Medicine and Health Sciences Commons^™

Physical Therapy Management Of A Patient With Chronic Knee Pain: A Case Report, Mohamed Elsaid

Case Report Papers

Background and Purpose: Knee pain affects a large number of adults, and as a result limits their functional mobility and may induce participation restrictions. A number of risk factors may contribute to knee pain, with osteoarthritis (OA) being the most prevalent cause. The rate of knee replacement surgery among individuals 65 and older has increased significantly over the years. Physical therapy (PT) is a non-surgical option that offers individuals relief of their knee pain. Case Description: The patient was a 48-year-old Caucasian female referred to physical therapy with chronic right knee pain. She received PT twice a week for eight …

Management Of A Patient With Bronchiectasis Using Pulmonary Rehabilitation And Balance Training: A Case Report, Megan Witherow Quarles

Case Report Posters

Bronchiectasis is a chronic lung disease defined by permanent abnormal dilation of the bronchi. Bronchiectasis often includes airway infection and inflammation. Pulmonary rehabilitation including progressive gait training, stair climbing, and cycling is a standard guideline for the treatment of bronchiectasis symptoms and for symptoms of other chronic lung diseases. Little research has been conducted on the effectiveness of pulmonary rehabilitation for patients with bronchiectasis. The purpose of this case report is to examine physical therapy (PT) management, utilizing pulmonary rehabilitation with incorporated balance training, for a geriatric patient with bronchiectasis.

Shoulder Strengthening, Taping And Postural Reeducation In A Breast Cancer Survivor After Bilateral Mastectomy: A Case Report, Nalis Mbianda

Case Report Posters

Breast cancer is the most common cancer experienced by females in the United States. In breast cancer survivors, weakness of the rotator cuff musculature is often considered a contributing factor to rotator cuff pathology. The purpose of this case report was to help fill the gaps in literature by documenting the use of therapeutic exercises to strengthen the shoulder complex, in conjunction with taping techniques for postural reeducation, of a female breast cancer survivor.

Management Of A Patient With Bronchiectasis Using Pulmonary Rehabilitation And Balance Training: A Case Report, Megan Witherow Quarles

Case Report Papers

Background and Purpose: Bronchiectasis is a chronic lung disease defined by permanent, abnormal dilation of the bronchi and accompanied by chronic airway infection which leads to airway inflammation. Bronchiectasis is progressive and leads to a cycle of worsening pulmonary damage. Pulmonary rehabilitation, including progressive gait training, cycling, and stair climbing, is often utilized as treatment for this condition. However, there has been little research conducted on its effectiveness for bronchiectasis. The purpose of this case report is to examine physical therapy (PT) management, utilizing pulmonary rehabilitation with incorporated balance training, for a geriatric patient with bronchiectasis. Description: The patient was …

Identification And Intervention For Action Planning Deficits In Children With Hemiplegic Cerebral Palsy, Swati M. Surkar

Theses & Dissertations

The primary purpose of this investigation was to describe and quantify action-planning deficits during goal-directed movements in children with hemiplegic cerebral palsy (HCP). Three specific topics were addressed: brain activation, kinematics, and the use of visual input. First, we assessed prefrontal cortex (PFC) activation during complex goal-directed actions in children with HCP. The outcome suggested that children with HCP have higher PFC activation than age matched typically developing (TD) children during action planning, potentially due to the difficulty in allocating attentional resources for simultaneously processing the cognitive (i.e., attention, memory, information processing) and motor demands of the goal-directed task. Reduced …

E For Everyone: Strategic Plan, Lindsay Calcaterra, Kaela Fischer, Kelley Flahaven, Megan Witherow Quarles, Maria Stern, Christina Tilton

Physical Therapy Administration

‘E for Everyone’ is an innovative and unique inclusion program that equalizes the playing field among all people with and without disabilities by creating opportunities to build synergistic relationships through teamwork, fun, and physical activity. Created during the Fall 2016 semester of the course Physical Therapy Administration, this strategic plan summarizes the program.

