Rehabilitation and Therapy Commons^™

Impact Of Cognitive Distraction On Six-Minute Walk Test And Gait Mechanics In A Patient With Functional Movement Disorder: A Case Report., Erin Kenny

Galileo-W Conference

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Walking Kinematics In Young Children With Limb Loss Using Early Versus Traditional Prosthetic Knee Prescription Protocols, Mark Daniel Geil, Zahra Safaeepour, Brian Giavedoni, Colleen Coulter

Faculty Articles

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an “Early Knee” (EK) protocol, which prescribes an articulating prosthetic knee in the child’s first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to …

High Supervised Resistance Training In Elderly Women: The Role Of Supervision Ratio, Denis Cesar Leite Vieira, Dahan Da Cunha Nascimento, Vitor Tajra, Tatiane Gomes Teixeira, Darlan Lopes De Farias, Ramires Tibana, Alessandro Oliveira Silva, Thiago Santos Rosa, Milton Rocha Moraes, Fabrício Azevedo Voltarelli, James W. Navalta, Jonato Prestes

Kinesiology and Nutrition Sciences Faculty Research

The objective of this study was to compare the effects of very high supervision (VHS-RT) versus high supervision (HS-RT) ratio resistance training (RT) on irisin, brain-derived neurotrophic factor (BNDF), muscle strength, functional capacity, and body composition in elderly women. Participants performed daily undulating periodized RT over 16 weeks with two different supervision ratios: VHS-RT at 1:2 (supervisor/subject) or HS-RT at 1:5. Serum was used to analyze brain derived neurotropic factor (BDNF) and irisin by enzyme-linked immunosorbent assay (ELISA). Body composition was evaluated by dual-energy X-ray absorptiometry, while functional capacity was evaluated using the Six-minute walk test, and Timed Up and …

Altered Achilles Tendon Morphology In Individuals With Chronic Post-Stroke Hemiparesis: A Case Report, Jing Nong Liang, Kai-Yu Ho

Physical Therapy Faculty Research

Background: Individuals post-stroke walk slowly and with more effort, which puts them at higher risks for falls. The slow walking speed results from insufficient propulsive forces generated by the paretic leg. Current rehabilitative efforts to improve walking function target increasing propulsive forces, but overlook the muscle-tendon unit. Case presentations: Two individuals with chronic post-stroke hemiparesis are presented. In both individuals post-stroke, paretic ankle plantarflexors presented with increased muscle tone. Gait kinetics revealed asymmetric propulsive forces, specifically, insufficient propulsive forces by the paretic legs, consistent with previous literature. Sonography revealed increased thickness of paretic Achilles tendon at the calcaneal insertion, in …

Altered Achilles Tendon Morphology In An Individual With Chronic Post-Stroke Hemiparesis: A Case Report, Jing Nong Liang, Kai-Yu Ho

Physical Therapy Faculty Research

Background: Individuals post-stroke walk slowly and with more effort, which puts them at higher risks for falls. The slow walking speed results from insufficient propulsive forces generated by the paretic leg. Current rehabilitative efforts to improve walking function target increasing propulsive forces, but overlook the muscle-tendon unit. Case presentations: Two individuals with chronic post-stroke hemiparesis are presented. In both individuals poststroke, paretic ankle plantarflexors presented with increased muscle tone. Gait kinetics revealed asymmetric propulsive forces, specifically, insufficient propulsive forces by the paretic legs, consistent with previous literature. Sonography revealed increased thickness of paretic Achilles tendon at the calcaneal insertion, in …

Liposomal Bupivacaine Results In Cost Savings While Managing Post-Operative Pain In Fragility Intertrochanteric Hip Fractures, Nainisha Chintalapudi, Avinesh Agarwalla Md, Joana Lu Pa, Hrayr G. Basmajian Md, Joseph N. Liu Md, Nirav H. Amin Md

Annual SHSP Student Research and Scholarship Day

No abstract provided.

