Medicine and Health Sciences Commons^™

A Pilot Program To Inform High School Students About Allied Healthcare Professions, Nhu Mac

UNLV Theses, Dissertations, Professional Papers, and Capstones

The literature revealed the lack of diversity in the workforce, limited recruiting and retention methods, and lack of exposure to these professions as the contributions to the shortage and demand for the profession of occupational therapy (OT), physical therapy (PT), and speech- language pathology (SLP). As a result, the fourteen-week program to inform high school students about OT, PT, and SLP roles in the community and public health was implemented at Desert Pines High School in Clark County School District (CCSD) to see if it would influence their perceived attitudes, knowledge, beliefs, and the likelihood of pursuing these careers. Using …

Perceived Value Of Acute Care Physical Therapy, Juliana Amenta, Andrew Falcinelli, Erin Heenan, Hannah Kendall

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/Significance/Objective: Although there is some research regarding physical therapy in the acute hospital setting, much of it is focused on the role physical therapists play with specific patient populations or diagnoses. By understanding more about how physical therapy services can add value in the acute hospital, their skills could be better utilized to maximize benefit for both individual patients and the hospital. The purpose of this study was to investigate the perceived value that physical therapists bring to the acute care hospital from the perspective of both physical therapists and their supervisors in Southern Nevada.

Methods: This study used an …

Effects Of A Remote Exercise Intervention On Aerobic Endurance In Individuals With Down Syndrome, Andrew Murata, Elena Wolf, Jonathan Crimm, Benjamin Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Down syndrome (Ds) or Trisomy 21 is a common genetic birth condition, and those with Ds typically display decreased cardiorespiratory fitness compared to those without Ds, potentially leading to an increased risk for cardiovascular conditions and mortality. Low cardiorespiratory fitness is partially caused by low physical activity levels in this population. The COVID-19 pandemic caused community-based activity programs to shut down, as individuals with Ds are at increased risk for COVID-19 hospitalization and death. Thus, it was vital to explore alternatives of in-person exercise during the pandemic. The purpose of this study was to investigate the effects of a …

Physical Therapy Alumni Rural Employment Assessment, Karen Aleyda Santos, Nikkita Jacob Crozier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction and Purpose: The University of Nevada, Las Vegas Doctor of Physical Therapy program (UNLVPT) encourages rural and underserved employment by requiring students to complete one clinical experience in either a rural or underserved setting. Students who participate in rural clinical experiences may be more likely to practice in rural settings. UNLVPT also assesses rural interest level during each student’s education. The purpose of this study was to determine if relationship exists between students’ pre- or post-clinical experience rural interest level and their practice location within the first two years after graduation. We hypothesized that an interest in rural practice …

Efficacy And Benefits Of Providing A Screening Clinic For Performing Arts Students, Shaun Bean, Joanna Centeno, Elizabeth Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

In past years, University of Nevada, Las Vegas physical therapy students (UNLVPT) have provided UNLV dance students with screening clinics, injury evaluations, and treatment sessions to help address their need for direct and specialized services. Through this project, UNLVPT has worked to help reduce injury risk in dancers and provided treatment and rehabilitation for injuries that have occurred. Due to the COVID-19 pandemic, our group was unable to treat dancers in person over the course of the 2020-2021 school year. In response to these limitations, we worked to reformat our screening process to make it practical in a virtual setting. …

Quality Assurance Of Service Learning Back School, Eric Bashaw, Vu Pham, Tyler Parvin, Ryan Pauly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Project Execution: Back School: During the 2019-20 academic year, two University of Nevada, Las Vegas Physical Therapy (UNLVPT) core faculty members, along with eight doctor of physical therapy students, provided three student-led, pro-bono back school classes at Volunteers in Medicine of Southern Nevada (VMSN). Each back school class consisted of two, 2-hour sessions where participants were screened for red flags, educated on pain management strategies and common causes of back pain, and given an individual home exercise program. Quality Assurance Surveys: Patient’s and VMSN staff were all given questions in the form of Likert-scale and open-ended questions via printed handouts …

