Medicine and Health Sciences Commons^™

Effects Of Positive Social Comparative Feedback On Motor Sequence Learning And Performance Expectancies, Allison F. Lewis, Rachel Bohnenkamp, Lynn Johnson, Dirk B. Den Ouden, Sarah Wilcox Phd, Stacy L. Fritz, Jill Campbell Stewart Pt,Phd

Faculty Publications

Introduction: Positive social comparative feedback indicates to the learner that they are performing better than others. While this type feedback supports motor skill learning in some tasks, the effect of social comparative feedback on implicit motor sequence learning remains unknown. The aim of this study was to determine the effect of positive social comparative feedback on the learning of and expectancies for a motor sequence task. Methods: Forty-eight individuals practiced a joystick-based sequence task and were divided into three feedback groups: CONTROL (no performance feedback), RT ONLY (response time only feedback), and RT+POS (response time plus positive social comparison). Participants …

Effect Of Behavioural Practice Targeted At The Motor Action Selection Network After Stroke, Jill C. Stewart Pt,Phd, Jessica F. Baird, Allison F. Lewis, Stacy L. Fritz, Julius Fridriksson

Faculty Publications

Motor action selection engages a network of frontal and parietal brain regions. After stroke, individuals activate a similar network, however, activation is higher, especially in the contralesional hemisphere. The current study examined the effect of practice on action selection performance and brain activation after stroke. Sixteen individuals with chronic stroke (Upper Extremity Fugl–Meyer motor score range: 18–61) moved a joystick with the more-impaired hand in two conditions: Select (externally cued choice; move right or left based on an abstract rule) and Execute (simple response; move same direction every trial). On Day 1, reaction time (RT) was longer in Select compared …

Effect Of Behavioural Practice Targeted At The Motor Action Selection Network After Stroke, Jill C. Stewart, Jessica F. Baird, Stacy L. Fritz, Julius Fridriksson Ph.D.

Faculty Publications

Motor action selection engages a network of frontal and parietal brain regions. After stroke, individuals activate a similar network, however, activation is higher, especially in the contralesional hemisphere. The current study examined the effect of practice on action selection performance and brain activation after stroke. Sixteen individuals with chronic stroke (Upper Extremity Fugl–Meyer motor score range: 18–61) moved a joystick with the more-impaired hand in two conditions: Select (externally cued choice; move right or left based on an abstract rule) and Execute (simple response; move same direction every trial). On Day 1, reaction time (RT) was longer in Select compared …

Task-Based Functional Connectivity And Blood-Oxygen-Level-Dependent Activation During Within-Scanner Performance Of Lumbopelvic Motor Tasks: A Functional Magnetic Resonance Imaging Study, Mark K. Jordon, Jill Campbell Stewart Pt,Phd, Sheri P. Silfies, Paul F. Beattie

Faculty Publications

There are a limited number of neuroimaging investigations into motor control of the lumbopelvic musculature. Most investigation examining motor control of the lumbopelvic musculature utilize transcranial magnetic stimulation (TMS) and focus primarily on the motor cortex. This has resulted in a dearth of knowledge as it relates to how other regions of the brain activate during lumbopelvic movement. Additionally, task-based functional connectivity during lumbopelvic movements has not been well elucidated. Therefore, we used functional magnetic resonance imaging (fMRI) to examine brain activation and ROI-to-ROI task-based functional connectivity in 19 healthy individuals (12 female, age 29.8 ± 4.5 years) during the …

Criterion Validation And Interpretability Of The Single Assessment Numerical Evaluation (Sane) Of Self-Reported Recovery In Patients With Neck Pain, Elizabeth Oakley, Chad E. Cook, Bryan O'Halloran

Faculty Publications

Background

The SANE is a PROM of recovery, which may assist clinicians in clinical decision-making and discharge planning. The psychometric measurement properties of the SANE have yet to be determined for neck pain.

Objectives

Threefold objectives included: 1)determine the numerical threshold for the SANE at which patients with neck pain determine their symptoms are acceptable; 2)determine the association between scores for the NDI and VAS, with the SANE; 3)determine the average number of visits, costs and value associated with the management of neck pain.

Design

Longitudinal repeated measures cohort design.