E For Everyone: Implementation Guide, Lindsay Calcaterra, Kaela Fischer, Kelley Flahaven, Megan Witherow Quarles, Maria Stern, Christina Tilton

Physical Therapy Administration

‘E for Everyone’ is an innovative and unique inclusion program that equalizes the playing field among all people with and without disabilities by creating opportunities to build synergistic relationships through teamwork, fun, and physical activity. Created during the Fall 2016 semester, concurrent with the course Physical Therapy Administration, this implementation guide describes the step by step process for implementing the program.

Physical Therapy Management Of A Patient After Hemorrhagic Stroke Using A Task-Oriented Approach In A Skilled Nursing Facility: A Case Report, Kaela Fischer

Case Report Posters

Stroke is the leading cause of long term disability in the U.S.; nearly 800,000 Americans have a stroke each year. Subarachnoid hemorrhagic stroke occurs when one of the blood vessels in the brain bursts causing a release of blood which increases intracranial pressure. There is a lack of rehabilitation research in the skilled nursing setting for hemorrhagic stroke. The purpose of this case report is to describe the PT management, using a task-oriented approach, of a patient with a subarachnoid hemorrhagic stroke being treated in a skilled nursing setting.

Physical Therapy Management Of A Patient With Chronic Brainstem Stroke Syndrome To Improve Functional Mobility: A Case Report, Kelley Flahaven

Case Report Papers

Background and Purpose: Brainstem strokes are much less common and have a higher mortality rate than cortical strokes. Brainstem strokes can lead to several physical impairments, including gaze palsies, quadriplegia, ataxia, or cranial nerve deficits, leading to decreased balance and safety as well as decreased independence with functional activities. The purpose of this case report is to provide an overview of the physical therapy care plan created for a patient with chronic brainstem strokes. Case Description: The patient is a middle-aged man who had two brainstem strokes over two years ago. He initially received physical, occupational, and speech therapies, then …

Functional Training In A Patient With Middle Cerebral Artery Stroke With Multiple Comorbidities: A Case Report, Darien Lewis

Case Report Papers

Background and Purpose: Strokes affecting the middle cerebral artery (MCA) cause impairments of recovery affected by the patient’s premorbid status. Although there is a significant amount of research detailing physical therapy (PT) interventions for patients with hemiplegia, there is a lack of evidence supporting interventions for patients with hemiplegia following stroke that have multiple comorbidities. The purpose of this case report is to describe a progressive PT plan of care (POC) for a patient following MCA stroke with multiple comorbidities in the skilled nursing setting. Case Description: The patient was a 71-year-old male admitted to the skilled nursing facility (SNF) …

The Use Of Manual Therapy In The Treatment Of A Patient With Chronic Low Back Pain And Sciatica: A Case Report, Elia N. Darazi

Case Report Papers

Background: Chronic low back pain (CLBP) is one of the most common conditions encountered in an outpatient physical therapy (PT) setting. While there are many different approaches used in the treatment of CLBP, the purpose of this case report is to detail the successful utilization of a short-course of manual therapy (MT) for a patient with CLBP and sciatica. Case Description: The patient was a 60-year-old male who presented to PT with a medical diagnosis of nerve root compression-left sciatica. At the initial evaluation, he presented with radiating left sided low back and lower extremity pain of approximately six months …

Clinical Instructors Perceptions Of The Pta-Cpi Assessment Of Critical Thinking, Trudy L. Hansen

Electronic Theses & Dissertations

The purpose of this study was to analyze how critical thinking skills are assessed for Physical Therapist Assistant students within the state of Kansas. Eight face to face interviews were conducted with clinical instructors who use the Physical Therapist Assistant Clinical Performance Instrument (PTA-CPI) as the instrument to assess critical thinking. Physical Therapy educational facilities supplied the names of clinical instructors who met the study’s criteria. Clinical instructor’s gave their definition of critical thinking, stated the advantages and disadvantages of the PTA-CPI, described their perceptions of a PTA student’s critical thinking skills in the clinical educational setting, and discussed what …

Physical Therapy Treatment Of A Patient With Chronic Low Back Pain And A Previous History Of A Substance Abuse Disorder: A Case Report, Marcus X. Alomar, Brian T. Swanson

