Medicine and Health Sciences Commons^™

Effects Of A Lateral Wedged Insole In Patients With Medial Compartment Osteoarthritis Of The Knee, Li-Wei Chou, Mu-Jung Kao, Pey-Yu Yang, Nai-Hsin Meng, Sui-Foon Lo, Hong-Wen Wu, Horng-Chaung Hsu

Rehabilitation Practice and Science

Background: Medial compartment osteoarthritis (OA) of the knee is one of the most prevalent and disabling chronic conditions affecting older adults. This study assesses the efficacy of an inserted lateral wedged insole for the conservative treatment of medial compartment knee OA.Methods: Thirteen outpatients (9 females and 4 males with a mean age of 71.0 and a standard deviation of 5.5) with medial compartment knee OA were prospectively treated with an inserted lateral wedged insole with an elevation of 12 mm for three months. The baseline and three-month visual analog scale (VAS) scores for subjective knee pain and the remission score …

Exploring The Relationship Between Body Build And Pressure Under The Ischial Tuberosity, Li-Ru Chen, Kuo-Hu Chen, Chia Lee, Ming-Shin Wang, Ting-Chang Chen, Cheng-Hsun Hsieh

Rehabilitation Practice and Science

Pressure ulcers usually occur over the ischial tuberosity of the people bound in wheelchairs. The objective of the study is to make a comparison between age, genders, and different factors of body build, including height, weight, body mass index, body fat percentage, waist circumference, buttock circumference, and mid-upper arm circumference, on their influences upon pressure under the ischial tuberosity.This experiment is a cross-sectional comparison study. We recruited 38 participants, including twenty-five males and thirteen females aged from 24 to 57. Our results showed that there were no differences on pressure under the ischial tuberosity among people of different age and …

Rehabilitation Of Transtibial Amputation Caused By Necrotizing Soft Tissue Infections: A Casereport, Shih-Kun Chang, Wai-Keung Lee, Huei-Yu Lo, Yau-Wai Wai, Won-Jean Lin, Kien-Jung Wang

Rehabilitation Practice and Science

Necrotizing soft tissue infections is an infrequent disease. Although many studies and casereports have been presented in recent years, none have described the impact of this disease on prosthetic fitting, ambulation training, and rehabilitation for patients with transtibial amputation.A 50 year-old man suffered from left transtibial amputation and received operation of split thickness skin grafts due to necrotizing soft tissue infections. He was trained to overcome the following problems: 1. Poor endurance, cardiopulmonary function and muscle strength of bilateral lower limbs. 2. The loss of dorsiflexion in the right ankle that resulted from excision of the anterior tibialis muscle. 3. …

Bilateral Putaminal Hemorrhage In A Young Female: A Casereport, Ke-Vin Chang, Wen-Shiang Chen, Huey-Wen Liang

Rehabilitation Practice and Science

Background: The etiology of spontaneous intracerebral hemorrhage (ICH) in young adults may include causative factors such as vascular abnormality, hypertension, anticoagulant therapy, brain tumor, and others. Hypertension is the most common cause of ICH in young adults in Taiwan. Simultaneous or multiple intracerebral hemorrhages are uncommon, and symmetrical distribution is even rarer. Most cases reported in the literature are in the elderly.Case: We report the case of a 29 years old female with a history of hypertension and elevated blood pressure, who presented with an acute onset of right side limb weakness. Results: Brain computed tomography (CT) showed hemorrhage in …

Exercise Training May Enhance Functional Capacity And Improve Heart Rate Impairment In Coronary Artery Disease Patients With Chronotropic Incompetence, Chen-Jung Hsu, Ssu-Yuan Chen, Ching Lan, Der-Sheng Han, Jin-Shin Lai

Rehabilitation Practice and Science

This study investigated whether coronary artery disease patients with chronotropic incompetence (CI) can significantly improve their functional capacity after exercise training. Forty-two men (mean age: 55.3±9.3yr) underwent coronary revascularization and without beta-blockade participated in a threemonth outpatient exercise training program. Patients were separated into a CI group (n=18) and a non-CI group (n=24) based on whether they could reach 85% of the age-predicted peak heart rate (HR). Chronotropic incompetence was defined as failure to achieve 85% of the age-predicted maximal HR. Bicycle exercise workouts were conducted three times weekly. The exercise duration was 30 minutes per session included 5 minutes …

