Rehabilitation and Therapy Commons^™

Use Of Clinical Test Clusters Versus Advanced Imaging Studies In The Management Of Patients With A Suspected Slap Tear, Richard C. Clark, Chasiti C. Chandler, Andrew C. Fuqua, Kelly N. Glymph, Grayson C. Lambert, Katherine J. Rigney

Physical Therapy Faculty Research

Background and Purpose

The Magnetic Resonance Arthrogram (MRA) has served as the gold standard for identifying patients with possible Superior Labrum Anterior-Posterior (SLAP) lesions and are often required by orthopaedic surgeons prior to clinical evaluation. However, as the literature shows MRA sensitivity as 0.65-0.98, and specificity between 0.80-1.00, there is still room for misinterpretation of the imaging study, and potential mismanagement of a patient who may or may not exhibit a true SLAP lesion. It is proposed that by grouping a series of clinical special tests it may be possible to develop greater sensitivity in identifying a SLAP lesion, resulting …

The Experiences Of Physical Rehabilitation In Individuals With Spinal Cord Injuries: A Qualitative Thematic Synthesis., Janelle Unger, Hardeep Singh, Avril Mansfield, Sander L Hitzig, Erica Lenton, Kristin E Musselman

Physical Therapy Publications

PURPOSE: The purpose of this thematic synthesis review was to identify and synthesise published qualitative research on the perspectives of individuals with spinal cord injuries with respect to physical rehabilitation interventions.

MATERIALS AND METHODS: The peer-reviewed literature was searched across seven databases and identified abstracts were independently screened by two reviewers. A thematic synthesis methodology was used to code and synthesise the results from the included studies.

RESULTS: In total, 7233 abstracts were identified; 31 articles were selected for inclusion, representing 26 physical rehabilitation interventions. The methodological quality of studies was moderate (Standards for Reporting Qualitative Research mean ± standard …

Relationship Between Balance And Physical Activity In Subjects With Non-Specific Chronic Low Back Pain, Muhsen B. Alsufiany

Loma Linda University Electronic Theses, Dissertations & Projects

Most research on sedentary lifestyle has focused on pain and disability outcomes, while neuromuscular outcomes (postural control and strength) have received less attention. The objective of the present study was to determine whether low level of physical activity is negatively associated with measures of lower body muscular strength and postural control in subjects with and without non-specific chronic low back pain (NSCLBP). Twenty-four subjects with NSCLBP (28.8±5.9 years) and 24 age, gender, and Body Mass Index (BMI) matched healthy controls participated in the study. Subjects were sub-classified into four subgroups based on their level of physical activity using the International …

Does Self-Evaluation And Education In Students Change Attitudes And Beliefs Towards Weight Stigma?, Henry A. Garcia

Loma Linda University Electronic Theses, Dissertations & Projects

The current state of global ensures physical therapists will encounter patients that are overweight/obese in all clinical settings, which makes them exceptionally positioned to promote lifestyle modifications to their patients. Unfortunately, weight stigma is highly prevalent among health care providers. Weight stigma has been shown to have adverse effects on patients. The purpose of this study is to measure weight bias in the doctor of physical therapy (DPT) students. Elicit change in obesity stigma in DPT students by way of self-evaluation while enrolled in a course Aspects of Health Promotion (AHP). Methods: Sixty students enrolled in AHP course participated in …

Effects Of Head Motion On Balance In Middle-Aged And Young Adults With Chronic Motion Sensitivity, Ammar E. Hafiz

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic motion sensitivity (CMS) often leads to a variety of symptoms including postural instability. There is limited research describing the effects of active head motion on standing postural stability in adults with motion sensitivity. Previous research has described the negative effects of chronic motion sensitivity on postural stability during active head motion. The purpose of this study was to compare the effects of slow and fast head motions, in multiple planes, on postural stability in healthy middle-aged adults with and without CMS. Secondary objective was to compare the effects of head motion on postural stability between young and middle-aged adults, …

Multi-Campus Dpt Programmatic Development In A Public University: Leadership Considerations, Betsy J. Becker, Teresa Cochran, Joseph Norman, Kyle Meyer

