Medicine and Health Sciences Commons^™

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

Salary Negotiation Dynamics For Athletic Trainers: Insights From Employers On Expectations And Organizational Influences, Julie M. Cavallario, Forrest Andrews, Kendallyn Johnson, Katherine Schalk, Cailee E. Welch Bacon

Rehabilitation Sciences Faculty Publications

Context

While researchers have previously identified that most athletic trainers (ATs) do not negotiate their salary, little is known about employers' expectations and behaviors relative to establishing and negotiating salaries for the ATs they hire.

Objective

To examine employers' expectations and behaviors regarding AT salary negotiation.

Design

Cross-sectional.

Setting

Web-based survey.

Patients or other participants

413 employers who are in a role that requires them to negotiate salary offers with prospective AT employees and who have minimally hired one AT into the organization they work for accessed the survey from a random sample of 7,000 ATs (6% access rate); 324 …

Perceptions Of Leadership Opportunities And Effectiveness Among Athletic Trainers: A Comparison Across Racial And Ethnic Groups, Nicolette A. Harris, Americus H. Williams, Julie M. Cavallario, Cailee E. Welch Bacon

Rehabilitation Sciences Faculty Publications

Context

Diverse representation in athletic training leadership is essential for fostering inclusion and innovation in the profession. Despite efforts to enhance leadership diversity, disparities persist, underscoring the need to explore barriers to leadership and the effectiveness of leadership in meeting the needs of athletic trainers (ATs).

Objective

To examine racial and ethnic differences in ATs' desire, pursuit, and attainment of leadership positions in the profession in addition to perceptions of current leadership effectiveness.

Design

Cross-sectional, web-based survey.

Participants

A purposeful sample of 1,173 racially and ethnically diverse ATs from an organized professional network followed by a random sample of 6,000 …

Case Report: Multifactorial Intervention For Safe Aging In Place, Ashwini Kulkarni

Rehabilitation Sciences Faculty Publications

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the …

The Landscape Of Virtual Reality Use In Mobility Rehabilitation From 2010-2023: A Scoping Review, Danielle T. Felsberg, Reza Pousti, Charlend K. Howard, Scott E. Ross, Louisa D. Raisbeck, Jared T. Mcguirt, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Significant advancements in virtual reality (VR) technology have occurred in the past decade, allowing clinical researchers to take advantage of these reduced barriers to explore the use of VR in patient populations. This scoping review on VR interventions to improve mobility in adults and children focuses on the literature from 2010-2023. A total of 2736 articles were screened and 126 articles met the inclusion criteria. Most of the studies were conducted in inpatient clinical settings (n = 41) and investigated VR interventions to improve balance (n = 118). Less immersive (n = 108) products such as Nintendo Wii or Xbox …

Comparing Immersive And Nonimmersive Clinical Experiences In Athletic Training Education: Effects On Student Engagement And Confidence, Julie M. Cavallario, Shana Pribesh, S. E. Walker

Rehabilitation Sciences Faculty Publications

Context

With the shift to a graduate-level professional degree in athletic training, it was hypothesized that immersive clinical experiences (ICEs) would be more effectively integrated into curricula than non-ICEs (N-ICEs) and better prepare students for practice.

Objective

To longitudinally compare clinical engagement opportunities in ICEs versus N-ICEs and assess if these opportunities are associated with changes in student confidence in performing related tasks.

Design

Prospective, longitudinal, time-diary study using a Web-based survey. Patients or Other Participants: Fifty-three first-year, master’s-level athletic training students from 21 programs.

Main Outcome Measure(s)

Participants reported their type of clinical experience (ICE, N-ICE, or none), the …

How Many Trials Are Needed For Consistent Clinical Gait Assessment?, Charlend K. Howard, Christopher K. Rhea, Jacquelyn R. Moxey, Kyle Langerhans, Paphawee Prupetkaew, Brittany S. Samulski

Rehabilitation Sciences Faculty Publications

Background: Clinical assessment of gait typically consists of patients walking a few trials at various speeds while the clinician assesses performance. Unfortunately, there is no clear guidance on how gait changes across trials, leaving clinicians uncertain about the optimal number of trials needed to observe consistent (non-variable) performance. To address this issue, we examined gait performance from a large dataset of older adults who participated in a community-based comprehensive fall risk assessment. Methods: Community-dwelling, older adults (n = 340; 70.8 ± 7.4 years; 120 men, 220 women) performed gait trials under two conditions: preferred and maximum walking speed. …

Emergency Action Plan Adoption Across Athletic Training Practice Settings, Samantha E. Scarneo-Miller, Rebecca L. Stearns, Christianne M. Eason, Alicia M. Pike Lacy, Rebecca M. Lopez, Zachary K. Winkelmann, Rebecca M. Hirschhorn, Susan W. Yeargin

Rehabilitation Sciences Faculty Publications

Context:

The 2024 NATA Position Statement provides updated recommendations for EAP adoption. Past research on the 2002 statement showed limited adoption by ATs. Assessing current adoption across practice settings offers a clearer picture of the EAP implementation landscape.

