Medicine and Health Sciences Commons^™

Clinical Ladders In Physical Therapy, Stonewall E. Gessner

Physical Therapy Scholarly Projects

The clinical laddering system as it pertains to physical therapy is described. The history, purpose, benefits, and development of clinical ladders is presented. The benefits include improved recruitment and retention of professional physical therapy staff.

A clinical ladder in a physical therapy department may be very beneficial, but the decision to develop it should be considered carefully. Developing a clinical ladder system is a time consuming and costly undertaking and other alternatives should be considered first.

Functional Outcome In Stroke Rehabilitation, Meridee S. Green

Physical Therapy Scholarly Projects

Stroke is the number one source of adult disability in the United States, with approximately 400,000 new stroke survivors each year. The cost of care and the loss of earnings as a result of stroke is considerable. Stroke rehabilitation is a health service provided to try to decrease the disability and the socioeconomic costs. The purpose of this paper is to conduct a literature search to provide a review of stroke epidemiology, outline four functional outcome measures used in stroke assessment (Fugl-Meyer Assessment, Motor Assessment Scale, Barthel Index, and the Functional Independence Measure), identify predictive factors in functional outcomes of …

A New Look At Old Principles Of Ultrasound Application, Jeffrey S. Haney

Physical Therapy Scholarly Projects

No abstract provided.

Vertebral Subluxation Complex, Debbie L. Horn

Physical Therapy Scholarly Projects

At one time or another most adults have back pain. Despite the fact that back pain is as prevalent as the common cold, it has been as puzzling as the Bermuda Triangle. The primary problem is that in many patients it is not possible to identify the cause of symptoms, particularly if the symptoms are relatively minor. A review of literature reveals a wide variety of single causative lesions which would adequately encompass the various symptoms encountered. However, they are complex conditions which are highly oversimplified. This problem was recognized by Renaissance International who presented the concept of the Vertebral …

The Association Between Preoperative Instruction On Length Of Hospital Stay In Total Knee Replacements, Beth Darlene Ihry

Physical Therapy Scholarly Projects

Preoperative instruction has been a critical aspect of surgical procedure since the 1970s when hospitals started formal programs. With the recent push for health care reform, all aspects of the medical profession are looking toward cost reduction. This independent study proposal was designed to assess the comparison of length of hospitalization in total knee replacement patients who have preoperative instruction versus those who do not receive preoperative instruction. Problem with the prior research involving preoperative teaching included the following: a wide variety of surgical diagnoses, the number of different physicians performing the surgeries, the small sample sizes, and outdated literature. …

Passive Range Of Motion For The Rigid Knee, Margaret B. Ingold

Physical Therapy Scholarly Projects

The purpose of this study is to investigate whether daily passive range of motion treatment will knee range of motion in the rigid patient. with moderate to severe rigidity due to prevent loss of Eleven subjects Alzheimer's or dementia were selected. Medical records were reviewed and knee ROM measurements from 3 consecutive years were recorded and analyzed. Federal regulations pertaining to treatment are discussed. The numbers of people affected and the costs of caring for them are described. The urgent need for clinical research to identify the most appropriate treatment is addressed. A literature review of studies relating to rigidity …

A Two-Method Comparison Of Muscle Testing The Serratus Anterior: Daniels And Worthingham Vs. Kendall And Mccreary, Arlene J. Johnson Proulx

Physical Therapy Scholarly Projects

The purpose of this study was to compare the amount of force produced by the left serratus anterior muscle when using two methods of muscle testing. Thirty subjects (5 men, 25 women) participated in this study. A manual muscle test was performed with each subject properly positioned for testing a good to normal muscle grade using the Daniels and Worthingham and Kendall and McCreary methods of muscle testing. A practice test of each method was performed and a rest period of one and a half minutes was allowed between tests. A hand-held dynamometer, the Dynatron II, measured objective data. Strength …

Applied Anatomy And Biomechanics Of The Scapula, Garrett T.K. Kennedy

Physical Therapy Scholarly Projects

The scapula is the first link in the upper extremity kinetic chain. Analysis of the applied anatomy and biomechanics of the scapular link allows the physical therapist to develop pathomechanical models for shoulder injuries. The current health care trend of developing rehabilitation protocols based on sound anatomical, physiological, and biomechanical principles necessitates a strong background in the structure and function of the shoulder.