Champ's Triathlon Training Program, Rachael Sollman

OTD Capstone Projects

Champ's Triathlon Training Program was created to provide an adaptive fitness opportunity to the community of Nashville, TN. This program was specifically targeting children 8 to 15 years old diagnosed with Down's Syndrome and Cerebral Palsy, Gross Motor Function Classification Scale levels I, II, and III. Champ's Triathlon Training Program was an extension of the Champ's Tri My Best Triathlon hosted by a team of therapists and Vanderbilt's Pediatric Clinic, including Kelley Newman. The program aimed to increase the participants' strength, flexibility, and endurance through triathlon related activities such as running/walking, swimming, and biking. Outcomes of the program were to …

Case Report: Effects Of Therapeutic Exercise On A Patient With Metastatic Osteosarcoma And Pathological Fracture, Jessica Phung, Sarah Mathew

San Marcos, Spring 2020

Purpose: The purpose of this case report is to demonstrate how conditioning exercise for patients with active metastatic neoplasms can improve quality of life (QoL) after a pathological fracture of lumbar vertebrae. Spinal metastasis, in this case from breast cancer, is primarily asymptomatic, and therefore, difficult to detect during early stages. Detection and diagnosis usually occur after initial manifestation of a pathological fracture leading to debilitating effects. Complications with metastatic bone cancer and surgical contraindications may bring patients into outpatient physical therapy to address the pathological fractures and QoL for patients.

Case Description & Methods: The patient is a 44-year …

Perceived Effectiveness Of Stem Cell Injections In Adults With Joint Injuries, Delaney Marie Merrill

Senior Theses

Introduction: Osteoarthritis plagues around 27 million Americans. Stem cell injections are a new method of treatment that could potentially cure this by regenerating cartilage in joints. Purpose: The purpose of this study is to examine the perceived effectiveness of stem cells at regenerating cartilage in joints, specifically the knees, hips, and shoulders. Methods: Participants were recruited via social media, forums, and from healthcare clinics that offer stem cell treatments. They were asked to complete a survey focusing primarily on the treatment protocol and how the injured joint felt post-stem cell injection. Frequencies were calculated to describe problematic joints, treatment history, …

Review Of Cerebral Palsy: The Various Intervention Techniques, Taylor Jo Schultz

Honors Thesis

Cerebral palsy (CP) is a neurodevelopmental disorder that results from a disruption in the development in the infantile or fetal brain. It affects over 17 million people worldwide. The goal of this review paper is to provide an in-depth literature review behind the causes, diagnosis, associated disorders of CP as well as the treatment interventions that would lead to a comprehensive treatment plan for CP patients. There are many possible causes of CP, contrary to the popular belief that CP is only caused by hypoxia or ischemia at birth. Diagnosis requires determining the motor function, part(s) of the body affected, …

Temporal Aspects Of Endogenous Pain Modulation During A Noxious Stimulus Prolonged For 1 Day, Marie K. Hoeger Bement, Kristian K. Petersen, Line B. Sørensen, Hjalte H. Andersen, Thomas Graven-Nielsen

Physical Therapy Faculty Research and Publications

Background

This study investigated (a) if a prolonged noxious stimulus (24‐hr topical capsaicin) in healthy adults would impair central pain inhibitory and facilitatory systems measured as a reduction in conditioned pain modulation (CPM) and enhancement of temporal summation of pain (TSP) and (b) if acute pain relief or exacerbation (cooling and heating the capsaicin patch) during the prolonged noxious stimulus would affect central pain modulation.

Methods

Twenty‐eight participants (26.2 ± 1.0 years; 12 women) wore a transdermal 8% capsaicin patch on the forearm for 24 hr. Data were collected at baseline (Day 0), 1 hr, 3 hr, Day 1 (post‐capsaicin …

Submaximal Isometric Force Steadiness In People With Multiple Sclerosis Under Single And Dual Task Conditions, Sheri Bunyan

Dissertations (1934 -)

Activities of daily living require steady, non-fatiguing, isometric muscular contractions to maintain postural control and stabilize body segments to facilitate interaction with the environment. Furthermore, typical activities often require simultaneous performance of cognitive and motor tasks. This may challenge people with multiple sclerosis, a chronic neurodegenerative disease of the central nervous system associated with motor and cognitive impairments. Despite functional relevance, isometric force steadiness in both the upper and lower extremities has not been explored in this population. Additionally, dual task experiments in multiple sclerosis have primarily used gait, a dynamic activity, as the motor task. Thus, the purpose of …

