Rehabilitation and Therapy Commons^™

A Consensus Guide To Using Functional Near-Infrared Spectroscopy In Posture And Gait Research, Jasmine C. Menant, Inbal Maidan, Lisa Alcock, Emad Al-Yahya, Antonio Cerasa, David J. Clark, Eling D. De Bruin, Sarah Fraser, Vera Gramigna, Dennis Hamacher, Fabian Herold, Roee Holtzer, Meltem Izzetoglu, Shannon Lim, Annette Pantall, Paulo Pelicioni, Sue Peters, Andrea L. Rosso, Rebecca St George, Samuel Stuart, Roberta Vasta, Rodrigo Vitorio, Anat Mirelman

Physical Therapy Publications

Background: Functional near-infrared spectroscopy (fNIRS) is increasingly used in the field of posture and gait to investigate patterns of cortical brain activation while people move freely. fNIRS methods, analysis and reporting of data vary greatly across studies which in turn can limit the replication of research, interpretation of findings and comparison across works.

Research question and methods: Considering these issues, we propose a set of practical recommendations for the conduct and reporting of fNIRS studies in posture and gait, acknowledging specific challenges related to clinical groups with posture and gait disorders.

Results: Our paper is organized around three main sections: …

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 …

Effect Of Predictability Of The Magnitude Of A Perturbation On Anticipatory And Compensatory Postural Adjustments, Tippawan Kaewmanee, Huaqing (Virginia) Liang, Alexander S. Aruin

Physical Therapy Faculty Research

Balance maintenance in response to a perturbation could be affected by the predictability of the magnitude of the body disturbance. We investigated anticipatory (APAs) and compensatory (CPAs) postural adjustments in response to perturbations of predictable and unpredictable magnitudes. Twenty young adults received series of perturbations of small or large magnitudes the order of which was varied. Electromyographic activity of six leg and trunk muscles and displacements of the center-of-pressure (COP) were recorded. The muscle onset time, integrals of muscle activity, and COP displacements in the anterior–posterior direction were analyzed during the APA and CPA phases. The results indicated that when …

Healing Hands: A Street Medic In The Twin Cities Uprising, Michael Rosentreter, Jaime González

Physical Therapy Faculty Publications

Civil rights activist and American hero the Reverend Doctor Martin Luther King Jr. once said, “A riot is the language of the unheard.” Resonance of this powerful statement was palpable during the civil unrest that broke out across the Twin Cities (Minneapolis/St. Paul, MN) this spring that sparked a global movement of protests against racial and social injustices. As the protests began in the Twin Cities, I traveled to Minneapolis as a street medic to help, eager to use my knowledge and skills as a newly-graduated physical therapist. It is my hope that a new environment of awareness yields and …

Who Is Wearing A Mask? Gender-, Age-, And Location-Related Differences During The Covid-19 Pandemic, Mike Haischer, Rachel Beilfuss, Meggie Rose Hart, Lauren Opielinski, David Wrucke, Gretchen Zirgaitis, Toni D. Urich, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Masks are an effective tool in combatting the spread of COVID-19, but some people still resist wearing them and mask-wearing behavior has not been experimentally studied in the United States. To understand the demographics of mask wearers and resistors, and the impact of mandates on mask-wearing behavior, we observed shoppers (n = 9935) entering retail stores during periods of June, July, and August 2020. Approximately 41% of the June sample wore a mask. At that time, the odds of an individual wearing a mask increased significantly with age and was also 1.5x greater for females than males. Additionally, the …

Time-Frequency Analysis Of Muscle Activation Patterns In People With Chronic Ankle Instability During Landing And Cutting Tasks, Hoon Kim, Rianna M. Palmieri-Smith, Kristof Kipp

Exercise Science Faculty Research and Publications

Background

People with chronic ankle instability (CAI) exhibit neuromuscular deficits. Previous studies, however, only investigated magnitudes of muscle activation and not the time-frequency domain.

Research question

Do people with CAI exhibit differences in muscle activation patterns in the time-frequency domain during landing, anticipated cutting, and unanticipated cutting compared to matched controls?

