Medicine and Health Sciences Commons^™

Cultural Diversity In The Practice Of Physical Therapy: A Review Of The Literature, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Background: Cultural competence is a term that encompasses one’s capacity for understanding, communication, and effective interactions with individuals across the cultural spectrum. Recognition of these principles and practical training focused on relevant skills and abilities are needed to prevent discriminatory practices based on patient age, ethnicity, socioeconomic status, race, religion, gender identification, and sexual orientation. A culturally competent physical therapist will be able to use these skills and abilities to promote effective communication with all patients and remove barriers to obtaining appropriate health care.

Methods: Toward this end, this study includes a review of the recent literature and focuses on …

An Analysis Of Graston Technique® For Soft-Tissue Therapy, James M. Mckivigan, Gina Tulimero

College of Health & Human Services (TUN) Publications and Research

The Graston Technique® of Soft-Tissue Therapy (GT), also known as instrument-assisted soft tissue mobilization (IASTM), is used by chiropractors, physicians, and therapists to manage pain and range-of-motion limitations caused by scar tissue and musculoskeletal injuries. The GT treats tissue injuries and pain by separating scar tissue and producing heat, which increases blood flow to the areas affected by pain or trauma. This paper provides a systematic review of the research published on the GT, focusing on its efficacy and patient outcomes. It introduces and explains the GT and provides a detailed description of the therapeutic procedures used to alleviate pain …

The Efficiency Of Digital Anatomy Teaching Strategies, Jeremy Sandberg, Rachel Calderon, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Background: In medical school, the teaching of anatomy is both time-consuming and complicated. As more schools allot less time to this subject, there is a growing need to restructure anatomy teaching methodologies. This paper examines digital dissection resources and identifies how and when they were implemented in the classroom.

Methods: An online survey tool was sent to osteopathic medical schools throughout the United States to determine the resources and methods being used and to assess how students were performing in corresponding anatomy courses. The anatomy director at each school was given a predetermined set of questions to enable an evaluation …

Reliability And Validity Of A Smartphone-Based Inclinometer Application Measuring Shoulder Internal Rotation, Taylor Lau, Sheng Lin, Tyler True, Wayne Wu, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

This study intended to evaluate the reliability and validity of a smartphone-based inclinometer application and compare these results to those of the standard clinical goniometer. The study measured the internal shoulder rotation of 19 men and 20 women. One third-year physical therapy student took all the smartphone-based inclinometer measurements, and another took all the clinical standard goniometer measurements. The subjects were randomly placed into set amounts of internal rotation, and then the two measurements were taken. The study found no significant difference between the smartphone-based inclinometer and the goniometer. The reliability between the app and the goniometers was good to …

Can Eccentric Exercise Of The Lower Limb Be Made More Efficiently, A Pilot Study, Jerrold S. Petrofsky, Robert Donatelli, James M. Mckivigan, Michael S. Laymon

College of Health & Human Services (TUN) Publications and Research

Abstract Background: Eccentric Exercise has been shown to be more effective in building muscle and healing damaged tissue than concentric or isometric exercise. It has also been shown to be effective in increasing motor control. But the duration of therapeutic exercise in physical therapy is limited by insurance to 30-60 minutes a day. Objectives: Four standard therapy eccentric exercises of the lower limbs were compared (toe raise, ball exercise, side lying eccentric exercise and incline board exercise) to a trainer called the BTE Eccentron to see if the efficiency of exercise could be increased using one exercise session to meet …

Blood Flow Restriction Exercise: A Systematic Review Of The Literature, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Blood flow restriction training is quickly gaining popularity in the United States. However, it is not without controversy. While there are many reported health benefits, there are equally as many risks. Most concerning is the lack of industry standardizations regarding cuff size and pressure. There is no required training to implement blood flow restriction training, which can be problematic when people with little knowledge practice this type of exercise. When blood flow is restricted, there is an impact on the cardiovascular system, nervous system, and muscular system. Damage can be done when blood flow is restricted with too much pressure …

Evaluating The Efficacy Of Vertebral Axial Decompression Therapy In Treatment Of Patients With Chronic Lower Back Pain: A Systematic Review, James M. Mckivigan, Brittany Krisak, Brittni Vogel, Ashley Harrington, Van Nguyen

College of Health & Human Services (TUN) Publications and Research

The primary objective of the study was to explore the effectiveness of Vertebral Axial Decompression (VAX-D) in treating patients with chronic low back pain (CLBP) as a safe and competent therapeutic method. Also, to determine the quality of life in alleviating chronic lumbar pain using mechanical Lumbar traction force applied to the lumbar spine. A systematic review and meta-analysis involving detailed literature survey on Vertebral Axial Decompression (VAX-D) therapy for patients with chronic low back pain were conducted in three databases namely MEDLINE, EMBASE and Cochrane Library from (January 1994 to February 2019). Studies supporting the outcomes with qualitative statistical …