Case Report Posters

The National Survey on Drug Use and Health (NSDUH) reported that an estimated 27 million people in the United States have reported use of an illicit drug within the past month. Low back pain continues to be a major cause of disability in the United States, with an estimated 70 percent of adults experiencing low back pain at some point during their lifetime. Active exercise programs that include pain education and cognitive behavioral therapy demonstrated significant superior outcome at reducing pain intensity, anxiety/depression, disability, and fear-avoidance compared to therapeutic exercise and manual therapy alone for patients with non-specific chronic low …

A Correlation Between Gpa And Physical Therapy Treatment Compliance, Courtney Griffith

Honors Projects

This study sought to find a relationship between students’ university grade point average and physical therapy treatment compliance. While other researchers have shown how important compliance is and have investigated factors that affect compliance and GPA separately, no one has studied how GPA and physical therapy treatment compliance are related. We investigated how these two factors interacted and were influenced by other aspects in a population that had not received much attention in literature regarding treatment compliance. This study was a cross sectional survey that used a source population of undergraduate and graduate students at Bowling Green State University in …

The Use Of Therapeutic Exercises And Manual Stretching For A Patient Following A Total Knee Arthroplasty (Tka) Revision: A Case Report, Nicholas Cebula

Case Report Posters

Total knee arthroplasty (TKA) is an orthopedic surgery involving the total replacement of compartments of the knee joint. Osteoarthritis (OA) is the most common reason for TKA. Risk factors for OA include: obesity, sports-related injuries, and genetics. The artificial knee joint typically lasts between 15-20 years; early failures may occur due to loosening of artificial components, infection, fractures, and instability. Approximately 581,000 TKA procedures are performed annually, and by 2030, the demand for TKA procedures is expected to grow by 673%. The purpose of this case report is to document the potential benefits of prescribed PT interventions, including therapeutic exercise …

Utilization Of Postural Control Training To Improve Gait Symmetry And Walking Ability In A Patient Following A Lacunar Stroke: A Case Report, Hannah C. Wilder, Amy J. Litterini

Case Report Posters

Alteration in gait is one of the most noted impairments following stroke. Improving walking ability is one of the most common goals amongst patients with stroke undergoing rehabilitation. Current literature describes visual and proprioceptive feedback and task-oriented training as effective in improving gait speed, mechanics, strength, and balance following stroke. Based on the research, postural control training may improve walking ability following stroke. The purpose of this case report is to outline physical therapy rehabilitation that utilized postural control training, task-oriented training, and visual feedback to improve walking ability and functional capacity in a patient following a lacunar stroke affecting …

Restoring Gait And Functional Mobility For A Patient With An Ischemic Stroke Through Physical Therapy: A Case Report, Colleen Kelly

Case Report Posters

During an ischemic stroke, blood flow is impeded due to blocked artery. Stroke is the 5^th leading cause of death and the primary cause of disability and dependency in adults in the United States. Patient age and stroke severity, size, and location are strong predictors in prognosis. Stroke rehabilitation during the first three months can reduce mortality. The purpose of this case report is to provide physical therapy management strategies used during an inpatient stay for a patient who experienced an ischemic stroke.

Restoring Gait And Functional Mobility For A Patient With An Ischemic Stroke Through Physical Therapy: A Case Report, Colleen Kelly

Case Report Papers

Stroke is the primary cause of disability and care dependency in adults in the United States. Research has found that the risk of mortality post stroke can be greatly reduced through stroke rehabilitation. The purpose of this case report is to provide a framework of physical therapy rehabilitation that facilitated functional mobility and gait in a patient who experienced a stroke. The patient was a 50-year old male who was admitted to an inpatient rehabilitation hospital for physical therapy following a left middle cerebral artery ischemic stroke four days prior. The patient received three weeks of physical therapy after displaying …

Optimizing The Composition And Delivery Of Assessment And Treatment Following Distal Radius Fracture, Michael L. Szekeres

