Medicine and Health Sciences Commons^™

Association Between The Amount Of Inpatient Rehabilitation Therapy And The Risk Of Disability And Mortality In Patients With Ischemic Stroke, Yu-Ju Chang, Gwo-Chi Hu, Yi-Pin Chiang, Yao-Chia Chuang, Chih-Lin Kuo

Rehabilitation Practice and Science

Background and Purpose: Most studies have demonstrated that rehabilitation program is able to improve functional recovery and reduce the risk of disability in patients with acute stroke. However, the relationship between the amount of the inpatient rehabilitation therapy and the risk of disability and mortality among patients with acute ischemic stroke is still unknown. The present study was undertaken to investigate the relationship between the amount of inpatient rehabilitation therapy and the risk of disability and mortality among patients with acute ischemic stroke, as well as to assess whether the association varies with respect to stroke severity Methods: We designed …

Effects Of Low-Level Laser Therapy On Matrix Metalloproteinase And Collagen Expression Of Tendon Cells, Chien-Hung Chen, Shih-Wei Hung, Jong-Hwei S. Pang, Wen-Chung Tsai, Miao-Sui Lin, Tung-Yang Yu, Hsiang-Ning Chang

Rehabilitation Practice and Science

Objective: Low-level laser therapy (LLLT) is commonly used to treat sports-related tendinopathy or tendon injury. However, scientific evidence of the effects and underlying molecular mechanisms of tendinopathy treatment remained limited. Tendon healing requires tenocyte migration to the repair site, followed by proliferation and synthesis of the extracellular matrix, including collagens. The study was designed to determine the effect of laser on the metabolism of collagen for injuried tendon repair, furthermore, become a foundation of the LLLT for tendon repair. Methods: Tendon cells from rat Achilles tendons were obtained to investigate the effect of LLLT on collagen metabolism in tendon repair. …

Physical Therapy Management Of A Patient After A Subacromial Decompression With Acromioplasty And Bursectomy: A Case Report, Brianne Landholt

Case Report Papers

Background: Subacromial impingement results from repetitive trauma to structures underneath the subacromial arch leading to a decrease in the subacromial space, impingement of soft tissue, and ultimately a decrease in functional abilities. Conservative treatment includes physical therapy, nonsteroidal anti-inflammatory drugs, and corticosteriod injections. If improvements are not observed, there is a surgical option of a subacromial decompression (SAD). Conclusive evidence supporting surgery over conservative measures does not exist1. Literature is lacking regarding SAD without rotator cuff (RTC) repair and performing SAD with both an acromioplasty and bursectomy. Therefore, the purpose of this case report was to investigate the functional outcomes …

Physical Therapy Management Of A Manual Laborer With Chronic Rotator Cuff Tendinopathy: A Case Report, Samuel Lasher

Case Report Papers

Background and Purpose: Rotator cuff tendinopathy (RCT) is a chronic tendon injury that can have significant impact on an individual’s occupation, recreation and personal life. Currently there is a paucity of information detailing physical therapy (PT) interventions for individuals with RCT, who must continue working. The purpose of this case report was to report a clinical experience detailing the PT management of a patient with RCT, who secondary to occupational obligations must continue to participate in activities harmful to her condition. Case Description: The patient was a 44 year-old, female, who worked as a manual laborer. She was diagnosed with …

The Relationship Of Plantar Sensation With Standing Balance And Gait Post-Stroke, Stephen Parsons

Electronic Thesis and Dissertation Repository

Gait and balance dysfunction after stroke limit independence and quality of life. Numerous contributing factors have been investigated but the role of sensation deficits has received little attention. This thesis investigated the relationship between plantar cutaneous sensation and 1) standing balance, 2) gait, and 3) use of vision to compensate for sensory loss with a secondary analysis of data from individuals with subacute stroke. Associations between standing balance, gait and sensation were investigated with Spearman correlations. Individuals classified as impaired or intact sensation were compared on gait and standing balance measures. This thesis found plantar sensation is related to standing …

Postoperative Management And Core Stabilization Interventions For A Semi-Pro Football Athlete Following Lumbar Discectomy: A Case Report, Isaiah Iaea

Case Report Papers

Although there is evidence to support a high success rate to return to work in the general population and to sports play in athletes following discectomy, less is known regarding the interventions that played a role in their return. The following case describes the interventions and management of a recreational football player following discectomy. Case description: The patient was a self-described highly active 24-year-old male post discectomy. The patient had pain, poor body mechanics, gait abnormalities, range of motion deficits, and strength deficits of his low back and lower extremities. Physical therapy interventions included soft tissue mobilization, stretching, exercise, and …

Effect Of Dual Tasking On Walking Over Even And Uneven Surfaces In Functionally Independent Community Older Adults, Olajide L. Kolawole

Seton Hall University Dissertations and Theses (ETDs)

While several studies have reported a decrement in performance by older adults while walking and concurrently performing a dual task on even surfaces, to date the effects of dual tasking while walking on uneven surfaces commonly found in the community has received less attention. Thus, we sought to test the hypothesis that an incremental decrement in gait parameters will be observed, when walking on an uneven versus an even surface and furthermore, that this decrement would be dependent upon the concurrent performance of a secondary cognitive and/or motor task in functionally independent-living-community older adults.