Objectives:

To examine ATs' adoption of new EAP best-practice recommendations across practice settings.

Design:

Cross-Sectional study.

Setting:

Online questionnaire.

Patients or Other Participants:

Clinically active ATs (n=614) working in any practice setting (Youth, Secondary School, Division 1 Power 4, Collegiate athletics – Not Power 4, Non-Major Professional Sports, Professional Sports, Non-Sideline).

Main Outcome Measures:

Prevalence of an EAP, adoption of recommendations, and …

An 11-Year (2012-2022) Review Of Journal Of Athletic Training Publication Study Designs And Sample Sizes, Zachary K. Winkelmann, Samantha E. Scarneo-Miller, Emily C. Smith, Ryan M. Argetsinger, Lindsey E. Eberman

Rehabilitation Sciences Faculty Publications

Background

Research findings must be representative by creating a sample of individuals, ensuring the results can be generalized and applicable to a larger population, which has historically been guided by a power analysis. However, the varied research design methods require a unique approach to sampling and a formula for recruitment and size. Therefore, the purpose of this study was to analyze historical data from published manuscripts in the Journal of Athletic Training (JAT) relative to study design and sample sizes. A secondary purpose was to further explore metrics for survey-based research.

Methods

This descriptive analysis explored 1267 publications in each …

The Impact Of Onboarding During Transition To Practice For Newly Credentialed Athletic Trainers, Ashley B. Thrasher, Stacy E. Walker, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context

As new athletic trainers (ATs) transition into their roles, some employers provide extensive orientation and onboarding to assist with the transition to practice (TTP); however, onboarding practices are inconsistent. Understanding how onboarding affects TTP can help employers implement impactful onboarding tactics.

Objective

Examine how the onboarding experience impacted the TTP and the effects of the process on individuals.

Design

Grounded theory.

Setting

Secondary school, hospital/clinic, college/university.

Patients or Other Participants

Seventeen newly credentialed, employed ATs who had graduated from professional masters' programs (11 female, 6 male; age = 25.6 ± 2.2 years) participated in this grounded theory study.

Data …

Understanding Injury-Related Fear In Individuals With Chronic Ankle Instability: A Qualitative Approach, Ashley M. B. Suttmiller, Julie M. Cavallario, Shelby E. Baez, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Context

The Tampa Scale of Kinesiophobia (TSK-11) is used to identify injury-related fear (IR-Fear) in individuals with chronic ankle instability (CAI) and is a predictor of poor health outcomes. Limited knowledge beyond quantitative scores necessitates a deeper, qualitative understanding of IR-Fear to reduce the burden of fear within CAI patients.

Objective

To explore the perceptions and experiences that influence IR-Fear within the CAI population.

Design

Consensual qualitative research.

Setting

Individual semistructured video conference interviews.

Patients or Other Participants

Nine participants with CAI were selected as a follow-up from a web-based questionnaire investigating the fear-avoidance model. Potential participants were contacted based …

High-Resolution Modeling Of Extreme Heat Events With Socioeconomic Consideration: A Real-Case Wrf-Les Approach, Maryam Golbazi, Frank Liu, Yin-Hsuen Chen, Timothy W. Juliano, Heather Richter

ODU Articles

The overarching goals of this work is to explore best practices for micro-scale modeling of a real case, identify relevant phenomena by using high-resolution modeling, and to explore their implications for public health, and climate resilience strategies in Hampton Roads, VA, USA. This project employs the Weather Research and Forecasting (WRF) model to conduct a comprehensive study of Hampton Roads, utilizing a coupled mesoscale to microscale modeling capable of resolving boundary layer turbulence. This study has three primary objectives: (1) to establish the optimal mesoscale to Large-Eddy Simulation (LES) configurations for complex geographical regions such as the Hampton Roads (HR) …

American Society Of Hematology/International Society On Thrombosis And Haemostasis 2024 Updated Guidelines For Treatment Of Venous Thromboembolism In Pediatric Patients, Paul Monagle, Muayad Azzam, Rachel Bercovitz, Marisol Betensky, Rukhmi Bhat, Tina Biss, Brian Branchford, Leonardo R. Brandão, Anthony K.C. Chan, E. Vincent S. Faustino, Julie Jaffray, Sophie Jones, Hassan Kawtharany, Bryce A. Kerlin, Nicole Kucine, Riten Kumar, Christoph Male, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sara K. Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Ayesha Zia, Reem A. Mustafa

Journal Articles: Pediatrics

BACKGROUND: The American Society of Hematology (ASH) guidelines on treatment of pediatric venous thromboembolism (VTE) were published in 2018. In the last 6 years, there has been a 10-fold increase in the number of children involved in VTE treatment trials.