Methods

Eleven people with CAI and eleven healthy matched controls (CON) performed landing, anticipated cutting, and unanticipated cutting as surface EMG of the lateral gastrocnemius, medial gastrocnemius, fibularis longus, soleus, and tibialis anterior were recorded. The time-frequency domain of surface EMG data was analyzed with wavelet transformations and principal …

Greater Fatigue Resistance Of Dorsiflexor Muscles In People With Prediabetes Than Type 2 Diabetes, Jonathon Senefeld, Lynette A. Singh-Peters, Kenji A. Kenno, Sandra K. Hunter, Jennifer M. Jakobi

Exercise Science Faculty Research and Publications

Although exercise can prevent progression to T2D among people with prediabetes, little is known about fatigue during exercise in people with prediabetes compared to T2D. The purpose of the study was to compare the magnitude and mechanisms of fatigability of the ankle dorsiflexor muscles between people with prediabetes and T2D. Ten people with prediabetes (6 females, 51.7 ± 6.9 years) and fourteen with T2D (6 females, 52.6 ± 6.2 years) who were matched for age, body mass index and physical activity performed an intermittent (6 s contraction: 4 s relaxation) fatiguing task at 75% maximal voluntary contraction (MVC) with the …

Exercise And Lifestyle Physical Activity Recommendations For People With Multiple Sclerosis Throughout The Disease Course, Rosalind Kalb, Theodore R. Brown, Susan Coote, Kathleen Costello, Ulrik Dalgas, Eric Garmon, Barbara Geisser, June Halper, Herb Karpatkin, Jennifer Keller, Alexander V. Ng, Lara A. Pilutti, Amanda Rohring, Paul Van Asch, Kathleen Zachowski, Robert W. Motl

Exercise Science Faculty Research and Publications

Objectives:

To provide clinicians who treat multiple sclerosis (MS) patients with evidence-based or expert opinion–based recommendations for promoting exercise and lifestyle physical activity across disability levels.

Methods:

The National MS Society (“Society”) convened clinical and research experts in the fields of MS, exercise, rehabilitation, and physical activity to (1) reach consensus on optimal exercise and lifestyle physical activity recommendations for individuals with MS at disability levels 0–9.0 on the Expanded Disability Status Scale (EDSS) and (2) identify and address barriers/facilitators for participation.

Recommendations:

Based on current evidence and expert opinion, the Society makes the following recommendations, endorsed by the Consortium …

Impaired Firing Behavior Of Individually Tracked Paretic Motor Units During Fatiguing Contractions Of The Dorsiflexors And Functional Implications Post Stroke, Francesco Negro, Kathleen Bathon, Jennifer Nguyen, Cassidy Bannon, Claudio Orizio, Sandra K. Hunter, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Introduction: This study quantified stroke-related changes in the following: (1) the averaged discharge rate of motor units (individually tracked and untracked) identified from high-density electromyography (HD-EMG) recordings, (2) global muscle EMG properties of the dorsiflexors during a fatiguing contraction, and the relationship between task endurance and measures of leg function.

Methods: Ten individuals with chronic stroke performed a sustained sub-maximal, isometric, fatiguing dorsiflexion contraction in paretic and non-paretic legs. Motor-unit firing behavior, task duration, maximal voluntary contraction strength (MVC), and clinical measures of leg function were obtained.

Results: Compared to the non-paretic leg, the paretic leg task duration was shorter, …

A Discrete-Choice Experiment To Assess Patients’ Preferences For Osteoarthritis Treatment: An Esceo Working Group, Mickael Hiligsmann, Elaine Dennison, Charlotte Beaudart, Gabriel Herrero-Beaumont, Jaime Branco, Olivier Bruyère, Philip G. Conaghan, Cyrus Cooper, Nasser Al-Daghri, Famida Jiwa, Willem Lems, Daniel Pinto, René Rizzoli, Thierry Thomas, Daniel Uebelhart, Nicolas Veronese, Jean-Yves Reginster

Physical Therapy Faculty Research and Publications

Objective

To evaluate the preferences of patients with osteoarthritis for treatment.

