Medicine and Health Sciences Commons^™

Conversion Paraplegia: A Casereport, Chin-Feng Yu Cheng, Shih-Ching Chen, Jiunn-Horng Kang

Rehabilitation Practice and Science

A 21-year-old man had progressive weakness and numbness of bilateral lower extremities and sphincter dysfunction after a traffic accident. The image and electrodiagnostic study showed no significant abnormal findings. Conversion paraplegia was suspected due to unusual clinical presentation, which cannot be explained by neuropathologic lesions. After intensive rehabilitation, patient's functional performance improved significantly and he could walk independently without device. But later, a fibrous dysplasia lesion was found at left sphenoid greater wing. He received an operation to remove it. The relationship between his benign brain tumor and conversion disorder is unknown, but the tumor that compressed temporal lobe might …

Voiding Dysfunction In Cerebellar Stroke: A Casereport, Chi-Chung Ho, Yu-Hui Huang, Su-Ju Tsai, Ko-Shin Jian, Yung-Liang Kao, Liu-Ing Bih

Rehabilitation Practice and Science

Animal studies have suggested that the cerebellum plays an inhibitory role in the collecting phase and a facilitatory role in the emptying phase of the voiding reflex in the micturition cycle.A 12 year old girl was admitted who complained of a headache and had a disturbance in consciousness after running in school. An emergent brain computed tomography scan showed massive bleeding over bilateral cerebellum hemispheres, vermis, and ventricles. An occipital craniotomy was performed to remove the hematoma. Simultaneously, an arterio-venous malformation was found and excised. She regained consciousness 3 weeks later, thereafter urine retention was noted as well as trunkal …

Effects Of Modified Constraint-Induced Therapy Versus Bilateral Movement Training On Upper Extremity Performance In Patients With Chronic Stroke: A Kinematic Analysis, Ya-Fen Chang, Wen-Chung Tsai, Chia-Ying Chung, Yin-Chou Lin, Yueh-Tsen Chen, Ching-Yi Wu, Ken-Chung Lin

Rehabilitation Practice and Science

Background and Objective: Several evidence-based treatment programs for improving upper extremity functions such as constraint-induced therapy (CIT)/modified CIT (mCIT) and bilateral movement training (BMT) have been developed recently. The mCIT program combines restraint of the unaffected hand with intensive training of the affected hand, and BMT involves intensive bilateral training with symmetrical functional training. In this study, the relative efficacy of mCIT vs. BMT was compared by a kinematic analysis that quantitatively assessed motor control in high functioning stroke patients when performing unilateral and bilateral functional tasks.Methods: In a pretest-posttest, randomized controlled trial, twenty-three stroke patients were randomly allocated to …

Assessment Of Individual Activities Of Daily Living And Its Association With Self-Rated Health Status In Elderly People, Yu-Ning Hu, Chin-Ching Li, Chia Lee, Rung-Huei Lin, Gwo-Chi Hu

Rehabilitation Practice and Science

Health-related quality-of-life in the elderly generally encompasses freedom from disease, good physical and psycho-social well-being, and preventing the loss of function in activities of daily living (ADL). Some indices of ADL, such as basic ADL and instrumental ADL, are considered to be measures of functional status in the elderly. However, in most studies, functional status is evaluated by either the summed ADL score or disability score in one or more ADLs. No studies have investigated the association between an individual's ADL function and self-rated health status. The purpose of this study was to investigate the relationship of functional status (i.e., …

The Wilson Disease: A Casereport, Nai-Chiung Huang, Ta-Sen Wei, Yen-Chung Chen, Wei-Chen Liang, Peng-Ta Liu