Am-Pac Basic Mobility Inpatient Short Form (Low Function) Psychometrics/Clinimetrics, Meghan Wonderling, David Miller, Selena Soria

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine whether the Activity Measure for Post-Acute Care® Basic Mobility Inpatient Short Form (Low Function) (6-clicks LF) has increased responsiveness for patients with lower levels of physical function compared to the Activity Measure for Post-Acute Care Basic Mobility Inpatient Short Form (6-clicks). Design: Retrospective cohort study using original scores and simulated scores for assessment of internal responsiveness of the 6-clicks LF compared to the 6-clicks. Simulated 6-clicks and 6-clicks LF scores were created as a hypothetical future AM-PAC® score. Results: We found a statistically significant difference between the 6-clicks and simulated 6-clicks, t=24.8, p < 0.00 [two-tailed]. The effect size was large (d=1.2, r=0.51).There was a statistically significant difference between the 6-clicks LF and simulated 6-clicks LF, t=19.7, p < 0.00 [two-tailed]. The effect size was medium (d=0.91, r=0.41). Finally, for patients with a 6-clicks score in the bottom five-percentile (n=27), we found a statistically significant difference between the 6-clicks and 6-clicks LF, t=11.9, p < 0.00 [two-tailed]. Conclusion: Among patients scoring less than 15, the 6-clicks LF has greater internal responsiveness than the 6-clicks and thus demonstrates that the new low-level questions in the 6-clicks LF better quantify low-level patients’ functional level. Research using non-simulated data should be completed in the future to confirm these findings.

Inter And Intra-Rater Reliability Of Dance Screening Tool, Kathleen Stone, Braden Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Previous literature has indicated that injury rates of ballet and modern dancers are among the highest of any physical activity. These injuries can be detrimental to the athlete and can also result in financial burden for dance companies due to time loss related to injuries. Preventative intervention aimed at those who are most at risk for injury can be effective at reducing the cost associated with lost time due to injury. An effective approach to identifying those most at risk for dance related injuries is to administer a functional movement screen. One such movement screen is the ballet-based Dance Technique …

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

A Mobile App Specifically Designed To Facilitate Exercise In Parkinson Disease: Single-Cohort Pilot Study On Feasibility, Safety, And Signal Of Efficacy, Merrill R. Landers, Terry D. Ellis

Integrated Health Sciences Faculty Publications

Background: Many people with Parkinson disease do not have access to exercise programs that are specifically tailored to their needs and capabilities. This mobile app allows people with Parkinson disease to access Parkinson disease–specific exercises that are individually tailored using in-app demographic questions and performance tests which are fed into an algorithm which in turn produces a video-guided exercise program. Objective: To test the feasibility, safety, and signal of efficacy of a mobile app that facilitates exercise for people with Parkinson disease. Methods: A prospective, single-cohort design of people with Parkinson disease who had downloaded the 9zest app for exercise …

Physical Therapy Nontreatment Events With Primary Physical Therapist, Stephen Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Physical therapy improves prognosis reduces stay and is generally helpful in aiding recovery from a wide range of ailments. Nontreatment rates occur for multiple reasons and are also related to the personalities of physical therapists.

Methods: We used data from a research project involving physical therapy at an acute care facility in our community. Our study focused on the retrospectively determined primary physical therapist for each patient. We used the chi-squared tests to compare nontreatment rates between days of the week and disease type and the reasons for nontreatment events. Repeated-measure models were used to evaluate the effect of …

Modulation Of Corticospinal Excitability Using Cathodal Transcranial Direct Current Stimulation To Improve Walking In Individuals With Chronic Post Stroke Hemiparesis, Neil Drobitch, Kylie Henry, Sage Lyons, James Schomig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Individuals who have experienced a pyramidal cerebrovascular accident (pCVA) often exhibit impairments to volitional control of corresponding motor tasks. Promising effects in motor response, post-application of transcranial direct current stimulation (tDCS), have been reported in studies on individuals with the ability to achieve independent gait for 20 minutes. These studies mainly examined the effects of combined tDCS with locomotor training on lower extremity function among higher functioning individuals post-stroke. The purpose of this study was to determine the effect of tDCS among individuals post-stroke who may not have independent ambulatory capabilities, focusing on motor response and less …