Posters and Presentations: Physical Therapy

Background/Purpose: Institutional pressure for expanded revenue streams, coupled with workforce development needs to insure patient access of health resources both drive programmatic expansion of healthcare education programs across multiple campus sites. Such expansion is predicated on deliberate planning and resource acquisition for effective course delivery and successful programmatic outcomes. The University of Nebraska Medical Center’s College of Allied Health Professions opened a second campus site in 2016, located 185 miles from the main campus and the urban corridor of the state. The Doctor of Physical Therapy (DPT) program (and four additional allied health professions) modified traditional course delivery to create …

Temporal And Functional Cortical Aspects Related To Mirror Visual Feedback During Target-Directed Movement In Healthy And Stroke Individuals, Maryam Rohafza

Dissertations

Stroke is the leading cause of disability in the United States (American Heart Association, American Stroke Association) affecting 800,000 individuals annually (i.e., one person every 45 seconds). Therapy for stroke often uses repetitive task practice, which is difficult to perform for patients due to impairment. Mirror visual feedback (MVF) based rehabilitation uses the effect of observing the mirror reflection of volitional movement of one limb, to activate visuomotor brain areas that process movement of the opposite limb. In persons with hemiplegia due to stroke, exercising the less affected limb while observing its reflection, perceived by them as the motion of …

Does Variability Of Footfall Kinematics Correlate With Dynamic Stability Of The Centre Of Mass During Walking?, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

A stable walking pattern is presumably essential to avoid falls. Stability of walking is most accurately determined by the short-term local dynamic stability (maximum Lyapunov exponent) of the body centre of mass. In many studies related to fall risk, however, variability of step width is considered to be indicative of the stability of the centre of mass during walking. However, other footfall parameters, in particular variability of stride time, have also been associated with increased risk for falling. Therefore, the aim of this study was to investigate the association between short-term local dynamic stability of the body centre of mass …

Exploring The Lived Experiences Of Academic Success In The First Year Of A Physical Therapist Program, Thuha Hoang

LSU New Orleans Theses and Dissertations

With a growing and more diverse population nationally, physical therapist programs have evolved to meet the demands for physical therapists in our healthcare system. Despite the substantial efforts to increase student populations to meet workforce shortage, 5-35% will depart in the early years of their program. Current evidence suggests the association of measurable factors with students’ academic success in physical therapist education. However, these measurable factors have accounted for a small variance in explaining the experiences of academic success. In order to sustain the current healthcare system, physical therapist programs need to ensure that students persist and graduate.

The purposes …

Ease Of Caregiving For Children: Re-Validation Of Psychometric Properties Of The Measure For Children With Cerebral Palsy Up To 11 Years Of Age., Mohammed S Alghamdi, Lisa A Chiarello, Lisa Avery, Robert J Palisano

Physical Therapy Publications

PURPOSE: To re-validate stability and hierarchal ordering of items, test-retest reliability, and construct validity of the Ease of Caregiving for Children measure for parents of children with cerebral palsy (CP) up to 11 years of age.

METHODS: Participants were 613 parents of children with CP between 1.5 and 11 years of age. Parents completed Ease of Caregiving for Children and both parents and therapists classified children's levels of gross motor, manual and communication functions.

RESULTS: Rasch analysis indicated acceptable fit of items, stable item calibration, and logical ordering of items by difficulty. Test-retest reliability was good: ICC = 0.69 (95% …

Effect Of Learning To Use A Mobility Aid On Gait And Cognitive Demands In People With Mild To Moderate Alzheimer's Disease: Part I - Cane, Susan W. Hunter, Alison Divine, Humberto Omana, Walter Wittich, Keith D Hill, Andrew M Johnson, Jeffrey D Holmes

Physical Therapy Publications

BACKGROUND: People with Alzheimer's disease (AD) exhibit balance and walking impairments that increase falls risk. Prescription of a mobility aid is done to improve stability, yet also requires increased cognitive resources. Single-point canes require unique motor sequencing for safe use. The effect of learning to use a single-point cane has not been evaluated in people with AD.

OBJECTIVES: In people with AD and healthy adult controls: 1) examine changes in gait while using a cane under various walking conditions; and 2) determine the cognitive and gait costs associated with concurrent cane walking while multi-tasking.

