Rehabilitation and Therapy Commons^™

The Challenges Of Exercise Selection For A Post-Operative Patient With Severe Deconditioning And Longstanding Neurogenic Claudication: A Case Report, Madison Lostra

Case Report Papers

Background and Purpose: Lumbar spinal stenosis is an increasingly common diagnosis due to its association with degenerative changes of the lumbar vertebrae and the advancing age of our population. This condition may lead to neurogenic claudication which often results in significant pain and disability. Due to the negative impact on quality of life, surgical intervention is often utilized to reduce symptoms. However, post-surgical management is highly variable. The purpose of this case report was to examine a rehabilitation program used to address functional limitations and reverse impairments in a patient with severe deconditioning due to neurogenic claudication as a result …

Physical Therapy Interventions Via Telehealth For A Child With Developmental Delay During The Covid-19 Pandemic: A Case Report, Julie Sullivan

Case Report Papers

Background and Purpose: During the Covid-19 pandemic of 2020, telehealth became widely used as an alternative delivery method of health care services. Due to its infrequent use prior to the pandemic, there is a gap in knowledge regarding the use of telehealth services for physical therapy (PT) in the pediatric population. The purpose of this case report is to discuss the use of PT telehealth services in pediatrics while describing the PT management of a child with gross motor delays in order to enhance care management in this population.

Case Description: A five-year-old male being treated in outpatient PT transitioned …

Restoring Functional Mobility In A 51-Year-Old Male Post Intramedullary Limb Lengthening Surgery Following Helicopter Crash: A Case Report, Shawn Novella

Case Report Papers

Background and Purpose: The annual incidence of femoral shaft fractures is about 10 per 100,000. When these injuries prompt bone to be resected, limb lengthening surgery may be utilized. However, the surgery takes a toll on the patient’s postoperative functional mobility. There is limited information regarding specific home health rehabilitation programs post surgery. The purpose of the report was to investigate the effect of a comprehensive home health PT program on the patient’s LE functional mobility, post bilateral limb lengthening surgery. Case Description: The case report details a 51-year-old male patient’s traumatic bilateral femoral fractures, osteomyelitis, and intramedullary limb lengthening …

A Systematic Review Of The Effects Of Blood Flow Restriction Training On Quadriceps Muscle Atrophy And Circumference Post Acl Reconstruction, Derek Charles, Ryan White, Caleb Reyes, Drew Palmer

Physical Therapy Faculty Research

Background:

ACL reconstruction often results in an extended period of muscle atrophy and weakness. Blood flow restriction (BFR) training is a technique that has been shown to decrease muscle atrophy in a variety of populations.

Purpose:

The purpose of this systematic review was to analyze the research presented on the effect of blood flow restriction training on quadriceps muscle atrophy and circumference post ACL reconstruction.

Study Design:

Systematic Review

Methods:

Articles were reviewed using the databases Google Scholar, PubMed, and EBSCO. Keywords included blood flow restriction training, ACL reconstruction, and quadriceps.

Inclusion criteria included:

English language, peer-reviewed journals; randomized control …

Mobilizations And Strengthening For Radiating Hip And Anterior Knee Pain: A Case Report, Thai Ho

Case Report Presentations

Research presentation slides:

Background and Purpose: The most common joint disorder in the United States is osteoarthritis (OA). Knee OA occurs in 10% men and 13% in women aged 60 years or older. Hip instability is commonly defined as hip joint unsteadiness that may cause pain. Joint restrictions and lack of hip strength may be associated with these two conditions. However, there is limited literature on hip strengthening and mobilizations on positive outcomes with hip instability. Therefore, the purpose of this case report was to utilize hip strengthening and mobilizations interventions on a patient with hip instability and knee OA. …

Assessment Of Performance Measures, Gait, And Rehabilitation Of A 68- Year Old Female With A Transtibial Amputation: A Case Report, Kellie Guillies

Case Report Presentations

Research presentation:

Background and Purpose: With 1.6 million Americans living with limb loss, transtibial amputations (TTA) are the most common type of below the knee amputations, and may contribute to concomitant musculoskeletal impairments, gait deviations, and decreased community ambulation. The purpose of this report was to describe the use of specific functional outcome measures, gait training with a prosthetic, and physical therapy (PT) intervention for functional mobility of a patient following a TTA. Case Description: The patient was a 68-year old female referred to outpatient PT 3 months following a right TTA. She presented with left lower leg pain and …