Neuromuscular Adaptations Following Slope Walking In Individuals Post-Stroke, Eric Akoopie, Brooke Conway Kleven, Trisha Koch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The excitability of the H-reflex pathway in the non-impaired nervous system can be augmented by altering the different parameters of a walking task, specifically slope. We sought to examine the adaptations in soleus H-reflex excitability and foot force control following an acute bout of upslope or downslope treadmill walking in people post-stroke compared to those who are non- impaired. Methods: We recruited 12 individuals with chronic post-stroke hemiparesis and 9 age-similar non- neurologically impaired individuals. Each subject was tested over 2 sessions separated by at least 7 days. For each session, subjects walked at a self-selected walking speed on …

Immediate Effects Of Cervical Spine Thrust Joint Manipulation On Gait Parameters In Individuals With Neck Pain, Marc Anthony D. Albano, Emily Blok, Beau Gronert, Ryan Masuda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypotheses: 1. To investigate for any change in gait parameters in individuals with neck pain while walking with different functional neck conditions immediately following cervical thrust joint manipulation (TJM) versus a sham intervention. 2. To investigate any association between Global Rating of Change (GROC) scores and gait parameters immediately following cervical thrust joint manipulation versus a sham intervention. The hypotheses were that, a) cervical TJM would have an immediate effect on gait parameters during walking with the neck in at least one of three conditions (neutral, flexion/extension and rotation) among individuals with neck pain; and b) higher scores on the …

Successful Patient Participation In Acute Hospital Physical Therapy, Jesse Kim, Joseph Fertitta, Patrick Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Research has demonstrated that physical therapy plays a crucial role in patient recovery in the acute hospital setting. Despite known benefits, scheduled sessions do not always occur and are called nontreatment (NT) events. Reported NT ranges from 15% to 26% of scheduled sessions. Previous studies have found an association between NT and patient diagnosis as well as between NT and day of the week on which treatment was scheduled. Identifying additional factors that affect NT is important if therapists and administrators are to make improvements. The purpose of this study is to determine if an association exists between physical …

Disposition And Success Of Patients Following Discharge In The Acute Setting, Ciera Cortney, Kathryn Lutjens, Kristopher Raines

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract: Background & Purpose: Many patients are seen in the hospital by physical therapists who also help decide where the patient will go after discharge (e.g., home, rehab hospital, skilled nursing facility) with the goal being the safest and best quality of life. Therapists may use different tests and measures along with their own professional judgment to help make a recommendation for a discharge location. The purpose of this study was to examine how PT’s recommendation for discharge location, POMA score, “6-clicks” score, age, diagnosis, and gender determine patient’s fall/readmission status after being discharged by hospital. Subjects: There were 113 …

Use Of Active Video Gaming In Children With Neromotor Dysfunction: A Systematic Review, Robert Manzanares, Lisa Popescu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Active video games (AVG) are gaining popularity as a strategy for improving motor function in children with neurologically-based movement disorders, but there is no consensus regarding AVG’s utility or effectiveness in this population. The purpose of this systematic review was to examine current evidence on the use of AVG to improve motor function in children 2-17 years of age with neurologically-based movement disorders. Methods: Authors followed standard criteria for systematic review conduct and rating quality of evidence including the PRISMA checklist. Databases searched were Scopus, MEDLINE, Cochrane Library, EMBASE, and CINAHL. Systematic reviews, randomized control trials, or …

Patient No-Show For Outpatient Physical Therapy: A National Survey, James Bokinskie, Payton Johnson, Trevor Mahoney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Patients who fail to show for scheduled medical appointments (no-show) create a cascade of issues for the health care system, the provider, and themselves. No-show can affect clinical productivity, cost and quality of care, and treatment outcomes. There is an overwhelming lack of research on no-show as it relates to outpatient physical therapy in the United States. The purposes of this study were to report national no-show rates, describe the presence and characteristics of no-show policies, determine the relationship of these policies and other demographic information to no-show rates, and describe the most commonly perceived reasons for no-show.

