Rehabilitation and Therapy Commons^™

Identifying Gait Pathology After Acl Reconstruction Using Temporal Characteristics Of Kinetics And Electromyography, Naoaki Ito, Jacob J. Capin, Ashutosh Khandha, Thomas S. Buchanan, Lynn Snyder-Mackler

Physical Therapy Faculty Research and Publications

Purpose

Asymmetrical gait mechanics after anterior cruciate ligament reconstruction (ACLR) are associated with the development of posttraumatic knee osteoarthritis. Current measures of gait mechanics have focused heavily on peak magnitudes of knee kinematics, kinetics, and joint contact forces but have seldom considered the rate of knee loading, cumulative knee load, or the timing of motor input surrounding peaks. The purpose of this study was to introduce and describe novel metrics of gait using temporal characteristics of kinetics and EMG to identify neuromuscular deficits of the quadriceps in patients after ACLR.

Methods

Gait mechanics were assessed 6 months (n = …

Total Knee Arthroplasty Assessments Should Include Strength And Performance-Based Functional Tests To Complement Range-Of-Motion And Patient-Reported Outcome Measures, Jacob J. Capin, Michael J. Bade, Jason M. Jennings, Lynn Snyder-Mackler, Jennifer E. Stevens-Lapsley

Physical Therapy Faculty Research and Publications

Range of motion (ROM) and pain often define successful recovery after total knee arthroplasty (TKA), but these routine clinical outcomes correlate poorly or not at all to functional capacity after TKA. The purpose of this Perspective is to underscore the importance of muscle strength and performance-based functional tests in addition to knee ROM and patient-reported outcome (PRO) measures to evaluate outcomes after TKA. Specifically: (1) muscle strength is the rate-limiting step for recovery of function after TKA; (2) progressive rehabilitation targeting early quadriceps muscle strengthening improves outcomes and does not compromise ROM after TKA; (3) ROM and PROs fail to …

Walking Improvement In Chronic Incomplete Spinal Cord Injury With Exoskeleton Robotic Training (Wise): A Randomized Controlled Trial, Dylan J Edwards, Gail Forrest, Mar Cortes, Margaret M Weightman, Cristina Sadowsky, Shuo-Hsiu Chang, Kimberly Furman, Amy Bialek, Sara Prokup, John Carlow, Leslie Vanhiel, Laura Kemp, Darrell Musick, Marc Campo, Arun Jayaraman

Faculty, Staff and Student Publications

Study design: Clinical trial.

Objective: To demonstrate that a 12-week exoskeleton-based robotic gait training regimen can lead to a clinically meaningful improvement in independent gait speed, in community-dwelling participants with chronic incomplete spinal cord injury (iSCI).

Setting: Outpatient rehabilitation or research institute.

Methods: Multi-site (United States), randomized, controlled trial, comparing exoskeleton gait training (12 weeks, 36 sessions) with standard gait training or no gait training (2:2:1 randomization) in chronic iSCI (>1 year post injury, AIS-C, and D), with residual stepping ability. The primary outcome measure was change in robot-independent gait speed (10-meter walk test, 10MWT) post 12-week intervention. Secondary …

Interprofessional Collaboration With Occupational Therapy Assistant And Physical Therapist Assistant Students Through A Simulated Academic Setting, Brooke Gentry, Samantha Harris, Cindy Hayden, Allen Keener

International Journal of Health Sciences Education

Background: There is a direct emphasis on interprofessional learning and interprofessional education (IPE) at the accreditation and national level (IPE, 2016). There are, however, no studies on the effectiveness in the delivery of interprofessional collaboration in the academic setting, specific to occupational therapy assistant students. Therefore, the following research has been developed to address this area of need in occupational therapy assistant education.

Methods: This research was conducted in the academic setting, through a simulated lab-based case with occupational therapy assistant and physical therapist assistant students as the participants. The perceived confidence and communication were measured through a pre …

A Novel Approach Toward Concussion Testing, Jorge K. Mercado, Ari Schacter, Danielle Euzent

Student Theses

A concussion is a violent jarring or shaking of the head caused by whiplash or direct impact that results in a disturbance of brain function. Concussions can be mild and brief, as a person may be dazed momentarily or can be more serious, resulting in a loss of consciousness. Underreporting of concussions is prevalent because they are a symptom-based diagnosis, lacking a clinical test. In this study, we investigated the use of VNG testing as a clinical diagnosis of concussions. Looking at the VNG test battery, the previous research cohort found that saccades, gaze, and positional testing are the most …

