Medicine and Health Sciences Commons^™

Republication Of "Uses Of Braces And Orthotics For Conservative Management Of Foot And Ankle Disorders"., Osama Elattar, Tyler Smith, Adam Ferguson, Daniel Farber, Keith Wapner

Orthopedic Surgery Resident Research

Nonsurgical management is almost always considered the first-line treatment for the vast majority of foot and ankle pathologies. Foot orthoses, shoe modifications, and therapeutic footwear are considered essential tools for successful conservative management of different foot and ankle disorders. Orthopedic foot and ankle surgeons should have a meticulous understanding of the lower extremity biomechanics as well as the pathoanatomy and the sequelae of diseases affecting the foot and/or ankle. This is essential to the understanding of the desired effects of the different inserts, orthotics, shoe modifications, or braces that may be prescribed for these conditions. In this article, we will …

Not All Patients Need Supervised Physical Therapy After Primary Total Knee Arthroplasty: A Systematic Review And Meta-Analysis., Yash P Chaudhry, Hunter Hayes, Zachary Wells, Efstratios Papadelis, Harpal S Khanuja, Carl Deirmengian

Orthopedic Surgery Resident Research

Although postoperative physical therapy (PT) has long been considered essential to successful total knee arthroplasty (TKA) recovery, recent literature has suggested that unsupervised home exercise regimens may offer similar benefits to formal supervised sessions. We aimed to compare objectively measured physical function and subjective patient-reported outcomes (PROs) between primary TKA patients who received formal supervised physical therapy sessions and those who received unsupervised home exercise regimens after discharge. Six electronic databases were queried to identify randomized controlled trials comparing supervised physical therapy to unsupervised home exercise regimens in primary TKA patients after discharge. Outcomes of interest included change from baseline …

Unsupervised Home Exercises Versus Formal Physical Therapy After Primary Total Hip Arthroplasty: A Systematic Review, Yash P. Chaudhry, Hunter Hayes, Zachary Wells, Efstratios Papadelis, Alfonso Arevalo, Timothy Horan, Harpal S Khanuja, Carl Deirmengian

Orthopedic Surgery Resident Research

Historically, postoperative exercise and physical therapy (PT) have been viewed as crucial to a successful outcome following primary total hip arthroplasty (THA). This systematic review and meta-analysis aimed to assess differences in both short- and long-term objective and self-reported measures between primary THA patients with formal supervised physical therapy versus unsupervised home exercises after discharge. A search was conducted of six electronic databases from inception to December 14, 2020, for randomized controlled trials (RCTs) comparing changes from baseline in lower extremity strength (LES), aerobic capacity, and self-reported physical function and quality of life (QoL) between supervised and unsupervised physical therapy/exercise …

Gunshot Wound To The Chest With Retained Epicardial Bullet., Toba Bolaji, Abuoma C Ekpendu, Frederick Giberson

Transitional Year

Gunshot wounds remain the most common cause of penetrating injuries in children and adolescents and the second leading cause of death among youth in the United States. Penetrating cardiac injuries carry a significantly increased mortality rate. The extent of damage caused depends on the type of firearm, the bullet used, the velocityand the trajectory. Therefore, rapid diagnosis and treatment is of the utmost importance. We report a case of a 19-year-old boy who presented to ouremergency department (ED) after sustaining a gunshot wound (GSW) to the right chest. In the ED, the patient was stabilized and a large hematoma was …

Is Tranexamic Acid Effective In Reducing Postoperative Blood Loss In Adult Patients With Lumbar Degenerative Disease Who Are Undergoing Posterior Lumbar Spinal Fusion Surgery?, Natalie L. Cervelli

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is tranexamic acid effective in reducing postoperative blood loss in adult patients with lumbar degenerative disease who are undergoing posterior lumbar spinal fusion surgery?”

STUDY DESIGN: A review of two double-blinded randomized controlled trials (RCT) and one RCT.

DATA SOURCES: All articles were peer-reviewed and published in English between 2017-2020. They were found through PubMed and chosen based on ability to answer the objective.

OUTCOMES MEASURED: The outcome measured in all articles was the objective amount of blood loss in mL contained in drainage output through …

Does The Application Of Kt Tape Decrease Pain In Chronic Low Back Pain?, Jordan Vitelli

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine “Does the application of KT tape decrease pain in chronic low back pain?”

Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2018 and 2019.

Data Sources: The three RCTs were published in English in peer reviewed journals and obtained from PubMed. The studies were selected based on their relevance to the clinical question.

Outcome Measured: The outcome measured within all three RCTs was pain intensity using the Visual Analog Scale (VAS). The VAS scoring ranges from 0 to 10, defining 0 as no pain …

No Pain No Gain: Student Performance Over Time On The Revised Neurophysiology Of Pain Questionnaire, Ruth Maher, Jeanne P. Welch

Research Day

Purpose/Hypothesis: Core competencies in pain management for pre-licensure health professional education have been established. The purpose of this study was to assess the effect of 10-hours of pain neurophysiology education (PNE) on physical therapy students' understanding of pain and retention of key concepts.

Number of Subjects: Thirty-three second-year physical therapy students.

Materials and Methods: Ten hours of PNE was embedded in a clinical neuroscience course which included a 2-hour lab assignment called “The Matrix”. The content was guided by key principles recommended by the International Association for the study of Pain (IASP). The lab assignment included case studies that required …

Bridging The Gap: The Lived Experience Of Women With Diastasis Recti Abdominis, Jennifer Wiley, Ruth Maher

Research Day

Research on Diastasis recti abdominis (DRA) has primarily focused on diagnostic tools, surgical and conservative treatments. Despite the association of significant physical symptoms and impact on quality of life, evidence is absent regarding knowledge or education provided to women about this condition.

Purpose: This study explored the lived experience of women who either self-identified or were medically diagnosed with DRA. A deeper insight into the experience of women with DRA may serve to enhance the patient-provider interaction during this critical time.

Methods: Qualitative methodology with a basic interpretive approach and purposive sampling was used. Participants shared their experiences through a …

A Clinical Review Of Robotic Navigation In Total Knee Arthroplasty: Historical Systems To Modern Design., Ahmed Siddiqi, Timothy Horan, Robert M Molloy, Michael R Bloomfield, Preetesh D Patel, Nicolas S Piuzzi

Orthopedic Surgery Resident Research

Robotic-assisted total knee arthroplasty (RA-TKA) has shown improved reproducibility and precision in mechanical alignment restoration, with improvement in early functional outcomes and 90-day episode of care cost savings compared to conventional TKA in some studies. However, its value is still to be determined.Current studies of RA-TKA systems are limited by short-term follow-up and significant heterogeneity of the available systems.In today's paradigm shift towards an increased emphasis on quality of care while curtailing costs, providing value-based care is the primary goal for healthcare systems and clinicians. As robotic technology continues to develop, longer-term studies evaluating implant survivorship and complications will determine …

Effect Of Motivational Behaviors And Race/Ethnicity On Academic Success In Physical Therapy Students: A Preliminary Study, Philip Fabrizio

PCOM Scholarly Papers

Objectives: Doctor of Physical Therapy (DPT) program admissions criteria and markers indicative of academic success appear to be mismatched. Acceptance into a DPT program implies that students have developed self-regulated learning strategies however, motivation behaviors are not typically assessed during the admissions process. The aim of this study was to determine direct effects of motivational behaviors and race/ethnicity on academic success and the moderating effect of race/ethnicity on motivational behaviors. Methods: Thirty-three first-year DPT students participated during their first foundational course, clinical anatomy. Motivation subscales from the motivated strategies for learning questionnaire (MSLQ) were used to assess student motivation behaviors …

Which Motivational Behaviors Impact Success In A Clinical Anatomy Course For Entry Level Doctor Of Physical Therapy Students?, Philip Fabrizio, Anne M.R. Agur, Shannon L. Groff

PCOM Scholarly Papers

Objectives: The motivational behavior of self-efficacy for learning and performance was correlated with academic success in Doctor of Physical Therapy (DPT) students taking clinical anatomy, the first foundational course in the program. Students’ motivation strategies have been reported to be important factors in academic success, however, these strategies have not been investigated in DPT students. Therefore, the purpose of this study was to determine if course grade in clinical anatomy was correlated with the motivation subscales of the Motivated Strategies for Learning Questionnaire (MSLQ).Materials and Methods: The MSLQ was administered to 33first-year DPT students who consented to participate in the …

Can Spinal Manipulation Be Used As An Effective Method To Reduce Pain For Patients With A Lumbar Disc Herniation Compared To Traditional Methods?, Aaron Blady

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “can spinal manipulation be used as an effective method to reduce pain for patients with a lumbar disc herniation compared to traditional methods?”