A Psuedo-Mass Of Shoulder Girdle Due To Spinal Accessory Nerve Injury After Neck Lymph Node Biopsy: A Casereport, Yen-Nung Lin, Jing-Hwa Wey, Mei-Chun Huang, Kwang-Hwa Chang, Chun-Chieh Chiu

Rehabilitation Practice and Science

Shoulder problems such as pain, weakness, limited range of motion and palpable mass are common complaints in PM&R clinic. This casereport describes a less common but not rare condition: iatrogenic accessory nerve injury after neck lymph node biopsy. The patient in this study presented symptoms of shoulder girdle pain and weakness and also complained of a ”hard palpated mass” over her shoulder girdle.A 49-year-old female complained of gradually worsening left shoulder pain accompanied by weakness and limited range of motion in her left shoulder for many months. She had sought medical advice for many times and rotator cuff pathology was …

Argininosuccinic Acidemia: A Casereport, Chih-Wei Lin, Huey-Jen Lay, I-Ju Chen

Rehabilitation Practice and Science

Urea cycle disorder (UCD) is one of inborn error diseases. Citrullinemia is the most common disease (1/57000) among them, followed by argininosuccinic acidemia (ASA) (1/70000). The common characteristic of UCD is hyperammonemia induced by the abnormal liver function. Common symptoms at the onset of diseases include altered consciousness, respiratory insufficiency and seizures. Developmental delay, mental retardation, cerebral palsy, and learning disability are common findings in long-term follow-ups. In this report, we give an account of a patient with ASA. Besides the aforementioned symptoms and long-term sequelae, this patient also has the problem of ataxia. However, the patient's conditions and developments …

Botulinum Toxin Type A Treatment For Drooling In Taiwanese Children With Cerebral Palsy: Three Casereports, Yu-Ching Lin, I-Ling Lin, Yu-Te Chiu, Jeng-Yi Shieh

Rehabilitation Practice and Science

Botulinum toxin is a promising treatment option for the management of drooling in patients with cerebral palsy. However, the effect of botulinum toxin type A in treating drooling of Taiwanese children with cerebral palsy has not been reported thus far. We injected single dose botulinum toxin into bilateral parotid glands of three children with cerebral palsy, and followed the results over a 9-month period. Drooling improved in all three patients without significant adverse effects during follow up. There were individual differences in terms of efficacy and duration of effect. Two patients had longer duration of effect than that reported in …

Is Electrical Stimulation A Predictive Tool For Autonomic Dysfunction In Males With Diabetes?, Susan Dorothy Rand

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine whether electrical stimulation can be used as a predictive tool to assess autonomic dysfunction in males with diabetes. The study was designed to better understand the extent of autonomic nervous system (ANS) dysfunction in the diabetic population.

Controls and patients with diabetes were recruited from the community at large and the Loma Linda University Diabetes Treatment Center and were managed by a physician. Twelve (12) people with diabetes and thirteen (13) control subjects participated. Mean age (years) for people with diabetes was 52.4 +/- 6.1 and 47.2 +/-11.1 for controls (p =0.05). …

Effects Of Voluntary Breathing On Force Responses To Electrical Stimulation (Es) Of Finger Extensors : A Pilot Study, Shang Li, W. H. Park, Elizabeth Ikeda, Charles Leonard

Physical Therapy and Rehabilitation Science Faculty Publications

Voluntary breathing can influence motor functions of non-respiratory skeletal muscles, e.g., finger muscles. The influence was proposed to be mediated by the ventilation-associated enhancement on corticospinal excitability of the finger muscles, possibly including spinal mechanisms. Force responses to electrical stimulation include spinal mechanisms. The purpose was to investigate the potential spinal mechanism mediating the voluntary breathing effects on responses of finger extension forces to electrical stimulation. A single-pulse electrical stimulation of the same intensity was delivered to the extensor digitorum communis (EDC) during voluntary breathing (forced inspiration, IN and force expiration, OUT) and normal breathing (Norm) across various submaximal levels …

Developing "Human Functioning And Rehabilitation Research" From The Comprehensive Perspective., Gerold Stucki, Jan Dietrich Reinhardt, Gunnar Grimby, John Melvin

Department of Rehabilitation Medicine Faculty Papers

With the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) has prepared the ground for a comprehensive understanding of Human Functioning and Rehabilitation Research, integrating the biomedical perspective on impairment with the social model of disability. This poses a number of old and new challenges regarding the enhancement of adequate research capacity. Here we will summarize approaches to address these challenges with respect to 3 areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programmes and the building of university centres and collaboration networks.

