Rehabilitation and Therapy Commons^™

Digital Rehabilitation For Hand And Wrist Pain: A Single-Arm Prospective Longitudinal Cohort Study, Fabíola Costa, Dora Janela, Maria Molinos, Robert G Moulder, Jorge Lains, Gerard E Francisco, Virgílio Bento, Vijay Yanamadala, Steven P Cohen, Fernando Dias Correia

Faculty, Staff and Student Publications

Introduction: Wrist and hand represent the third most common body part in work-related injuries, being associated with long-term absenteeism. Telerehabilitation can promote access to treatment, patient adherence, and engagement, while reducing health care-related costs.

Objective: Report the results of a fully remote digital care program (DCP) for wrist and hand pain (WP).

Methods: A single-arm interventional study was conducted on individuals with WP applying for a DCP. Primary outcome was the mean change in the Numerical Pain Rating Scale after 8 weeks (considering a minimum clinically important change of 30%). Secondary outcomes were: disability (Quick Disabilities of the Arm, Shoulder, …

Emerging Evidence For Intrathecal Management Of Neuropathic Pain Following Spinal Cord Injury, Jay Karri, James Doan, Christian Vangeison, Marissa Catalanotto, Ameet S Nagpal, Sheng Li

Faculty, Staff and Student Publications

A high prevalence of patients with spinal cord injury (SCI) suffer from chronic neuropathic pain. Unfortunately, the precise pathophysiological mechanisms underlying this phenomenon have yet to be clearly elucidated and targeted treatments are largely lacking. As an unfortunate consequence, neuropathic pain in the population with SCI is refractory to standard of care treatments and represents a significant contributor to morbidity and suffering. In recent years, advances from SCI-specific animal studies and translational models have furthered our understanding of the neuronal excitability, glial dysregulation, and chronic inflammation processes that facilitate neuropathic pain. These developments have served advantageously to facilitate exploration into …

Editorial: How Can Wearable Robotic And Sensor Technology Advance Neurorehabilitation?, Shuo-Hsiu Chang, Shih-Chiao Tseng, Hao Su, Gerard E Francisco

Faculty, Staff and Student Publications

No abstract provided.

Effects Of Il-10 On Local Cell Populations And Functional Recovery Following Vml Injury, Zain Blackwell

Biomedical Engineering Undergraduate Honors Theses

Volumetric muscle loss (VML) injuries are prevalent in both military personnel suffering from battlefield related incidents, and civilians following severe motor accidents. Despite its prevalence, VML has no pro-regenerative clinical treatments in place to recover some of the functional capabilities of the damaged muscle. Free flap grafting, debridement of damaged tissue, and physical therapy are the only clinical standards available that offer little functional recovery benefits, even after years of consistent treatment. In this study, anti-inflammatory cytokine interleukin-10 in conjunction with autologous minced muscle was assessed as a possible treatment for VML injuries and its influences on cellular behavior within …

The Relationship Between Self-Reported Exercise Levels During Pregnancy And Labor Pains, Jaiden Outten, Maria Johnson, Katherine Ingram Ph.D., Sadaf Dabeer Ph.D., Julianna Filguerias Meireles Ph.D., Janeen Amason R.N., Ph.D

Symposium of Student Scholars

Abstract

Background: Physical activity is important to maintain overall health and wellness even during pregnancy. There are numerous benefits to exercise during pregnancy that include reduced back pain and lower risk of preeclampsia and gestational diabetes. Recent studies have shown an association between aerobic exercise and reduction in the intensity of labor pains. Purpose: The purpose of this study is to determine the association among level of exercise level and the intensity of pain during active labor. Methods: Women up to 2 years postpartum were invited to complete an online survey about the frequency of exercise (none, occasionally, a few …

Dextromethorphan-Quinidine Is Helpful For Pseudobulbar Affect Disorder In Stroke Patients, Michael Francis, Mira Hamame, Md, Mariam Nasrallah, Md, Alison Nesbitt, Do, James Peter Meza, Md, Phd

