Rehabilitation and Therapy Commons^™

The Effects Of Leg Length Discrepancy On Gait And Balance, Colin E. Dombroski

Electronic Thesis and Dissertation Repository

Leg length discrepancy is a condition shown to affect 25-70% of the general population. The ubiquitous nature of leg length discrepancy can prove frustrating to many clinicians, particularly due to lack of consensus surrounding the amount of discrepancy that necessitates treatment.

The present research is intended to address the uncertainty surrounding diagnostic and treatment thresholds, through three related studies. In the first study, leg length discrepancy was manipulated in a sample of 15 healthy young adults, using a novel heel-to-toe lift (creating discrepancies of 5mm, 20mm, and 30mm), and the effects of this new discrepancy was observed on the spatial-temporal …

Determining The Validity Of The Nintendo Wii Balance Board As An Assessment Tool For Balance, Sabrina Mae Deans

UNLV Theses, Dissertations, Professional Papers, and Capstones

Context. Application of the Nintendo Wii-fit balance board and its games have been used in Physical Therapy clinics, showing success in individuals with neurological disorders, and has been recommended as a minimum baseline assessment of a symptoms checklist and standardized cognitive and balance assessments for concussion management by the NCAA. However, it still faces challenges of being considered a reliable and consistent tool for producing normative data in the allied healthcare. Because there is little to no evidence for the Wii-fit balance board as a valid balance assessment tool for clinical and/or research usage, the significance of this study is …

Fatigue And Mobility Post-Stroke, Svetlana Knorr

Electronic Thesis and Dissertation Repository

Fatigue post-stroke is a disabling and persistent symptom affecting many stroke survivors. Despite its high prevalence, the pathophysiology underlying this phenomenon remains obscure. Thus, the aim of this thesis was to study the neuromuscular basis underlying fatigue post-stroke and its association with self-reported fatigue and with the performance of tasks incorporating balance and mobility components.

Community-dwelling stroke survivors who had mild to moderate deficits in functional balance and mobility participated in a series of investigations. Chapter 2 describes the initial validation of the Community Balance and Mobility (CB&M) scale for use in persons with chronic stroke. Chapter 3 reported the …

Muscle Fatigue And Motor Output Variability With Acute Stress In Healthy Young Adults And Veterans With Posttraumatic Stress Disorder, Manda Linea Keller

Dissertations (1934 -)

Acute stress can alter motor performance differently for men and women. The first aim of this dissertation addresses possible causes for the sex difference in the motor response of a low-intensity fatiguing contraction of the elbow flexor muscles to an acute stressor (difficult mental math) in young, healthy adults. Muscle fatigue increased for men and women when exposed to the stressor, but impairment was more prominent for the women. This work showed that fatigue in the central nervous system, specifically in cortical motor and premotor areas, as well as relaxation rates of the muscle (quantified with cortical stimulation) were not …

Virtual Reality Gaming As A Tool For Rehabilitation In Physical Therapy, Abel A. Rendon

Loma Linda University Electronic Theses, Dissertations & Projects

Balance control decreases in the elderly and currently 33 to 50 percent of people over 65 years of age experience a fall each year resulting in ten thousand deaths annually. Many balance‐training programs use expensive equipment and a clinical setting for the training. The need for reliable and low cost tools is essential for fall prevention and rehabilitation of the aging population. Virtual reality gaming is emerging as a solution for this problem. The purpose of the six week study was to determine the effects of virtual reality gaming, specifically the Nintendo Wii Fit Balance Board (WBB), on dynamic balance …

Athletic Training Students' Ability To Identify Scapular Dyskinesis, Priscilla M. Dwelly

Graduate Theses and Dissertations

Scapular dyskinesis refers to abnormal movement patterns of the scapula, which have been associated with injury. Previous investigations have validated the scapular dyskinesis test as a visual assessment method using physicians, physical therapists, and certified athletic trainers. Through educational programs, athletic training students should be taught what scapular dyskinesis is and how to identify it. Therefore, the purpose of this investigation was to (a) evaluate entry-level graduate athletic training students' ability to identify scapular dyskinesis, (b) assess their reliability, and (c) determine if they were able to correctly identify the muscles involved in rehabilitating an individual with scapular dyskinesis. Follow-up …

Stretching With Whole Body Vibration Versus Traditional Static Stretches To Increase Acute Hamstring Range Of Motion, Anastasia Elizabeth Bourne

