Rehabilitation and Therapy Commons^™

Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

Validation Of An Inertial-Measurement-Unit System For Calculating Hip And Knee Flexion Angles During Gait, Joonsun Park

Master's Theses

Technological advances regarding Inertial Measurements Units (IMUs) have positioned this type of sensor as an alternative for camera-based motion capture. This study introduces a new IMU based system (IMU_sys) to measure hip and knee flexion angles. PURPOSE: To validate the use of a five-sensor IMU_sys for the measurement of knee and hip flexion angles during gait in adults and pediatrics at two different time points. METHODS: Bilateral hip and knee flexion patterns (LH, RH, LK, and RK) of twenty-two healthy participants (12 adults and 10 pediatric) between the ages of 8 – 35 years were investigated. Participants …

Curricular Influence On Professional Formation In Physical Therapy Students, Chad W. Jackson

Electronic Theses and Dissertations

Professionalism is needed from each healthcare professional to meet the needs of patients, society, and the expectation that the profession has for its members. Professionalism comprises many attributes and is developed explicitly and implicitly over time through a variety of influential factors. Professional formation education should be an intentional emphasis in any professional program. However, in the academic preparation of healthcare professionals, including physical therapists, a lack of consistency exists in professionalism curricula. It does not appear there are published studies that have specifically compared the effect of curricular approaches in physical therapy education on students’ professional formation. The purpose …

Cardiovascular Effects Of Exercise And Use Of Abdominal Binder In Patients Of Parkinson’S Disease With Orthostatic Hypotension, Faizan Ahmed

Electronic Thesis and Dissertation Repository

Orthostatic hypotension (OH) is a common manifestation of autonomic dysfunction in Parkinson’s Disease. It can adversely affect a patient’s functional capacity, exercise tolerance and quality of life, while increasing the risk of falls, cerebrovascular disease and overall mortality. Use of an abdominal binder (AB) can help counter OH; however, this has not been sufficiently studied in patients with Parkinson’s Disease (PwPD). Moreover, the hemodynamic effects of upper and lower extremity exercise are unclear in PwPD with OH. Although OH can impair the cerebral circulation, the consequences on the cerebral hemodynamics of wearing an AB or performing exercise are unknown in …

Joint Protection Programs For People With Hand Arthritis, Pavlos Bobos

Electronic Thesis and Dissertation Repository

The fact that Joint Protection Programs (JPP) can reduce pain and improve function is based on small, but definitive Randomized Controlled Trials (RCTs), conducted in the 1980s. However, changes over time in the nature of hand use, the rapid expansion of technology, and improvements in our understanding of health literacy mean that these programs are now outdated. Further, problems with adherence to JPP are well documented. The purpose of this thesis was 1) to conduct a scoping review to map all the available evidence around joint protection programs in published and unpublished studies 2) to evaluate the effectiveness of joint …

The Influence Of Autonomic Function On Pain Modulation Before And After Exercise And Cognitive Task In Fibromyalgia, Abdulaziz Awali

Dissertations (1934 -)

Fibromyalgia (FM) is a chronic pain condition characterized by widespread pain. People with FM have alterations in autonomic function compared to healthy individuals. Exercise can decrease pain in people with FM, however some people with FM experience pain exacerbation when initiating exercise. Whether variability in pain at rest and following exercise is related to altered autonomic function, including the potential implications with other stressful events such as mental math, is not known. This dissertation aimed at investigating: 1) the relation between cardiovascular autonomic function and central pain facilitation and inhibition, measured by temporal summation of pain (TS) and conditioned pain …

Pain Modulatory Effects Of Exercise In Chronic Pain, Giovanni Berardi

Dissertations (1934 -)