Reference Group Data For The Functional Gait Assessment, Martha L. Walker, Alvis G. Austin, Gina M. Banke, Suzanne R. Foxx, Lynn Gaetano, Laurie A. Gardner, Jill Mcelhiney, Kisiah Morris, Liz Penn

Rehabilitation Sciences Faculty Publications

Background and Purpose: The Functional Gait Assessment (FGA) is a clinical tool for evaluating performance in walking. The purpose of this study was to determine age-referenced norms for performance on the FGA in community-living older adults.

Subjects: Subjects were 200 adults, ages 40 to 89 years, living independently.

Methods: Each subject completed the FGA one time and was scored simultaneously by 2 testers.

Results: The intraclass correlation coefficient for interrater reliability was .93. Mean scores for the FGA ranged from 29/30 for adults in their 40s to 21/30 for adults in their 80s.

Discussion and Conclusion: Patient performance on the …

Using Art In Occupational Therapy With People Who Have Cancer: A Qualitative Case Study, Jennifer R. Dochod

Masters Theses

OBJECTIVE. To explore the role of art, with a small group of people who have cancer, as a means provide distraction from pain, to help express feelings, and to assist in making connections with others.

METHOD. Using a randomized sample from Gilda’s Club, a support center for those with cancer, in-house social workers recruited two participants to take part in a small group case study conducted by a master’s level occupational therapy student.

RESULTS. Two participants enrolled in the art class conducted by the researcher. Predetermined questions gathered through participant interviews and class discussions provided the data. Although the participant …

Assistive Technology Enhancement Of Written Expression For Individuals With Neurodevelopmental Disorders [Poster], Laura Greiss Hess, Kerrie Lemons Chitwood, Susan Harris

Collected Faculty Scholarship

The purpose of this project is to carry out an intensive training program in subjects with a broad range of neurodevelopmental disabilities to assess the efficacy of assistive technology (AT) intervention.

Ua10/1 Cec: Clinical Exchange Corner, Mary Lloyd Moore, Laura Reynolds, Wku Suzanne Vitale Clinical Education Complex

CEC Publications

No abstract provided.

Assistive Technology Enhancement Of Written Expression For Individuals With Neurodevelopmental Disorders, Laura Greiss Hess, Kerrie Lemons Chitwood, Susan Harris

Collected Faculty Scholarship

This study involves the use of computer software to assess the use of assistive technology (AT) in individuals with neurodevelopmental disorders. We will present an update of the subjects in the study, including research issues, subject diagnoses and diagnostic trends as assessed through baseline and follow-up testing.

The Realization Of The Rights To Health, Education And Social Welfare Among Disabled Youth In Ingwavuma And Bhambanana, Kwazulu Natal, Ali Mumford

Independent Study Project (ISP) Collection

This practicum based study was completed in an effort to explore the realization of the rights to health, education and social welfare for disabled children in Ingwavuma and Bhambana, KwaZulu Natal. Very little research has been done on disabled children in South Africa, and estimations of prevalence range from 3.3-6.4%. The absence of accurate data creates a situation where implementation of policy and delivery of services is slow and does not always address the most urgent needs. The new South Africa aimed to bring rights and freedom to all groups of people, but the question which this study attempts to …

Mechanisms Of Fatigue Differ After Low- And High-Force Fatiguing Contractions In Men And Women, Tejin Yoon, Bonnie A. Schlinder-Delap, Erin E. Griffith, Sandra K. Hunter

Exercise Science Faculty Research and Publications

The magnitude of failure in voluntary drive after fatiguing contractions of different intensities in men and women is not known. The purpose of this study was to compare the time to task failure and voluntary activation of men and women for a sustained isometric contraction performed at a low and high intensity with the elbow flexor muscles. Nine men and nine women sustained an isometric contraction at 20% and 80% of maximal voluntary contraction (MVC) force until task failure during separate sessions. The men had a shorter time to failure than women for the 20% but not the 80% MVC …

An Exploratory Survey Of Occupational Therapists' Role In Hippotherapy, Cristina Cerquozzi, Ericka Cerquozzi, Amy Darragh, Heather Miller-Kuhaneck

Occupational Therapy Faculty Publications

The term hippotherapy is derived from the Greek word for horse, or hippos. The American Hippotherapy Association (2007) defines hippotherapy as an occupational, physical, or speech therapy intervention strategy, using the movements of a horse, used as part of an intervention program to facilitate functional gain. In hippotherapy, therapists use the movements of the horse as a vehicle for improving clients' functional limitations. Hippotherapy is an intervention method mentioned in the occupational therapy literature more than 20 years ago (Engel, 1984) that has received minimal research attention within our field. Little is known about the role of occupational therapists in …