Methods

Threshold measures for self-reported recovery with the …

Knowledge, Attitude, And Practice Of Orthopedic Manual Physical Therapists Toward Lifestyle Screening And Education: A Descriptive Study, Jillian M. Zollinger, Sozina Katuli

Faculty Publications

Introduction. Lifestyle-focused rehabilitation plans need to become part of the standard system of care for the treatment of chronic diseases. To achieve this goal, the KAP of rehabilitation professionals toward lifestyle medicine needs to be understood. This study investigated the niche of orthopedic manual physical therapy and is purposed as a foundational model for continued research. Method. A survey instrument was designed to investigate the KAP of orthopedic manual physical therapists toward lifestyle screening and education. Results. There were 155 participants of which 58.1-72.3% reported frequently talking to their patients about lifestyle topics, while 78.1-80.6% felt highly confident and competent …

Integrating Survivors Of Stroke Into Exercise‐Based Cardiac Rehabilitation Improves Endurance And Functional Strength, Elizabeth Wherley Regan Dpt, Ph.D., Reed Handlery, Jill Campbell Stewart, Joseph Lee Pearson Ms,Drph, Sarah Wilcox Phd, Stacy L. Fritz Phd, Pt

Faculty Publications

Background

Cardiac rehabilitation (CR) is a structured exercise program prevalent in the United States for people with cardiovascular disease that has been shown to increase cardiovascular endurance and improve quality of life. Despite similar cardiovascular risk factors, stroke is not among the covered diagnoses for CR. The purpose of this study was to examine the participant impact of integrating survivors of stroke into the exercise portion of an existing hospital‐based CR program through measures of physical function and other health impacts and through qualitative evaluation of participant perception.

Methods and Results

Subacute and chronic survivors of stroke were integrated into …

Targeted Engagement Of The Action Selection Network During Task-Oriented Arm Training After Stroke, Jill Campbell Stewart Pt,Phd, Kaci Handlery, Jessica F. Baird, Erika L. Blanck, Geetanjali Pathak, Stacy L. Fritz

Faculty Publications

Action selection (AS), or selection of an action from a set of alternatives, is an important movement preparation process that engages a frontal-parietal network. The addition of AS demands to arm training after stroke could be used to engage this motor planning process and the neural network that supports it. The purpose of this case series is to describe the feasibility and outcomes associated with task-oriented arm training aimed at engaging the AS behavioral process and the related neural network in three individuals with chronic stroke. Three participants with mild to moderate motor deficits completed 13 to 15 sessions of …

Effects Of Pain Neuroscience Education On Physician Assistant Students Understanding Of Pain And Attitudes And Beliefs About Pain., Kory Zimney, Adriaan Louw, Julie Johnson, Suzanne Peppers, Kevin Farrell

Faculty Publications

PURPOSE: Evaluate the effectiveness and efficiency of two different pain neuroscience education (PNE) lectures provided to physician assistant (PA) students. Primary outcomes explored were knowledge of pain and shift in attitudes and beliefs about chronic pain after the lecture.

METHODS: A PNE lecture was provided at two separate university PA programs. One program received a two-hour PNE lecture with a case-based example. The other program received a one-hour PNE lecture without the casebased example. Measurement of change for pre and post-test pain knowledge and attitudes and beliefs about chronic pain were recorded.

RESULTS: Students at both universities showed medium effect …

Biomarkers Of Rehabilitation Therapy Vary According To Stroke Severity, Erin Burke Quinlan, Lucy Dodakian, Jill See, Alison Mckenzie, Jill Campbell Stewart Pt,Phd, Steven C. Cramer

Faculty Publications

Biomarkers that capture treatment effects could improve the precision of clinical decision making for restorative therapies. We examined the performance of candidate structural, functional, and angiogenesis-related MRI biomarkers before and after a 3-week course of standardized robotic therapy in 18 patients with chronic stroke and hypothesized that results vary significantly according to stroke severity. Patients were 4.1 ± 1 months poststroke, with baseline arm Fugl-Meyer scores of 20–60. When all patients were examined together, no imaging measure changed over time in a manner that correlated with treatment-induced motor gains. However, when also considering the interaction with baseline motor status, treatment-induced …

Pelvic Pain, Pelvic Organ Prolapse, Urinary And Colorectal Distress Incidence And Relationship To Quality Of Life And Birth Mode, Lori Maria Walton, Christine Abreu, Eliena Jeffus, Amy Trautwein, Shenya Xavier

Faculty Publications

Abstract Purpose: To determine the incidence and impact of pelvic pain, pelvic organ prolapse, urinary and colorectal distress and quality of life by birth mode for women in the chronic postpartum period. Study design: Cross-sectional correlational design utilizing purposive sampling of (n=21) female postpartum subjects ages 18-45. Background: Caesarean Section (CS) incidence is reported at 32% nationwide, well above the recommended safe rate of 10% (WHO). Literature is not clear regarding role of birth mode in postpartum symptoms including: pelvic pain, colorectal distress, pelvic organ prolapse, and quality of life. Methods: Data collection took place after IRB approval from Andrews …

A Randomized Clinical Trial On The Effects Of Extracorporeal Shockwave Therapy, Joint Mobilizations And Exercise On Plantar Heel Pain In Patients With Plantar Fasciitis., Elizabeth Oakley, Paolo Sanzo

