Medicine and Health Sciences Commons^™

Mitigating Risk Factors For Disease Progression In Patients With Varus Gonarthrosis, Angelo Boulougouris

Electronic Thesis and Dissertation Repository

Knee osteoarthritis (OA) is a leading cause of disability worldwide. Its growing burden is related to an aging population, obesity and physical inactivity. The progression of knee OA involves both biomechanical and systemic mechanisms. Known risk factors that might be altered through interventions include lower limb alignment, the distribution of loads across the knee during walking, body composition and muscular strength. The overall purpose of this thesis was to evaluate the effects of multi-modal, rehabilitative and surgical interventions that target different risk factors for disease progression in patients with medial compartment knee OA and varus mal-alignment (varus gonarthrosis). The thesis …

A Pilot Study To Investigate Concerns In Patients Undergoing Neck Dissection Surgery, Daniel Sundar Raj Arulananda Doss

Electronic Thesis and Dissertation Repository

Abstract:

This study investigates concerns in patients undergoing neck dissection surgery. Forty patients were recruited at Pre-surgery, Discharge and 1-month Post-surgery. The Patient Concerns Inventory - Level of Importance questionnaire (PCI-LOI), Shoulder Pain and Disability Index (SPADI), Neck Dissection Impairment Index (NDII) and the University of Washington - Quality of Life questionnaire (UWQOL) were used.

The study identified "Anxiety" at Pre-surgery and "Appearance" at Discharge and 1-month Post-surgery as the important patient concerns. Patients’ concerns were found to change over time. Support for cross-sectional convergent validity of the PCI-LOI was evidenced by significant correlations between the PCI-LOI and the UWQOL …

Venoarterial Extracorporeal Membrane Oxygenation (Ecmo) For Support During Whole Lung Lavage For Pulmonary Alveolar Proteinosis., Hitoshi Hirose, Julie Monteagudo, Nicholas C. Cavarocchi, Boyd Hehn, Naveed Hasan

Nicholas C Cavarocchi MDJ

INTRODUCTION ECMO as support during whole lung lavage (WLL) for pulmonary alveolar proteinosis is reserved for severe cases where oxygenation is inadequate to support the patient using the ventilator alone. While most publications describe a venovenous cannulation with variable results we present a successful case using venoarterial cannulation and discuss the potential benefits of this mode of ECMO support. CASE PRESENTATION We present the case of a 44 year old female with a past medical history of Behcets disease and a BMI of 37 who was diagnosed with pulmonary alveolar proteinosis (PAP) on a lung biopsy after presenting with dyspnea. …

Clinical Feasibility Of Noninvasive Visualization Of Lymphatic Flow With Principles Of Spin Labeling Mr Imaging: Implications For Lymphedema Assessment, Swati Rane, Paula M C Donahue, Ted Towse, Sheila Ridner, Michael Chappell, John Jordi, John Gore, Manus J. Donahue

Peer Reviewed Articles

Purpose

To extend a commonly used noninvasive arterial spin labeling magnetic resonance (MR) imaging method for measuring blood flow to evaluate lymphatic flow.

Materials and Methods

All volunteers (n = 12) provided informed consent in accordance with institutional review board and HIPAA regulations. Quantitative relaxation time (T1 and T2) measurements were made in extracted human lymphatic fluid at 3.0 T. Guided by these parameters, an arterial spin labeling MR imaging approach was adapted to measure lymphatic flow (flow-alternating inversion-recovery lymphatic water labeling, 3 × 3 × 5 mm) in healthy subjects (n = 6; mean age, 30 years …

Inter-Rater Reliability Of Lumbar Segmental Instability Tests And The Subclassification, Faisal Mohammad Alyazedi

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: This study investigated the inter-rater reliability of three structural end-range lumbar segmental instability tests with the highest positive Likelihood Ratio against flexion-extension radiographs, and three functional mid-range clinical tests that predict the success of lumbar stabilization exercises in patients with recurrent or chronic low back pain (R/CLBP). It also investigated the reliability of lumbar segmental instability subclassification as: Functional, Structural and Combined Instability. Method: 40 adult with R/CLBP patients (30 men and 10 women), 18 to 80 years of age, underwent repeated measurements of specific clinical tests for structural or functional lumbar segmental instability. Results: Other than the Lack …

Injuries Common To Tactical Personnel (A Multidisciplinary Review), Rob Orr, Michael Stierli

Rob Marc Orr

No abstract provided.

The 30-15 Intermittent Fitness Assessment As A Predictor Of Injury Risk In Police Recruits, Rob Orr, Michael Stierli, Ben Hinton, Michael Steele

Rob Marc Orr

Police recruits with lower intermittent metabolic fitness as measured by the 30-15 Intermittent Fitness Test are at a greater risk of sustaining an injury or illness during police recruit training.

