Medicine and Health Sciences Commons^™

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

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

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

Meeting The Needs Of Students With Traumatic Brain Lnjury, Heather K. Koole

Dissertations

School reintegration following pediatric traumatic brain injury (TBI) presents a number of challenges. This dissertation comprises three studies exploring common themes of best practice, training, and supporting success for students with TBI in school settings.

Study 1 reports the results of a survey of 70 speech-language pathologists (SLPs) who responded to questions about their use of clinical activities that described more or less contextualized services. Current literature supports contextualized service delivery as best practice. Findings indicated that 98% of participants reported using at least one contextualized practice. Higher use of contextualized practices was associated with working in schools (compared to …

Outpatient Physical Therapy Following Surgical Repair Of A Left Patellar Tendon Rupture: A Case Report, Michael Kilgas

Case Report Posters

Patellar tendon tears often occur in patients less than 40 years old with forced flexion of the knee. Surgical repair of the tendon is most commonly the treatment following a tear; additionally, performing surgery to repair the tendon in a timely fashion is an important prognostic factor. The purpose of this case report is to outline the deficits following surgical repair of a left patellar tendon rupture, describe specific physical therapy interventions used during 12 weeks of outpatient rehabilitation, and report the outcomes of physical therapy.

Outpatient Physical Therapy Following Surgical Repair Of A Left Patellar Tendon Rupture: A Case Report, Michael Kilgas

Case Report Papers

Background/Purpose: Patellar tendon tears often occur in patients less than 40 years old during physical activity with forced flexion of the knee. Surgical repair of the tendon is often the treatment following a tear; additionally, performing surgery to repair the tendon in a timely fashion is an important prognostic factor. The purpose of this case report is to outline the deficits following surgical repair of a left patellar tendon rupture, describe specific physical therapy interventions used during 12 weeks of outpatient rehabilitation, and report the outcomes of physical therapy. Case Description: Patient DH presented to physical therapy with restricted range …

Acute Care Physical Therapy Management Of A Former Professional Athlete Following Unicompartmental Knee Arthroplasty: A Case Report, Michelle Cronin

Case Report Posters

Background: Unicompartmental knee arthroplasty (UKA): replacement of one compartment of the tibiofemoral joint. A balance between an ambitious plan of care and mindfulness of the acute inflammatory process poses a challenge for acute care physical therapists. There is a lack of literature that addresses the acute care physical therapy management of patients who have undergone this procedure. Specifically, little is known about the acute care physical therapy management of former elite athletes who undergo UKA in middle age. Purpose: To describe the acute care physical therapy management of a former professional tennis player immediately following UKA.

Functional Mobility And Gait Training During Inpatient Rehabilitation Following Middle Cerebral Artery Stroke: A Case Report, Emily Wallingford

Case Report Posters

Mortality from stroke is the 4th leading cause of death in the US, and is a leading cause of long-term severe disability among adults. Incidences of disabilities include: hemiparesis, unable to walk without assistance, dependent in ADLs, aphasia, and depression. Stroke survivors represent the largest group admitted to rehabilitation hospitals and approximately 1 in 4 patients with stroke are placed in long-term care. The purpose of this case report is to be a description of practice and interventions targeting functional mobility and gait retraining for patients within inpatient rehabilitation setting.

Strengthening And Postural Training For A Patient With Leg Length Discrepancy And Anterior Pelvic Tilt: A Case Report, Oana Butnarasu

Case Report Posters

Background: Leg length discrepancy (LLD) is a frequent orthopedic problem that presents as either shortening or lengthening of one of the lower limbs. Patients with LLD of 1-2cm often present with back or/and lower extremity pain, pelvic asymmetry, scoliosis, and difficulty in gait pattern. Purpose: The purpose of this case report is to describe the physical management of a patient with LLD and left anterior pelvic tilt who experienced pain in the left hip.

