Medicine and Health Sciences Commons^™

Fibromyalgia, Bruce T. Amundson

Physical Therapy Scholarly Projects

One of the more common diagnosis that a physical therapist treats in the clinic is fibromyalgia (FM). Fibromyalgia is the latest name given to a condition that, for the most part, has received mixed acceptance at the clinical level. Part of the reason that FM has been poorly accepted is due to the lack of a clearly defined set of signs and symptoms. In the last few years, new research has delineated the signs and symptoms in a manner that makes FM a more understandable condition.

The Merck Manual defines FM as a group of non-articular rheumatic disorders characterized by …

Rehabilitation Of The Surgical Repair Of A Recurrent Anterior Dislocation Of The Glenohumeral Joint, Kellie L. Beckley

Physical Therapy Scholarly Projects

Increasingly shoulder dislocations and instabilities are being recognized among athletes as a common disabling condition in the health care setting today.

Dislocations of the shoulder represent approximately 50% of all major joint dislocations. Of these shoulder dislocations, 95% are anterior dislocations. After a primary anterior dislocation, recurrence of dislocation occurs in 90% to 95% of patients in their mid 20s or younger. A high percentage of these injuries occur in repetitive athletic activities in which large forces and high velocities are produced, such as hockey, football, and baseball.

Consequently with the recognition of instability as the primary etiological factor for …

The Effect Of Backward Treadmill Walking On Lower Extremity Kinetics, Scott Billing

Physical Therapy Scholarly Projects

Many physical therapy diagnoses require minimal anterior loading of the knee in their rehabilitation protocols. These include, but are not limited to, tibial plateau fractures, patellofemoral pain, patellar fractures, quadriceps tendinitis, and status post anterior cruciate ligament reconstruction. In the clinical setting, backward walking (BW), or "retro-walking," is often used during the rehabilitation of such diagnoses. We propose backward walking will initiate greater hamstring recruitment due to the kinematics and kinetics of this gait pattern and thereby result in less anterior knee stress. It is the purpose of this research project to determine if hamstring recruitment can increase in a …

Gluteus Medius Inhibition In Association With Sacroiliac Joint Dysfunction, Amy J. Clifford

Physical Therapy Scholarly Projects

Sacroiliac joint dysfunction is one of the most common diagnoses of low back pain. Musculoskeletal imbalance is one of the precipitating factors which cause sacroiliac joint dysfunction (SIJ). The gluteus medius, a primary stabilizer of the pelvis, has been observed clinically to be weak in a significant number of individuals with SIJ dysfunction. The purpose of this study was to determine the difference in gluteus medius function in subjects without SIJ dysfunction in comparison to subjects with SIJ dysfunction. To make this comparison, electromyographic data and information regarding lower extremity stability were collected using a force plate.

This study showed …

Management Of Spasticity: A Review Of Two Methods Of Medical Intervention, Andrea Grock

Physical Therapy Scholarly Projects

Spasticity is an entity with which physical therapists are quite frequently faced. It is a common phenomenon among individuals who have sustained central nervous system damage. Spasticity is "associated with a wide variety of neurological diagnoses and may have benefits as well as negative qualities. The negative effects can lead to multiple complications which interfere with functions of every day living. Management of spasticity becomes necessary when it ~causes complications or interferes with function. There are several modes of intervention, including conservative physical therapy approaches and/or medical approaches.

The purpose of this independent study is to review two medical methods …

Total Quality Management In Physical Therapy: A Primer For Physical Therapists In Search Of Quality, Brian C. Kittelson

Physical Therapy Scholarly Projects

Total quality management (TQM), a management system first successfully utilized in the manufacturing industry, has gained much popularity in the healthcare industry over the past few years. Books, articles, conferences, workshops, and video tapes that teach health care executives how to utilize TQM in their organizations abound. Unfortunately, resources which specifically apply the TQM philosophy and tools to the practice of physical therapy are few. The purpose of this project is to provide a resource that introduces the philosophy, methods, and tools of TQM with applications to the physical therapy setting.