Faculty Publications

Plantar fasciitis (PF) is the most common cause of heel pain today impacting on the patient’s walking ability, work tolerance, and ability to participate in active sport. Two million people in the United States (US) are treated for PF yearly with heel pain accounting for 11 to 15% of visits to medical professionals. It is estimated that 10% of the US population will develop PF during their lifetime. Treatment for PF may include a variety of interventions ranging from conservative treatment to surgical interventions. One of the suggested treatments for PF is the use of extracorporeal shockwave therapy (ECSWT). ECSWT …

A Randomized Clinical Trial On The Effects Of Extracorporeal Shockwave Therapy, Joint Mobilizations And Exercise On Plantar Heel Pain In Patients With Plantar Fasciitis, Paolo Sanzo, Elizabeth Oakley

Faculty Publications

Plantar fasciitis (PF) is the most common cause of heel pain today impacting on the patient’s walking ability, work tolerance, and ability to participate in active sport. Two million people in the United States (US) are treated for PF yearly with heel pain accounting for 11 to 15% of visits to medical professionals. It is estimated that 10% of the US population will develop PF during their lifetime. Treatment for PF may include a variety of interventions ranging from conservative treatment to surgical interventions. One of the suggested treatments for PF is the use of extracorporeal shockwave therapy (ECSWT). ECSWT …

The Effects Of Practice On The Concurrent Performance Of A Speech And Postural Task In Persons With Parkinson Disease And Healthy Controls, K. Bo Foreman, Stuart Sondrup, Christopher Dromey, Eon Jarvis, Shawn Nissen, Leland E. Dibble

Faculty Publications

Purpose. Persons with Parkinson disease (PD) demonstrate deficits in motor learning as well as bidirectional interference (the performance of one task concurrently interferes with the performance of another task) during dual-task performance. Few studies have examined the practice dosages necessary for behavioral change in rehabilitation relevant tasks. Therefore, to compare the effects of age and PD on motor learning during dual-task performance, this pilot study examined persons with PD as well as neurologically healthy participants during concurrent performance of postural and speaking tasks. Methods. Seven persons with PD and 7 healthy age-matched and 10 healthy young control subjects …

Planning And Adjustments For The Control Of Reach Extent In A Virtual Environment, Jill Campbell Stewart Pt,Phd, James Gordon, Carolee J. Winstein

Faculty Publications

Background Skilled performance of reach actions includes both anticipatory planning and compensatory adjustments made while moving. The execution of reach actions in a virtual environment (VE) demonstrates similar characteristics to reaches performed in the real-world, however, it is unclear whether the VE itself significantly impacts movement planning or compensatory adjustments. The purpose of this study was to directly compare the use of planning and adjustments to control extent for unconstrained reach actions performed in an immersive VE to those performed in an analogous real-world environment (RWE). Methods Five non-disabled adults (29 ± 5 years) reached with the dominant, right arm …

Strain And Counterstrain For Structural Integrators, Caryn Pierce

Faculty Publications

Strain and counterstrain (SCS) is an indirect approach to manipulating fascia. In addition to its usefulness as an integration tool, knowledge of the reflexive mechanisms involved in SCS deepens our understanding of how fascia functions to protect vital structures from injury and how unbalanced posture and movement patterns develop after trauma.

Mechanisms Of The Contextual Interference Effect In Individuals Poststroke, Nicolas Schweughofer, Jeong-Yoon Lee, Hui-Ting Goh, Youggeun Choi, Sung Shin Kim, Jill Campbell Stewart Pt,Phd, Rebecca Lewthwaite, Carolee J. Winstein

Faculty Publications

Although intermixing different motor learning tasks via random schedules enhances long-term retention compared with “blocked” schedules, the mechanism underlying this contextual interference effect has been unclear. Furthermore, previous studies have reported inconclusive results in individuals poststroke. We instructed participants to learn to produce three grip force patterns in either random or blocked schedules and measured the contextual interference effect by long-term forgetting: the change in performance between immediate and 24-h posttests. Nondisabled participants exhibited the contextual interference effect: no forgetting in the random condition but forgetting in the blocked condition. Participants at least 3 mo poststroke exhibited no forgetting in …

Minimizing The Source Of Nociception And Its Concurrent Effect On Sensory Hypersensitivity: An Exploratory Study In Chronic Whiplash Patients, Geoff M. Schneider, Ashley D. Smith, Allen Hooper, Paul Stratford, Kathryn J. Schneider, Michael D. Westaway, Bevan Frizzell, Lee Olson

