complaint found with patients with muscular dystrophy is fatigue. It is noted that fatigue affects daily activities, but it is believed that physical activity can help reduce this. The purpose of this systematic review is to research how effective physical activity is at reducing fatigue …

Staying Sharp: The Cutting Edge Of Research On Cognition And Aging, Regula H. Robnett

Occupational Therapy Faculty Presentations

Workshop PowerPoint presentation given June 11, 2015, for the 25th Maine Geriatrics Conference in Bar Harbor, Maine. Presentation reviews the latest evidence on cognition and aging. While there is an overwhelming amount of data out there, it is crucial to be informed consumers so the information can be used to enhance one's own life and the lives of others. As people age, changes occur in the brain that can impact learning, memory, and overall daily performance. However, techniques based on promoting preserved skills, embracing new learning, and providing contextual adaptations can be used to improve overall performance. Workshop presentation included …

Connectivity Measures Are Robust Biomarkers Of Cortical Function And Plasticity After Stroke, Jennifer Wu, Erin Burke Quinlan, Lucy Dodakian, Alison Mckenzie, Nikhita Kathuria, Robert J. Zhou, Renee Augsburger, Jill See, Vu H. Lee, Ramesh Srinivasan, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Valid biomarkers of motor system function after stroke could improve clinical decision-making. Electroencephalography-based measures are safe, inexpensive, and accessible in complex medical settings and so are attractive candidates. This study examined specific electroencephalography cortical connectivity measures as biomarkers by assessing their relationship with motor deficits across 28 days of intensive therapy. Resting-state connectivity measures were acquired four times using dense array (256 leads) electroencephalography in 12 hemiparetic patients (7.3 ± 4.0 months post-stroke, age 26–75 years, six male/six female) across 28 days of intensive therapy targeting arm motor deficits. Structural magnetic resonance imaging measured corticospinal tract injury and infarct volume. …

Occupational Deprivation Or Occupational Adaptation Of Mexican Americans On Renal Dialysis, Shirley A. Wells

Occupational Therapy Faculty Publications

The aim of this study was to explore the occupational changes and perceptions experienced by Mexican Americans with end-stage renal disease (ESRD) and their families living with dialysis. In-depth interviews were conducted with 17 Mexican Americans with ESRD and 17 family members. The participants with ESRD described altered or lost activity patterns, capacities and freedoms. With a heightened awareness of death, the family members made altered occupational choices, which were consistent with their cultural values. Changes in the physical body, adhering to the dialysis regimen and environmental restrictions created barriers to occupational participation. These findings suggest that living with dialysis …

The Use Of Parkinson’S Disease Specific Rehabilitative Interventions To Treat A Patient With Lewy Body Dementia: A Case Report, Cassandra Dawley

Case Report Papers

Background and Purpose: (Lewy Body Dementia) LBD is commonly known as a differential diagnosis of Parkinson’s Disease (PD) as they both have a similar epidemiology and present with similar symptoms. Due to the paucity of research on physical therapy (PT) interventions for LBD, it may be suitable to use PD specific interventions as a treatment. The proposal to use Parkinson specific interventions, primarily Lee Silverman Voice Treatment-Big (LSVT BIG), may be considered. The purpose of this case study was to provide information about what LBD is, how it presents, and how PD specific interventions were used as a treatment. Case …

Intersection Of Career Counseling And Psychosocial Adjustment To Disability For Adults With Acquired Disabilities, Tina M. Anctil Peterman

Counselor Education Faculty Publications and Presentations

This program shares a theoretical and practical approach to career counseling with adults with acquired disabilities. Practitioners must possess a working knowledge of the adjustment to disability process as it relates to the client's career transition. Participants will learn how career interventions can facilitate the client's adjustment to their disability.

Comparison Of Robotics, Functional Electrical Stimulation, And Motor Learning Methods For Treatment Of Persistent Upper Extremity Dysfunction After Stroke: A Randomized Controlled Trial, Jessica Mccabe, Michelle Monkiewicz, John P. Holcomb, Svetlana Pundik, Janis J. Daly

Mathematics and Statistics Faculty Publications

Objective

To compare response to upper-limb treatment using robotics plus motor learning (ML) versus functional electrical stimulation (FES) plus ML versus ML alone, according to a measure of complex functional everyday tasks for chronic, severely impaired stroke survivors.

Design

Single-blind, randomized trial.

Setting

Medical center.

Participants

Enrolled subjects (N=39) were >1 year post single stroke (attrition rate=10%; 35 completed the study).