The Use Of Medical Exercise Therapy For A Post-Operative Gastrocnemius Recession Patient After Multiple Conservative Physical Therapy Treatments Failed: A Case Report, Caitlin Cross

Case Report Posters

Background: Achilles Tendonitis affects 9% of all recreational runners. Treatment is variable. Surgery is controversial. Gastrocnemius Recession: Small incision to postero-medial lower leg to release gastrocnemius tendon; most commonly used to treat equino-varus contracture; lack of literature when used to treat chronic achilles tendonitis; no known literature for the postoperative physical therapy management. Medical Exercise Therapy (MET): Developed by the Holten Institute; 60 minutes of graded exercise; high repetitions with low weight; functional weight bearing during functional movement patterns. Purpose: The purpose of this case report was to report the use MET for a patient after a gastrocnemius recession as …

Acute Care Pt Management Of A Patient Following A Total Knee Arthroplasty With Partial Weight Bear Orders Secondary To Bone Cyst In The Femur: A Case Report, John Quinn

Case Report Posters

Background: Total Knee Arthroplasy (TKA): OA is the most common joint disorder in the US. A TKA is a surgical procedure aimed to relieve signs and symptoms of severe osteoarthritis. Acute care following a TKA includes: Swelling management, increasing range of motion, enhancing muscle control and strength in the involved lower extremity, maximizing patient’s mobility with the goal of functional independence. Weight bear status: weight bear as tolerated. Bone Cyst: A bone cyst is a common bone defect found in weight bearing joints such as the knee and hip. They may weaken bone integrity and must be accounted for in …

Balance And Functional Skill Training For A Patient With Cognitive Dysfunction And Impaired Safety Awareness: A Case Report, Cameron Mccombs

Case Report Posters

Background: With advances in medicine, there are increasing numbers of people living who have had a stroke. One of the major factors that can limit improvement is cognitive dysfunction. Cognitive rehabilitation in conjunction with large amounts of repetition can result in lasting neuronal changes. Purpose: The purpose of this case study is to describe the decision making process for physical therapy examination and intervention for a patient who had a stroke with accompanying cognitive dysfunction and decreased

Instrument Assisted Soft Tissue Mobilization And Conservative Management Of Shoulder Pain In An Elderly Male: A Case Report, Dana Mccoy

Case Report Posters

Background: Shoulder pain is a frequent complaint among the elderly population, numerous etiologies cause shoulder joint pain such as osteoarthritis, adhesive capsulitis, and rotator cuff disease (impingement, tendonitis, and cuff tear). A conservative treatment for shoulder pathology is Augmented Soft Tissue Mobilization (ASTM) that uses specifically designed sold instruments to perform manual therapy. Sound Assisted Soft Tissue Mobilization (SASTM®) is a technique which uses ceramic polymer tools with resonating capability. Limited evidence exists to support the use of SASTM® as a manual therapy treatment. Purpose: The purpose of this case report is to illustrate the physical therapy management of shoulder …

Activity-Based Therapies For Repair Of The Corticospinal System Injured During Development, Kathleen M. Friel, Preston T. J. A. Williams, Najet Serradj, Samit Chakrabarty, John H. Martin

Publications and Research

This review presents the mechanistic underpinnings of corticospinal tract (CST) development, derived from animal models, and applies what has been learned to inform neural activity-based strategies for CST repair.We first discuss that, in normal development, early bilateral CST projections are later refined into a dense crossed CST projection, with maintenance of sparse ipsilateral projections. Using a novel mouse genetic model, we show that promoting the ipsilateral CST projection produces mirror movements, common in hemiplegic cerebral palsy (CP), suggesting that ipsilateral CST projections become maladaptive when they become abnormally dense and strong.We next discuss howanimal studies support a developmental “competition rule” …

The Pediatric Pt Management Of A Survivor Of Cancer: A Case Report, Kaylene Samuels

Case Report Posters

Cancer in the cerebellum in a pediatric population is rare. The cerebellum is responsible for: coordination of ongoing movements, postural control, visual gaze, performing smooth purposeful movements. There is limited evidence investigating the physical therapy management of pediatric survivors of cancer, more specifically, in cerebellum brain tumors. The purpose of this case report was to investigate the PT management of a pediatric survivor of cancer who had a cerebellar tumor resection.