Understanding Ayres' Sensory Integration, Susanne Smith Roley, Zoe Mailloux, Heather Miller-Kuhaneck, Tara J. Glennon

Occupational Therapy Faculty Publications

Occupational therapists and occupational therapy assistants rely on knowledge and skills to guide their intervention planning as they help clients who are experiencing difficulties with engaging in occupation. Sensory integration theory, with its rich history grounded in the science of human growth and development, offers occupational therapy practitioners specific intervention strategies to remediate the underlying sensory issues that affect functional performance.

This article articulates the core principles of sensory integration as originally developed by Dr. A. Jean Ayres, explains the rationale for developing a trademark specifically linked to these core principles, and identifies the impact that this trademark can have …

The Effect Of Lower Extremity Ergometry Exercise On Deltoid Intramuscular Temperatures During And Following A 30-Minute 1-Kg Ice Bag Treatment, Shigeru Takeuchi

All-Inclusive List of Electronic Theses and Dissertations

Context: The practice of cycling for cardiovascular benefits and the simultaneous application of an ice bag to the upper extremity for cryotherapy effects is convenient and time-saving. However, exercise increases body temperature specially in working muscles. However, non-working areas are used to dissipate heat by receiving warmed blood. Objective: To determine the effect of lower body exercise on deltoid cooling during 1-kg ice bag treatment and post treatment rewarming, separately. Design: Two ( during and after ice application) 2 X 5 repeated measures designs with the treatment condition (bike and rest) and time (baseline, 1-, 10-, 20-, and 30-minutes during …

Physiological Effects Of Vibration In Select Populations, Colleen S. Maloney-Hinds

Loma Linda University Electronic Theses, Dissertations & Projects

Recently, researchers have demonstrated that Whole Body Vibration results in significant increases in skin blood flow. No study has determined if there is an optimal frequency or duration for optimizing this response. In addition, there is no known mechanism for the increase in skin blood flow. It is hypothesized that nitric oxide (NO) is responsible for the increase in skin blood flow due to its ability to vasodilate the smooth muscle in response to shear stress. Therefore, the purpose of this research was to determine the optimal frequency and duration of vibration and determine if NO is the mechanism for …

Acute Reperfusion Therapy In St-Elevation Myocardial Infarction From 1994-2003, Brahmajee K. Nallamouthu, Martha E. Blaney, Susan M. Morris, Lori Parsons, Dave P. Miller, John G. Canto, Hal V. Barron, Harlan M. Krumholz

Collected Faculty Scholarship

Background—Appropriate utilization of acute reperfusion therapy is not a national performance measure for ST-elevation myocardial infarction at this time, and the extent of its contemporary use among ideal patients is unknown.

Methods—From the National Registry of Myocardial Infarction, we identified 238,291 patients enrolled from June 1994 to May 2003 who were ideally suited for acute reperfusion therapy with fibrinolytic therapy or primary percutaneous coronary intervention. We determined rates of not receiving therapy across 3 time periods (June 1994–May 1997, June 1997–May 2000, June 2000– May 2003) and evaluated factors associated with underutilization.

Results—The proportion of ideal patients …

Intervention To Enhance Skilled Arm And Hand Movements After Stroke: A Feasibility Study Using A New Virtual Reality System, Jill Campbell Stewart Pt,Phd, Shih-Ching Yeh, Younbo Jung, Hyunjin Yoon

Faculty Publications

Background: Rehabilitation programs designed to develop skill in upper extremity (UE) function after stroke require progressive practice that engage and challenge the learner. Virtual realty (VR) provides a unique environment where the presentation of stimuli can be controlled systematically for optimal challenge by adapting task difficulty as performance improves. We describe four VR tasks that were developed and tested to improve arm and hand movement skills for individuals with hemiparesis. Methods: Two participants with chronic post-stroke paresis and different levels of motor severity attended 12 training sessions lasting 1 to 2 hours each over a 3-week period. Behavior measures and …

The Physiological Consequences Of Bed Rest, Kristin J. Stuempfle, Daniel G. Drury

