Rehabilitation and Therapy Commons^™

Young Adults Can Learn To Predict Unexpected Posterior Perturbations Using An Auditory Cue, Huaqing Liang, Tippawan Kaewmanee, Alexander S. Aruin

Physical Therapy Faculty Research

To reduce the effect of an expected postural perturbation, central nervous system uses anticipatory postural adjustments (APAs), which include the activation and inhibition of the postural muscles and a slight shift of the center-of-pressure (COP) position. The generation of APAs majorly relies on the availability of visual information, and is learned through past experience. Hence, such protective mechanism to maintain balance is not implemented when perturbation comes from one’s back unexpectedly. Our previous work showed that young adults could rely on an auditory cue only to generate APAs for a front perturbation similar to that when vision was available. So …

Older Adults Retain The Ability To Predict External Perturbations Using Auditory Cues Only, Huaqing Liang, Tippawan Kaewmanee, Alexander S. Aruin

Physical Therapy Faculty Research

To maintain balance and prevent destabilization, humans utilize anticipatory postural adjustments (APAs) prior to the postural perturbations based on predictions and past experience. APAs involve the activation and inhibition of the trunk and leg muscles and a shift of the center-of-pressure (COP) position. The generation of APAs majorly relies on the availability and accuracy of visual information. However, our previous work showed that young adults could rely on an auditory cue only to generate APAs for an external perturbation similar to that when the visual information was available. Older adults generally have diminished APAs and consequently diminished postural control when …

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 …

Pre-Stretching Of The Hamstrings Before Squatting Acutely Increases Biceps Femoris Thickness Without Impairing Exercise Performance, Thiago Barbosa Trindade, Leônidas Oliveira Neto, José Claudino Neto Pita, Vagner Deuel De Oliveira Tavares, Paulo Moreira Silva Dantas, Brad J. Schoenfeld, Jonato Prestes

Publications and Research

Background: Bilateral squat exercise is widely used in resistance training (RT) programs to increase lower limb strength and muscle mass, but this exercise does not result in significant hypertrophy of the hamstrings. It has been speculated that stretching between sets with a certain degree of tension results in muscle hypertrophy, while acute stretching could decrease performance during maximal contractions.

Objective: This study investigated the acute effects of hamstring stretching before bilateral squatting on muscle thickness (MT), electromyography (EMG), and total training volume (TTV) on exercise performance.

Methods: Fourteen resistance-trained young men, with ∼7.5 years of RT experience, performed the 10 …

Using A Timed Motor Task To Predict One-Year Functional Decline In Amnestic Mild Cognitive Impairment, Sydney Y. Schaefer, Andrew Hooyman, Kevin Duff

Physical Therapy Faculty Articles and Research

Affordable, noninvasive methods of predicting functional decline are needed for individuals at risk for Alzheimer’s disease. This study tested whether a timed upper-extremity motor task predicted functional decline over one year in 79 adults diagnosed with amnestic mild cognitive impairment. Participants completed subjective and objective measures of daily functioning at baseline and one year later. Motor task performance and delayed memory were also evaluated at baseline. Motor task performance was a significant predictor of one-year follow-up daily functioning, improving model fits by 18– 35%. Thus, motor behavior has potential to be an affordable enrichment strategy that is sensitive to functional …

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 …

How Can Care Settings For People With Intellectual Disabilities Embed Health Promotion?, Kristel Vlot-Van Anrooij, Monique C. J. Kiks-Leensen, Anneke Van Der Cruijsen, Henk Jansen, Koos Van Der Velden, Geraline Leusink, Thessa I. M. Hilgenkamp, Jenneken Naaldenberg

Physical Therapy Faculty Research

Background:People with intellectual disabilities (ID) depend on their environment to live healthily. Asset‐based health promotion enhances a settings’ health‐promoting capacity starting with identifying protective or promotive factors that sustain health. Method: This inclusive mixed‐methods study used group sessions to generate and rank ideas on assets supporting healthy nutrition and physical activity in Dutch intellectual disability care settings. Participants included people with moderate intellectual disabilities and family and care professionals of people with severe/profound intellectual disabilities. Results: Fifty‐one participants identified 185 assets in group sessions. They include the following: (i) the social network and ways “people” can support, (ii) assets in/around …

Automatic Detection Of Dynamic And Static Activities Of The Older Adults Using A Wearable Sensor And Support Vector Machines, Jian Zhang, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Although Support Vector Machines (SVM) are widely used for classifying human motion patterns, their application in the automatic recognition of dynamic and static activities of daily life in the healthy older adults is limited. Using a body mounted wireless inertial measurement unit (IMU), this paper explores the use of an SVM approach for classifying dynamic (walking) and static (sitting, standing and lying) activities of the older adults. Specifically, data formatting and feature extraction methods associated with IMU signals are discussed. To evaluate the performance of the SVM algorithm, the effects of two parameters involved in SVM algorithm—the soft margin constant …

Reliable And Valid Measures For The Clinical Assessment Of Balance And Gait In Older Adults With Dementia: A Systematic Review, Jacqueline Baker, Danielle De Laat, Emily Kruger, Sarah Mcrae, Sabrina Trung, Carly Zottola, Humberto Omana, Susan W. Hunter

Physical Therapy Publications

No abstract provided.

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

Physical Therapy Scholarly Projects

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

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

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

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

Does Early Physical Therapy Intervention Reduce Opioid Burden And Improve Functionality In The Management Of Chronic Lower Back Pain?, Shedrick Martin, Kimberly Tallian, Victoria T Nguyen, Jason Van Dyke, Harminder Sikand

Articles, Abstracts, and Reports

Introduction: Chronic lower back pain is a leading cause of disability in US adults. Opioid use continues to be controversial despite the Centers for Disease Control and Prevention guidance on chronic pain management to use nonpharmacologic and nonopioid pharmacologic interventions. The objectives of the study were to assess the impact of early physical therapy (PT) intervention on improving functionality and reducing opioid burden in patients with chronic lower back pain.

Methods: A single-center, retrospective chart review of patients receiving ≥6 PT visits and treated with either opioids first (OF) or PT first (PTF) therapy for chronic lower back pain were …

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

Physical Therapy Scholarly Projects

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

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

Physiological Factors Of Female Runners With And Without Stress Fracture Histories: A Pilot Study., Therese E Johnston, Colleen Dempsey, Frances Gilman, Ryan Tomlinson, Ann-Katrin Jacketti, Jeremy Close

Department of Physical Therapy Faculty Papers

BACKGROUND: Female runners are at increased risk of stress fractures (SFs) compared with men. Literature is lacking with regard to best practice for preventing and treating SFs in women. The purpose of the study was to compare physiological measures and running-related factors between women of various ages and running abilities with and without a history of running-related SFs.

HYPOTHESIS: Women with and without SF histories will differ with regard to medical and menstrual history, bone health, body composition, nutrition, and running history.

STUDY DESIGN: Prospective cohort study.

LEVEL OF EVIDENCE: Level 2.

METHODS: A total of 20 female runners with …

Mini-Logger- A Wearable Inertial Measurement Unit (Imu) For Postural Sway Analysis, Michael Pollind, Rahul Soangra

Physical Therapy Faculty Articles and Research

Postural instability assessment is an important tool in fall risk analysis and for timely intervention of falls to reduce or prevent fall injuries. Traditionally fall risk is measured though postural sway assessment and is collected through forceplates by mapping Center of Pressure (COP) excursions or using motion analysis camera system for marker sway trajectories. However, both of these systems are expensive and lack portability to their usage in clinical environments. In this study, we developed a novel wearable low-cost MEMS inertial sensor and validated its usage for human postural sway assessment in standing posture with eyes open/closed, vibration/no vibration, and …

