Rehabilitation and Therapy Commons^™

Walking Kinematics In Young Children With Limb Loss Using Early Versus Traditional Prosthetic Knee Prescription Protocols, Mark Daniel Geil, Zahra Safaeepour, Brian Giavedoni, Colleen Coulter

Faculty Articles

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an “Early Knee” (EK) protocol, which prescribes an articulating prosthetic knee in the child’s first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to …

Case Report: Effects Of Therapeutic Exercise On A Patient With Metastatic Osteosarcoma And Pathological Fracture, Jessica Phung, Sarah Mathew

San Marcos, Spring 2020

Purpose: The purpose of this case report is to demonstrate how conditioning exercise for patients with active metastatic neoplasms can improve quality of life (QoL) after a pathological fracture of lumbar vertebrae. Spinal metastasis, in this case from breast cancer, is primarily asymptomatic, and therefore, difficult to detect during early stages. Detection and diagnosis usually occur after initial manifestation of a pathological fracture leading to debilitating effects. Complications with metastatic bone cancer and surgical contraindications may bring patients into outpatient physical therapy to address the pathological fractures and QoL for patients.

Case Description & Methods: The patient is a 44-year …

Comparison Of Pre- And Post-Operative Shoulder Muscle Emg Profiles In Reverse Total Shoulder Arthroplasty Patients, Emily Lau, Sreten Franovic, Noah Kuhlmann, Eric C. Makhni Md, Stephanie Muh Md

Medical Student Research Symposium

Background: Deltoid muscle function is central in reverse total shoulder arthroplasty (RTSA) function; however, there is limited information available regarding changes in deltoid activity before and after surgery. Few tests exist to evaluate specific muscle metrics pre and post operatively. Surface Electromyographic (EMG) is non-invasive and allows for observation of motions with multifaceted analysis of movement with minimal patient demand. Understanding the changes in shoulder muscle activation, namely in the deltoid, in patients pre and post-RTSA can further advance understanding of the procedure and rehabilitation efforts.

Methods: Nine individuals were recruited for this study: all patients underwent RTSA by a …

The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh

Medical Student Research Symposium

Objective: To understand the current landscape of urine drug testing (UDT) guidelines as part of risk assessment for opioid abuse, and to offer recommendations towards adopting universal screening guidelines.

Background: There has been an opioid epidemic within the United States, and the role of prescription opioids has been well established. Despite proposed recommendations, there has yet to be a published universal screening guideline on the use of UDT in the setting of opioid abuse risk stratification as well as postoperative drug monitoring.

Methods: We explored current guidelines for UDT on two levels. First, we explore general indications for UDT within …

Athletic Trainers’ Perceived And Actual Knowledge Of Cupping Therapy Concepts, Stephen A. Cage, Zachary K. Winkelmann, Brandon J. Warner, Diana M. Gallegos

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: To date, there does not appear to be a study published that has examined the prevalence of clinical use and the perceived and actual knowledge of cupping therapy that clinicians possess. The purpose of this study was to determine the perceived and actual knowledge of cupping therapy among athletic trainers. Methods: 113 certified athletic trainers completed the study (age = 35 ± 10 years, years of certified experience = 12 ± 10 years). Participants were sent an electronic survey via email that assessed frequency of usage, perceived knowledge, and actual knowledge of cupping therapy. Data were downloaded and analyzed …

The Effects Of Strength And Conditioning On Functional Movement Screen™ Scores In Secondary School Basketball., Rollin Ross Dexter, Christopher P. Renggli, James May, Lindsay Larkins

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: Injury prevention and mitigation are among the primary responsibilities of Athletic Trainers. Research has indicated that basketball players at the secondary-school level suffer up to 2.1 time loss injuries (TLI) per 1,000 athletic exposures (AE). It has been suggested that Functional Movement Screen (FMS™) composite and individual task scores may help determine injury risk. Researchers have suggested that a variety of strength and conditioning strategies may positively alter both composite and individual FMS™ task scores and reduce movement asymmetry. Methods: During a retrospective analysis of the records of all junior varsity and varsity basketball players at one secondary school …