Functional Sitting Skill Development, Sitting Posture And The Relationship To Object Permanence In Infants With Motor Delays, Karl Jancart, Jessica Spirnak, Claire Boe, Amber Delprince, Regina Harbourne

Graduate Student Research Symposium

Functional Sitting Skill Development, Sitting Posture and the Relationship to Object Permanence in Infants with Motor Delays

Early in development, infant movement allows exploration and manipulation of objects, which builds cognition. Object permanence, the ability to understand that objects exist when they cannot be seen, is a cognitive construct developed in infancy, and has been shown to relate to early motor development, specifically self-mobility. However, the development of sitting may also contribute to building cognition through object understanding. The purpose of this study was to investigate the relationship of functional sitting skill development, measured by a standardized clinical test (Gross …

Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary On Blood Flow Restriction Exercise: Considerations Of Methodology, Application, And Safety, Mathias Wernbom, Brad J. Schoenfeld, Gøran Paulsen, Thomas Bjørnsen, Kristoffer T. Cumming, Per Aagaard, Brian C. Clark, Truls Raastad

Publications and Research

Low-load exercise combined with blood flow restriction (BFR) is known to induce significant gains in muscle strength and size, and this mode of training is increasingly used in both healthy and clinical populations, as documented in the recent review of Patterson et al. (2019). However, since the first training studies on BFR exercise appeared about 20 years ago, there have been some concerns about its safety, in particular with regard to the potential risk for muscle damage (Wernbom et al., 2019). In a recent editorial, Wernbom et al. (2019) briefly discussed the accumulating evidence for muscle damage and rhabdomyolysis with …

Comparison Of Pre- And Post-Operative Shoulder Muscle Emg Profiles In Reverse Total Shoulder Arthroplasty Patients, Emily Lau, Sreten Franovic, Noah Kuhlmann, Eric C. Makhni Md, Stephanie Muh Md

Medical Student Research Symposium

Background: Deltoid muscle function is central in reverse total shoulder arthroplasty (RTSA) function; however, there is limited information available regarding changes in deltoid activity before and after surgery. Few tests exist to evaluate specific muscle metrics pre and post operatively. Surface Electromyographic (EMG) is non-invasive and allows for observation of motions with multifaceted analysis of movement with minimal patient demand. Understanding the changes in shoulder muscle activation, namely in the deltoid, in patients pre and post-RTSA can further advance understanding of the procedure and rehabilitation efforts.

Methods: Nine individuals were recruited for this study: all patients underwent RTSA by a …

Reliability And Validity Of A Smartphone-Based Inclinometer Application Measuring Shoulder Internal Rotation, Taylor Lau, Sheng Lin, Tyler True, Wayne Wu, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

This study intended to evaluate the reliability and validity of a smartphone-based inclinometer application and compare these results to those of the standard clinical goniometer. The study measured the internal shoulder rotation of 19 men and 20 women. One third-year physical therapy student took all the smartphone-based inclinometer measurements, and another took all the clinical standard goniometer measurements. The subjects were randomly placed into set amounts of internal rotation, and then the two measurements were taken. The study found no significant difference between the smartphone-based inclinometer and the goniometer. The reliability between the app and the goniometers was good to …

O-Season Training Habits And Bmi, Not Preseason Jump Measures, Are Associated With Time-Loss Injury In Female Collegiate Soccer Players, Jason Brumitt, Alma Mattocks, Amy Engilis, Jill A. Sikkema, Jeremy Loew

Faculty Publications - College of Physical Therapy

The primary purpose of this study was to determine the effectiveness of the standing long jump (SLJ) and the single-leg hop (SLH) tests to discriminate lower quadrant (low back and lower extremities) injury occurrence in female collegiate soccer players. The secondary purpose of this study was to determine associations between injury and o-season training habits or anthropometric measures. SLJ, SLH, and anthropometric measures were collected during a preseason screening clinic. Each subject completed a questionnaire providing demographic information and o-season training habits. Each athlete performed three SLJ and three SLH per leg. SLJ and SLH scores were not associated with …

Relationship Between Movement Quality, Functional Ambulation Status, And Spatiotemporal Gait Parameters In Children With Myelomeningocele., Megan Flores, Kathleen Manella, Elizabeth Ardolino

Physical Therapy Collection

Aims: We investigated relationships among the Pediatric Neuromuscular Recovery Scale (Peds NRS), modified Hoffer Scale, and spatiotemporal gait parameters in children with myelomeningocele (MMC).