Rehabilitation Practice and Science

Wilson disease is a rare autosomal recessive inherited disorder of copper metabolism. The genetic defect, localized to chromosome arm 13q, has been shown to affect the copper-transporting adenosine triphosphatase gene. The major pathology is excessive deposition of copper in the liver, brain, and other tissues. The most common presenting neurological features are tremor, dystonia and ataxia that influence the motor control and gait. The diagnosis is confirmed by measurement of serum ceruloplasmin, urinary copper excretion and hepatic copper content as well as the detection of Kayser-Fleischer rings.The subject in our case study is a 25-year-old, female patient with Wilson disease. …

Huge Retroperitoneal Liposarcoma As The Initial Presentation Of Sciatica: A Casereport, Li-Ling Lin, Ssu-Yuan Chen, Chi-Lun Rau, Shin-Liang Pan, Yu-Wen Tien

Rehabilitation Practice and Science

Background: Retroperitoneal liposarcoma is one of the common soft-tissue tumors that occur in the retroperitoneal cavity. It often invades adjacent structures and causes symptoms of gastrointestinal or urinary tract infection. However, it rarely causes sciatica by compressing the lumbosarcral nerve roots. A recent reviewarticle of the domestic literatures revealed that this is the first casereport on sciatica caused by retroperitoneal liposarcoma.Case: We present the case of a 29-year-old man who complained of left knee pain for half a year. The pain gradually progressed to his left lateral calf. Sciatica was suspected based on his clinical symptoms and electrodiagnostic studies. However, …

The Effect Of A Health Promotion Program On Overweight Polio Survivors, Yen-Nung Lin, Chi-Yang Hsu, Chyan-Yeong Wang, Kwang-Hwa Chang, Tsan-Hon Liou

Rehabilitation Practice and Science

Although health promotion issues specific to people with physical disabilities have received much attention in the last ten years, related clinical trials studying the efficacy and viability of these programs are lacking. In this pilot study, we implemented a short-term health promotion intervention for overweight/obese post-polio survivors. The study design included a three-month intervention containing exercise, diet education and health behavior modification, a before-and-after comparison, and a 12-month follow-up.Thirty one subjects were enrolled. They were divided into three groups by their mobility ability. Group 1 was comprised of those who could walk independently without an orthosis; group 2 subjects walked …

Aphasia In A Congenital Deaf Man: A Casereport, Shu-Yi Wang, Jin-Cherng Chen, Huei-Ting Chen

Rehabilitation Practice and Science

Congenitally deaf persons don't have the ability to communicate verbally due to profound hearing impairment. Thus, they rely on words and sign language to communicate with others. Physicians tend to pay less attention to people who can't communicate verbally. We report the case of a 45-year-old congenitally deaf man who developed a left frontotemporal brain tumor. He was right-handed. As a result of the tumor, he lost both the ability to form words and the sign language he had relied upon to communicate with others. He recovered some ability to communicate 6 months after surgery. He was able to use …

Transient Osteoporosis Of The Hip During Pregnancy: A Casereport, Wen-Chuan Pai, Ching-Yang Lin, Mu-Jung Kao, Fong-Cheng Lin

Rehabilitation Practice and Science

Transient osteoporosis, also called ”bone marrow edema syndrome”, is a rare disorder of unknown etiology. It primarily affects women in the third trimester of pregnancy as well as middle-aged, overweight men, and the hip joint is most commonly involved. The main symptom of transient osteoporosis of the hip is a sudden onset of pain at the lateral aspect of the hip. Mild limitation of hip range of motion is often present. A 36-year-old woman presented to our outpatient department 5 weeks after cesarean section with bilateral hip pain, which had begun suddenly during her eighth month of pregnancy. Magnetic resonance …

Reliability And Validity Of The Iliac Crest Leveling And Paper Thickness Correction Method For Measuring Functional Leg-Length Discrepancy, Chun-Yi Lin, Tzu-Jung Wu, His-Hui Sung, Ke-Shin Jian, Chi-Chung Ho

Rehabilitation Practice and Science

The objective of this study is to determine the reliability and validity of a clinical measurement for functional leg-length discrepancy (LLD) using the level and paper thickness correction (LPC) method to determine intra-rater and inter-rater reliability and validity. We induced a simulated LLD (5-30 mm) for each subject twice in a block-simulating group (n=17), none of whom had an apparent LLD. The X-ray group (n=7), who had LLD, were measured using radiographs to measure the LLD. The examiner performed the LPC method in both groups by adjusting the bilateral height of the top iliac crest margin via the level and …

Teaching-Learning Philosophy, Celia Pechak

Selected Works Temporary Series

No abstract provided.