Effective Treatment Of An Apparent Lateral Ankle Sprain Using A Regional Interdependent Approach With Positional Release Therapy And Mulligan Concept, Joshua K. Underwood

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Objective: Present a pair of clinical cases demonstrating the utilization of regional interdependent (RI) evaluation and treatment in an apparent lateral ankle sprain. The utilization of both Positional Release Therapy (PRT) and Mulligan Concept (MC) on secondary school athletes with an apparent acute lateral ankle sprain are presented. Background: Lateral ankle sprains are a common injury in athletics. While the MC has been shown to be an effective manual therapy in ankle sprains, if the treatment is not pain-free it is considered not warranted. The concept of RI attempts to connect apparently unconnected dysfunctions within the body which collectively contribute …

Student Athlete Perceptions Of Athletic Trainers’ Competence Based On Appearance And Dress, Jennifer J. Rogers

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Context: Physical appearance and dress attire may be a major influence on a person’s perception of an individual’s professional competence. Objective: To examine influence of Athletic Trainer (AT) physical appearance and dress attire on student-athletes’ perception of an AT’s competence. Design: Cross-Sectional Study Setting: NATA District 5 Participants: Student athletes (n=156; female: n=71; male: n=78) from NCAA Division III and NAIA institutions participated in the study. Interventions: Participants viewed one of four Body Mass Index (BMI) specific AT images [underweight BMI=18, normal weight BMI=24, overweight BMI=30, or an obese BMI=36] while answering 36 Student Athlete Response (SAR) Form survey questions …

Effect Of Cupping Therapy On Skin Surface Temperature In Healthy Individuals, Stephen A. Cage, Brandon J. Warner, D. Mitchelle Gallegos

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The purpose of this study was to examine the effect of cupping therapy on skin surface temperature, and therefore local blood flow, at the medial forearm. Methods: 32 healthy subjects [13 females (age = 21.14 ± 1.70, height = 168.00 ± 9.70 cm, mass = 67.07 ± 16.93) and 16 males (age = 21.78 ± 1.90, height = 180.62 ± 6.09, mass = 88.35 ± 14.66) participated in this study. A mark was made with a permanent marker 7 cm distal to the medial forearm. Cupping therapy was performed over this mark with the use of a plastic pump …

The Effectiveness Of An Infrapatellar Strap On Reducing Pain Associated With Patellar Tendinopathy, Jenny Toonstra, Andrea Cripps

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: To determine the effectiveness of an infrapatellar strap on pain reduction in participants with patellar tendinopathy. Methods: Articles were identified from PubMed, CINAHL, Medline, and SportDiscus using the string “((((patellar tendinitis OR patellar tendinopathy))) AND ((cho-pat strap OR infrapatellar strap OR compression device OR brace))) AND pain” from January 2009-January 2019, resulting in nine studies. After a review of the title and abstracts, six studies were reviewed in-depth. Of these articles, four studies met the inclusion criteria. Two independent reviewers assessed the level of evidence of included studies using the Oxford Center for Evidence-Based Medicine (2009). Changes in pain …

Relationship Between Movement Quality, Functional Ambulation Status, And Spatiotemporal Gait Parameters In Children With Myelomeningocele., Megan Flores, Kathleen Manella, Elizabeth Ardolino

Physical Therapy Collection

Aims: We investigated relationships among the Pediatric Neuromuscular Recovery Scale (Peds NRS), modified Hoffer Scale, and spatiotemporal gait parameters in children with myelomeningocele (MMC).

Methods: 21 children with MMC, age 5.3 years (SD = 2.6), were assessed by three clinicians using the Peds NRS and modified Hoffer Scale. In eight children, gait parameters were also measured.

Results: The Peds NRS summary score demonstrated good correlation with modified Hoffer Scale score (r = -0.64, p = 0.002) that accounted for 41% of variation in summary score. Six Peds NRS seated/standing items exhibited good relationships with modified Hoffer Scale …

Metastatic Spinal Cord Compression Mimicking Cauda Equina Syndrome Illustrating Importance Of Adequate Diagnostic Imaging, Jonathan L. Holt, Joseph Hill, Farzin Farhandnejad, Karyn Doddy, Se Won Lee

Physical Medicine & Rehabilitation

See additional files.

Rehabilitation Following Valproic Acid-Induced Hyperammonemic Encephalopathy (Vhe) In A Patient With Intractable Epilepsy, Dan Nguyen, Ann Ikonne, Sewon Lee, Mark Steinhauer

Physical Medicine & Rehabilitation

See additional documents.

Worsening Weakness After Posterior Cervical Decompression And Fusion; The Challenge In Diagnosis, Steven D. Kim, Joseph Hill, Farzin Farhandnejad, Karyn Doddy

Physical Medicine & Rehabilitation

See additional files.

Unmasking Severe Hypotension After Intermittent Catheter For Distended Bladder In A Patient With Cervical Spinal Cord Injury, Dennis Nguyen, Neal Ekpoudia, Ellsworth Remson, Farzin Farhandnejad, Se Won Lee

Physical Medicine & Rehabilitation

See additional files.

A Quantitative Comparison Of Arm Activity Between Survivors Of Breast Cancer And Healthy Controls: Use Of Accelerometry, Mary Insana Fisher, Claire C. Davies, Timothy L. Uhl

Physical Therapy Faculty Publications

Purpose

Survivors of breast cancer (BC) on the non-dominant side have more persistent deficits than those with cancer on the dominant limb. What is not known is whether those with BC use their involved upper limbs more, less, or at the same level as women without BC. Accelerometer use offers a quantifiable method to measure activity levels of upper limbs. The purpose of this study was to quantify the activity levels of the non-dominant involved limb among survivors of BC and compare these values to their dominant limb, as well as the non-dominant limb of a control group.

Methods

Participants …

“But I’Ve Always Lived Here”: Evidence Informed Analysis On Aging In Place, Roxanne Mueller, Allison Paris, Holly Olsen, Lindsey Valentine, Chris Childers

Physical Therapy Collection

Purpose: The purpose of this poster/presentation is to provide an exploration and analysis of aging in place. To ensure the success of the older adult to remain in their home it is essential to determine and meet the changing needs of the aging population in a way that preserves lifelong health and wellness.

Description: The global trend of population aging is on the continual rise due to longer life expectancy and lower fertility rates.¹ It is predicted that by the year 2036 one in every four individuals will be a senior citizen. In some areas, the availability of …

Can Treadmill Training With Musical Cueing In Individuals With Progressive Parkinson’S Disease Improve Ambulation?, Kristen Barta, Derrick F. Campbell, Sharon Dunnivan-Mitchell Pt, Dpt

Physical Therapy Collection

The purpose of this study was to measure the effectiveness of a specialized musical composition in combination with treadmill training to impact gait parameters and balance in people with progressive Parkinson’s disease (PD). Incorporation of auditory stimulation, typically via metronome, to improve movement has been successfully used in rehabilitation for decades. Treadmill training, also frequently used in treatment of PD, has shown short- and long-term improvements in stride length, cadence, stance and swing phase. Music assisted therapy utilizing expertly designed musical composition, known as informed composition, has recently become available for use in rehabilitation in collaboration with music therapists. Combination …

Pills And Spills: An Assessment Of Medications And Fall Risk In Older Patients, Kelly L. Covert, Courtney D. Hall

ETSU Faculty Works

No abstract provided.

Predictors Of Swallowing Outcomes In Patients With Combat-Injury Related Dysphagia, Nancy Pearl Solomon, Angela M. Dietsch, Katie Dietrich-Burns

Department of Special Education and Communication Disorders: Faculty Publications

Background: Traumatic injuries, such as those from combat-related activities, can lead to complicated clinical presentations that may include dysphagia.