Exercise training is recommended as a first-line treatment in the management of fibromyalgia due to its ability to improve symptoms and function. However, many with fibromyalgia report limited tolerance to exercise due to exacerbation of pain and fatigue during and following participation of a single bout of exercise. The purpose of this dissertation was to determine the influence of contraction type on local and systemic experimental pain sensitivity, performance fatigue, and perceived pain and fatigue during exercise and through recovery in people with and without fibromyalgia.Experimental and perceived pain were measured before and after a single bout of submaximal intermittent …

Experimental & Simulation Approaches To Study Neuromuscular Control In People With Chronic Ankle Instability, Hoon Kim

Dissertations (1934 -)

Ankle sprains are among the most common musculoskeletal injuries, and up to 70% of people who sprain their ankles develop chronic ankle instability (CAI). Moreover, people who develop CAI have a significantly higher risk of developing ankle osteoarthritis. Recent research has identified neuromuscular deficits that may be responsible for the high recurrence rates of ankle sprains and for the progression towards ankle osteoarthritis in people with CAI. Unfortunately, current rehabilitation strategies are not completely successful because the mechanisms responsible for these deficits are not fully elucidated. Therefore, the purpose of this dissertation was to investigate individual muscle forces and force …

Middle Cerebral Artery Occlusion And The Effects Of Physical Therapy In The Skilled Nursing Facility: A Case Study, Delany Faiman

Physical Therapy Scholarly Projects

Background and Purpose: Stroke is the leading cause of disability and fifth leading cause of death among adults in the Unites States. This case study evaluates the effectiveness of inpatient physical therapy following a right middle cerebral artery occlusion and the outcomes throughout the weeks of treatment.

Case Description: The patient was an 80-year-old male who received physical therapy within the hospital for six days before he was referred to a skilled nursing facility. The patient completed four total weeks of skilled physical therapy in the nursing home prior to discharge.

Intervention: The therapy provided to the …

The Impact Of A Holistic Admissions Review Process In A Doctor Of Physical Therapy Program, Carrie Hawkins

Graduate Theses, Dissertations, and Capstones

Holistic admissions processes in doctor of physical therapy (DPT) education programs are perceived as a means to increasing the diversity of the profession. While previous research has correlated the Graduate Record Examination (GRE) to success on the National Physical Therapy Examination (NPTE) and the grade point average (GPA) to success in the program coursework, the impact of a holistic admissions process on the academic factors or on the demographics of the applicants offered admission has not been extensively studied for DPT education programs. This study was conducted to determine if the addition of a holistic application review process rubric to …

Effect Of Unilateral Lower-Limb Amputation On Intact Limb Biomechanics: A Systematic Review, Amanda Boyd

Master's Theses

The United States will perform 30,000-40,000 amputations this year (Ertl et al., 2019). As a common medical intervention, there is extensive research regarding rehabilitation strategies and post-operative care. Many studies have explored the effects of the affected limb and prosthetic intervention yet have neglected that of the contralateral limb (De Asha et al., 2014; Jones et al., 2006; Winter & Sienko, 1988). Studies have reported an increase in secondary musculoskeletal conditions among unilateral lower-limb amputees, particularly in the intact limb, indicating the need for additional research (Gailey et al., 2008). The purpose of this systematic review was to investigate the …

Intimate Partner Violence (Ipv): Clinical And Societal Perspectives, Marudan Sivagurunathan

Electronic Thesis and Dissertation Repository

Intimate Partner Violence (IPV) can have a lasting impact on survivors’ emotional, physical, and psychological wellbeing. IPV is multifaceted and can influence survivors’ interactions across various institutions, including healthcare settings. This PhD project consists of both qualitative and quantitative studies aimed at exploring the clinical and societal perspectives around IPV.

Study #1 sought to explore the discourses around male IPV drawn from a social networking site (Reddit.com). While some areas related to IPV are well researched, studies on male intimate partner violence survivors are limited. The results from study #1 show that male IPV disclosure is a complex process. While …

Application Of Lsvt-Big Protocol Intervention In 74-Year-Old Female With Parkinson’S Disease: A Case Report, Abigail Stroup

Physical Therapy Scholarly Projects

Background and Purpose. Parkinson’s disease (PD) is a chronic, progressive neurodegenerative condition affecting 60,000 Americans each year.1 This case study evaluates the effectiveness of physical therapy, including the LSVT-BIG protocol, for an individual with Parkinson’s.

