Rehabilitation and Therapy Commons^™

Assistive Utensil: A Spork For Hand Tremors And Spatial Awareness, Ana Font Hernandez, Jacob Kabariti, Troy Taylor

Publications and Research

In this poster, we present a 3D printed solution for hand tremors and special awareness. Our spork is an assistive device designed and 3D printed for patients suffering from scleroderma, systemic sclerosis, Parkinson's, multiple sclerosis, drug withdrawal, etc. The scale-based handle will act as a counterweight to offset the contents on the other end and reduce shakiness. The larger grip allows an easy and comfortable hold. The product will be 3D printed for a customizable fit and at an affordable price. Lastly, the product will include a haptic feedback sensor to assist the visually impaired in locating food contents on …

Spinal Cord Trauma: An Overview Of Normal Structure And Function, Primary And Secondary Mechanisms Of Injury, And Emerging Treatment Modalities, Daniel Morin

Senior Honors Theses

The structures of the spinal cord and vertebral column are designed to provide flexibility, while still providing ample protection for the spinal cord deep within. While it does offer remarkable protection against most routine trauma, the spinal cord is still vulnerable to high-force etiologies of trauma and may become damaged as a result. These events are referred to as primary injury. Following the initial injury, the body’s own physiological responses cause a cascade of deleterious effects, known as secondary injury. Secondary injury is a major therapeutic target in mitigating the effects of spinal cord injury (SCI), and much research is …

Motor Subtypes Of Parkinson’S Disease Can Be Identified By Frequency Component Of Postural Stability, Saba Rezvanian, Thurmon Lockhart, Christopher Frames, Rahul Soangra, Abraham Lieberman

Physical Therapy Faculty Articles and Research

Parkinson’s disease (PD) can be divided into two subtypes based on clinical features—namely tremor dominant (TD) and postural instability and gait difficulty (PIGD). This categorization is important at the early stage of PD, since identifying the subtypes can help to predict the clinical progression of the disease. Accordingly, correctly diagnosing subtypes is critical in initiating appropriate early interventions and tracking the progression of the disease. However, as the disease progresses, it becomes increasingly difficult to further distinguish those attributes that are relevant to the subtypes. In this study, we investigated whether a method using the standing center of pressure (COP) …

Biomarkers Of Rehabilitation Therapy Vary According To Stroke Severity, Erin Burke Quinlan, Lucy Dodakian, Jill See, Alison Mckenzie, Jill Campbell Stewart, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Biomarkers that capture treatment effects could improve the precision of clinical decision making for restorative therapies. We examined the performance of candidate structural, functional,and angiogenesis-related MRI biomarkers before and after a 3-week course of standardized robotic therapy in 18 patients with chronic stroke and hypothesized that results vary significantly according to stroke severity. Patients were 4.1 ± 1 months poststroke, with baseline arm Fugl-Meyer scores of 20–60. When all patients were examined together, no imaging measure changed over time in a manner that correlated with treatment-induced motor gains. However, when also considering the interaction with baseline motor status, treatment-induced motor …

Critically Appraised Paper For “Adaptive Vs. Non-Adaptive Cognitive Training By Means Of A Personalized App: A Randomized Trial In People With Multiple Sclerosis.”, Erin Chaffee, Ty Duong, Kaylee Gothelf, Emily Minor, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

The purpose of this study was to evaluate the effectiveness of a working-memory program to improve the cognitive status of people with multiple sclerosis (MS). Given the increasing use of technology in modern-day society, further research is required to provide evidence supporting working-memory training devices that are easily accessible for people with memory deficits.

Critically Appraised Paper For “Effects Of Dance On Motor Functions, Cognitive Functions, And Mental Symptoms Of Parkinson’S Disease: A Quasi-Randomized Pilot Trial”, May Anne Gamueda, Caroline Lee, Susan Nguyen, Ajay Pala, Blanka Pentek, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

Parkinson’s disease (PD) is a systemic condition that presents not only motor but also nonmotor symptoms, as a result of dopamine deficiency in the basal ganglia. Rehabilitation typically focuses on motor deficits, however, despite the fact that nonmotor symptoms have a significant impact on quality of life. The researchers of this study investigated the effectiveness of dance on motor functions, cognitive functions, and mental symptoms of individuals with PD. They chose dance as their intervention because it has been shown to activate the basal ganglia as well as improve mood. In addition to motor function and mood, the researchers also …

Muscle Synergy During A Single Leg Standing Test In Ambulatory Children With Cerebral Palsy, Brennan L. Smith

Theses and Dissertations--Kinesiology and Health Promotion

INTRODUCTION: Cerebral Palsy (CP) is a sensorimotor disorder characterized by dysfunctional motor coordination, balance problems, and loss of selective motor control. Motor coordination exhibited as co-contraction, has been subjectively quantified using gait analysis, but recent studies have begun to objectively analyze the amount of co-contraction by collecting electromyography (EMG) data. Center of pressure excursion (COPE) measurements collected during a single leg standing test (SLST) have shown to be more valid measurements of balance in populations with motor disabilities than a SLST alone. A recent study has correlated increased COPE velocity with a lower fall risk as determined by reported fall …

Trunk Musculoskeletal Response In Maximum Voluntary Exertions: A Combined Measurement-Modeling Investigation, F. Ghezelbash, Z. El Ouaaid, A. Shirazi-Adl, A. Plamondon, N. Arjmand

Études primaires

Maximum voluntary exertion (MVE) tasks quantify trunk strength and maximal muscle electromyography (EMG) activities with both clinical and biomechanical implications. The aims here are to evaluate the performance of an existing trunk musculoskeletal model, estimate maximum muscle stresses and spinal forces, and explore likely differences between males and females in maximum voluntary exertions. We, therefore, measured trunk strength and EMG activities of 19 healthy right-handed subjects (9 females and 10 males) in flexion, extension, lateral and axial directions. MVEs for all subjects were then simulated in a subject-specific trunk musculoskeletal model, and estimated muscle activities were compared with EMGs. Analysis …

Trunk Postural Adjustments: Medium-Term Reliability And Correlation With Changes Of Clinical Outcomes Following An 8-Week Lumbar Stabilization Exercise Program, Jean-Alexandre Boucher, Richard Preuss, Sharon M. Henry, Marilee Nugent, Christian Larivière

Études primaires

Background

Low back pain (LBP) has been previously associated with delayed anticipatory postural adjustments (APAs) determined by trunk muscle activation. Lumbar stabilization exercise programs (LSEP) for patients with LBP may restore the trunk neuromuscular control of the lumbar spine, and normalize APAs. This exploratory study aimed at testing the reliability of EMG and kinematics-based postural adjustment measures over an 8-week interval, assessing their sensitivity to LBP status and treatment and examining their relationship with clinical outcomes.

Methods

Muscle activation of 10 trunk muscles, using surface electromyography (EMG), and lumbar angular kinematics were recorded during a rapid arm-raising/lowering task. Patients with …

The Effects Of An 8-Week Stabilization Exercise Program On Lumbar Multifidus Muscle Thickness And Activation As Measured With Ultrasound Imaging In Patients With Low Back Pain: An Exploratory Study, Christian Larivière, Dany H. Gagnon, Sharon M. Henry, Richard Preuss, Jean-Pierre Dumas

Études primaires

Background

Lumbar stabilization exercise programs (LSEP) produce positive effects on clinical outcomes, but the underlying mechanisms remain relatively unexplored. Psychological and neuromuscular mechanisms can be involved, such as a better activation of the lumbar multifidus, which represents one possibility.

Objectives

To determine the following: (1) the effect of an LSEP on lumbar multifidus muscle thickness and activation, as measured with rehabilitative ultrasound imaging (RUSI), in patients with low back pain (LBP); (2) the correlation between RUSI measures and any change in clinical outcomes following the LSEP; and (3) the reliability of RUSI measures in control subjects over 8 weeks.

Design …

Will Vestibulo-Ocular Reflex And Balance Rehabilitation Reduce Visual Deficits & Improve Stability Of A Patient With Multiple Sclerosis?, Natalie Hunt, Jennifer Kiggins

Sacred Heart University Scholar

Context: Identification of rehabilitation exercises to decrease symptomology in a patient with Multiple Sclerosis (MS) is necessary for enhancing quality of life. Various vestibulo-ocular reflex (VOR) rehabilitation exercises can help patients adapt to balance problems. Currently, no researcher has utilized the VSR™ Sport and inVision™ systems by NeuroCom® for rehabilitation among patients with MS.

Objective: The purpose of the study was to create a rehabilitation protocol incorporating VOR and balance exercises to decrease visual deficits and improve stability in a patient with MS. This study will examine the effects of rehabilitation and determine if scores improve from baseline testing.

Design: …

Rehabilitation Of An Injured Golden Eagle (Aquila Chrysaetos): A Case Study, Fida Muhammad Khan, Fakhar-I- Abbas, Abu Ul Hassan Faiz

Journal of Bioresource Management

Habitat destruction and anthropogenic activities cause wild birds to migrate towards urban areas in search of food and sometimes nesting in high-roof buildings, where they are caught by local people using different techniques and are further used for hunting or recreational purposes. An injured Golden Eagle (Aquila chrysaetos) was found entangled in bushes near the vicinity of Balkasar Research Complex, Chakwal, Pakistan. After complete physical examination, a wound on the right wing and closed leg fracture was diagnosed. The successful treatment was done by anti-parasitic and anti-bacterial drugs with careful monitoring. Splint was adjusted after aligning the fractured …

Impacts Of Exercise On Functional Ability Of Recovering Gbs Patients: An Integrative Literature Review, Yasmin Sheriff

Grace Peterson Nursing Research Colloquium

This integrative literature review aimed to investigate the impacts exercise has on functional ability of GBS patients in recovery.

Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer

DePaul Discoveries

Reduction of stressors and anxiety levels in adolescents with chronic illnesses is a critical concept in pediatric health care in America today. The many stressors associated with chronic illness include displaying physical and mental differences, social stigma, financial difficulty, and family stress. These stressors may affect the adolescent’s ability to learn and cope in everyday life. The current research was a critical review of the literature examining studies done with adolescents coping with chronic diseases and illnesses. The aim was to analyze the most efficacious non-pharmacological methods for reducing stressors in adolescents with chronic illness. A critical review of the …

Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph

Osteopathic Medicine Student Research Posters

Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …

Trunk And Respiratory Motor Control In Typically Developing Children And Its Implications In Children With Chronic Spinal Cord Injury., Goutam Singh

Electronic Theses and Dissertations

Independent sitting is a major milestone and is also a prerequisite for optimal performance of activities of daily living (ADLs). Development of sitting posture control is a dynamic process involving control of degrees of freedom of head and trunk. Traditionally, trunk has been modeled as a single unit (segment). However, recent studies have suggested that it is made up multiple spinal units, controlled by a combination of trunk muscles. During typical development, posture control of trunk is different for different trunk segments. This motor development of trunk control is a complex process due to constant interaction between the nervous system …

Factors In Patient Responsiveness To Directional Preference-Matched Treatment Of Neck Pain With Or Without Upper Extremity Radiation, Benjamin Holmes, Ruta Brazauskas, Laura D. Cassidy, Rachel A. Wiegand

Journal of Patient-Centered Research and Reviews

Purpose

Patient-related predictive factors in responsiveness to directional preference therapy for neck pain with or without upper extremity radiation (NP/R) have not been reported. A directional preference is any neck movement that, when performed repeatedly to end range, results in centralization and/or alleviation of NP/R. It was hypothesized that patient compliance with a prescribed, directional preference-matched home exercise program would improve positive responsiveness to NP/R treatment.

Methods

Patient-related factors thought to affect responsiveness to care were collected retrospectively from charts and de-identified for patients with NP/R who underwent chiropractic treatment at a multispecialty spine clinic from January 2014 through June …

Sex-Dependent Effects Of Ho-1 Deletion From Adipocytes In Mice, Peter A. Hosick, Mary Frances Weeks, Michael W. Hankins, Kyle H. Moore, David E. Stec

Department of Exercise Science and Physical Education Scholarship and Creative Works

Induction of heme oxygenase-1 (HO-1) has been demonstrated to decrease body weight and improve insulin sensitivity in several models of obesity in rodents. To further study the role of HO-1 in adipose tissue, we created an adipose-specific HO-1 knockout mouse model. Male and female mice were fed either a control or a high-fat diet for 30 weeks. Body weights were measured weekly and body composition, fasting blood glucose and insulin levels were determined every six weeks. Adipocyte-specific knockout of HO-1 had no significant effect on body weight in mice fed a high-fat diet but increased body weight in female mice …

Exercise Tolerance Improves After Pulmonary Rehabilitation In Pulmonary Hypertension Patients, Arunabh Talwar, Sonu Sahni, Sameer Verma, Sara Z. Khan, Sean Dhar, Nina Kohn

Touro College of Osteopathic Medicine (New York) Publications and Research

Pulmonary rehabilitation (PR) is part of the recommended management plan of pulmonary hypertension (PHTN) and is important to better quality of life and exercise tolerance. This study aimed at determining effectiveness of PR on exercise capacity. Retrospective chart analysis was conducted on patients referred to our PHTN clinic for PR. Patients who had PHTN diagnosed on right heart catheterization (defined by mean pulmonary artery pressure>25 mmHg) and completed a standardized 12-week PR program were considered for the study. Patients’ baseline exercise tolerance was recorded as speed attainable on a treadmill and duration of exercise in minutes. Demographics, age, sex, …

Neurobehavioral Function In Adults Recovering Consciousness After Severe Traumatic Brain Injury: A Scoping Review, Jennifer Weaver, Ann Guernon, Trudy Mallinson, Theresa Louise-Bender Pape, Thomas Harrod

Clinical Research and Leadership Faculty Posters and Presentations

This scoping review aims to report the findings of current literature examining the assessment of neurobehavioral function and recovery along the continuum of disorders of consciousness (DOC) from coma to full consciousness.