Methods: …

Immediate Effects Of Cervical Spine Manipulation On Gait Parameters In Individuals With And Without Mechanical Neck Pain, Jordan Isom, Shaylyn Kennedy, Justin May, Samuel Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to determine 1) if there were any differences in gait parameters between participants with mechanical neck pain and those without and 2) if cervical spine manipulation has an immediate effect on these gait parameters.

Methods: Twenty participants with mechanical neck pain and twenty participants without neck pain were randomly assigned into either the sham or manipulation group. The two intervention groups participated in walking across a GAITRite Walkway that recorded gait parameters such as stride length, cadence and step width before and after cervical spine manipulation. The participants walked at their own cadence …

The Immediate Effects Of Cervicothoracic Manipulation Versus Stretching On Upper Trapezius Pressure Pain Thresholds And Range Of Motion In Individuals Without Neck Pain, Kevin Carr, Morgan King, Erin Oelklaus, Brendan Parry

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Myofascial pain may be considered one of the most common clinical findings in patients with neck pain (NP). Motor aspects of myofascial pain include disturbed motor function and muscle weakness secondary to motor inhibition, muscle stiffness, and restricted range of motion (ROM). Currently, it is unclear which interventions may have the greatest immediate impact on pressure pain sensitivity and ROM. Several studies have demonstrated improved pressure pain thresholds (PPT) after cervical manipulation; however, it is not clear if manipulation targeted to the cervicothoracic (CT) junction will have a similar effect. Others recommend stretching as a method to …

Four Weeks Of Minimalist Style Running Training Reduced Lumbar Paraspinal Muscle Activation During Shod Running, Stephanie Barton, David Brown, Talia Joyce

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Research has shown that the risk of low back dysfunctions in runners is related to the increased mileage of distance running. Repetitive shock loading of the spinal structures during running has been indicated as one of the important biomechanical mechanisms underlying such injury. Acute changes in foot strike pattern, like those seen during minimalist style running, have been shown to lead to modifications in lumbar range of motion. Minimalist style running could lead to changes in lumbar biomechanics and muscle activation, potentially reducing the loading on the musculoskeletal structures of the lower back. However, the long term …

Comparing Usability And Variance Of Low- And High Technology Approaches To Gait Analysis In Health Adults, John Mcconnell, Brian Silverman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to compare the usability, reliability, and objectivity of four tools that represented varying gait analysis technologies used in clinical practice and/or research. Low technology clinical tools included the Gait Abnormality Rating Scale (GARS-M) and the Rancho Los Amigos Observational Gait Analysis (Rancho OGA). High technology tools included the GAITRiteÒ computerized walkway, and the APDM Mobility LabÔ wearable sensor system.

Subjects: 74 healthy adults ages 18-41 years (mean = 24.82, SD = 4.39) 33 males and 40 females.

Methods: Subjects were instructed to walk at a self-selected speed for two minutes …

Physical Therapy Non-Treatment Of The Acute Hospital Inpatient, Daniel Lee Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detrimental effects of inactivity and mobility extend to the most ill and injured patients in the acute hospital setting. Facilitating the activity and exercise of these most critical patients often requires the skill and expertise of a physical therapist. When physical therapists are involved in the care of hospital inpatients they experience significant benefits; patients experience fewer secondary complications related to their primary illness or injury, they spend less time in critical care units and less time in the hospital overall, and when they leave they go to less restrictive environments and more comfortable care settings. These known benefits …

The Effect Of Balance Training With An Innovative Approach Compared To Traditional Balance Exercises, Brian Curtis Waite

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the use of an X Box 360 KinectTM game as a modality for improving balance. Specifically, this study explores the use of the Target Kick mini game on Kinect SportsTM as a tool for VR rehabilitation. Subjects (N=18, age 23.3 ±2.87 yrs, mass 71.83 ±15.25 kg, height 168.4 ±7.79 cm) with no lower extremity injury were randomly placed into three groups (X Box n = 6, Traditional n = 6, and Control n = 6). The X Box (XBOX) group performed ten minutes of balance training by playing an X Box game …

Land-Based Exercise And Its Effect On Quality Of Life Outcomes In Patients With Knee Osteoarthritis: A Systematic Review, Cody R. Buckner, Lindsay C. Martin, Michael L. Soukup

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The purpose of this systematic review was to examine effectiveness of land-based exercise interventions for improving quality of life (QOL) of individuals with symptomatic knee osteoarthritis.

