Medicine and Health Sciences Commons^™

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 …

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 …

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 …

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 …

The Influence Of Socioeconomic Factors On Fear Of Falling And Mobility Outcomes After Lower Limb Loss: A Preliminary Study, Tyler Chin, Heather Fox, Juan Gutierrez Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with …

Fine-Wire Intramuscular Insertion To The Lumbar Paraspinal Muscles Does Not Affect Muscle Activation And Performance During High Exertion Spinal Extension Muscle Contractions, James Dimascio, Rebeka Hicks, Matthew Kimber, Kelsey Synder

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Low back pain (LBP) is associated with paraspinal muscle dysfunctions. A method to study the deep lumbar paraspinal muscle activation is with intramuscular electromyography (EMG). However, it is currently unknown how paraspinal muscle performance is affected by the invasive intramuscular insertion and the presence of the fine-wire electrode in the muscle. The purpose of this study was to analyze how insertion of fine-wire EMG into lumbar paraspinal muscle affects the lumbar paraspinal muscle fatigue, endurance, activation, and peak extension torque during high exertion spinal extension exercises. Participants: 20 individuals between the ages of 18-40 participated. The participants …

Predictors Of Physical Therapy Non-Treatment Among Patients Scheduled For Treatment Two Times A Day In The Acute Hospital, Sara Bookout, Kyle Ozaki

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Consistent participation in physical therapy treatment is the key to the success of any physical therapy treatment program. Scheduled therapy sessions that do not result in treatment (non-treatment) may cause longer hospital stays and/or poor outcomes. A better understanding of the factors affecting non-treatment could allow proper adjustments to prevent non-treatment by hospital administration, improve patient-therapist interaction, and may result in improved care, greater patient satisfaction, and lower healthcare costs. The purpose of this study was to investigate characteristics of patients that affect physical therapy non-treatment events for patients scheduled for therapy twice a day (BID) in …

A Comparison Of Measured And Self-Reported Blood Pressure Status Among Low-Income Housing Residents In New York City, James H. Williams Ab, Dustin T. Duncan Scd, Jonathan Cantor Ms, Brian Elbel Phd Mph, Gbenga Ogedegbe Md Ms Mph, Joseph Ravenell Md Ms

Journal of Health Disparities Research and Practice

Self-report is widely used to measure hypertension prevalence in population-based studies, but there is little research comparing self-report with measured blood pressure among low-income populations. The objective of this study was to compare self-reported and measured blood pressure status among a sample of low-income housing residents in New York City (n=118). We completed a cross-sectional analysis comparing self-report with measured blood pressure status. We determined the sensitivity, specificity, and positive predictive value (PPV) of each self-report metric. Of the sample, 68.1% was Black, 71.1% had a household income under $25,000/year, and 28.5% did not complete high school. In our study, …

Low Back Pain In Student Nurses: Literature Review And Prospective Cohort Study, Nancy Menzel, Du Feng, Jessica Doolen

Nursing Faculty Publications

There is consensus that registered nurses worldwide have a high prevalence of work-related musculoskeletal disorders, particularly of the back. Patient handling activities such as lifting present the highest risk of injury, activities that begin in nursing school. A literature review identified 21 studies of back pain in nursing students, indicating a wide range of prevalence rates. A prospective cohort study of nursing students in a United States baccalaureate program followed 119 students who completed the Nordic Musculoskeletal Questionnaire upon beginning the 16 month upper division major and then a year later. There was no statistically significant change in low back …

The Effects Of Locomotion-Induced Shock Loading On Tibiofemoral Bone Stress Response, Alexa Standerfer, Suzenna Ngo, Karen Daun

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Knee osteoarthritis (Coats, Zioupos, & Aspden) is a degenerative joint disease that negatively impacts the quality of life. About 9.3 million people in the U.S. population are affected. It has been suggested via magnetic resonance imaging (MRI) studies that bone marrow edema (i.e., indicative of bone stress response) and joint structure changes may be the main contributing factors of pain in OA. Frontal plane lower extremity (LE) alignment has been a topic of much interest regarding development of OA in the knee joint. It is hypothesized that varus alignment increases forces through the medial compartment of the knee, thereby …