Masters Theses

PURPOSE The purpose of this study was to determine if performing static active knee extension hamstring stretching using the Pneumex Pro-Vibe vibrating platform increased acute hamstring range of motion (ROM) greater than traditional static active knee extension hamstring stretching. METHODS: A within subject design was utilized with subjects undergoing static stretching with vibration and without vibration (conditions counterbalanced). Pre- and post-test active and passive ROM was measured for the right leg, with subjects first undergoing a 5-minute warm-up on a stationary bicycle. Supine active knee extension was performed on the Pro-Vibe platform with and without vibration. The stretch was held …

Walk Softly And Carry A Big Stick: Strategies To Decrease Dynamic Knee Joint Loading, Daniel J. Bechard

Electronic Thesis and Dissertation Repository

Excessive dynamic loading of the knee joint, quantified indirectly during three dimensional gait analysis, is a risk factor for the progression of knee osteoarthritis (OA). The overall objective of this thesis was to explore the effects of prolonged walking and the use of Nordic walking poles on selected gait characteristics indicative of knee joint load. The first study evaluated the time-varying behaviour, reliability, and validity of selected gait kinematics during 60 minutes of treadmill walking in 20 healthy adults. Maximum lateral trunk lean angle and maximum toe-out angle did not change over time, were consistent from day to day and …

The Effects Of Traditional Strengthening Exercises Versus Functional Task Training On Pain, Strength, And Functional Mobility In The 45-65 Year Old Adult With Knee Osteoarthritis, Christine M. Stutz-Doyle

Seton Hall University Dissertations and Theses (ETDs)

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Thrust Joint Manipulation Education: Student Perceptions Of Learning And Practical Experiences In Spinal Manipulation Within Entry-Level Physical Therapist Education Programs, Joshua Thomas Marks, Lisa Basl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Spinal thrust joint manipulation (TJM) education is mandatory in all professional entry-level physical therapy programs, yet TJM is under-utilized in daily practice. This descriptive study expands on previous data about how TJM is taught and includes data for the perceived confidence students have when performing TJM.

Methods: A 39-question descriptive survey inquiring about TJM education and selfperceived confidence in performing TJM was distributed via email to 213 accredited physical therapy programs.

Subjects: Respondents ranged in age from 22-45 (mean age=25.61 years). Respondents included 435 professional physical therapy students (84 male, 285 female) who have completed their …

The Effects Of A Lumbopelvic Hip Complex Conditioning Program On Dynamic Knee Valgus In Female Tennis Players, Katelyn Marie Roling

Graduate Theses and Dissertations

Female athletes have a four-to-six times greater risk of sustaining a lower extremity injury than their male counterparts (Hewett, 2000). One explanation for the discrepancy in injury rates is increased dynamic knee valgus angles caused by neuromuscular imbalances of the lumbopelvic hip complex (LPHC). The purpose of this study was to determine if implementing a LPHC conditioning program improved neuromuscular deficiencies. Seven female collegiate tennis players competitive at the NCAA Division I level volunteered for the study (19.7 + .95 years, 167.3 + 7.4 cm, and 60.72 kg + 6.71 kg). The subjects participated in a 16 week LPHC conditioning …

Effect Of Aquastretch On Range Of Motion At Knee Joint In Total Knee Arthroplasty Patients, Raja Devinder Kochar

UNLV Theses, Dissertations, Professional Papers, and Capstones

The success of the Total Knee Arthroplasty (TKA) depends upon its functional outcomes of increase in reduction in pain, and gait ambulation and performing functional activities of daily living. Compromised range of motion, pain and weakness can reduce their ability to perform activities of daily living. Aquatic Physical Therapy may offer an alternative intervention to traditional Physical Therapy Rehabilitation and many studies have shown improvements in range of motion, swelling, pain reduction, stiffness and quality of life after TKA. AquaStretch, a relatively new form of aquatic therapy, claims to restore the functional mobility which is lost restrictions caused due to …

Patient Factors And Day Of The Week Influencing Physical Therapy Non-Treatment Events In The Acute Care Setting, Daniel Goodrich, Curtis Doug Jensen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background. In acute care hospitals, scheduled physical therapy visits not resulting in treatment may increase patient length of stay and the financial burden to the hospital. Previous literature has not fully evaluated the occurrence of these events, nor have any associated factors been identified.

Objective. Measure the rate of non-treatment and determine which patient characteristics were most likely to predict a non-treatment event.

Design. Retrospective review of documentation at a suburban hospital.

