Rehabilitation and Therapy Commons^™

Sex-Related Differences In Gait Characteristics And Their Associations With Symptoms In Individuals With Patellofemoral Osteoarthritis, Harvi Hart Dr.

Physical Therapy Publications

Background

Patellofemoral osteoarthritis (OA) is an important subgroup of knee OA. However, the influence of sex on gait characteristics in patients with patellofemoral OA is unknown.

Research question

Compare gait characteristics in females and males with patellofemoral OA and investigate their associations with patellofemoral joint-related symptoms and limitations.

Methods

Mixed effects polynomial regression models compared knee flexion-extension and adduction moments, knee flexion angles, and vertical ground reaction forces over 100% of stance between 26 females and 22 males with patellofemoral OA, with and without adjustment for walking speed and body mass. Multivariable linear regression models were then used to …

The Immediate Effects Of The Nunee Patellar Support On Individuals With Patellofemoral Pain Syndrome, Nick Linn

Graduate Theses, Dissertations, and Problem Reports

Patellofemoral pain syndrome (PFPS) is a common form of anterior knee pain caused by general overuse, muscular weakness or strength imbalances, and poor movement coordination leading to abnormal alignment or mal-tracking of the patella. Recent guidelines do not recommend the use of a knee orthosis due to a lack of evidence supporting their effectiveness. A new patellar support (NuNee, K-Neesio LLC.) which uses distraction force to relieve pressure placed on the patella, has been proposed. The purpose of this study was to examine the immediate effects of the NuNee patellar support on perceived pain, biomechanics, and function in individuals with …

Assessment Of Postural, Locomotor, And Physical Fitness Status In Individuals With Intellectual And Developmental Disabilities, Alana J. Turner

Theses and Dissertations

Introduction: Postural control and locomotion deficits can be observed during the early years of childhood development and throughout life. For those with disabilities, these deficits can advance past the development years and into adolescence and adulthood while affecting the quality of life and daily activity. Finding interactive rehabilitative activities to delay or limit these deficits is essential for people with disabilities to improve their quality of life, inclusion, and overall movement. Adapted physical activity/sports like badminton and virtual reality could promote improvements in postural and locomotor status for young adults with intellectual and developmental disabilities like cerebral palsy (CP), intellectual …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Muscle-Specific Contributions To Lower Extremity Net Joint Moments While Squatting With Different External Loads, Kristof Kipp, Hoon Kim, William I. Wolf

Exercise Science Faculty Research and Publications

The purpose of this study was to determine muscle-specific contributions to lower extremity net joint moments (NJMs) during squats with different external loads. Nine healthy subjects performed sets of the back squat exercise with 0, 25, 50, and 75% of body mass as an added external load. Motion capture and force plate data were used to calculate NJMs and to estimate individual muscle forces via static optimization. Individual muscle forces were multiplied by their respective moment arms to calculate the resulting muscle-specific joint moment. Statistical parametric mapping (α = 0.05) was used to determine load-dependent changes in the time series …

Knee Cartilage T2 Relaxation Times 3 Months After Acl Reconstruction Are Associated With Knee Gait Variables Linked To Knee Osteoarthritis, Jack R. Williams, Kelsey Neal, Abdulmajeed Alfayyadh, Kendra Lennon, Jacob J. Capin, Ashutosh Khandha, Kurt Manal, Hollis G. Potter, Lynn Snyder-Mackler, Thomas S. Buchanan

Physical Therapy Faculty Research and Publications

Osteoarthritis development after ACL reconstruction (ACLR) is not well understood. Investigators have examined associations between knee biomechanical alterations and quantitative MRI (qMRI) variables, reflective of cartilage health, 12–60 months following ACLR; however, none have done so early after surgery. As part of an exploratory study, 45 individuals (age, 23 ± 7 years) underwent motion analysis during walking and qMRI 3 months after ACLR. For each limb, peak knee adduction moment (pKAM) and peak knee flexion moment (pKFM) were determined using inverse dynamics and peak medial compartment force was calculated using a neuromusculoskeletal model. T₂ relaxation times in the medial …

