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. …

Evidence Based Falls Management Program In The Nursing Home, Deloris Jacobs

Graduate Theses, Dissertations, and Capstones

The cost of fall injuries for both nursing homes and patients can be staggering. Facilities can incur large financial penalties following notices of severe deficiencies from regulatory agencies and will incur substantial legal fees in the event of a wrongful injury or death lawsuit. Patients injured in falls are at risk of increased financial costs for care in the nursing home as well as a lower quality of life. They are likely to incur co-pay or coinsurance costs for care by physicians and other professional services, and costs for rehabilitative services, out of pocket expenses, medical equipment, prescription drugs, and …

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 …

Hip Fracture Evaluation With Alternatives Of Total Hip Arthroplasty Versus Hemiarthroplasty (Health): Protocol For A Multicentre Randomised Trial, Mohit Bhandari, P. J. Devereaux, Thomas A. Einhorn, Lehana Thabane, Emil H. Schemitsch, Kenneth J. Koval, Frede Frihagen, Rudolf W. Poolman, Kevin Tetsworth, Ernesto Guerra-Farfán, Kim Madden, Sheila Sprague, Gordon Guyatt, Ali Oliasharazi, Franklin D. Shuler, Jonathon Salva, James Day, Tigran Garabekyan, Felix Cheung, Linda Morgan, Timothy Wilson-Byrne Md, Mary Beth Cordle

Orthopaedics

Introduction: Hip fractures are a leading cause of mortality and disability worldwide, and the number of hip fractures is expected to rise to over 6 million per year by 2050. The optimal approach for the surgical management of displaced femoral neck fractures remains unknown. Current evidence suggests the use of arthroplasty; however, there is lack of evidence regarding whether patients with displaced femoral neck fractures experience better outcomes with total hip arthroplasty (THA) or hemiarthroplasty (HA). The HEALTH trial compares outcomes following THA versus HA in patients 50 years of age or older with displaced femoral neck fractures.

Methods and …

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 …

Concurrent Validation Of The Dash And The Quickdash In Comparison To Neck-Specific Scales In Patients With Neck Pain, Saurabh Mehta, Joy Macdermid, Lisa Carlesso, Colleen Mcphee

Saurabh Mehta

Study Design. Concurrent validity study. Objective. To examine the validity of the Disabilities of Arm, Shoulder, and Hand (DASH) and the QuickDASH in patients with neck pain in comparison with the Neck Disability Index (NDI), the Cervical Spine Outcome Questionnaire (CSOQ), and the Visual Analogue Scale (VAS) for pain. To examine the agreement between the DASH and the QuickDASH and assess whether the QuickDASH can be used instead of full DASH in patients with neck pain. Summary of Background Data. NDI is commonly used for measuring neck-related disability in patients with neck pain; but it does not offer to assess …

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 …

Heads Up: The Importance Of Brain Rest After A Concussion A Paper Presented To Meet Partial Requirements, Kacie Wilkes

Graduate Research Projects

No abstract provided.

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 …

Effectiveness Of Stretching Of The Flexor Retinaculum With Ultrasonic Therapy In The Management Of Carpal Tunnel Syndrome, Waqar Ahmed Awan, Muhammad Naveed Babur, Misha Ansari, Maria Liaqat

Pakistan Journal of Neurological Sciences (PJNS)

Aims & Objective: The objective of study was to compare the effectiveness of manual stretching of the flexor retinaculum with or without ultrasonic therapy. Methods: The study was started by selecting the 50 patients from the out patients department of Al-nafees Hospital AlipurFarash and National institute of Rehabilitation Medicine Islamabad with history of carpal tunnel syndrome. The 25 patients in experimental group were treated with manual stretching of flexor retinaculum and ultrasound and 25 patients of control group were treated with manual stretching of flexor retinaculum. Every session was started by assessment of improvement of the symptoms in each patient. …

Stroke Rehabilitation In Pakistan: What We Know And What We Need To Do?, Farooq Azam Rathore, Akhtar Waheed

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is one of the leading causes of adult neurological disability all around the globe. There have been some remarkable improvements in the acute management of stroke. These include the use of thrombolysis, development of radiological investigations including computerized tomographic scan and magnetic resonance imaging and establishment of acute stroke units. There have been some promising advances the field of stroke rehabilitation as well in the last three decades.

Diagnostic Issues And Clinical Spectrum Of Childhood Degenerative Brain Diseases, Tipu Sultan, Ashfa Ameer Khan, Muhammad Arshad Khawaja, Zia Ur Rahman, Ahsan Waheed Rathore

Pakistan Journal of Neurological Sciences (PJNS)

To find out the spectrum of clinical presentation and typesof neurodegenerative disorders of childhoodin tertiary care child neurology centre of Pakistan. To find out the role of brain imaging in the diagnosis of degenerative brain disorders in children. Methods: It will bea retrospective, descriptive study conducted at department of paediatric neurology,The Children’s Hospital, Institute of child health, Lahore, Pakistanfrom January 1st,2004 to December 31,2013 (10 years). A total of 22,737 patients were admitted in the Paediatric Neurology department in the above said period. Out of them 366 children fulfilled the inclusion criteria. History, clinical examination and relevant investigations were evaluated …

A Case Report Of Joubert Syndrome In Adult Presenting With Seizures, Ramla Nayaib Hashmi, Umm Ul Kiram

Pakistan Journal of Neurological Sciences (PJNS)

Joubert syndrome (JS) is rare autosomal recessive condition characterized by hypotonia, ataxia, psychomotor delay, and variable occurrence of oculomotor apraxia and neonatal breathing abnormalitie,intellectual disability, and specific mid-hindbrain malformation (“molar tooth sign”, MTS) We reportthe case of Joubert syndrome in a 32 years old female patient presenting with intellectual impairment, breathing abnormal breathing patterns like tachypnea followed by apnea ataxia, and seizures. She was diagnosed on the basis of Magnetic Resonance Imaging (MRI) and clinical features. JoubertSyndrome should be considered in all patients presenting with hypotonia, ataxia, nystagmus, breathing abnormalities and developmental delay. Its neuroimaging hallmarks include molar tooth sign …

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 …

Learning What High Quality Compassionate Care Means For Cancer Patients And Translating That Into Practice, Fiona Mckenzie, Katherine Joel, Charlotte Williams, Kathy Pritchard-Jones Professor

Patient Experience Journal

In 2010, UCLPartners, a partnership of health care providers and universities in North Central London, began a collaboration with local commissioners that aimed to think about cancer care and diagnosis differently. Understanding that a good patient experience can only be delivered by putting patients first and working together along their journey from symptoms to recovery, we brought clinical leaders together with patients to think about how to improve outcomes for patients, outside institutional barriers. From the very beginning this new network, an integrated cancer system, focused on understanding what mattered most to patients and organising how it worked and how …

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.