Clinical Application And Feasibility Of Utilizing The Pedi-Cat To Assess Activity And Participation Among Children Receiving Physical Therapy Incorporating Hippotherapy, Susan Conroy, Trish Evans, Dana Butler-Moburg, Richard Beuttler, Janelle Robinson, Matt Huebert, Erin O. Mahoney, Marybeth Grant-Beuttler

Pharmacy Faculty Articles and Research

Background

Hippotherapy (HPOT) is a physical therapy (PT) treatment tool using equine movement to improve mobility for children with movement impairments. Although research suggests HPOT improves body structure and function, there is limited evidence regarding its impact on activity and participation outcomes in a clinical setting. The Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) may be useful in HPOT settings to highlight changes in activity and participation.

Purpose

1) Evaluate the PEDI-CAT’s sensitivity to changes in activity and participation among children receiving PT using HPOT; 2) determine feasibility of administering the PEDI-CAT in a HPOT setting; and 3) …

Acute Response Of A Lower Extremity Mobility Routine On Arom, Sprint Time, And Vertical Jump Height In Flexible And Nonflexible Adults., Flinn Christian

Undergraduate Theses and Capstone Projects

Although previous studies have shown that stretching can increase range of motion and affect performance, the comparison of the effects on flexible and nonflexible adults is not clear. Therefore, the purpose of this study was to determine how flexible and nonflexible adults responded to a lower extremity mobility routine focusing on the hip and ankle joints. A randomized treatment experimental design was used in which subjects had their hip and ankle ranges of motion, lower body flexibility, countermovement vertical jump, and sprint performance assessed. They were then randomly assigned to one of two treatment orders for hip (n=9) or ankle …

Concepts Of Leadership And The Value Of Leadership For Health Care Professionals: Perspectives From Doctor Of Physical Therapy Students, Tara Haj

Dissertations, Theses, and Projects

The complex and rapidly changing environment of health care requires health care professionals with leadership knowledge and skills. Many health professional education programs have recognized the importance of developing the leadership abilities of students studying to be professionals in their field. There is emerging evidence of the need for leadership development for physical therapists, including a set of leadership competencies that has recently been identified by physical therapists. The perspective of Doctor of Physical Therapy (DPT) students regarding leadership and the value of leadership for health care professionals is unknown.

This qualitative phenomenological study utilizing semi-structured interviews was conducted to …

Adaption, Retention, And Readaptation Strategies For Unfamiliar Leka (Lower-Extremity Knee Angles), Leea M. Perry

Honors Capstones

This capstone aimed to look into individuals’ abilities to adapt, retain, and readapt a newly-provided, typically over-exaggerated, goal knee angle for their right leg based upon feedback received and accuracy of examined gait pattern. Research was carried out using individuals aged 18-25, looking at the potential of “learning” per say, a new pattern for their rather instinctual previously formed habits for walking. Knee angle, both baseline and individuals’ attempts at goal angle, were measured with a knee brace worn throughout data collection. Participants for this study were blind in terms of what their goal LEKA (lower-extremity knee angle) was. The …

Barriers To Exercise And Physical Activity - Insight From The Rural Practitioner, Erin G. Tillery

Honors College Theses

Sedentary lifestyles are a growing public health concern. Furthermore, many rural Americans lack adequate access to healthcare resources. When healthcare is sought, the patient-practitioner interactions may serve to influence the patient’s lifestyle choices. The practitioners' exercise and physical activity habits may shape the effectiveness of the patient-practitioners interaction. Here, we explored the potential barriers to exercise and physical activity (PA) in licensed physical and occupational therapists. In addition, we aimed to describe barriers to exercise and PA in individuals with a history of stroke from the perspective of the practitioner. Lastly, how current exercise and physical activity habits influence their …

General Variability Leads To Specific Adaptation Toward Energy Optimal Policies, Sabrina J. Abram, Katherine L. Poggensee, Natalia Sánchez, Surabhi N. Simha, James M. Finley, Steven H. Collins, J. Maxwell Donelan

Physical Therapy Faculty Articles and Research

Our nervous systems can learn optimal control policies in response to changes to our bodies, tasks, and movement contexts. For example, humans can learn to adapt their control policy in walking contexts where the energy-optimal policy is shifted along variables such as step frequency or step width. However, it is unclear how the nervous system determines which ways to adapt its control policy. Here, we asked how human participants explore through variations in their control policy to identify more optimal policies in new contexts. We created new contexts using exoskeletons that apply assistive torques to each ankle at each walking …

