Medicine and Health Sciences Commons^™

Effect Of Pitching Restrictions And Mound Distance On Youth Baseball Pitch Counts., Hailey Mair, Nicholas A Kenney, Timothy L Uhl, L Robert Ullery, Robert G Hosey

Physical Therapy Faculty Publications

BACKGROUND: Studies have shown that higher pitch counts are directly related to a greater incidence of elbow and shoulder pain among youth baseball pitchers.

PURPOSE/HYPOTHESIS: The purpose of this study was to examine the effect of different pitching restriction rules on the number of pitches thrown in youth baseball leagues. We hypothesized that more pitches would be thrown in leagues with inning restrictions versus leagues with pitch count restrictions as well as in leagues with a longer mound distance (from pitching mound to home plate).

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: Pitch count data were collected for …

Bending The Elbow During Shoulder Flexion Facilitates Greater Scapular Upward Rotation And A More Favorable Scapular Muscle Activation Pattern, Alon Rabin, Brakha R. Tabi, Timothy L. Uhl, Zvi Kozol

Physical Therapy Faculty Publications

Context: Decreased scapular upward rotation (UR) and diminished activation of the serratus anterior (SA) and lower trapezius (LT) are often observed among patients with subacromial impingement syndrome. Maintaining the elbow fully flexed during shoulder flexion may limit glenohumeral motion due to passive insufficiency of the triceps brachii and therefore facilitate greater scapular UR and increased scapular muscle activation. Objectives: To compare scapular UR, SA, upper trapezius (UT), middle trapezius, and LT activation levels between shoulder flexion with the elbow extended (Flexion-EE) to shoulder flexion with the elbow fully flexed (Flexion-EF). This study hypothesized that Flexion-EF would result in …

Efficacy Of Power Training To Improve Physical Function In Individuals Diagnosed With Frailty And Chronic Disease: A Meta-Analysis, Alexander B. Sklivas, Lauren E. Robinson, Timothy L. Uhl, Esther E. Dupont-Versteegden, Kirby P. Mayer

Physical Therapy Faculty Publications

Muscle power training with emphasis on high-velocity of concentric movement improves physical functionality in healthy older adults, and, maybe superior to traditional exercise programs. Power training may also be advantageous for patients with acute and chronic illnesses, as well as frail individuals. To determine the efficacy of power training compared with traditional resistance training on physical function outcomes in individuals diagnosed with frailty, acute illness or chronic disease. PubMed (MEDLINE), CINAHL, PEDro, Web of Science, and Google Scholar. (1) at least one study group receives muscle power training of randomized controlled trial (RCT) (2) study participants diagnosed as prefrail, frail …

A Nation-Wide Survey Of High School Baseball Coaches’ Perceptions Indicates Their Arm Care Programs Play A Role In Injury Prevention, Kyle A. Matsel, E. E. Weiss, R. J. Butler, Matthew C. Hoch, Philip M. Westgate, Terry R. Malone, Timothy L. Uhl

Physical Therapy Faculty Publications

Background
Arm care programs consisting of upper extremity strengthening and stretching have been recommended for injury prevention for pitchers of all ages. There has been no investigation into high school baseball coaches’ usage and perceptions of arm care programs to mitigate physical impairments associated with injuries in baseball players.

Hypothesis/Purpose
The purpose of this study was to investigate the current usage of arm care programs by high school baseball coaches. The primary objective was to determine if coaches use group-based or individualized arm care programs. The secondary objective sought to determine if the use of arm care programs is influenced …

Identifying Risk Factors Of Upper Extremity Injuries In Collegiate Baseball Players: A Pilot Study, Robert Slowik, Christopher Morris, Matthew C. Hoch, Timothy L. Uhl

Physical Therapy Faculty Publications

Background
Repetitive pitching places tremendous forces on the shoulder and elbow which can lead to upper extremity (UE) or lower extremity (LE) overuse injuries.

Purpose
The purpose of this study was to evaluate pre-season physical measurements in collegiate baseball players and track in-season baseball throwing volume to determine which factors may predict throwing overuse injuries.

Study Design
Retrospective Cohort study.

Methods
Baseline preseason mobility, strength, endurance, and perception of function were measured in 17 collegiate baseball pitchers. Participants were then followed during the course of the season to collect rate of individual exposure, estimated pitch volume, and rating of perceived …

Post-Operative Rehabilitation For Scapular Muscle Reattachment: A Case Report, Wendy Burke, W. Ben Kibler, Timothy L. Uhl

Physical Therapy Faculty Publications

Background and Purpose: Scapular muscle detachment is a rare orthopedic problem that has been described in the literature in patients following traumatic events involving traction, direct trauma, or a motor vehicle accident. The purpose of this case report is to describe the post-operative rehabilitation following scapular muscle reattachment surgery. Unique to this case report is the patient's perspective, an orthopedic physical therapist with 25 years of experience.