Methods: 21 children with MMC, age 5.3 years (SD = 2.6), were assessed by three clinicians using the Peds NRS and modified Hoffer Scale. In eight children, gait parameters were also measured.

Results: The Peds NRS summary score demonstrated good correlation with modified Hoffer Scale score (r = -0.64, p = 0.002) that accounted for 41% of variation in summary score. Six Peds NRS seated/standing items exhibited good relationships with modified Hoffer Scale …

Qualitative Analysis Of Reflective Narratives Of Physical Therapy Students Attempting To Implement Biopsychosocial Approaches To Care, Ricardo Gonzalez, Sari Harris, Justin Lee, Patrick Mcmahon, Rebecca Wezensky, Jeff Houck, Daniel Kang, Kevin Sellars

Student-Faculty Research - College of Physical Therapy

Purpose: To examine the learning process of physical therapy students attempting to apply BPS principles to clinical treatment during both an initial training period under mentorship, and during clinical rotations.

Falls Risk Screening In Community-Dwelling Older Adults, Austyn Byasse, Kevin Joines, Rachel Cundy, Carlos Navia, Virginia Edwards, Rachel Lineback, Cindy Zablotny, Theresa Raudsepp

Student-Faculty Research - College of Physical Therapy

Purpose: To determine a way to reduce clinician burden in the identification of individuals at risk for falls.

Effect Of Dual-Tasking On Walking And Cognitive Demands In Adults With Alzheimer's Dementia Experienced In Using A 4-Wheeled Walker, Susan W. Hunter, Humberto Omana, Edward Madou, Walter Wittich, Keith D Hill, Andrew M Johnson, Alison Divine, Jeffrey D Holmes

Physical Therapy Publications

BACKGROUND: Learning to walk with a 4-wheeled walker increases cognitive demands in people with Alzheimer's dementia (AD). However, it is expected that experience will offset the increased cognitive demand. Current research has not yet evaluated gait in people with AD experienced in using a 4-wheeled walker under complex gait situations.

RESEARCH QUESTION: What is the effect of dual-task testing on the spatial-temporal gait parameters and cognitive performance of people with AD experienced with a 4-wheeled walker?

METHODS: Twenty-three adults with mild to moderate AD (87.4 ± 6.2 years, 48 % female) and at least 6 months of walker use experience …

Changes In Tendon Thickness Only Occurs In Patients With Achilles Tendinopathy, Sarah Garner, Kelsey Harnar, Jesus Soltero Plaza, Kevin Coriano, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

A previous George Fox Study examined the effect of a heavy load eccentric exercise program for patients with achilles tendinopathy (AT) to test the hypothesis of improved outcomes and decreased tendon thickness.

Do Generic Health And Population Norm Based Outcomes Adequately Detect Change In Patients Attending Outpatient Physical Therapy?, Li-Zandre Philbrook, Jeff Houck, Jonah Koski, Kyle Johnston, Kyle Sumida, Ben Wagar

Student-Faculty Research - College of Physical Therapy

The purpose was to determine the ability of Patient Reported Outcome Measurement Information (PROMIS) Pain Interference (PI), Physical Function (PF), Fatigue, and Self-Efficacy of Symptom Management (SE) scales to detect change and outcomes compared to population norms at discharge from an outpatient orthopedic clinic.

Screening And Addressing Fatigue Symptoms In Patients With Orthopedic Problems Using The Promis Fatigue Scale, Breanna Becker, Karina Kreider, Hannah Lawrence, Kayla Winter, Caleb Zimmerman, Jeff Houck, Li-Zandre Philbrook

Student-Faculty Research - College of Physical Therapy

In the primary care setting, fatigue is a common complaint, outnumbered only by cough. 41.9% of patients in an outpatient physical therapy setting reported unacceptable fatigue. Fatigue scores are weakly correlated to physical function and pain interference (using Patient Reported Outcome Measurement Information Systems [PROMIS]). Therefore, detecting fatigue and addressing it directly is necessary.

