Medicine and Health Sciences Commons^™

Total Quality Management In Physical Therapy: A Primer For Physical Therapists In Search Of Quality, Brian C. Kittelson

Physical Therapy Scholarly Projects

Total quality management (TQM), a management system first successfully utilized in the manufacturing industry, has gained much popularity in the healthcare industry over the past few years. Books, articles, conferences, workshops, and video tapes that teach health care executives how to utilize TQM in their organizations abound. Unfortunately, resources which specifically apply the TQM philosophy and tools to the practice of physical therapy are few. The purpose of this project is to provide a resource that introduces the philosophy, methods, and tools of TQM with applications to the physical therapy setting.

Chapter one briefly discusses the general history of TQM …

Parkinson's Disease: An Exercise Approach To Treatment, Kara Lynn Klosterman

Physical Therapy Scholarly Projects

Parkinson's Disease (PO) is a common neurological disorder affecting elderly people. Patients suffering from PO typically display three cardinal signs: tremor, rigidity, and bradykinesia. As the disease progresses, secondary symptoms develop. These cardinal signs and secondary symptoms decrease the patient's abilities to function during normal daily activity.

Physical therapists are specially trained in the evaluation and treatment of persons with movement disorders such as PD. Research demonstrates success in the treatment of PO when physical therapy services are utilized. Physical therapists educate patients and their families about PD. Via exercise, physical therapists prevent the onset of complications and improve the …

Patient Compliance With Medical Regimens, Stacie R. Lund

Physical Therapy Scholarly Projects

Patient compliance is defined as the patients' following a request, wish, or demand that a health care provider has decided is necessary and beneficial for the improvement of the health of the patient. Oftentimes, though suggestions by providers are in the patient's best interest, patients will instead either disregard what has been told to them or actively go against the suggestions. Certainly, the patient is the manager of his/her own health care program, however, noncompliance is a very common problem. There are several reasons for noncompliance, including the psychological make-up of the patient, the patient's social environment, the nature of …

Fibromyalgia: Diagnosis And Management, Janet Mckinnon Rasmusson

Physical Therapy Scholarly Projects

Fibromyalgia is a nonarticular rheumatic disease of unknown origin. It is diagnosed by the presence of widespread pain of more than three months duration and tenderness at 11 or more of 18 tender point sites. Typical symptoms of this syndrome are generalized pain, stiffness, and chronic fatigue due to sleep disturbances. Other uncommon symptoms include headaches, anxiety, depression, irritable bowel syndrome, and numbness. These symptoms become worse with the presence of modulating factors such as weather, stress, fatigue, overexertion, or inactivity.

The purposes of this independent study are to examine the prevalence and demographics of this disorder, discuss the etiology …

A Review Of Chronic Lateral Ankle Instability, Marcy K. Narum

Physical Therapy Scholarly Projects

Ankle injuries constitute one of the most common and most frequent injuries affecting the lower extremities, with lateral ligament sprains comprising the majority of the ankle injuries. The development of chronic lateral ankle instability is a relatively common occurrence following an acute ankle sprain. Previously the treatment of chronic lateral ankle instability has been primary surgical intervention, but more recently the initial treatment is shifting toward a conservative approach emphasizing functional rehabilitation of the unstable ankle. Frequently the treatment of recurrent sprains and chronic instability addresses only the symptoms; however, a treatment program addressing the underlying causes of instability needs …

Hippotherapy: A Survey Of Therapists Nationwide, Yvette J. Normandin

Physical Therapy Scholarly Projects

The purpose of this study was to survey physical therapists nationwide who are involved with North American Riding for the Handicapped Association (NARHA) certified centers to obtain their perspectives regarding the need for more empirical research and outcome studies, benefits of Therapeutic Horseback Riding, and methods of objective evaluation utilized when determining patient improvement. Of the 261 surveys mailed, 125 (48.8%) were returned with 110 utilized for data interpretation.