Proprioceptive Neuromuscular Facilitation And Overground Gait Training For A Patient Following A Left Central Medullary Stroke: A Case Report, Shelby Stegemann

Case Report Papers

Background and Purpose: Central medullary stroke is a rare type of stroke that is characterized by contralateral hemiplegia sparing the face, contralateral loss of deep sensation, and ipsilateral hypoglossal paralysis. It makes up a small percentage of the types of strokes that affect nearly 795,000 Americans every year. While there has been extensive research on rehabilitation principles for the general treatment of stroke, there has been little research on rehabilitation for patients following a central medullary stroke. The purpose of this case report was to describe a multifaceted intervention program with the emphasis on proprioceptive neuromuscular facilitation (PNF) and overground …

The Creation Of An Algorithm To Assist Survivorship Clinics Identify The Rehabilitation Needs Of Cancer Survivors: An Administrative Case Report, Joseph Connor

Case Report Papers

Background and Purpose: Approximately 40% of cancer survivors have unmet rehabilitation needs. Cancer survivors not receiving rehabilitation care may be due to survivorship clinics struggling to identify which of their survivors are appropriate for rehabilitation. The purpose of this case report was to review the literature and create an algorithm that could assist survivorship clinics with rehabilitation referrals.
Case Description: A survivorship clinic in Maine was attempting to address the lack of a rehabilitation screening process. A survey done by the clinic showed that approximately 40% of their survivors used rehabilitation services. To address this lack of a screening process, …

Restoring Functional Mobility For A Patient Following A Comminuted Patella Fracture Status Post Open Reduction Internal Fixation: A Case Report, Elaina Cosentino

Case Report Papers

Background and Purpose: The patella serves an important role in the protection and biomechanics of the knee joint. A fracture of the patella typically requires surgery and immobilization, which can have detrimental impacts on functional mobility. The purpose of this case study was to document a rehabilitation program following a comminuted patella fracture status post open reduction internal fixation (ORIF).
Case Description: The patient was a 62-year-old female who sustained a comminuted patella fracture following a traumatic fall down the stairs, and underwent ORIF to her right patella. She was prescribed a straight knee immobilizer for eight weeks leaving her …

Inpatient Rehabilitation For A 75-Year-Old Female Following A Left-Sided Pontine Infarct: A Case Report, Marisa Flores

Case Report Papers

Background and Purpose: Although cerebrovascular accidents (CVAs), or strokes, occur often in the United States, only 7% of those strokes affect the pons, an area of the brainstem that provides life-sustaining functions. Due to the rarity of pontine strokes, there is insufficient evidence supporting successful interventions that yield functional benefits for patients admitted to inpatient rehabilitation units (IRU). The purpose of this case report was to examine gait, balance and functional mobility interventions on the restoration of mobility and functional independence of a patient within an IRU.
Case Description: The patient was a 75-year-old female 3 days status post a …

Physical Therapy Interventions Via Telehealth For A Child With Developmental Delay During The Covid-19 Pandemic: A Case Report, Julie Sullivan

Case Report Presentations

Research presentation slides:

Background and Purpose: During the Covid-19 pandemic of 2020, telehealth became widely used as an alternative delivery method of health care services. Due to its infrequent use prior to the pandemic, there is a gap in knowledge regarding the use of telehealth services for physical therapy (PT) in the pediatric population. The purpose of this case report is to discuss the use of PT telehealth services in pediatrics while describing the PT management of a child with gross motor delays in order to enhance care management in this population.
Case Description: A five-year-old male being treated in …

Physical Therapy Management Of Gross Function Loss Following Gunshot Wound To Left Hand: A Case Report, Matthew Freeman

Case Report Presentations

Research presentation slides:

Background and Purpose: Nonfatal gunshot emergencies occur regularly within the United States but do not often lead to patients entering outpatient physical therapy clinics for rehabilitation. The complex musculoskeletal injuries which result from gunshot wounds may require prolonged rehabilitative care to best achieve functional outcomes, but clinicians may find a gap in the current literature for guidance. The purpose of this case study is to describe the outpatient rehabilitation treatment interventions for a gunshot wound to the hand, including manual therapy, therapeutic exercise, therapeutic activity, and neuromuscular reeducation.
Case Description: The patient was a 34-year-old, left hand …

