Rehabilitation and Therapy Commons^™

Physical Therapists’ Perceptions Of Barriers To The Use Of Evidence-Based Fall Prevention Intervention With Individuals Of 65 Years Of Age Or Older, Charles Agbonghae

Student Dissertations

Falls are a problem in the elderly population. Evidence-based fall prevention programs are available but physical therapists do not always utilize them. The literature identifies a number of barriers to clinician’s use of evidence-based interventions in general but there is limited knowledge of barriers to the use of evidence-based interventions in the clinical practice area of fall prevention. The purpose of this study was to identify barriers perceived by physical therapists to the use of evidence-based fall prevention interventions with individuals of 65 years of age or older. The study utilized an on-line survey of physical therapists licensed in Texas. …

Ballroom Dance For Persons With Multiple Sclerosis: A Pilot Feasibility Study, Alexander V. Ng, Sheri Bunyan, Jimin Suh, Pamela Huenink, Tyler Gregory, Shannon Gambon, Deborah Miller

Exercise Science Faculty Research and Publications

Purpose: The purpose of this study was to evaluate the exercise intensity and feasibility of recreational ballroom dance for persons with multiple sclerosis (MS).

Methods: Seven persons with MS participated in 2 one-hour dance sessions per week for 6 weeks. Dance types included rumba, foxtrot, waltz, and push-pull. Six other persons with MS comprised a control group that did not dance. Heart rate and ratings of perceived exertion (RPE) were monitored during the sessions. Outcomes included: quality of life, fatigue, depression, self-efficacy, timed up and go, Berg Balance Scale, Dynamic Gait Index and the Multiple Sclerosis Functional Composite comprising 9-hole …

Developmental Trajectories And Reference Percentiles For Range Of Motion, Endurance, And Muscle Strength Of Children With Cerebral Palsy., Lynn M Jeffries, Alyssa Laforme Fiss, Sarah Westcott Mccoy, Doreen Bartlett, Lisa Avery, Steven Hanna

Physical Therapy Publications

BACKGROUND: Children with cerebral palsy (CP) frequently present with secondary impairments in spinal alignment and extremity range of motion, endurance for activity, and muscle strength. Creation of developmental trajectories for these impairments will help guide clinical decision-making.

OBJECTIVE: For children in each level of the Gross Motor Function Classification System (GMFCS) this study aimed to: (1) create longitudinal developmental trajectories for range of motion (Spinal Alignment and Range of Motion Measures [SAROMM]), endurance (Early Activity Scale for Endurance [EASE]), and functional strength (Functional Strength Assessment [FSA]); and (2) develop age-specific reference percentiles and amount of change typical over 1 year …

Using The Backward Design Process To Integrate Interprofessional Education Utilizing Simulation In Ot And Pt Educational Curricula, Norman C. Belleza, Maureen Johnson

Physical Therapy Collection

Interprofessional simulation education (IPSE) has been integrated into the OT and PT curriculum. Having a dedicated simulation center on-site allows for continued use of IPSE for regular monitoring and assessment of student achievement in interprofessional exchanges. Additional healthcare disciplines can also integrate IPSE including nursing, nurse practitioner, physician’s assistant, post-graduate professionals, athletic trainers, and speech and langue pathology. Inclusion of IPSE will augment the collaborative effort for increased interactions among various health care providers.

Balance And Strength Interventions For An Older Individual With Peripheral Polyneuropathy: A Case Report, Hanna Geib

Case Report Papers

Background and Purpose: Peripheral polyneuropathy (PPN) is a condition resulting from damage to the peripheral nervous system, causing sensory abnormalities (e.g. tingling, burning, and loss of sensation) occurring distally to proximally. Individuals with PPN experience proprioceptive sensory loss and muscle weakness, resulting in decreased functional mobility. A common cause of PPN is diabetes mellitus, however 20-25% of cases are deemed idiopathic. Interventions of balance training and lower extremity strengthening have been shown to have a small positive effect on the progression of PPN. The purpose of this case report is to describe the physical therapy (PT) management of an elderly …

Thrust Joint Manipulation To The Cervical Spine In Participants With A Primary Complaint Of Temporomandibular Disorder (Tmd): A Randomized Clinical Trial, Breanna C. Reynolds

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Temporomandibular disorder (TMD) is a common and costly problem often leading to chronic pain. There exists moderate evidence for physical therapy (PT) interventions in the management of TMD. A known relationship between TMD and the cervical spine exists with some evidence to support cervical intervention treatments. Cervical spine thrust joint manipulation (TJM) is an effective PT intervention explored in a limited fashion for this population. Objectives: To determine the immediate and short term (1 and 4 week) effects of cervical TJM on pain, dysfunction, and perception of change in individuals with a primary complaint of TMD. Methods: In this …