Intensive, Interprofessional Therapy: A Case Approach, Emma C. Schrotenboer

Honors Theses

This research looks at the impacts of intensive, interprofessional therapy for children with disabilities. There is very little literature currently published on this topic, although what is available generally finds that more intense therapy is more beneficial. The child who was studied was a camper at Adam’s Camp therapy camp, a week-long program that involves six hours of therapy each day with therapists from five different fields. Her progress over the week, as well as her retention of skills several weeks later, were determined by pre- and post-camp surveys sent to the mother and the therapists’ notes from during the …

Quantifying Intra- And Interlimb Use During Unimanual And Bimanual Tasks In Persons With Hemiparesis Post-Stroke, Susan V. Duff, Aaron Miller, Lori Quinn, Gregory Youdan Jr., Lauri Bishop, Heather Ruthrauff, Eric Wade

Physical Therapy Faculty Articles and Research

Background

Individuals with hemiparesis post-stroke often have difficulty with tasks requiring upper extremity (UE) intra- and interlimb use, yet methods to quantify both are limited.

Objective

To develop a quantitative yet sensitive method to identify distinct features of UE intra- and interlimb use during task performance.

Methods

Twenty adults post-stroke and 20 controls wore five inertial sensors (wrists, upper arms, sternum) during 12 seated UE tasks. Three sensor modalities (acceleration, angular rate of change, orientation) were examined for three metrics (peak to peak amplitude, time, and frequency). To allow for comparison between sensor data, the resultant values were combined into …

Spinal Cord Injury (Sci), Roxana Sanchez, Katherine Misla, Jessica Galewsky

Client Educational Handouts

No abstract provided.

Duchenne’S Muscular Dystrophy & Occupational Therapy, Vanessa Sagredo, Meagan C. Romero

Client Educational Handouts

No abstract provided.

The Effect Of A Standardized Training Program To Enhance The Therapeutic Alliance In Patients With Chronic Low Back Pain: A Mixed Methods Analytical Approach, Marino Bucci, Dominick Haynes, Megan Cundiff

UCF DPT Research Capstone

Background: Chronic low back pain (cLBP) affects up to 84% of adults. Evidence suggests a strong therapeutic alliance (TA) enhances care in a variety of ways. While themes associated with strong alliances have been identified, few studies have provided instructions on utilizing this information to craft a strong TA in physical therapy. Therefore, the aim of this study was to look at the effectiveness and feasibility of a training protocol to enhance the TA in patients with cLBP.

Methods: A total of 19 practicing physical therapists and 16 physical therapy students completed a TA training course with a pre and …

Emg Amplitude During Fatiguing Low-Load Versus High-Load Biceps Curls, Jeremy S. Wydra, Jacob C. Gilbert, Allison P. Mann

UCF DPT Research Capstone

The role of load in strength training is being debated in the literature, with studies reporting similar changes in skeletal muscle size following fatiguing low-load and high-load training. Electromyographic (EMG) signal recording can be utilized to compare muscle activity between fatiguing low-load and high-load training, but little is known about the behavior of the biceps brachii muscle during shortening (concentric) and lengthening (eccentric) muscle actions. We sought to compare changes in EMG amplitude throughout fatiguing low-load versus high-load resistance training during both concentric and eccentric muscle actions.

METHODS: Nine men and eight women, all resistance trained, participated in this study. …

Effectiveness Of Physical Therapy And/Or Music Therapy On Enhancing Motor Skills In Children With Asd: A Systematic Review, Julia Reagan, Lauren Zoller, Michelle Brown

DPT Capstones

Objective: Autism spectrum disorder (ASD) is a diagnosis that encompasses severa ldevelopmental disorders which present with neurological impairments, developmental delays, and correlates to increased motor dysfunction. Research to date has shown success with the use of music therapy and physical therapy treatment in the ASD population. However, further investigation needs to be conducted to determine which of these treatment options is most effective. The purpose of this systematic review is to explore if music therapy alone, physical therapy alone, or a combination of music therapy and physical therapy elicits the greatest benefit to enhance gross motor skills in children with …

Covid-19 Restrictions Decreased Dpt Students’ Health Outcomes, Asha Marchant, Natalie Quesnel, Anja Parikh

DPT Capstones

Introduction: The COVID-19 pandemic has presented increased constraints on physical activity leading to the adoption of more sedentary lifestyles for populations worldwide, including graduate students. The detrimental effects of a sedentary lifestyle include increasing the risk for cardiovascular disease. Cardiovascular (CV) disease has conventionally been a pathology associated with older adults, but recent evidence has shown that younger individuals are developing CV issues. The COVID-19 restrictions created an additional barrier furthering graduate students’ sedentary lifestyles and possibly increasing their risk for cardiovascular disease.