•This study is designed to capture the range of constructs researchers have used to measure NBF during recovery of consciousness.

•The research question for this review was: “What constructs are most frequently used to assess neurobehavioral function in adults recovering consciousness after severe TBI?”

A Novel Approach To The Safe And Effective Mobilization Of A Super-Obese Patient: A Case Report, Jessica Anaf, Amy Wigmore, Kathy Stiller

Internet Journal of Allied Health Sciences and Practice

Purpose: The incidence of obesity is rising worldwide, as is the presentation of these patients to the acute hospital setting. As a result of their complex nature, including medical co-morbidities, psychosocial issues, and healthcare resource limitations, management of these patients requires a coordinated and intensive multi-disciplinary approach. Although there are considerable data reporting the surgical management of obese patients, there is very limited literature regarding non-surgical interventions, including approaches to safe and effective mobilization. Methods: A case report is presented of a 55-year-old super-obese male transferred to a major tertiary referral healthcare centre for management of his overall medical condition …

The Impact Of Chemotherapy And Radiotherapy For Breast Cancer On Cognition And Functional Performance: A Comparative Analysis Of Survey Data Taken At Three Time Points Post-Treatment, Ann Marie Potter

Theses and Dissertations

Cognitive impairment related to treatment for breast cancer, affects as many as 75% of patients in study samples (Jansen, Cooper, Dodd & Miaskowski, 2011). Deficits in the cognitive domains of short-term memory, attention, speed of information processing, judgment, reasoning, spatial attention, and verbal memory have been documented. The extent to which these deficits impact functional performance within this population has not yet been quantified. The purpose of this study was to investigate the impact of breast cancer on self-reported cognition and functional performance in the six months post-completion in two groups of breast cancer survivors, a chemotherapy group and chemotherapy …

Walking Performance Is Positively Correlated To Calf Muscle Fiber Size In Peripheral Artery Disease Subjects, But Fibers Show Aberrant Mitophagy: An Observational Study, Sarah H. White, Mary M. Mcdermott, Robert L. Sufit, Kate Kosmac, Alex W. Bugg, Marta Gonzalez-Freire, Luigi Ferrucci, Lu Tian, Lihui Zhao, Ying Gao, Melina R. Kibbe, Michael H. Criqui, Christiaan Leeuwenburgh, Charlotte A. Peterson

Physical Therapy Faculty Publications

Background: Patients with lower extremity peripheral artery disease (PAD) have decreased mobility, which is not fully explained by impaired blood supply to the lower limb. Additionally, reports are conflicted regarding fiber type distribution patterns in PAD, but agree that skeletal muscle mitochondrial respiration is impaired.

Methods: To test the hypothesis that reduced muscle fiber oxidative activity and type I distribution are negatively associated with walking performance in PAD, calf muscle biopsies from non-PAD (n = 7) and PAD participants (n = 26) were analyzed immunohistochemically for fiber type and size, oxidative activity, markers of autophagy, and capillary density. Data were …

Disease Burden And Functional Outcomes In Congenital Myotonic Dystrophy: A Cross-Sectional Study, Nicholas E. Johnson, Russell Butterfield, Kiera Berggren, Man Hung, Wei Chen, Deanna Dibella, Melissa Dixon, Heather Hayes, Evan M. Pucillo, Jerry Bounsanga, Chad Heatwole, Craig Campbell

Physical Therapy Collection

OBJECTIVE: Herein, we describe the disease burden and age-related changes of congenital-onset myotonic dystrophy (CDM) in childhood.

METHODS: Children with CDM and age-matched controls aged 0 to 13 years were enrolled. Participants were divided into cohorts based on the following age groups: 0-2, 3-6, and 7-13 years. Each cohort received age-appropriate evaluations including functional testing, oral facial strength testing, neuropsychological testing, quality-of-life measurements, and ECG. Independent-samples t test or Wilcoxon 2-sample test was used to compare the differences between children with CDM and controls. Probability values less than 0.05 are reported as significant.