Methods

A discrete-choice experiment was conducted among adult OA patients who were presented with 12 choice sets of two treatment options and asked in each to select the treatment they would prefer. Based on literature reviews, expert consultation, patient survey and expert meeting, treatment options were characterized by seven attributes: improvement in pain, improvement in walking, ability to manage domestic activities, ability to manage social activities, improvement in overall energy and well-being, risk of moderate/severe side effects and impact on disease progression. Random parameters logit model was used to …

Measures Of Pediatric Function And Physical Activity In Arthritis, Anna E. Greer, Maura D. Iversen

Exercise Science Faculty Publications

Physical function can be assessed through physical examination with the use of performance-based measures and patient-reported outcome measures (PROMs). Each form of assessment provides a unique contribution to the understanding of the impact of rheumatologic conditions on the patient. PROMs of physical function (PF) are an important component of the assessment of children with arthritis and have been included in the recommended core set of measures for childhood arthritis and musculoskeletal conditions. These measures provide the child’s or parent’s perspective of function within the context of daily living. Measures of PF include both generic measures, which are designed for use …

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 …

Utilization Of A Double Robot To Promote Critical Thinking By Novice Student Physical Therapists, Bonnie L. Rogulj, Mechelle Roy, Megan Dickerson

Physical Therapy Collection

This presentation discusses the clinical significance of the utilization of a double robot during a simulated telehealth session by novice student physical therapists to develop critical thinking skills. We demonstrate how to create a simulated telehealth session utilizing a double robot to promote critical thinking by novice student physical therapists. Finally, the limitations for virtual healthcare simulation are addressed as well as strategies for successful outcomes in the development of critical thinking skills.

Targeted Engagement Of The Action Selection Network During Task-Oriented Arm Training After Stroke, Jill Campbell Stewart Pt,Phd, Kaci Handlery, Jessica F. Baird, Erika L. Blanck, Geetanjali Pathak, Stacy L. Fritz

Faculty Publications

Action selection (AS), or selection of an action from a set of alternatives, is an important movement preparation process that engages a frontal-parietal network. The addition of AS demands to arm training after stroke could be used to engage this motor planning process and the neural network that supports it. The purpose of this case series is to describe the feasibility and outcomes associated with task-oriented arm training aimed at engaging the AS behavioral process and the related neural network in three individuals with chronic stroke. Three participants with mild to moderate motor deficits completed 13 to 15 sessions of …

Post-Stroke Cognitive Impairments And Responsiveness To Motor Rehabilitation: A Review, Jennapher Lingo Vangilder, Andrew Hooyman, Daniel S. Peterson, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

Purpose of Review
This review discusses the prevalence of cognitive deficits following stroke and their impact on responsiveness to therapeutic intervention within a motor learning context.

Recent Findings
Clinical and experimental studies have established that post-stroke cognitive and motor deficits may impede ambulation, augment fall risk, and influence the efficacy of interventions. Recent research suggests the presence of cognitive deficits may play a larger role in motor recovery than previously understood.

Summary
Considering that cognitive impairments affect motor relearning, post-stroke motor rehabilitation therapies may benefit from formal neuropsychological testing. For example, early work suggests that in neurotypical adults, cognitive function …

The Association Between Medication Use And Gait In Adults With Intellectual Disabilities, S. Maas, D. A.M. Festen, Thessa I.M. Hilgenkamp, A. Oppewal

Physical Therapy Faculty Research

Background: Adults with intellectual disabilities (ID) often have polypharmacy and often use antipsychotics. Both polypharmacy and antipsychotics have a negative effect on gait in the general population, but this has not been studied in adults with ID. These negative effects may add to pre‐existing gait disturbances in adults with ID and increase the risk for adverse health outcomes in this population. Therefore, the aim of this study is to investigate the difference in gait parameters between adults with ID with and without polypharmacy and between adults with ID using and not using antipsychotics. Method: The gait parameters of 31 participants …

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 …

Effect Of Motor-Assisted Elliptical Training Speed And Body Weight Support On Center Of Pressure Movement Variability, Farahnaz Fallahtafti, Chase M. Pfeifer, Thad W. Buster, Judith M. Burnfield