Electronic Thesis and Dissertation Repository

Distal radius fracture (DRF) is the most common fracture.¹ The most recent Cochrane review indicated “The available evidence from randomized controlled trials is insufficient to establish the relative effectiveness of the various interventions used in the rehabilitation of adults with fractures of the distal radius”.²

Since the relative effectiveness of the various interventions used for rehabilitation after DRF is unknown, the main goal of this thesis is to focus on one aspect of both assessment and treatment to add to the current literature base. The first paper (Chapter 2) describes a new method using a modified finger goniometer …

Physical Therapy Management Of A Patient With Chronic Knee Pain: A Case Report, Mohamed Elsaid

Case Report Posters

Knee pain affects approximately 25% of adults, and as a result limits functional mobility and may induce participation restrictions. Risk factors may contribute to knee pain, with osteoarthritis (OA) being the most prevalent cause in individuals 50 years and older. The rate of knee replacement surgery among individuals 65 and older has increased by approximately eight fold from 1979-2002. Physical Therapy (PT) is a nonsurgical option that offers individuals relief. The purpose of this case report is to review the PT treatment and management for a patient with chronic knee pain, and use evidence based interventions, such as therapeutic exercises, …

Early Utilization Of The 6-Minute Walk Test (6mwt) In An Active Patient After Cardiac Surgery - A Case Report, Christian Boucher, Kirsten Buchanan

Case Report Posters

Coronary artery disease affects more than 13 million Americans. A sub-population of these patients, despite exercising regularly, can develop cardiac disease. The 6-Minute Walk Test (6MWT) is a functional outcome measure that is easy to implement and has been used across multiple populations. There is limited literature that has investigated the use of the 6MWT on post-operative day one (POD1) after cardiac surgery. Patients participating in self motivated exercise programs prior to surgery are found to excel with early utilization of the 6MWT. For this active sub-population the 6MWT on POD1 may be a more specific and sensitive outcome measure. …

Subacute Physical Therapy Management For Abnormalities Of Gait And Mobility Following An Acute Accident With Farm Equipment: A Case Report, Maria Stern

Case Report Posters

Workers in the agricultural industry experience 243 injuries per day that result in lost work time, with five percent of these resulting in permanent impairments. Functional decline can occur as a result of prolonged hospitalizations. Endurance and strength of the lower extremities, mobility, and tolerance for ambulation are decreased in this population. Physical therapy (PT) interventions can target these impairments to improve functional ability. The purpose of this case report is to describe the PT management used in a subacute setting to improve functional ability, mobility, and gait in a patient who experienced deconditioning due to prolonged hospitalization following an …

Profiles Of Fatigue Severity And Variability Among Adolescents And Young Adults With Cerebral Palsy, Laura K. Brunton, Doreen J. Bartlett

Physical Therapy Publications

Background: Individuals with cerebral palsy (CP) experience progressive changes in functional status with the development of secondary impairments such as fatigue. Detailed accounts of the fatigue experience in CP are lacking.

Purpose: This study describes the severity and variability of fatigue in CP using the Fatigue Impact and Severity Self-Assessment.

Methods: This was a descriptive cross-sectional study surveying 130 (61 males) individuals (mean age 18 years, 11 months; SD four years, six months) with CP. Analyses comprised comparisons between two groups (Gross Motor Function Classification System (GMFCS) I and II-V), frequency counts and proportions.

Results: Significant differences exist between GMFCS …

Combining Physical Therapy And Podiatry For A Patient With Plantar Fasciitis: A Case Report, Kathleen Barnes, Kirsten Buchanan

Case Report Posters

One million cases of plantar fasciitis (PF) are reported annually in the United States. Studies have separately investigated the effectiveness of physical therapy (PT) interventions as well as steroid injections from podiatry – but not in conjunction with each other. There is a lack of research investigating an interdisciplinary approach utilizing PT and podiatry for PF. This case report investigated an interdisciplinary approach combining physical therapy and podiatry utilizing steroid injections in the treatment of a patient with plantar fasciitis.