The Impact Of Load Carriage On Mobility And Marksmanship Of The Tactical Response Officer, Simon D. Carlton, Rob Orr, Michael Stierli, Patrick D. Carbone

Rob Marc Orr

The loads carried by specialist tactical police officers may decrease their mobility over short distances but improve their marksmanship performance at close range.

Extreme Conditioning Programs And The Tactical Athlete, Rob Orr

Rob Marc Orr

No abstract provided.

Contrais: Conservative Treatment For Adolescent Idiopathic Scoliosis: A Randomised Controlled Trial, Allan Abbott, Hans Moller, Paul Gerdhem

Allan D. Abbott

Background: Idiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in children and adolescents. Recent reviews on bracing and exercise treatment have provided some evidence for effect of these interventions. The purpose of this study is to improve the evidence base regarding the effectiveness of conservative treatments for preventing curve progression in idiopathic scoliosis. Methods/design: Patients: Previously untreated girls and boys with idiopathic scoliosis, 9 to 17 years of age with at least one year of remaining growth and a curve Cobb angle of 25–40 degrees will be included. A total of 135 participants will be randomly …

Endurance And Fatigue Characteristics Of The Neck Muscles In Patients With Cervical Radiculopathy, Marie Halvorsen, Allan Abbott, Anneli Peolsson, Asa Dedering

Allan D. Abbott

Purpose: The aim of the study was to compare myoelectric manifestation in neck muscle endurance and fatigue characteristics during sub-maximal isometric endurance test in patients with cervical radiculopathy and asymptomatic subjects. An additional aim was to explore associations between primary neck muscle endurance, myoelectric fatigability, and self-rated levels of fatigue, pain and subjective health measurements in patients with cervical radiculopathy.

Methods: Muscle fatigue in the ventral and dorsal neck muscles was assessed in patients with cervical radiculopathy and in an asymptomatic group during an isometric neck muscle endurance test in prone and supine. 46 patients and 34 asymptomatic subjects participated. …

Examining The Shift In Occupational Identity After A Brain Injury, Mikelle Bryson-Campbell

Electronic Thesis and Dissertation Repository

Occupational identity is defined by Kielhofner (2002) as a sense of who we are as an occupational being, based on our past, current, and future occupational roles. When a life disruption occurs such as a brain injury (BI) and the disruption impacts the ability to conduct an occupation deemed meaningful an important process of transition occurs (Muenchberger, Kendall, & Neal, 2008). In turn occupational identity may shift to reflect the current health and economic status of the individual and what occupations are judged as meaningful.

The current study examined the shift in occupational identity in BI survivors in a two …

Comparing The Cumulative Pain Patients Experience Waiting For Knee Arthroplasty To Their Postoperative Pain, Eric S. Schwenk, Richard H. Epstein, Md, Cphims, Franklin Dexter

Department of Anesthesiology Faculty Papers

Introduction: Reduction of pain is a major goal of anesthesiologists treating patients undergoing knee arthroplasty. This has been achieved traditionally through the use of regional analgesia. Although these techniques decrease postoperative pain, they inherently do not affect the longstanding pain patients experience as they wait for surgery. Our objectives were to quantify: 1) the decrease in pain achieved by surgical joint replacement; and 2) the decrease in postoperative pain achievable through femoral nerve blocks versus opioids. From a systems-based perspective, we wanted to determine how much reduction in waiting time before surgery would be necessary to achieve an equal cumulative …

Interprofessional Socialization And Dual Identity Development Amongst Cross-Disciplinary Students, Hossein Khalili

Electronic Thesis and Dissertation Repository

The purpose of this study was to develop and test an interprofessional socialization (IPS) framework through assessing the impact of an IPS-based interprofessional education program on interprofessional socialization and dual identity development among health professional students. Although health professional educational programs have been successful in equipping graduates with skills, knowledge and professionalism, the emphasis on specialization and profession-specific education has enhanced the development of a uniprofessional identity, which has been found to be a major barrier towards Interprofessional Person-Centered Collaborative Practice (IPCPCP). Despite the growing acknowledgment of IPS in the current IPE and collaborative practice literature, there is a lack …

In Vitro Manual Therapy And Biorobotic Simulation Of Glenohumeral Joint Mobilization Techniques, Hunter Johnson Smith

Theses and Dissertations (ETD)

Physical therapists (PT) employ mobilization techniques for restoring range of motion to joints. Few studies have attempted to quantify the biomechanics of manual therapy on the glenohumeral (GH) joint. The objectives of this study were to develop an in vitro protocol to determine the biomechanical effects of joint mobilization on the GH joint, and to then simulate these mobilizations in the University of Tennessee Health Science Center (UTHSC) Joint Implant Biomechanics Laboratory’s Robotic Testing Platform (RTP).