Dynamic Gait Index assessed the subject’s …

Outpatient Physical Therapy Management Of A Patient Three Months Following Left Shoulder Arthroscopic Repair Of A Type-Ii Slap Lesion: A Case Report, Charles Dowd

Case Report Papers

Background and Purpose: Research demonstrates a drastic increase in the prevalence of type-II superior labral anterior-posterior (SLAP) lesion repairs, and its surgical correction has become the favored method of treatment, because of its ability to effectively improve quality of life (QOL). The purpose of this case report is to document the examination, evaluation, and plan of care (POC) concerning a patient who was referred to physical therapy (PT) three months following the surgical correction of a type-II SLAP lesion. Case Description: The patient was a middle-aged male who was referred to PT for evaluation and treatment following an arthroscopic repair …

Cross-Cultural Adaptation And Psychometric Testing Of The Hindi Version Of The Patient-Rated Wrist Evaluation, Saurabh Mehta, Bhavna Mhatre, Joy C. Macdermid, Amita Mehta

Saurabh Mehta

The purpose of this study was to perform cross-cultural adaptation and Hindi translation of the patient-rated wrist evaluation (PRWE) and assess psychometric properties of the PRWE-Hindi. Cross-cultural adaptation and Hindi translation of the PRWE was performed using standardized guidelines. Intraclass correlation coefficient (ICC) was used for assessing test–retest reliability, and Cronbach’s alpha (CA) was used for assessing the internal consistency of the PRWE-Hindi. Construct validity was assessed by examining the correlations between the PRWE-Hindi and grip strength, wrist range of movements, and self-reported pain and disability. A total of 50 patients with distal radius fracture were recruited and assessed three …

Chronic Pain Grade Questionnaire, Manraj Kaur, Saurabh Mehta

Saurabh Mehta

The Chronic Pain Grade Questionnaire (CPGQ) is a seven item instrument designed to evaluate overall severity of chronic pain based on two dimensions, pain intensity and pain-related disability, in individuals who suffer from chronic pain that has lasted for at least six months. The notion of graded classification of chronic pain severity was derived from the dysfunctional chronic pain concept provided by Turk and Rudy (1988). The two disability items were adopted from the Multidimensional Pain inventory (Von Korff et al 1992).

Home-Based Multidisciplinary Rehabilitation Following Hip Fracture Surgery: What Is The Evidence?, Kathleen Donohue, Richelle Hoevenaars, Jocelyn Mceachern, Erica Zeman, Saurabh Mehta

Saurabh Mehta

Objective. To determine the effects of multidisciplinary home rehabilitation (MHR) on functional and quality of life (QOL) outcomes following hip fracture surgery. Methods. Systematic review methodology suggested by Cochrane Collaboration was adopted. Reviewers independently searched the literature, selected the studies, extracted data, and performed critical appraisal of studies. Summary of the results of included studies was provided. Results. Five studies were included. Over the short-term, functional status and lower extremity strength were better in the MHR group compared to the no treatment group (NT). Over the long-term, the MHR group showed greater improvements in balance confidence, functional status, and lower …

The Implications Of Chronic Pain Models For Rehabilitation Of Distal Radius Fracture, Saurabh Mehta, Joy Macdermid, Mary Tremblay

Saurabh Mehta

Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned …

Closed-Chain Quadriceps Strengthening And Hamstring Stretching In The Conservative Treatment Of Medial Plica Syndrome: A Case Report, Michael Gamache

Case Report Papers

Background and Purpose: Medial Plica Syndrome (MPS) is characterized by pain on the anteriomedial aspect of the knee. The pain results from irritation caused by repetitive use or direct impact. Closed-chain exercises and hamstring stretching have shown to decrease compressive forces on the anterior aspect of the knee. This case report will look at using these exercises in the conservative management of MPS. Case Description: The patient is a 13-year-old female who sustained a direct blow to the anteriomedial aspect of her left knee. After a diagnosis of Chondromalacia Patella, she was treated with non-specific exercises. Pain continued and no …

The Physical Therapy Management Of A Patient With Adverse Mechanical Tension Including The Use Of Neural Gliders And Tensioners: A Case Report, Brent Manley

