Musculoskeletal System Commons^™

Research Roundup From The Research Committee, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

With the expectations of accountability by consumers and third party payors for the efficacy of physical therapy practice, there has been a significant increase in the push to develop outcome measures in rehabilitation. One type of these measures, patient-reported outcome measures (PROs), are becoming increasingly more common in clinical practice. The American Physical Therapy Association’s Guide to Physical Therapist Practice 3rd edition includes outcomes assessment as an integral part of the Patient and Client Management model, and delineates that appropriate tests and measures depend upon established psychometric properties of the measurement.1 The Section on Research formed the Evidence Database to …

Research Round-Up: Manual Muscle Testing, Mary Insana Fisher, Shana Harrington

Physical Therapy Faculty Publications

Manual muscle testing was developed in response to the need to assess muscle strength losses during the polio outbreak in early part of the 20th century. The development of this original method is credited to Wilhelmine Wright and Robert W. Lovett, MD. Wright presented this method in 1912 in the Boston Medical Surgical Journal, and Lovett expanded the description of the testing method in 1916 in the Journal of the American Medical Association. The development of quantifying muscle strength by rating force generated against external resistance was an important development in objectifying assessment methods of the time.

Today, manual muscle …

Oncology Section Edge Task Force On Breast Cancer Outcomes: A Systematic Review Of Outcome Measures For Functional Mobility, Mary Insana Fisher, Jeannette Lee, Claire Davies, Hannah Geyer, Genevieve Colon, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Breast cancer treatments in women with breast cancer often result in physical impairments that lead to activity limitations and participation restrictions. These limitations and restrictions manifest in impaired functional mobility skills that may impact survivorship. Thus, evaluation of functional mobility is an important part of survivorship care.

Purpose: To identify functional mobility outcome measures that possess strong psychometric properties and are clinically useful for examination of women treated for breast cancer.

Methods: Multiple electronic databases were searched for articles published after 1995. Studies were included if they reported psychometric properties, used clinically feasible methods, were performed on adults, and …

The Effects Of Home-Based Pilates In Healthy College-Age Females, Betsy Donahoe-Fillmore, Mary Insana Fisher, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: To quantify and determine the effects of Pilates on core endurance, hamstring flexibility, balance, body composition/mass and perceived stress level in healthy college age females.

Study Design: Randomized controlled trial design.

Background: Emerging research on the Pilates technique is inconclusive regarding benefits to core endurance, flexibility, balance, body mass, and perceived stress.

Methods and Measures: Female college students (n=57; 18-35 years old) were randomly assigned to a Pilates group, who exercised at home with a DVD, or a control group who did not engage in Pilates practice. Core endurance, hamstring flexibility, balance, body composition and stress measurements were taken …

Muscular And Neural Contributions To Postactivation Potentiation, Brian Joseph Wallace

Theses and Dissertations--Kinesiology and Health Promotion

Muscle performance is partially a consequence of its recent contractile history. Postactivation potentiation (PAP) can occur after muscle contractions and leads to enhanced neuromuscular performance. The purpose of this dissertation was to explain the relationship between muscle factors (twitch potentiation, TP) and neural factors (reflex potentiation, RP) contributing to overall PAP following a non-fatiguing volitional muscle contraction. The tibial nerves of fifteen resistance trained volunteers (eleven men, four women) were stimulated intermittently at supramaximal (Mmax) and submaximal (Hmax) intensities for 20 minutes on separate days under three conditions: rest (Control); after a after a 10 second maximum voluntary isometric contraction …

Segmental Musculoskeletal Examinations Using Dual-Energy X-Ray Absorptiometry (Dxa): Positioning And Analysis Considerations, Nicolas H. Hart, Sophia Nimphius, Tania Spiteri, Jodie L. Cochrane, Robert U. Newton

Research outputs 2014 to 2021

Musculoskeletal examinations provide informative and valuable quantitative insight into muscle and bone health. DXA is one mainstream tool used to accurately and reliably determine body composition components and bone mass characteristics in-vivo. Presently, whole body scan models separate the body into axial and appendicular regions, however there is a need for localised appendicular segmentation models to further examine regions of interest within the upper and lower extremities. Similarly, in-consistencies pertaining to patient positioning exist in the litera-ture which influence measurement precision and analysis out-comes highlighting a need for standardised procedure. This paper provides standardised and reproducible: 1) positioning and analysis …

Computational Modeling To Assess Surgical Procedures For The Treatment Of Adult Acquired Flatfoot Deformity, Brian A. Smith

Theses and Dissertations

Several surgically corrective procedures are considered to treat Adult Acquired Flatfoot Deformity (AAFD) patients, relieve pain, and restore function. Procedure selection is based on best practices and surgeon preference. Recent research created patient specific models of Adult Acquired Flatfoot Deformity (AAFD) to explore their predictive capabilities and examine effectiveness of the surgical procedure used to treat the deformity. The models’ behavior was governed solely by patient bodyweight, soft tissue constraints, and joint contact without the assumption of idealized joints. The current work expanded those models to determine if an alternate procedure would be more effective for the individual. These procedures …

The Effect Of Chronic Sleep Deprivation On Tumor Necrosis Factor Alpha And Bone Health In Peri-Menopausal Rats, Megan Robertson, Derek Booth, Erin Wainwright, Cody Arbuckle, Frank Frisch

Student Scholar Symposium Abstracts and Posters

Post-menopausal osteoporosis is a common syndrome in the United States. The cessation of estrogen signaling coupled with the production of pro-inflammatory cytokines from sleep deprivation leads to an even greater risk of post-menopausal osteoporosis by creating an imbalance between osteoblasts and osteoclasts. With estrogen no longer present to regulate the concentration of osteoclasts and pro-inflammatory cytokines increasing production of osteoclasts, bone is degraded at a faster rate than it is formed. One of the most common treatments for osteoporosis is Zolendronate (a nitrogenous bisphosphonate), which decreases the number of osteoclasts in bone. This preliminary study looked at the effects on …

Effects Of Yoga On Arm Volume Among Women With Breast Cancer Related Lymphedema: A Pilot Study, Mary Insana Fisher, Betsy Donahoe-Fillmore, Laura Leach, Colleen O'Malley, Cheryl Paeplow, Tess Prescott, Harold L. Merriman

Physical Therapy Faculty Publications

Lymphedema affects 3–58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3×/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at …

What Are The Best Skeletal Indicators Of Handedness?, Margret B. White, Anne Su

Undergraduate Research Posters 2014

Previous research indicates that there are asymmetries in limb bone structure and dimensions. It is hypothesized that these asymmetries are the result of hand preference, or repeated unilateral mechanical loading. The aim of this study was to first identify the best skeletal indicators of handedness by means of a comprehensive literature search. Based on the previous findings of other researchers, we examined non-pathological male individuals (N=19, aged 20-35) from the Hamann-Todd Skeletal Collection at the Cleveland Museum of Natural History for asymmetry of paired second metacarpals, by measuring the difference between right and left diameters at mid-shaft. We also tested …

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 …

Fall Risk Prediction Using Wearable Wireless Sensors, Thurmon Lockhart, Chris Frame, Rahul Soangra, John Lach

Physical Therapy Faculty Articles and Research

Wearable wireless sensors and nonlinear dynamics identify postural characteristics relevant to balance control and dynamic stability, revealing predictive risk of falls among older adults.

The Quadmill: Effects Of Eccentric Training Vs. Concentric Training On Lower Extremity Power And Anaerobic Capacity 2014., John Crosby

Master's Theses

Training focuses on the concentric action of muscle during exercise for most exercise programs, but eccentric training may yield greater results. The Quadmill^TM is a unique piece of training equipment that focuses on training the quadriceps muscle eccentrically. Purpose: to determine if using the Quadmill^TM could increase power and anaerobic capacity to the same level, if not greater, than a standard concentric focused lower body training protocol. Participants were 44 undergraduate college students (24 Male 20 Female) Design: participants placed into three equal groups (Quadmill^TM, Lifting, Control). The two experimental groups (Quadmill^TM and Lifting) underwent …

Clay Modeling Of The Musculoskeletal System: Does Active Learning Increase Retention And Comprehension, Kelly Massey

Interdisciplinary STEM Teaching & Learning Conference (2012-2019) (Archived)

The focus of a Structural Kinesiology course is a detailed study into the musculoskeletal system and joint action. The course contains a lot of memorization: skeletal muscle origin, insertions, innervations and muscle/joint actions but there is also an applied component for the content. Group study has been incorporated into the course to increase knowledge retention and comprehension however group interaction has been seen to be minimal. Two studies have looked at group construction of skeletal muscle models using clay during class time in assisting with the active learning of muscle origin, insertion and actions (Cruz-Espaillat et al., 2010 & Waters …

Classifying Lower Extremity Muscle Fatigue During Walking Using Machine Learning And Inertial Sensors, Jian Zhang, Thurmon Lockhart, Rahul Soangra

Physical Therapy Faculty Articles and Research

Fatigue in lower extremity musculature is associated with decline in postural stability, motor performance and alters normal walking patterns in human subjects. Automated recognition of lower extremity muscle fatigue condition may be advantageous in early detection of fall and injury risks. Supervised machine learning methods such as Support Vector Machines (SVM) have been previously used for classifying healthy and pathological gait patterns and also for separating old and young gait patterns. In this study we explore the classification potential of SVM in recognition of gait patterns utilizing an inertial measurement unit associated with lower extremity muscular fatigue. Both kinematic and …

The Importance Of Managing Psychosocial Health: A Case Study, Mary Insana Fisher, Harold L. Merriman

Physical Therapy Faculty Publications

Managing the physical aspects of lymphedema requires an individual to be committed to daily treatment of this chronic condition. Performing manual lymph drainage, using compression bandaging or compression garments, exercising, and caring for the skin all take time and a high level of dedication. This commitment to self-care can be emotionally and psychologically exhausting.

When coupled with other emotional stressors in a patient’s life, successful treatment of lymphedema is challenging. We present a case demonstrating how the physical and psychological aspects of care interplay, and, when well-managed, can positively affect the outcome.

Breast Cancer Edge Task Force Outcomes - Clinical Measures Of Strength And Muscular Endurance: A Systematic Review, Mary Insana Fisher, Claire Davies, Christine Beuthin, Genevieve Colon, Brittany Zoll, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Muscular strength deficits are a common morbidity following treatment for breast cancer. Accurate assessment of strength and muscular endurance following breast cancer treatments is essential in identifying deficits and planning rehabilitation strategies.

Purpose: The purpose of this systematic review was to identify strength and muscular endurance outcome measures for use with women treated for breast cancer that possess strong psychometric properties and are clinically useful.

Methods: Multiple electronic databases were searched between February and June 2013. Included studies of tools used to assess strength and muscular endurance met the following criteria: reported psychometric properties, clinically feasible methods, adults (preferably …

Test Items In The Complete And Short Forms Of The Bot-2 That Contribute Substantially To Motor Performance Assessments In Typically Developing Children 6-10 Years Of Age, Kadi Carmosino, Ashley Grzeszczak, Kaylie Mcmurray, Ali Olivo, Bo Slutz, Brittany Zoll, Betsy Donahoe-Fillmore, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: Determine the magnitude of association between individual subtest items of the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), and the respective total subtest scores and to review items on the BOT-2 Short Form.

Background: The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), is a test used to measure gross motor proficiency in both typically developing children and children with developmental disabilities between the ages of four and twenty-one. The BOT-2 Short Form consists of fourteen test items proportionally selected from the subtests of the Complete Form. It can be used as a screening tool and takes less …

Interleukin-1 Receptor Antagonist Modulates Inflammation And Scarring After Ligament Injury, Connie S. Chamberlain, Ellen M. Leiferman, Kayt E. Frisch, Sarah E. Duenwald-Kuehl, Stacey L. Brickson, William L. Murphy, Georffrey S. Baer, Ray Vanderby

Faculty Publications - Biomedical, Mechanical, and Civil Engineering

Ligaments have limited regenerative potential and as a consequence, repair is protracted and results in a mechanically inferior tissue more scar-like than native ligament. We previously reported that a single injection of interleukin-1 receptor antagonist (IL-1Ra) delivered at the time of injury, decreased the number of M2 macrophage-associated inflammatory cytokines. Based on these results, we hypothesized that IL-1Ra administered after injury and closer to peak inflammation (as would occur clinically), would more effectively decrease inflammation and thereby improve healing. Since IL-1Ra has a short half-life, we also investigated the effect of multiple injections. The objective of this study was to …

The Influence Of Partial And Full Thickness Tears On Infraspinatus Tendon Strain Patterns, Kayt E. Frisch, David Marcu, Geoffrey S. Baer, Darryl G. Thelen, Ray Vanderby

Faculty Publications - Biomedical, Mechanical, and Civil Engineering

Tears on the bursal and articular sides of the rotator cuff tendons are known to behave differently and strain is thought to play a role in this difference. This study investigates the effect of tear location on the changes in three strain measurements (grip-to-grip, insertion, and mid-substance tissue) in a sheep infraspinatus tendon model during axial loading. We introduced a 14mm wide defect near the insertion from either the articular or bursal side of the tendon to three depths (3 mm, 7mm & full) progressively. For each condition, tendons were sinusoidally stretched (4% at 0.5 Hz) while insertion and midsubstance …

Influence Of Tendon Tears On Ultrasound Echo Intensity In Response To Loading, Kayt E. Frisch, David Marcu, Geoffrey S. Baer, Darryl G. Thelen, Ray Vanderby

Faculty Publications - Biomedical, Mechanical, and Civil Engineering

Acoustoelastic (AE) ultrasound image analysis is a promising non-invasive approach that uses load-dependent echo intensity changes to characterize stiffness of tendinous tissue. The purpose of this study was to investigate whether AE can detect localized changes in tendon stiffness due to partial and full-thickness tendon tears. Ovine infraspinatus tendons with different levels of damage (Intact, 33%, 66% and full thickness cuts initiated on the articular and bursal sides) were cyclically loaded in a mechanical testing system while cine ultrasound images were recorded. The load-induced changes in echo intensity on the bursal and articular side of the tendon were determined. Consistent …

Pain Assessment And Possible Mechanism Of Delayed Onset Muscle Soreness, Wing Yin Lau

Theses: Doctorates and Masters

Muscle pain is felt during exercise or daily activities for several days after performing unaccustomed exercise, which is referred to as delayed onset muscle soreness (DOMS). Many people experience DOMS, but its underlying mechanisms are not fully understood. One of the challenges in the investigation of DOMS is its subjective nature, which makes the assessment ambiguous, thus establishing a standardised protocol is necessary. The present thesis scrutinised muscle pain assessments (Study 1, Study 2), developed a new assessment of muscle pain focusing on muscle fascia (Study 3), and investigated why DOMS is reduced after the second than the first bout …

Neuromuscular Factors Affecting Stretch-Induced Torque Loss, Gabriel Siqueira Trajano

Theses: Doctorates and Masters

The mechanisms underpinning the immediate torque loss induced by acute, static muscle stretching are still not clear. The current research was designed to examine the neuromuscular factors influencing this torque loss. In Study 1, the contributions of central versus peripheral factors to the stretch-induced torque loss were investigated. Measures of central drive, including the EMG amplitude normalised to the muscle compound action potential amplitude (EMG:M), percent voluntary activation (%VA) and first volitional wave amplitude (V:M), and measures of peripheral function, including the twitch peak torque and 20:80 Hz tetanic torque ratio were made before, and immediately and 15 min after …

Osteoarthritis And Articular Cartilage: Biomechanics And Novel Treatment Paradigms, Ray Marks

Publications and Research

Background: Osteoarthritis is a widespread highly painful disabling age-related disease with no known cure. Although novel strategies for ameliorating osteoarthritic damage abound, it is likely that none will be successful over time if the entire spectrum of the disease and the effects of joint biomechanics on joint tissues are not carefully considered.

Objectives: 1) To detail the structure of healthy articular cartilage, the key tissue affected by osteoarthritis. 2) To detail what aspects of cartilage damage best characterize osteoarthritis. 3) To consider the role of biomechanical factors in developing solutions to treat osteoarthritic joint damage. Methods: Literature sources from 1980 …

Potential For Using Smartphone Accelerometers In Non-Laboratory Environments, Rahul Soangra, Thurmon Lockhart, Christopher W. Frames, Jian Zhang, Seong Hyun Moon, Jongsoon Park