Respondents indicated a large need for more empirical research to support therapeutic horseback riding as a treatment method and to facilitate increased acceptance by the medical field in general. Only a …

Overview Of The Flaccid Hemiplegic Shoulder Following A Stroke, Tricia R. Pederson

Physical Therapy Scholarly Projects

Stroke may cause long-term disability and impairment in the hemiplegic shoulder. Problems may develop early in the flaccid phase of recovery and complicate the entire rehabilitation process. The etiology and treatment of shoulder complications remains uncertain. Contributing factors include inappropriate handling and positioning, abnormal muscle tone, impaired sensation, and musculoskeletal pathology.

Prevention and treatment of shoulder dysfunction begins with positioning, early range of motion, and education. Physical therapists play an important role in stroke management by administering therapeutic positioning programs, teaching appropriate exercise regimens, and instructing in proper handling techniques.

The purpose of this paper is to review methods being …

Multiple Sclerosis: A Literature Review, Jody E. Price

Physical Therapy Scholarly Projects

Multiple Sclerosis (MS), a demyelinating disease of the Central Nervous System (CNS), is the most common cause of nontraumatic disability affecting young adults in the United States. The resultant lesions lead to a variety of symptoms which include: weakness, sensory disturbances, visual problems, spasticity, fatigue, and paralysis. There are also a number of psychological and emotional issues that the MS patient must face. The cause of MS remains unknown and the diagnosis is often difficult. The course and severity of the disease varies from patient to patient. There is no known cure or prevention.

Current treatments include drug therapy, physical …

Diagnostic Criteria And Management Of Carpal Tunnel Syndrome, Holly Rogers

Physical Therapy Scholarly Projects

Carpal tunnel syndrome (CTS) is an entrapment neuropathy involving the median nerve as it passes through the carpal tunnel. CTS is widely recognized as the most common of all nerve entrapment syndromes. CTS develops when irritation causes the tendon sheaths passing through the carpal tunnel to swell, constricting the tunnel and compressing the median nerve. Manifestations of CTS are varied, but usually include pain, numbness and weakness of the hand. Incidence of CTS has risen sharply in the past five years. Prevention of CTS and reduction of it's effects appears to be the best solution for this disorder. Physical therapists …

A Detailed Look At The Innovative Manual Therapy Technique: Strain/Counterstrain, Rochelle Skarperud

Physical Therapy Scholarly Projects

The purpose of the following literature review is to provide the reader with information regarding the manual therapy technique of strain/counterstrain. The review will describe the origin, theory, rationale, and methods associated with the treatment technique of strain/counterstrain. The role of the muscle spindle and trigger point as utilized in the technique are discussed in detail, along with a comparison of strain/counterstrain to similar manual therapy techniques. Several of the techniques discussed are: acupressure, acupuncture, osteopathic manipulation, and muscle energy techniques. To further support the authors' viewpoints, several case studies are presented and reviewed. The general treatment techniques and guidelines …

The Effects Of Supramalleolar Orthoses On The Biomechanics Of The Knee, Foot, And Ankle During Gait: A Single-Subject Design, Jennifer Ruth Stauffer

Physical Therapy Scholarly Projects

Gait deviations are a common problem associated with disorders of movement and posture such as cerebral palsy (CP). Inhibitive casts and ankle-foot orthoses have been used to treat gait deviations in children with CP, but they have not satisfied the needs of children who are able to achieve active dorsiflexion and plantarflexion but lack stability at the subtalar joint. Supramalleolar orthoses (SMOs) were developed to address that need. SMOs, along with physical therapy, have been used to treat children with CP, but little research has been conducted to determine the actual effects of the SMO on lower extremity biomechanics during …

Occupational Cumulative Trauma Disorders: Prevention And Treatment, Michelle Uyeno

Physical Therapy Scholarly Projects

Cumulative Trauma Disorders (CTDs) consist of a group of musculoskeletal injuries caused by overuse or repetitive strain. The purpose of this Independent Study was to review the literature concerning occupational CTDs, the methods of prevention, and treatment as it related to physical therapy. The most beneficial means of controlling CTDs appear to be taking preventative measures with jobsite analysis and employee education. Treatment is varied and dependent upon the actual diagnosis and causative factor. Therapists may attempt heat or cold modalities, work hardening programs, or manual therapy such as strain-counterstrain. An important aspect to treatment is early intervention. Due to …