The purpose of this review of the literature is to provide a compilation of information regarding scapular anatomy and function. The paper is organized into four chapters. Chapter one discusses the phylogenetic and embryological development of the …

Electrical Stimulation As An Adjunct To Healing, Mary J. Lee

Physical Therapy Scholarly Projects

The purpose of this overview is to offer a possible avenue for advancing wound or ulcer healing when working with a population who experience complications of skin healing. In respect to their normal functional activities, these persons will experience limitations, and will also require more utilization of medical resources to assist in their progress. Dermal ulcers may predispose them to even further complications. There are many factors which influence the healing rate. Low voltage current and, more recently, the use of high voltage pulsed current, has been researched to serve as an additional treatment possibility for improved skin status.

Correlation Between Forefoot Varus And Passive Knee Extension, Scott B. Nice

Physical Therapy Scholarly Projects

The purpose of this study was to examine if a relationship exists between the amount of passive knee extension measured along with the degree of forefoot varus. The intent was to demonstrate that a positive relationship does exist.

Twenty single limbs were tested and all met the criteria set. Forefoot measurements were taken in the prone position, the plane of the lesser metatarsal bones was measured in relation to the bisection of the posterior aspect of the heel. Passive knee extension was recorded by measuring the distance of the lift of the calcaneus from the table, with the thigh stabilized …

Quality Assurance Issues In The Delivery Of Assistive Technology Services, Donald N. Olson

Physical Therapy Scholarly Projects

This independent study report provides an overview of the current state of the field of assistive technology for persons who have significant disabilities.

The field is extremely broad, and encompasses both low and high technology. Personnel working in field are diverse as well, representing nearly a dozen different disciplines. Two key issues confronting the collective field are professional education and credentialing.

In general, pre service professional programs do little to prepare students to deal with technological interventions. Some professionals who want to improve their competence in this area are doing so through graduate or post-graduate study, workshop attendance, or clinical …

The Effectiveness Of Back School, Suzanne R. Sandsmark

Physical Therapy Scholarly Projects

Four of five people suffer from low-back pain sometime during their lifetime. The nuaber of people with disabling back pain in the United States has increased by 168\ from 1971 to 1981. The purpose of this independent study report is to determine whether back school is as effective means of educating patients about proper back care; and whether back school helps prevent further back injury.

Back school clients at the Broadway Health Centre from July 15. 1992 to October 1. 1992 were invited to participate in this study. In addition. patients with back injuries referred to the Broadway Health Centre …

An Overview Of Transfemoral Socket Designs, Bradley C. Wehe

Physical Therapy Scholarly Projects

In the field of amputee rehabilitation, there are many variables that determine if the outcome is one of success. A large part of the process evolves from the type of prosthesis that is recommended for the amputee. With the advent of new technology, we are faced with the problem of deciding on the proper components that will make up the prosthesis. The complexity of artificial limbs has increased over the past years as the concept of suction componentry has evolved.

We are now faced with multiple types and styles of transfemoral socket designs and suspensions. A literature review was performed …

The Intervertebral Disc And Low Back Pain, Bruce H. Wessman

Physical Therapy Scholarly Projects

Low back pain has an enormous socioeconomic impact in this country. Even with advancement in diagnostic technology, the incidence and severity of low back pain continues to increase. The intervertebral disc plays an important causative role in the production of low back pain. The intervertebral disc may cause direct discogenic pain by mechanical and/or chemical irritation of the nociceptor receptors found within the outer one-third of the annulus fibrosis, or cause back pain by an indirect method. The incidence of low back pain is first reported around the age of 25 and is most prevalent from ages 35-60. It is …

Wound Care For Facial Burns, Barbara E. Wilson

Physical Therapy Scholarly Projects

More severely burned patients are surviving thermal burn injuries due to advances in medicine. A burn on any area of the body requires appropriate wound management. However, facial burns present with unique problems as the face is constantly exposed to society and the environment.

The purpose of this paper is to provide physical therapists with facial burn wound care and rehabilitation. Knowledgeable physical therapists are needed as members of rehabilitation teams to return facially burned patients to optimal functional and cosmetic levels.