Can Cue Location Influence Postural Sway Control In A Post-Concussion Syndrome Case?, Andrew J. Meszaros, Alyssa Carey, Robin Dorociak, Erik Cronrath, Farah Makani, Monica Martinez

Student-Faculty Research - College of Physical Therapy

Center for Disease Control reports the following as fall risk factors: lower extremity weakness, vision problems, and difficulty maintaining balance during walking. Greatest predictor for a fall, is prior fall within the last year. Injury from a fall leads to: fear of falls, inactivity, atrophy, higher risk for falls. Kouzake and Masani (2008) indicated that improvements in postural sway are attributed to light touch increasing proprioception, rather than through mechanical support. Examples of light touch-enhanced proprioceptive feedback: walls and assistive walking devices. Successful strategy in bimanual tasks?

Validity Of The Paper Pull Test For Strength In Patients With Hallux Valgus, Taylor Eckel, Alex Hughes, Jaymee Kau, Jessica Lumba, Kristen Omohundro, Kara Oshiro, Jeff Houck, Marcey Keefer Hutchison

Student-Faculty Research - College of Physical Therapy

Hallux valgus (HV) is a progressive deformity affecting the foot and big toe and it most commonly affects middle to older aged females. This study explores the validity of the paper pull test to assess the strength and function and utilizes PROMIS scores to assess the relationship between biological and pyschosocial factors in patients with HV.

Blood Flow Restriction Training For The Rotator Cuff: A Randomized Controlled Trial, Zach Klemmer, Mike Stroud, Edward Cheng, Neil Cayanan, Sheldon Shishido, Jason Brumitt, Marcey Keefer Hutchison, Daniel Kang

Student-Faculty Research - College of Physical Therapy

Purpose: To compare strength gains of the supraspinatus and external rotators, and changes in tendon size of the supraspinatus after performing sidelying external rotation (ER) exercise with or without BFR.

Creating Evidence-Based Practitioners: Bridging The Gap Between The Classroom And Clinic, Carolyn J. Murphy, Patti T. Calk

Journal of Interprofessional Practice and Collaboration

Occupational therapy (OT) academia is responsible for educating students about evidence-based practice (EBP). Unfortunately, students rarely see the connection between academic assignments related to research and application in clinical practice. Academicians need to explore instructional methods to help students bridge the gap between the classroom and being able to apply them in a clinical setting. Stube and Jedlicka (2007) noted that teaching strategies and methods that incorporate what students perceive as being clinically relevant promotes learning and utilization of evidence into practice. The purpose of this paper is to report the outcomes related to combining the concepts of problem-based learning …

“But I’Ve Always Lived Here”: Evidence Informed Analysis On Aging In Place, Roxanne Mueller, Allison Paris, Holly Olsen, Lindsey Valentine, Chris Childers

Physical Therapy Collection

Purpose: The purpose of this poster/presentation is to provide an exploration and analysis of aging in place. To ensure the success of the older adult to remain in their home it is essential to determine and meet the changing needs of the aging population in a way that preserves lifelong health and wellness.

Description: The global trend of population aging is on the continual rise due to longer life expectancy and lower fertility rates.¹ It is predicted that by the year 2036 one in every four individuals will be a senior citizen. In some areas, the availability of …

Can Treadmill Training With Musical Cueing In Individuals With Progressive Parkinson’S Disease Improve Ambulation?, Kristen Barta, Derrick F. Campbell, Sharon Dunnivan-Mitchell Pt, Dpt

Physical Therapy Collection

The purpose of this study was to measure the effectiveness of a specialized musical composition in combination with treadmill training to impact gait parameters and balance in people with progressive Parkinson’s disease (PD). Incorporation of auditory stimulation, typically via metronome, to improve movement has been successfully used in rehabilitation for decades. Treadmill training, also frequently used in treatment of PD, has shown short- and long-term improvements in stride length, cadence, stance and swing phase. Music assisted therapy utilizing expertly designed musical composition, known as informed composition, has recently become available for use in rehabilitation in collaboration with music therapists. Combination …