Use Of Functional Strengthening, Balance Training, And Stretching In The Treatment Of A Patient Following A T11-L5 Spinal Fusion: A Case Report, Anna Sidloski, Brian T. Swanson

Case Report Posters

There is abundant evidence available regarding treatment approaches for patients suffering from low back pain (LBP), but limited research focusing on physical therapy (PT) treatment status post-multilevel spinal fusion with postural impairments. The purpose of this case report is to describe the management and functional improvement of a patient s/p spinal fusion with severe postural impairments, elevated fall risk, and high levels of back pain.

Physical Therapy And Cognitive Behavioral Therapy In A Patient With Multiple Co-Morbidities – A Case Report, Jeanine Manubay, Kirsten Buchanan

Case Report Posters

Traditional physical therapy (PT) interventions can be challenging to implement in the complex patient with multiple comorbidities. Cognitive behavioral therapy (CBT) is a behavioral therapy technique used to change obstructive behaviors and improve functional and emotional health. CBT has shown positive outcomes in patients with cancer and elderly patients with depression, but has not been studied in conjunction with PT in medically complex patients. The purpose of this case report was to document the utilization and outcomes of CBT along with traditional physical therapy for a medically complex patient diagnosed with end stage renal disease and multiple co-morbidities.

Application Of Manual Therapy Utilizing Maitland Principles In The Rehabilitation Of A Patient Following Rotator Cuff Repair, Kehinde Aderibigbe, Brian T. Swanson

Case Report Posters

In the United States, more than 500,000 rotator cuff repairs and shoulder arthroscopies are performed annually. Following surgery, physical therapy (PT) often utilizes various manual therapy (MT) and therapeutic exercise (TE) interventions. Post-operatively, accessory joint mobilizations (AJM) help to prevent adhesions and may decrease excitability of central nociceptive pathways. However, there is no consensus about the most appropriate postoperative utilization and timing of MT following surgery. Maitland describes a framework for clinical decision making that is patient-centric and focuses on frequent reassessment to guide the application of manual therapy. In this framework, comparable signs are identified at initial evaluation, and …

Physical Therapy And Cognitive Behavioral Therapy In A Patient With Multiple Co-Morbidities – A Case Report, Jeanine Manubay

Case Report Papers

Background and Purpose: Cognitive behavioral therapy (CBT) is grounded in the premise that by altering a patient’s negative thought processes, one can improve functional and emotional health. When multiple co-morbidities limit traditional physical therapy interventions, CBT may be a consideration. While CBT has shown benefits in patients with cancer and others, there is a lack of research investigating its effectiveness in conjunction with physical therapy (PT) in the medically complex patient. The purpose of this case report was to document the outcomes of CBT along with traditional PT for a medically complex patient diagnosed with end stage renal disease and …

Use Of Functional Strengthening, Balance Training, And Stretching In The Treatment Of A Patient Following A T11-L5 Spinal Fusion: A Case Report, Anna Sidloski

Case Report Papers

Background and Purpose: Lumbar spinal fusion surgery has been utilized to manage levels of low back pain and instability. However, pain often persists post-operatively. Evidence supports the use of Transverse Abdominis recruitment in patients with LBP. Research demonstrates strengthening the hip musculature may allow for improved outcomes for those who experience LBP. There is limited research focusing on lower extremity strengthening, flexibility, and balance training in a patient following a T11-L5 spinal fusion. Case Description: The patient was a 68-year-old male presenting to physical therapy eight weeks’ status post T11-L5 spinal fusion with ~45 degrees forward-flexed posture, weak lower extremity …

A Comprehensive Physical Therapy Program For Adult-Onset Dystonia: A Case Report, Karissa Wells, Kirsten Buchanan

Case Report Posters

Dystonia can present with symptoms of involuntary muscle contractions, resting tremors, and diminished muscular control. Patients with dystonia can present similarly to patients with Parkinson’s disease due to the association with the basal ganglia. While there is significant research on physical therapy (PT) interventions for patients with Parkinson’s disease there is limited research on the PT evaluation and treatment of patients with dystonia. The purpose of this case report was to describe a comprehensive PT regimen, based on Parkinson’s disease research, for a patient diagnosed with adult-onset dystonia.