STUDY DESIGN: A systematic review of one randomized controlled trial, one randomized controlled pilot study, and one double-blind, randomized control trial published in 2010 and after. All studies were published in English.

DATA SOURCES: Data sources for this review were articles published in peer-reviewed journals using PubMed Database.

OUTCOME(S) MEASURED: The outcome measured was change in pain. This was accomplished by using a …

Is Massage Therapy Effective In Reducing Labor Pain In Intrapartum Women?, Veronica K. Pham

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether massage therapy is an effective intervention in reducing pain in intrapartum women.

STUDY DESIGN: A systematic review of two randomized controlled trails (RCTs) and one case study published between 2009-2019. All studies were published in English.

DATA SOURCES: The two double-blind RCTs and case study were found via PubMed. All sources were published in peer reviewed journals and chosen based on their relevance to the clinical question.

OUTCOMES: Pain reduction was the outcome measured in all three studies using visual analog scale. In this systematic review, pain level …

Do Schroth Exercises Improve Quality Of Life For Patients With Idiopathic Scoliosis?, Lindsay N. Drubel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Schroth exercises improve quality of life for patients with idiopathic scoliosis.

STUDY DESIGN: A systematic review of two randomized controlled trials and one case series published between 2015 and 2016 which present patient-oriented evidence.

DATA SOURCES: The articles chosen for this review were found using the PubMed Database.

OUTCOME MEASURED: The outcome measured was patient reported scoliosis specific quality of life, which includes patient reported changes in pain. This outcome was assessed through the Scoliosis Research Society 23 questionnaire, the Scoliosis Research Society 22r questionnaire, and …

Does Irish Set Dancing Effectively Improve The Quality Of Life In Patients With Parkinson’S Disease?, Kenneth Anderson Jr

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this evidence based medicine (EBM) review was to determine whether or not Irish set dancing effectively improves the quality of life in patients with Parkinson’s Disease.

STUDY DESIGN: A systematic review of three peer-reviewed studies published between the years of 2013 though 2016.

DATA SOURCES: The first study reviewed was a pilot multicenter randomized controlled trial (RCT), the second study reviewed was a single blind, parallel group RCT, while the third study was an observational case study. All three studies were selected based on their relevance to the clinical question and their inclusion of patient reported …

Is Pain Intensity Reduced By The Application Of Kinesio Tape In Postmenopausal Women With Mild To Moderate Venous Insufficiency?, Yeimi Ortiz Chavez

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine (EBM) review is to determine whether or not “Is pain intensity reduced by the application of kinesio tape in postmenopausal women with mild to moderate venous insufficiency?”

STUDY DESIGN: A systemic review compiling data from three randomized controlled trials between 2013 and 2014, all in the English language.

DATA SOURCES: Three pertinent studies evaluating the reduction of pain intensity in postmenopausal women with mild to moderate chronic venous insufficiency were included in this review. Sources were selected using PubMed and Cochrane Library.

OUTCOME(S) MEASURED: Patient perception of pain using a Visual …

Is Pulse Ultrasound Effective At Decreasing Pain In Patients With Knee Osteoarthritis?, Shannon Dieffenderfer

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is pulse ultrasound effective at decreasing pain in patients with knee osteoarthritis?”

Study Design: Review of three double-blind, randomized, controlled trials published after the year 2013.

Data Sources: Studies were published in peer-reviewed journals, found using PubMed database searches and were selected based on patient-oriented outcomes.

Outcome Measured: The pain Visual Analog Scale is a unidimensional, continuous scale of pain intensity usually 10cm in length, anchored by “no pain” (score of 0) and “worst imaginable pain” (score of 10). Patients self-report by placing a line on …

Is The Use Of Kinesio Tape (Kt) Effective In Reducing Pain Postoperative Anterior Cruciate Ligament (Acl) Surgery?, Annabeth D. Pruett

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not is the use of Kinesio Tape (KT) effective in reducing pain post-operative anterior cruciate ligament (ACL) surgery.

STUDY DESIGN: Review of three randomized control trial studies that were published between 2013 and 2017 in peer reviewed journals. Two articles were published in English language while one article was published in Polish language then translated to English language.

