Medicine and Health Sciences Commons^™

In Vivo Behavior Of The Soleus Muscle During Various Activities In Persons Post-Stroke, Madison Swaney, Molly Carter, Mitchell Mckinley, Joshua Nelson, Robin Dorociak, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

Current protocols for post stroke populations consists of inconsistent and outdated interventions that target less functional strength training through heavier and slower movements. Current research displays a 90/10 principle displaying the tendon as the primary power absorber and generator during ballistic and cyclic movements, supported by a primarily isometric muscle activation. Power generation is key for walking. High angular velocity needed during the gait cycle to be able to produce and absorb power rapidly. Ballistic training requires the perfect tradeoff between speed and force to generate and train populations targeting power absorption and output with greater tendon activity. Therefore, current …

Is Sway-Referenced Haptic Assistance Sensitive To Perceptual Context, Andrew Meszaros, Robin Dorociack, Peter Jang, Tanner Lehr, Bayli Mohl

Student-Faculty Research - College of Physical Therapy

Falls account for >$50 billion of medical spending in 2015 (CDC). Real-time haptic feedback shows promise at reducing static standing COM sway (Meszaros, 2019). Pilot data variability suggests that some haptic-wearers ‘over-correct’ (unnecessarily reducing available degrees of freedom), when haptic correction is perceived as ‘a mistake. Does over-correction reduce multi-segment control and impair sway stability (Hsu, Scholz, et al. 2007)?

Implementing Pt In Pediatric Primary Care, Juliann Fronius, Scout Cai, Courtney Hoffman, Carlee Martin, Joel Wiley, Chris Yuen, Ryan Jacobson

Student-Faculty Research - College of Physical Therapy

Patients are referred to PT everyday, but referrals can delay care. Early care is preferred, but getting to the right healthcare provider at the right time is ideal. Upstream PT improves patient care and clinician experience. Purpose: Implement PT within pediatric primary care.

Imu And Markerless Technology In Gait Analysis: Clinical Lessons, Jessa Barendse, Trevor Nannini, Joanna Zuckerman, Tess Swake, Robin Dorociak, Peter Jang, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

- Haptic feedback refers to the external vibratory cue that is activated by data picked up by the haptic device, Inertial Measurement Unit (IMU) (Figure 1), which senses joint position.

- Position-driven haptic touch input can modify movement in real-time (Meszaros, 2019)

- Original goal: to reduce knee hyperextension during gait using a popliteal fossa tactor driven by an IMU-based angle sensor (Sagemotion)

-Concerns arose on the validity of IMU/tactor and markerless motion analysis ❏ Are these algorithm-based data technologies clinic-ready?

- Does Sagemotion IMU fire the tactor at the actual knee angle selected in its software?

- Can markerless …

Hamstring Tendons Don’T Lie #Eccentricsdontexist, Alec Espinoza, Chris Garcia, Enoch Ho, Ian Rousseau, Joel Centeno, Robin Dorociak, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

Research done on the plantarflexor MTU have shown the degree of achilles tendon and muscle fascicle shortening/stretching is specific to demands of the activity. To expand on this principle, we wanted to explore if a similar relationship exists with the Biceps Femoris MTU. We predict that the biceps femoris (long head) muscle tendon unit (MTU) will behave similarly to the Achilles tendon complex exhibiting the 80/20 principle during dynamic activities (jogging, walking) and the muscle fascicle will lengthen more than the MTU during stationary exercise (Nordic hamstring curls, Romanian deadlifts).

Fatigue Changes Biomechanical Variables In Drop Vertical Jump Performance In Competitive Basketball Players, Isabella Bruno, Caroline Linardos, Michala Rennels, Kristina Williams, Robin Dorociak, Jaydee Romick, Jason Brumitt

Student-Faculty Research - College of Physical Therapy

The drop vertical jump (DVJ) has been used as a tool to identify athletes at risk for injury. Initial studies have suggested an association between biomechanical variables and injury (1); however, subsequent research has demonstrated no relationship (2-4). Evaluating variables in fatigued athletes may help clinicians identify athletes at risk. Advances in motion capture technology now allow for assessment of variables after a fatigue protocol.