RESULTS: Forty-one participants with CDM and 29 …

Can Gait Signatures Provide Quantitative Measures For Aiding Clinical Decision-Making? A Systematic Meta-Analysis Of Gait Variability Behavior In Patients With Parkinson’S Disease, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

A disturbed, inconsistent walking pattern is a common feature of patients with Parkinson's disease (PwPD). Such extreme variability in both temporal and spatial parameters of gait has been associated with unstable walking and an elevated prevalence of falls. However, despite their ability to discretise healthy from pathological function, normative variability values for key gait parameters are still missing. Furthermore, an understanding of each parameter's response to pathology, as well as the inter-parameter relationships, has received little attention. The aim of this systematic literature review and meta-analysis was therefore to define threshold levels for pathological gait variability as well as to …

Revealing The Quality Of Movement: A Meta-Analysis Review To Quantify The Thresholds To Pathological Variability During Standing And Walking, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Neuromotor processes are inherently noisy, which results in variability during movement and fluctu-ations in motor control. Although controversial, low levels of variability are traditionally considered healthy, while increased levels are thought to be pathological. This systematic review and meta-analysisof the literature investigates the thresholds between healthy and pathological task variability.

After examining 13,195 publications, 109 studies were included. Results from over 3000 healthy sub-jects and 2775 patients revealed an overall positive effect size of pathology on variability of 0.59 forwalking and 0.80 for sway. For the coefficient of variation of stride time (ST) and sway area (SA), upperthresholds of 2.6% …

Management Of Charcot–Marie–Tooth Disease: Improving Long-Term Care With A Multidisciplinary Approach, Donald Mccorquodale, Evan M. Pucillo, Nicholas E. Johnson

Physical Therapy Collection

Charcot–Marie–Tooth (CMT) disease is the most common inherited neuropathy and one of the most common inherited diseases in humans. The diagnosis of CMT is traditionally made by the neurologic specialist, yet the optimal management of CMT patients includes genetic counselors, physical and occupational therapists, physiatrists, orthotists, mental health providers, and community resources. Rapidly developing genetic discoveries and novel gene discovery techniques continue to add a growing number of genetic subtypes of CMT. The first large clinical natural history and therapeutic trials have added to our knowledge of each CMT subtype and revealed how CMT impacts patient quality of life. In …

Retrospective Frames Of Disability: Themes Derived From Parents Of Children Who Grew Up With Congenital Disability, Sheryl L. Holt

Theses and Dissertations--Rehabilitation Sciences

Introduction: For children born with physical disabilities, the perspectives and actions of their parents prove significant to their childhood developmental outcomes clinically, educationally, socially, and with regard to community participation. The lived world and perceptions of parents who have children with disabilities however is not well investigated. This study sought to understand parents’ framing of theirs and their children’s disability experiences. Family systems together with family systems intervention models, and disability theory were used to provide structure to interview instrumentation and subsequent analysis. Child-centered and ecologic influences were also used to track the transformative processes over time that infuses parental …

The Effects Of External Focus Of Attention Exercise Rehabilitation On Dual Task Walking In Parkinson's Disease, Eric N. Beck

Theses and Dissertations (Comprehensive)

Parkinson’s disease impairs control of well-learned movements, and therefore, individuals with Parkinson’s disease are forced to walk with greater conscious control. This causes difficulties while walking and completing a secondary task simultaneously (dual tasking), in that distractions from conscious control of walking increase the risk of falls and injury. Although, attention-based exercise may be a potential avenue to decrease the demands associated with walking in Parkinson’s disease. For example, an external focus of attention (on manipulated objects) has been found to recruit the networks that are important for walking with little conscious control (automatic control networks). In contrast, an internal …

The Feedforward And Feedback Controls On Gait In Adults With Diabetes, Chun-Kai Huang

Theses & Dissertations

There are nearly 26 million people with diabetes mellitus (DM) in the US, and half of chronic DMs develop somatosensory deficits due to diabetic polyneuropathy or diabetic peripheral neuropathy (DPN). The absence or impaired somatosensory feedback (e.g. touch sensation or joint proprioception) resulted from the damage of large nerve fiber, and motor deficits such as attenuated muscle strength and abnormal plantar pressure of lower extremity have been identified in DPN, and these sensorimotor impairments lead to an increased number of falls. To reduce the risk of falling, a well-coordinated and adapted limb movement driven by the feedforward (anticipatory) and feedback …