OBJECTIVE: The ASH Committee on Quality and Guidelines agreed to update the pediatric guidelines in conjunction with the International Society on Thrombosis and Haemostasis (ISTH). These ASH/ISTH evidence-based guidelines are intended to support patients, clinicians, and other health care professionals in the management of pediatric patients with VTE.

METHODS: ASH/ISTH formed a multidisciplinary guideline panel to minimize potential bias from …

Introducing The University Of New Mexico 12-Level Functional Scale: A Novel Approach For Assessing Functional Recovery In Orthopaedic Trauma Patients, Devin A. Maez, Rick J. Gehlert, Thomas A. Decoster

Western Journal of Orthopaedics

The University of California at Los Angeles (UCLA) Activity Scale and other common activity scales are primarily used for patients undergoing joint reconstructive surgery. However, no such scale exists for musculoskeletal trauma patients. The authors propose The University of New Mexico (UNM) 12-Level Functional Activity Scale to address this gap in assessing functional activity and managing postoperative care for orthopaedic trauma patients. A comprehensive review of existing scales led to the development of the UNM Scale, emphasizing simplicity, objectivity, and potential benefits in patient education and interdisciplinary collaboration. The UNM Scale provides a structured approach to assess and monitor functional …

Fluoroscopy-Guided Versus 3d Navigated Percutaneous Sacroiliac Screw Fixation: A Comparison Of Radiation Exposure And Surgical Duration, Tyler J. Chavez, Jeremiah M. Langsfeld, Solomon Oloyede, Gordon H. Lee, Urvij Modhia

Western Journal of Orthopaedics

Background: Pelvic ring injuries are complex surgical challenges requiring significant radiation exposure for safe placement of sacroiliac (SI) screw fixation. Traditionally, SI fixation has been performed with conventional C-arm fluoroscopy to guide screw placement. 3D navigated imaging is a technique that uses fluoroscopic scans and a navigation tracker to guide screws in space. The purpose of this study is to characterize a single institution’s experience with navigated SI fixation and the resulting radiation exposure to patient and staff. Methods: Records of 60 patients who underwent SI fixation using either conventional fluoroscopy (43) or 3D navigation (17) were reviewed. Exposure data …

Fishtail Deformity Complication Of Distal Humeral Fractures In Children, Jorge E. Licano, Ryan Price, Devin A. Maez, Selina A. Silva

Western Journal of Orthopaedics

Background: Pelvic ring injuries are complex surgical challenges requiring significant radiation exposure for safe placement of sacroiliac (SI) screw fixation. Traditionally, SI fixation has been performed with conventional C-arm fluoroscopy to guide screw placement. 3D navigated imaging is a technique that uses fluoroscopic scans and a navigation tracker to guide screws in space. The purpose of this study is to characterize a single institution’s experience with navigated SI fixation and the resulting radiation exposure to patient and staff. Methods: Records of 60 patients who underwent SI fixation using either conventional fluoroscopy (43) or 3D navigation (17) were reviewed. Exposure data …

Rare Case Of Fungal Osteomyelitis Affecting An Intramedullary Lag Screw, Matthew C. Watterson, Robert T. Rella, Timothy K. Summers, David Michaeli, Jess Mullens

Western Journal of Orthopaedics

Osteomyelitis is an infection of the bone that is most commonly of bacterial origin. Cases of fungal osteomyelitis are rare, and treatment often requires a prolonged course of antimicrobials. The authors report a case of a 72-year old man with fungal osteomyelitis affecting an intracortical lag screw, which was discovered during fixation of the left femoral shaft following an injury that occurred 68 years after placement of the affected lag screw. Chronic osteomyelitis can be indolent and subclinical, with the patient experiencing no signs or symptoms of the disease despite having bone infection for decades. This condition may become clinically …

Closed Treatment Of Displaced Radial Neck Fracture In An Adult, Nicholas Newcomb, Tomas Holy, Naomi Kelley, Nathan T. Morrell