Case Report Papers

Background and Purpose: Adverse mechanical tension on one’s nervous system can impair a nerves ability to mobilize in relation to its interfacing tissues and lead to sensations of pain, paresthesia and numbness. The impairment is typically treated by managing the interfacing tissues in addition to mobilizing the nerve through the use of gliders and tensioners. The purposes of this case report were to (1) provide overview of adverse mechanical tension and (2) to report a case describing specific physical therapy management approaches and outcomes during outpatient rehabilitation for a patient with adverse mechanical tension. Case Description: The patient was a …

Pre-Operative Outpatient Physical Therapy Of A Torn Rotator Cuff And Peripheral Nerve Injury Caused By Anterior Shoulder Dislocation: A Case Report, Taylor Lacouture

Case Report Posters

Background: Due to the high degree of available range of motion of the Glenohumeral joint, it is highly susceptible to instability and injury. 98% of all traumatic shoulder dislocations are anterior. Rotator cuff injuries and peripheral nerve injuries are commonly associated with traumatic anterior shoulder dislocations. Very little literature exists on pre-operative PT. Purpose: To investigate the effectiveness of pre-operative physical therapy (PT) management including passive range of motion, joint mobilization and exercises for a patient with both a torn rotator cuff and suspected neuropraxic peripheral nerve injury.

Pre-Operative Outpatient Physical Therapy Of A Torn Rotator Cuff And Suspected Nerve Injury Caused By Anterior Shoulder Dislocation: A Case Report, Taylor Lacouture

Case Report Papers

Background and purpose: Rotator cuff repair surgeries are very common and there are many different post-operative rehabilitation protocols available, but there is little to no literature on pre-operative therapy. The purpose of this case report is to investigate the effectiveness of pre-operative passive range of motion (ROM), joint mobilization and exercises for a patient with both a torn rotator cuff and a suspected neuropraxic peripheral nerve injury. Case Description: The patient was a healthy 47-year-old male with no prior medical or surgical history. He was referred to outpatient physical therapy for pre-operative joint mobilization and exercise for his left shoulder, …

Pt Management Of A Patient With A Cva Focusing On Functional Training With Neurodevelopmental Treatment-Based Interventions In The Inpatient Acute Rehabilitation Setting: A Case Report, Jessica Takatsuki

Case Report Papers

Background and Purpose: Patients whom have experienced a cerbrovascascular accident (CVA) commonly have difficulties with functional mobility. Rehabilitation is a common route taken by individuals who have experienced a CVA in order to regain function and independence. Neurodevelopmental treatment (NDT), a rehabilitation technique, emphasizes the integration of postural control and task performance, control of selective movement for the production of coordinated sequences of movement, and the contribution of sensory inputs to motor control and motor learning. The purpose of this case report is to describe functional training in conjunction with NDT-based interventions for a patient with a CVA during a …

Carpal Tunnel Syndrome: A Retrospective Analysis Of Conservative Treatments, Sarah E. Johnson, Britta L. Carlson, Maureen G. Meyers

Hand and Upper Extremity

Objective: The purpose of this study was to identify which conservative occupational therapy (OT) treatment(s) were most effective in reducing pain in patients diagnosed with carpal tunnel syndrome (CTS).

Design: A retrospective study of 222 de-identified treatment cases of patients seen from January 1st, 2004 to December 31st, 2013 were examined. Paired sample t-tests determined statistical significance between eight initial and final outcome measures. Binary logistic regressions determined statistical significance of clinically effective treatments that reduced pain at rest and pain with activity.

Setting: The 222 cases were from 31 outpatient rehabilitation clinics offering occupational therapy services.

Subjects: Participants were …

Physical Therapy Non-Treatment Of The Acute Hospital Inpatient, Daniel Lee Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detrimental effects of inactivity and mobility extend to the most ill and injured patients in the acute hospital setting. Facilitating the activity and exercise of these most critical patients often requires the skill and expertise of a physical therapist. When physical therapists are involved in the care of hospital inpatients they experience significant benefits; patients experience fewer secondary complications related to their primary illness or injury, they spend less time in critical care units and less time in the hospital overall, and when they leave they go to less restrictive environments and more comfortable care settings. These known benefits …

Nationwide Acute Care Physical Therapist Practice Analysis Identifies Knowledge, Skills, And Behaviors That Reflect Acute Care Practice, Sharon L. Gorman, Ellen Wruble Hakim, Wendy Johnson, Sujoy Bose, Katherine S. Harris, Molly H. Crist, Karen Holtgrefe, Jennifer M. Ryan, Michael S. Simpson, Jean Bryan Coe

Sujoy Bose

Background and Purpose. Acute care physical therapists have experienced the effects of dramatic changes in health care reimbursement systems and population demographics. Acute care hospitals now serve a patient population of much older, chronically ill patients who are hospitalized for shorter periods of time in a practice environment in which physical therapy staffing resources are often inadequate. The purposes of this study were to document common experiences in the practice of acute care physical therapy and to identify differences in the perceptions of physical therapists with varying levels of experience and in various sizes of acute care facilities. Subjects and …

For Patients With Acute Cerebral Vascular Accident, Is Virtual Reality Gaming More Effective Than Standard Recreational Therapy For The Improvement Of Hand Function?, Amy Marie Sequeira Boeschen, Elizabeth Jeanne Szoboszlay, Martha Welderufael, Kitsum Li

Kitsum Li

To evaluate the safety, feasibility, and efficacy of VR gaming using the Nintendo Wii vs. standard recreational therapy for the improvement of UE function in patients who have experienced a stroke.