METHODS: Seventeen participants with AD (age …

The Effect Of Physical Therapy On Patient Self-Reported Outcomes And Perceptions Of Mobility After Lower Extremity Amputations, Gregory Amaya, Rosman Gante, Zachary Meinzer, Abbas Sadrossadat

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The number of people with limb loss is rapidly growing, partly due to an aging society and the prevalence of diabetes. Physical Therapy (PT) has been shown to improve perceived functional outcomes and quality of life in older adults and individuals with diabetes, but it is unclear why certain patients do not receive PT after amputation and whether the beneficial outcomes shown in other populations translate to individuals with limb loss. The purpose of this study was to determine whether receiving PT among patients with limb loss correlates with an improved quality of life, better mobility, and …

Lumbopelvic Muscle Performance And Morphology Differences: Implications For Low Back Pain In Individuals With Unilateral Above-The-Knee Amputation, Melissa Damele, Rachel Gross, Ronauldo Robina

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The number of people living with an amputation in the United States is rising at a rate of almost 200,000 cases a year [1]. The incidence of low back pain (LBP) in individuals with lower limb amputation (LLA) has been shown to be much greater than in the general population at 52%- 72% [2-4]. High amputation level, disuse, and abnormal movement patterns associated with prosthetic gait have been theorized to lead to decreased lower back muscle performance, contributing to the high prevalence of LBP in individuals with LLA [5-7]. However, lumbar muscle morphology and performance have not …

Modulation Of Corticospinal Excitability Using Cathodal Transcranial Direct Current Stimulation To Improve Walking In Individuals With Chronic Post Stroke Hemiparesis, Neil Drobitch, Kylie Henry, Sage Lyons, James Schomig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Individuals who have experienced a pyramidal cerebrovascular accident (pCVA) often exhibit impairments to volitional control of corresponding motor tasks. Promising effects in motor response, post-application of transcranial direct current stimulation (tDCS), have been reported in studies on individuals with the ability to achieve independent gait for 20 minutes. These studies mainly examined the effects of combined tDCS with locomotor training on lower extremity function among higher functioning individuals post-stroke. The purpose of this study was to determine the effect of tDCS among individuals post-stroke who may not have independent ambulatory capabilities, focusing on motor response and less …

Rural Or Underserved Practice Interest Among Doctor Of Physical Therapy Students. Do Clinical Education Experiences Change Opinions?, Brandon Godin, Trenton Poulson, Mac Neil Moresca, Tyler Satoshige

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: People living in rural and underserved areas are poorly served by our country's healthcare system. The Federal Office of Rural Health Policy reports that approximately 18% of people in the United States live in rural areas. Within the physician and nursing literature the largest reported predictor of rural practice is having a rural background. Mandated rural medical rotations during training have been shown to positively alter interest in rural practice and employment. While nursing and medical students have been thus studied, limited evidence exists for physical therapists. The objective of this study was to determine how rural …

The Moderation Effect Of Bdnf Genotype And Self-Reported Lifetime Physical Activity Habits On Postural Instability In Parkinson’S Disease, Samantha Johnson, Tyler Ormsby

UNLV Theses, Dissertations, Professional Papers, and Capstones

Brain-derived neurotrophic factor (BDNF) levels play an important role in neuroplasticity in normal and neurologically compromised individuals. Studies suggest that BDNF levels increase in response to physical activity and are also affected by genotype. In individuals with Parkinson’s Disease (PD), it is not known if physical activity habits and BDNF genotype modulate this neuroprotective response. The purpose of this study was to determine if BDNF genotype interacts with lifetime self-reported physical activity levels to affect age of disease onset and severity of PD symptoms, specifically gait, balance, and motor dysfunction

Patellar Tendon Morphology In Trans-Tibial Amputees Utilizing A Prosthesis With A Patellar-Tendon-Bearing Feature, Jessica Kellogg, Kelly Teter, Michelle Evers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: A patellar-tendon-bearing (PTB) bar is a common prosthetic design feature used in individuals with trans-tibial amputations. As the patellar tendon in the knee of residual limb is subjected to the perpendicular compressive force not commonly seen in normal tendon loading, it is possible for tendon remodeling and degeneration to occur over time; however, there is limited data to support this idea. The primary purpose of this study was to use ultrasound imaging to compare the morphological differences between tendons of the residual and intact limb in unilateral trans-tibial amputees who utilize a prosthesis with a PTB feature. We hypothesized …