Interventions

All groups received treatment 5d/wk for 5h/d (60 sessions), with unique treatment as follows: ML alone (n=11) (5h/d partial- and whole-task practice of complex functional tasks), robotics plus ML (n=12) (3.5h/d of ML and 1.5h/d of shoulder/elbow robotics), …

Effect Of A 7-Week Rock Climbing Class On Physical Fitness And Performance, Justin Scott Cargo

Masters Theses

The purpose of this study was to assess changes in physical fitness and performance by rock climbing twice a week over a 7-week time period. Rock climbing is on the rise in popularity as seen in the rise of indoor climbing gyms and the increase in rock climbing competitions (Wall, C. B., Starek, J. E., Fleck, S. J., & Byrnes, W. C., 2004). Notably, the International Federation of Sport Climbing has held the Climbing World Championships biennially since the first event in 1991 (Schoffl, Burtscher, & Coscia, 2013), which emphasizes the importance of this research to apply to training programs. …

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, …

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 …

Does Insertion Of Intramuscular Electromyographic Electrodes Alter Motor Behavior During Locomotion?, Jo Armour Smith, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Intramuscular electromyography (EMG) is commonly used to quantify activity in the trunk musculature. However, it is unclear if the discomfort or fear of pain associated with insertion of intramuscular EMG electrodes results in altered motor behavior. This study examined whether intramuscular EMG affects locomotor speed and trunk motion, and examined the anticipated and actual pain associated with electrode insertion in healthy individuals and individuals with a history of low back pain (LBP). Before and after insertion of intramuscular electrodes into the lumbar and thoracic paraspinals, participants performed multiple repetitions of a walking turn at self-selected and controlled average speed. Low …

Age And Sex Differences In Steadiness Of Elbow Flexor Muscles With Imposed Cognitive Demand, Hugo M. Pereira, Vincent C. Spears, Bonnie Schlinder-Delap, Tejin Yoon, Kristy A. Nielson, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Purpose: These studies determined (1) age and sex-related differences in steadiness of isometric contractions when high cognitive demand was imposed across a range of forces with the elbow flexor muscles (study 1) and, (2) sex differences in steadiness among older adults when low cognitive demand was imposed (study 2).

Methods: 36 young adults (18–25 years; 18 women) and 30 older adults (60–82 years; 17 women) performed isometric contractions at 5%, 30% and 40% of maximum voluntary contraction (MVC). Study 1 involved a high-cognitive demand session (serial subtractions by 13 during the contraction) and a control session …

Utilization Of Specialized Camp Services Among Parents Of A Child With A Disability, Heather Ann Wroten

Electronic Theses, Projects, and Dissertations

The purpose of this study was to explore the utilization of specialized camp services among parents of a child with a disability. This study sought to investigate specialized camp services as respite for families. The data was gathered utilizing a mixed method survey approach. The surveys were distributed to primary caregivers of a child with a disability who have attended Camp Paivika within the past three years. The sample size of this study was 69 respondents. The results show that the family unit benefits by way of de-isolation. The camper increases social skills, confidence, and independence. The caregivers experience emotional …

An Innovative Approach To Decreasing Concussions In Adolescent Female Soccer Athletes: 2370 Board #117 May 29, 9, A. Lynn Millar, Brent A. Harper, Jared Casazza, Cameron Lephew, Meredith Moore, Timothy Schmidt

Faculty Publications

Concussion is a public health issue, fundamental to health promotion and injury prevention. Concussions are prevalent in adolescent athletic competition, in high-collision and non-collision sports. A history of previous concussion increases risk by a factor of three, female gender increases it 1.5 to 2.5 times, and female middle-school soccer players have 22.9 times increased risk during games. Non-collision concussions (indirect) may be primed by altered movement patterns from previous injuries, disruption of cervical proprioception, or musculoskeletal pain. Assessment of dynamic balance and functional movement allows identification of poor movement patterns or control.

PURPOSE: To assess a preventative movement-based warm-up routine …

Investigating The Effects Of Combining Treadmill Training With Trans-Spinal Direct Current Stimulation On Motor Skill Recovery After Spinal Cord Injury, Jennifer Blake, Rebecca Bullen, Jeremy Pahl, Samantha Scicchigno

Dissertations, Theses, and Capstone Projects

This study assessed the effect of treadmill training with or without trans-spinal direct current stimulation on motor recovery following a T13/L1 spinal cord hemi section in CD-1 mice. Mice all received the same spinal cord injury, which resulted in left hind limb paralysis, and were assigned to one of three groups. Control animals received no treatment. Treadmill only mice were treated with 5 sessions of treadmill training. Treadmill + stimulation animals were treated with concurrent treadmill training and trans-spinal direct current stimulation. Progress was assessed by analyzing each subject’s steps on a horizontal ladder test, which the animals performed both …

Implications Of Muscle Activation Patterns On Balance In The Elderly, Arielle Bailey, Goldie Baum, Hadassa Radzik, Aruna Woods

