Medicine and Health Sciences Commons^™

Comparison Of Vascular Dopplers In Measuring Limb Occlusion Pressure For Blood Flow Restriction Therapy, Kiara Barrett, Logan Page, Marcin Szczyglowski, Tyler Martin, J. Grant Mouser

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 4: Issue 1, Article 7, 2023. The use of blood flow restriction is becoming more common and requires the use of individualized pressures in order to remain a safe and effective rehabilitation modality. Measuring limb occlusion pressure (LOP) allows the practitioner to set the restriction pressure so that full occlusion does not occur. Objective: Compare a research-grade clinical vascular doppler and a consumer-grade vascular doppler in the measurement of LOP. Design: A randomized crossover design measuring LOP in the upper and lower body. Methods: 20 participants (men=10) visited the laboratory on one occasion. …

Effects Of A 12-Week Remote Exercise Program On Balance In Adults With Down Syndrome, Kayla Kotake, Sherwin Cadiao, Nicole Kaes, Jayston Prudencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis Individuals with Down syndrome (Ds) tend to have deficits in balance and postural control, which negatively affects their ability to perform physical activities safely and independently. Previous research has shown that exercise can improve balance in people with Ds, however, most studies looked at balance in children with Ds. As the average life expectancy for people with Ds has increased, there is a need for research investigating balance in adults with Ds. Also, there is a need to increase exercise opportunities (eg, remote exercise programs) for adults with Ds, as physical inactivity and sedentary behavior are prevalent among individuals …

Creating A University-Based Performing Arts Clinic: Challenges And Lessons, Carissa Limtiaco, Alan Savanapridi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fine artists performing at the collegiate level are at a high risk for developing performance related musculoskeletal injuries due to the unique physical demands and repetitive nature of their movements. Previous research has reported incidence rates as high as 81% and 62% for student dancers and musicians respectively. Despite the high injury rates, research has shown that student performers underreport injuries and are reluctant to seek medical management from health professionals due to unhealthy beliefs and attitudes often held by this population as well as the lack of specialized healthcare. The goal of the UNLV College of Fine Arts (CFA) …

The Psychometric Properties Of The Modified Fear Of Falling Avoidance Behavior Questionnaire In Parkinson’S Disease And Older Adults, Billy La, Arturo Aldaco, Ashley Haller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/purpose: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ), developed in 2011 to measure fear of falling avoidance behavior, has good evidence for reliability and validity. However, a recently modified version (mFFABQ) is theorized to be easier to understand for those completing the questionnaire because the Likert responses are more logical in completing the item stem. The purpose of this study was to examine the test-retest reliability and construct validity of the mFFABQ in adults with Parkinson’s Disease (PD) and older adults aged 60-90 years. Methods: Thirty-nine participants (age 72.21 ± 9.5; 29 men, 10 women) diagnosed with PD (diagnosis …

Lumbopelvic Biomechanics And Muscle Performance In Individuals With Unilateral Transfemoral Amputation: Implications For Lower Back Pain, Jason Ciccotelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

Many people with lower extremity amputation (LEA) experience lower back pain (LBP). The amount of pain they experienced can be debilitating and severely interferes with activities of daily living. Previous studies have explored LBP in populations without LEA, and the evidence is also growing within the limb loss population. However, the mechanism for the high prevalence of LBP after LEA remains unclear. The lower back muscles, specifically the multifidi muscles, play an important role in stabilization of the spine during motion, and LBP has been associated with decreased mobility in patient populations, but the degree of dysfunction in the spinal …

Utilization And Perception Of Peer-Support After Lower Limb Loss In The United States: Potential Benefits On Mobility Outcomes, Moriah Maluotoga, Roopkiran Thind

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Limb loss is a life-changing event that significantly impacts patients’ functioning as well as psychosocial well-being. Psychosocial support in the form of amputee peer-support is widely recognized as beneficial to individuals after lower limb loss (LLL). However, there is currently a lack of research on the utilization of peer-support after LLL and its perceived benefits to function. The purpose of this cross-sectional study was to examine and quantify participants’ experiences with peer-support after LLL, and how peer-support experience is associated with mobility outcomes. We hypothesized that participants with LLL would express generally positive experiences with peer-support and that it …