Physical Therapy Faculty Articles and Research

In recent years, there has been rising interest in using accelerometers as an alternative instrument to measure the center of pressure. Accelerometers are inexpensive, small, sensitive, and can be readily used in non-laboratory environments. In addition to this, smartphones with built-in accelerometers add to their capability with real-time processing of data from sensors. Clinicians and researchers are currently in disagreement from whether these measurements provide the same physiological information about the participant’s balance. In this study, twelve participants were asked to wear smartphone on their right ASIS using a belt clip and stand still on the forceplate. The data was …

Evaluation Of Tissue-Engineered Tendon Enthesis Polymer Constructs, Joshua A. Bundy Bs, Mary Beth Wade Phd, Hitomi Nakao Md, Phillip Mcclellan Phd, Qing Yu Phd, Robin Jacquet-Childs Ms, William J. Landis Phd

Williams Honors College, Honors Research Projects

Both scientists and clinicians have proposed tissue engineering as the future of medicine. The possibilities for tissue engineering, that is, fabrication of tissues and organs in the laboratory and their translation to patients, appear to be endless, and many believe that this new approach in medicine will result in abolishing many common ailments, injuries, and congenital defects. Injuries to a tendon enthesis, the normal tissue connection between tendon and bone, are of particular concern to clinicians because of their frequency and failure to repair as a result of surgery. While these injuries may not be life threatening, they can certainly …

Trunk Coordination In Dancers And Non-Dancers, Danielle N. Jarvis, Jo Armour Smith, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Variability, or how a task changes across trials, may reveal differences between athletes of differing skill levels. The purpose of this study was to examine trunk and lower extremity (LE) single joint kinematic variability and inter-segmental coordination variability in dancers and non-dancers during bipedal vertical dance jumps (sautés). Twenty healthy females, ten with no formal dance training and ten professional dancers, performed 20 consecutive sautés. Single joint kinematic variability was assessed using mean standard deviation of angular displacement, and inter-segmental coordination variability was assessed using angular deviation of the coupling angle between segments. Within the context of the standard error …

The Influence Of Hip Strength On Lower-Limb, Pelvis, And Trunk Kinematics And Coordination Patterns During Walking And Hopping In Healthy Women, Jo Armour Smith, John M. Popovich, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Study Design

Cross-sectional laboratory study.

Objectives

To compare peak lower-limb, pelvis, and trunk kinematics and interjoint and intersegmental coordination in women with strong and weak hip muscle performance.

Background

Persons with lower extremity musculoskeletal disorders often demonstrate a combination of weak hip musculature and altered kinematics during weight-bearing dynamic tasks. However, the association between hip strength and kinematics independent of pathology or pain is unclear.

Methods

Peak hip extensor and abductor torques were measured in 150 healthy young women. Of these, 10 fit the criteria for the strong group and 9 for the weak group, representing those with the strongest …

Agreement In Gait Speed From Smartphone And Stopwatch For Five Meter Walk In Laboratory And Clinical Environments, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Gait speed is suggested as an independent predictor of post-operative morbidity and mortality in elderly cardiovascular disease (CVD) patients. Society of thoracic surgeons has recently classified gait speed as the only important indicator of health for CVD patients. It has been seen that patients with slow gait speed above 70 years of age, taking more than 6 seconds to walk 5 meters are particularly at high risk for adverse outcomes. Twelve young participants walked in their self-selected, slow and fast speed with five reflective markers at sternum and heels and toes of both feet in laboratory environment. A smartphone was …

Comparison Of Corded And Cordless Handpieces On Forearm Muscle Activity, Procedure Time And Ease Of Use During Simulated Tooth Polishing, Gayle Mccombs, Daniel M. Russell

Dental Hygiene Faculty Publications

Purpose: Dental professionals suffer from a high prevalence of work-related musculoskeletal disorders (MSD). Dental hygienists in particular have a high prevalence of pain in the forearms and hands. The objective of this study was to compare 1 cordless handpiece to 2 corded handpieces during simulated tooth polishing in terms of the muscle loads (recorded as electromyography (EMG) activity), duration of polishing procedure, and dental hygienist opinion about ease of use. Methods: EMG was used to quantify muscle electrical activity of 4 forearm muscles during simulated dental polishing with 2 corded handpieces (HP-A and HP-B) and 1 cordless handpiece (HP-C). A …