The GH joint is an incredibly shallow socket joint. This gives the joint an unusually large range of motion (ROM) compared to other ball …

Oncology Section Task Force On Breast Cancer Outcomes: Scapular Assessment, Mary Insana Fisher, Pamela K. Levangie

Physical Therapy Faculty Publications

Background: Functional deficits and changes in scapular mechanics following breast cancer (BC) treatments have been documented. Scapular assessment is important when examining the shoulder in survivors of breast cancer to document the need for or effectiveness of physical therapy intervention. The Oncology Section Task Force on Breast Cancer Outcomes sought to identify scapular examination tools that can be recommended for routine use in individuals treated for BC.

Methods: A systematic review of the literature on scapular measures was conducted. Relevant studies were examined for psychometric properties and clinical usefulness. Each method was given a recommendation score based on the Breast …

Household Wealth And Neurocognitive Development Disparities Among School-Aged Children In Nepal., Shivani A Patel, Laura E Murray-Kolb, Steven C Leclerq, Subarna K Khatry, James M. Tielsch, Joanne Katz, Parul Christian

Global Health Faculty Publications

BACKGROUND: Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal.

METHODS: We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home …

Hirayama Disease, A Rare Cause Of Posture Related Cord Compression: A Case Report From Radiological Perspective, Shumaila Arooj, Fatima Mubarak, Muhammad Azeemuddin, Zafar Sajjad, Wasey Jilani

Department of Radiology

Hirayama Disease is a disease of young adults lying in the age group between twenty to thirty years. It is an extremely uncommon disorder. Its other synonyms are juvenile muscular atrophy of the distal upper extremity (JMADUE) or monomelic amyotrophy (MMA). A previously healthy 25-year-old man presented with gradually increasing weakness in both hands for the past few years. There was neither history of trauma nor family history of neuromuscular disease. MRI was advised. Routine cervical sagittal MR images (Non-flexion or extension) revealed cord flattening and atrophy at C5 to C7 levels.There was evidence of syrinx. Flexion MRI was performed …

Grip Strength Is Associated With Marksmanship And Defensive Tactics, But Not Injuries, In Police Recruits, Rob Orr, M. Stierli, B. Hinton, Michael Steele

Rob Marc Orr

No abstract provided.

Grip Strength Is Associated With Marksmanship And Defensive Tactics, But Not Injuries, In Police Recruits, Mike Steele

Mike Steele

No abstract provided.

Short Term Sensory And Vascular Responses To Physical Agent Modalities And Exercise In Healthy Volunteers And Patients With Distal Radius Fracture., Shaguftha Shaik

Electronic Thesis and Dissertation Repository

Currently, there is weak evidence on the effectiveness of different rehabilitation regimens following distal radius fracture (DRF). This thesis evaluated sensory and vascular effects of exercise, thermal and ultrasound interventions that can be used in the mobilization phase (cast removal) after DRF.

Methods

• This thesis includes 3 studies. The first study compared responses to Immersion in Cold water Evaluation (ICE) in the DRF and uninjured hands. Skin blood flow (Sbf), skin temperature (temp.) and sensory perception thresholds (sPT) at 2000Hz for A –beta fibres and at 5 Hz for C fibres were obtained before, immediately after ICE and 10 min …

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

Physical Therapy Faculty Research

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 …

Can The Upper Limb Tension Test 1 (Ultt1) Stand Alone In Diagnosing Median Nerve Compression In Adult Patients With Carpal Tunnel Syndrome (Cts)?, Brianna Palmer

Critically Appraised Topics (CAT)

An appraisal was made on a validity study by Vanti et al, regarding the upper limb neurodynamic test 1 (ULTT1) for diagnosing carpal tunnel syndrome (CTS). The selected paper included current patients at an occupational medicine clinic with suspected CTS and referral for nerve conduction study (NCS).

Using Wainner’s Criteria to indicate a positive ULTT1, calculated sensitivity was 0.9167 and specificity was 0.150. In limiting criteria for a positive test by requiring provocation of 1^st-3^rd digits only, the sensitivity decreased to 0.5417, however specificity increased to 0.70.

This study was effective in defining the inclusion criteria for …

Effect Of Mandibular Mobilization On Electromyographic Signals In Muscles Of Mastication And Static Balance In Individuals With Temporomandibular Disorder: Study Protocol For A Randomized Controlled Tria, Yasmin El Hage, Fabiano Politti, Dowglas F. Magalhaes De Soura, Carolina Marciela Herpich, Igor Phillip Dos Santos Gloria, Cid Andre Fidelis De Paula Gomes, Ana Paula Amaral, Nivea Cristina De Melo, Thais Correa Da Silva, Edgar Edmur Camargo Arruda, Cesar Ferreira Amorim, Inae Caroline Gadotti, Tabajara Oliveira Gonzalez, Fausto Berzin, Sandra Kalil Bussadori, Marilia Barbosa Santos Garcia, Bruno Roberto Borges Barbosa, Daniela Aparecida Biasotto-Gonzalez

Department of Physical Therapy Faculty Publications

Background

The stomatognathic system and dysfunction in this system may be related to postural control. The proposal of the present study is to assess the effect of mandibular mobilization in individuals with temporomandibular disorder using surface electromyography of the muscles of mastication and stabilometric variables.