Influences On Job Retention Among Homeless Persons With Substance Abuse Or Psychiatric Disabilities, Russell K. Schutt, Norman C. Hursh

The Journal of Sociology & Social Welfare

Job retention is an important psychosocial rehabilitation goal, but one that is not often achieved. We investigate facilitators of and barriers to employment retention among homeless individuals with psychiatric and substance abuse diagnoses who were re-interviewed eight or more years after participating in a traditional vocational rehabilitation program. Most program graduates who maintained employment had secured social support from a variety of sources; personal motivation was also a critical element in job retention and compensated in some cases for an absence of social support. Both the availability of social support contacts and personal motivation influenced likelihood of maintaining sobriety. Physical …

Connecting Youth And Communities: Customized Career Planning For Youth With Psychiatric Disabilities, Kim Brown

The Journal of Sociology & Social Welfare

Young people with psychiatric disabilities are significantly overrepresented in the juvenile justice system, tend to be employed sporadically if at all, and frequently have negative connections within and to their communities. Recent research conducted in Montana with youth who have developmental and/or physical disabilities demonstrates the effectiveness of using a customized career planning model to increase linkages to resources and access to community- based employment. Side benefits include improved self-esteem and positive community connections. The customization model holds promise as a way to reduce the risk factors young people with psychiatric disabilitiesf ace and increase the resiliency factors that can …

Does The Gi Bill Support Educational Attainment For Veterans With Disabilities? Implications For Current Veterans In Resuming Civilian Life, Alexa Smith-Osborne

The Journal of Sociology & Social Welfare

A secondary data analysis of the 2001 National Survey of Veterans (NSV) for 2075 Gulf War-era veterans was conducted to investigate whether the GI Bill (the Servicemen's Readjustment Act of 1944, most recent provisions of which have been entitled the Montgomery GI Bill and the Post 9/11 GI Bill), considered as a social welfare policy, demonstrated protective effects for veterans with disabilities in terms of successful re-entry and sustained enrollment in higher education. Regression analyses to test the mediation effects of use of the GI Bill, use of non-Veterans' Administration (VA)financial aid, and use of VA health services suggested mediation …

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 …

Imitation In Fragile X Syndrome: Implications For Autism, Marta Macedoni-Luksic, Laura Greiss Hess, Sally J. Rogers, David Gosar, Kerrie Lemons-Chitwood, Randi Hagerman

Occupational Therapy | Faculty Scholarship

To address the specific impairment of imitation in autism, the imitation abilities of 22 children with fragile X syndrome (FXS) with and without autism were compared. Based on previous research, we predicted that children with FXS and autism would have significantly more difficulty with non-meaningful imitation tasks. After controlling for full-scale IQ and age, the groups did not differ in their overall imitation accuracy scores, but analysis of error patterns revealed that children with FXS and autism made more groping errors and additional movements than the comparison group. These error patterns are consistent with the hypothesis that an action production …