Intra- And Inter-Rater Reliability Of A Ballet-Based Dance Technique Screening Instrument, Jessie Lesar, Zachary Shaver, Ivetta Lassey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: To execute the aesthetic demands of dance while utilizing proper biomechanical body position, a dancer needs the ability to maintain lumbopelvic stability, external rotation of the femur, and alignment of the knee, foot, and ankle. The ability to identify technique deficits can guide preventative programs that may reduce injury risk and frequency. Purpose: The purpose of this study was to investigate intra- and inter-rater reliability of the ballet-based Dance Technique Screening Instrument by physical therapists (PTs) and student PTs (SPTs) with prior dance medicine or dance experience. Subjects: Twenty-eight adult subjects served as raters which included licensed PTs and …

Neurodynamics Under Different Walking Speeds In Individuals With Chronic Post-Stroke Hemiparesis, Corey Ackley, Kiley Aki, Joshua Arias, Jassie Trinh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is the leading cause of long-term disability in adults worldwide. The ability to return to walking is often a main goal of rehabilitation in individuals with chronic post-stroke hemiparesis. To increase walking speed, non-neurologically impaired individuals produce greater ankle propulsion force at push-off with greater ankle dorsiflexion angles in swing phase with no change in ankle muscle co-contraction index in the swing phase. It remains unclear if individuals post-stroke would adopt similar neuromuscular strategies. Therefore, our aim was to examine the effect of altered walking speeds on propulsion force at push-off, ankle dorsiflexion angle during swing, …

Physiotherapy Is Associated With Improvements In Gait And Balance In Individuals With Cognitive Impairment: A Retrospective Analysis, Steven Jackson, Elbert Chen, Jason Phan

UNLV Theses, Dissertations, Professional Papers, and Capstones

BACKGROUND: Evidence suggests that individuals with cognitive impairment (CI) exhibit significant motor impairments; however, these motor impairments receive little treatment attention compared to more prominent CI. Moreover, there is a lack of evidence about physiotherapy (PT) in individuals with CI. OBJECTIVE: The purpose of this study was to determine if PT was effective at improving gait and balance in individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI). METHODS: Retrospective data of 173 individuals with CI conditions and an initial evaluation for PT were extracted from electronic records from January 2016 …

Impact Of Clinician Experience And Positive Language On Subject Expectation Of Cervical Spine Manipulation Effects, Joshua Wood, Jonah Mawae, Stephen Elmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Acute neck pain is a worldwide epidemic that physical therapists treat with cervical spine manipulation (CSM). While the mechanical and neurological effects of CSM are important, it is possible that the patient’s perception of the therapist’s skill level may also play a role in patient outcomes. Along with the patient’s perception of the practitioner, evidence suggests that patient expectation for intervention efficacy may also alter patient outcomes. The implication is that special consideration must be taken when practitioners choose their words when describing both themselves and their interventions. The purpose of this study is to examine if …

Electromyography Activation Of Shoulder And Trunk Muscles Is Greater During Closed Chain Compared To Open Chain Exercises, Federico Pozzi, Hillary A. Plummer, Natalia Sánchez, Yunae Lee, Lori A. Michener

Physical Therapy Faculty Articles and Research

Background
To compare the activation of shoulder and trunk muscles between six pairs of closed (CC) and open chain (OC) exercises for the upper extremity, matched for performance characteristics. The secondary aims were to compare shoulder and trunk muscle activation and shoulder activation ratios during each pair of CC and OC exercise.

Methods
Twenty-two healthy young adults were recruited. During visit 1, the 5-repetition maximum resistance was established for each CC and OC exercise. During visit 2, electromyography activation from the infraspinatus (INF), deltoid (DEL), serratus anterior (SA), upper, middle and lower trapezius (UT, MT, LT), erector spinae (ES) and …

The Effect Of Functional Movement Control On Patient-Reported Outcomes In Individuals With Non-Arthritic Hip Pain, Ryan Mcgovern

Electronic Theses and Dissertations

Purpose: Both the single leg squat test and step-down test assess for deficiencies relating to the hip and surrounding musculoskeletal structures and could be useful in the evaluation of functional movement control for individuals with non-arthritic hip pain. The purpose of this study is to determine if individuals with non-arthritic hip pain that improve functional movement control during the single leg squat test and step-down test have better patient-reported outcomes than those that do not improve, following the implementation of a rehabilitation intervention and a standardized home-exercise program.