Case Description: A 47-year-old female physical therapist experienced a traction injury to bilateral upper extremities during a medical procedure resulting in bilateral rhomboid, and bilateral lower trapezius muscles were detached from the medial …

Injury Rates In Major League Baseball During The 2020 Covid-19 Season, Brooks N. Platt, Timothy L. Uhl, Aaron D. Sciascia, Anthony J. Zacharias, Nicole G. Lemaster, Austin V. Stone

Physical Therapy Faculty Publications

Background: The 2020 Major League Baseball (MLB) season was drastically altered because of the COVID-19 pandemic. The changes included an extended layoff between March and July as well as a shortened preseason.

Purpose/Hypothesis: To determine the incidence and epidemiology of MLB injuries in the abbreviated 2020 season compared with prior seasons. We hypothesized that there was an increase in the overall injury rate in the 2020 season compared with the 2018-2019 seasons and that it equally affected all body regions.

Study Design: Descriptive epidemiology study.

Methods: The MLB transactions database was queried to find players who had been placed on …

Elastic Resistance Effectiveness On Increasing Strength Of Shoulders And Hips, Kelsey J. Picha, Muataz R. Almaddah, Jordan Barker, Tavis Ciochetty, W. Scott Black, Timothy L. Uhl

Physical Therapy Faculty Publications

Elastic resistance is a common training method used to gain strength. Currently, progression with elastic resistance is based on the perceived exertion of the exercise or completion of targeted repetitions; exact resistance is typically unknown. This study's objective is to determine if knowledge of load during elastic resistance exercise will increase strength gains during exercises. Participants were randomized into two strength training groups, elastic resistance only and elastic resistance using a load cell (LC) that displays force during exercise. The LC group used a Smart Handle (Patterson Medical Supply, Chicago, IL) to complete all exercises. Each participant completed the same …

The Relationship Between Pitching Volume And Arm Soreness In Collegiate Baseball Pitchers, Angel L. Lazu, Shawn D. Love, Timothy A. Butterfield, Robert A. English, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: Excessive baseball pitch volume has been associated with increased risk of injury in adolescents. However, many collegiate athletes report non-time loss injuries over the course of the season. It is unknown how pitch volume throughout a collegiate baseball season affects arm soreness.

Purpose: The primary purpose of this study was to determine the relationship between pitch volume and self-reported arm soreness. A secondary purpose was to determine the relationship between change in pitch volume and change in arm soreness over the course of the season for collegiate baseball pitchers.

Study Design: Prospective Cohort.

Methods: Seven collegiate baseball …

National Athletic Trainers' Association Position Statement: Evaluation, Management, And Outcomes Of And Return-To-Play Criteria For Overhead Athletes With Superior Labral Anterior-Posterior Injuries, Lori A. Michener, Jeffrey S. Abrams, Kellie C. Huxel Bliven, Sue Falsone, Kevin G. Laudner, Edward G. Mcfarland, James E. Tibone, Charles A. Thigpen, Timothy L. Uhl

Physical Therapy Faculty Publications

Objective: To present recommendations for the diagnosis, management, outcomes, and return to play of athletes with superior labral anterior-posterior (SLAP) injuries.

Background: In overhead athletes, SLAP tears are common as either acute or chronic injuries. The clinical guidelines presented here were developed based on a systematic review of the current evidence and the consensus of the writing panel. Clinicians can use these guidelines to inform decision making regarding the diagnosis, acute and long-term conservative and surgical treatment, and expected outcomes of and return-to-play guidelines for athletes with SLAP injuries.

Recommendations: Physical examination tests may aid diagnosis; 6 tests are recommended …

Calculation Of Resistive Loads For Elastic Resistive Exercises, Kelsey J. Picha, Timothy L. Uhl

Physical Therapy Faculty Publications

Context:

What is the correct resistive load to start resistive training with elastic resistance to gain strength? This question is typically answered by the clinician's best estimate and patient's level of discomfort without objective evidence.

Objective:

To determine the average level of resistance to initiate a strengthening routine with elastic resistance following isometric strength testing.

Design:

Cohort.

Setting:

Clinical.

Participants:

Thirty-four subjects (31±13yrs, 73±17kg, 170±12cm).