Visuomotor Adaptation During Asymmetric Walking, Charles Napoli

Masters Theses

Necessary for effective ambulation, head stability affords optimal conditions for the perception of visual information during dynamic tasks. This maintenance of head-in-space equilibrium is achieved, in part, by the attenuation of the high frequency impact shock resulting from ground contact. While a great deal of experimentation has been done on the matter during steady state locomotion, little is known about how head stability or dynamic visual acuity is maintained during asymmetric walking.

In this study, fifteen participants were instructed to walk on a split-belt treadmill for ten minutes while verbally reporting the orientation of a randomized Landolt-C optotype that was …

Kinematic Analysis Of A Series Of Jumps In First Position In Professional Ballet Dancers, Jessica Smith, Kevin Robinson, Pat Sells

Internet Journal of Allied Health Sciences and Practice

Purpose: Few ballet-specific studies in the literature examine kinematics during dance activities. Sports studies have identified injury risk in athletes by observing kinematics during specific activity, but this has not yet been explored for ballet. Evaluating kinematics in dancers has the potential to identify injury risk and influence treatment for prevention and rehabilitation. Therefore, the purpose of this study was to examine the landing kinematics of professional ballet dancers during a series of 16 ballet-specific jumps. Methods: This study was a multi-factor repeated measures design. Participants (3 males, 16 females aged 19-33 years; first or second company members) performed 16 …

Asymmetries In Dynamic Valgus Index After Anterior Cruciate Ligament Reconstruction: A Proof-Of-Concept Study, Kai Yu Ho, Andrew Murata

Physical Therapy Faculty Publications

Individuals with anterior cruciate ligament reconstruction (ACLR) are at a higher risk for subsequent anterior cruciate ligament (ACL) tears. Risk factors for ACL injuries likely involve a combination of anatomical, biomechanical, and neuromuscular factors. Dynamic knee valgus has been indicated as a possible biomechanical factor for future ACL injuries. Given that knee valgus is often accompanied by contralateral pelvic drop during single-leg activities, a dynamic valgus index (DVI) that quantifies combined kinematics of the knee and hip in the frontal plane has recently been developed. As the premise of asymmetrical DVI between limbs in the ACLR population has not been …

Biomechanically Inspired Assistive Technology To Restore Movement Of The Upper Limbs After Stroke, Ariel Thomas

Graduate Theses, Dissertations, and Problem Reports

A stroke often damages the neural structures responsible for movement. Stroke is a heterogeneous disease, affecting each survivor differently. There are common motor features of a stroke, but even these features vary across time as an individual proceeds through different stages of recovery. The different ways in which stroke motor impairment can present itself are often overlooked, but these differences are fundamental to the understanding of the disease and its recovery. When motor assessments are capable of acquiring information necessary to parse out a detailed profile of each stroke case, this will lead to an improved neuromechanical understanding of the …

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 …

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 …

Lower Extremity Kinetics And Muscle Activation During Gait Are Significantly Different During And After Pregnancy Compared To Nulliparous Females, Jennifer J. Bagwell, Nicholas Reynolds, Michelle Walaszek, Hannah Runez, Kristina Lam, Jo Armour Smith, Dimitrios Katsavelis

Physical Therapy Faculty Articles and Research

Background

Low back, pelvic, and lower extremity pain are common during and after pregnancy. Understanding differences in mechanics between pregnant and non-pregnant females is a first step toward identifying potential pathological mechanisms. The primary purpose of this study was to compare joint kinetics and muscle activation during gait between females during and after pregnancy to nulliparous females.