Physical Therapy Management Of An In-Patient After Total Knee Arthroplasty: A Case Report, Jareth Pamer

Case Report Posters

Background: Increasing prevalence of knee OA and TKA; according to the American Academy of Orthopedic Surgeons, there will have been a half a million TKA procedures performed by 2030. Purpose: The purpose of this case report is to describe the physical therapy management of an in-patient status post total knee arthroplasty.

Inpatient Physical Therapy For A Patient With Dementia After Right Above Knee Amputation: A Case Report, Benjamin Blanchette

Case Report Posters

Background: Lower limb amputation is a traumatic procedure that is most commonly performed on individuals who are diabetic or have peripheral vascular disease. Other causes of amputation include infection, trauma or cancer. A sarcoma is a cancer in tissues such as muscle, fat, cartilage, or bone. The treatment goal is to excise and prevent growth or metastasis of the sarcoma. There is limited literature regarding dementia involving motor planning deficits and physical therapy. However, based upon the interventions provided by physical therapists it is believed that individuals with dementia involving motor planning deficits will have some difficulty. Purpose: The purpose …

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

Case Report Posters

Background: Lewy Body Dementia (LBD), and the role of physical therapy (PT) in treating this population, is scarce in the literature. LBD is considered a differential diagnosis of Parkinson’s Disease (PD); therefore, the idea to use PD specific interventions, primarily Lee Silverman Voice Treatment-Big (LSVT BIG), may be considered a suitable intervention. Purpose: To educate the readers about LBD, how it presents, and how PD related interventions can be used as a treatment.

Outpatient Physical Therapy Management Of A Female Athlete With A Left Anterior Cruciate Ligament Reconstruction And Left Medial Meniscectomy: A Case Report, Kyle Brown

Case Report Posters

Background: The anterior cruciate ligament (ACL) is a structure within the knee that prevents anterior translation of the tibia on the femur as well as checks lateral rotation of the tibia and extension of the knee. The ACL is typically injured in noncontact sports by a sudden deceleration prior to a change of direction or landing motion. Female athletes are more than twice as likely to sustain an injury to the ACL. An ACL injury is often accompanied by an injury to the meniscus of the same knee. Purpose: The purpose of this case report is to provide a comprehensive …

The Effects Of Robot-Assisted Gait Training And Task-Specific Training On Adl Function And Mobility For A Patient After A Stroke: A Case Report, Maegen Johnson

Case Report Posters

Background: Stroke is the fourth leading cause of death and the leading cause of long term disability in the United States. Repetitive task-specific training has been shown to be favorable in stroke rehabilitation. Robot-assisted gait training (RAGT) incorporates gait training and repetitive task-specific training. RAGT has been shown to increase the likeliness of independent walking ability in patients who have experienced a stroke, especially when utilized in first three months. Currently there is limited research regarding the impact of RAGT on ADL function. Purpose: To describe the impact of robot-assisted gait training in combination with task-specific training on the functional …

Multimodal Physical Therapy Interventions Designed To Restore Independence And Motor Control In A Patient With Acute Cerebellar Stroke, Annarae Andresen

Case Report Posters

Background: The cerebellum integrates sensory perception, coordination, and motor control. Cerebellar stroke accounts for 3.4% of the 600,000 strokes that occur annually in the United States. Due to the rarity of ACS, very little research has been conducted regarding multimodal PT interventions as a treatment option. Purpose: The purpose of this case report was to describe multimodal PT interventions designed to restore independence and motor control for a patient with ACS.