Factors Affecting Peak Effort In Max Effort Tests, Amanda Pardue, Michael Forster, Taylor Kopecky, Zoralei Dayley, Jeff Houck, Rebecca Dobler

Student-Faculty Research - College of Physical Therapy

Challenging older adults to execute peak effort functional tests is not common. A peak effort test pushes patients to the point of not sustaining the task. The Wingate test is a peak effort test that measures the amount of revolutions per second a participant can perform over 30s. Older adults with knee osteoarthritis (OA) may regulate their effort during the Wingate. Alternatively, high exertion during the Wingate test may yield high value in influencing attitudes related to pain and aging. The purpose of this study was to develop themes of what influences peak effort during the Wingate test in participants …

Effect Of Perturbation-Based Balance Training On Fall Risk And Fear Of Falls In Community-Dwelling Older Adults – A Pilot Study, Lindsey Kelly, Casey Kostecki, Garrett Markham, Conner Morris, Trevor Strem, Lyndsay Strutzenberger, Gabe Haberly

Student-Faculty Research - College of Physical Therapy

Falls are a major health concern among adults ≥65 years as it is the leading cause of injury and injury related death in the United States. Perturbation-based training (PBT) has been shown to reduce rate of falls by 50% and 24 slips has been shown to be optimal. It is unknown whether falls reduction would be greater with one session or spread out over multiple sessions. The purpose of this study was to determine the effects of PBT dosage (12 slips over 2 sessions vs. 24 slips in one session) on falls incidence, fear of falling, and reactive stepping in …

Does The Size-Weight Illusion Exist During Deadlift?, Dakota Kerbow, Luke Mallory, Robin Dorociak, Peter Jang, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

Purpose:

to assess whether the SWI exists during deadlift (whole body loading), and identify the mechanical factors that explain or overcome the illusion

Changes In Quadriceps Strength In Recreationally Active Individuals Using Single-Limb Or Double-Limb Blood Flow Restriction, Brogan Boen, Logan Cockrell, Olivia Aho, Taylor Bryant, Bethany Nguyen, Jason Brumitt

Student-Faculty Research - College of Physical Therapy

Blood flow restriction training utilizes a tourniquet system to occlude arterial and venous flow while one performs exercises. This training strategy allows one to exercise using loads at a lower percentage of 1RM while experiencing physiological change similar to those achieved when training at a higher percentage of 1RM.

40-Day Fit, A Journey For Heroes, Michael B. O'Neill

Doctor of Leadership

This project is a collective portfolio of discovery and development that explores the intersection of societal health and the vitality of the church, recognizing a state of decline in both areas. This critical, yet often overlooked issue, is the foundation of this research-driven initiative. It is a practical process of diagnosis and treatment of a problem or an opportunity, in context, leading to application. The portfolio project represents a journey of discovery and reframing, where research methods, strategic objectives, and project milestones guide the identification of needs, problems, and opportunities. These elements serve as the driving forces behind crafting solutions …

Heparin Induced Thrombocytopenia (Hit), Tanya Yatskiv

Doctor of Medical Science (DMSc)

Introduction:

Heparin was first discovered in 1915 and is still widely used to this day.1 In 1958 however, it was noted that a small percentage of recipients of heparin develop antibodies to the drug which cause a mild to moderate thrombocytopenia and can progress the patient into a severe prothrombotic state.2 The prothrombotic state can be detrimental due to venous and arterial thromboembolisms that lead to life and limb-threatening manifestations. The mechanism of the thrombocytopenia and immune reaction was not identified until 1973.2 The adverse drug effect is induced by platelet-activating antibodies against platelet factor 4 (PF4) and heparin.3 These …

Meta-Analysis Of The Rate Of Unplanned Pregnancies In Rural Areas Of The United States And The Use Of Technology-Based Sexual Education Programs, Hannah Audiss

Doctor of Medical Science (DMSc)

Objective

To discuss rural-urban disparities of adolescent unplanned pregnancies and sexual education availability. The potential of virtual sexual education programs are discussed by examining two studies that have used technology-based interventions to assess variables related to pregnancy prevention.

Data Sources

A review was conducted by gathering randomized controlled trials and systematic reviews utilizing databases such as ScienceDirect, PubMed and Wiley Online Library. Research articles included in this paper were from 1995 to present day and are inclusive of all races.