Purpose: The purpose of the present study is to determine the effects of COVID-19 restrictions on The …

Identifying Motivators, Facilitators, And Barriers To Engaging In An Online Fine Motor Exercise Program, Kristine Ricossa, Kyndra Menefee, Lauren Rally, Mia Do, Charis Chan

Occupational Therapy | MSOT Capstone Projects

Purpose: The aim of this qualitative study was to examine the impact of the motivators, facilitators and barriers for individuals with Parkinson’s Disease (PD) in engaging in a fine motor exercise program given online. Methods: Using a phenomenological design, a purposive sample of 6 individuals with PD were recruited. Data were collected through semi-structured interviews via zoom with follow up member checks. Data were analyzed through an inductive approach by developing generalizations from themes based on the interview data. Results: Three common themes were developed, ‘integrating and forming habits’, ‘acknowledging participation in exercise can fight the disease’, ‘recognizing improvement in …

Comparison Of Treadmill Training For Individuals Post-Cerebrovascular Accident In Normalizing Reciprocal Gait And Improving Balance: A Systematic Review, Gregory Bell, Kayla Harrell, Alex Loya, Nora Salgado

DPT Capstones

Background. Optimizing rehabilitation techniques for patients with chronic stroke remains an ongoing effort. Previous research has yet to synthesize the effectiveness of underwater treadmill training (UTT) and body weight supported treadmill training (BWSTT) for improving common impairments in balance and gait.

Purpose. The purpose of this review was to compare the effectiveness of UTT in helping to normalize reciprocal gait pattern and improve balance compared to BWSTT in patients with chronic cerebrovascular accidents (CVA).

Data Sources. CINAHL, Medline, PubMed, and Embase databases were searched over a period of several months from October of 2020 through March of 2021.

Study Selection. …

Implicit Bias Regarding Race In Physical Therapist Students: A Mixed Method Study, Brianna Dawkins, Joseph Kennerly

DPT Capstones

Introduction: Bias is defined as a tendency to show favor for or against something or someone; bias can be implicit or explicit. When their implicit biases are left unchecked, healthcare practitioners are more likely to negatively affect patient health outcomes. The purposes of this study were to examine implicit racial bias among physical therapist students, and explore their perspectives about how cultural competency content regarding race and ethnicity could be improved in their current education program.

Methods: Thirty-three students from the Doctor of Physical Therapy (DPT) Program at The University of Texas at El Paso (UTEP) completed a pre-Implicit Association …

Examining Grit And Social Capital In First-Generation And Continuing Generation Students In A Doctor Of Physical Therapy Program, Maria Isabel Avila

DPT Capstones

Background and Purpose: Decreasing educational disparities experienced by minorities is an important step toward improving diversity in healthcare. The purposes of this study were to identify if grit or social capital is related to Doctor of Physical Therapy (DPT) student success, and to identify if First Generation College Students (FGCSs) have different levels of grit and social capital compared to their Continuing Generation College Student (CGCS) peers.

Subjects: Participants were 1st, 4th, and 7th-semester students in the 9-semester DPT Program at The University of Texas at El Paso (UTEP) in summer 2020.

Methods: This was an exploratory, non-experimental study employing …

Does Exergaming Improve Physical And Mental Health Outcomes For Individuals Living With Severe Mental Illness Compared To Traditional Treatment: A Systematic Review, David González, James Walther

DPT Capstones

Background: Physical activity improves physiological and psychological health outcomes. Increased research has been dedicated to the effect of physical activity through active video game play. Limited studies have explored active video game play in people diagnosed with severe mental illness (SMI). The term “exergaming” is relatively new but describes the current body of research studies that employ active video game play in lieu of traditional exercise. This review focuses on finding the most current available evidence exploring the effects of physical activity through exergaming on the physical and psychiatric health outcomes of people with SMI.

Methods: Articles across 6 databases …

Ultrasound Imaging Can Surrogate Mechanical Skinfold Calipers Assessing Subcutaneous Adipose Tissue And Body Fat Mass When A Standardized Protocol Is Used, Angel Rodriguez, Sebastian Lopez

DPT Capstones

Purpose: The purpose of this study is two-fold: 1) to determine the agreement between ultrasound (US) imaging and mechanical skinfold (SF) caliper measurements using a standardized protocol and 2) to determine the agreement between SF caliper and US imaging inestimating total body fat mass and percent body fat mass using anthropometric formulas for body composition.