DATA SOURCES: All three randomized control trials were found via PubMed

OUTCOMES MEASURED: The primary outcomes measured by the patient and investigator was the efficacy of KT in the …

Are Plasma Rich Platelets More Effective In Decreasing Chronic Lower Back Pain As Compared To Epidural Injections In Young Adults?, Linda M. Leones

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not PRP injections are more effective in decreasing chronic lower back pain as compared to epidural injections in young adults.

Study Design: Systematic review of three English language randomized controlled trials (RCTs), all published after 2012.

Data Sources: Two double-blind RCTs and one randomized open blinded end point (PROBE), which analyzed the effectiveness of PRP and epidural injections in young adults with chronic lower back pain. All studies were found using PubMed.

Outcome(s) Measured: Each of the articles analyzed the pain relief and function ability stated by …

Can Yoga Therapy Help To Decrease Osteoarthritis-Related Pain In Adults With Knee Osteoarthritis?, Justin Mahr

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not yoga therapy can help to decrease osteoarthritis-related pain in adults with knee osteoarthritis.

Study Design: A review of two randomized controlled trials and one randomized control trial pilot study that were published in English in peer-reviewed journals after 2007.

Data Sources: All articles were selected from peer-reviewed journals and found via PubMed.

Outcome(s) Measured: Patient perception of pain using either a Walking Numerical Rating Scale (WNRS) and/or a Western Ontario and McMaster Universities OA Index scale (WOMAC).

Results: All three studies …

Is Dry Cupping Therapy Effective For Non-Specific Chronic Neck Pain In Adults?, Kaila Muser

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective Evidence Based Medicine (EBM) review is to determine whether or not “Dry Cupping Therapy is effective for non-specific chronic neck pain in adults?”

Study Design: Review of 3 randomized controlled trials (RCT)

Data Sources: All studies were published in peer-reviewed journals found in PubMed or Cochrane Database.

Outcomes measured: Patients were divided into two groups, the experimental group or the control group. Patients in the experimental group received dry cupping therapy. Patients in the control group received no therapy at all, normal standard of care (physiotherapy, sports activities, analgesics), or progressive muscle relaxation. The …

Does Resistance Training Reduce Low Back Pain?, Lauren N. Carosi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not resistance training reduces low back pain.

STUDY DESIGN: Review of three English language primary studies published in 2011, 2014, and 2015.

DATA SOURCES: Randomized controlled and clinical trials comparing resistance training (kettlebell training, graded activity, TOTRX, LEXT) to physiotherapy exercise and no exercise intervention, found using PubMed.

OUTCOME MEASURED: Severity of pain in the low-back area, measured using Pain Numerical Rating Scale (NRSpain) and pain visual-analog scale.

RESULTS: Two out of three studies found that resistance training reduced low back pain in comparison to a control …

Is The Use Of Kinesio Tape (Kt) Effective In Improving Gross Motor Functionality Throughout The Sit-To-Stand Transfer Activity In Children With Cerebral Palsy (Cp)?, Rachel L. Dodies

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Kinesio tape (KT) is effective in improving gross motor functionality throughout the sit-to-stand transfer activity in children with cerebral palsy (CP).

Study Design: Review of three English language primary studies published between 2011 and 2015.

Data Sources: One not-blinded randomized controlled trial (RCT), one single-blind RCT, and one cross-sectional study were found using the PubMed database.

Outcomes Measured: The outcomes that were measured were improvement in gross motor function, sitting posture, functional independence, balance, ambulation, and agility from sitting to standing. This …

Does Nebulized Hypertonic Saline Solution Decrease Hospital Admission Rates When Compared To Nebulized Normal Saline In Children Less Than Or Equal To 24 Months Old With Bronchiolitis?, Korie Alecxih

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not nebulized hypertonic saline solution reduces hospital admission rates when compared to nebulized normal saline solution in children less than or equal to 24 months of age diagnosed with acute bronchiolitis in the emergency department setting.

STUDY DESIGN: Systematic review of three randomized, double-blind, placebo controlled trials in the English language all published in 2014.

DATA SOURCES: Data sources obtained for this review were articles published in peerreviewed journals found using PubMed Database.