Faculty Publications

Abstract. Background. The cervical zygapophyseal joints may be a primary source of pain in up to 60% of individuals with chronic whiplash associated disorders (WAD) and may be a contributing factor for peripheral and centrally mediated pain (sensory hypersensitivity). Sensory hypersensitivity has been associated with a poor prognosis. The purpose of the study was to determine if there is a change in measures indicative of sensory hypersensitivity in patients with chronic WAD grade II following a medial branch block (MBB) procedure in the cervical spine. Methods. Measures of sensory hypersensitivity were taken via quantitative sensory testing (QST) consisting of pressure …

Intervention To Enhance Skilled Arm And Hand Movements After Stroke: A Feasibility Study Using A New Virtual Reality System, Jill Campbell Stewart Pt,Phd, Shih-Ching Yeh, Younbo Jung, Hyunjin Yoon

Faculty Publications

Background: Rehabilitation programs designed to develop skill in upper extremity (UE) function after stroke require progressive practice that engage and challenge the learner. Virtual realty (VR) provides a unique environment where the presentation of stimuli can be controlled systematically for optimal challenge by adapting task difficulty as performance improves. We describe four VR tasks that were developed and tested to improve arm and hand movement skills for individuals with hemiparesis. Methods: Two participants with chronic post-stroke paresis and different levels of motor severity attended 12 training sessions lasting 1 to 2 hours each over a 3-week period. Behavior measures and …

A Retrospective, Descriptive Study Of Shoulder Outcomes In Outpatient Physical Therapy, A. Lynn Millar, Philip A. Jasheway, Wendy Eaton, Frances Christensen

Faculty Publications

Study Design: A retrospective, descriptive study of clients with shoulder dysfunction referred to physical therapy. Objectives: To (1) describe the clinical and functional outcomes of clients with shoulder dysfunction following outpatient physical therapy, and (2) to compare the outcomes by type of shoulder dysfunction. Background: Although individuals with shoulder dysfunction are commonly referred to physical therapy, few large descriptive studies regarding outcomes following physical therapy are available. Methods and Measures: Data for 878 clients (468 female, 410 male) were retrieved and analyzed. This database was developed between 1997 and 2000 and included 4 outpatient facilities from 1 healthcare system in …

Relationship Of Urinary Incontinence To Hysterectomy And Episiotomy, Elizabeth Oakley, Debra Buchtel, Rachel Atanosian, A. Lynn Millar

Faculty Publications

BACKGROUND: Urinary incontinence (UI) is a problem that affects women of all ages. Research has identified many risk factors for the development of UI but is inconclusive regarding the relationship between episiotomy and hysterectomy and the development of UI symptoms. Physical therapists are emerging as primary care providers which increases the importance of attention to and knowledge of risk factors facilitate timely screening and care for women at risk or who have UI signs and symptoms. PURPOSE: The purpose of this study was to examine the relationship between episiotomy and hysterectomy and incidence of urinary incontinence. SUBJECTS: The subjects included …

A Comparison Of Four Electrical Stimulation Types On Staphylococcus Aureus Growth In Vitro, Harold L. Merriman, Chris A. Hegyi, Cheryl R. Albright-Overton, John Carlos Jr., Robert W. Putnam, Janet A. Mulcare

Faculty Publications

We evaluated the efficacy of common electrical stimulation (ES) types on bacterial growth in vitro using clinically relevant conditions. Four types of ES-continuous micro-amperage direct current (μADC), high-voltage pulsed current (HVPC), low-voltage monophasic milliamperage pulsed current (LVMmAPC), and low-voltage biphasic milliamperage pulsed current (LVBmAPC)-were each applied to a separate set of culture plates containing Staphylococcus aureus for 1 h at 37°C on 3 consecutive days. After ES treatment, the zone of inhibition surrounding each electrode was measured. Zone of inhibition measurements showed a significant inhibitory effect for continuous μADC and HVPC (p < 0.05), but not for LVM-mAPC and LVBmAPC. Differences in bacterial growth inhibition were not found for polarity and time. These data suggest that for infected wounds, HVPC and continuous μADC treatments may have an initial bacterial inhibitory effect, which does not significantly change with subsequent treatments.

Effects Of Aerobic Training In Adolescents With Down Syndrome, A. Lynn Millar, Bo Fernhall, Lee N. Burkett

Faculty Publications

The purpose of this study was to evaluate the effects that aerobic training has on adolescents and young adults with Down syndrome. Fourteen individuals with Down syndrome (mean age = 17.7 yr) participated in a 10-wk walking/jogging exercise training study. A pre- and post-training walking treadmill test was performed to determine the following parameters: peak oxygen uptake (VO2, absolute and relative), minute ventilation (VE, l•min-1), heart rate HR, b•min-1), RER (VCO2/VO2), and time and grade to exhaustion. Following the pre-training evaluations, subjects were assigned to a control group (N = 4) or an exercise group (N= 10). The exercise group …