Burn wounds are closely monitored, cleaned, and debrided to minimize infection. Skin care and patient education begins once …

An Analysis And Prediction Of A Patient-Focused Health Care Delivery System On The Practice Of Physical Therapy, Stephen M. Rood

Physical Therapy Scholarly Projects

The purpose of this independent study is to look at physical therapy's role within a new health care delivery system called patient-focused care (FCC). It supplies information on the status of our current health care industry and offers overwhelming support on requests for change. There is a comprehensive, comparative analysis of the current health care delivery system and that of the new experimental patient-focused health care delivery system. It offers a comparison of six major components in each model, such as physical structure, reporting structure, and process and procedures in job description, plans of care, scheduling, and cross training. Finally, …

Normative Data Of Cervical Spine Range Of Motion In The Elderly, Lisa J. Caspers

Physical Therapy Scholarly Projects

The purposes of this study were to develop normal values for cervical active range of motion and to determine whether age and gender affect cervical active motions. Sixty-one independent elderly individuals (36 females and 25 males), whose ages ranged from 60 to 90 years, voluntarily participated in this investigation. Six cervical active motions: flexion, extension, right and left lateral flexion, and right and left rotation, were taken by one physical therapist with the CROM device. Generally, between age groups, mean AROM values indicated losses in all cervical motions, with the exception of flexion. Among male and female subjects, extension, left …

Intertester Reliability Using The Cybex Edi 320® Inclinometer, Schawnn M. Decker

Physical Therapy Scholarly Projects

The American Medical Association (AMA) currently accepts range of motion measurements, particularly spinal measurements obtained by an inclinometer, as reliable and accurate. Reproducibility of intra-subject results are considered high, but intertester reliability has not been addressed.

With the help of three physical therapists trained in the use of the Cybex EDI 320® inclinometer, 10 subjects were tested on three consecutive days by each tester to obtain measurements of lumbar flexion, corresponding hip flexion, lumbar extension, corresponding hip extension, and lateral flexion. Straight leg raise measurements were also obtained for validity measurements as requested by the AMA.

Results of this study …

Progressive Resistive Weight Training And The Deconditioned Elderly Patient, Blaine Fercho

Physical Therapy Scholarly Projects

Physical conditioning to improve levels of functional independence is a key rehabilitation process for many elderly adults. This Independent Study is a review of published information concerning exercise for the elderly population with special attention focused on progressive resistive weight training. The inclusion and participation in exercise has been shown to provide many benefits for improving physiological systems' functioning, and also reduce the systems' natural age decline. Exercise participation is therefore highly beneficial; whether it is aerobic, weight training, or recreational activity. Progressive resistive weight training provides the gains of a strengthening program and allows for endurance/aerobic training through the …

A Guideline To Preemployment Screening, Jeanne M. Hall

Physical Therapy Scholarly Projects

This paper presents a literature review of ways to reduce the cost of Worker's Compensation Claims. Years reviewed are 1976 through 1992. Methods reviewed in this paper include preemployment screening, preplacement screening, job analysis, Ergonomics as it relates t o preemployment screening, and the legal aspects of preemployment/replacement screening. Guidelines are given for formulation of preplacement screening.

A Comprehensive Back Education Program In Industry, Julie L. Hamalainen

Physical Therapy Scholarly Projects

Chronic low back pain is not a new phenomenon plaguing the medical community. Eighty percent of the adult population will at some time be affected by low back pain. Back pain is the leading cause of compensable injury in industries nationwide, with related cost projections ranging from 16-30 billion dollars per year being spent on health care, workers' compensation, and lost work time.

The industrial community has been responding to these facts with various programs. Literature supports programs with a comprehensive approach versus those with a limited or more narrow focus. The purpose of this paper is to evaluate the …

The Motor Control Theory And How It Is Being Incorporated Into Present Physical Therapy Curricula, Laurie Toulouse Jung

Physical Therapy Scholarly Projects

The Motor Control Model or Theory is a conglomeration of recent studies by professionals and scientists from a wide variety of fields. This theory on motor control consists of concepts and ideas that can be used by therapists to treat neurologically impaired patients. Its theories are different from the traditional Facilitation Model theories which are based on Rood, Brunnstrom, PNF, and NOT. Because the Motor Control Theory is a new and valuable tool for physical therapists to use in the clinic, it is important that it be introduced to present and future physical therapists.

The purpose of this study was …

The Foot, Our Base Of Support, Sandra G. Lunde

Physical Therapy Scholarly Projects

The purpose of this independent study was to consolidate information on biomechanics of the foot and ankle and the possible effects on the rest of the body of faulty mechanics. A literature search and specialized continuing education contributed to improved working knowledge of the significance of variations of the normal biomechanics. The physical therapist relates to the patient through complaints of foot pain, or through foot evaluation to get to other sites of pain. A thorough evaluation process, shoe recommendations, stretching, and/or strengthening exercises, and orthotic evaluation are the results of study.

