Medicine and Health Sciences Commons^™

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Motor Imagery And Action Observation As An Alternative Gait Training Intervention For The Elderly, Matthew F. Cirelli, Brian Fettner, Lindita Ismaili, Danielle Jordan

Dissertations, Theses, and Capstone Projects

Motor imagery (MI) is the mental representation of movement without any body movement. Action observation (AO) is a non-physical method of training, in which the learner observes the action of another individual. Eighteen subjects between ages 60-80 were randomly assigned to 3 training groups, the MI, AO and motor training groups. All subjects were assessed and measured with the Expanded Timed-Get Up and Go (TUG) test and Figure-8-Walk (F8W) test. All three groups yielded a significant improvement in difference in total TUG time (<0.05). When individual aspects of the TUG were considered, the sit to stand component improved in the MI and Motor groups. The results of this study suggest that MI and AO can improve cadence and have an effect mirroring that of motor practice. If utilized properly, MI and AO may be indicated as a rehabilitation intervention adjunct to gait training, and potentially decrease the risk of falls in the elderly population.

The Effects Of Morning Versus Evening Stretching Exercises In Hamstrings Flexibility Gains, Camron Einerman, Emily Eleff, Ana Ilijeska, Aliza Zinberg

Dissertations, Theses, and Capstone Projects

Many human physiological functions, including muscle flexibility, exhibit a pattern over a 24-hour period, known as circadian rhythm. Muscle flexibility and its circadian rhythm have been researched, though much more information is needed, especially regarding the hamstring muscle group. The object of this study was to determine if stretching at different times of the day results in differences in hamstring flexibility. Since muscles and joints are most flexible at night, greater ranges of motion should be available, allowing for a greater degree of stretching to take place. We hypothesize that when utilizing the optimal type, duration, and frequency of stretch, …

Research Components In Curriculum Of Doctor Of Physical Therapy Programs, Stephen Ingrassia, Gary Mulligan, Roman Tverdovskiy, Andy Zhu

Dissertations, Theses, and Capstone Projects

PURPOSE: The purpose of the study is to determine the current Doctor of Physical Therapy program curriculum, as it applies to research classes and research projects. We investigated the current research requirements of various DPT programs nationwide to determine DPT graduates’ preparedness to conduct research post-graduation.

METHODS: Participants of the current study were recent DPT college graduates selected from DPT programs across the United States. Subjects were asked to participate in a brief online survey questionnaire in reference to their DPT program research curriculum.

RESULTS: A total of 215 DPT programs contacted, out of which 39 schools were able to …

Effect Of Monophasic Pulsed Current On The Treatment Of Plantar Fasciitis, Abdullah Alotaibi

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Plantar fasciitis (PF) is one of the most common soft tissue disorders that causes inferior heel and rear foot pain. Monophasic pulsed current (MPC) is a method of electrical stimulation (ES) clinically used to promote and accelerate wound healing processes. The aim of this prospective clinical trial was to investigate the effect of MPC and MPC coupled with plantar fascia specific stretching exercises (SE) in the treatment of PF. Methods: Forty four participants (twenty- two subjects were women; 22 were men with a mean age of 49 ± 10.6 years) diagnosed with PF were randomly allocated to receive MPC …

Integrating Guided Motor Imagery And Cross Education Into Rehabilitation: Scientific Review And Clinical Application, Emily Bouchard

Mahurin Honors College Capstone Experience/Thesis Projects

BACKGROUND: Guided motor imagery and cross education are two concepts that build upon motor programs. Guided motor imagery consists of imagining a specific action, thereby activating the respective motor program without an actual movement. Cross education incorporates contralateral training to activate the motor program of an action to the resting limb. These techniques yield neurological actions that can lead to improved performance outcomes when integrated into physical therapy programs. PURPOSE: This literature review investigated guided motor imagery and cross education within the scientific literature, identified and summarized evident themes and provided suggestions for incorporating these methods into rehabilitation programs. METHODS: …

Development Of A Tool To Assess Children’S Perceptions Of Their Own Balance (The Pediatric Balance Perception Battery): A Pilot Study, Jillian L. Beckett, Ashlee A. Harmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Psychosocial aspects of balance including self-perception, behaviors, and experiences, have been found to contribute to activity limitations and participation restrictions in adults. Clinical tools have been established to measure how adults feel about their own balance and the extent to which fear of falling and other related characteristics interfere with participation. There are no clinical tools presently available to explore these relationships and quantify the extent to which they interfere with activity and participation in children.

Purpose: To develop and test reliability and validity of a tool to evaluate balance self-perception in a pediatric population.

Participants: This sample of …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

The Effects Of A Progressive Exercise Program On Functional Activity And Quality Of Life For Older Overweight Women With Knee Osteoarthritis, Ty Carlson, Devin Edvalson, Tyler Peck, Brad Robison

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose Osteoarthritis (OA) is a common symptomatic condition experienced by older adults, especially in the overweight population, that affects the knees in particular. This study compares the effectiveness of two progressive exercise protocols (walking and stepping) on function and quality of life in older, overweight women with OA. This study includes self-management training and assesses participant selfperceived efficacy in managing OA.

Subjects This is a quasi-experimental design utilizing 16 women ≥ 50 years of age (60.44 ± 6.04) with a BMI > 25 (34.21 ± 7.28) and radiographic diagnosis of OA in at least one knee.

Methods and Measures …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …

Evidence For The Validity Of A Tool For Improved Pressure Ulcer Staging By The Non-Expert In The Live Patient, Janelle Borg, Carrie Johnston, Megan Lucke, Jordan Sinclair

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses.

Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada.

Methods: Subjects assessed 11 wounds on the patients independently. They …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …