Therapeutics Commons^™

Enhancing Clinic Efficiency: A Quality Improvement Initiative For Postoperative Patient Care In An Outpatient Orthopedic Physician Practice Setting, D Stepan, T Jp Greffly, R M. Williams

Clinical Practice in Athletic Training

Introduction: Following orthopedic surgery, patient post-operative (post-op) visits are deemed global surgical observations where day 00 to day 90 are appointments that cannot be billed. Patients are typically seen 3 times during this global period. Thus, the outpatient clinic needs to have non-billable time slots each day for these patients. The current scheduling model double books patients every 15 minutes, with the physician being the primary provider seeing patients for post-op visits. Therefore, the clinic has demonstrated inefficiencies with scheduling these patients while having sufficient appointments available for billable patients. This quality improvement initiative aimed to decrease post-op patient visits …

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 …

Perceptions And Use Of The Athletic Training Milestones In Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Barton E. Anderson, Julie M. Cavallario, Bonnie L. Van Lunen, Lindsey E. Eberman

Clinical Practice in Athletic Training

The Athletic Training Milestones (AT Milestones) were developed as an evaluation tool to capture the breadth and depth of athletic training knowledge, skills, and behavior. However, it is unclear whether athletic training programs are implementing this tool or how they are implementing it to gauge the clinical progression of students or residents in athletic training. We aimed to explore the perceptions and use of the AT Milestones among educators in athletic training programs. We used a cross-sectional, web- based survey with open-ended questions to collect data from athletic training programs on if and how they implement the AT Milestones at …

The Value Of Using Validated Competency-Based Assessments Across The Career Span Of An Athletic Trainer, Matthew Drescher, Lindsey Eberman

Clinical Practice in Athletic Training

No abstract provided.

The Development, Implementation, And Value Of The Athletic Training Milestones For Assessing Progressive Clinical Behaviors, Hollie Walusz, Eric Sauers, Mark Laursen, Forrest Pecha

Clinical Practice in Athletic Training

No abstract provided.

Standardized Patient Evaluation Tool: A Valid Measure Of The Core Competencies, Lindsey E. Eberman, Jessica Edler Nye

Clinical Practice in Athletic Training

No abstract provided.

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

A Literature Review Of Current Treatments For The Hypermobility Subtype Of Ehlers-Danlos Syndrome, John Gericke, Mary Zsolway, Chelsea Reyes, Pooja Patel, Saad Ahmed, Julia Hwang, Venkateswar Venkataraman

Rowan-Virtua Research Day

Purpose: The purpose of this study is to compare pharmacologic intervention, neurocognitive therapy, physical therapy, and orthotics in treating the hypermobility subtype of Ehlers-Danlos Syndrome (hEDS) and determine which has the most positive effect on symptoms.

Introduction: Ehlers-Danlos Syndrome is an inheritable connective tissue disorder which results from a genetic mutation that alters the body’s ability to produce collagen. The most common subtype of Ehlers-Danlos Syndrome is hEDS, which leads to hypermobility and hyperextensibility and can cause frequent joint dislocations.

Methods: A review of literature was performed to compare each treatment based on reported results. The types of studies reviewed …

Blood Flow Restriction Therapy: A Review Of Physiology, Clinical Application, And Guidelines For Implementation, Nathan Schuliger

Senior Honors Theses

Blood flow restriction (BFR) therapy is an emerging clinical modality utilizing the metabolic stress of a hypoxic state to induce hypertrophic and strength adaptations in a manner allowing for reduced external loading. BFR has a variety of applications in rehabilitation settings, showing great potential for patients seeking the benefits of high intensity training without the associated degrees of mechanical stress. This literature review details the proposed mechanisms of BFR, along with various clinical applications of BFR including active and aerobic BFR. Concerns and contraindications for BFR usage are discussed regarding certain clinical populations, with risk stratification recommendations provided. Current BFR …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

Diagnostic Accuracy Of Mcmurry’S Test In The Diagnosis Of Meniscal Tears, Jessica Smyth, Hartwell Rainey

Physician Assistant Capstones, 2020-current

No abstract provided.

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Innovative Care Of Individuals In The Athletic Training Room: A Case Series, Kathryn E. Young

Senior Honors Projects, 2010-2019

This work follows three unique cases of athletic injuries and/or injuries in patients. These cases were selected because of the innovative nature of the rehabilitation process conducted by the sports medicine team via the athletic training room or the unique nature of the injury/case.

The first is a concussion sustained from a motor vehicle accident in a collegiate female thrower. This is unique because it’s a non-sport related concussion handled as an athletic trainer would handle a sports related concussion. It also demonstrates a new unique protocol for concussion management.

The second case is a patient with two complete anterior …

A Brain-Computer Interface For Closed-Loop Sensory Stimulation During Motor Training In Patients With Tetraplegia, Sarah Helen Thomas

Theses and Dissertations--Biomedical Engineering

Normal movement execution requires proper coupling of motor and sensory activation. An increasing body of literature supports the idea that incorporation of sensory stimulation into motor rehabilitation practices increases its effectiveness. Paired associative stimulation (PAS) studies, in which afferent and efferent pathways are activated in tandem, have brought attention to the importance of well-timed stimulation rather than non-associative (i.e., open-loop) activation. In patients with tetraplegia resulting from spinal cord injury (SCI), varying degrees of upper limb function may remain and could be harnessed for rehabilitation. Incorporating associative sensory stimulation coupled with self-paced motor training would be a means for supplementing …

Transitioning To The Role Of A Professional Physical Therapist Through Community Engagement, Brittany L. Wentzel

VA Engage Journal

This article recounts the author's experiences observing and interning with physical therapists in a variety of settings.The hands-on experiences the author describes allowed the author to learn the specific procedures and requirements in a typical day as a Physical Therapist, and to gain knowledge on the protocol for different injuries, the muscles that each exercise strengthens, and how to properly perform exercises to prevent further injuries. The author also explores how these experiences fostered observational and interpersonal skills and solidified the decision to pursue Physical Therapy as a career.

Effects Of Lower Extremity Aerobic Exercise And Conditioned Pain Modulation On Evoked Shoulder Pain, Logan Lumpkins, Craig Wassinger

Undergraduate Honors Theses

Background: Emerging evidence suggests that aerobic exercise and conditioned pain modulation may be advocated in treating patients with musculoskeletal pain. The effects of lower extremity aerobic exercise and conditioned pain modulation on evoked shoulder pain are not known.

Purpose: To determine the acute effects of lower extremity aerobic exercise and conditioned pain modulation on outcomes of evoked shoulder pain from pain pressure threshold measurements.

Study Design: Repeated measures.

Methods: Thirty (30) healthy volunteers were tested over the course of two sessions. Session 1 consisted of collecting pain pressure threshold measurements over the infraspinatus before and immediately following a conditioned pain …

Teaching Joint Mobilizations In Physical Therapist Assistant Programs: Implications For Instruction And Policy, Renae H. Gorman

Student Dissertations

This research answers the question: Are physical therapist assistant programs teaching the manual therapy skill of joint mobilizations? This study also gathers information regarding how the joint mobilization techniques are being instructed and assessed within the Physical Therapist Assistant programs. This information could serve as the foundation for future research regarding developing instructional and evaluation strategies for manual therapy skills. The findings of this study may also affect the physical therapist assistants in clinical performance of manual therapy. The findings are pertinent due to conflicting statements by the professional organizations and the accrediting agency of physical therapist assistant educational programs. …

Toward A Research Agenda For Oncology Physical Therapy, Lucinda Pfalzer, Nicole L. Stout, Shana Harrington, Mary Insana Fisher

Physical Therapy Faculty Publications

Research Round-up: Cancer survivors frequently experience cancer treatment–related functional impairments and disability. While a growing body of evidence supports the effectiveness of rehabilitation interventions for these individuals, there are significant gaps in the existing literature and no interdisciplinary agreement on the priorities for cancer rehabilitation research. In 2016, the Oncology Section revised its strategic plan and set an objective to create an oncology rehabilitation research agenda for the physical therapy (PT) profession. To achieve this goal, the scope of the agenda, a development and review process, and dissemination plan need to be developed.

Physical Therapy After Triangular Fibrocartilage Injuries And Ulnar Wrist Pain, Mohamed A. Abdelmegeed

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The ulnar side of the wrist has been referred to as the “black box” of the wrist because of its complex structures and sophisticated anatomy, disorders at this anatomical site have been compared to those of low back pain

Purposes: The purpose of this study was to apply the Brief International Classification of Functioning (ICF) Core Set for Hand Conditions to the physical therapy outcome measures, and to evaluate the contribution of these measures to overall health in subjects with ulnar wrist pain. A secondary purpose was to investigate the effect of wrist orthotics and strengthening exercise on …

A Qualitative Examination Of Optimal Professional Traits Of Physical Therapists. – An Exploratory Investigation, Nicholas G. Wood

Honors College Theses

Physical therapists are constantly searching for aspects of their professional practice to improve, in order to enhance interactions with patients, eventually leading to a more successful practice (Resnek & Jensen, 2003). Although this is the case, limited research has been found which has examined optimal qualities of physical therapists from neither a qualitative perspective, nor based upon their location. Thus, the purpose of this study is to use a qualitative approach to describe optimal qualities necessary for a successful physical therapy practice. In addition, this study aims to determine if therapists practicing in a rural community describe different qualities than …

Piecing The Puzzle Together With The Use Of Physical Therapy, Mikayla Pruitt

Honors Projects

For my Honors Project I decided to create a set of exercise cards for children with autism. The front of each card had a picture symbolizing the exercise/activity, and on the back included directions, supplies and tips to complete the activity. The following is a selection of a few exercise cards from each of the four exercise sections, as well as the title card, table of contents cards, information cards, and source cards.

Cancer Survivorship Care: An Emphasis On Rehabilitation Needs In Maine, Cassandra Dawley, Charles Dowd, Irina Fedulow, Miranda Carlson, Lisa Gerhardt, Erin Pike, Kaitlin Powers, Nicole Christine, Angela Serrani

Disease Prevention and Health Promotion Resources

Presentation proposing that standardized rehabilitation and wellness services be incorporated into cancer treatment as well as into a personalized plan of care to be carried out after cancer treatment ends. Proposal is based on research regarding evidence of causation concerning impairments developed as a result of a cancer diagnosis and cancer treatment, evidence regarding rehabilitation and physical activity as an effective intervention in the prevention and treatment of impairments from cancer diagnosis and cancer treatment, and the underlying behavioral change theory for incorporation of a Cancer Survivorship Rehabilitation Algorithm which includes the use of rehabilitation and wellness services in the …

Cancer Survivorship Care: An Emphasis On Rehabilitation Needs In Maine, Miranda Carlson, Nicole Christine, Charles Dowd, Cassandra Dawley, Irina Fedulow, Lisa Gerhardt, Erin Pike, Kaitlin Powers, Angela Serrani

Disease Prevention and Health Promotion Papers

The first section of this report addresses the evidence of causation concerning impairments developed as a result of a cancer diagnosis and cancer treatment. The second section investigates the evidence regarding rehabilitation and physical activity as an effective intervention in the prevention and treatment of impairments from cancer diagnosis and cancer treatment. The third section discusses the underlying behavioral change theory for incorporation of our Cancer Survivorship Rehabilitation Algorithm (Appendix 1), which details our proposed use of rehabilitation and wellness services in the continuum of cancer care and includes an outline for a survivorship care plan. This section also discusses …

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 …

Chhs July E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Ultrasound Imaging Of Lumbar Multifidus Immediately Following Three Physical Therapy Techniques In Asymptomatic Individuals, Victoria Byers, Steven Lim, Kathryn Rice

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design

Randomized, blinded, cohort, within subjects design.

Background and Objective

The effects of different manual therapy (MT) techniques on lumbar multifidus (LM) thickness have been investigated in subjects with low back pain (LBP) but have not been investigated in asymptomatic subjects. The objective of this study was to examine the immediate effects of mobilization and manipulation on contraction thickness of LM in healthy individuals.

Methods and Measures

Forty-two healthy individuals participated in the study. Ultrasound imaging techniques were used to record LM thickness (L4-5 level) at rest, during an abdominal drawing in maneuver (ADIM), and during a prone upper …

Effect Of 3-Electrode Electrical Stimulation On Current Delivery And Healing In Chronic Wounds, Hyejin Suh

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic wounds have been an enormous burden on the healthcare system due to their prevalence and the lack of efficacy of current treatment modalities. Over the years, electrical stimulation (ES) has been widely used in the treatment of wounds. Unfortunately, the effectiveness of this treatment is under scrutiny, since many studies have failed to report successive and/or consistent effects of ES on wound healing. This inconsistency may be due to the uneven current produced by the conventional 2-electrode delivery system (2-channel ES) and the reduced resting blood flow resulting from thermally cool treatment rooms. In this study, a new approach …

Is Electrical Stimulation A Predictive Tool For Autonomic Dysfunction In Males With Diabetes?, Susan Dorothy Rand

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine whether electrical stimulation can be used as a predictive tool to assess autonomic dysfunction in males with diabetes. The study was designed to better understand the extent of autonomic nervous system (ANS) dysfunction in the diabetic population.

Controls and patients with diabetes were recruited from the community at large and the Loma Linda University Diabetes Treatment Center and were managed by a physician. Twelve (12) people with diabetes and thirteen (13) control subjects participated. Mean age (years) for people with diabetes was 52.4 +/- 6.1 and 47.2 +/-11.1 for controls (p =0.05). …

Disaggregating The Relative Influence Of Genetic, Environmental And Individual Factors On Ldl And Hdl Cholesterols And Bmi For A Sample Of African American (Aa) Mothers And Daughters, C. Jayne Brahler, Jewel Harden, Michelle Mchone, Matthew Soules, Eric Evans, Ann Alyanak, Fred Diakpieng, Paul M. Vanderburgh

Health and Sport Science Faculty Publications

There are many reports about the associations between blood lipids, body mass index (BMI) and dietary cholesterol intakes both within the individual and between related individuals. The purpose of this descriptive research project was to investigate the relationships between LDL and HDL cholesterols, body mass index and dietary cholesterol intakes for a sample of African American (AA) mothers and their daughters and to attempt to separate the contribution of genetic versus environmental factors. Mother and daughter participants (n =42 and 66, respectively) were 12-14-hours fasted when blood samples were drawn, heights and weights measured, and 24 hour food recalls completed.