Chapter one briefly discusses the general history of TQM …

Parkinson's Disease: An Exercise Approach To Treatment, Kara Lynn Klosterman

Physical Therapy Scholarly Projects

Parkinson's Disease (PO) is a common neurological disorder affecting elderly people. Patients suffering from PO typically display three cardinal signs: tremor, rigidity, and bradykinesia. As the disease progresses, secondary symptoms develop. These cardinal signs and secondary symptoms decrease the patient's abilities to function during normal daily activity.

Physical therapists are specially trained in the evaluation and treatment of persons with movement disorders such as PD. Research demonstrates success in the treatment of PO when physical therapy services are utilized. Physical therapists educate patients and their families about PD. Via exercise, physical therapists prevent the onset of complications and improve the …

Analysis Of Normal Human Postural Response During Stance, Christy M. Kramer

Physical Therapy Scholarly Projects

The purpose of this paper is to review the literature that examines normal standing postural responses including sensory input and motor response. This literature review also reviews changes in the use of sensory input and motor response which occur throughout the human lifespan. In addition, this literature review questions whether physical therapy can assist patients whose postural responses are not within ranges considered normal.

The information in this literature review should assist people within the field of physical therapy to increase their awareness of normal postural responses during stance. It should also increase the awareness among practitioners of how normal …

Patient Compliance With Medical Regimens, Stacie R. Lund

Physical Therapy Scholarly Projects

Patient compliance is defined as the patients' following a request, wish, or demand that a health care provider has decided is necessary and beneficial for the improvement of the health of the patient. Oftentimes, though suggestions by providers are in the patient's best interest, patients will instead either disregard what has been told to them or actively go against the suggestions. Certainly, the patient is the manager of his/her own health care program, however, noncompliance is a very common problem. There are several reasons for noncompliance, including the psychological make-up of the patient, the patient's social environment, the nature of …

Outcome Based Survey On The University Of North Dakota Physical Therapy Curriculum, Elizabeth L. Malae

Physical Therapy Scholarly Projects

According to the American Physical Therapy Association's (APTA) current Standards for Accreditation of Physical Therapy Education Programs, "Criterion A for Standard VI states: The Comprehensive curriculum plan includes an organized and sequential series of integrated student-oriented learning experiences designed to enhance attainment of terminal competencies." How can we be sure that these educational goals and objectives of achieving technical clinical competency and meeting the needs of society and the profession are being met? One method is to get feedback from the students involved in the physical therapy program by means of a survey. This study will examine the content and …

Fibromyalgia: Diagnosis And Management, Janet Mckinnon Rasmusson

Physical Therapy Scholarly Projects

Fibromyalgia is a nonarticular rheumatic disease of unknown origin. It is diagnosed by the presence of widespread pain of more than three months duration and tenderness at 11 or more of 18 tender point sites. Typical symptoms of this syndrome are generalized pain, stiffness, and chronic fatigue due to sleep disturbances. Other uncommon symptoms include headaches, anxiety, depression, irritable bowel syndrome, and numbness. These symptoms become worse with the presence of modulating factors such as weather, stress, fatigue, overexertion, or inactivity.

The purposes of this independent study are to examine the prevalence and demographics of this disorder, discuss the etiology …

A Review Of Chronic Lateral Ankle Instability, Marcy K. Narum

Physical Therapy Scholarly Projects

Ankle injuries constitute one of the most common and most frequent injuries affecting the lower extremities, with lateral ligament sprains comprising the majority of the ankle injuries. The development of chronic lateral ankle instability is a relatively common occurrence following an acute ankle sprain. Previously the treatment of chronic lateral ankle instability has been primary surgical intervention, but more recently the initial treatment is shifting toward a conservative approach emphasizing functional rehabilitation of the unstable ankle. Frequently the treatment of recurrent sprains and chronic instability addresses only the symptoms; however, a treatment program addressing the underlying causes of instability needs …

Hippotherapy: A Survey Of Therapists Nationwide, Yvette J. Normandin

Physical Therapy Scholarly Projects

The purpose of this study was to survey physical therapists nationwide who are involved with North American Riding for the Handicapped Association (NARHA) certified centers to obtain their perspectives regarding the need for more empirical research and outcome studies, benefits of Therapeutic Horseback Riding, and methods of objective evaluation utilized when determining patient improvement. Of the 261 surveys mailed, 125 (48.8%) were returned with 110 utilized for data interpretation.