Effectiveness Of Intermittent Mechanical Traction In Cervical Radiculopathy: A Systematic Review, Gilmour Gregory, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

The aim of this review was to assess the effectiveness of intermittent mechanical traction (IMT) in treating cervical radiculopathy (CR). A literature search was conducted electronically, and the data were extracted from the available papers that evaluated IMT and its combination with other therapies. The risk of bias was assessed using the criteria recommended by the Cochrane Back Review Group. The quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation method (GRADE). Nine of the articles met the inclusion criteria and were included in the review. Results showed that four studies with very low level …

Innovations In Occupational Therapy Education: The Centralized Service Learning Model, Lauren E. Milton, Robyn Otty

College of Health & Human Services (TUN) Publications and Research

Partnerships between community organizations and engaged university members creates realistic learning experiences for occupational therapy students while encouraging civic responsibility. The authors propose service learning as the core of an innovative course design framework using the Centralized Service Learning Model (CSLM). Three phases are described. Phase One provides a description of the CSLM using a generalizable model, with specific application within existing occupational therapy program coursework. Phase Two provides leadership opportunities for a subsequent cohort of students within the curriculum. Finally, Phase Three integrates faculty scholarship. To understand students’ knowledge-level awareness, a survey based on course objectives can be administered, …

Evaluating Medical Students’ Proficiency With A Handheld Ophthalmoscope: A Pilot Study, Gregory Gilmour, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Introduction: Historically, testing medical students’ skills using a handheld ophthalmoscope has been difficult to do objectively. Many programs train students using plastic models of the eye which are a very limited fidelity simulator of a real human eye. This makes it difficult to be sure that actual proficiency is attained given the differences between the various models and actual patients. The purpose of this article is to introduce a method of testing where a medical student must match a patient with his/her fundus photo, ensuring objective evaluation as well as developing skills on real patients which are more likely to …

Complex Regional Pain Syndrome Type I Treated With Active Release Technique, Kathleen Hughes, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

This report describes the examination, intervention, and outcome for a patient with CRPS type I treated with ART®. The patient was diagnosed with CRPS following a grade II ATFL sprain. For two months, treatment consisted of weekly 45-minute sessions including ART® in combination with self-massage, desensitization, joint mobilization, gait training, therapeutic exercise, and patient education. A brief reexamination was performed weekly. A clinically significant increase of 13 points on the LEFS was measured after eight weeks of treatment, as were improvements in quality of gait and gait distance. In addition, the patient experienced the return of ankle range of motion …

Efficacy Of Yoga Therapy In Treating Low Back Pain, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Background: Non-specific low back pain is a frequent condition that is often treated using non-pharmaceutical interventions such as exercise therapy. Yoga is one popular form of mind-body workout that can be applied to treat nonspecific low back pain.

Objective: To evaluate the impact yoga as a treatment therapy for chronic non-specific low back pain has on pain and functional ability in comparison to no exercise or the prescription of medication.

Search Methods: A review of existing studies that described randomized control trials that focused on the treatment of chronic low back pain with yoga and were published …

A Systematic Review On The Efficacy Of Iontophoresis As A Treatment For Lateral Epicondylitis, James M. Mckivigan, Brent Yamashita, Derek Smith

College of Health & Human Services (TUN) Publications and Research

Background and purpose: It is still inconclusive which method of iontophoresis delivers the most medication deepest through the skin, and therefore most effective in treating lateral epicondylitis. The purpose of this systematic review is to analyze the efficacy of treatments for lateral epicondylitis using iontophoresis.

Method: The review included articles from peer-reviewed journals with sufficient data related to the purpose and focus of the study. Inclusion criteria included randomized control trials, cohort studies, case studies, systematic reviews, meta-analyses, and pilot studies published since 2000.

Results: Fourteen relevant studies were identified. Twelve were experimental in vivo studies, two …

The Effect Of An 8-Minute Yoga Breathing Program On Fitness, Weight Loss And Breathing Capacity, Jerrold S. Petrofsky, Michael S. Laymon, Iman Akef Khowailed, Haneul Lee, Allie Petrofsky

College of Health & Human Services (TUN) Publications and Research

This was a single blinded randomized study with an intervention group and a control group to examine a modification in lifestyle and an 8-minute exercise session each day to lose weight. Fifty-seven female subjects participated. Subjects underwent girth measurements at the umbilicus, hips, thigh and upper arm; weight, height (for BMI), body fat, heart rate, blood pressure, abdominal strength, leg strength, arm strength, sedentary O2 saturation, treadmill challenged O2 saturation, resting metabolism (which includes fat metabolism), and lung capacity. Measures were repeated at baseline and the end of the 6-week period. During the 6-week period, they followed a healthy recommended …

