Rehabilitation and Therapy Commons^™

Development And Validation Of The Self-Management Assessment For The Residuum And Prosthesis (S.M.A.R.T.), Daniel Joseph Lee

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Self-management is the process of preventing complications through meticulous self-care and vigilant self-inspection. Persons with long-term impairments or diseases must follow an effective self-management routine as part of their care regimen to reduce the risk of injury. Assessment of knowledge as it relates to self-management is standard care forpersons with chronic disease and long-term impairments. Identifying knowledge gaps allows for patient-centered educational interventions to be targeted to the person’s area of deficit. Despite the importance of self-management in persons with limb loss, there is currently no valid and reliable way to objectively assess knowledge specific to this population.

Purposes: …

Impact Of Physical Therapist Attitudes And Beliefs On The Outcomes Of Patients With Low Back Pain, Adam P. Rufa

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction: Physical therapist attitudes and beliefs about low back pain (LBP) have been shown to influence patientbeliefs and affect clinician behavior. The purpose of this project was to investigate physical therapist attitudes and beliefsabout LBP, identify factors that influence those beliefs, and determine if attitudes and beliefs have an impact on patientoutcomes. Methods: This study was a retrospective cohort design that included a survey of physical therapists and thecollection of patient outcomes from Focus on Therapeutic Outcomes, Inc. (FOTO). Attitudes and beliefs were measured using the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain Attitudes and …

Impact Of Strength And Range Of Motion On Loss Of Ambulation And Functional Change Measures In Boys With Dmd, Tina Duong

Department of Physical Therapy Student Theses, Dissertations and Capstones

Duchenne muscular dystrophy (DMD) is an x-linked lethal progressive disorder affecting boys who are typically diagnosed due to motor delays or weakness. Key features include loss of motor function throughout the lifetime resulting in early mortality from cardiopulmonary complications in the late 2nd and 3rd decades of life. Rates of progression are variable yet sequential due to a typical pattern of motor weakness that occurs from proximal to distal muscle groups. Current standards of care include contracture management and Glucocorticosteroids (GC). Timed function tests have been used to understand and predict loss offunctional milestones such as walking, getting off the …

Effects Of Cueing On Sit To Stand Transfers In Parkinson Disease, Rebecca Ann Martin

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Individuals with Parkinson Disease (PD) often experience difficulty transferring from sit to stand (STS). Current evidence suggests cues which promote an external attentional focus improve gait and transfers for individuals with PD. However, this research utilizes cues which are difficult to replicate in clinical or natural environments making the findings difficult to generalize or implement. Purpose: The primary purpose of this study is to determine the effect of 3 different explicit cues on STS for individuals with PD. Additionally we sought to determine if, in this population, a relationship exists between latency of movement initiation and postural sway …

Financial Impact Associated With Implementation Of The Low Back Pain Clinical Practice Guideline In Outpatient Physical Therapist Practice, Heidi Kosakowski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Dysfunction and disability arising from low back pain (LBP) affects more people than any other condition globally, and results in changes to the quality of life for many individuals. The financial burden of managing low back pain is among the highest both in the United States and globally. Clinical practice guidelines (CPGs) provide recommendations on patient management strategies and have the potential to simultaneously improve patient outcomes and lower health care costs. Limited evidence exists on the impact of CPG implementation on downstream medical costs that are incurred after physical therapist care. A retrospective observational study was conducted that examined …

Neurophysiological Effects Of Dry Needling To The Thoracolumbar Junction Multifidi In Subjects With Low Back Pain And Decreased Hamstring Length, Nicole Ginette Clark

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: Dry needling is becoming increasingly popular in the treatment of neuromusculoskeletal conditions. The neurophysiological effect of treatment, specifically those related to the sympathetic nervous system (SNS) is considered a relevant physiological mechanism contributing to a patient’s rehabilitation. The primary purpose of this study was toinvestigate the neurophysiological effects of dry needling, as measured by sympathetic outflow and muscular flexibility. A secondary purpose of this study was to determine if changes in SNS activity correlate with clinically meaningful improvements in pain and disability. Design: This was a prospective, double-blind randomized clinical trial. Subjects: The study sample consisted of …

Correlation Of Trust And Outcomes Following Physical Therapy For Chronic Low Back Pain, Kory J. Zimney

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Trust is a key component for developing therapeutic alliance. Improvements in trust have been found to improve outcomes forpatients receiving psychiatric and medical physician care. Current trust measurement scales have not been utilized in a physical therapy setting and no studies have explored the relation of trust in provider to physical therapy outcomes.

Purpose: The primary goal was to explore the correlation of patient trust measured at various points within the therapeutic encounter to the change in outcome measurements after receiving physical therapy care.

Research Design and Methods: Non-experimental correlational quantitative analysis of patient trust in their physical therapist …

Does The Range Of Walking Speeds Produced By Community-Dwelling Older Adults Relate To Or Predict Function, Disability, And Community Mobility?, Michelle Germaine Criss

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Self-selected (SSWS) and maximum walking speeds (MWS) are frequently studied and related to multiple body systems, function, falls, and mortality. Walking at a slow speed voluntarily or measuring a range of walking speeds (WS), however, has rarely been investigated. Purpose: The aims ofthis project were to explore a proposed measure of WS adaptability called total walking speed range(TWSR), to assess the reliability and validity of slow walking speed (slowWS) as a component of TWSR, to assess if TWSR could predict function, disability or community mobility, and finally, to compare thepredictive ability of TWSR to single walking speeds. Methods: This …

Comprehensive Physical Function Measure For The Intensive Care Unit: The Use Of Rasch Analysis And Item Response Theory, Michelle Lynn Peterson

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction: This dissertation study provides an in-depth examination of current intensive care unit (ICU) physical function assessment measures and synthesizes these into one comprehensive measurement tool that addresses multiple areas of function.

Background: A recent systematic review identified 26 measures being used in ICU clinical research, although a subsequent systematic review revealed only 14 of those physical function assessment measures have psychometric properties evaluated specifically for the ICU setting. A robust physical function assessment measure for use in the ICU, allows for determination of efficacy of treatment, comparison of studies across settings, and broader interpretation of results.

Specific Aims: Aim …

Examination Of Student Learning Outcomes During A Musculoskeletal Spine Assessment Course: Hybrid Blended Model Versus Traditional Classroom Delivery In A Doctor Of Physical Therapy Program, David J. Denton

Theses, Dissertations and Capstones

This study explored content delivery comparisons concerning a hybrid blended model versus a traditional lecture model in a Doctor of Physical Therapy Program. There is a gap in the physical therapy literature describing the intricacies of distance, online, and hybrid models used in doctoral education. Thirty students were randomly selected out of a hat to be placed into one of two groups with an n=15. The course chosen in the study was a clinical decision-making segment based on assessment and examination of level of the spine. Group 1 was instructed only using traditional methods of live in person lecture and …

Combined Effects Of Telehealth And Modified Constraint-Induced Movement Therapy For Individuals With Chronic Hemiparesis, Mary Ann Smith, Machiko R. Tomita

Occupational Therapy Collection

Telehealth use allows improved access to services and results in potential cost savings. The purpose of this study was to examine the effectiveness of a combined modified Constrained Induced Movement Therapy (mCIMT) program using telehealth and in-person sessions, for participants with higher (Group 1) and lower (Group 2) functional ability of the hemiparetic upper extremity. Using a pre-experimental design with a 6-week intervention, 28 participants were assessed twice on use of upper extremity via subjective and objective measures. For the Motor Activity Log, the amount of use and quality of use were significant for Groups 1 and 2. Significant improvements …

Mobile Technology Intervention For Weight Loss In Rural Men: Protocol For A Pilot Pragmatic Randomised Controlled Trial, Christine M. Eisenhauer, Fabiana Almeida Brito, Aaron M. Yoder, Kevin A. Kupzyk, Carol H. Pullen, Katherine E. Salinas, Jessica Miller, Patricia A. Hageman

Journal Articles: Physical Therapy

INTRODUCTION: Men who are overweight or obese in the rural Midwestern USA are an unrepresented, at-risk group exhibiting rising rates of cardiovascular disease, poor access to preventive care and poor lifestyle behaviours that contribute to sedentary lifestyle and unhealthy diet. Self-monitoring of eating and activity has demonstrated efficacy for weight loss. Use of mobile technologies for self-monitoring eating and activity may address rural men's access disparities to preventive health resources and support weight loss. Our pilot trial will assess the feasibility and acceptability of two mobile applications for weight loss in rural men to inform a future, full-scale trial.