Subjects: Forty-six individuals (31 females; 15 males) with a mean age of …

Innovative Care Of Individuals In The Athletic Training Room: A Case Series, Kathryn E. Young

Senior Honors Projects, 2010-2019

This work follows three unique cases of athletic injuries and/or injuries in patients. These cases were selected because of the innovative nature of the rehabilitation process conducted by the sports medicine team via the athletic training room or the unique nature of the injury/case.

The first is a concussion sustained from a motor vehicle accident in a collegiate female thrower. This is unique because it’s a non-sport related concussion handled as an athletic trainer would handle a sports related concussion. It also demonstrates a new unique protocol for concussion management.

The second case is a patient with two complete anterior …

Asymmetric Crying Facies Syndrome, Kai-Yu Ho Pt, Phd, Jing Nong Liang Pt, Phd

Physical Therapy Faculty Research

A female infant, born vaginally at 40 weeks of gestation with a birthweight of 3260 g had an Apgar score of 10 at 1 and 5 minutes. She presented with an asymmetric facial expression when crying, with the right side of her mouth deviating inferior-laterally (Figure, A and Video[available at www.jpeds.com]). At rest, her facial expression was symmetric and a thinner left lower lip was noted (Figure, B). A pediatricneurologist noted intact motor, reflex, and cranial nerve functions, and she was diagnosed with asymmetric crying facies, likely because of hypoplasia of the left depressor angularis oris muscle. Asymmetric crying facies …

Simulation Enhances Soft Skills Among Inter-Professionals Participating In An International Service-Learning Experience To A Resource-Limited Country, Suzanne Trotter, Sharon Dunnivan-Mitchell

Physical Therapy Collection

Introduction: Soft skills are the hallmark of a master healthcare provider. One of the most effective ways to teach soft skills to healthcare providers is through service-learning. Evidence suggests that adding simulation as part of a service-learning team’s pre-departure training (PDT) will better prepare them to resolve ethical and cultural dilemmas often encountered in resource-limited countries, plus facilitate soft skills. We hypothesized that simulation could improve soft skills of physical and occupational therapy students and clinicians providing rehabilitation services on a one-week service-learning experience in Guatemala.

Methods: A convenience sample of 21 physical and occupational therapy students and …

Analysis Of Injuries And Costs Of Public Safety Occupations: A Systematic Review, Jade Witmer

Graduate Theses

Public safety occupations, such as firefighters and law enforcement, perform physically demanding tasks in unpredictable environments with additional external loads putting them at risk for sustaining a musculoskeletal injury while on duty. The goal of this systematic review was to address the incidence of musculoskeletal injuries and costs related to those in the public safety occupations of firefighting and law enforcement.

Comparison Of Hip Range Of Motion And Arch Height Index Of Collegiate Female Dancers And Collegiate Females, Philip A. Anloague, Lauren Macnab, Brittany Pease

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Dance requires athleticism and an optimal degree of stiffness and compliance to maximize performance and aesthetics. There is little research published on the utility of hip range of motion (ROM) and arch height index measures (AHI) in the female dance population.

Emg Analysis Of Lassimus Dorsi, Middle Trapezius, And Erector Spinae Muscle Activity During Spinal Rotation: A Pilot Study, Katie Holzheimer, Ross Swartz, Keely Hutchens, Joshua Still

Physical Therapy Scholarly Projects

Purpose/Hypothesis: Spinal rotation is a very common movement that occurs multiple times each day during normal daily activities or even during certain sport performances. Since this motion is a contributing factor to back injuries, it will be important for physical therapists to consider this concept with rehabilitation programs for current back injuries as well as prevention of future injuries. The LD has attachments to many areas of the body, including the spine, humerus, scapula, and pelvis, which explains why this muscle also contributes to multiple actions at the trunk and upper extremity. Due to the attachment sites and the …

Inter-Rater And Intra-Rater Reliability Of The Repetitive Step Test In Community Dwelling Older Adults, Harold L. Merriman, Kurt Jackson, Kristin Beigel, Sara Simpson, Jennifer Smith, Jamie Wynk

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Each year one in every three adults over the age of 65 experience a fall resulting in serious injury and in some instances death. In this population, fall injuries are the leading cause of death and are associated with the greatest number of nonfatal injuries and trauma hospital admissions. Since balance and muscle performance decreases as one ages, it is vitally important to assess these factors as part of a comprehensive strategy to monitor and predict fall risk. The Repetitive Step Test (RST) has previously showed the ability in community dwelling older adults to differentiate recurrent fallers from non-fallers and …