Methods: This retrospective observational database study captured dysphagia-related information for 215 United States military service members admitted to the first stateside military treatment facility after sustaining combat-related or combat-like traumatic injuries. A multidimensional relational database was developed to document the nature, course, and management for dysphagia in this unique population and to explore variables predictive of swallowing recovery using Bayesian statistical modeling and inferential statistical methods.

Results: Bayesian statistical modeling revealed the importance of maxillofacial fractures and soft …

Ectopic Pregnancy In A Woman With T9 Ais A Paraplegia Secondary To High-Grade Spinal Cord Pilocytic Astrocytoma, Elisabeth K. Acker

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Ectopic pregnancy in a woman with T9 AIS A (motor complete, sensory complete) paraplegia secondary to a high-grade spinal cord pilocytic astrocytoma

Background

In the United States, 20,000 women of childbearing age have a spinal cord injury (SCI). While SCI induces transient amenorrhea immediately after injury, women generally have normal reproductive function after SCI, and their fertility is unimpaired. Medications that commonly manage complications of SCI should be avoided or discontinued during pregnancy. Complications inherent to SCI, including urologic issues, are often exacerbated during pregnancy.

Methods

This is a case report on a female Veteran who initially presented to the …

Age And Functional Outcomes Post-Neurologic Insult In Patients Attending Inpatient Rehabilitation, Jonathan Bowman Spt, Elena Crooks Pt, Dpt, Phd, Doug Weeks Phd, Kimberly Honn Phd

2020 Symposium Posters

Introduction

Neurologic insults such as strokes and traumatic brain injuries (TBI) affect over 1 million Americans every year. The lack of current knowledge informing accurate prognoses causes victims and their loved ones distress, and is a focus of much research. The purpose of this study was to determine whether patient age at time of insult could predict change in functional outcomes during inpatient rehabilitation.

Methods

Subjects were patients of an inpatient rehabilitation facility (IRF) post-stroke or TBI. The Functional Independence Measure (FIM) assessed functional independence and cognitive status at admission and discharge from the IRF. The Montebello Rehabilitation Factor Score …

Pilot Evaluation Of The Usability And Utility Of A Wearable Technology To Monitor And Evaluate Health Condition, Drew Nielsen, David Shipon, Md, Facc, Facp

Phase 1

Introduction: Cardiac rehabilitation programs have particularly poor attrition and rehospitalization from cardiac-related events is a large burden on the medical system, as 8.9% of patients who have acute MI are rehospitalized within one year. External barriers may exist that prevent patients from adequately completing in-house cardiac rehabilitation, which makes them strong candidates for a home-based rehab program (HBCR). Previous randomized trials have generated evidence that HBCR can achieve similar cardiac improvements in 3- 12-month clinical outcomes. With the large-scale adoption of wearable technologies, with an estimated 8.2 million devices owned by individuals over 55, we have an opportunity to incorporate …

Caffeine Ingestion Enhances Repetition Velocity In Resistance Exercise: A Randomized, Crossover, Double-Blind Study Involving Control And Placebo Conditions, Jozo Grgic, Sandro Venier, Brad J. Schoenfeld, Pavle Mikulic

Publications and Research

We aimed to examine the effects of placebo and caffeine compared to a control condition on mean velocity in the bench press exercise. Twenty-five resistance-trained men participated in this randomized, crossover, double-blind study. The participants performed the bench press with loads of 50%, 75%, and 90% of one-repetition maximum (1RM), after no supplementation (i.e., control), and after ingesting caffeine (6 mg/kg), and placebo (6 mg/kg of dextrose). At 50% 1RM, there was a significant effect of caffeine on mean velocity compared to control (effect size [ES] = 0.29; p = 0.003), but not when compared to placebo (ES = 0.09; …

Comparison Of Home Therapy Vs Formal Outpatient Physical Therapy In Post-Operative Management Of Two-Incision Distal Bicep Tendon Repair, Joseph Botros, John Horneff Iii, Md, Thomas Harper, Brent Page