Greater Fatigability And Motor Unit Discharge Variability In Human Type 2 Diabetes, Jonathon Senefeld, Kevin G. Keenan, Kevin S. Ryan, Sarah E. D'Astice, Francesco Negro, Sandra K. Hunter

Exercise Science Faculty Research and Publications

This study determined the discharge characteristics of motor units from two lower limb muscles before and after fatiguing exercise in people with type 2 diabetes (T2D) with no symptoms of polyneuropathy and activity-matched controls. Seventeen people with T2D (65.0 ± 5.6 years; 8 women) and 17 controls (63.6 ± 4.5 years; 8 women) performed: (a) intermittent, isometric contractions at 50% maximal voluntary isometric contraction (MVIC) sustained to failure with the ankle dorsiflexors, and (b) a dynamic fatiguing task (30% MVIC load) for 6 min with the knee extensors. Before and after the fatiguing tasks, motor unit characteristics (including coefficient of …

The Benefits Of Utilizing Student Created Videos To Promote Ethical Practice In Physical Therapy, Sonia Gawronski, Bryan Baracaldo Spt, Emily Dickinson Spt, Jennifer Holtzer Spt, Daniel Jacobs Spt, Nicole Lipinski Spt, Menherit Goodwyn Spt

Annual SHSP Student Research and Scholarship Day

No abstract provided.

Development And Validation Of Wearable Inertial Sensor System For Postural Sway Analysis, Michael Pollind, Rahul Soangra

Physical Therapy Faculty Articles and Research

Postural sway is a fall risk assessment tool traditionally measured using forceplates. However, it is expensive and lack portability to usage in clinical environments. In this study, a wearable low-cost MEMS inertial sensor was developed and validated for sway assessment. This study had two principal objectives (1) To develop and validate an Inertial Measurement Unit (IMU) for sway analysis (2) To assess the feasibility of IMU in detecting slight balance impairments due to reduced proprioception or induced subthreshold vibrations on the feet. A total of 10 healthy young adults (five males and five females) participated in this study. We found …

Association Between Changes In Subjective And Objective Measures Of Mobility In People With Lower Limb Amputations After Inpatient Rehabilitation, Gabrielle Cieslak, Humberto Omana, Edward Madou, Courtney Frengopoulos, Ricardo Viana, Michael W Payne, Susan W. Hunter

Physical Therapy Publications

Functional recovery for people with lower limb amputations is quantified using objective or subjective measures of performance. In this brief report, the prospective relationship between objective and subjective mobility after rehabilitation was evaluated in people with lower limb amputations. Adults undergoing inpatient prosthetic rehabilitation for a first unilateral transtibial or transfemoral level lower limb amputation were recruited. Assessment times: discharge and 4-mo follow-up. Gait velocity and the L Test under single- and dual-task conditions measured objective mobility. The Prosthetic Evaluation Questionnaire (section 4 and question 5b) measured subjective mobility. Paired t tests and Pearson correlation analysis evaluated change over time …

Psychometric Properties Of Segmental Assessment Of Trunk Control In Infants And Toddlers With Down Syndrome., Megan Flores, Katy Mitchell, Christina Bickley, Carolyn P. Da Silva

Physical Therapy Collection

Purpose: This study investigated infants and toddlers with Down syndrome (DS) to determine: reliability of the Segmental Assessment of Trunk Control (SATCo), concurrent validity of the SATCo with the Gross Motor Function Measure (GMFM), and whether age and SATCo score predict GMFM score.

Methods: Eighteen infants and toddlers with DS were tested on the SATCo by 2 physical therapist (PT) raters. One PT rater administered the GMFM. After 2 weeks, PT raters rescored their recorded SATCo sessions. A third PT rater also scored the SATCo videos.

Results: Interrater reliability of the SATCo was moderate to good and …

Use, Perceptions, And Awareness Of Libguides Among Undergraduate And Graduate Health Professions Students, John Carey, Ajatshatru Pathak, Sarah C. Johnson

Publications and Research

Objective–This study investigated usage, perceptions, and awareness of library research guides created using Springshare’s LibGuides among undergraduate and graduate health professions students.