The Effects Of Patellofemoral Taping On Patellofemoral Joint Alignment And Contact Area, Ryan Epstein, Ron Garcia, Nicole Riley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: It is widely accepted that patellofemoral pain (PFP) is the result of excessive stress between the retro-patellar surface and the femoral trochlea. Elevated patellofemoral joint (PFJ) stress may be associated with a reduction in PFJ contact area resulting from patellar malalignment (e.g., lateral displacement, lateral tilt, or patellar alta and/or quadriceps imbalance). McConnell and Kinesio taping techniques are commonly used to address PFP and improve PFJ alignment. It has been theorized that PFJ taping can alter the PFJ alignment which may increase the patella’s contact area within the femoral trochlea, thereby resulting in a reduction in PFP. To date, …

Thrust Joint Manipulation Utilization By Us Physical Therapists, Sean Reilly, Rebecca Slaughter, Erwin Ventura

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Online survey study. Objective: To determine physical therapists’ utilization of thrust joint manipulation (TJM) and their comfort level in using TJM between the cervical, thoracic, and lumbar regions of the spine. We hypothesized that physical therapists who use TJM would report regular use and comfort providing it to the thoracic and lumbar spines, but not so much for the cervical spine. Background: Recent surveys of first professional physical therapy degree programs have found that TJM to the cervical spine is not taught to the same degree as to the thoracic and lumbar spines. Methods: We developed a survey …

Use Of A Mobile Application To Increase Patient Compliance To A Prescribed Home Exercise Program And Improve Outcomes, Ellie Cobb, Jed Hurst, Ethan Konshuk

UNLV Theses, Dissertations, Professional Papers, and Capstones

Methods: The creator of the app offered free use of their app to a physical therapy clinic. As the app is only compatible with Apple products, the clinic used the app with any patient that had an iPhone. Retrospective review was conducted to determine if differences in patient outcomes were observed. Patients who had access to an iPad or iPhone were considered part of the “app group” and used the mobile app to reference and report PT HEP compliance. Patients without access to an iPad or iPhone were considered part of the “non-app group” and received traditional PT HEP prescription …

The Effect Of Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Subjects With Low Back Pain, Shane Collins, Abbay Dow, Daniel Rincon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, double-blinded, controlled clinical trial. Objective: To measure the effects of dry needling to the lumbar multifidus (MF) muscle for any change in resting and contracted thickness of the transversus abdominis (TrA) muscle as well as symptoms and disability in individuals with low back pain (LBP). Background: Recent studies have demonstrated that individuals with LBP have diminished co-activation of the lumbar MF and TrA muscles, which when working appropriately in healthy individuals, contributes to spinal stability and function. A significant change in the resting and contracted thickness of TrA has been found with dry needling to the lumbar …

Comparing Functional Motor Control And Gait Parameters In Children With Autism To Those Of Age-Matched Peers Who Are Typically Developing, Patricia Stevenson, Samantha Novotny, Jillian May, Christopher Ancell

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare motor performance of children with Autism Spectrum Disorder (ASD) to that of age-matched peers who are typically developing (TD) on motor control tasks plus symmetry and variability of gait parameters across four walking conditions. A sample of convenience of children with ASD (n=6) and peers who are TD (n=6) were recruited. Motor control was assessed using initiation and completion times on the Timed Up and Go (TUG) test. Gait parameters were collected using a computerized walkway under four trial conditions: 1) walking at self-selected velocity (SSV); 2) walking during a tray-carrying task …

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: …

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 …

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 …

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 …

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …

The Percussionist Bodybuilder: Optimizing Performance Through Exercise And Nutrition, Anthony Joseph Merlino