Methods/Design

A randomized, controlled, blind, clinical trial will be carried out, with the participants divided into three groups: 1) facial massage therapy (control group), 2) nonspecific mandibular mobilization and 3) specific mandibular mobilization. All groups will be assessed before and after treatment using the Research Diagnostic Criteria for Temporomandibular Disorders, surface electromyography of the masseter …

Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi

Collected Faculty and Staff Scholarship

Literature reports the frequent use of shoulder slings by occupational therapists for the management of post-stroke shoulder subluxation despite the low evidence for its efficacy. To understand the clinical context that defies current research evidence, a survey was distributed among California occupational therapists. One hundred and sixty-eight participants responded to the survey, answering questions regarding the occurrences and clinical reasoning in the use of shoulder sling with patients post stroke. 81.5% of the respondents reported the use of shoulder sling. However, the actual sling prescription was limited to 28.4% of their patients. Slings were primarily prescribed for upper extremity management …

Immediate Effect Of Posture Correction Of Trapezius Activity In Computer Users Having Neck Pain – An Electromyographic Analysis, Kanwalpreet Kaur, Pooja Ghosh Das, P. K. Lenka, Shahhawaz Anwer

Internet Journal of Allied Health Sciences and Practice

Objectives: Aberrant activity of the trapezius muscle and associated postural abnormalities have been identified as potential factors for neck pain in computer users, thus postural correction is often advocated. The purpose of this trial was to examine the effect of specific scapular postural correction exercises on middle and lower trapezius activity. Methods: Sixty participants matched for the duration of daily computer use were included in the study. Twenty had no neck pain and exhibited “good” scapular posture (constituting Control group C), while forty reported pain (Neck Disability Index ≥ 15/100) for ≥ 3 months over 12 month period. The latter …

Role-Emergent Model: An Effective Strategy To Address Clinical Placement Shortages, Rosemin Kassam, Mona Kwong, John B. Collins

Internet Journal of Allied Health Sciences and Practice

Purpose: To evaluate the effectiveness of an advanced pharmacy practice experience (APPE) delivered at “role-emergent” placement sites within long-term care (LTC) facilities that are preceptored by off-site community pharmacists.Method: Seven LTC facilities participated: five newly recruited test sites preceptored by off-site pharmacists who supervised students remotely (“role-emergent” placements), and two previously established hospital-based facilities with on-site pharmacists who provided continuous student supervision (“role-established” placements) as a comparison group. Students participated in pre-APPE training. Both qualitative and quantitative methods were used to obtain student learning performance on 13 pre-defined learning objectives and 21 indicators of site resources and skills-development opportunities. Structured …

Genetic Engineering And The Pursuit Of Human Perfection, K. C. Pugh

CedarEthics Online

The idea of perfection has always captivated the attention of people across the ages. Whether in the form of gods, nature, or role models, people have always looked towards some form of the purest ideal. Perfection is not a novel idea by any means; however, it is only in recent years that human beings have actually sought to achieve it.

Genetic Engineering And The Pursuit Of Human Perfection, K. C. Pugh

Student Papers

The idea of perfection has always captivated the attention of people across the ages. Whether in the form of gods, nature, or role models, people have always looked towards some form of the purest ideal. Perfection is not a novel idea by any means; however, it is only in recent years that human beings have actually sought to achieve it.

Vest Chest Physiotherapy Airway Clearance Is Associated With Nitric Oxide Metabolism., Joseph H. Sisson, Todd A. Wyatt, Jacqueline A. Pavlik, Pawanjit S. Sarna, Peter J. Murphy

Journal Articles: Pulmonary & Critical Care Med

Background. Vest chest physiotherapy (VCPT) enhances airway clearance in cystic fibrosis (CF) by an unknown mechanism. Because cilia are sensitive to nitric oxide (NO), we hypothesized that VCPT enhances clearance by changing NO metabolism. Methods. Both normal subjects and stable CF subjects had pre- and post-VCPT airway clearance assessed using nasal saccharin transit time (NSTT) followed by a collection of exhaled breath condensate (EBC) analyzed for NO metabolites (NO x ). Results. VCPT shorted NSTT by 35% in normal and stable CF subjects with no difference observed between the groups. EBC NO x concentrations decreased 68% in control subjects after …