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent article using

Hammond FM, Alexander DN, Cutler AJ, et al. PRISM II: an open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, stroke or traumatic brain injury. BMC Neurology. 2016;16:89. https://doi.org/10.1186/s12883-016-0609-0

for a patient with pseudobulbar affect following stroke

Conservative Management Of Low Back Pain, Se Won Lee, Dan Nguyen, Denny Mack, Eric Aguila, Mary Thomas, Karyn Doddy

HCA Healthcare Journal of Medicine

Low back pain (LBP) is frequently encountered in outpatient clinics and affects individual patients and society in general with decreased physical function, quality of life, disability, and/or economic burden. Although most acute LBP resolves on its own, recurrent and chronic LBP is a common reason for outpatient clinic visits. This review explores pragmatic approaches to LBP in the clinical setting, focusing on recognizing prognostic factors, initial approaches to evaluation, including selective imaging, and conservative management including patient education, therapeutic exercises and bracing.

Effects Of The Tailored Activity Program (Tap) On Dementia-Related Symptoms, Health Events And Caregiver Wellbeing: A Randomized Controlled Trial, Laura N Gitlin, Katherine Marx, Catherine V. Piersol, Nancy A Hodgson, Jin Huang, David L Roth, Constantine Lyketsos

Department of Occupational Therapy Faculty Papers

BACKGROUND: People living with dementia (PLWD) and caregivers are adversely impacted by lack of meaningful activity leading to worse symptoms and impaired quality-of-life. There is a critical need to develop effective and well-tolerated treatments that mitigate clinical symptoms, engage PLWD and support caregiver wellbeing. We tested whether, compared to attention control, the Tailored Activity Program (TAP) reduced clinical symptoms and health-related events, and improved caregiver wellbeing, and if TAP activities were well-tolerated.

METHODS: We conducted a single-blind randomized controlled trial among 250 dyads recruited from Baltimore-Washington DC (2012-2016) with a dementia diagnosis and clinically significant agitation/aggression. Dyads were randomized to …

Usability Of Abattoir-Acquired Pig Eyes For Refractive Excimer Laser Research, Marius Topka, Yao Zhang, Antonia Bock, Peter Riedel, Johannes Lörner, Alexander Hammer, Eva Maier, Friedrich Paulsen, Christian M Hammer

Faculty, Staff and Student Publications

The purpose of this study was to elucidate, under which conditions abattoir-acquired pig eyes are suitable for refractive excimer laser experiments. Porcine eyes from tunnel-scalded (n = 5) and tank-scalded (n = 10) pigs were compared to unscalded eyes (n = 5) and to eyes scalded in the laboratory (n = 5). The corneal epithelium was removed before an excimer laser was used to perform a - 8.0 D photoablation. Corneal thickness was measured by optical coherence topography before and after photoablation. The ablation depth was determined with a contour measuring station, the morphology of the ablated areas was characterized …

Does Subthalamic Deep Brain Stimulation Impact Asymmetry And Dyscoordination Of Gait In Parkinson’S Disease?, Deepak K. Ravi, Christian R. Baumann, Elena Bernasconi, Michelle Gwerder, Niklas K. Ignasiak, Mechtild Uhl, Lennart Stieglitz, William R. Taylor, Navrag B. Singh

Physical Therapy Faculty Articles and Research

Background. Subthalamic deep brain stimulation (STN-DBS) is an effective treatment for selected Parkinson’s disease (PD) patients. Gait characteristics are often altered after surgery, but quantitative therapeutic effects are poorly described. Objective. The goal of this study was to systematically investigate modifications in asymmetry and dyscoordination of gait 6 months postoperatively in patients with PD and compare the outcomes with preoperative baseline and to asymptomatic controls without PD. Methods. A convenience sample of thirty-two patients with PD (19 with postural instability and gait disorder (PIGD) type and 13 with tremor dominant disease) and 51 asymptomatic controls participated. Parkinson patients …

Front-Loading Of Anatomy Content Has No Effect On Long-Term Anatomy Knowledge Retention Among Physical Therapy Students: A Prospective Cohort Study., Amy H. Amabile, Kim Nixon-Cave, Larry J. Georgetti, Ashley C. Sims