Study Eligibility Criteria

Studies were included if the interventions worked with young adolescents ages 13-24 year old, utilized technology-based interventions …

The Association Between Prenatal Acetaminophen Use And Adhd Development In Childhood, Jocelyne Blanco

Doctor of Medical Science (DMSc)

Background: The purpose of this article is to produce a review of the literature on a recently growing topic of interest. We believe the widespread use of acetaminophen in pregnancy makes the rising concern for acetaminophen use in pregnancy and the development of childhood attention deficit hyperactivity disorder (ADHD) a national public health matter. The mechanism of action of acetaminophen, the pathophysiology of drug transfer through the placental barrier, and the most up-to-date research studies were analyzed with the goal of bringing clarity and promoting healthy pregnancies for all.

Methods: PubMed, PLOS One, and Google Scholar served as the cornerstone …

Thoughtful Integration Of Active Learning Teaching Strategies Into Physician Assistant Education, Daniel Berger

Doctor of Medical Science (DMSc)

Introduction:

The future of healthcare relies upon how we train student clinicians. It is integral to continually reevaluate our methodologies of teaching and work to better approach the challenging task of educating competent and compassionate physician assistants in a short two-to-three-year window. While the traditional modality of teaching has been primarily lecture-based, there has been a growing movement to incorporate active learning into medical education. This learner-driven model puts students in the driver’s seat and allows for greater amounts of self-directed learning prior to class followed by the reinforcement of concepts during class time. Though lecture-based teaching could be the …

The Role Of Self-Sampling For Hpv In The Primary Prevention Of Cervical Cancer, Divya Patel

Doctor of Medical Science (DMSc)

Introduction:

Cervical cancer is a striking women's health problem worldwide. It is the fourth most common cancer in women and the seventh most common cancer worldwide1. There were roughly 604,000 new cases of cervical cancer and 342,000 deaths in 20202. Most of these cases occur in developing countries due to ineffective screening initiatives2. Screening essentially allows pre-cancerous lesions to be identified at stages where they can easily be treated; screening methods include cytology and HPV testing (Human Papillomavirus)1. HPV has over 100 strains and is one of the most common risk factors for cervical cancer. HPV testing is more sensitive …

Lipoprotein(A): Review Of Existing Guidelines And Application For Practicing Clinicians, Daniella Manarang

Doctor of Medical Science (DMSc)

Purpose A growing amount of research has constituted lipoprotein(a) as an independent risk factor for cardiovascular disease. The main objective of this review is to summarize the current guidelines for testing and managing Lp(a) and provide guidance to clinicians on how to practically utilize Lp(a) with what is known today. Methods: EBSCO, PubMed, and Ovid were searched for this review. Search terms included lipoprotein(a), clinical practice, guidelines, screening, and cardiovascular disease. Sources within ten years were obtained to cover recent material. Results: The current literature on the association between Lp(a) and CVD outcomes and up-to-date guidelines on testing and management …

Early Management Of Nutritional Deficiencies To Reduce Musculoskeletal Disabilities Of Pediatric Populations In Africa, Kristin Freitas

Doctor of Medical Science (DMSc)

An estimated 1.3 billion individuals live with disabilities across the world, however many of these impairments are developed throughout childhood and could be prevented or treated with prompt and early intervention. In Africa, nutritional deficiencies are a common reason for disability in pediatric populations, often due to a limited supply of resources and diets high in grains and beans. This results in the development of genu varum and valgum deformities, which are most commonly caused by rickets attributed to calcium deficiencies in these areas. The children often go untreated, evidently causing musculoskeletal disabilities and further complications of osteomalacia or fractures …

The Role Of Niacinamide In Skin Cancer Risk Reduction, Britny Ruilova Tellez

Doctor of Medical Science (DMSc)

The contents of this article are the author’s original unpublished findings.

Background: Each year, approximately 6 million Americans are treated for skin cancer, resulting in a total annual medical expense of $8.9 billion 1. The two most common types of skin cancer are basal cell carcinoma (BCC) followed by squamous cell carcinoma (SCC)2. The metastatic potential of these cancers is minimal; however, their treatment may involve severe scarring and disfigurement2. In contrast, melanoma is an aggressive skin malignancy that grows rapidly and can metastasize in a quick manner2. Risk factors of these skin cancers include UV exposure, fair skin complexions, …

Review Of "The #Actuallyautistic Guide To Advocacy: Step-By- Step Advice On How To Ally And Speak Up With Autistic People And The Autism Community", Jennifer M. Brady

The Christian Librarian

No abstract provided.