Respondents indicated a large need for more empirical research to support therapeutic horseback riding as a treatment method and to facilitate increased acceptance by the medical field in general. Only a …

A Detailed Look At The Innovative Manual Therapy Technique: Strain/Counterstrain, Rochelle Skarperud

Physical Therapy Scholarly Projects

The purpose of the following literature review is to provide the reader with information regarding the manual therapy technique of strain/counterstrain. The review will describe the origin, theory, rationale, and methods associated with the treatment technique of strain/counterstrain. The role of the muscle spindle and trigger point as utilized in the technique are discussed in detail, along with a comparison of strain/counterstrain to similar manual therapy techniques. Several of the techniques discussed are: acupressure, acupuncture, osteopathic manipulation, and muscle energy techniques. To further support the authors' viewpoints, several case studies are presented and reviewed. The general treatment techniques and guidelines …

The Effects Of Supramalleolar Orthoses On The Biomechanics Of The Knee, Foot, And Ankle During Gait: A Single-Subject Design, Jennifer Ruth Stauffer

Physical Therapy Scholarly Projects

Gait deviations are a common problem associated with disorders of movement and posture such as cerebral palsy (CP). Inhibitive casts and ankle-foot orthoses have been used to treat gait deviations in children with CP, but they have not satisfied the needs of children who are able to achieve active dorsiflexion and plantarflexion but lack stability at the subtalar joint. Supramalleolar orthoses (SMOs) were developed to address that need. SMOs, along with physical therapy, have been used to treat children with CP, but little research has been conducted to determine the actual effects of the SMO on lower extremity biomechanics during …

The Effects Of Repeat Testing On Performance Scores Utilizing The Isostation B-200, Stephanie D. Kyes

Physical Therapy Scholarly Projects

The purpose of this experimental study was twofold: 1) to determine if there was a significant increase in performance, or learning effect, between the first and second test sessions on the Isostation B-200 for normal subjects, and 2) if so, was there a specific percentage of increase that can be attributed as a learning effect for each age, gender, or activity level.

Twenty-two subjects (8 men, 14 women) with no prior history or treatment for low back pain were utilized in this study. All subjects were tested in two positions. First, in an upright standing position and second, in twenty …

A Historical Perspective Of Medical Care Coverage In The United States, Rhonda Noyes

Physical Therapy Scholarly Projects

Reimbursement of medical services by third-party payers is becoming more contingent upon the effectiveness of services at an affordable cost. The push for cost containment brings about the need for the health care professional to have a sound understanding of medical care coverage to provide quality services at an affordable price.

The present coverage of medical care in the united States is largely dependent upon medical benefits offered by employers. In order to understand current trends in medical care coverage and the reliance on employer based coverage, this independent study explores the origins and development of the current medical care …

Multiple Sclerosis: A Literature Review, Jody E. Price

Physical Therapy Scholarly Projects

Multiple Sclerosis (MS), a demyelinating disease of the Central Nervous System (CNS), is the most common cause of nontraumatic disability affecting young adults in the United States. The resultant lesions lead to a variety of symptoms which include: weakness, sensory disturbances, visual problems, spasticity, fatigue, and paralysis. There are also a number of psychological and emotional issues that the MS patient must face. The cause of MS remains unknown and the diagnosis is often difficult. The course and severity of the disease varies from patient to patient. There is no known cure or prevention.