Phase 1

Background: Distal bicep tendon tears are a relatively uncommon injury, affecting 1.2/ 100,000 persons per year; they can also cause substantial loss in supination and flexion strength. The most common treatment is a double incision distal bicep tendon repair, which involves surgical reinsertion of the bicep tendon onto the radial tuberosity. Following surgery, physicians have traditionally recommended the patient undergo 5-12 weeks of formal outpatient physical therapy. This can be a significant cost and time burden to the patient. Therefore, some physicians have instead opted for home physical therapy, in which the patient is given instructions on exercises to complete …

Clinical And Neurophysiological Effects Of Dry Needling On Individuals With Chronic Ankle Instability, Jennifer Mullins

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are generally considered innocuous injuries; however, as many as 74% of patients will develop chronic symptoms. 1-3 Chronic ankle instability (CAI) is defined by a history of ankle sprain accompanied by ongoing bouts of giving way, residual ankle sprain symptoms, and a decrease in patient-perceived function. As understanding of sensorimotor deficits in individuals with CAI have advanced, treatment strategies have evolved to include a robust focus on balance training to mitigate dynamic and static postural control impairments exhibited in individuals with CAI. A problem arises as these improvements have not been conclusively linked to a decrease in CAI. …

Biopsychological Predictors Of Pain And Function In Patients With Rotator Cuff Conditions, Nicole Cascia

Theses and Dissertations--Rehabilitation Sciences

Predicting worse patient-reported outcomes in those with Rotator Cuff (RC) conditions is dependent on examining both biological and psychological impairments. In order to help determine which biopsychological factors are associated with pain and function in patients with RC related conditions and to determine who may be at an increased risk for worse outcomes after Reverse Shoulder Arthroplasty (RSA), biopsychological associations between patient demographics, scapular motion, humeral motion, RC tear size, pain associated psychological distress, and function were clinically evaluated to investigate prediction models for pain and function. The central hypothesis is that in a group of patients with symptomatic Cuff …

Safety, Feasibility, And Efficacy Of Early Rehabilitation In Patients Requiring Continuous Renal Replacement: A Quality Improvement Study, Kirby P. Mayer, Amanda R. Hornsby, Victor Ortiz Soriano, Timothy C. Lin, Jennifer T. Cunningham, Hanwen Yuan, Caroline E. Hauschild, Peter E. Morris, Javier A. Neyra

Physical Therapy Faculty Publications

Introduction: Early rehabilitation in critically ill patients is associated with improved outcomes. Recent research demonstrates that patients requiring continuous renal replacement therapy (CRRT) can safely engage in mobility. The purpose of this study was to assess safety and feasibility of early rehabilitation with focus on mobility in patients requiring CRRT.

Methods: Study design was a mixed methods analysis of a quality improvement protocol. The setting was an intensive care unit (ICU) at a tertiary medical center. Safety was prospectively recorded by incidence of major adverse events including dislodgement of CRRT catheter, accidental extubation, bleeding, and hemodynamic emergency; and minor adverse …

The Efficacy Of Yoga As An Adjunctive Therapy To Standard Multidisciplinary Care In The Treatment Of Female Patients Presenting With Cognitive Eating Disorder Symptoms, Cassidy Nagle

Capstone Showcase

Introduction: Current treatment of patients exhibiting cognitive eating disorder symptoms is standard multidisciplinary care (SMDC) involving behavioral therapy, medical management and dietetics. Because these symptoms often persist or relapse despite treatment, research has begun to explore adjunctive therapies like yoga for this population. This review will explore seven studies in order to analyze the effect of yoga (I) on cognitive eating disorder symptoms (O) in teenage and adult females (P) when added to SMDC compared to symptom reduction with SMDC alone (C).

Methods: A literature search was conducted in PubMed, Academic Search Ultimate and Google Scholar starting November 2018. Seven …

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 …