A Literature Review On Wheelchair Products And Fitting, Lee M. Werchau

Physical Therapy Scholarly Projects

Physical therapists are often involved in wheelchair prescription. An important factor when recommending or prescribing a wheelchair is proper fit. Proper wheelchair fitting is critical when attempting to get maximum independence, normalize tone in spastic or low tone clients, as well as decreasing bony deformities and pressure ulcers. Crucial measurements for wheelchair fitting include backrest height and seat width, depth, and height. To assure ultimate independence an individuals mental competence, ROM in upper extremities, cardiopulmonary health, and coordination must be evaluated prior to prescribing a wheelchair. Options to consider are the type of seat cushion, wheelchair frame, peripherals, and safety. …

Assessment Of Physical Therapy Needs At Third Street Clinic, Susan Wheeldon

Physical Therapy Scholarly Projects

Health care is being provided free of charge at the Third Street Clinic in Grand Forks, North Dakota, for those people who are uninsured or who do not qualify for Medicare or Medicaid. Physical Therapy is not presently offered as a service at the Clinic.

Physical Therapy is part of comprehensive health care. Therapists provide caring and expertise in the areas of neurological rehabilitation, orthopedic/musculoskeletal problems, pediatrics, and work hardening. As volunteers, therapists are involved in providing care at free clinics across the nation.

The Third Street Clinic agreed to have a needs assessment performed to identify those clients who …

Women With Physical Disabilities Choosing To Have Children, Alexia Anne Evans

Senior Honors Theses and Projects

Society views women with physical disabilities as being incapable of competent parenting. Many of these women do, however, choose to have children. This paper, in addition to describing common producers of disability in child-bearing aged women, explores the literature concerning the role of mother and how women with physical disabilities fulfill that role. Two women with postpolio were interviewed about their experiences in raising children. The interviews showed themes of reaction to discouragement, impact on mobility, and individual method of compensation. Implications for occupational therapy intervention are drawn

In Vitro Effects Of Two Silver Electrodes On Select Wound Pathogens, Linda Jean Laatsch-Lybeck, Poh Chye Ong, Luther C. Kloth

Physical Therapy Faculty Research and Publications

The use of electrical current to promote wound healing is well documented. However, little is understood about the effects of micro-amperage direct current (μADC) on growth of wound pathogens. The purpose of this project was to investigate the antibacterial effects of a silver wire/silver nylon electrode carrying μADC in vitro on several Gram positive and Gram negative bacteria. The current was delivered via silver wire and silver nylon electrodes at an amplitude of 100 μA for a 30-minute duration in an in vitro system. Results demonstrated that only silver wire carrying current inhibited bacterial growth around …

Patellofemoral Pain In Female Ballet Dancers: Correlation With Iliotibial Band Tightness And Tibial External Rotation, John Winslow, Evangeline Yoder

Rehabilitation Sciences Faculty Publications

Review of the literature reveals that ballet dancers have a high incidence of idiopathic patellofemoral pain. Twenty-four female ballet dancers were subjects in a study of the relationship between: 1) iliotibial band (ITB) tightness and patellofemoral pain, and 2) ITB tightness and degrees of tibial external rotation used in the dance demi-plie. Dancers were initially assessed by questionnaire to determine if any had knee pain. Twelve subjects mel the study criteria for patellofemoral pain, and 12 dancers without knee pain served as controls for the study. Iliotibial band tightness was measured (Ober test), and degrees of tibial external rotation used …

Mentorship Experiences In A Group Of Occupational Therapy Leaders., Ruth Levine Schemm, Theodore Bross

Department of Occupational Therapy Faculty Papers

OBJECTIVES: The development of occupational therapy leaders is a long-held goal of many members of the American Occupational Therapy Association and of state associations. The initiation of mentor programs is a common means to accomplish this goal. These programs take time and effort, and, although occupational therapists have described how mentorship programs work in the literature, there are few articles that describe the actual mentorship experiences of occupational therapy leaders.