Dissertations, Theses, and Capstone Projects

More than one third of adults ages 65 years old and older fall each year in the United States. This can result in trauma, hospital admissions, and potential death. The purpose of this study was to investigate the effects of waist-pull perturbation training on balance in the elderly. There were two experimental groups, elderly non-fallers (n=9) and elderly fallers (n=5) between ages 65-86, and a control group comprised of young, healthy subjects (n=10) ages 21-31. All subjects underwent baseline and post-training measurements using EMG recordings of the tibialis anterior, gastrocnemius, vastus lateralis and semimembranosus. Training was performing using repeated waist-pull …

Use Of The Bioness L300® Functional Electrical Stimulator In Acute Stroke Rehabilitation, Christine Flanigan, Colleen M. Martinez, Beth N. Terranova, Nicholas Wildi

Dissertations, Theses, and Capstone Projects

Purpose. Over 150,000 people in the U.S. every year experience foot drop following a stroke, slowing their ambulation and increasing their falls risk. We explore whether the use of functional electrical stimulation (FES) to the common fibular nerve during acute rehabilitation can maximize ambulation gains. Methods. Five in-patients admitted at Burke Rehabilitation Hospital experiencing foot drop participated. While receiving conventional physical therapy, four subjects wore the Bioness L300® device, and one subject used an elastic figure-8 wrapped elastic bandage. Gait parameters were evaluated at initial evaluation, an intermittent evaluation, and discharge. Results. During their stay, subjects significantly improved in gait …

The Influence Of Forward Head Posture On Suprahyoid Activity During Oropharyngeal Swallowing: A Surface Electromyographic Analysis, Brianne Carroll, Sierra Hunt, Katherine Sheeleigh, Mark Wnukowski

Dissertations, Theses, and Capstone Projects

STUDY DESIGN: Within subjects repeated measures design.

OBJECTIVE: The aim of this research is to explore the effect that Forward Head Posture has on the mylohyoid muscle during swallowing in a healthy population.

BACKGROUND: Forward Head Posture (FHP) is the most common deviation from ideal head posture, and has become more prominent due to the rise of smart phones and the prevalence of computers in the household and workplace. FHP is associated with a variety of detrimental effects on the musculoskeletal system that arise from the abnormal positioning of the cranial and cervical bones and joints. In particular, the muscles …

An Electromyographic Comparison Of The Functional Performance Of The Gluteus Maximus Muscle In Prolonged Sitting Versus Standing Populations, Kerry Campagnola, Giusi Gerbino, Erica Johnson, Adrienne O’Keefe

Dissertations, Theses, and Capstone Projects

PURPOSE: A common clinical concern of Physical Therapists is the inexplicably weak gluteus maximus (GM) muscle; we hypothesized that this may be linked to the popular habit of prolonged sitting. The purpose of this study was to determine if surface electromyography (sEMG) output and timing of the GM and hamstrings muscles differed between people who sit for prolonged periods of time and people who stand for prolonged periods of time. METHODS: The design of our study was a single session case-control study. Subjects were 22 healthy adults (23-36 years old) who either sat or stood for 8-10 hours a day …

Dancer Performance On The Lower Quarter Y Balance Test: A Longitudinal Study, Megan Dehey, Kelly Kaems, Molly Saunders, Gabrielle Schneider

Dissertations, Theses, and Capstone Projects

Purpose: There is a need in the current literature for further information regarding dancer performance on the Y Balance Test (YBT). This study tracked the test scores of a group of dancers to assess change over time and relationship of balance scores to injury risk. It is hoped that clinicians may be able to use the information found in this study to more accurately screen dancers for asymmetries, deficits, and changes over time using the YBT. Such screenings would allow for more effective care and better assessment of readiness to return to dance. Method: A group of 12 dancers between …

The Effects Of Cooling During Gait On Gait Endurance In Persons With Multiple Sclerosis Using The Six Minute Walk Test, Meghan Higgins, Esther Sosowsky, Elisheva Zinberg

Dissertations, Theses, and Capstone Projects

Background: Persons with MS (pwMS) are limited in their mobility due to thermosensitivity. Exercising at a sufficient volume and intensity to increase mobility can result in increased core temperatures and resultant worsening of symptoms. The use of cooling garments to lower core temperature has been found to be a successful means of allowing pwMS to exercise for longer periods. Previous studies have relied on precooling for an extended period of time prior to activity, to achieve improved exercise performance. Cooling during the performance itself, or pericooling, may allow for similar performance gains to be realized without spending the time needed …

Interactions Between Descending And Somatosensory Inputs In Humans, Lisa Krivis, Ann Mackey, Maureen Mcdonough, Denise Uttaro