Μ-Opioid Receptor Agonist Injections Into The Presumed Pre-Bötzinger Complex And The Surrounding Region Of Awake Goats Do Not Alter Eupneic Breathing, K. L. Krause, Suzanne E. Neumueller, B. D. Marshall, T. Kiner, Joshua M. Bonis, Lawrence Pan, B. Qian, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Opioids are clinically important in the alleviation of pain. An undesirable side effect of opioids is depression of breathing. Data from isolated preparations suggest this effect is due to attenuation of discharge activity of neurons in the pre-Bötzinger complex (preBötzC), a medullary area with respiratory rhythmogenic properties. The purpose of this study was to examine how [d-Ala(2),N-Me-Phe(4),Gly(5)-ol]-enkephalin (DAMGO), a μ-opioid receptor agonist, affected breathing after injection into the presumed preBötzC of the adult awake goat. We hypothesized that DAMGO would cause breathing to decrease and become irregular when injected into the presumed preBötzC and the surrounding region of the conscious …

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

Sex Differences In Response To Cognitive Stress During A Fatiguing Contraction, Tejin Yoon, Manda Linea Keller, Bonnie Schlinder-Delap, April L. Harkins, Romuald Lepers, Sandra K. Hunter

Exercise Science Faculty Research and Publications

This study compared the time to task failure for a submaximal fatiguing contraction in the presence and absence of a cognitive stressor in men and women. In study 1, 10 men and 10 women (22 ± 3 yr of age) performed an isometric fatiguing contraction at 20% maximal voluntary contraction force until task failure with the elbow flexor muscles during two separate sessions. Subjects performed a mental-math task during one of the fatiguing contractions that aimed to increase anxiety and stress (stressor session). Salivary cortisol and reported levels of arousal (visual analog scale for anxiety, and State-Trait Anxiety Inventory …

Advanced Education & Research Training Initiative [Aerti] 2009, Mark Daniel Geil, John W. Michael

Faculty Articles

The American Academy of Orthotists and Prosthetists has long recognized the valuable synergy between research and education, and the mutual importance of each in advancing the field. Consequently, a focal point of an Academy grant initiative funded by the U.S. Department of Education has been a systematic analysis of research capacity and advanced education. A grant project in 2004 convened a series of meetings and produced the Advanced Education and Research Training Initiative (AERTI) report.

Continuing the initiative, a multidisciplinary and multinational group of experts convened in Chicago July 17-19, 2009 to review the 2004 AERTI Report, evaluate its recommendations …

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 …

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 …

Shoulder Rehabilitation For The Injured Overhead-Throwing Athlete, Joshua M. Raskoff

Recreation, Parks, and Tourism Administration

Baseball incorporates the violent motion of throwing as a main act of physical exertion. The shoulder joint is vulnerable to injury during this movement. The overall purpose of this study was to produce a rehabilitation program for injured overhead-throwing athletes and have it evaluated by healthcare professionals. A paper and pen style questionnaire was sent through the mail to a network of professionals in California. Eighteen of the 20 questionnaires were returned. The quantitative feedback of the Likert scale questions indicated that the program was effective and usable while the qualitative feedback indicated the opposite. The additional comments allowed experts …

Women Bound To Be Active: One Year Follow-Up To An Innovative Pilot Intervention To Increase Physical Activity And Self-Worth In Women, Jennifer L. Huberty, Jamie Vener, Laura Schulte, Sara M. Roberts, Beth Stevens, Lynda Ransdell

Kinesiology Faculty Publications and Presentations

The purpose of this investigation was to assess the effectiveness of a lifestyle intervention (a women’s book club; Women Bound to be Active) in promoting long-term physical activity (PA). Thirty-five women (26-70 years; mean age 50.6 years) completed the 8-month intervention and participated in the one-year follow-up. At follow-up, PA returned to baseline levels; however, self-worth and body mass index significantly improved. Women were more knowledgeable about PA at follow-up; however, they failed to maintain PA after the intervention. Components of the intervention were effective in improving self-worth and lowering BMI at one-year follow-up. To enhance long-term PA adherence continued …

Sleep-Disordered Breathing Affects Auditory Processing In 5–7 Year-Old Children: Evidence From Brain Recordings, Alexandra P.F. Key, Dennis L. Molfese, Louise O’Brien, David Gozal