Medical Marijuana And Pain Management: The Physician’S Catch 22, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

In this paper, concerns connected to the usage of marijuana in treating patients are extensively analyzed. It is revealed that physicians have been in conflict with the federal government as to whether to use cannabis for medical purposes or if they should consider prescribing other drugs. A large percentage of physicians admit that marijuana could be an effective drug in treating patients, especially those with acute pain, nausea, AIDS, muscle spasms, and cancer, among other ailments. However, patients and physicians are scared of the strict laws that criminalize the use of marijuana for medical and recreational purposes. Physicians are also …

Yoga As Complementary Alternative Medicine, Let’S Not Forget What Works!, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Practitioners today have to contend with a stream of new treatment options that are increasing in number almost daily. The patients undeniably win when we incorporate the latest technology with traditional treatment methods but too often the old gets completely pushed out to make room for the new. While many Complementary Alternative Medicine (CAM) therapies may be considered “old” by some practitioners, there is still a steady flow of articles being published showing that they remain effective. What if instead of abandoning the traditional therapies we used them in true compliment to the newest options? Here we will explore some …

The Effect Of Thermacare Heat Wraps On Balance And Mobility In Seniors With Impaired Gait - A Cross Over Study, Jerrold S. Petrofsky, Michael S. Laymon, Iman Akef Khowailed, Haneul Lee

College of Health & Human Services (TUN) Publications and Research

To examine if the use of heat at home can result in better quality and safer mobility in the elderly with gait and balance impairments.

Setting: Randomized longitudinal cross over study design in a clinical setting.

Methods: 20 people with impaired mobility (assessed as a score of more than 4 on the Stepping On questionnaire) were tested with a multi-camera gait analysis system, a treadmill with pressure sensors, a balance platform and the timed up and go and walking speed tests before and after using ThermaCare continuous heat wraps on their legs and knees for 6 days at 4 hours …

17Β-Estradiol Induced Effects On Anterior Cruciate Ligament Laxness And Neuromuscular Activation Patterns In Female Runners, Iman Akef Khowailed, Jerrold S. Petrofsky, Everett Lohman, Noha Daher, Mohamed Olfat

College of Health & Human Services (TUN) Publications and Research

Background: To investigate the effects of 17β-Estradiol across phases of menstrual cycle on the laxness of the anterior cruciate ligament (ACL) and the neuromuscular control around the knee joint in female runners.

Methods: Twelve healthy female runners, who reported normal menstrual cycles for the previous 6 months were tested twice across one complete menstrual cycle for serum levels of 17β Estradiol (E), and knee joint laxity (KJL). Electromyographic (EMG) activity of the quadriceps and hamstrings muscles was also recorded during running on a treadmill. The changes in the EMG activity, KJL, and hormonal concentrations were recorded for each …

Effect Of Tai Chi Exercise Combined With Mental Imagery Theory In Improving Balance In A Diabetic And Elderly Population, Abdulrahman Alsubiheen, Jerrold S. Petrofsky, Noha S. Daher, Everett Lohman, Edward Balbas

College of Health & Human Services (TUN) Publications and Research

BACKGROUND: One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group.
MATERIAL AND METHODS: Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40–80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week …

The Effect Of Bmi On Oxygen Saturation At Rest And During Mild Walking, Jerrold S. Petrofsky, Michael S. Laymon, Iman Akef Khowailed, Stacy Fisher, Andrew Mills

College of Health & Human Services (TUN) Publications and Research

Eighty one subjects were examined for the relationship between BMI, body fat, arterial oxygen saturation and arterial PO2 with the subjects at rest and after 5 minutes of walking on a treadmill ergometer at 3 mph at a 3% grade. They had BMIs between 19 and 50. All subjects were free of cardiovascular disease and had normal blood pressure making it safe for them to participate in mild exercise. They were all able to walk for at least 10 minutes without cardiovascular complications and were not taking any medications that altered the autonomic nervous system. The age was between 22 …

Six Weeks Habituation Of Simulated Barefoot Running Induces Neuromuscular Adaptations And Changes In Foot Strike Patterns In Female Runners, Iman Akef Khowailed, Jerrold S. Petrofsky, Everett Lohman, Noha Daher

College of Health & Human Services (TUN) Publications and Research

BACKGROUND: The aim of this study was to examine the effects of a 6-week training program of simulated barefoot running (SBR) on running kinetics in habitually shod (wearing shoes) female recreational runners.
MATERIAL AND METHODS: Twelve female runners age 25.7±3.4 years gradually increased running distance in Vibram FiveFingers minimal shoes over a 6-week period. The kinetic analysis of treadmill running at 10 Km/h was performed pre- and post-intervention in shod running, non-habituated SBR, and habituated SBR conditions. Spatiotemporal parameters, ground reaction force components, and electromyography (EMG) were measured in all conditions.
RESULTS: Post-intervention data indicated a significant …