Sodium-Glucose Cotransporter 2 Inhibitor (Sglt2-I) In The Prevention Of Diabetic Kidney Disease Progression, And Its Role As An Antihypertensive Agent In The African American Population, Aran Michael G. Manalang

Doctor of Medical Science (DMSc)

Introduction:

Needs Assessment:

Originally used as antidiabetic medications, later clinical trial data showed beneficial effects in reducing the onset and progression of renal complications in people with and without diabetes. 13 Randomized clinical trials and ‘real world’ observational studies involving mostly type 2 diabetes patients showed that SGLT2-i can slow the decline in glomerular filtration rate (GFR), and reduce the onset of microalbuminuria and slow or even reverse the progression of proteinuria.13 Additionally, with diabetes being one of the many chronic conditions still primarily managed by primary care providers (PCP), it falls upon these professionals to have the knowledge and …

Review Of The Literature: Analysis Of The Effectiveness Of Mobile Integrated Health - Community Paramedicine Programs In Reducing Pre-Hospital Ems Calls And Transportations, Annika N. Schultz

Doctor of Medical Science (DMSc)

Pre-hospital Emergency Medical Service (EMS) systems, including fire departments and ambulance transport services, are increasingly overburdened with high call volumes and unnecessary utilization of services leading to provider burnout, depletion of resources and rising healthcare costs. Many local EMS systems have recognized a need for a more sustainable solution to help reduce the number of unnecessary 9-1-1 calls and transportation to the Emergency Department (ED). Local agencies are beginning to expand the role and scope of practice for paramedics through programs referred to as Mobile Integrated Health – Community Paramedicine (MIH-CP). This new branch of medicine aims to provide patient-centered …

The Role Of Pharmacogenetics On Breast Cancer Treatment Efficacy And Toxicity, Noor Alani

Doctor of Medical Science (DMSc)

Purpose: This research article aims to shed light on the pivotal role of pharmacogenetics in breast cancer treatment by examining genetic variations that influence the efficacy and toxicity of commonly used drugs. Furthermore, this study highlights the significance of personalized treatment approaches in optimizing patient outcomes.

Method: A comprehensive literature search was conducted using databases such as PubMed. Search terms included "pharmacogenetics," "breast cancer treatment," "genetic markers," and "adverse effects." This review critically analyzes relevant studies that focus on the impact of genetic variations on the response to drugs used in breast cancer treatment.

Results: The review …

Emerging Evidence For Diagnosis And Treatment Of Wake Up Stroke Patients, Asa Di Carlo

Doctor of Medical Science (DMSc)

Strokes are the leading cause of permanent disability and the second leading singular cause of death in more developed countries.3 Over 13 million individuals worldwide suffer strokes annually, 1 with the vast majority of these being from an ischemic event. Out of these, 20-25% actually occur in individuals who wake up with stroke symptoms, which historically has been considered outside of the time window for treatment.2,3 Previous guidelines indicate that in patients with acute ischemic strokes IV thrombolytic therapy should be administered within 4.5 hours for symptom onset, and is not recommended in patients with an unknown time of symptom …

Discussion Of The Risks And Benefits Of Intensive Blood Pressure Control In The Elderly, Kennedy Emerson

Doctor of Medical Science (DMSc)

PURPOSE:

The primary purpose of this paper is to review the current available evidence on benefits and risks of intensive blood pressure control (< 120 mmHg systolic) in the greater than 75-year-old population. The secondary purpose will focus on discussion of general recommendations for blood pressure treatment in non-diabetics in this population.

METHOD:

A PubMed and NEJM literature search was directed towards search terms: hypertension, intensive, standard, older, and elderly, as well as search terms surrounding risk: adverse event, fall, fracture, syncope, AKI, and mortality. Fourteen articles are used for the basis of this paper, six of which are large scale RCTs.