Interventions:

The force produced was measured in Newtons (N) with an isometric dynamometer. The force distance was the distance from center of joint to location of force applied was measured in meters to calculate torque …

The Effectiveness Of Cervical Traction And Exercise In Decreasing Neck And Arm Pain For Patients With Cervical Radiculopathy: A Critically Appraised Topic, Shelby Baez, Johanna M. Hoch, Timothy L. Uhl

Physical Therapy Faculty Publications

Clinical Question:

Is there evidence to suggest intermittent cervical traction with cervical and scapular strengthening exercises is more effective in decreasing neck and arm pain when compared with cervical and scapular strengthening exercises alone in nonoperative patients with cervical radiculopathy?

Clinical Bottom Line:

There is currently inconsistent, high-quality evidence that suggests that the use of intermittent cervical traction in addition to strengthening exercises is more effective at decreasing pain in nonoperative patients with cervical radiculopathy when compared with strengthening alone. Future research should continue to examine long-term outcomes associated with cervical radiculopathy patients who use intermittent cervical traction as an …

Reliability And Validity Of A Biomechanically Based Analysis Method For The Tennis Serve, Natalie L. Myers, W. Ben Kibler, Leah Lamborn, Belinda J. Smith, Tony English, Cale A. Jacobs, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: An observational tennis serve analysis (OTSA) tool was developed using previously established body positions from three-dimensional kinematic motion analysis studies. These positions, defined as nodes, have been associated with efficient force production and minimal joint loading. However, the tool has yet to be examined scientifically.

Purpose: The primary purpose of this investigation was to determine the inter-observer reliability for each node between two health care professionals (HCPs) that developed the OTSA, and secondarily to investigate the validity of the OTSA.

Methods: Two separate studies were performed to meet these objectives. An inter-observer reliability study preceded the …

Oncology Edge Task Force On Prostate Cancer Outcomes: A Systematic Review Of Outcome Measures For Functional Mobility, Claire Davies, Genevieve Colon, Hannah Geyer, Lucinda Pfalzer, Mary Insana Fisher

Physical Therapy Faculty Publications

Background: The medical treatment of prostate cancer results in multiple impairments in body structure and declines functional abilities, resulting in activity limitations and participation restrictions. Measurement of functional mobility is an essential outcome measure in survivorship care.

Purpose: The purpose of this systematic review is to make recommendations of the best measurement tools to assess functional mobility in men treated for prostate cancer based on psychometric properties and clinical utility.

Methods: Multiple electronic databases were searched from February to March 2014. Studies of tools used to assess functional mobility were included if they met the following criteria: reported psychometric properties, …

Breast Cancer Rehabilitation: Clinical Examination And Outcomes Assessment, Nicole L. Stout, Shana Harrington, Lucinda Pfalzer, Mary Insana Fisher

Physical Therapy Faculty Publications

Breast cancer is the most commonly diagnosed cancer in women in the United States. The treatment for breast cancer occurs along a protracted time period and includes many different disease treatment modalities. These treatments carry with them a large number of adverse effects that negatively impact function in both the short term and long term. It is necessary for rehabilitation providers to interface with patients being treated for breast cancer throughout the continuum of care so that interval assessments can be conducted to identify emerging impairments and alleviate disability. To achieve this, the rehabilitation provider must have an understanding of …

A Comparison Of The Upper Limb Lift Test Between Women With Breast Cancer And Healthy Control Subjects, Mary Insana Fisher, Lucinda Pfalzer, Ellen W. Levy, Shana Harrington, Lynn H. Gerber, Nicole L. Stout

Physical Therapy Faculty Publications

Presentation at the World Confederation for Physical Therapy Congress, held May 1-4, 2015, in Singapore.

Background: Objective measures of upper limb (UL) function specific to breast cancer survivors (BC) are limited. Motion, strength, and muscular endurance are measurable components of UL function. A clinical test that quantifies these components is needed.

Purpose: This study compares the Upper Limb Lift Test (ULLT) between women with BC and healthy control subjects (HC) at baseline, 1-3 months, and 12+ months post-operatively enrolled in a prospective surveillance trial with early intervention. A secondary purpose was to validate the ULLT by comparing findings to self-reported …

The Association Between Critical Thinking And Scholastic Aptitude On First-Time Pass Rate Of The National Physical Therapy Examination, Daniel W. Suckow, C. Jayne Brahler, Betsy Donahoe-Fillmore, Mary Insana Fisher, Philip A. Anloague

Physical Therapy Faculty Publications

Objectives: 1) To investigate the relationships among critical thinking (CT) abilities, overall academic performance in the Doctorate of Physical Therapy (DPT) program as measured by cumulative grade point average (GPA), and National Physical Therapy Examination (NPTE) licensure scores, and 2) To determine if NPTE scores were significantly different between groups of students who were classified as having low, moderate or high CT abilities.