The Effect Of Continuous Heat Wraps On Balance And Gait In The Elderly, Jerrold S. Petrofsky, Michael S. Laymon, Iman Akef Khowailed

College of Health & Human Services (TUN) Publications and Research

Background: In an ageing geriatric population, tremor and poor balance become more pronounced and can lead to falls. Falls are the leading cause of mortality in this population. Continuous heat wraps have been shown to increase tissue flexibility. It was the purpose of this study to examine the effects of heat on balance and gait in the elderly with impaired mobility.

Subjects: Twenty people with impaired mobility (assessed as a score of more than 4 on the “Stepping On” questionnaire) were tested with a balance platform after using ThermaCare continuous heat wraps on their legs and knees for …

Environment: Improving Access And Participation, Tricia A. Catalino, Lori E. Meyer

College of Health & Human Services (TUN) Publications and Research

In this introduction to the Division for Early Childhood (DEC) Recommended Practices, we will briefly explain what we mean by the environment and what it means for young children with disabilities and their families. This will provide a framework for conceptualizing the inter-relatedness of environmental settings and features. We will also define types of environments in which children develop and grow and outline key ideas to consider when implementing the Environment recommended practices. This chapter will use vignettes to illustrate important themes and show examples of how practitioners can best use the Environment recommended practices.

Promoting Professional Development For Physical Therapists In Early Intervention, Tricia A. Catalino, Lisa A. Chiarello, Toby Long, Priscilla Weaver

College of Health & Human Services (TUN) Publications and Research

Early intervention (EI) service providers are expected to form cohesive teams to build the capacity of a family to promote their child’s development. Given the differences in personnel preparation across disciplines of service providers, the Early Childhood Personnel Center (ECPC) is creating integrated and comprehensive professional development models for those who provide services for young children with disabilities and their families. To help guide this process it is important to identify inter-disciplinary competencies as well as the unique knowledge and skills that each discipline contributes to the development and implementation of effective intervention plans. This paper describes personnel preparation of …

Effect Of Monophasic Pulsed Current On Heel Pain And Functional Activities Caused By Plantar Fasciitis, Abdullah K. Alotaibi, Jerrold S. Petrofsky, Noha S. Daher, Everett Lohman, Michael S. Laymon, Hasan M. Syed

College of Health & Human Services (TUN) Publications and Research

Background: Plantar fasciitis (PF) is a soft tissue disorder considered to be one of the most common causes of inferior heel pain. The aim of this study was to investigate the effect of monophasic pulsed current (MPC) and MPC coupled with plantar fascia-specific stretching exercises (SE) on the treatment of PF.

Material and Methods: Forty-four participants (22 women and 22 men, with a mean age of 49 years) diagnosed with PF were randomly assigned to receive MPC (n=22) or MPC coupled with plantar fascia-specific SE (n=22). Prior to and after 4 weeks of treatment, participants underwent baseline evaluation; …

Effect Of Heat, Cold, And Pressure On The Transverse Carpal Ligament And Median Nerve: A Pilot Study, Michael S. Laymon, Jerrold S. Petrofsky, James M. Mckivigan, Haneul Lee, Jongeun Yim

College of Health & Human Services (TUN) Publications and Research

Background: This study quantified the effects of heat, cold, and pressure on the median nerve and transverse carpal ligament in subjects without carpal tunnel syndrome.

Material/Methods: Subjects were individuals ages 20–50 who had no symptoms of carpal tunnel disease. Imaging ultrasound was used to measure the clearance around the median nerve, transverse ligament elasticity, nerve conduction velocity, thickness of the carpal ligament, and area of the median nerve. Pressure was applied to the carpal ligament to assess the effects of increasing pressure on these structures. On 3 separate days, 10 subjects had ThermaCare heat or cold packs applied, …

Evidence-Based Use Of Cold For Plantar Fasciitis, Michael S. Laymon, Jerrold S. Petrofsky, Faris Alshammari, Stacy Fisher

College of Health & Human Services (TUN) Publications and Research

Objective

The purpose of this study was to examine the effect of cold applied the night before or in the morning on pain and symptoms of plantar fasciitis.

Design

Experimental study.

Methods

Thirty subjects with plantar fasciitis were recruited for this study. Subjects with plantar fasciitis either had no intervention, cold applied (20 minutes) at night before bed, or 20 minutes in the morning upon wakening. Plantar fascia tenderness and pain were evaluated. There were ten subjects in each group. Measures included visual analog scale, plantar facial thickness via high resolution ultrasound, algometer measure, and range of motion of the …