Methods: A systematic search included PubMed, CINAHL, Scopus, Academic Search Premier, and the Cochrane Database of Systematic Reviews. Inclusion criteria included land-based exercise interventions aimed to improve lower extremity strength and QOL, published since 2000. Exclusion criteria included OA of joints other than the knee, and aquatic-based and surgical interventions. Studies were evaluated using a modified version of the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) methodology score.

Results: Level of …

Therapeutic Neuroscience Education For Patients With Chronic Low Back Pain And Its Effect On Activity Level, Pain Perception, And Function, Stephen Burton, Amber Domingo, Ryan Spencer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Chronic low back pain (CLBP) is a significant cause of disability and inactivity in the United States. Patients with chronic pain are often symptomatic even in the absence of tissue damage. This is a major reason patients need to be educated about their pain. Cognitions such as fear, anxiety and faulty beliefs may impact the pain experiences and changing cognitions are important in changing pain behavior. If patients understand that the pain they are experiencing may not be a true indication of the health of their tissues, they may experience less fear of their pain, and may be able …

Therapist Characteristics Influencing Physical Therapy Non-Treatment In The Acute Care Setting, Daniel Mcgarvey, Colby Olsen, Aaron Van Wagoner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Research has found that participation in physical therapy (PT) services in the acute care setting increases functional outcomes and decreases patient length of stay. Certain physical therapist characteristics could be a potential source of influence on patient non-participation in physical therapy in the acute care setting. The purpose of this study was to determine whether specific characteristics of therapists and patients are predictive of physical therapy non-treatment.

Subjects: Subjects included 16 physical therapists or physical therapist assistants and 1225 patients at a community acute care hospital.

Methods: Characteristics of each therapist and their corresponding patient data were …

Foot Volume Change During Long Distance Running In Healthy Adults, Meghan Boni, Istvan Takacs, Rebecca Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: Healthy adults frequently engage in running as a means of cardiovascular exercise. Larger running shoes are often chosen based on common beliefs that feet swell during running, yet many continue to encounter foot injuries, such as blisters, as a result of this activity. Previous research has analyzed the changes in foot volume during short bouts of activity. However, there has been limited research on the effect of long distance running on foot volume, which is where many of these injuries are seen. The purpose of this study was to examine the effects of long distance running, defined …

Determining The Validity Of The Nintendo Wii Balance Board As An Assessment Tool For Balance, Sabrina Mae Deans

UNLV Theses, Dissertations, Professional Papers, and Capstones

Context. Application of the Nintendo Wii-fit balance board and its games have been used in Physical Therapy clinics, showing success in individuals with neurological disorders, and has been recommended as a minimum baseline assessment of a symptoms checklist and standardized cognitive and balance assessments for concussion management by the NCAA. However, it still faces challenges of being considered a reliable and consistent tool for producing normative data in the allied healthcare. Because there is little to no evidence for the Wii-fit balance board as a valid balance assessment tool for clinical and/or research usage, the significance of this study is …

Patient Factors And Day Of The Week Influencing Physical Therapy Non-Treatment Events In The Acute Care Setting, Daniel Goodrich, Curtis Doug Jensen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background. In acute care hospitals, scheduled physical therapy visits not resulting in treatment may increase patient length of stay and the financial burden to the hospital. Previous literature has not fully evaluated the occurrence of these events, nor have any associated factors been identified.

Objective. Measure the rate of non-treatment and determine which patient characteristics were most likely to predict a non-treatment event.

Design. Retrospective review of documentation at a suburban hospital.

Methods. Data were collected from records of 1,096 patients, totaling 6,097 scheduled sessions. The rate of non-treatment was calculated and logistic regression used to …