The Feasibility Of A Large-Amplitude Aquatic-Based Exercise Occupational Therapy Program For Individuals With Early Parkinson’S Disease, Brigitte Baker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this research was to determine if a 4-week aquatic-based, large-amplitude exercise program would increase strength and coordination for occupational performance in areas of activities of daily living (ADLs) and mobility in individuals with Parkinson's disease (PD) stage I-II, functional mobility as measured by Timed Up and Go test, and quality of life as measured by PDQ-39 in relation to occupational engagement.Methodology: Recruitment was through capstone placement site, Hands on Rehab, 7921 Professional Circle, Huntington Beach, CA 92648, in which a signed EAA was on file. Informed Consent was reviewed by the student-clinician as well as the …

Effects Of Patellofemoral Pain On Central Activation And Function Of The Gluteus Medius Muscle In Physically Active Females, Michelle Samuel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patellofemoral pain (PFP) is the most common knee injury among runners, military personnel, adolescents and recreationally active persons. PFP commonly presents as diffuse pain across the anterior knee that increases with activities such as running, squatting, and walking up and down stairs. Nearly 75% of patients with PFP either alter or completely stop physical activity as a result of the pain. There are numerous mechanisms that contribute to PFP symptoms; such as muscle weakness, abnormal joint mechanics and abnormal joint stress, which make it difficult to successfully treat. In addition, PFP may lead to patellofemoral joint (PFJ) osteoarthritis, a debilitating …

The Impact Of High-Intensity Interval Training On Vascular Function In Adults: A Systematic Review And Meta-Analysis, Mousa Khalafi, Mohammad Hossein Sakhaei, Fatemeh Kazeminasab, Michael E. Symonds, Sara K. Rosenkranz

Kinesiology and Nutrition Sciences Faculty Publications

Aim: We performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) compared with moderateintensity continuous training (MICT) or with no exercise (CON) on vascular function in adults who were free of cardiometabolic diseases and those with cardiometabolic diseases.

Methods: A search across three electronic databases including Scopus, PubMed, and Web of Science was conducted through February 2022 to identify the randomized trials evaluating HIIT vs. MICT and/or CON on vascular function as measured using brachial artery flow-mediated dilation (FMD) in adults. Separate analyses were conducted for HIIT vs. MICT and/or CON to calculate weighted …

Association Between Arthritis And Yoga Among Veterans, Anupreet Arora

UNLV Theses, Dissertations, Professional Papers, and Capstones

Yoga is a state of complete mindfulness and self-realization with an inwardly drawn focus, a state of mind – body integration in which there is a harmony between form and action. Yoga can help us treat a myriad of chronic health conditions like obesity, heart diseases, diabetes, depression, gastrointestinal problems, asthma, hypertension, chronic low back pain, and arthritis to name a few. Arthritis is a frequent, debilitating chronic disease which can cripple an individual if allowed to progress unchecked. In 2021, the prevalence of arthritis in USA was around 24% with a projection of 37% by 2030. Prevalence of arthritis …

Direction Of Attentional Focus In Prosthetic Training: Current Practice And Potential For Improving Motor Learning In Individuals With Lower Limb Loss, Alexander Bonczyk, Maria Katrina Tillada Dimapilis, Sarah Partridge, Samantha Ruiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting.

Methods: Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age=50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience=10 years, range=4-21 years) during …

The Role Of Socioeconomic Status, Race, And Gender In Patient-Reported Outcomes Following Total Hip Arthroplasty, Allyn M. Bove, James Porter, Aatif Sayeed, Clair Smith, Brian A. Klatt

Journal of Health Disparities Research and Practice

Background

Disparities in total joint arthroplasty are well-documented. However, much of the research regarding disparities in vulnerable populations receiving total hip arthroplasty (THA) have focused on short-term outcomes. The purpose of this study was to examine the effects of race, gender, and socioeconomic status (SES) on patient-reported outcomes six months following THA.