Case Description. The patient was a 74-year-old female diagnosed with PD who received outpatient physical therapy services four times per week for four weeks.

Intervention. The therapeutic interventions provided included dynamic, large amplitude exercises per the LSVT-BIG protocol as well as gait, stair, and bed mobility training.

Outcomes. Outcome measures included the Lower Extremity Functional Scale (LEFS), Timed “Up & Go” (TUG), Five-Times-Sit-to-Stand …

Clinical Decision-Making In A Patient With Cervical Radiculopathy And Cubital Tunnel Syndrome: Double Crush Syndrome, Taylor Nord

Physical Therapy Scholarly Projects

Background and Purpose: Double crush syndrome (DCS) is pathology involving the association between proximal and distal nerve lesions. It is often difficult to diagnose due to the variety of possible sources of tissue involvement and, therefore, is difficult to treat effectively. The purpose of this case report is to describe the physical therapy diagnosis and treatment of an older adult with DCS consisting of cervical radiculopathy (CR) and cubital tunnel syndrome (CuTS).

Case Description: 74-year-old female with a diagnosis of CR was referred to physical therapy. The physical examination confirmed this diagnosis. Due to the patient not responding well …

Therapeutic Interventions For Managing Diabetic Shoulder, Sanaa A. Alsubheen

Electronic Thesis and Dissertation Repository

Shoulder pain is a common complaint of diabetic patients that causes motion limitations and functional disability. Adhesive capsulitis (AC) is the most common disabling shoulder disorder. There is no optimal non-surgical treatment for managing AC in diabetic patients. Furthermore, the impact of diabetes on shoulder recovery and factors predicting shoulder function following shoulder arthroplasty is not well investigated.

Purpose and Methods

The main purpose of this thesis was to inform clinical practice about the best intervention for managing AC in diabetic patients, and to assess the impact of diabetes on functional outcomes after shoulder arthroplasty, with the following objectives: 1) …

Physical Therapy Management For A 68-Year-Old Female Following Right Breast Lumpectomy: A Case Report, Mackenzie Dumm

Physical Therapy Scholarly Projects

Background and Purpose. This case report describes and evaluates the clinical decision-making process, physical therapy interventions, and clinical outcomes of a patient with upper extremity pain and functional limitations that presented following breast cancer treatment including a right breast lumpectomy, chemotherapy, and radiation therapy.

Case Description. The patient was a 68-year-old female who was diagnosed with breast cancer in the right breast and received post-surgical physical therapy simultaneously with radiation therapy.

Intervention. Physical therapy interventions were developed with an emphasis on low intensity and short duration cardiovascular activity, thoracic mobility, upper extremity strengthening, scapular stabilization, scar tissue mobilization, …

Implementing The Hodgson Red Yellow Green Mobilization Consensus Recommendation In A Medical And Surgical Icu: A Retrospective Study Exploring The Effectiveness Of An Early Mobilization Decision Protocol In Icu, Swati Patel

Seton Hall University Dissertations and Theses (ETDs)