Mckenzie Based Approach For Screening Lumbar Spine In A Patient With A Hamstring Strain: A Case Report, Daniel Diperna

Case Report Presentations

Research presentation slides:

Background and Purpose: The leading cause of musculoskeletal (MSK) disorders globally is low back pain (LBP). Historically, research efforts have been focused on the pathoanatomical causes of LBP. However, recent evidence found a high prevalence of structural abnormalities in the lumbar spine using magnetic resonance imaging (MRI) in asymptomatic patients and it is common that spinal pathology is the true culprit for patients referred to physical therapy (PT) with extremity diagnoses. Therefore, research has shifted to focus on classification systems to group patients based on subjective responses to specific movement patterns. The purpose of this case report …

Neuromuscular Response To A Single Session Of Whole-Body Vibration In Children With Cerebral Palsy: A Pilot Study, Huaqing (Virginia) Liang, Gena Henderson, Jianhua Wu

Physical Therapy Faculty Research

Background Whole-body vibration (WBV) is a relative new intervention paradigm that could reduce spasticity and improve motor function in children with cerebral palsy (CP). We investigated neuromuscular response to a single session of side-alternating WBV with different amplitudes in children with CP.

Methods Ten children with spastic CP aged 7–17 years at GMFCS level I-III participated in this pilot study. Participants received two sessions of side-alternating WBV with the same frequency (20 Hz) but different amplitudes (low-amplitude: 1 mm and high-amplitude: 2 mm). Each session included six sets of 90 s of WBV and 90 s of rest. Before and …

In-Season Rehabilitation Program Using Blood Flow Restriction With Therapy For Two Decathletes With Patellar Tendinopathy: A Case Report, Tyler Cuddeford, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background and Purpose: Patellar tendinopathy is an overuse injury experienced primarily by athletes; especially athletes who participate in sports that involve frequent jumping. Therapeutic exercise is the primary conservative treatment for patients with this condition. However, some patients with patellar tendinopathy may be unable to tolerate the loading that occurs during exercise. The use of blood flow restriction (BFR) therapy for patients with patellar tendinopathy may allow the athlete to exercise with a lower load while still experiencing the physiological benefits associated with training at a higher intensity. The purpose of this case report was to detail the outcomes from …

Sex Differences In Fatigability Following Exercise Normalised To The Power–Duration Relationship, Paul Ansdell, Jacob Skarabot, Elliott Atkinson, Sarah Corden, Amber Tygart, Kristy M. Hicks, Kevin Thomas, Sandra K. Hunter, Glyn Howatson, Stuart Goodall

Exercise Science Faculty Research and Publications

Due to morphological differences, females demonstrate greater fatigue resistance of locomotor muscle during single-limb and whole-body exercise modalities. Whilst females sustain a greater relative intensity of single-limb, isometric exercise than males, limited investigation has been performed during whole-body exercise. Accordingly, this study established the power–duration relationship during cycling in 18 trained participants (eight females). Subsequently, constant-load exercise was performed at critical power (CP)-matched intensities within the heavy and severe domains, with the mechanisms of fatigability assessed via non-invasive neurostimulation, near-infrared spectroscopy and pulmonary gas exchange during and following exercise. Relative CP (72 ± 5 vs. 74 ± 2% P …

Clinical Update For Physical Therapists: Coagulopathy And Covid-19, Kathleen M. Lukaszewicz, Ellen Hillegass, Michael Puthoff, A. Kate Macphedran

Physical Therapy Faculty Research and Publications

Physical therapists have a unique role in both prevention of venous thromboembolism (VTE) through the promotion of early mobility and physical activity and diagnosis through discovery of signs and symptoms of VTE. This Perspective updates clinicians on the latest information regarding pathophysiology of coagulopathy associated with COVID-19 and applies VTE clinical practice guidelines to COVID-19 in order to provide guidance on physical therapist management.