Outpatient Physical Therapy Following Triple Arthrodesis Surgery: A Case Report, Nella Bernardoni

Case Report Posters

Background: Triple arthrodesis is the surgical fusion of the talonavicular, talocalcaneal, and calcaneocuboid joints of the foot. Joint surface preparation includes debridement, removal of cartilage, burring of subchondral bone, and fish scaling of the joint surfaces. The joints are then fused using screws. No inversion or eversion motion, only plantarflexion and dorsiflexion. Primary goals: abolish pain, correct underlying deformities, and restore a stable platform for ambulation. Indicated for severe arthritis, instability, and deformity that cannot be controlled with nonsurgical approaches. Purpose: To provide an overview of triple arthrodesis surgery and to report a case describing the specific outpatient physical therapy …

Anti-Gravity Treadmill And Functional Training For An Army Soldier Following A Femoroplasty And Labral Repair: A Case Report, Christopher Halloran

Case Report Posters

Background/Purpose: Femoral Acetabular Impingement (FAI) is characterized by three specific types of impingement between the head of the femur and acetabulum. Cam impingement occurs when the head of the femur is abnormally shaped. The head of the femur isn’t round, it is more of a pistol grip shape. It's even referred to as a pistol grip deformity. Due to this abnormal shape, the head of the femur cannot move properly in the anatomically designed ball-and-socket joint. The result is a shearing force on the labrum and the articular cartilage. Minimal amounts of articles were found that truly utilized physical therapy …

Outpatient Physical Therapy Management Of A Breast Cancer Survivor Following Kyphoplasty With A Complex Medical History, Molly Thornton

Case Report Posters

Background and Purpose: There are over 3 million breast cancer survivors in the U.S. Cancer and its treatment can cause a wide variety of long-term physical and psychological problems. The physical therapist’s role is not well defined for this population. The purpose of this case report is to describe the outpatient physical therapy management for a patient with a history of breast cancer as well as considerable additional health issues.

Physical Therapy Outcomes In A 28 Year Old Male With A Femoral Neck Fracture Using Aquatic And Land-Based Therapeutic Exercise: A Case Study, Daniel Johnson

Case Report Posters

Background: Hip fractures occur in approximately 341,000 persons each year in the U.S. Hip fractures at a young age are uncommon and are usually the result of a high-velocity injury or, rarely, secondary to bone pathology. Morbidity associated with an inability to return to a pre-fracture level of mobility often results in a loss of independence, reduction in quality of life, and depression. There is a lack of available literature on the physical therapy management of hip fractures in the younger patient population. Purpose: The purpose of this case report was to investigate the physical therapy management of a 28 …

Transmedial Documentation For Non-Visual Image Access, Melody J. Mccotter

Proceedings from the Document Academy

In my doctoral studies on information accessibility for the individual who is blind or visually impaired, I’ve been exploring the ways we can make image documents more accessible. This requires using an alternative sensory modality, and translating the document into a different format. The questions that arise when we consider this process are many, but among them are:

• Is it the same document once we’ve converted it to an audio narrative about the work, or a 3D topographic map of an artwork, or a musical interpretation?
• If it is not the same document, how truthful can the “trans-medial” translation be …

Improving Functional Independence With Rehabilitation Following A Metastatic Melanoma Brain Tumor Resection: A Case Report, Benjamin Sherr

Case Report Posters

History: A 67 year-old male with a one year history of melanoma complained of headaches 1-2 weeks prior to admission to an acute care hospital with left sided hemiplegia and dysarthria. A head CT scan revealed an intracerebral hematoma and a lesion suspicious for metastasis within the right parietal lobe. A right parietal craniotomy, evacuation of the hematoma and resection of the brain tumor were performed and the pathology revealed metastatic melanoma. Discussion: The patient received 18, 60-75 minute physical therapy sessions over a span of 21 days while in the inpatient rehabilitation unit. This case study utilized many essential …

Outpatient Physical Therapy Management Of A Patient Three Months Following Left Shoulder Arthroscopic Repair Of A Type-Ii Slap Lesion: A Case Report, Charles Dowd