Center for Brain, Biology, and Behavior: Faculty Publications

Poor sleep in children is associated with lower neurocognitive functioning and increased maladaptive behaviors. The current study examined the impact of snoring (the most common manifestation of sleep-disordered breathing) on cognitive and brain functioning in a sample of 35 asymptomatic children ages 5–7 years identified in the community as having habitual snoring (SDB). All participants completed polysomnographic, neurocognitive (NEPSY) and psychophysiological (ERPs to speech sounds) assessments. The results indicated that sub-clinical levels of SDB may not necessarily lead to reduced performance on standardized behavioral measures of attention and memory. However, brain indices of speech perception and discrimination (N1/P2) are sensitive …

Utilization Of Dantrolene In Stiff-Person Syndrome: A Case Report, John M. Vasudevan, Md, S. Kamal Fetouh, Md,, Nethra S. Ankam, Md, Adam L. Schreiber, Do, Ma

Department of Rehabilitation Medicine Faculty Papers

Setting: University hospital-based acute rehabilitation.

Patient: 75-year-old woman with Stiff-Person Syndrome (SPS) with a recent fall and Colles fracture.

Case Description: Four months prior to admission, the patient was diagnosed with SPS, negative for anti-GAD antibodies. Diagnosis was based on a 3-year history of progressive rigidity leading to frequent falls and fractures. Anxiety and fear of falling limited her mobility, and she sustained a sacral pressure ulcer during acute hospitalization. On admission, history was remarkable for unsteady gait and muscle cramps exacerbated when startled or excited. Examination was remarkable for rigidity in her axial and limb muscles. She presented …

The Effects Of Shoe Traction And Obstacle Height On Lower Extremity Coordination Dynamics During Walking., Leslie Decker, Jeremy J. Houser, John M. Noble, Gregory M. Karst, Nicholas Stergiou

Journal Articles: Physical Therapy

This study aims to investigate the effects of shoe traction and obstacle height on lower extremity relative phase dynamics (analysis of intralimb coordination) during walking to better understand the mechanisms employed to avoid slippage following obstacle clearance. Ten participants walked at a self-selected pace during eight conditions: four obstacle heights (0%, 10%, 20%, and 40% of limb length) while wearing two pairs of shoes (low and high traction). A coordination analysis was used and phasing relationships between lower extremity segments were examined. The results demonstrated that significant behavioral changes were elicited under varied obstacle heights and frictional conditions. Both decreasing …

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 …

Transverse Myelitis In Pregnancy: A Case Report, Brian P. Mcdonald, Do, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Faculty Papers

Objective: Describe the clinical course and treatment of a patient with paraplegia secondary to transverse myelitis during her pregnancy.

Setting: Acute Inpatient Rehabilitation Unit, University Hospital.

Participant: 36 year old Caucasian woman at 18 weeks gestation.

Interventions: Provided education and training on basic childcare tasks at a wheelchair level, and on how to obtain wheelchair accessible baby furniture. Provided availability of a peer who sustained a spinal cord injury prior to pregnancy. Maintained a close working relationship with maternal fetal health department regarding management of nausea and pain management, and educated team members about the possibility of autonomic …

The Effects Of Interx Therapy And Tens On Pain Relief In Patients Suffering From Medial Tibial Stress Syndrome, John Robert Erwin

Student Theses and Dissertations

One common injury throughout athletics involving running, is medial tibial stress syndrome (MTSS). In athletic training, electrical stimulation is used for control of pain associated with orthopedic injury. The purpose of this study is to compare the effect of InterX electrotherapy and Transcutaneous Electrical Nerve Stimulation's (TENS) ability to aid in the relief of pain from MTSS during running. Fourteen athletes with a current history of MTSS participated. A 2 minute warm up to reach an RPE score of 12 occurred first. Upon completion, the electrical stimulation was applied while the subject exercised at an RPE of 12 for 10 …