Department of Physical Therapy Faculty Papers

BACKGROUND: Information learned over a longer period of time has been shown to result in better long-term knowledge retention than information learned over a shorter period of time. In order to address multiple curricular goals, the timing and spacing of anatomy content within the Doctor of Physical Therapy (DPT) program at our institution recently changed from a very spaced to a very compressed format. The purpose of the present study was to assess differences in anatomy knowledge retention that might have been impacted by this change. The research hypothesis was that students receiving spaced instruction would have significantly better anatomy …

Myonuclear Transcriptional Dynamics In Response To Exercise Following Satellite Cell Depletion, Yuan Wen, Davis A. Englund, Bailey D. Peck, Kevin A. Murach, John J. Mccarthy, Charlotte A. Peterson

Physical Therapy Faculty Publications

Skeletal muscle is composed of post-mitotic myofibers that form a syncytium containing hundreds of myonuclei. Using a progressive exercise training model in the mouse and single nucleus RNA-sequencing (snRNA-seq) for high-resolution characterization of myonuclear transcription, we show myonuclear functional specialization in muscle. After 4 weeks of exercise training, snRNA-seq reveals that resident muscle stem cells, or satellite cells, are activated with acute exercise but demonstrate limited lineage progression while contributing to muscle adaptation. In the absence of satellite cells, a portion of nuclei demonstrates divergent transcriptional dynamics associated with mixed-fate identities compared with satellite cell replete muscles. These data provide …

Different Biomechanical Variables Explain Within-Subjects Versus Between-Subjects Variance In Step Length Asymmetry Post-Stroke, Natalia Sánchez, Nicolas Schweighofer, James M. Finley

Physical Therapy Faculty Articles and Research

Step length asymmetry (SLA) is common in most stroke survivors. Several studies have shown that factors such as paretic propulsion can explain between-subjects differences in SLA. However, whether the factors that account for between-subjects variance in SLA are consistent with those that account for within subjects, stride-by-stride variance in SLA has not been determined. SLA direction is heterogeneous, and different impairments likely contribute to differences in SLA direction. Here, we identified common predictors between-subjects that explain within-subjects variance in SLA using sparse partial least squares regression (sPLSR). We determined whether the SLA predictors differ based on SLA direction and whether …

Analysis Of Occupational Therapy’S Role To Promote Healthy Sleep Participation To Support Caregivers Of Children With Autism Spectrum Disorder, Sophia N. Roman

Student Capstone Papers

Children with autism spectrum disorder (ASD) face sleep disturbances. Healthy sleep habits are essential for children with ASD and their caregivers to properly engage in their everyday lives. Occupational therapists are trained to evaluate clients in areas that contribute to sleep dysfunction and to focus on promoting optimal sleep performance. There is limited research on caregivers’ perceptions of their child’s sleep disturbances, these disturbances’ influence on occupational engagement, and whether occupational therapists have collaborated with caregivers of children with ASD to treat this area of occupation. Collecting data from caregivers by using a questionnaire can provide occupational therapy (OT) practitioners …

Using Biofeedback To Reduce Spatiotemporal Asymmetry Impairs Dynamic Balance In People Post-Stroke, Sungwoo Park, Chang Liu, Natalia Sánchez, Julie K. Tilson, Sara J. Mulroy, James M. Finley

Physical Therapy Faculty Articles and Research

Background. People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined. Objective. We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum. Methods. We performed clinical balance assessments and measured wholebody angular momentum during walking using a full-body marker set in a sample of 36 people with …

Development Of A Novel Cognitive-Motor Dual Task Assessment Battery In Neurodegenerative Disease, Jason Longhurst

UNLV Theses, Dissertations, Professional Papers, and Capstones

Automaticity --- the ability to perform a task with directing attentional resources to its completion --- is commonly reduced among individuals with neurodegenerative diseases. These automaticity deficits result in impaired functional and daily activities and are sensitive to subtle, subclinical impairments. However, current measurement of automaticity by dual task paradigms is methodologically limited. In order to gain insight into the current state of the literature regarding cognitive-motor interference in symptomatic and prodromal neurodegenerative disease, the author of this dissertation conducted a scoping review (Chapter 1). To address the methodological limitations of current measurement of automaticity, a new measurement tool was …