Background: More than 4 million people are admitted annually to intensive care units (ICUs). Due to immobility, many ICU survivors experience significant cognitive, psychological, and physically disabling side effects regardless of admitting diagnosis. Multiple studies and quality improvement projects have shown the safety, feasibility, and benefits of early mobilization in the ICU setting. Hodgson et al (2014) published consensus recommendations for safe active mobilization of mechanically ventilated critically ill adults. To date, there is no standardized and simple triage protocol for identifying patients for early mobilization. No study so far has described operationalizing and implementing the Red-Yellow-Green system described …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Reliability Of The Lateral Reach Test In People With Unilateral Transfemoral Amputations, Stephen Hill, Samantha Leonard, Elizabeth Vianey Trujillo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lateral reach testing has been established as useful in quantifying stability and fall-risk for older populations without limb loss,1 and has potential for providing useful information about fall-risk, recovery, and rehabilitation of individuals after unilateral trans-femoral amputation. Investigators sought to determine the feasibility and reliability of the Lateral Reach Test (LRT) in people with unilateral trans-femoral amputations. Nine individuals, aged 20-68, with a unilateral trans-femoral amputation were recruited for this study. Two females and seven males participated, and the average height and weight for the group was 167cm and 76kg, respectively. Three participants had right trans-femoral amputations while six had …

Brain Volumes And Dual-Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jon Basterrechea, Daniel Krist, Caitlin Moreland, Morgan Wise

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. Objective: To examine associations between brain volumes, dual task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. Methods: We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual task performance, and measures of gait and balance. Results: Greater cognitive function and combined dual task effect (DTE) is associated with smaller brain volumes. In contrast, greater motor DTE is associated with larger …

Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Effects Of Transcranial Direct Current Stimulation On Gait And Balance Post-Stroke, Leonard Ubalde, Jordon Jacklin, Peyton Hobson, Sara Wright-Avila

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Non-invasive brain stimulation is effective in combination with traditional physical therapy to facilitate motor performance in patients who recently survived a stroke. Current literature has focused on transcranial direct current stimulation and transcranial magnetic stimulation efficacy for improving the completion of fine motor tasks in the upper extremities. However, there is a lack of current evidence regarding the efficacy of this therapy in the lower extremities. Objective: To measure the effects of transcranial direct current stimulation on lower extremity clinical outcomes in patients who had a stroke including gait speed, functional reach, and balance. Methods: Randomized control trial in …

The Effectiveness Of Implementing A Collegiate Dance Clinic At The University Of Nevada, Las Vegas, Quinn Williams, Kristin Allman, Matthew Mcarthur, Ryan Yim

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screenings are commonly employed in athletics to identify deficits in performance with the goal of providing interventions to decrease injury risk; however, their utilization is uncommon in collegiate dance programs. Therefore, the purpose of this service learning project was to address the needs of the University of Nevada, Las Vegas (UNLV) dance program through implementation of an injury screening and prevention clinic for collegiate-level dancers. Four second year Doctor of Physical Therapy students (SPTs) supervised by a clinical faculty member with dance medicine expertise researched, developed, and provided screenings to identify increased risk for dance-specific injuries, and education to decrease …

Partnering With The Nevada Physical Therapy Association To Improve Pt/Pta Engagement, Rachel Cooklin, Joshua Cooper, Madison Luna

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The American Physical Therapy Association (APTA) is the professional organization that represents Physical Therapy and exists to promote the needs of society by advocating access and availability of all Physical Therapy services. The Nevada Physical Therapy Association (NVPTA) is a chapter of the APTA that represents the Physical Therapy profession in Nevada. In 2017, only 38.9% of licensed Physical Therapists (PTs) and 7.9% of licensed Physical Therapy Assistants (PTAs) practicing in Nevada were members of the NVPTA. Objective: The purpose of this service-learning project was to explore membership trends in the NVPTA, explore why membership amongst PTAs is low, …

Comparisons Of Patellar Bone Mineral Density Between Individuals With And Without Patellofemoral Pain, Chris Khuu, Allina Cummins, Steven Shepherd

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Although bone stress injuries have been reported in individuals with patellofemoral pain (PFP), especially within the lateral patella, it remains unclear whether persons with PFP exhibit altered patellar regional bone mineral density (BMD). The primary purpose of this study was to compare BMD of the patella (lateral, medial, and total regions) between individuals with and without PFP using quantitative computed tomography (QCT). The secondary aim was to examine the associations between patellar regional BMD and patellofemoral joint (PFJ) alignment. Methods: Ten individuals with retropatellar pain and 10 sex, age, weight, height, and activity matched pain-free controls underwent a QCT …