Health Sciences Faculty Publications

Bed rest often is used to treat a wide variety of medical conditions. However, bed rest results in profound deconditioning of the body. Bed rest reduces the hydrostatic pressure gradient within the cardiovascular system, reduces muscle force production, virtually eliminates compression on the bones, and lowers total energy expenditure. This review focuses on the deconditioning that occurs in the cardiovascular, muscular, and skeletal systems following bed rest. Reduction in plasma volume reduces cardiac preload, stroke volume, cardiac output, and ultimately, maximal oxygen consumption. Skeletal muscle volume, muscle cross sectional area, and fiber cross sectional area decrease, which results in diminished …

Concept Mapping 101, Heather Miller-Kuhaneck, Joanne M. Bortone, Lenore Frost

Occupational Therapy Faculty Publications

Concept maps are visual depictions of information, generally in diagram form, that are used to enhance and document learning (Novak, 1990; Whiteley, 2005). As a learning tool, concept maps have been used for many years in the fields of education and nursing (Novak, 1990; Schuster, 2002). The methods and uses of concept mapping have evolved in the areas of academic education, clinical education, and research since the 1970s (All & Havens, 1997; Novak, 1990; Schuster, 2002; Whiteley, 2005). This article discusses the use of concept mapping in occupational therapy education.

Bactericidal And Cytotoxic Effects Of Chloramine-T On Wound Pathogens And Human Fibroblasts In Vitro, Luther C. Kloth, Joseph E. Berman, Linda Jean Laatsch-Lybeck, Phyllis A. Kirchner

Physical Therapy Faculty Research and Publications

OBJECTIVES: To evaluate cytotoxicity and bactericidal effects of chloramine-T.

METHODS: In vitro study of various concentrations and exposure times to preparations containing human fibroblasts or 1.5 x 10⁸ colony forming units per milliliter (CFU/mL) of 3 gram-positive bacteria-Staphylococcus aureus, methicillin-resistant S aureus, and vancomycin-resistant Enterococcus faecalis-and 2 gram-negative bacteria-Escherichia coli and Pseudomonas aeruginosa-with and without fetal bovine serum present.

MAIN OUTCOME MEASURES: Percentage reduction of bacterial growth and percentage of viable fibroblasts 48 hours after exposure.

RESULTS: All gram-positive growth was reduced by 95% to 100%, regardless of dose, with or without serum. …

A Qualitative Study Of Inpatient Rehabilitation Client Perceptions Of The Semi-Fixed Environment, Liane Hewitt

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Literature supports the importance of the environment on promoting or compromising health. However, little is known about how the semi-fixed environment affects client perceptions and recovery from a debilitating condition. The purpose of this study was to investigate beliefs about control within the semi-fixed environment and client perceptions of the rehabilitation process.

Design and Method. This study utilized a basic qualitative research design with 10 rehabilitation clients whose average inpatient length of stay was 14 days. Data were collected in two phases. Phase I included two inpatient visits involving semi-structured interviews on the rehabilitation process and …

Co-Localization Of P-Creb And P-Nr1 In Spinothalamic Neurons In A Chronic Muscle Pain Model, Marie K. Hoeger Bement, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Activation of the cAMP pathway is an important mediator of chronic muscle pain. This study examined phosphorylation of the transcription factor cAMP-response-element-binding protein (p-CREB) and the NR1 subunit of the NMDA receptor (p-NR1) in the spinal cord. Bilateral mechanical hyperalgesia of the paw was induced by administering two injections of acidic saline, 5 days apart, into the gastrocnemius muscle of male Sprague–Dawley rats. The proportion of spinothalamic neurons that expressed p-NR1 or p-CREB did not change in the dorsal horn 24 h after the second intramuscular acid injection compared with animals that received pH 7.2 injections. This lack of change …

Antibacterial Activity Of Positive And Negative Polarity Low-Voltage Pulsed Current (Lvpc) On Six Typical Gram-Positive And Gram-Negative Bacterial Pathogens Of Chronic Wounds, Georg Daeschlein, Ojan Assadian, Luther C. Kloth, Christina Meinl, Frank Ney, Axel Kramer

Physical Therapy Faculty Research and Publications

The positive effect of electrical stimulation (ES) on wound healing has been shown in vitro and in vivo. On the basis of increased blood flow, protein denaturation, and stimulation of cellular defense, an antibacterial effect of ES is to be expected. Although the antibacterial effect of ES already has been demonstrated in vitro, little attention has been paid to the direct antibacterial effect of changing polarity of the applied current. The aim of this study was to investigate the antibacterial effect of positive and negative monophasic low-voltage pulsed current on typical Gram-positive and Gram-negative pathogens of chronic wounds. Using the …