Cognitive Load Theory Principles Applied To Simulation Instructional Design For Novice Health Professional Learners, Susan M. Grieve

Department of Physical Therapy Student Theses, Dissertations and Capstones

While the body of evidence supporting the use of simulation-based learning in the education of health professionals is growing, howor why simulation-based learning works is not yet understood. There is a clear need for evidence, grounded in contemporary educational theory, to clarify the features of simulation instructional design that optimize learning outcomes and efficiency in health care professional students.

Cognitive Load Theory (CLT) is a theoretical framework focused on a learner’s working memory capacity. One principle of CLT is example based learning. While this principle has been applied in both traditional classroom and laboratory settings, and has shown positive …

Effects Of Generic Group-Based Versus Personalized Individual-Based Exercise Programs On Balance, Gait, And Functional Performance Of Older Adults With Mild Balance Dysfunction And Living In Residential Care Facilities - A Randomized Controlled Trial, Varatharajan Lingam

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). …

Effectiveness Of A Manual Therapy Approach In Treatment Of Patients With Lumbar Spinal Stenosis, Haitham Ramadan

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: The use of manual therapy for the management of lumbar spinal stenosis (LSS) has not been adequately systematically reviewed in an attempt to determine its effectiveness on patients with LSS. The lack of evidence in support ofcommonly used conservative interventions continues to result in a lack of clarity regarding what interventions should be used to manage patients with LSS. Objective: To use a randomized comparative trial to compare the functional clinical outcomes achieved by patients with LSS receiving two different physical therapy interventions. Methods: In this randomized controlled trial, a total of40 participants diagnosed with LSS were randomized into …

Lived Experience Of Exemplary Physical Therapist Students In Clinical Education: A Phenonenological Study, Laura Hagan

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction and Review of the Literature. The academic community has made it priority to determine best practice in the clinical education (CE) of Physical Therapist (PT) students. The perspective of various stakeholders has been considered inthe profession’s pursuit of excellence. Previous research highlighting the characteristics of expert clinicians and clinicalinstructors in physical therapy has served as a model for those who strive for excellence. The student and critical stakeholder, however, has not been given the opportunity to be heard. To date, no literature has explored the experience of PT student who demonstrate excellence. This study aims to understand the lived …

Caring For Children With Severe Cerebral Palsy: The Lived Experience Of Parents, Jason Eric Cook

Department of Physical Therapy Student Theses, Dissertations and Capstones

The purpose of this study is to explore the lived experience of parents who care for their child withcerebral palsy who function at Gross Motor Function Classification System (GMFCS) Level V. Additionally, the study also explores the parent’s understandings and beliefs about pain and non-pain related emotional distress, and the meaning of caring, providing care, and providing comfort for their child with GMFCS Level V cerebral palsy. The study was conducted using a qualitative, hermeneutic phenomenology approach with semi-structured interviews and participant-initiated journaling. The study included 11 participants who are caregiving parents of their child with GMFCS Level V cerebral …

What Are Typical Outcomes Associated With Physical Therapy For Foot & Ankle Patients?, Judith F. Baumhauer, Christopher Neville, Kostantinos Vasalos, Chad Condidorio, Kathleen Fear, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: It is unclear whether patients attending physical therapy, post-op or for conservative care, achieve clinically important differences (CID) on the patient reported outcome information system (PROMIS) scales. Key PROMIS outcomes physical function (PF) and pain interference (PI) match well with treatments provided in physical therapy. Physical therapy may also influence depression (Dep). Documentation of PROMIS outcomes associated with physical therapy are useful to help set patient expectations. The purpose of this analysis was to document expected PROMIS PF, PI, and Dep outcomes after physical therapy for foot and ankle diagnoses by 1) reporting average improvement and 2) examining whether …

Interrater Reliability Of The Pediatric Neuromuscular Recovery Scale In Children With Spina Bifida, Elizabeth Ardolino, Megan Flores, Germaine Ferreira, Susan Jeantete, Kathleen Manella

Physical Therapy Collection

Purpose: There is a paucity of outcome measures to assess the quality of functional mobility in children with spina bifida¹. The Pediatric Neuromuscular Recovery Scale (Peds NRS) is a valid and reliable outcome measure that was developed to assess the motor capacity of children with spinal cord injury^2-6. The purpose of this study was to examine the interrater reliability of the Pediatric Neuromuscular Recovery Scale (Peds NRS) to classify motor capacity in children with myelomeningocele (MMC) form of spina bifida.