METHODS …

Effects Of Yoga On Mindfulness In Pediatric Patients With Oncology Diagnoses Through Guardian Perspectives: A Research Protocol, Victoria Ciszak, Dana Cutler, Gabriella Lamanna, Kristen Ogonowski

Student Research Poster Presentations 2020

Abstract:

Background: Yoga practice is commonly utilized by physical therapists in order to promote physical and mental health. In populations with a poorer prognosis, mindfulness and overall well-being becomes increasingly important. In particular, the pediatric cancer population requires an intervention that keeps these emotional needs in mind. Because children are physically and mentally developing throughout their oncology treatments, it is crucial that a comprehensive psychosocial treatment plan is initiated. Yoga can fill this need as it has elements that influence behavior and physical development.

Objective: The aim of this protocol paper is to determine all necessary procedures for future …

El Baloncesto Es Vida: A Look Into Strength And Conditioning, Physical Therapy, And Coaching During My Internship Abroad, Jessica Doublesin

2020 Honors Symposium

An experience abroad can help a person grow in confidence and knowledge and allow them to immerse themselves in a new culture. During my time in Valencia, Spain, I was able to work at a youth basketball club, CB L’Horta Godella, alongside the club’s strength and conditioning coaches and the physical therapist and be a coach for the young athletes. The fact that I lived with a Spanish family and had an open mindset towards making friends and exploring new things allowed me to grow closer to the culture in Spain. By using my knowledge and passion for sports and …

Updated Poster Presentation Abstract (N = 58) From 2020 Combined Sections Meeting Of The American Physical Therapy Association: How Well Do Clinical Walking Measures Predict Natural Walking Behavior In Parkinson Disease?, James T. Cavanaugh, Cristina Colon-Semenza, Tammy Deangelis, Ryan P. Duncan, Daniel Fulford, Martha Hessler, Michael Lavalley, Timothy Nordahl, Lisa Quintiliani, Kerri S. Rawson, Marie Saint-Hilaire, Cathi A. Thomas, Jenna A. Zajac, Gammon M. Earhart, Terry D. Ellis

Physical Therapy Faculty Publications

Declines in the amount and intensity of natural walking behavior in people with Parkinson disease (PD) may precede declines in motor behavior, gait, and balance. Physical interventions targeting walking behavior in PD may have the greatest impact on slowing the progression of disability. Despite a lack of supporting evidence, however, clinicians may be more likely to rely on quick performance measures of walking speed, capacity, and balance to make inferences about a patient’s walking health, rather than direct measures of natural walking behavior. Our primary purpose, therefore, was to examine the extent to which clinical walking measures might predict natural …

The Impact Of Exercise In Spaceflight And Microgravity Environments, William Bybee

Mahurin Honors College Capstone Experience/Thesis Projects

Since mankind’s first spaceflight, a significant barricade in reaching distant planets has been the damaging effects of microgravity upon the human body. Effects range from loss in bone mineral density and severe muscle atrophy to autoimmune disorders. The most effective countermeasure of these effects to date is exercise. Implementation of exercise in microgravity is not an easy task, so various specialized equipment must be utilized to effectively administer it. Even with this equipment, exercise as it is currently used does not entirely prevent body systems from undergoing detrimental changes. New modalities and implementations are currently being investigated that may significantly …

Can A Prescribed Walking Program With Or Without Monitoring Impact Dizziness In The Older Adults? A Pilot Study, Amie Marie Jasper

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background. Dizziness, a common complaint among older adults, is associated with multiple falls, loss of function and independence, and reduced balance confidence. The Clinical Practice Guideline for Peripheral Vestibular Hypofunction recommends walking for endurance as a component of vestibular rehabilitation (VR). However, studies on VR in the olderadults do not include walking in the intervention.

Research Design: 1) A pragmatic, randomized, experimental design to evaluate the impact of walking on vestibular outcomes, length of stay, and number of visits, and to examine whether pedometers increase the adherence of older adults with vestibular issues to a walking program; 2) a descriptive …

Does The Type Of Dual Cognitive Task Impact Gait Variability Using The Quantitative Timed Up And Go (Qtug) In Community-Dwelling Adults?, Laurie G. Hiatt

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: The purpose of this study was to determine how different cognitive dual-tasks impact gaitvariability in community-dwelling adults using the Quantitative Timed Up and Go (QTUG).

Methods: Participants aged 65 and older were recruited from two communities in Iowa and Wisconsin. Inclusion criteria: theability to stand and ambulate without an assistive device, having no orthopedic surgical procedures in the previous six weeks, living independently in the community, demonstrating corrected vision and ability to read, sufficient auditory function to carry on a conversation and ability to follow directions. Participants needed to follow three step commands and have no history …

Does One Session Of Pre-Operative Pelvic Floor Muscle Training Aid In Improving Urinary Incontinence Immediately Following Robotic Assisted Radical Prostatectomy? A Retrospective And Pilot Study, Francine Noel-Ford

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Despite advancements in surgical techniques through the use of robotic assisted radical prostatectomy, urinary incontinence remains the most common side effect following surgery affecting men’s quality of life.