METHOD: To study the experiences of elected occupational therapy leaders, a 30-item questionnaire was distributed at the annual meeting of the Committee of State Association Presidents and completed by 53 …

Long Term Restoration Of Peak Torque, Endurance And Muscle Activation Post Anterior Cruciate Ligament Reconstruction, Darryl Alan Turner

Theses : Honours

In recent years, Accelerated Rehabilitation (A.R.) protocols have been used following Anterior Cruciate Ligament (A.C.L.) reconstructions, the longer term effects of these programs are seldom analysed. This study examined musculoskeletal mechanisms that might affect long term functional restoration, the control subjects (n = 19) of mixed age and gender, had no previous knee deficiencies and were recreationally fit. The experimental subjects (n = 17) had undergone intra-articular A.C.L reconstruction, using bone patellar-tendon bone grafts performed by the same surgeon and had also participated in the A.R. protocol, similar to that described by Shelbourne and Nitz (1990). The experimental group attended …

A Comparison Study Of The Effects Of Methods Of Pain Control On Client Outcomes, Susan K. Cristofori

Masters Theses

A correlational ex post facto design was used to study the relationships between methods of pain control and client perception of pain, achievement of the physical therapy regime and length of stay following total joint replacement surgery. Continuous epidural infusion and patient controlled analgesia (PCA) were the pain control methods examined in the study.; Perception of pain was measured using a 6-word descriptor verbal rating scale. Achievement of physical therapy was measured using the activity criteria on the case care map used at the study hospital. Length of stay was measured using daily census records. (1) The study site was …

Development And Evaluation Of The Cardiac Exercise Health Belief Scale, Virginia R. Mcginn

Masters Theses

The purpose of the study was to develop and evaluate the Cardiac Exercise Health Belief Scale (CEHBS) which is based on the Health Belief Model. The CEHBS focuses on the concepts of benefits and barriers. Ninety post cardiac event subjects, 69 males and 21 females, were recruited from two Michigan hospitals during their hospital stay. The CEHBS was mailed to subjects six to eight weeks following discharge.; Cronbach alpha for the CEHBS benefits subscale was.90 and for the barriers subscale was.84. Content validity was established by expert review. During factor analysis all items did load on factors related to the …

Personality Traits And The Extent To Which They Are Valued By Practicing Physical Therapists In The General Hospital Setting, Shiela M. Robison, Rachel K. Seppanen

Masters Theses

This descriptive study seeks to identify the value placed on personality traits by physical therapists and to develop a personality trait profile indicating what is desired of physical therapists in the general hospital setting. Five hundred surveys were sent to the physical therapy (PT) directors of a nationwide sample of randomly selected hospitals accredited by the American Hospital Association with greater than 75, but less than 150 beds. Two hundred and ninety-four surveys (59%) were returned. Survey responses were coded and analyzed using the Statistical Package for the Social Sciences (SPSS). The data was analyzed by using the descriptive measures …

Investigating Use Of The Transdisciplinary Approach In The Public School System: Assessment Of The Interaction Between The Physical Therapist And The Regular Education Teacher, Jennifer C. Bunker, Jennifer M. Wolffis

Masters Theses

The purpose of our research was to determine the extent that physical therapists utilize components of the transdisciplinary approach in their interaction with regular education teachers when working with children kindergarten through sixth grade who participate in regular education classes. 325 surveys were distributed to physical therapists in the Midwest region of the United States who work in a school environment. 46% of the surveys were returned and met our inclusion criteria. Our results showed that 28.7% of the respondents indicated use of the transdisciplinary approach. 41% of the respondents reported presence of a written philosophy. 9% of the therapists …

Timed Wheelchair Ambulation Of Children Aged 11-17 Years And Their Perceptions Of Their Function, Karen Feuerstein, Susan Fisher, Kristy Van Zee

Masters Theses

Problem. Little data is available to aid physical therapists in writing functional wheelchair velocity goals. Purpose. This study begins to establish baseline data on wheelchair velocity. The authors hypothesize that there will be a significant relationship between a child's perceived function and their wheelchair velocity over a given distance. Methods. One female and 10 male community manual wheelchair users aged 11-17 completed 3 time trials of 150 feet on carpet with 1 minute rest between trials. Following the WRAT-R reading screen, the subjects completed a questionnaire about wheelchair function in the community. Results. A two-tailed significance test of the correlation …