Ampakines Stimulate Phrenic Motor Output After Cervical Spinal Cord Injury, L. B. Wollman, Kristi A. Streeter, A. F. Fusco, E. J. Gonzalez-Rothi, M. S. Sandhu, J. J. Greer, D. D. Fuller

Physical Therapy Faculty Research and Publications

Activation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors increases phrenic motor output. Ampakines are a class of drugs that are positive allosteric modulators of AMPA receptors. We hypothesized that 1) ampakines can stimulate phrenic activity after incomplete cervical spinal cord injury (SCI), and 2) pairing ampakines with brief hypoxia could enable sustained facilitation of phrenic bursting. Phrenic activity was recorded ipsilateral (IL) and contralateral (CL) to C2 spinal cord hemisection (C2Hx) in anesthetized adult rats. Two weeks after C2Hx, ampakine CX717 (15 mg/kg, i.v.) increased IL (61 ± 46% baseline, BL) and CL burst amplitude (47 ± 26%BL) in 8 of 8 …

Two Weeks Of Remote Ischemic Conditioning Improves Brachial Artery Flow Mediated Dilation In Chronic Stroke Survivors, Allison S. Hyngstrom, Jennifer Nguyen, Michael Wright, Sergey Tarima, Brian D. Schmit, David D. Gutterman, Matthew J. Durand

Physical Therapy Faculty Research and Publications

Many stroke survivors have reduced cardiorespiratory fitness as a result of their stroke. Ischemic conditioning (IC) is a noninvasive, cost-effective, easy-to-administer intervention that can be performed at home and has been shown to improve both motor function in stroke survivors and vascular endothelial function in healthy individuals. In this study, we examined the effects of 2 wk of remote IC (RIC) on brachial artery flow mediated dilation (FMD) in chronic stroke survivors. We hypothesized that FMD would be improved following RIC compared with a sham RIC control group. This was a prospective, randomized, double-blinded, controlled study. Twenty-four chronic stroke survivors …

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 …

Effects Of Visual Referencing On Backward And Forward Treadmill Walking In Vr Environments, Rahul Soangra, Sivakumar Rajagopal

Physical Therapy Faculty Articles and Research

Backward walking is used increasingly as a rehabilitation exercise for stroke and diabetic peripheral neuropathy patients to improve strength and balance. However, it is unclear how visual referencing affects backward and forward walking. In this study, we evaluated spatiotemporal gait characteristics changes due to visual referencing while backward/forward walking. Sixteen healthy young participants were recruited in this study. All participants walked for 2 min with and without visual referencing in the virtual reality environment. While walking backward participants faced the virtual reality screen similar to forward walking, but their treadmill belt direction of movement was reversed. All participants walked at …

Utilising Co-Design To Improve Outpatient Neurological Care In A Rural Setting, Andrew J. Butler, Sarah J. Prior, Sajina Mathew, David Carter, Brad F. Ellem

Patient Experience Journal

It has been identified that the physiotherapy needs of patients with central neurological conditions are specific and that this cohort are generally under-serviced in rural and remote areas in Australia. A quality improvement project was undertaken to improve patient experience in outpatient physiotherapy services in Tasmania, facilitating increased self-efficacy and quality of life, in patients with central chronic neurological conditions.. An experience-based co-design approach was utilised, involving past and current patients as well as physiotherapy staff in the project design, data collection, analysis and evaluation phases. The results suggest that timely access to care and goal achievement are common areas …

Development, Reliability And Validity Of The Safe Use Of Mobility Aids Checklist (Sumac) For 4-Wheeled Walker Use In People Living With Dementia., Susan W. Hunter, Alison Divine, Humberto Omana, Ed Madou, Jeffrey Holmes

Physical Therapy Publications

BACKGROUND: Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change.

METHODS: Healthcare professionals (HCP) experienced in rehabilitation of …

Proposing A New Algorithm For Premanipulative Testing In Physical Therapy Practice, Brent Harper, Daniel Miner, Harrison Vaughan

Physical Therapy Faculty Articles and Research

In the field of physical therapy, there is debate as to the clinical utility of premanipulative vascular assessments. Cervical artery dysfunction (CAD) risk assessment involves a multi-system approach to differentiate between spontaneous versus mechanical events. The purposes of this inductive analysis of the literature are to discuss the link between cervical spine manipulation (CSM) and CAD, to examine the literature on premanipulative vascular tests, and to suggest an optimal sequence of premanipulative testing based on the differentiation of a spontaneous versus mechanical vascular event. Knowing what premanipulative vascular tests assess and the associated clinical application facilitates an evidence-informed decision for …