Fall Prevention Service-Learning Project, Alexis Mansoor, Kendra Morrison, Jeremy Nordfelt, Cheng Yang Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The purpose of this service-learning project was to: 1) reduce falls in the Las Vegas, Nevada community by implementing the Stepping On fall prevention program and 2) to investigate the effect of planning and implementing a service learning project (SLP) on physical therapy (PT) students’ education and professional development. Description: Under the supervision of our advisor, we planned and organized this SLP, became certified leaders of Stepping On, recruited and screened older adults using the STEADI fall risk screening tool, and facilitated the program at a local community hospital. We facilitated group discussion and instructed the exercises outlined in …

Patient, Student, And Faculty Perceptions Of A Student Led Pro-Bono Education And Treatment Based Back School For Uninsured Nevadans, James Tingey, Daniel Tiano, Rebecca Templeton, Meagan Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Importance: To determine feasibility and benefits of student led back school in an underserved population. Perceptions were positive support benefits for all participants. Objective: To evaluate perceived benefits for uninsured participants, students, and faculty with implementation of an evidence based, student led back school. Design: Eight DPT students created curriculum delivered over two days of two-hour classes, one week apart including screening and abbreviated evaluation of LBP, group education, specific exercise selection, and home exercise program assignment. Following first session, analysis performed to improve subsequent sessions. Setting: Cooperative effort between the pro bono clinic, Volunteers in Medicine of Southern Nevada, …

Dosage, Mode, And Timing Of Acute Care Physical Therapy: A Scoping Review, Brendan Acosta, Bradley Goins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Aims and Objectives: 1) To synthesize available evidence for mode, dosage, and timing of physical therapy in the acute care hospital setting. 2) To report the evidence about the effects of mode, dosage, and timing of physical therapy in the acute care hospital setting on LOS, associated costs, and PT-related outcomes. Background: Hospital based physical therapy quality depends on providing evidence-based interventions, however, the research regarding dosage, mode, and timing of physical therapy in the acute care hospital setting has not been synthesized for patient populations except for total joint arthroplasties or patients in the ICU. Design: A systematic search …

Patient And Facility Perceptions On The Feasibility Of A Student-Run Pro-Bono Back-School For Uninsured Patients With Low Back Pain, Javier Ascanio-Pellon, Sofia Cruz, Lauren Liebert, Trevor Pacuk

UNLV Theses, Dissertations, Professional Papers, and Capstones

A. Background of Knowledge: Nevada ranks 8th highest in uninsured population in the United States. People who are uninsured may be more affected by low back pain (LBP) than their insured counterparts. Volunteers in Medicine of Southern Nevada (VMSN), a non-profit organization, serves uninsured people in Nevada. VMSN partnered with UNLV Physical Therapy (UNLVPT) to provide a back-school for patients. UNLVPT proposed a service-learning model to provide both education and treatment for VMSN patients with LBP. B. Purpose: The purpose of this community-based research project is to create and implement a student-run pro-bono back-school for uninsured individuals with LBP in …

Rhythmic Auditory Cueing Of Gait In Parkinson Disease, Adam Patrick Horin

Arts & Sciences Electronic Theses and Dissertations

Parkinson disease (PD) is a neurodegenerative movement disorder characterized by motor complications such as gait deficits and is caused by the depletion of dopamine producing neurons in the basal ganglia (BG). Gait deficits, including decreased velocity and increased variability, are among the most debilitating symptoms of PD and lead to an increased risk of falls. Common pharmacological treatments do not target many gait symptoms. Therefore, gait rehabilitation methods that can improve these deficits in gait are highly important. A common form of gait rehabilitation is known as rhythmic auditory cueing, in which an individual matches their footfalls to the beat …