Case Report Posters

Background: Research demonstrates a drastic increase in the prevalence of type-II superior labral anterior-posterior (SLAP) lesion repairs, and its surgical correction has become the favored method of treatment, because of its ability to effectively improve quality of life (QOL). A type-II SLAP lesion consists of fraying and degenerative changes to the superior labrum, in an anterior to posterior direction, with the biceps tendon detached from the glenoid. Purpose: Document the examination, evaluation, and plan of care (POC) concerning a patient that was referred to physical therapy (PT) three months following the surgical correction of a type-II SLAP lesion.

Outpatient Physical Therapy Following Surgical Debridement Of Osteochondritis Dissecans Of The Talar Dome: A Case Report, Angela Serrani

Case Report Posters

Background: Osteochondritis Dissecans (OCD): Alteration of subchondral bone with disruption of the adjacent articular cartilage; cause unknown, hypotheses include repetitive trauma and or non-traumatic disruption of subchondral blood supply; suspected chondral injury with up to 50% of ankle instability episodes. Treatment Options: Goals: relieve symptoms and improve function; non-surgical: rest, immobilization, NSAIDS; surgical: excision of lesion, excision with cutterage and/or microfracturing, filling the defect with bone graft, antegrade transmelleolar drilling, retrograde drilling, fixation, osteochondral transplantation, and autologous chondrocyte implantation. Purpose: To describe physical therapy treatment and outcomes for a patient following surgical debridement of OCD of the talar dome.

Physical Therapy Management With Emphasis On Quadriceps Strength Training For Chronic Patellar Dislocations In A Female Adolescent With Kabuki Syndrome: A Case Report, Liesel Jay

Case Report Posters

Background: Kabuki Syndrome (KS) has a current estimated prevalence at 1 in 32,000. KS is a rare, but highly recognizable genetic disorder manifested in the craniofacial, skeletal, neurological, and cardiovascular systems/regions of the body. Patellar dislocations are common in children with KS due to the presence of hypotonia causing muscle imbalances and joint laxity. Most commonly, treatment of patellar islocations are done conservatively through exercise. Surgical interventions (lateral release, medical imbrication, medial patellofemoral ligament reconstruction, or bone realignment) are considered with continued dislocations. Purpose: Physical therapy management approach with a focus on addressing chronic patellar dislocations through quadriceps strengthening in …

The Use Of Electrical Stimulation And Cryotherapy In Pain Reduction For A Patient Following An Arthroscopic Partial Meniscectomy: A Case Report, Miranda Carlson

Case Report Posters

Background: An arthroscopic partial meniscectomy is a common procedure that consists of removing some of the meniscus from the tibio-femoral joint. It is a minimally invasive surgery. Following the procedure, physical therapy is used to improve function. In many cases, some level of pain management is utilized which may include Transcutaneous Electrical Nerve Stimulation (TENS) and cryotherapy. TENS has been shown to be more effective than pain medication following arthroscopic knee surgery and aid in faster regains of strength and range of motion. Cryotherapy for pain management has been shown to have a significant effect on the level of pain, …

Wordless Intervention For Epilepsy In Learning Disabilities (Wield): Study Protocol For A Randomized Controlled Feasibility Trial, Marie-Anne Durand, Bob Gates, Georgina Parkes, Asif Zia

Dartmouth Scholarship

Epilepsy is the most common neurological problem that affects people with learning disabilities. The high seizure frequency, resistance to treatments, associated skills deficit and co-morbidities make the management of epilepsy particularly challenging for people with learning disabilities. The Books Beyond Words booklet for epilepsy uses images to help people with learning disabilities manage their condition and improve quality of life. Our aim is to conduct a randomized controlled feasibility trial exploring key methodological, design and acceptability issues, in order to subsequently undertake a large-scale randomized controlled trial of the Books Beyond Words booklet for epilepsy.