Methods. Data were collected from records of 1,096 patients, totaling 6,097 scheduled sessions. The rate of non-treatment was calculated and logistic regression used to …

Development Of A Scale To Assess Avoidance Behavior Due To A Fear Of Falling: The Fear Of Falling Avoidance Behavior Questionnaire (Ffabq), Cortney Durand, D. Shalom Powell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: A history of falls or imbalance may lead to a fear of falling which may lead to self-imposed avoidance of activity; this avoidance may stimulate a vicious cycle of deconditioning and subsequent falls.

Objective: The purpose of this study was to develop a questionnaire that would quantify avoidance behavior due to a fear of falling.

Design: This study consisted of two parts, questionnaire development and psychometric testing. Questionnaire development included an expert panel and 39 assisted living residents. Psychometric testing included 63 community dwelling subjects with various health conditions.

Methods: Questionnaire development included the evaluation …

Effects Of Environment On Children's Motor Scores, Eligibility Status, And Administration Times, Derrick Mittelstadt, Abigail Parker, Kirsten Pickett, Heather Temkin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Best practices for assessing developmental skills in young children focus on naturalistic observation in everyday settings, but the effects of environment on test scores, eligibility status and administration time have not been explored. The Peabody Developmental Motor Scales-Second Edition (PDMS-2) was administered to 34 children aged 18 to 59 months in natural and pull-out settings. PDMS-2 total, gross, and fine motor quotient (TMQ, GMQ, and FMQ) scores were significantly lower in the natural environment (p’s≤.014). Based on our results, more children would qualify for services when tested in natural environments using TMQ and GMQ scores. It also took significantly longer …

Safety Of Cervical Manipulation: Are Adverse Events Preventable And Are Manipulations Being Performed Appropriately?, Joseph Anders, Jessica March, Amber Perez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: Documented case reports found in medical literature describing adverse events associated with cervical spine manipulation (CSM) were reviewed to determine if the CSM was used appropriately and if the events could have been prevented. Our hypothesis was that CSM had been used inappropriately and that adverse events could have been prevented. This study also looked to identify potential characteristics that may put the patient at risk for injury, or even death as a result of a CSM.

Methods: One hundred and thirty four cases, reported in 93 articles, published between 1950 and 2010, were reviewed. CSMs were categorized as …

The Acute Effects Of Various Types Of Stretching (Static, Dynamic, Ballistic, And No Stretch) Of The Iliopsoas On 40-Yard Sprint Times In Non-Athletes, Scott David Christensen, Craig Perry, Ryan Richard Resnik

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine the effect of static, ballistic, dynamic, and no stretching immediately prior to a 40-yard sprint in college students. There were 35 healthy subjects (22 male and 13 female) between the ages of 24 and 37 (Mean = 26.46 yrs, SD = 2.99 yrs) who participated. The experiment consisted of running 4, 40-yard sprint trials immediately following 1 of 4 different stretching protocols. Prior to each 40- yard sprint trial, a 5-minute warm up was performed at 3.5 mph on a treadmill. Each subject received each of the four techniques in a randomized …

Employment Selections Of Resident And Non-Resident Graduates Of Physical Therapy Programs In Underserved Western States, Trever J. Cornia, Ryan B. Dutot, Jacob T. Parsons, Kathryn D. Swart

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose:Physical therapy (PT) is an essential component of the healthcare system in providing a comprehensive treatment plan for patients with functional limitations. The demand for physical therapy services is projected to expand in the next eight years, leading to an increased need for practicing physical therapists. The Mountain States plus Washington State (MSPWS) demonstrate the greatest shortage of therapists and are considered to be medically underserved. The purpose of this study was to determine the retention rates of resident and non-resident physical therapy graduates of public universities in the MSPWS and to determine which factors influenced their …

The Acute Effects Of Static Stretching Of The Gastrocnemius On Limits Of Stability In Young Adults Versus Elderly Adults, Matt Bugnet, Kirk Player

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Balance is an important part of everyday life for all individuals with many body systems interacting to achieve optimal balance. Proprioceptive organs aid in this interaction, while also acting as stretch receptors. Therefore, it is possible that stretching may influence the overall balance of the individual. The purpose of this study was to investigate the acute effects of stretching on dynamic balance of healthy young and elderly adults. The two groups were used to determine if stretching may discriminately affect balance at different ages.

Subjects: Thirty healthy adults between the ages of 18 and 35 …

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

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design

Randomized, blinded, cohort, within subjects design.