Current treatments include drug therapy, physical …

Overview Of The Flaccid Hemiplegic Shoulder Following A Stroke, Tricia R. Pederson

Physical Therapy Scholarly Projects

Stroke may cause long-term disability and impairment in the hemiplegic shoulder. Problems may develop early in the flaccid phase of recovery and complicate the entire rehabilitation process. The etiology and treatment of shoulder complications remains uncertain. Contributing factors include inappropriate handling and positioning, abnormal muscle tone, impaired sensation, and musculoskeletal pathology.

Prevention and treatment of shoulder dysfunction begins with positioning, early range of motion, and education. Physical therapists play an important role in stroke management by administering therapeutic positioning programs, teaching appropriate exercise regimens, and instructing in proper handling techniques.

The purpose of this paper is to review methods being …

A Literature Review On Wheelchair Products And Fitting, Lee M. Werchau

Physical Therapy Scholarly Projects

Physical therapists are often involved in wheelchair prescription. An important factor when recommending or prescribing a wheelchair is proper fit. Proper wheelchair fitting is critical when attempting to get maximum independence, normalize tone in spastic or low tone clients, as well as decreasing bony deformities and pressure ulcers. Crucial measurements for wheelchair fitting include backrest height and seat width, depth, and height. To assure ultimate independence an individuals mental competence, ROM in upper extremities, cardiopulmonary health, and coordination must be evaluated prior to prescribing a wheelchair. Options to consider are the type of seat cushion, wheelchair frame, peripherals, and safety. …

Debridement Teaching Aid, Katharine E. Ward

Physical Therapy Scholarly Projects

Physical therapists treat patients with wounds. Debridement is one area of wound care which physical therapists frequently perform. Debridement is a particularly difficult skill to learn in the classroom due to the inability to simulate authentic conditions.

This study is intended to be a debridement teaching aid in the physical therapy classroom and/or the professional setting. Written text discusses the classification, healing, assessment, debridement, and dressing of wounds. Photographs of wounds and wound care clarify the written text.

The purpose of this teaching module is to help students and professional staff feel more comfortable with wound care and debridement upon …

Medical Disease And Low Back Pain: The Physical Therapy Evaluation, Heather Lynn Alderson

Physical Therapy Scholarly Projects

The heightened level of autonomy currently experienced by the profession of physical therapy demands that, in addition to identifying and managing movement dysfunctions of the musculoskeletal system, physical therapists be knowledgeable of signs and symptoms which may indicate medical disease. Individuals who present with low back pain (LBP) are commonly seen in the physical therapy clinic. While most often the source of a patient's LBP is of mechanical musculoskeletal origin, a great number of differential diagnoses classified as medical diseases also exist that are capable of precipitating low back pain. The purpose of this independent study is to: (a) outline …

A Literature Review Of The Results Of Traditional Versus Accelerated Anterior Cruciate Ligament (Acl) Rehabilitation In Treatment Following Acl Reconstruction, Cara L. Conway

Physical Therapy Scholarly Projects

In recent years, the rehabilitation of the anterior cruciate ligament (ACL) has undergone changes in its protocol. The changes in ACL rehabilitation protocol are due to clinical observations and trends in ACL rehabilitation across the country. The traditional and presently used accelerated ACL rehabilitation programs are not much different in the activities performed as in the time frames when each activity is permitted.

The main purpose of this literature review is to provide material for clinicians to have accurate and recent knowledge of ACL rehabilitation. This knowledge will allow the clinician to provide the best and most beneficial treatment to …

A Survey: The Documentation Of Manual Therapy, Kimo Danielsen

Physical Therapy Scholarly Projects

Manual therapy, though clinically valuable, lacks published research to support efficacy. The purpose of this project was to survey therapists in the U.S. who use manual therapy · in their clinical practice. Methods: All orthopedic clinical specialists (OCS) in the United States (n=325) as recognized by the American Physical Therapy Association's 1993 Directory of Clinical Specialists were sent a survey that contained questions regarding demographics, frequency of documentation, and items included in documentation. . The information gained through the survey questions were analyzed for descriptive trends. Results: There was a 45% response rate. Majority of the respondents indicated they were …