OUTCOMES MEASURED: The outcome measured was hospital admission rate. Hospital admission rate is calculated …

Can The Nintendo Wii Be Used As A More Effective Method Of Rehabilitation Than Traditional Physiotherapy Exercises For Patients With Knee Reconstruction Surgery?, Samantha Snyder

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the Nintendo Wii can be used as a more effective method of rehabilitation than traditional physiotherapy exercises for patients with knee reconstruction surgery?

STUDY DESIGN: Review of three English language primary studies, published after 1999.

DATA SOURCES: Two randomized controlled trials (RCTs) and one case study with no comparison group were found using PubMed. These studies analyzed Nintendo Wii intervention in patients that underwent knee reconstructive surgery in need of rehabilitation.

OUTCOME MEASURED: The outcome measured was improvement in balance through use of the Activity-Specific Balance …

Osteopathic Manipulative Medicine (Omm) And Reduction Of Nsaid Use In Low Back Pain: A Pilot Study, Kristopher Kelly

PCOM Biomedical Studies Student Scholarship

This randomized controlled pilot study is to determine if a combination of muscle energy and soft tissue techniques can reduce the amount of daily NSAID use in patients suffering from chronic non-specific low back pain (CNSLBP). Osteopathic manipulative treatment has been shown to be useful in treating low back pain. However, its role in reducing daily NSAID use in CNSLBP patients is unclear. This study was conducted at PCOM from January 2014 to April 2014. By design, patients were to be randomized into either a treatment group consisting of OMT or a control group consisting of a sham OMT. Of …

Is Acupuncture Effective In The Prophylaxis Of Recurrent Urinary Tract Infections In Adult Women?, Caitlin E. Mumford

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is effective in the prophylaxis of recurrent urinary infections in adult women.

STUDY DESIGN: Systematic review of three English language primary studies, published between 1998 and 2003.

DATA SOURCES: Three randomized, controlled trials published after 1996, comparing acupuncture to placebo in the prophylaxis of urinary tract infections were obtained using EBSCOhost and PubMed.

OUTCOMES MEASURED: All three studies measured incidence or absence of urinary tract infections, as defined by distal urinary symptoms and/or bacteriuria of ≥ 105 cfu/ml.

RESULTS: Three …

Is Aztreonam Lysine For Inhalation Effective In The Treatment Of Patients With Cystic Fibrosis And Pseudomonas Aeruginosa Airway Infection?, Christine Shevchenko

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aztreonam lysine for inhalation is effective in the treatment of patients with cystic fibrosis and Pseudomonas aeruginosa airway infection.

STUDY DESIGN: Review of three English language primary randomized controlled trials published in 2008, 2009, and 2011.

DATA SOURCES: Three randomized, double-blind, placebo-controlled studies using Cochrane and Pubmed databases.

OUTCOMES MEASURED: Patient oriented outcomes measured included change in respiratory symptoms measured by the Cystic Fibrosis Questionnaire-Revised and need for additional anti-pseudomonal antibiotics indicative of pulmonary exacerbation.

RESULTS: In both cystic fibrosis (CF) …

Is Electrical Muscle Stimulation Effective In The Progression Of Oral Feeding, For Patients With Dysphagia, Caused By A Stroke?, Kristen Iaconelli

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not electrical muscle stimulation is effective in the progression of oral feeding, for patients with dysphagia, caused by a stroke.

STUDY DESIGN: Review of 3 randomized controlled trials, published between 2008-2009.

DATA SOURCES: All 3 randomized controlled trials were found using the Cochrane database.

OUTCOMES MEASURED: All 3 studies measured subjective swallowing function pre- and post-treatment, however, each trial differed in the way they measured this. Permsirivanich et al used a functional oral intake scale (FOIS), or a 7-point scale reflecting the patient’s report of …

Does Whole Body Vibration (Wbv) Therapy Positively Affect The Motor Skills Of Patients Who Have Been Diagnosed With Parkinson’S Disease?, Courtney Forsyth

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether Whole Body Vibration (WBV) therapy positively affects the motor skills of patients who have been diagnosed with Parkinson’s disease.

STUDY DESIGN: Review of 3 English language primary studies. All three were randomized control trials; one was rater blinded and one double blinded with a placebo.

DATA SOURCES: All of the articles were Randomized Control Trials found using the PubMed database.

OUTCOMES MEASURED: Each of the three studies looked at the symptoms of Parkinson’s disease patients before and after Whole Body Vibration Therapy. Each study used the Unified Parkinson’s Disease …