Subjects: Twenty-one children with MMC (1.4- 10 years of age; mean age of 5.3 …

Integrating Interprofessional Education With Simulation Experiences Within Ot And Pt Curricula: A Look At The Backwards Design Process, Nicole Rodriguez, Norman C. Belleza, Maureen Johnson

Physical Therapy Collection

Interprofessional education has become a significant focus across healthcare disciplines noting the benefits that can be achieved through improving patient outcomes, increasing awareness for potential referral to other providers, and fostering collaboration.

The integration of simulation into established OT and PT curriculum was a less daunting task by using the backward design process. Continued growth and the addition of Speech Therapy, Nursing, and Physician’s Assistant programs will further necessitate use of backward design to integrate meaningful multidisciplinary activities for students.

Patellar Tendon Morphology In Trans-Tibial Amputees Utilizing A Prosthesis With A Patellar-Tendon-Bearing Feature, Kai-Yu Ho, Michelle Harty, Jessica Kellogg, Kelly Teter, Szu-Ping Lee, Yu-Jen Chang, Gregory Bashford

Faculty & Staff Scholarship

A patellar-tendon-bearing (PTB) bar is a common design feature used in the socket of trans-tibial prostheses to place load on the pressure-tolerant tissue. As the patellar tendon in the residual limb is subjected to the perpendicular compressive force not commonly experienced in normal tendons, it is possible for tendon degeneration to occur over time. The purpose of this study was to compare patellar tendon morphology and neovascularity between the residual and intact limbs in trans-tibial amputees and healthy controls. Fifteen unilateral trans-tibial amputees who utilized a prosthesis with a PTB feature and 15 age- and sex- matched controls participated. Sonography …

Factors Related To Intra-Tendinous Morphology Of Achilles Tendon In Runners, Kai-Yu Ho, Ari Baquet, Yu-Jen Chang, Luang-Chang Chien, Michelle Harty, Gregory Bashford, Kornelia Kulig

Faculty & Staff Scholarship

The purpose of this study was to determine and explore factors (age, sex, anthropometry, running and injury/pain history, tendon gross morphology, neovascularization, ankle range of motion, and ankle plantarflexor muscle endurance) related to intra-tendinous morphological alterations of the Achilles tendon in runners. An intra-tendinous morphological change was defined as collagen fiber disorganization detected by a low peak spatial frequency radius (PSFR) obtained from spatial frequency analysis (SFA) techniques in sonography. Ninety-one runners (53 males and 38 females; 37.9 ± 11.6 years) with 8.8 ± 7.3 years of running experience participated. Height, weight, and waist and hip circumferences were recorded. Participants …

The Role Of Sirt1 In Skeletal Muscle Function And Repair Of Older Mice, Mathew J. Myers, Danielle L. Sheperd, Andrya J. Durr, David S. Stanton, Junaith S. Mohamed, John M. Hollander, Stephen E. Alway

Faculty & Staff Scholarship

Background Sirtuin 1 (SIRT1) is a NAD+ sensitive deacetylase that has been linked to longevity and has been suggested to confer beneficial effects that counter aging-associated deterioration. Muscle repair is dependent upon satellite cell function, which is reported to be reduced with aging; however, it is not known if this is linked to an aging-suppression of SIRT1. This study tested the hypothesis that Sirtuin 1 (SIRT1) overexpression would increase the extent of muscle repair and muscle function in older mice. Methods We examined satellite cell dependent repair in tibialis anterior, gastrocnemius, and soleus muscles of 13 young wild-type mice (20–30 …

The Treatment Of Shoulder Dysfunction By The Correction Of Shouler Girdle Muscle Imbalances: A Case Study, Zachary Peterson

Physical Therapy Scholarly Projects

Background and Purpose: Shoulder dysfunction is a broad expression that encompasses the shoulder girdle not being able to perform fluently, without pain, or within normal ranges of motion. Current literature elaborates on potential causes of dysfunction such as: osteoarthritis, impingement syndrome, and cervical myelopathy. From a clinical standpoint, it is crucial to differentiate between possible diagnoses to ensure the proper treatment is utilized.

Case Description: The patient was a 66‐year‐old female who was referred with the initial diagnosis of shoulder osteoarthritis. She presented with headache pain that was debilitating and followed a pattern consistent with muscle guarding, limited L shoulder …

A Case Report: Treatment Of Facioscapulohumeral Muscular Dystrophy, Jeremy Korthuis

Physical Therapy Scholarly Projects

Purpose: The purpose of the case study was to explain a treatment program involving low/moderate intensity strength training and stretching for a patient with facioscapulohumeral muscular dystrophy (FSHD).

Background: FSHD is the third most common type of muscular dystrophy. This pathology results from a mutation in chromosome 4 and results in progressive weakening of facial, scapular, and hip musculature. Research behind effective strengthening programs is often inconclusive and varies in results.

Case Description: The patient was a 34-year-old female, who was diagnosed with FSHD 3 years prior to our first visit. She had complaints of left shoulder pain (2-3/10), shoulder …

Outpatient Pt Management Of Patient With Bilateral Knee Pain S/P Stem Cell Cartilage Replacement Therapy Of Both Knees, Justin Hett

Physical Therapy Scholarly Projects

Background and Purpose: This article describes the 6-week outpatient physical therapy management of a 65-year-old male who c/o bilateral knee pain s/p stem cell cartilage replacement therapy. The patient presented with decreased ROM in both knees R>L, difficulty ambulating moderate distances, knee pain, and decreased LE strength bilaterally. The purpose of this article is to describe the treatments used for this patient and the results from these treatments.

Description: The treatment of this patient involved range of motion, strengthening, patient education, and stretching.

Outcomes: Following PT intervention, the patient had increased ROM in both knees L>R, normal strength, …

Standard And Cognitive Four Square Step Test (Fsst), Renee Hoffman, Hannah Bucholz

Physical Therapy Scholarly Projects

Background/Purpose: The Four Square Step Test (FSST) measures dynamic standing balance and agility and was developed to identify older adults at risk for falls. It has a cognitive component for remembering the stepping sequence but has never been tested with an additional cognitive task. The purpose of this study was to collect normative data for the FSST and Cognitive FSST in community dwelling adults for various age groups.

Materials/Methods: Eighty-seven community-dwelling adults (55 females, 32 males) between the age 21 and 86 (48.22 years) were included in the study. Participants completed a fall risk checklist and a cognitive screen prior …

Outpatient Physical Therapy Management Of A Patient Diagnosed With Myotonic Muscular Dystrophy Type 2, Ashley Jobe

Physical Therapy Scholarly Projects

Background and Purpose. This article describes the 3-week outpatient Physical Therapy management of a 63-year-old female with a diagnosis of Myotonic Muscular Dystrophy (MMD) Type 2. MMD is an inherited disorder, which progressively impacts muscular, respiratory, cardiac, nervous, and endocrine systems. MMD Type 2 is characterized by muscle weakness, muscle pain, and myotonia. The patient in this case study presented to physical therapy with upper and lower extremity weakness and balance impairment. The purpose of this article is to describe the initial physical therapy evaluation process for a patient with MMD, as well as the interventions used for this patient …

A Case Report: Factors Influencing The Physical Therapy Care Following Medical Treatment Of An Anaplastic Oligodendroglioma, Connor Camrud

Physical Therapy Scholarly Projects

Purpose The purpose of this case report is to describe the clinical decision-making processes of the physical therapy (PT) care for a patient who was diagnosed with an anaplastic oligodendroglioma and subsequently had surgical decompression and resection, chemotherapy, and radiation.

Background Anaplastic oligodendrogliomas account for 3% to 20% of all brain tumors. The incidence of this tumor is 40% greater in males than females. Average onset occurs between 35 and 44 years of age. Anaplastic oligodendrogliomas commonly occur in the frontal lobes and are supratentorial. Patients will often present with headaches, new weakness, vision changes, and a decline in cognitive …

A Case Report: Adhesive Capsulitis And Physical Therapy Intervention, Haley Brenner

Physical Therapy Scholarly Projects

Background and Purpose The purpose of this case report is to describe the physical therapy interventions for a patient with adhesive capsulitis.

Case Description The patient was a 68-year-old right-handed male who presented with left shoulder pain and limited range of motion (ROM) following a fall 7 months prior. The patient had a past medical history of type II diabetes mellitus. The diagnosis of adhesive capsulitis was determined following radiographs, mechanism of injury, past medical history, and physical therapy examination and evaluation.