Methods

Electronic health record data were retrospectively analyzed for 269 individuals who underwent THA at a large urban hospital from 2013-16. Data retrieved included patient demographics, baseline health information, data regarding hospital length of stay when undergoing THA, post-operative complications, and patient-reported function, measured by the Harris Hip …

Stretching After An In-Water Warm-Up Does Not Acutely Improve Sprint Freestyle Swim Performance In Diii Collegiate Swimmers, Haven L. Westra, Alexander H.K. Montoye

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 2: Issue 1, Article 11, 2021. Stretching, as part of a warm-up prior to competition, has been used as a method to enhance performance in swimming and other sports, but its efficacy as a potential ergogenic aid remains understudied. This study’s purpose was to determine if acute static stretching or a dynamic warm-up, following an in-water swim-specific warm-up, improved sprint freestyle swim performance in collegiate swimmers. NCAA Division III swimmers (n=15, 67% female) participated in three testing protocols. In each protocol, participants did an in-water warm up and either a dynamic warmup …

The Effect Of Ankle Taping On The Kinematics Of The Lower Extremity While Running On Level, Inclined, And Declined Slopes, Dominique Cava, Derek M. R. Kivi, Paolo Sanzo, Carlos Zerpa

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 2: Issue 1, Article 8, 2021. Therapeutic taping is often prescribed as a treatment for various overuse injuries in the lower extremity. Researchers believe that taping may control the position and alter alignment of the calcaneus to correct foot pathologies when applied to the ankle in runners, however, the utility and specific mechanical effects of different taping techniques remains unclear. The purpose of this study was to explore the effect of ankle taping (no tape (NT), Kinesiotape® (KT), or Leukotape® (LT)) across different slope conditions (level, inclined, and declined) on the kinematics of …

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 Vicious Cycle Of Fear Of Falling Avoidance Behavior In Parkinson’S Disease: A Path Analysis, Kameron Jacobson, Nicole Matsunami, Hannah Mccarl, Michelle Regis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Development Of A Novel Cognitive-Motor Dual Task Assessment Battery In Neurodegenerative Disease, Jason Longhurst

UNLV Theses, Dissertations, Professional Papers, and Capstones

Automaticity --- the ability to perform a task with directing attentional resources to its completion --- is commonly reduced among individuals with neurodegenerative diseases. These automaticity deficits result in impaired functional and daily activities and are sensitive to subtle, subclinical impairments. However, current measurement of automaticity by dual task paradigms is methodologically limited. In order to gain insight into the current state of the literature regarding cognitive-motor interference in symptomatic and prodromal neurodegenerative disease, the author of this dissertation conducted a scoping review (Chapter 1). To address the methodological limitations of current measurement of automaticity, a new measurement tool was …

Examining The Experiences Of Lgbtq Dpt Students: A Critical Ethnography, Catherine Turner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the experiences of LGBTQ Doctor of Physical Therapy (DPT) students at a large public university in the south-western United States, as it relates to the culture and climate of the program and campus. The LGBTQ community faces its own unique health disparities. Research in medicine suggests improving the diversity of the healthcare profession is a vital component in improving access to care, and this requires the creation of inclusive and supportive educational environments for LGBTQ identifying healthcare students. However, minimal research exists examining the experiences of LGBTQ physical therapy students.

The study …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Dosage, Mode, And Timing Of Acute Care Physical Therapy: A Scoping Review, Brendan Acosta, Bradley Goins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Aims and Objectives: 1) To synthesize available evidence for mode, dosage, and timing of physical therapy in the acute care hospital setting. 2) To report the evidence about the effects of mode, dosage, and timing of physical therapy in the acute care hospital setting on LOS, associated costs, and PT-related outcomes. Background: Hospital based physical therapy quality depends on providing evidence-based interventions, however, the research regarding dosage, mode, and timing of physical therapy in the acute care hospital setting has not been synthesized for patient populations except for total joint arthroplasties or patients in the ICU. Design: A systematic search …

Brain Volumes And Dual-Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jon Basterrechea, Daniel Krist, Caitlin Moreland, Morgan Wise