Background: It is well-established that physical therapy practice requires good clinical reasoning skills. Passage of the NPTE is required for licensure. Research to date has been mixed as to whether CT abilities or GPA can predict success …

Oncology Section Edge Task Force On Prostate Cancer Outcomes: A Systematic Review Of Clinical Measures Of Strength And Muscular Endurance, Mary Insana Fisher, Claire Davies, Genevieve Colon, Hannah Geyer, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Strength deficits are a common morbidity following treatment for prostate cancer. Accurate assessment of strength and muscular endurance following prostate cancer treatments is essential to identify deficits and plan rehabilitation.

Purpose: To identify strength and muscular endurance outcome measures that possess strong psychometric properties and are clinically useful for examination of men treated for prostate cancer.

Methods: Multiple electronic databases were searched for articles published after 1995. Studies of tools used to assess strength and muscular endurance were included if they reported psychometric properties, were clinically feasible methods, performed on adults, and published in the English language. Each outcome …

The Effects Of Home-Based Pilates In Healthy College-Age Females, Betsy Donahoe-Fillmore, Mary Insana Fisher, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: To quantify and determine the effects of Pilates on core endurance, hamstring flexibility, balance, body composition/mass and perceived stress level in healthy college age females.

Study Design: Randomized controlled trial design.

Background: Emerging research on the Pilates technique is inconclusive regarding benefits to core endurance, flexibility, balance, body mass, and perceived stress.

Methods and Measures: Female college students (n=57; 18-35 years old) were randomly assigned to a Pilates group, who exercised at home with a DVD, or a control group who did not engage in Pilates practice. Core endurance, hamstring flexibility, balance, body composition and stress measurements were taken …

Research Roundup From The Research Committee, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

With the expectations of accountability by consumers and third party payors for the efficacy of physical therapy practice, there has been a significant increase in the push to develop outcome measures in rehabilitation. One type of these measures, patient-reported outcome measures (PROs), are becoming increasingly more common in clinical practice. The American Physical Therapy Association’s Guide to Physical Therapist Practice 3rd edition includes outcomes assessment as an integral part of the Patient and Client Management model, and delineates that appropriate tests and measures depend upon established psychometric properties of the measurement.1 The Section on Research formed the Evidence Database to …

Oncology Section Edge Task Force On Breast Cancer Outcomes: A Systematic Review Of Outcome Measures For Functional Mobility, Mary Insana Fisher, Jeannette Lee, Claire Davies, Hannah Geyer, Genevieve Colon, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Breast cancer treatments in women with breast cancer often result in physical impairments that lead to activity limitations and participation restrictions. These limitations and restrictions manifest in impaired functional mobility skills that may impact survivorship. Thus, evaluation of functional mobility is an important part of survivorship care.

Purpose: To identify functional mobility outcome measures that possess strong psychometric properties and are clinically useful for examination of women treated for breast cancer.

Methods: Multiple electronic databases were searched for articles published after 1995. Studies were included if they reported psychometric properties, used clinically feasible methods, were performed on adults, and …

Research Round-Up: Manual Muscle Testing, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

Manual muscle testing was developed in response to the need to assess muscle strength losses during the polio outbreak in early part of the 20th century. The development of this original method is credited to Wilhelmine Wright and Robert W. Lovett, MD. Wright presented this method in 1912 in the Boston Medical Surgical Journal, and Lovett expanded the description of the testing method in 1916 in the Journal of the American Medical Association. The development of quantifying muscle strength by rating force generated against external resistance was an important development in objectifying assessment methods of the time.

Today, manual muscle …

Effects Of Yoga On Arm Volume Among Women With Breast Cancer Related Lymphedema: A Pilot Study, Mary Insana Fisher, Betsy Donahoe-Fillmore, Laura Leach, Colleen O'Malley, Cheryl Paeplow, Tess Prescott, Harold L. Merriman

Physical Therapy Faculty Publications

Lymphedema affects 3–58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3×/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at …

The Importance Of Managing Psychosocial Health: A Case Study, Mary Insana Fisher, Harold L. Merriman

Physical Therapy Faculty Publications

Managing the physical aspects of lymphedema requires an individual to be committed to daily treatment of this chronic condition. Performing manual lymph drainage, using compression bandaging or compression garments, exercising, and caring for the skin all take time and a high level of dedication. This commitment to self-care can be emotionally and psychologically exhausting.