Methods

Twenty pregnant females completed testing on three occasions (second trimester, third trimester, and post-partum), while 20 matched, nulliparous controls were tested once. Motion capture, force data, and surface electromyography were averaged across seven trials during gait. Lower extremity kinematics, lower extremity moments …

The Effects Of Somatosensory Input On Gait In Individuals Post-Stroke, Victor Hung, Amanda Reilly, Rachel Wood, Nikita Yuskov

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is a leading cause of disability that results in various neurological deficits, one of which is hemiplegia. This deficit alters the gait cycle, resulting in decreased propulsion force by plantar flexor muscles, decreased activation of dorsiflexor (DF) muscles, and increased coactivation of antagonistic ankle muscles. Stroke also leads to altered somatosensory input which results in decreased balance and gait speed, ultimately increasing fall risk. Therapies targeting increased somatosensory input have been shown to be beneficial in stroke as well as other neurological populations. However, no known studies have investigated the acute effects of local vibration to …

The Effects Of A 6-Week Controlled Whole-Body Vibration Training Program In Reducing Falls Risk Among Healthy Older Adults, Fabricio Saucedo Jr.

Open Access Theses & Dissertations

Falling is the second leading cause of accidental or injury-related death in the aging population worldwide and a leading cause of serious injury. Whole-body vibration (WBV) training has been implemented as a way to improve functional performance among the elderly and reduce the falls risk. The purposes of this study were: 1) examine to what extent a six-week course of WBV training reduced falls risk and improved fall outcomes in response to slips, and 2) examine whether the benefits of WBV training could be retained at least 2 months after the completion of the entire training session. A total of …

An Evaluation Of Postural Control And Balance After Anterior Cruciate Ligament Reconstruction, Kathryn Lucas

Theses and Dissertations--Rehabilitation Sciences

Over 100,000 anterior cruciate ligament reconstructions (ACLR) occur annually in the United States, with one in four individuals sustaining a second injury within the first two years after reconstruction. Due to the proprioceptive nature of the anterior cruciate ligament, the lack of regaining postural control and balance are likely large contributors to the rate of secondary injuries after ACLR. Recent literature has identified cerebral changes after anterior cruciate ligament injury and surgery, likely due to altered sensation and feedback loops. However, no study thus far has investigated the neurological feedback loops that may place this group at higher risk of …

Influences Of Functional And Psychological Factors On Biomechanics Following An Anterior Cruciate Ligament (Acl) Reconstruction, Chelsey Roe

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to return to sport (RTS) test batteries following primary anterior cruciate ligament reconstruction (ACLR) (Aim 1) and define recovery in athletes from 4-9 months after ACLR across three domains: 1) psychological recovery and biomechanics (Aim 2), 2) rehabilitation quantity and biomechanics (Aim 3), and 3) functional performance and biomechanics (Aim 4). Ultimately, the results of this research would quantify recovery following ACLR in athletes with a desire to RTS and identify objective criteria throughout rehabilitation prior to RTS.

Participants: Twenty-two post-ACLR athletes 17 females, 8 males, …

Improvement In Overground Walking After Treadmill-Based Gait Training In A Child With Agenesis Of The Corpus Callosum, Gena Henderson, Matthew Beerse, Huaqing Liang, Diego Ferreira, Jianhua Wu

Physical Therapy Faculty Research

Background: Agenesis of the corpus callosum (ACC) is a rare congenital brain defect that produces a wide variety of cognitive and motor impairments. Literature regarding the response of pediatric populations with ACC to physical rehabilitation is scarce. Treadmill-based gait training (TT) has been shown to improve walking ability in some pediatric populations but has not been investigated in children with ACC.

Objective: The purpose of this study was to investigate the effect of a novel treadmill intervention paradigm on the gait parameters of a child with ACC.

Design: A single-participant design with 2 phases was used.