Dissertations, Theses, and Capstone Projects

In this study, we assessed the corticospinal integration in healthy people while seated. Corticospinal integration was assessed by establishing the latency and amplitude of motor evoked potentials (MEPs) evoked following transcranial magnetic stimulation (TMS) of the primary motor cortex area representing the leg muscles, and the latency and amplitude of spinally-mediated reflex responses. Further, the modulation pattern of the spinally-mediated reflex responses were determined following subthreshold and suprathreshold TMS. All compound muscle action potentials, descending motor or spinally-mediated reflexes were recorded from the leg muscles through surface electromyography. Both subthreshold and suprathreshold TMS induced a similar modulation pattern on the …

Effect Of Absent Tactile Sensation On Multi-Digit Coordination Underlying Hand Control, Michael P. Alcorn, Bruce Faulkner, Matthew Macina, Brian Sherman

Dissertations, Theses, and Capstone Projects

We investigated the effect of anesthesia, causing absent tactile sensation feedback, on multi-digit coordination underlying hand control. The purpose of the study is to expand our understanding on the essential role of tactile sensation feedback in the sensorimotor integration process by examining the motor coordination patterns during multi-digit forces production tasks. We hypothesized that absent tactile sensation feedback would interrupt the force sharing pattern at local and non-local digits. Twelve participants were utilized for data collection and statistical analysis (25.6 ± 4.1 years old, 6 males and 6 females), right-handed (according to their preferred hand use for writing and eating) …

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 …

The Effects Of Maximal Strength Training On Gait And Balance In Persons With Multiple Sclerosis: A Pretest Posttest Pilot Study, Janet Klein, David Park, Charles Wright, Michael Zervas

Dissertations, Theses, and Capstone Projects

Background: Physical Therapy strength training programs utilizing mild to moderate intensity are commonly prescribed to address many of the deficits found in multiple sclerosis, but studies examining the effectiveness of higher intensity strength training in gait and balance have not been performed. Maximal strength training (MST), which involves lifting nearly maximal weights (85-95% of an individual’s one repetition maximum [1RM]) with low repetitions, has been shown to improve functional abilities in both healthy and non-MS impaired populations. The higher intensity training used in MST may result in greater activation of the CNS, providing a greater stimulus to improvement than …

Retrospective Chart Review Of Patients Following Unilateral Total Knee Replacement To Assess Achievement Of Functional Milestones Based On Type Of Anesthetic Used Intra-Operatively, William S. Benish, Lolline Chong, Elana Kram, Danielle Krieger

Dissertations, Theses, and Capstone Projects

PURPOSE: Given the large number of Total Knee Replacements (TKR) performed annually in the US and the prediction that those numbers will increase, providing optimal analgesia during TKR is an important strategy for reducing cost and improving patient outcomes. Currently, no standard analgesia protocol for TKR exists and facilities in the US and world-wide use varied methods of analgesia. The purpose of the present study is to determine which analgesic technique; femoral nerve block (FNB), saphenous nerve block (SNB) or periarticular injection (PAI), within the context of a multi-modal pain management regimen, results in optimal TKR patient outcomes and achievement …

Evaluating Physical Therapy For Adolescent Patients With Low Back Pain, Kelly Denise Gonzales

Doctor of Nursing Practice Final Manuscripts

Background: Low back pain is a condition affecting many people worldwide. The age of onset is variable, affecting all patient populations from childhood throughout the lifespan. Aims/Purpose: The efficacy of physical therapy for adolescent patients with back pain seen in a pediatric orthopedic clinic was evaluated through comparison of pre and post-intervention pain scores. Patient compliance with physical therapy was monitored and evaluated against outcomes.

Design: A six-month retrospective chart review of adolescent patients with a diagnosis of low back pain. Patients with a diagnosis of low back pain were referred for physical therapy and provided with a home exercise …

The Advances In Prosthetics, Jose Garcia

Symposium Of University Research and Creative Expression (SOURCE)

Throughout time, many people have been able to build, create, and do amazing things with their arms and legs. However, those who have lost limbs at birth or through an event in their life sometimes have a harder time being as accomplished as others. While some people without limbs have had a harder life, some have been able to accomplish what others with a normal physiology can by the use of prosthetics. This presentation will focus on the advances of prosthetics, the benefits for the user, and their future development. The main focus will be on prosthetic arms and their …

Amyotrophic Lateral Sclerosis, The Primary Motor Neuron Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Amyotrophic lateral sclerosis is a degenerative neurological disease that damages nerve cells in the brain, in particular the neurons that are involved in voluntary muscle movements. Internationally the disorder is also known as Charcot’s disease and motor neuron disease. In the United States, amyotrophic lateral sclerosis is often referred to as Lou Gehrig’s disease, motor neuron disease, and more colloquially ALS. Amyotrophic Lateral Sclerosis is the most prominent of the five motor neuron diseases, distinguishing itself from the others through degeneration of both upper motor neurons (UMN) and lower motor neurons (LMN) respectively. The “Father of neurology” Jean-Marie Charcot founded …