Western Journal of Orthopaedics

Making up 1.5% to 4.0% of all fractures, radial head and neck fractures are typically treated based on the severity of angulation at the radial neck or if range of motion (ROM) is blocked. In this study, we present a case of a 43-year old woman with a Mason Type 2 radial neck fracture, successfully treated with closed reduction and one week of immobilization, resulting in near anatomic radial neck angulation without the need for operative intervention. The patient returned to work within two weeks and regained full ROM by six months, maintaining near anatomic reduction throughout. Keywords: Elbow Injury; …

Two-Stage Total Knee Arthroplasty (Tka) For A Rigid And Infected Knee: A Rare Case Report Of Aspergillosis, Túlio Vinícius De Oliveira Campos, David G. Kasuya Barbosa, Victor A. Kasuya Barbosa, Santiago Enrique Sarmiento Molina, Guilherme Moreira De Abreu Silva, Marco Antônio Percope De Andrade

Western Journal of Orthopaedics

Knee infection caused by Aspergillus is a rare condition that presents a diagnostic challenge for orthopaedic surgeons and musculoskeletal specialists. This case report aims to describe the treatment of a patient with active articular Aspergillus infection and knee arthrofibrosis through a two-stage total knee arthroplasty (TKA). A 37-year old woman presented with knee arthrofibrosis, which was complicated by an Aspergillus infection. The treatment involved a two-stage procedure: 1) bone cuts for TKA and systemic antibiotic therapy; and 2) TKA with the use of specific antibiotic-loaded cement. The patient has been followed for 30 months, showing no signs of failure.

Proximal Tibia Biplanar Anterior And Lateral Closing Wedge Osteotomy With Concomitant Revision Anterior Cruciate Ligament Reconstruction: A Case Report, Shane H. Johns, Lisandro Nardin, Jessica A. Nelson, Robert Schenck

Western Journal of Orthopaedics

This report documents a unique, successful strategy to manage a failed anterior cruciate ligament reconstruction (ACLR) in the setting of coronal and sagittal plane malalignment. The patient is a 38-year-old man with a history of a failed ACLR who presented with recurrent knee instability. Imaging revealed a posterior tibial slope (PTS) of 17° complicated by a varus malalignment of 10°. A single-stage anterior and lateral closing wedge tibial osteotomy (biplanar) with simultaneous revision anterior cruciate ligament reconstruction was performed. Final radiographic evaluation revealed that the tibial osteotomy healed with correction of coronal alignment to a physiologic 3° varus and a …

Recurrent Baker’S Cyst In A Pediatric Athlete: A Case Report, Gaurav Singh, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

Also known as popliteal cysts, Baker’s cysts are fluid-filled lesions found in the popliteal fossa, typically originating from the gastrocnemius-semimembranosus bursa. While these cysts are relatively common in adults, with a prevalence ranging from 5.0% to 41.0%, they are extremely rare in children, showing an incidence of just 2.4%. In most cases, Baker’s cysts result from intra-articular knee pathologies that lead to an increased production and sequestration of synovial fluid. The authors present the case of an athletic 16-year-old adolescent boy with a recurrent left-knee Baker’s cyst with magnetic resonance imaging showing no intra-articular pathology. Despite conservative treatment, including non-steroidal …

Treatment Of Congenital Cruciate Ligament Absence In A Teenager Knee-Ding Stability, Gaurav Singh, Anna Bergquist, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

The congenital absence of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) is an extremely rare condition, with an estimated prevalence of 0.017 per 1,000 live births for ACL agenesis. The authors present the case of a 15-year-old adolescent girl with autosomal dominant multiple synostosis, who developed progressive bilateral knee pain and functional limitations. Bilateral knee x-rays revealed trochlear dysplasia and an absent tibial eminence, suggesting a congenital ligamentous abnormality. Magnetic resonance imaging confirmed the bilateral absence of both the ACL and PCL. Surgical reconstruction of both ligaments was performed, with the first procedure taking place in October …

Assessing Reproductive Health In Zoo-Managed African Elephant Bulls (Loxodonta Africana), Kaitlyn Marie Campbell

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Populations of zoo-managed African elephant (Loxodonta Africana) exhibit substantial individual- and population-level variation in reproductive success, yet research has largely focused on females, leaving male fertility poorly understood. Subfertility in bulls, characterized by low libido and inconsistent semen quality, poses significant challenges to genetic management and long-term population sustainability. This study a) systematically evaluates semen quality, b) identifies physiological, behavioral, social, and environmental determinants of fertility, and c) advances ex situ conservation through the expansion of the African elephant sperm bank. Between January 2023 and July 2025, 209 semen collection events were conducted from 13 sexually mature bulls …

Healthy Here Family Healthy Weight Program Year 1 Summary, Camille R. Velarde, Courtney A. Fitzgerald, Theresa H. Cruz

Reports & Documents

No abstract provided.