Interrater Reliability Of The Wolf Motor Function Test–Functional Ability Scale: Why It Matters, Susan V. Duff, Jiaxue He, Monica A. Nelsen, Christianne J. Lane, Veronica T. Rowe, Steve L. Wolf, Alexander W. Dromerick, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Background. One important objective for clinical trialists in rehabilitation is determining efficacy of interventions to enhance motor behavior. In part, limitation in the precision of measurement presents a challenge. The few valid, low-cost observational tools available to assess motor behavior cannot escape the variability inherent in test administration and scoring. This is especially true when there are multiple evaluators and raters, as in the case of multisite randomized controlled trials (RCTs). One way to enhance reliability and reduce variability is to implement rigorous quality control (QC) procedures. Objective. This article describes a systematic QC process used to refine …

Home-Based Constraint Induced Movement Therapy Poststroke, Stephen Isbel, Christine Chapparo, David Mcconnell, Judy Ranka

The Open Journal of Occupational Therapy

Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors.

Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL).

Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]): Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 – 10.18, …

“I Think Relax, Relax And It Flows A Lot Easier”: Exploring Client-Generated Relax Strategies, Dianne Cirone, Sara E. Mcewen

The Open Journal of Occupational Therapy

Background. Some adult stroke survivors participating in Cognitive Orientation to daily Occupational Performance (CO-OP) treatment programs self-generated relax strategies that have not been explored in previous CO-OP publications. The objective of this study was to describe the process by which adults with stroke used relax strategies and to explore the outcomes associated with their use.

Methods. Secondary analysis of transcripts of intervention sessions from five participants was conducted.

Results. All five participants applied relax strategies after initially observing a breakdown in performance that was attributed to increased fatigue or tension. The relax strategies used by the participants during their occupations …

Psychometric Evaluation Of Self-Report Pain And Disability Measures For Elbow Disorders, Joshua Vincent

Electronic Thesis and Dissertation Repository

Elbow disorders are one of the commonest musculoskeletal problems with a prevalence of 9% in men and 8.1% in women. Patient centered care is the goal of current healthcare delivery models; but optimizing treatment outcome and clinical research is hampered by a lack of outcome measures. Since pain and disability resulting from elbow disorders are experienced differently across individuals, they are best captured by patient reported outcome measures (PROM).

PROMs like the Patient-rated Elbow Evaluation (PREE); American Shoulder and Elbow surgeons – Elbow form (pASES-e) have been developed for use in elbow disorders, but important questions remain about their measurement …

Dr. R. Tait Mckenzie: Pioneer And Legacy To Physiatry., John F. Ditunno, Jr, Richard E. Verville

Department of Rehabilitation Medicine Faculty Papers

No abstract provided.

An Overview Of Cancer Rehabilitation And Exercise In The Literature: Promoting Increased Referrals To Improve Oncology Outcomes, Leslie J. Waltke

Journal of Patient-Centered Research and Reviews

Medical management for malignant neoplastic diseases includes surgery, chemotherapy, radiation, and hormonal and biological therapies. Each of these antineoplastic interventions has unique impacts on physiological, musculoskeletal and functional performance. Cancer rehabilitation is the area of physical medicine responsible for addressing impairments associated with cancer treatment and survivorship, advanced disease and end of life. Although it is expected that more than one-half of persons being treated for cancer will suffer moderate pain and physical and functional decline, and that most will describe fatigue, referrals to rehabilitation are traditionally low. Evidence suggests that referrals to rehabilitation before, during and after treatment for …

Identification Of Functional Parameters For The Classification Of Older Female Fallers And Prediction Of ‘First-Time’ Fallers, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Falls remain a challenge for ageing societies. Strong evidence indicates that a previous fall is the strongest single screening indicator for a subsequent fall and the need for assessing fall risk without accounting for fall history is therefore imperative. Testing in three functional domains (using a total 92 measures) were completed in 84 older women (60–85 years of age), including muscular control, standing balance, and mean and variability of gait. Participants were retrospectively classified as fallers (n = 38) or non-fallers (n = 42) and additionally in a prospective manner to identify first-time fallers (FTFs) (n = 6) within a …

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

UNLV Theses, Dissertations, Professional Papers, and Capstones

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

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

UNLV Theses, Dissertations, Professional Papers, and Capstones

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