Methods: The present study has a repeated measures design where 2 independent testers measured 8 SFs using a mechanical caliper and US imaging, respectively, on 49 volunteers (24 males and 25 females). Anthropometric protocol followed the International Society for the Advancement of Kinanthropometry’s (ISAK) standardization …

Efficacy Of 4-D Smart Wireless Motion Sensors For Analysis Of Gait: A Pilot Study, Juan Torres, Jonathan Britton

DPT Capstones

Background: Wearable technology has become a widely utilized method of objective data collection in healthcare. Several barriers currently exist that are limiting their clinical utility. 4-D Smart Wireless Motion Sensors (4-D SWMS) have been developed to offer a less obtrusive wireless sensor that can be used in a variety of settings. The addition of machine learning to captured motion sensor data has the ability to improve classification accuracy in the analysis of gait.

Purpose: The purpose of this pilot study is to determine whether the 4-D SWMS are sensitive enough to accurately differentiate normal gait parameters in healthy individuals.

Methods: …

Effects Of Neuromuscular Interventions Utilizing External Biofeedback Apparatuses On The Risk And Incidence Of Second Anterior Cruciate Ligament Injuries: A Systematic Review., Marisa Olmo, Rebecca Sharp

DPT Capstones

STUDY DESIGN: Systematic review.

BACKGROUND: Anterior cruciate ligament (ACL) injury is a common orthopedic condition with an estimated rate of 20,000 to 600,000 injuries in the US per year, with higher incidences in athletic and female populations. The rate of re-injury following surgical ACL repair (ACLR)ranges between 13.8-33.3%. Current clinical practice guidelines for ACLR rehabilitation cite inconclusive evidence for definitive outcome measures that accurately determine successful return to sport (RTS). There is a need to establish more effective avenues of rehabilitation interventions to decrease the rate of reinjury, particularly in female athletes. Recent evidence suggests interventions utilizing external biofeedback apparatuses …

Acute Hemodynamic Responses In Women Older Than 40 Years Old Following Resistance Training With Blood Flow Restriction Compared To Resistance Training Alone: A Systematic Review, Larissa Castro, Roger Castro, Michelle Constante, Seles Lerma

DPT Capstones

Introduction: Blood flow restriction (BFR) is a novel training method that has gained recent popularity given the benefits and similar results to resistance training (RT) with lower intensities. The authors of this systematic review sought to determine the acute hemodynamic effects of BFR plus RT compared to RT alone in women over 40 years old.

Methods: The databases searched included Pubmed, EBSCO (Cumulative Index of Nursing and Allied Health Literature (CINHAL), SPORTDiscuss, Medline, Academic Search Complete) and Cochrane. Keywords utilized included BFR, occlusion therapy, female, older female, women, older women, RT, hemodynamic, blood pressure, and the boolean phrase utilized was …

Traditional Physical Therapy Versus Traditional Physical Therapy Plus Pain Education For Treatment Of Chronic Neck Pain: A Systematic Review, Jesus Gabriel Altamiranda Molina, Adrian Joshua Llañez, Oscar Martinez, Collin Wigely

DPT Capstones

Objectives: Chronic neck pain, or neck pain that endures for longer than three months, is a very common musculoskeletal condition that affects a large number of individuals annually. Traditional physical therapy interventions used to treat this condition often include manual therapy techniques and neck specific exercises. Pain neuroscience education, which focuses on the pathophysiology of pain, is a method used to treat chronic pain conditions. The purpose of this systematic review is to determine whether the addition of pain neuroscience education techniques to traditional physical therapy interventions improves patient outcomes in those with chronic neck pain.

Methods: An electronic search …

Survey Of Confidence And Knowledge To Manage Patellofemoral Pain In Readers Versus Nonreaders Of The Physical Therapy Clinical Practice Guideline, Richard W. Willy, Lisa T. Hoglund, Neal R. Glaviano, Lori A. Bolgla, David M. Bazett-Jones

Department of Physical Therapy Faculty Papers

Objectives: To compare beliefs of physical therapists (PTs) who read the clinical practice guideline (CPG) for the management of individuals with patellofemoral pain (PFP) to those who have not read the CPG.

Design: Cross-sectional study.

Setting: Online survey.

Participants: 494 currently licensed/registered PTs or physiotherapists.

Main Outcome Measures: Respondents answered Likert-based or open-ended questions regarding the diagnosis, prognosis, risk factors, and management of individuals with PFP, as well as confidence for managing individuals with PFP, especially the ability to identify beneficial and non-beneficial interventions. We dichotomized responses into participants who read (READERS) and did not read (NonREADERS) the CPG.

Results: …