UNLV Theses, Dissertations, Professional Papers, and Capstones

Do preventive therapies have the potential to help avoid common injuries among percussionists? This document investigates physiological therapy and nutrition in relation to percussion performance. My interest in this subject matter is derived from my personal experiences with injuries related to the performance of percussion. Although I have studied and played percussion professionally for more than a decade, I was unaware of certain methods of rehabilitation that were available to me prior to my injuries. As I learned about the rehabilitation process through first hand experience, I discovered that my injuries were very common among percussionists. This raised the question: …

The Effects Of A Progressive Exercise Program On Functional Activity And Quality Of Life For Older Overweight Women With Knee Osteoarthritis, Ty Carlson, Devin Edvalson, Tyler Peck, Brad Robison

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose Osteoarthritis (OA) is a common symptomatic condition experienced by older adults, especially in the overweight population, that affects the knees in particular. This study compares the effectiveness of two progressive exercise protocols (walking and stepping) on function and quality of life in older, overweight women with OA. This study includes self-management training and assesses participant selfperceived efficacy in managing OA.

Subjects This is a quasi-experimental design utilizing 16 women ≥ 50 years of age (60.44 ± 6.04) with a BMI > 25 (34.21 ± 7.28) and radiographic diagnosis of OA in at least one knee.

Methods and Measures …

Evidence For The Validity Of A Tool For Improved Pressure Ulcer Staging By The Non-Expert In The Live Patient, Janelle Borg, Carrie Johnston, Megan Lucke, Jordan Sinclair

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses.

Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada.

Methods: Subjects assessed 11 wounds on the patients independently. They …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …

Conceptual Framework Of A Novel Intervention To Improve Mobility In Children With Cerebral Palsy: The Successes And Challenges Of Implementing A Large Amplitude Movement Protocol, Tania Goodwill, Erin Jarrett, Beren Shah, Alanna Stockford

UNLV Theses, Dissertations, Professional Papers, and Capstones

While cerebral palsy remains one of the most common childhood disabilities, clinicians continue to face significant challenges developing effective treatment strategies for the widely variable presentation of motor function impairments associated with cerebral palsy. A large gap exists between current research based evidence and feasible clinical practice. The purpose of this paper is to introduce a novel intervention protocol, explore the theoretical framework behind the protocol and provide insight to clinicians about the successes and challenges faced while pilot testing the intervention. The novel intervention was adapted and implemented by researchers combining a large amplitude movement protocol with the well-researched …

Development Of A Tool To Assess Children’S Perceptions Of Their Own Balance (The Pediatric Balance Perception Battery): A Pilot Study, Jillian L. Beckett, Ashlee A. Harmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Psychosocial aspects of balance including self-perception, behaviors, and experiences, have been found to contribute to activity limitations and participation restrictions in adults. Clinical tools have been established to measure how adults feel about their own balance and the extent to which fear of falling and other related characteristics interfere with participation. There are no clinical tools presently available to explore these relationships and quantify the extent to which they interfere with activity and participation in children.

Purpose: To develop and test reliability and validity of a tool to evaluate balance self-perception in a pediatric population.

Participants: This sample of …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …

The Effects Of A Single Bout Of Self-~Myofascial Release On Flexibility And Maximum Voluntary Contraction, Jonathan Robert Garcia

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to determine the effect of foam rolling on hamstrings flexibility, isometric and isokinetic torque. Participants: Thirteen female participants (N = 13; age: 28.5 + 6.8 years of age; height: 165.5 + 6.7 cm; mass: 64.2 + 8.4 kg) volunteered to participate in the study.

Methods: Hamstring flexibility was assessed using a sit and reach test; muscle strength was assessed by having participants complete a maximal voluntary isometric contraction (MVIC) of the hamstrings and maximal effort isokinetic knee flexion test using an isokinetic dynamometer. Participants completed these tests prior to any intervention (pre-rolling 1), …

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 …