Objective: To explore the role of a single pre-operative pelvic floor muscle training session. To determine if men who receive the training session have a decrease incidence of incontinence post-op, whether pelvic floor muscle strength pre-operatively is an independent predictor of urinary incontinence, and the impact of incontinence on quality of life in men following a robotic-assisted radical prostatectomy in the early stages post-operatively.

Design: A two part study with a …

Neck Muscle Composition In Persistent Whiplash Associated Disorder: A Relationship With Disability, Bradford G. Callan

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose/hypothesis: Neck pain and related symptoms following a motor vehicle collision (MVC) can significantly influence the quality of life for some people. While the MVC related mechanics of the head and neck gives rise to the term whiplash, the signs and symptoms of neck related disability are often complex and are clinically referred to as whiplash associated disorder(WAD). Muscle fatty infiltrate (MFI) has been associated with persistent WAD, but its influence on the generation and maintenance of WAD is largely unknown. The purpose of this study was to evaluate the relationship between MFI and baseline demographic variables related to persistent …

Cortical Activation During Shoulder And Finger Movements In Healthy Adults: A Functional Near-Infrared Spectroscopy (Fnirs) Study., Chieh-Ling Yang, Shannon B Lim, Sue Peters, Janice J Eng

Physical Therapy Publications

Characterization of cortical activation patterns during movement of the upper extremity in healthy adults is helpful in understanding recovery mechanisms following neurological disorders. This study explores cortical activation patterns associated with movements of the shoulder and fingers in healthy adults using functional near-infrared spectroscopy (fNIRS). Twelve healthy right-handed participants were recruited. Two motor tasks (shoulder abduction and finger extension) with two different trial lengths (10 s and 20 s) were performed in a sitting position at a rate of 0.5 Hz. The hemodynamic response, as indicated by oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR), over both hemispheres was acquired using a 54-channel …

A Case Of Thoracic Spondylosis Deformans And Multilevel Instrumented Spinal Fusion In An 84-Year-Old Male., Amy H Amabile, J Raymond Shea, Vishal Desai, Lisa T Hoglund, Jamie N Elcock, Anthony Lombardo, Matthew C Schiffino

Department of Physical Therapy Faculty Papers

Spondylosis deformans is a type of spinal claw osteophytosis which can be found on the anterolateral vertebral bodies of any region, and which consists of protrusions of intervertebral disc tissue covered by a bony shell. We report here a case of thoracic spondylosis deformans and multilevel instrumented fusion found during routine dissection of a cadaver. Theories of the etiology of this condition are reviewed in general, and with respect to this specific case and the potential interaction of the presenting comorbidities. The clinical implications of these osteophytes, including musculoskeletal and visceral sequelae, are also discussed.

Functional Electrical Stimulation Plus Visual Feedback Balance Training For Standing Balance Performance Among Individuals With Incomplete Spinal Cord Injury: A Case Series, David J Houston, Jae W Lee, Janelle Unger, Kei Masani, Kristin E Musselman

Physical Therapy Publications

Individuals with an incomplete spinal cord injury (iSCI) are highly susceptible to falls during walking or standing. Our objective was to evaluate a therapeutic tool for standing balance that combined functional electrical stimulation, applied bilaterally to the plantarflexors and dorsiflexors, with visual feedback balance training (FES+VFBT). Five adults with iSCI completed 12 FES+VFBT sessions over 4 weeks. During the training sessions, participants completed each of the four balance exercises twice. Visual feedback of the center-of-pressure (COP) location was provided as participants completed the balance exercises and received FES to assist with performance of the exercises. A closed-loop FES system was …

Effects Of Ankle Angular Position And Standing Surface On Postural Control Of Upright Stance, Fawaz A. Alwadani, Huaqing Liang, Alexander S. Aruin

Physical Therapy Faculty Research

The purpose of the study was to investigate the effects of ankle angular position and standing surface type on static upright balance. Ten young adults stood on a force platform or on a firm wedge that induced 15° of either dorsiflexion or plantarflexion. In addition, a piece of foam was placed on top of the force platform and on the wedge. The center of pressure distance and velocity in the anteroposterior and mediolateral directions were calculated. Significantly larger magnitudes in most of the investigated variables were seen while standing with ankles in the dorsiflexion when compared with standing with the …