Intervention The patient was seen for a total of 8 physical therapy sessions over the span of 6 …

Collaborative Physical And Music Therapy Interventions For Impairments Of Chronic Stroke: A Case Study, Jake Leverington, Kelsey Bell

Physical Therapy Scholarly Projects

[Background and Purpose] In the United States, the annual prevalence of stroke is estimated to be 800,000. 1 Following a stroke, physical therapy (PT) interventions aim to help individuals recover from impairments such as muscle weakness and overall functional limitation. Current research supports both physical and music therapy (MT) interventions on an individual basis. The purpose of this case study was to evaluate the effectiveness of combined PT and MT interventions for strength, balance, gait, and functional activity for person following stroke.

[Case Description] The patient is a 50- year-old caucasian female post right cerebral vascular accident (CVA) with left …

Electromyographic (Emg) Activity Of The Gluteus Medius During Various Hip Exercises, Kalie Maiden, Mitchell Karbo, Taylor Doeden, Analise Richtsmeier

Physical Therapy Scholarly Projects

Background and Purpose. The purpose of the study was to record and analyze muscle recruitment patterns of the gluteus medius and gluteus maximus muscles when performing a side lying abduction exercise requiring consistent force to roll a ball up and down the wall using the dominant lower extremity. Comparisons were made between the use of either a small, medium or large ball. The subjects performed a standing abduction exercises with theraband around both ankles as well.

Case Description. Fifteen subjects were recruited from the University of North Dakota Department of Physical Therapy to perform the four different types of exercises. …

Collaboration Between Physical Therapy And Music Therapy: A Case Study Of The Interventions And Their Effects On Parkinson's Disease, Mercedes Stein, Kristyn Bergh

Physical Therapy Scholarly Projects

Background and Purpose: Parkinson's Disease is a chronic and progressive neurological disorder that causes motor dysfunction leading to dyskinesia, bradykinesia, muscular rigidity, resting tremors, postural impairments, and gait impairments. These impairments can have a tremendous negative impact on a person's everyday life. This case study demonstrates the collaboration of physical therapy and music therapy interventions and its effects on a female with Parkinson's Disease.

Case Description: The patient is a 72-year old female diagnosed with Parkinson's Disease around 2010. Her primary reason for seeking treatment is due to an increase in freezing of gait and overall decrease in mobility that …

Influence Of Clinical Instructor And Physical Therapist Student Characteristics On The Use Of Standardized Tests And Measures In Clinical Practice, Vicki Lafay

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Physical therapist (PT) students report discord between what they learn in the academic environment and what they experience in clinical practice. Despite increasing reporting requirements, standardized tests and measures (STMs) are not well integrated into routine clinical practice. The primary purposes of this study were to (1) examine clinical instructor (CI) and PT student characteristics and beliefs that influence the use of STMs in clinical practice, and (2) explore alignment between the STMs students learn during academic preparation to those commonly reported in clinical practice. Procedures/Methodology: In this mixed method sequential explanatory study, participant demographic characteristics, perceived STM …

Trigger Point Dry Needling, Manual Therapy And Exercise Versus Manual Therapy And Exercise For The Management Of Achilles Tendinopathy: A Feasibility Study, Alex Michael Koszalinski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: The effect of trigger point dry needling (TDN) on myofascial trigger points (MTP) in Achilles tendinopathy are unknown. Objectives: To determine the feasibility of a large randomized controlled trial (RCT) to compare the effects of TDN to exercise in a patient population with Achilles tendinopathy. Methods: This single-factor, pretest-posttest control group design included 22 subjects between the ages of 24 and 65 years with Achilles tendinopathy. Subjects were randomly assigned to either a control group (MT+Ex) or experimental group (TDN+MT+Ex). Subjects in both groups completed 8 physical therapy treatment sessions over 4 weeks. The intervention for the TDN+MT+Ex group …

White Matter Biomarkers Associated With Motor Change In Individuals With Stroke: A Continuous Theta Burst Stimulation Study, K P Wadden, Sue Peters, M R Borich, J L Neva, K S Hayward, C S Mang, N J Snow, K E Brown, T S Woodward, S K Meehan, L A Boyd

Physical Therapy Publications

Continuous theta burst stimulation (cTBS) is a form of noninvasive repetitive brain stimulation that, when delivered over the contralesional hemisphere, can influence the excitability of the ipsilesional hemisphere in individuals with stroke. cTBS applied prior to skilled motor practice interventions may augment motor learning; however, there is a high degree of variability in individual response to this intervention. The main objective of the present study was to assess white matter biomarkers of response to cTBS paired with skilled motor practice in individuals with chronic stroke. We tested the effects of stimulation of the contralesional hemisphere at the site of the …