When coupled with other emotional stressors in a patient’s life, successful treatment of lymphedema is challenging. We present a case demonstrating how the physical and psychological aspects of care interplay, and, when well-managed, can positively affect the outcome.

Breast Cancer Edge Task Force Outcomes - Clinical Measures Of Strength And Muscular Endurance: A Systematic Review, Mary Insana Fisher, Claire Davies, Christine Beuthin, Genevieve Colon, Brittany Zoll, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Muscular strength deficits are a common morbidity following treatment for breast cancer. Accurate assessment of strength and muscular endurance following breast cancer treatments is essential in identifying deficits and planning rehabilitation strategies.

Purpose: The purpose of this systematic review was to identify strength and muscular endurance outcome measures for use with women treated for breast cancer that possess strong psychometric properties and are clinically useful.

Methods: Multiple electronic databases were searched between February and June 2013. Included studies of tools used to assess strength and muscular endurance met the following criteria: reported psychometric properties, clinically feasible methods, adults (preferably …

Test Items In The Complete And Short Forms Of The Bot-2 That Contribute Substantially To Motor Performance Assessments In Typically Developing Children 6-10 Years Of Age, Kadi Carmosino, Ashley Grzeszczak, Kaylie Mcmurray, Ali Olivo, Bo Slutz, Brittany Zoll, Betsy Donahoe-Fillmore, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: Determine the magnitude of association between individual subtest items of the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), and the respective total subtest scores and to review items on the BOT-2 Short Form.

Background: The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), is a test used to measure gross motor proficiency in both typically developing children and children with developmental disabilities between the ages of four and twenty-one. The BOT-2 Short Form consists of fourteen test items proportionally selected from the subtests of the Complete Form. It can be used as a screening tool and takes less …

Oncology Section Task Force On Breast Cancer Outcomes: Scapular Assessment, Mary Insana Fisher, Pamela K. Levangie

Physical Therapy Faculty Publications

Background: Functional deficits and changes in scapular mechanics following breast cancer (BC) treatments have been documented. Scapular assessment is important when examining the shoulder in survivors of breast cancer to document the need for or effectiveness of physical therapy intervention. The Oncology Section Task Force on Breast Cancer Outcomes sought to identify scapular examination tools that can be recommended for routine use in individuals treated for BC.

Methods: A systematic review of the literature on scapular measures was conducted. Relevant studies were examined for psychometric properties and clinical usefulness. Each method was given a recommendation score based on the Breast …

Oncology Section Task Force On Breast Cancer Outcomes: An Introduction To The Edge Task Force And Clinical Measures Of Upper Extremity Function, Pamela K. Levangie, Mary Insana Fisher

Physical Therapy Faculty Publications

With the proliferation of outcome measures in the literature, many of which lack documentation of sufficient psychometric properties to justify use, it is difficult to document patient change or demonstrate effectiveness of interventions. The goal of the Section on Research’s EDGE (Evaluation Database to Guide Effectiveness) Task Force is to facilitate identification of valid and reliable tests and measures that reflect clinically important outcomes and are responsive to change for standard use across selected patient groups. This paper lays the groundwork for understanding the work of the Oncology Section’s Breast Cancer EDGE Task Force on clinical measures of shoulder function …

A Comparison Of Upper Extremity Function Between Female Breast Cancer Survivors And Healthy Controls: Typical Self-Report Of Function, Motion, Strength, And Muscular Endurance, Mary Insana Fisher

Physical Therapy Faculty Publications

Many women who have experienced breast cancer (BC) report continued impairments in upper extremity (UE) function beyond the time required for normal healing after surgical treatment. Most research supporting this has not made comparisons between survivors of breast cancer (BCS) to a sample of healthy women. This lack of comparison to a healthy cohort prevents an understanding of whether continued deficits in UE function are due to normal aging or the BC treatment.

The purpose of this research was to compare quality of life (QOL) and UE function among long term breast cancer survivors and similar aged women without cancer. …

Whole-Body Vibration Improves Functional Mobility, Flexibility, And Relative Risk For Falling In The Assisted Living Elderly: A Case Series, Christina Garrity, Harold L. Merriman, C. Jayne Brahler

Physical Therapy Faculty Publications

Study design: A randomized double blind repeated measures, case series study of whole body vibration (WBV) in the assisted living elderly.

Background: A single exposure to WBV has been shown to have benefit with respect to muscle activity, strength, balance, and power in some studies while other studies have found no benefit. Its overall effectiveness is unknown due to the conflicting findings reported in the literature.

Case description: Six subjects (5 female, 1 male; mean age = 85.4) in an assisted living community volunteered to participate. Subjects were exposed to a single bout of WBV at 0, 2, 20, and …