Improvement In Overground Walking After Treadmill-Based Gait Training In A Child With Agenesis Of The Corpus Callosum, Gena Henderson, Matthew Beerse, Huaqing Liang, Diego Ferreira, Jianhua Wu

Physical Therapy Faculty Research

Background: Agenesis of the corpus callosum (ACC) is a rare congenital brain defect that produces a wide variety of cognitive and motor impairments. Literature regarding the response of pediatric populations with ACC to physical rehabilitation is scarce. Treadmill-based gait training (TT) has been shown to improve walking ability in some pediatric populations but has not been investigated in children with ACC.

Objective: The purpose of this study was to investigate the effect of a novel treadmill intervention paradigm on the gait parameters of a child with ACC.

Design: A single-participant design with 2 phases was used.

Methods: The settings were …

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

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The purpose of this study was to explore validity of the paper pull test (PPT) to assess hallux flexion strength and function in persons with hallux valgus (HV). The following hypotheses were tested: 1) The PPT is valid for inferring 1st MTP flexion strength and heel rise (HR) performance (e.g. heel height). 2) A specified threshold of force during the PPT can be identified that discriminates patients with HV. 3) Muscle activity (abductor hallucis [AH], flexor hallucis brevis [FHB]), in patients with HV will be distinct from controls across three tasks: 1) PPT, 2) lowering phase of a HR, …

Clinical Measurements Of The Posterior Shoulder Endurance Test (Pset), Neil A. Evans

Theses and Dissertations--Rehabilitation Sciences

Of the intrinsic factors responsible for non-traumatic shoulder pain, muscular endurance is often not measured by rehabilitation professionals due to the lack of available shoulder endurance measures. Measurement properties of the PSET have not been adequately assessed in previous studies. The purpose of this dissertation was to develop the clinical measurement properties of the Posterior Shoulder Endurance Test (PSET) so that it might be used as a clinical measure of shoulder muscular endurance.

Electromyography (EMG) offers the ability to identify which muscles in the posterior shoulder girdle are fatiguing during the PSET. Surface EMG of upper trapezius (UT), middle trapezius …

Psychosocial Predictors Of Chronic Pain And Pain-Related Disability 12 Months After Lower Extremity Fracture, Joshua Judson Van Wyngaarden

Theses and Dissertations--Rehabilitation Sciences

Over 700,000 lower extremity fractures occur each year with a large portion of these patients developing adverse long-term pain and disability outcomes. Current literature indicates that 39% to 62.7% of all patients report continued pain long after traumatic lower extremity fracture. Concurrent physical limitations and reduced quality of life are common, with nearly one-third of all patients reporting pain-related disability seven years after limb threatening trauma, and approximately 50% of these patients having limitations in functional mobility and activities of daily living at long-term follow-up. These poor long-term injury-related pain and disability outcomes are alarming and require further action to …

Outcomes Of Formalized Physical Therapy Vs. Self-Directed Home Exercise, Thomas Lee, Daniel Bowles

Phase 1

Introduction: After a formal microdiscectomy or 1-2 level anterior cervical discectomy and fusion (ACDF) there exists a lack of consensus on effectiveness of postoperative formal physical therapy (PT) rehabilitation efficacy. We seek to determine whether home PT is equivalent to standard PT using patient reported outcomes measures (PROMs) after the aforementioned operations.

Methods: This study is a prospective single center cohort study. The inclusion criteria is patients undergoing a microdiscectomy or ACDF operation excluding patients under 18, infection, trauma, tumor, or revision. Outcomes are measured using PROMs specific for each operation.

Results: Preliminary data suggests that post-operative …

Physical Therapy For Gait, Balance, And Cognition In Individuals With Cognitive Impairment: A Retrospective Analysis, Jason Longhurst, Jason Phan, Elbert Chen, Steven Jackson, Merrill R. Landers

Integrated Health Sciences Faculty Research

© 2020 Jason Longhurst et al. Objectives. The purpose of this study was to determine if a pragmatic physical therapy (PT) program was associated with improved cognition, gait, and balance in individuals with cognitive impairment. This study investigated these associations for individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI) in order to better characterize outcomes to PT for each diagnostic group. Methods. Data before and after one month of physical therapy were extracted from patient records (67 with AD, 34 with VaD, 35 with DLB, and 37 with MCI). The …