Methods–The researchers recruited 100 health professions students in April 2017 from Hunter College, a senior college within the City University of New York system. Participants were asked to complete a paper survey to ascertain their use, perceptions, and awareness of Springhare’s LibGuides.

Results–Nearly two-thirds of study participants were not aware of library-created LibGuides and 68% had never used this tool. Compared to undergraduates, graduate students were more likely to be aware of LibGuides. The use of LibGuides was …

A Comparison Of Denoising Methods In Onset Determination In Medial Gastrocnemius Muscle Activations During Stance, Jian Zhang, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

One of the most basic pieces of information gained from dynamic electromyography is accurately defining muscle action and phase timing within the gait cycle. The human gait relies on selective timing and the intensity of appropriate muscle activations for stability, loading, and progression over the supporting foot during stance, and further to advance the limb in the swing phase. A common clinical practice is utilizing a low-pass filter to denoise integrated electromyogram (EMG) signals and to determine onset and cessation events using a predefined threshold. However, the accuracy of the defining period of significant muscle activations via EMG varies with …

Supplementary Material To The Manuscript Titled: Mobile Phone Sensors Can Discern Medication-Related Gait Quality Changes In Parkinson's Patients In A Real-World Setting, Niklas König Ignasiak, Albert Pierce, Vincent Berardi, Wilford K. Eiteman-Pang, Cyril Rakovski

Physical Therapy Faculty Data Sets

This file contains the data that was used to classify high and low quality gait patterns in patients with Parkinson's disease. Acceleration and gyroscope data was recorded with a conventional smartphone in a real-world environment. High (i.e. ON medication) and low (i.e. OFF medication) quality labels were given by a human observer according to medication intake times.

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

Physical Therapy Scholarly Projects

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

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

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

Ca2+ Dependency Of Limb Muscle Fiber Contractile Mechanics In Young And Older Adults, Laura E. Teigen, Christopher W. Sundberg, Lauren J. Kelly, Sandra K. Hunter, Robert H. Fitts

Exercise Science Faculty Research and Publications

Age-induced declines in skeletal muscle contractile function have been attributed to multiple cellular factors, including lower peak force (P_o), decreased Ca²⁺ sensitivity, and reduced shortening velocity (V_o). However, changes in these cellular properties with aging remain unresolved, especially in older women, and the effect of submaximal Ca²⁺ on contractile function is unknown. Thus, we compared contractile properties of muscle fibers from 19 young (24 ± 3 yr; 8 women) and 21 older adults (77 ± 7 yr; 7 women) under maximal and submaximal Ca²⁺ and assessed the abundance of three proteins thought to …

Evaluation Of Repetitive Jumping Intensity On The Digi-Jump Machine, T. Scott Lyons, James W. Navalta, Whitley J. Stone, Scott W. Arnett, Mark A. Schafer, Laura Igaune

Kinesiology and Nutrition Sciences Faculty Research

Cardiorespiratory endurance is an important element of aerobic fitness, particularly in weight management and reducing risk for cardiovascular disease. While there are numerous options for aerobic exercise, rope jumping is often overlooked. In addition to regular exercise and a healthy diet, the American Heart Association strongly recommends rope jumping. The first purpose of this study was to determine the steady state metabolic cost of repetitive jumping on the Digi-Jump machine to evaluate whether exercise on this device is more or less strenuous than similar exercise with a jump rope, as demonstrated in previous literature. A second purpose was to determine …

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

Seton Hall University Dissertations and Theses (ETDs)

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

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

UNLV Theses, Dissertations, Professional Papers, and Capstones

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

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

UNLV Theses, Dissertations, Professional Papers, and Capstones

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

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

UNLV Theses, Dissertations, Professional Papers, and Capstones

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

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

UNLV Theses, Dissertations, Professional Papers, and Capstones

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