Background and Objective

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

Methods and Measures

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

Influence Of Foot Position On Lower Extremity Muscle Activation, Erin L. Wessman

Physical Therapy Scholarly Projects

With sports participation be it from children, teenagers, or adults; injuries will occur. In 2008-2009 an increase in high school sports participation was at an all-time high increasing to just above 7.5 million. Within this population, knee injuries ranked 3rd, with anterior cruciate ligament (ACL) injuries ranking 4th among all knee injuries. The purpose of this study was to compare muscle activation of six lower extremity muscles in five different foot positions during a single-leg squat in attempts to associate a certain foot position with an increase/decrease in muscle activation, which could then be proposed as a risk factor for …

Does High Intensity Treadmill Therapy In Infants With Down Syndrome Contribute To Attaining Motor Milestones At An Earlier Age?, Rebekah E. Bennett

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not high intensity treadmill therapy is effective in helping children with Down syndrome attain motor milestones at an earlier age.

The Effect Of Joint Mobilization On Functional Outcomes Associated With Chronic Ankle Instability, Matthew C. Hoch

University of Kentucky Doctoral Dissertations

Ankle sprains are among the most common injuries sustained by physically active individuals. Although ankle sprains are often considered innocuous in nature, a large percentage of individuals experience repetitive sprains, residual symptoms, and recurrent ankle instability following a single acute sprain; otherwise known as chronic ankle instability (CAI). In addition to repetitive ankle trauma, those with CAI experience reductions in functional capacity over the life span. This indicates that current intervention strategies for CAI are inadequate and require further investigation.

The objective of this dissertation was to explore differences in walking and running gait parameters between individuals with and without …

Muscle Activity In Lower Extremity During Single-Leg Squat: Role Of Supination And Pronation, Brett J. Debele

Physical Therapy Scholarly Projects

Introduction: Literature has consistently reported a high prevalence of ACL injury rates. A correlation between excessive subtalar joint pronation and ACL injury rates has been noted but research into plausible reasons for this relationship is limited. The purpose of this study was to establish potential cause-and-effect relationships between foot position and ACL injury risk.

Methods: This study used single leg squats with simulated foot positions and examined resulting knee joint forces from motion and lower extremity muscle activation patterns that may cause ACL injury risk. Methods: This study recruited male and female participants aged 18 to 30 from campus at …

Sarcopenia And Aging: Skeletal Muscle Fiber Type Composition Of The Long-Lived Ames Dwarf Mouse Compared To Its Wild-Type Counterpart, Cory Leier

Physical Therapy Scholarly Projects

Skeletal muscle fiber type composition has not been studied in the long-lived Ames dwarf mouse when compared to its wild-type counterpart. Hindlimb soleus skeletal muscle from two 3-month old dwarf and two 3-month old wild-type mice was analyzed for muscle fiber size, proportion of type I (slow-twitch) and type II (fast-twitch) muscle fibers, myonuclei content per muscle fiber, and total cross sectional area of the muscle. Results revealed a significant difference in muscle fiber size (t(58)=-9.71, p

Prosthetic Training Following A Transfemoral Amputation: A Case Report, Jonathan Beck

Physical Therapy Scholarly Projects

Background and Purpose: There has been an increase in amputations since the start of the Iraq/Afghanistan war, but thousands of Americans have a limb amputated each year due to peripheral vascular disease, diabetes, or infections. New technology in the field of prosthetics, especially prosthetic knees, has helped improve these individuals’ function. The most recent advancement in prosthetic knees is the C-leg, a micro-processor-controlled knee; however, a wide variety of prosthetic knees are available. Therefore, it is critical to select the right prosthetic knee to meet each individual’s needs and goals.

Case Description: The patient was a 58-year-old gentleman who underwent …

Muscle Fiber Type Characterization In The Ames Dwarf Mouse: A Model Of Delayed Aging, Angela M. Williams

Physical Therapy Scholarly Projects

Introduction: Normal muscle wasting due to aging, known as sarcopenia, has many implications in society, especially with a growing population of elderly people. In this study, muscle fiber size and count, nuclei count, and ratio of fast- to slow-twitch fibers was studied between Ames dwarf mice (df), an established model of aging, and wild-type mice (WT) to learn more about the mechanisms of aging, specifically related to skeletal muscle.

Methods: Four hind limb muscles were harvested from two Ames dwarf mice and two wildtype mice, sliced cross-sectionally and mounted on slides. After mounting, the slides were stained three different ways …