Comparison Of Pediatric Physical Therapy Service In The Educational Versus Medical Setting With Special Focus On Iep Development, Nicki Christopherson

Physical Therapy Scholarly Projects

The passage of Public Law 94-142, the Education for all Handicapped Children Act, in 1975, has created an increased demand for physical therapists to work with children in the educational setting. The intent of the law is that all individuals have the right to a free, appropriate public education. In order for an individual with a disability to receive an appropriate education, related services, including physical therapy, are provided.

Physical therapy has traditionally been a medical service. In accordance with the law, the services delivered by a physical therapist in the school setting must be educationally related. Service provisions including …

A Review Of The Utilization Of Emg Biofeedback, Jeanine Lee Forsgren

Physical Therapy Scholarly Projects

Electromyographic (EMG) biofeedback is gaining popularity as a treatment modality in physical therapy. It is used in the areas of neurological and orthopedic rehabilitation as well as injury prevention and performance improvement. The use of this modality can aid in the rehabilitation process by identifying weak muscles which need to be strengthened. Physical therapy also utilizes EMG biofeedback to identify and change movement patterns which may contribute to injury through the overuse or incorrect use of various muscles. EMG biofeedback is used to assist the patient in learning how to control muscular movement to correct the problems which are identified. …

An Emg Analysis Of Closed Kinetic Chain Exercise Versus Open Kinetic Chain Exercise In The Upper Extremity, Bradley J. Neis

Physical Therapy Scholarly Projects

Both closed kinetic chain and open kinetic chain activities are common in rehabilitation involving the lower extremity and the upper extremity. Although closed chain activities are performed regularly in the rehabilitation setting for the upper extremity, there has been little or no research proving that these activities are better, worse, or the same as open chain activities. Therefore, the purpose of this research project was to compare muscle activity in both open and closed chain exercises in the upper extremity and determine if there is a difference in the two forms of exercise. Five healthy subjects without previous shoulder or …

A Review Of Spinal Rom Measurement Tools, Dawn Kamihara

Physical Therapy Scholarly Projects

Physical therapists rely on measurements to communicate with one another, establish patient status, predict treatment response, document treatment efficacy, and claim scientific credibility for the profession. Therefore, the quality of measurements should be of great concern to physical therapists and, hence, therapists should be able to examine the quality of measurement tools they are using critically. A variety of measurement tools are being utilized in physical therapy to quantify spinal mobility; however, there is no clarity as to which of the tools are optimal. In particular, the spinal range of motion measurement tools will be examined because of the high …

The Role Of Foot Biomechanics In Lower Extremity Pathologies, Don Martin

Physical Therapy Scholarly Projects

Lower extremity pathologies caused by abnormal biomechanics of the subtalar joint are commonly seen in the health care setting. Certain foot types will predispose an individual to excessive amounts of subtalar joint pronation or supination during gait. Subtalar joint movement is transmitted proximally to the lower extremity during gait and excessive amounts of pronation or supination can lead to altered biomechanics in the lower extremity with development of various lower extremity injuries. The purpose of this study is to analyze the biomechanical events of the subtalar joint of the foot during gait in order to show how abnormalities in these …

An Overview Of Multidirectional Instability Of The Shoulder, Troy Ivesdal

Physical Therapy Scholarly Projects

Multidirectional instability (MOl) of the shoulder is an increasingly recognized clinical entity to physical therapists, yet it remains poorly defined and not fully understood. The clinical importance of correct diagnosis is necessary for rehabilitation and surgical procedures. The purpose of this paper is to address the issue of MOl and its importance in the field of physical therapy.

General anatomy will be presented with attention given to biomechanics which may lead to this pathology. Etiological factors will be discussed including symptoms and proper diagnostic procedures for instability. Finally, treatment of multidirectional instability will be reviewed with a focus on proprioceptive …