Department of Mechanical and Materials Engineering: Faculty Publications

Background: A motor-assisted elliptical trainer is being used clinically to help individuals with physical disabilities regain and/or retain walking ability and cardiorespiratory fitness. Unknown is how the device’s training parameters can be used to optimize movement variability and regularity. This study examined the effect of motor-assisted elliptical training speed as well as body weight support (BWS) on center of pressure (CoP) movement variability and regularity during training. Methods: CoP was recorded using in-shoe pressure insoles as participants motor-assisted elliptical trained at three speeds (20, 40, and 60 cycles per minute) each performed at four BWS levels (0%, 20%, 40%, and …

Direct Healthcare Costs Associated With Oligoarticular Juvenile Idiopathic Arthritis At A Single Center, Amit Thakral, Daniel Pinto, Michael Miller, Megan L. Curran, Marisa Klein-Gitelman, Dustin D. French

Physical Therapy Faculty Research and Publications

Oligoarticular juvenile idiopathic arthritis (JIA) is a common disease in pediatric rheumatology. The management of oligoarticular JIA can result in a considerable economic burden. This study is a four-year, retrospective cost identification analysis performed to determine the annual direct cost of care for patients with oligoarticular JIA and possible predictive clinical factors. Direct healthcare costs were defined as those associated with office visits, laboratory studies, hospital admissions, joint injections, medications, infusions, radiology tests, and emergency room visits. Disease characteristics and patient information included ANA status, gender, age at diagnosis, duration from diagnosis to initial visit during the study period, and …

Optimal Interventions To Address Drop Foot And Increase Gait Speed In Stroke Populations, Christopher Tran, Tommy Ngo, Dana Hazlett, Ethan Jung, Faris Alshammari

San Marcos, Summer 2020

Background: The mechanism of stroke or cerebral vascular accident (CVA) is an interruption of blood flow to the brain, which can result in many different neuromuscular impairments including drop foot. There is limited research focusing on comparative interventions for gait improvement in early stroke.

Purpose: The purpose of this study was to review the various physical thereapy interventions to benefit patients with drop foot following a single stroke.

Methods: A comprehensive systematic search was conducted within the PubMed and ProQuest databases. This study examined papers assessing conventional physical therapy for stroke patients with drop foot who had their 1st stroke …

The Effectiveness Of Home Health Physical Therapy Following Diagnosis Of Acute Respiratory Failure Secondary To Covid-19: A Case Report, Desiree Lyall, Maura Owens

San Marcos, Summer 2020

The purpose of this case study is to describe the effects of home health physical therapy involving gait training, respiratory exercises, disease process education and rehabilitation exercises for strength, endurance and balance in the treatment of a 73 year-old, male patient with a diagnosis of acute respirtory failure secondary to Covid-19.

For a patient with a diagnosis of acute respiratory failure secondary to Covid-19 diagnosis home health physical therapy was an effective treatment option to facilitate return to prior level of function. This case study supports previous research and recommended treatment guidelines for the effectiveness of gait training, respiratory exercises, …

The Effectiveness Of Heart Rate Variability Biofeedback In Conjunction With Traditional Treatment For Thoracic Outlet Syndrome In A 25-Year-Old Female: A Case Report, Sepehr Rezaei

San Marcos, Summer 2020

Introduction: Thoracic outlet syndrome (TOS) is a complex condition that causes pain, tingling sensation, hypesthesia, muscle atrophy, weakness, and edematous changes in the upper quadrant (UQ) and down upper extremity (UE). ^3,7,8,16,17 TOS is due to compression of neurovascular bundles in the interscalene triangle, costoclavicular space, and under pectoralis minor and caused by trauma, congenital malformations such as a cervical rib, and abnormal/poor postures from muscle imbalances.^3,7,8,16,17 Interventions for TOS can consist of correcting posture by addressing muscle imbalance, decreasing tone and muscle tightness and rib mobilization, and in rare cases, rib resection. ^{3,7,8,13,16,17} However, there is limited research …

Remedying Healthcare Disparities Affecting The Black Community, Savonna Reed

San Marcos, Summer 2020

The purpose of this literature review is to determine how black communities are being impacted by racial/social determinants of cardiovascular health, and to investigate potential healthcare solutions to eliminate these disparities.