The Relationship Among Isokinetic Knee Parameters And Three Functional Tests, Kristen Brinks, Ronda Delong, Tanya Stout

Masters Theses

The purpose of this study was to investigate the correlation between knee strength and endurance, as tested by the Biodex{dollar}\sp\circler{dollar} isokinetic system, and the lateral step-up, cross-over hop for distance, and triple hop for distance. Subjects included 20 males and 30 females aged 21-40 years with no history of low back, hip, knee, or ankle injury that was treated by a physician. Bilateral knee flexion and extension strength, power, and endurance was measured at 60, 180 and 300 degrees/second with the hip extended and flexed 115{dollar}\sp\circ{dollar}. Isokinetic data were normalized to body weight and correlated to hop distance which was …

The Effect Of Family Participation On The Outcome Of Patients With Traumatic Brain Injury In Rehabilitation, Grant Middleton, Brett Ransom

Masters Theses

The purpose of this study was to explore the relationship between physical therapists' perceptions and institutional policies relating to family participation in rehabilitation and rehabilitation outcome of patients with traumatic brain injury. Utilizing surveys, we collected information about institutional policy from institutions that were members of the Commission for Accreditation of Rehabilitation Facilities (CARF) in the Midwestern United States. Thirteen institutional surveys provided usable Functional Independence Measure (FIM) scores for patients rehabilitated in 1993, which were used as the outcome measure. The therapists' perceptions survey (n = 104) gathered data about the belief of physical therapists relating to family involvement …

Knowledge Of High School Students Concerning Physical Therapy, Occupational Therapy, And Nursing, Amy Godlewski, Karen Oorbeck, Beth Spitzley

Masters Theses

The purpose of this study was to determine the level of knowledge of Kent County high school students regarding physical therapy, occupational therapy and nursing. A survey created by the investigators asked specific questions concerning these professions. The survey was administered to 545 eleventh and twelfth grade students. The scores were compared to demographic data and school characteristics (i.e. urban, suburban, rural, public or private). The researchers' hypotheses were that students would have a low level of knowledge concerning all these professions, and that students would be more familiar with nursing compared to physical therapy or occupational therapy. These hypotheses …

Functional Independence Measurement Scale: Analysis Of Variables To Determine Predictability To Stroke Patient's Discharge Site, Joseph A. Cloud, Daren C. Johnson, Tricia A. Lauinger

Masters Theses

The purpose was to define subsets of variables that are found within the Functional Independence Measurement (FIM) scale that demonstrate a high predictability to right cerebral vascular accident (CVA) patient's discharge site, including home, foster home, and skilled nursing facility. The researchers wanted to find if gait, along with other subsets, has a high prediction to discharge site than overall FIM admission and discharge scores together and separately.; Gait did not show a higher prediction to discharge site compared with subsets of FIM variables and overall FIM admission and discharge scores, together and separately. However, other subsets were found to …

Effectiveness Of An Interdisciplinary Chronic Low Back Pain Program Based On Return To Work Outcome, John R. Bromfield, Deborah A. Knowles, Stacie M. Schoenberg

Masters Theses

The purpose of this study was to determine the effectiveness of a Midwestern Hospital's Interdisciplinary Outpatient Chronic Low Back Pain program. Rate of return to work was selected as the outcome measure for effectiveness. For purposes of discussion, the percentage of patients who were compliant with home exercise, who were involved in a vocational rehabilitation program, and who consulted a physician since discharge were analyzed. There were 118 male and female subjects, average age of 43; who successfully completed the 8 week chronic low back pain program between 1992 and 1994. Subjects were then sent questionnaires at 1, 3, 6, …

Utilization Of Collaborative Clinical Education Placements, Sandie Marston, Sally Talbot

Masters Theses

The purpose of this study was to describe the collaborative model's utilization, effectiveness, and effect on ease of student placement. Surveys were sent to academic coordinators of clinical education at all 130 physical therapy programs in the United States. Four of these surveys were sent as a pilot study. Of 126 surveys sent, 114 were received for a 90% return rate. Frequencies of responses were calculated. 75% of respondents report using the collaborative model. Of those who use the model, 95% reported that it met their objectives for clinical education, and 93% reported decrease (24%) or no change (69%) in …