Zero Balancing In The Chiropractic Practice, Michele Doucette Dc

Journal of Transformative Touch

Discovering the profound gifts of the leading-edge structural and energetic manual therapy Zero Balancing (ZB), and adding it to my chiropractic and nutrition practice, has unified my personal growth with the sustainability of my professional practice. Much of humanity is starving for wholeness, authenticity, and meaningful connection with ourselves, others, and something greater. Chiropractors are well positioned to be leaders in a true evolution of healthcare, especially if, as we continue to explore the various branches of our therapeutic repertoires, we stay connected to our vitalistic roots that are now more supported than ever by new findings in the fields …

Lost In Translation: Simple Steps In Experimental Design Of Neurorehabilitation-Based Research Interventions To Promote Motor Recovery Post-Stroke, Natalia Sánchez, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Stroke continues to be a leading cause of disability. Basic neurorehabilitation research is necessary to inform the neuropathophysiology of impaired motor control, and to develop targeted interventions with potential to remediate disability post-stroke. Despite knowledge gained from basic research studies, the effectiveness of researchbased interventions for reducing motor impairment has been no greater than standard of practice interventions. In this perspective, we offer suggestions for overcoming translational barriers integral to experimental design, to augment traditional protocols, and re-route the rehabilitation trajectory toward recovery and away from compensation. First, we suggest that researchers consider modifying task practice schedules to focus on …

Placenta-Expanded Stromal Cell Therapy In A Rodent Model Of Simulated Weightlessness, Amber M. Paul, Linda Rubinstein, Charles Houseman, Metadel Abegaz, Steffy Tabares Ruiz

Publications

Long duration spaceflight poses potential health risks to astronauts during flight and re-adaptation after return to Earth. There is an emerging need for NASA to provide successful and reliable therapeutics for long duration missions when capability for medical intervention will be limited. Clinically relevant, human placenta-derived therapeutic stromal cells (PLX-PAD) are a promising therapeutic alternative. We found that treatment of adult female mice with PLX-PAD near the onset of simulated weightlessness by hindlimb unloading (HU, 30 d) was well-tolerated and partially mitigated decrements caused by HU. Specifically, PLX-PAD treatment rescued HU-induced thymic atrophy, and mitigated HU-induced changes in percentages of …

Gait And Balance Changes With Investigational Peripheral Nerve Cell Therapy During Deep Brain Stimulation In People With Parkinson’S Disease, Geetanjali Gera, Zain Guduru, Tritia R. Yamasaki, Julie A. Gurwell, Monica Chau, Anna Krotinger, Frederick A. Schmitt, John T. Slevin, Greg A. Gerhardt, Craig G. Van Horne, Jorge E. Quintero

Physical Therapy Faculty Publications

Background: The efficacy of deep brain stimulation (DBS) and dopaminergic therapy is known to decrease over time. Hence, a new investigational approach combines implanting autologous injury-activated peripheral nerve grafts (APNG) at the time of bilateral DBS surgery to the globus pallidus interna. Objectives: In a study where APNG was unilaterally implanted into the substantia nigra, we explored the effects on clinical gait and balance assessments over two years in 14 individuals with Parkinson’s disease. Methods: Computerized gait and balance evaluations were performed without medication, and stimulation was in the off state for at least 12 h to best assess the …

How The Symptoms And Conditions Associated With Diabetes Can Impact Mobility And Health Of The Individual: A Literature Review, Kaitlin Grace Fotis

Honors Projects

A literature review on diabetes, diabetic neuropathy, diabetic amyotrophy, sores, ulcers, and amputations, and nephropathy and how, through this snowballing journey, physical therapy can aid an individual. Diabetes can impact the mortality and morbidity of an individual and it alone can have lifelong effects upon the individual. These effects may include dependency upon medication, lifestyle modifications, and diet and physical activity guidelines. If their condition were to worsen, they could find themselves battling circulatory issues and neuropathy thereby hindering their physical function. Many individuals with circulatory issues, diabetic neuropathy, and diabetic amyotrophy develop injuries on their feet like ulcers and …

Ankle Muscle Activation And Mechanics During The Ebbet's Foot Drills, Quentin Adam Archuleta

Theses, Dissertations and Capstones

Introduction: The ankle is a complex structure of three joints that allow multiplanar motion (Brockett & Chapman, 2016). Lateral ankle sprains (LAS) are the most common injury seen today in both the general and athletic populations and have a high recurrence rate. When left untreated or mistreated, it often leads to developing chronic ankle instability or osteoarthritis, which a lower quality of life. Dr. Russ Ebbets created a set of foot drills with the claim that they can strengthen the muscles of the lower leg, lessen lower leg aliments, and the chances of a severe ankle sprain (Ebbets, 2011a). …

The Effect Of Upper-String Musician Practice Session On Scapular Kinematics, Connor James Brown

Theses, Dissertations and Capstones

Background: Shoulder pain is common in the upper-string musician population. [43,49] Pain has been linked with injury and impairments. Altered scapular kinematics has been associated with patients diagnosed with shoulder injury or impairment. Fatigue of the shoulder complex through repeated arm motions has been shown to alter scapular kinematics, resulting in shoulder pathologies, including rotator cuff impingement syndrome. [12,15,28] Upper string musicians have been documented with practicing multiple hours in a day and it could be inferred those practice sessions could be fatiguing. [24,49]

Purpose: This study aimed to examine the effect of upper string musician practice session …

Genus Applications For Alzheimer's Disease Pathology, Whitney L Carter

Undergraduate Arts and Research Showcase

Estimates vary, but it is thought that 5.5 million Americans age 60 and up may be living with Alzheimer’s diseases (AD). AD is the most common type of dementia and is characterized by a decline in episodic memories, long-term memory, language, attention, and personality changes. The first symptoms can vary, but for most people memory is the first capacity to become impaired. However, symptoms can also be a decline in non-memory aspects of cognition like work-finding, vision/spatial issues, and impaired reasoning or judgement. AD is identified mainly by two histopathological features: extracellular plague of amyloid-beta protein and intracellular neuronal tangles …

Healing Right Way: Study Protocol For A Stepped Wedge Cluster Randomised Controlled Trial To Enhance Rehabilitation Services And Improve Quality Of Life In Aboriginal Australians After Brain Injury, Elizabeth Armstrong, Juli Coffin, Deborah J. Hersh, Judith M. Katzenellenbogen, Sandra Thompson, Leon Flicker, Meaghan Mcallister, Dominique A. Cadilhac, Tapan Rai, Erin Godecke, Colleen Hayward, Graeme J. Hankey, Neil M. Drew, Ivan Lin, Deborah Woods, Natalie Ciccone

Research outputs 2014 to 2021

Introduction: Despite higher incidence of brain injury among Aboriginal compared with non-Aboriginal Australians, suboptimal engagement exists between rehabilitation services and Aboriginal brain injury survivors. Aboriginal patients often feel culturally insecure in hospital and navigation of services post discharge is complex. Health professionals report feeling ill-equipped working with Aboriginal patients. This study will test the impact of a research-informed culturally secure intervention model for Aboriginal people with brain injury.

Methods and Analysis: Design: Stepped wedge cluster randomised control trial design; intervention sequentially introduced at four pairs of healthcare sites across Western Australia at 26-week intervals.