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. Objective: To examine associations between brain volumes, dual task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. Methods: We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual task performance, and measures of gait and balance. Results: Greater cognitive function and combined dual task effect (DTE) is associated with smaller brain volumes. In contrast, greater motor DTE is associated with larger …

Partnering With The Nevada Physical Therapy Association To Improve Pt/Pta Engagement, Rachel Cooklin, Joshua Cooper, Madison Luna

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The American Physical Therapy Association (APTA) is the professional organization that represents Physical Therapy and exists to promote the needs of society by advocating access and availability of all Physical Therapy services. The Nevada Physical Therapy Association (NVPTA) is a chapter of the APTA that represents the Physical Therapy profession in Nevada. In 2017, only 38.9% of licensed Physical Therapists (PTs) and 7.9% of licensed Physical Therapy Assistants (PTAs) practicing in Nevada were members of the NVPTA. Objective: The purpose of this service-learning project was to explore membership trends in the NVPTA, explore why membership amongst PTAs is low, …

Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Patient, Student, And Faculty Perceptions Of A Student Led Pro-Bono Education And Treatment Based Back School For Uninsured Nevadans, James Tingey, Daniel Tiano, Rebecca Templeton, Meagan Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Importance: To determine feasibility and benefits of student led back school in an underserved population. Perceptions were positive support benefits for all participants. Objective: To evaluate perceived benefits for uninsured participants, students, and faculty with implementation of an evidence based, student led back school. Design: Eight DPT students created curriculum delivered over two days of two-hour classes, one week apart including screening and abbreviated evaluation of LBP, group education, specific exercise selection, and home exercise program assignment. Following first session, analysis performed to improve subsequent sessions. Setting: Cooperative effort between the pro bono clinic, Volunteers in Medicine of Southern 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 …

Factors Related To Intra-Tendinous Morphology Of Achilles Tendon In Runners, Kai-Yu Ho, Ari Baquet, Yu-Jen Chang, Lung-Chan Chien, Michelle Harty, Gregory Bashford, Kornelia Kulig

Physical Therapy Faculty Publications

The purpose of this study was to determine and explore factors (age, sex, anthropometry, running and injury/pain history, tendon gross morphology, neovascularization, ankle range of motion, and ankle plantarflexor muscle endurance) related to intra-tendinous morphological alterations of the Achilles tendon in runners. An intra-tendinous morphological change was defined as collagen fiber disorganization detected by a low peak spatial frequency radius (PSFR) obtained from spatial frequency analysis (SFA) techniques in sonography. Ninety-one runners (53 males and 38 females; 37.9 ± 11.6 years) with 8.8 ± 7.3 years of running experience participated. Height, weight, and waist and hip circumferences were recorded. Participants …

Physiotherapy Is Associated With Improvements In Gait And Balance In Individuals With Cognitive Impairment: A Retrospective Analysis, Steven Jackson, Elbert Chen, Jason Phan

UNLV Theses, Dissertations, Professional Papers, and Capstones

BACKGROUND: Evidence suggests that individuals with cognitive impairment (CI) exhibit significant motor impairments; however, these motor impairments receive little treatment attention compared to more prominent CI. Moreover, there is a lack of evidence about physiotherapy (PT) in individuals with CI. OBJECTIVE: The purpose of this study was to determine if PT was effective at improving gait and balance in individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI). METHODS: Retrospective data of 173 individuals with CI conditions and an initial evaluation for PT were extracted from electronic records from January 2016 …

Impact Of Clinician Experience And Positive Language On Subject Expectation Of Cervical Spine Manipulation Effects, Joshua Wood, Jonah Mawae, Stephen Elmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Acute neck pain is a worldwide epidemic that physical therapists treat with cervical spine manipulation (CSM). While the mechanical and neurological effects of CSM are important, it is possible that the patient’s perception of the therapist’s skill level may also play a role in patient outcomes. Along with the patient’s perception of the practitioner, evidence suggests that patient expectation for intervention efficacy may also alter patient outcomes. The implication is that special consideration must be taken when practitioners choose their words when describing both themselves and their interventions. The purpose of this study is to examine if …