Ber Anena’S Vagina Diaries, A Review: An African Student’S Encounter With The American Health System, Akua Agyeiwaa Denkyi-Manieson

Department of English: Dissertations, Theses, and Student Research

This work delves into the disappointment, indifference, and pretense experienced by the narrator when she sorts the American healthcare system. It also addresses the struggles immigrants face, particularly from Africa, as they navigate a healthcare system that often requires them to prove their pain and worthiness of attention. The narrative emphasizes the importance of not generalizing the entire healthcare system based on a single negative experience while acknowledging the profound impact on one's perception of the system. Furthermore, it explores the paradox between the availability of better resources in America compared to the narrator's home country and the mistreatment and …

Effect Of Integrated Neuromuscular Inhibition Technique On Iliotibial Band Friction Syndrome, Esraa Tarek Farouk Ahmed, Amir Mohamed Saleh, Hassan Hussien Ahmed, Doaa Rafat El Azab

Journal of Medicine in Scientific Research

Background: It was reported that, 25% of adults experience limited mobility and a diminished quality of life due to knee pain. The iliotibial band friction syndrome (ITBFS) is a frequent overuse injury that causes lateral knee pain. It is marked by recurrent lateral knee pain as well as motor impairment in the lower extremities. Pain worsens with exercise and weight-bearing activities, especially at 30° of knee flexion, and patients usually have a history of overuse caused by knee flexion and extension.Objective: To determine the impact of the integrated neuromuscular inhibition technique on pain intensity, knee range of motion and knee …

Endoscopic Management Of Third Ventricular Colloid Cysts: Efficacy, Safety, Technique, Result, And Limitations, Mohammad Abdulsalam Soliman

Journal of Medicine in Scientific Research

Background: Colloid cysts of the third ventricle are rare, benign lesions that may cause life-threatening obstructive hydrocephalus. Full-endoscopic resection has emerged as a minimally invasive alternative to microsurgical approaches. This study evaluates the surgical outcomes and safety profile of the trans-frontal endoscopic technique, with emphasis on the swiveling technique for capsule excision. Methods: This retrospective and prospective cohort study included 24 patients who underwent full-endoscopic trans-frontal resection of third ventricular colloid cysts at Al- Ahrar Teaching Hospital, a tertiary neurosurgical center in Egypt, between January 2016 and December 2024. All procedures were performed using a 6° angled rigid neuroendoscopy with …

Investigating The Ideal Candidate For The Fda’S Over-The-Counter Hearing Aids, Jamie N. Mayer

Capstone Showcase

Hearing loss is an underdiagnosed and undertreated medical condition affecting millions of Americans across a variety of ages and stages of life. Over-the-counter hearing aids are a new category of hearing aids created by the FDA. By targeting affordability and accessibility, over-the-counter hearing aids reduce barriers to care that individuals with hearing loss may face. There is a major impact of hearing loss on adults, specifically, for our elderly population who struggle with communication, staying engaged socially, and the additional stress of comorbid conditions. Elderly adults have the potential to derive immense benefit from over-the-counter hearing aids, specifically for those …

Pathophysiology, Risk Factors, Diagnosis And Management Of Complex Regional Pain Syndrome (Crps), Joyce Zhang

Capstone Showcase

Complex Regional Pain Syndrome (CRPS) is a debilitating neurological condition affecting up to 200,000 individuals annually in the United States. It is marked by pain that far exceeds the expected response to an injury, and is often accompanied by sensory, vasomotor, sudomotor, and motor disturbances. Although frequently triggered by physical trauma, CRPS can also arise spontaneously and without any significant finding on imaging, complicating diagnosis and treatment. The chronic nature of CRPS disrupts a person’s quality of life and is linked to psychological conditions such as depression and anxiety. Early recognition of its diverse symptoms with guidance by the Budapest …

Coronary Artery Disease – Future Tools For Optimizing Primary Prevention, Nick Makosiej

Capstone Showcase

Coronary artery disease (CAD) is a progressive, obstructive, and inflammatory process affecting the endothelial lining of the coronary arteries, which ultimately compromises the perfusion of the myocardium and can lead to ischemic infarction. This narrowing of vasculature which supplies the myocardial tissue leads to a spectrum of anginal syndromes and inevitably, catastrophic consequences. This article is focused on understanding the pathophysiology of this disease process and educating providers on emerging clinical tools that can be utilized to prevent progression, and ultimately reduce morbidity and mortality of this insidious disease process.