Methods: The settings were …

Can The Forward-Step-Down Test Be Used Reliably In The Clinical Setting To Assess Movement Changes Resulting From Maximal Exertion? A Pilot Study, Erin Mccallister, Daniel W. Flowers

Internet Journal of Allied Health Sciences and Practice

Introduction: Visual assessment of lower extremity mechanics is used frequently in clinical practice, and objective scoring of the visual assessment is beneficial to improve objectivity of patient evaluation. In addition, lower extremity mechanics change with fatigue and these changes may increase the risk of lower extremity injury. The Forward-Step-Down Test (FSDT) is one such objective tool, but its ability to detect changes in movement quality in response to exertion are not known. Methods: This study utilized a repeated-measures design, where the participants were scored on the FSDT before performing the Bruce protocol for an exertion stimulus. The participants were re-scored …

Connecting The Pieces: How Low Back Pain Alters Lower Extremity Biomechanics And Shock Attenuation In Active Individuals, Alexa Johnson

Theses and Dissertations--Rehabilitation Sciences

Low back pain in collegiate athletes has been reported at a rate of 37% from a wide array of sports including soccer, volleyball, football, swimming, and baseball. Whereas, in a military population the prevalence of low back pain is 70% higher than the general population. Compensatory movement strategies are often used as an attempt to reduce pain. Though compensatory movement strategies may effectively reduce pain, they are often associated with altered lower extremity loading patterns. Those who suffer from chronic low back pain tend to walk and run slower and with less trunk and pelvis coordination and variability. Individuals with …

Freezing Of Gait: Mechanisms, Mechanics, And Management, Peter S. Myers

Arts & Sciences Electronic Theses and Dissertations

Parkinson disease (PD) is a neurodegenerative disease with multiple motor and non-motor symptoms, including postural instability, gait impairments, and cognitive deficits. More than 50% of individuals with PD experience a symptom called freezing of gait (FOG), described as a transient inability to take another step forward. Individuals with PD who experience FOG (freezers) have further postural, gait, and cognitive impairments compared to individuals with PD without FOG (non-freezers). While degeneration of the dopaminergic neurons in the substantia nigra is accepted as the primary etiology of the disease, research shows that the disease has a global impact on the brain, accounting …

Risk Factors Associated With Low Back Pain In Golfers: A Systematic Review And Meta-Analysis, Jo Armour Smith, Andrew Hawkins, Marybeth Grant-Beuttler, Richard Beuttler, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Context:

Low back pain is common in golfers. The risk factors for golf-related low back pain are unclear but may include individual demographic, anthropometric, and practice factors as well as movement characteristics of the golf swing.

Objective:

The aims of this systematic review were to summarize and synthesize evidence for factors associated with low back pain in recreational and professional golfers.

Data Sources:

A systematic literature search was conducted using the PubMed, CINAHL, and SPORTDiscus electronic databases through September 2017.

Study Selection:

Studies were included if they quantified demographic, anthropometric, biomechanical, or practice variables in individuals with and without golf-related …

Changes In Reach To Eat Movement Control After Intensive Training For Children With Unilateral Cerebral Palsy, Yaching Hung, Aryeh D. Spingarn

Publications and Research

Ya Ching Hung EdD. and Aryeh Spingarn EP-C, CSCS, EIM-Level 2 Queens College, City University of New York Department of Family, Nutrition, and Exercise Sciences, Changes in Reach to Eat Movement Control After Intensive Training for Children with Unilateral Cerebral Palsy. Purpose: The current study compares the effects of an intervention on children with Congenital Hemiplegia during a simple eating task using kinematic analyses. Previous studies looked at simple bimanual tasks such as opening a drawer; no studies examined the effects of intensive training on unimanual reach, grasp, and eat movement control. Methods: 20 children with Unilateral Spastic Cerebral Palsy …

Midfoot Power During Walking And Stair Ascent In Healthy Adults, Frank Diliberto, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Intrinsic foot muscles have the capacity to attenuate and reverse arch deformation under loaded conditions. This function is proposed to be an important component in generating the midfoot power and stability requisite for gastroc-soleus muscle action at the ankle during forward propulsion. Synergistic activation of intrinsic foot muscles is proposed to function as a ‘foot core’ during weightbearing activity that is analogous to the function of the smaller muscles at the spine. If this theory were sound, midfoot power would be expected to increase, potentially in proportion to ankle power, as the muscular demand of a task increases. The …