As physical therapists, we commonly treat patients following lumbar spinal fusion surgery. Post-op outcomes have been found to be impacted by racial disparities in decision making in whether care providers offer surgical care, differences in access to care due to socioeconomic barriers, and differences in attitudes towards surgical care among ethnic groups.

Review of current literature has revealed that more research should be done to establish ways of remedying …

Analysis Of Physical Therapy Interventions Vs. Kinesio Taping For Relieving Low Back Pain, Amanda Orr

San Marcos, Summer 2020

Introduction/Background: This topic focuses on the utilization of kinesio taping (KT) to assist with decreasing pain in the low back. According to Shipton, low back pain has gone up by more than 50% since 1990. These factors are attributed to smoking, obesity, sedentary occupations, and to low socioeconomic status.Globally, in 2016, it is said that low back pain contributed 57.6 years to disability and the prevalence peaks around the ages of 35-55 years according to the World Health Organization.

Purpose: The purpose of this literature review is to compare research articles between KT with physical therapy interventions as compared …

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 …

Sound Effects On Standing Postural Strategies In The Elderly Via Frequency Analysis Approach, Yun-Ju Lee, Chang-Hsu Chen, Chao-Che Wu, Yu-Jung Chen, Jing-Nong Liang

Physical Therapy Faculty Research

Sound and sound frequency could improve postural sway in the elderly. The power spectrum intervals of the center of pressure (COP) displacement are associated with different postural regulations, which could be revealed by frequency analysis. The aim of the study was to investigate the effects of sound on dual-tasking postural control and conduct frequency analysis to distinguish postural regulations in the elderly. Fifteen young and 15 older healthy participants were instructed to stand on a force platform and performed the Purdue Pegboard test while hearing 50 dB sounds with sound frequencies of 250 Hz, 1000 Hz, 4000 Hz, or no …

Acute Systemic Inflammation Reduces Both Carotid And Aortic Wave Reflection In Healthy Adults, Thessa Hilgenkamp, Elizabeth C. Schroeder, Wesley L. Lefferts, Bo Fernhall

Physical Therapy Faculty Research

Acute inflammation increases the risk of cardiac and cerebrovascular events, possibly related to alterations in the hemodynamic load. Wave reflection at the aorta and carotid provides insight into downstream vascular changes and hemodynamic load at the heart and brain. Acute inflammation has been suggested to reduce wave reflection via downstream vasodilation; however, this is not firmly established and has only been investigated at the aorta. We sought to explore the effect of acute inflammation on aortic and carotid hemodynamics in healthy, young adults. Pressure waveforms were collected via radial and carotid applanation tonometry in 23 adults (26 ± 4 years) …

Passive, Yet Not Inactive: Robotic Exoskeleton Walking Increases Cortical Activation Dependent On Task, Sue Peters, Shannon B. Lim, Dennis R. Louie, Chieh-Ling Yang, Janice J. Eng

Physical Therapy Publications

Background

Experimental designs using surrogate gait-like movements, such as in functional magnetic resonance imaging (MRI), cannot fully capture the cortical activation associated with overground gait. Overground gait in a robotic exoskeleton may be an ideal tool to generate controlled sensorimotor stimulation of gait conditions like ‘active’ (i.e. user moves with the device) and ‘passive’ (i.e. user is moved by the device) gait. To truly understand these neural mechanisms, functional near-infrared spectroscopy (fNIRS) would yield greater ecological validity. Thus, the aim of this experiment was to use fNIRS to delineate brain activation differences between ‘Active’ and ‘Passive’ overground gait …

Mediolateral Damping Of An Overhead Body Weight Support System Assists Stability During Treadmill Walking, M. Bannwart, S. L. Bayer, Niklas König Ignasiak, M. Bolliger, G. Rauter, C. A. Easthope

Physical Therapy Faculty Articles and Research

Background

Body weight support systems with three or more degrees of freedom (3-DoF) are permissive and safe environments that provide unloading and allow unrestricted movement in any direction. This enables training of walking and balance control at an early stage in rehabilitation. Transparent systems generate a support force vector that is near vertical at all positions in the workspace to only minimally interfere with natural movement patterns. Patients with impaired balance, however, may benefit from additional mediolateral support that can be adjusted according to their capacity. An elegant solution for providing balance support might be by rendering viscous damping along …