The Relationship Between Standing For Long Times And Appearance Of Varicose Vein Among Barber In Northern Districts / West Bank, Ziad Nasrallah

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

The aim of this study was to identify the relationship between standing for long time and physical ap-pearance of varicose vein among barbers, as well as the medical problems associated with long standing. A descriptive analytical design was used to test many demographic variables, namely age, weight, height, period of activity, and daily hours of standing. This was done with the help of a questionnaire that in-volved four domains with 32 questions. The samples included 195 barbers chosen from different cities (Jenin, Nablus and Tollkaram) in Northern West bank. We found that those who stand for long time are 75 …

Participant Retention In Trauma Intensive Care Unit (Icu) Follow-Up Studies: A Post-Hoc Analysis Of A Previous Scoping Review, Himanshu Rawal, Daniel L. Young, Roozbeh Nikooie, Awsse H. Al Ani, Lisa Aronson Friedman, Sumana Vasishta, Elliott R. Haut, Elizabeth Colantuoni, Dale M. Needham, Victor D. Dinglas

Physical Therapy Faculty Research

Background The study aimed to synthesize participant retention-related data for longitudinal follow-up studies of survivors from trauma intensive care units (ICUs). Methods Within a published scoping review evaluating ICU patient outcomes after hospital discharge, two screeners independently searched for trauma ICU survivorship studies. Results There were 11 trauma ICU follow-up studies, all of which were cohort studies. Twelve months (range: 1-60 months) was the most frequent follow-up time point for assessment (63% of studies). Retention rates ranged from 54% to 94% across time points and could not be calculated for two studies (18%). Pooled retention rates at 3, 6, and …

The Teaching And Evaluation Of Professionalism For Dpt Students During The Clinical Education Experience, Bruce N. Elliott

Internet Journal of Allied Health Sciences and Practice

Abstract

Purpose: The purpose of this comparative study was to investigate the reports of clinical instructors (CIs) and Doctor of Physical Therapy (DPT) students from two different physical therapy programs in New England regarding their opinions on the teaching and evaluative techniques of professionalism during a clinical education rotation. One program emphasized professionalism prior to the students beginning their clinical rotations, while the other program did not have the same emphasis.

Methods: Three items from the professional practice section of the Clinical Performance Instrument (CPI) (accountability, communication, and professional behavior), were utilized to create the conceptual framework around which the …

Functional Performance In People With Parkinson’S Disease: Lsvt Big For Life®, Mark Blanchard, Barbara Doucet, Cassidy Perilloux, Tamara Marchetta, Darian Price, Ashley Pattison, Galla Bonanni, Baily Amedee

Journal of Interprofessional Practice and Collaboration

This study aimed to observe the effects that an LSVT BIG for LIFE^® program had on functional performance and overall health related quality of life. Method. Seven participants with Parkinson’s disease participated in onsite LSVT BIG for LIFE sessions throughout a 40-week program. Each session included the completion of seven LSVT BIG^® exercises, one functional component task (sit to stand), a mindfulness activity, and a functional activity. Seven standardized assessments including the Box and Blocks Test (BBT), Falls Efficacy Scale (FES), Parkinson’s Disease Questionnaire-39 (PDQ-39), Patient Specific Functional Scale (PSFS), Physical Performance Test (PPT), Timed Up and Go …

Une Revue Des Méthodes D’Évaluation De La Rentabilité De La Prévention Des Lésions Professionnelles, Martin Lebeau

Rapports de recherche scientifique

Les lésions professionnelles entraînent des coûts élevés qui sont assumés par l’ensemble des acteurs économiques de la société (travailleurs, employeurs, assureurs, collectivité). L’investissement dans la prévention des lésions professionnelles peut permettre d’en réduire l’ampleur. Toutefois, l’investissement en vaut-il toujours le coût? Et comment peut-on estimer la rentabilité d’un investissement en prévention?

Cette étude s’inscrit dans la volonté institutionnelle de développer des connaissances et des outils en lien avec le calcul de la rentabilité des investissements en prévention des lésions professionnelles dans les entreprises.

Une recension des plus récentes études sur le sujet, publiées entre 1995 et 2017, a permis de …