Reliability And Validity Of A Biomechanically Based Analysis Method For The Tennis Serve, Natalie L. Myers, W. Ben Kibler, Leah Lamborn, Belinda J. Smith, Tony English, Cale A. Jacobs, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: An observational tennis serve analysis (OTSA) tool was developed using previously established body positions from three-dimensional kinematic motion analysis studies. These positions, defined as nodes, have been associated with efficient force production and minimal joint loading. However, the tool has yet to be examined scientifically.

Purpose: The primary purpose of this investigation was to determine the inter-observer reliability for each node between two health care professionals (HCPs) that developed the OTSA, and secondarily to investigate the validity of the OTSA.

Methods: Two separate studies were performed to meet these objectives. An inter-observer reliability study preceded the …

Longitudinal Adaptations In Muscle Strength, Functional Performance, Gait Biomechanics, And Patient-Reported Function After Unilateral Total Knee Arthroplasty, Paul W. Kline

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to impairments after total knee arthroplasty (TKA) (Aim 1) and define recovery between 3 and 6 months after TKA across four domains: 1) hip and knee muscle performance, 2) functional performance, 3) patient-reported function, and 4) biomechanics of walking and stair descent (Aim 2). Additionally, this project sought to explore the relationships between each domain (Aim 3) and establish predictive models to allow clinicians to use clinical measures to predict future gait biomechanics in patients after TKA (Aim 4). Ultimately, the results of this research would …

Constraining Kinematics During Single-Leg Squats And Step-Ups Can Reduce Quadratus Lumborum Activation And Facilitate Gluteal Activation, Shaylyn Kowalchuk

Electronic Thesis and Dissertation Repository

Increased quadratus lumborum activation and decreased gluteal activation may lead to lateral pelvic drop and increased hip adduction and internal rotation during single-leg exercises. These activation patterns and motions are associated with low back pain or lower extremity injuries. The purpose of this study was to evaluate if mechanically restricting hip adduction and internal rotation of the femur affected muscle activation. Twenty female track and field athletes performed single-leg squats and step-ups, and the quadratus lumborum, gluteus medius and maximus muscles activations were measured with surface electromyography. This study tested the hypothesis that mechanically restricted exercises would decrease quadratus lumborum …

Multi-Digit Coordination In Absence Of Cutaneous Sensory Feedback During Grasping Tasks, Christina Gioeli, Kerry Mcpartlan, Emily Reid, Matthew Turturro

Dissertations, Theses, and Capstone Projects

Motor learning and adaptation to object properties and task requirements requires integration of cutaneous sensory feedback with motor commands. Joint mechanics constantly change, with individual joints or muscles compensation so performance output is the same per task. Effects of mixed cutaneous sensory feedback on multi-digit coordination is not well understood. Investigators sought to determine the influence absent cutaneous sensory feedback has on motor learning and adaptation, and how the CNS coordinates multi-digit mechanical output to adapt to manual tasks, with partially intact digital sensory feedback. 19 participants were randomly assigned for three-digit anesthesia administration (TIM- thumb, index, middle; TRL- thumb, …

Mobility Of Individuals With Multiple Sclerosis And The Influence Of Physical Therapy, Brenda L. Davies

Theses & Dissertations

One main purpose was to explore the compensatory gait strategies of individuals with multiple sclerosis (MS). To address this purpose, we quantified the mechanical work generated by the lower extremity joints during walking. The outcomes from this investi­gation suggested that individuals with MS redistribute positive mechanical work during walking to the hip in order to compensate for a reduced ability of the ankle to generate positive mechanical work. Additionally, we also explored the motor control of the ankle as a potential contributing factor to the mobility limitations of individuals with MS. The outcomes from this investigation indicated that individuals with …