Guidelines For Physical Therapy Practice In An Educational/School Setting: Documentation, Sara N. Masilko

Physical Therapy Scholarly Projects

The purpose of this study was to thoroughly review the various documentation requirements and uses in both clinical and educational settings, with the final outcome being to establish the documentation portion of the Guidelines for Physical Therapy Practice in the Educational/School Setting for the State of North Dakota.

A thorough search was made of national and state level requirements, educational setting guidelines from other states, and the uses of the problem-oriented medical record.

A good understanding of the problem-oriented medical record format is invaluable as a communication tool which can be effectively applied in either setting. The use of monthly …

Muscleworks: A Computer-Assisted Study Tool For Muscle Function And Anatomy, Neil H. Otto

Physical Therapy Scholarly Projects

This independent study report reviews the advantages and disadvantages of computer assisted instruction (CAl), the criteria for justifying CAl development and examples of CAl in anatomy. Basic information regarding representative software packages is provided. A detailed description of MuscleWorks, the author's Appleworks-based data base of the muscular system is given, which includes justification, applications, and step-by-step instructions for most effective use. Sample questions and answers are provided. Printouts of each screen display utilized in the given examples are also furnished.

The author concludes that no other software package closely resembling MuscieWorks is currently being marketed, and that use of the …

Qualifications, Roles, Advanced Competencies, And Job Descriptions For Physical Therapy Services In The Public School/Educational Setting, Anne G. Putbrese

Physical Therapy Scholarly Projects

The North Dakota Physical Therapy Association, the state professional organization for physical therapy practice, asked several of its members involved in the area of pediatric practice to develop guidelines for physical therapy practice in the public school setting in North Dakota. Eleven physical therapists met to give input on developing these guidelines. A list of topics to include in the guidelines was generated, and several therapists volunteered to research and develop one or several of the topics on the list. This independent study report developed information on the topics of qualifications, roles, advanced competencies, and job descriptions for physical therapy …

Progression Of Vascular Disease In The Diabetic Lower Extremity, Kathleen Reinecke

Physical Therapy Scholarly Projects

Diabetes mellitus is a major health care issue affecting thousands of people each year. As medical research strives for a better understanding of diabetes, the life expectancy of diabetics is increasing, and the complications associated with this disease process become more evident. Vascular disease has specific clinical manifestations as related to diabetes. It is the progression of arterial insufficiency in the vascular disease of diabetics that will be discussed in this study. The risk factors identified in diabetic vascular disease are presented as is their overall effect in the disease process. Current concepts of noninvasive vascular testing in the diabetic …

Pediatric Physical Therapy Assessment In North Dakota, Joellen W. Roller

Physical Therapy Scholarly Projects

The Pediatric Physical Therapists in the state of North Dakota have developed Guidelines of Practice. As part of this process, there was a need for a through review of the assessment and evaluation information used by pediatric therapists. This independent study report should fill that need. By reviewing the literature, information was gathered on how to assess evaluation instruments and the scope information a review of of was two the instrumentation available. This then organized into five categories with or three tests in each category. A total of 14 standardized tests are reviewed. A description of each test is provided, …

Interexaminer Reliability Of The Mckenzie Algorithm For The Evaluation Of Cervical Pain, Eric Rikio Sakamoto

Physical Therapy Scholarly Projects

The purpose of this study was to investigate the interexaminer reliability of the McKenzie algorithm. Thirty-one subjects (25 females and 6 males), ages 20 to 77, with reported neck pain participated in this study. Each subject was examined twice by two McKenzie trained physical therapists. The subjects were evaluated separately utilizing standard McKenzie Cervical Assessment formats and procedures. Upon completion of the assessment, each therapist used an adapted McKenzie cervical algorithm to classify each patient into one of the possible syndromes (Postural, Dysfunction, or Derangements 1-7). Only five diagnostic categories contained enough data to accurately examine reliability and, therefore, coefficient …

Specificity Of Discharge Exercise Programs And Behavioral Contracting For Physical Therapy Patients, Kevin L. Spooner

Physical Therapy Scholarly Projects

Adherence to discharge home exercise programs has statistically shown poor results. The purpose of this independent study is to review present-day discharge exercise programs for physical therapy, and to offer alternatives for better adherence (or compliance) and effectiveness.

A brief history of physical therapy and exercise programs is reviewed to outline the progression of the two topics. Behavioral contracting is a strategy used by health professionals to improve patient/client adherence to health regimes. The patient/client signs a contract indicating they will follow the guidelines outlined in their discharge exercise program.

Presently, the most optimal discharge exercise program involves specificity of …