Recruitment: Aboriginal participants aged ≥18 years …

Effect Of Eurycoma Longifolia And Eccentric Exercise On Quadriceps Strength In Elite Rugby Player, Ahmad Zawawi Zakaria

Student Works (2020-2029)

Optimizing performance by resistance training over a limited amount of time was imperative in a training year plan. Superior effect of eccentric training has been documented but less known its influence on elite athletes which incorporated submaximal and supramaximal intensity eccentric that was essential for muscle strength and hypertrophy. Correspondingly, Eurycoma longifolia Jack (ElJ) supplementation has been shown to stimulate the production of the non-prohibited androgenic hormones, which was important for athletic performance in terms of muscular strength and size. However, investigation was not sufficiently vigorous on such effect of a supplement in elite athletes. Therefore, the major aim of …

Cardiorespiratory Fitness Diminishes The Effects Of Age On White Matter Hyperintensity Volume, Nathan F. Johnson, Ahmed A. Bahrani, David K. Powell, Gregory A. Jicha, Brian T. Gold

Physical Therapy Faculty Publications

White matter hyperintensities (WMHs) are among the most commonly observed marker of cerebrovascular disease. Age is a key risk factor for WMH development. Cardiorespiratory fitness (CRF) is associated with increased vessel compliance, but it remains unknown if high CRF affects WMH volume. This study explored the effects of CRF on WMH volume in community-dwelling older adults. We further tested the possibility of an interaction between CRF and age on WMH volume. Participants were 76 adults between the ages of 59 and 77 (mean age = 65.36 years, SD = 3.92) who underwent a maximal graded exercise test and structural brain …

Photoactivatable Cre Recombinase 3.0 For In Vivo Mouse Applications, Kumi Morikawa, Kazuhiro Furuhashi, Carmen De Sena-Tomas, Alvaro L. Garcia-Garcia, Ramsey Bekdash, Alison D. Klein, Nicholas Gallerani, Hannah E. Yamamoto, Seon Hye E. Park, Grant S. Collins, Fuun Kawano, Moritoshi Sato, Chyuan Sheng Lin, Kimara L. Targoff, Edmund Au, Michael C. Salling, Masayuki Yazawa

School of Medicine Faculty Publications

Optogenetic genome engineering tools enable spatiotemporal control of gene expression and provide new insight into biological function. Here, we report the new version of genetically encoded photoactivatable (PA) Cre recombinase, PA-Cre 3.0. To improve PA-Cre technology, we compare light-dimerization tools and optimize for mammalian expression using a CAG promoter, Magnets, and 2A self-cleaving peptide. To prevent background recombination caused by the high sequence similarity in the dimerization domains, we modify the codons for mouse gene targeting and viral production. Overall, these modifications significantly reduce dark leak activity and improve blue-light induction developing our new version, PA-Cre 3.0. As a resource, …

Giving Credence To The Experience Of X-Linked Hypophosphatemia In Adulthood: An Interprofessional Mixed-Methods Study, Melissa Hughes, Carolyn Macica, Catherine Meriano, Maya Doyle

Journal of Patient-Centered Research and Reviews

Purpose: X-linked hypophosphatemia (XLH) is a rare X-linked dominant metabolic bone disease, often diagnosed in childhood but causing increasing physical debilitation and pain in adulthood. Physical comorbidities of XLH in adulthood include pervasive and early-onset degenerative arthritis, mineralizing enthesophytes and osteophytes, osteomalacia and pseudofracture, dental abscesses, and hearing loss.

Methods: This mixed-methods analysis included physical findings, diagnostic imaging, occupational and physical therapy assessments, and semi-structured interviews by social work to understand the functional outcomes and lived experience of XLH in adulthood, through connections between qualitative data obtained by social work and occupational therapy with the quantitative findings from other disciplines. …

Myocardial Work Index: A Novel Method For Assessment Of Myocardial Function In South Asian Recreational Athletes, Shantanu Sengupta, Renuka Jain, Nitin Burkule, Susan Olet, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: We used a novel noninvasive method based on speckle-tracking echocardiography to evaluate myocardial performance in South Asian recreational athletes who completed a half marathon.

Methods: Transthoracic echocardiography was performed on 24 recreational athletes 48 hours before they took part in a half marathon (premarathon), within 2 hours of half marathon completion (postmarathon), and 72 hours after completion. Clinical, laboratory, and echocardiographic variables were collected. Speckle-tracking echocardiography was performed in all subjects to characterize myocardial mechanics.

Results: Mean age of participants was 41.8 ± 7.4 years, and 23 (95.8%) were male. No subject had a prior history of coronary artery …