RESULTS:

Though there has been a general lack of consensus on appropriate hypertensive management in the elderly, data has increasingly shown that lower blood pressure goals …

Impacts Of Stigma On Female Service Members, Alisha Weatherly-Kershaw

Doctor of Psychology (PsyD)

There are a variety of factors that prevent people from seeking mental health treatment. The stigma associated with mental health disorders or seeking treatment is a primary deterrent. This stigma is particularly impactful within the armed forces when they are assessed for fitness for duty. Because most research examines stigma’s impact on male military members, this study aims to identify the type of stigma that creates the most significant barrier to female service members seeking mental health treatment. Results indicate that stigmatizing perceptions of service members significantly impact female service members holding negative views towards seeking treatment.

Measurement And Assessment Of Grief In A Large International Sample, C. Killikelly, A. Kagialis, S. Henneman, H. Coronado, D. Demanarig, H. Farahani, A.A. Ozdo ̈ Gru, B. Yalçın, A. Yockey, C.L. Gosnell, F. Jia, M. Maisel, E. Stelzer, D. Wilson, J. Anderson, K. Charlesj, J.P. Cummings, C. Faasl, B. Knapp, B. Koneczny, Chris Koch, L.M. Bauer, C. Cuccolo, J.E. Edlund, G.F. Heermanss, S. Mcgillivray, C. Shane-Simpson, A. Staples, Z. Zheng, M.S. Zlokovich, M.S. Irgens

Faculty Publications - Psychology Department

Background: In 2022, the International Classification of Diseases (ICD-11) and an update of the Diagnostic Sta- tistical Manual of Mental Disorders (DSM 5 TR) were released for implementation worldwide and now include the new Prolonged Grief Disorder (PGD). The newest definition of PGD is based on robust clinical research from the Global North yet until now has not been tested for global applicability. Methods: The current study assesses the new PGD ICD-11 criteria in a large international sample of 1393 bereaved adults. The majority of the sample was included from the USА. Additionally, we conduct a sub-sample analysis to evaluate …

It's Time To (Again) Recognize The Considerable Clinical And Public Health Significance Of Cardiorespiratory Fitness, Leonard A. Kaminsky, Mary T. Imboden, Cemal Ozemek

Faculty Publications - Department of Kinesiology

In this issue of the Journal of the American College of Cardiology, Kokkinos et al5 studied the relationship of both a single CRF value, and change in CRF, with all-cause mortality in a large (n 1⁄4 93,060) sample from the ETHOS (Exercise Testing and Health Outcomes Study) cohort. In this cohort, CRF was estimated as the peak metabolic equivalents (METs) derived from the peak speed and grade obtained on a treadmill exercise test. The findings from the single measure of CRF showed, compared with the low-CRF group (w5 METs), reductions in mortality rate across each higher-CRF group in both those …

Cardiorespiratory Fitness As A Vital Sign Of Cvd Risk In The Covid-19 Era, Matthew P. Harber, James E. Peterman, Mary Imboden, Leonard Kaminsky, Ruth E.M. Ashton, Ross Arena, Mark A. Faghy

Faculty Publications - Department of Kinesiology

The severe health consequences of the corona virus disease 2019 (COVID-19) pandemic have been exacerbated by the prevalence of cardiovascular disease (CVD) risk factors, such as physical inactivity, obesity, hypertension, and diabetes. Further, policy decisions during the pandemic augmented unhealthy lifestyle behaviors and health inequalities, likely increasing the global disease burden. Cardiorespiratory fitness (CRF) is a well-established biomarker associated with CVD risk. Emerging data demonstrate that high CRF offers some protection against severe outcomes from COVID-19 infection, highlighting the importance of CRF for population health and the potential for limiting the severity of future pandemics. CRF is best assessed by …

Muscle Fascicle Length Changes Of The Long Head Of Biceps Femoris Muscle During Various Physical Activities, Rusty Batykefer, Austin Hardin, Kyla Gomes, Octavio Tan, Bryce Yamashita, Alwin Sacro, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

We predict that the muscle fascicles of the biceps femoris long head will behave similarly to the ankle plantar flexors in that they will undergo smaller length changes during dynamic activities (running, walking) and greater changes during static activities (single leg Romanian deadlift, standing hamstring curl).