Rehabilitation and Therapy Commons^™

Gait Training A Patient Who Was Deaf With Multiple Total Hip Revisions: A Case Report, Natalie Slattery, Kirsten Buchanan

Case Report Posters

93% of patients who have a total hip arthroplasty (THA) are due to end-stage osteoarthritis. 15-30% of patients who survive a stroke continue to live with a long-term disability. The most common abnormal gait pattern after surviving a stroke is due to hemiparesis. Patients who are deaf require greater visual and tactile cueing during gait training. Gait training has been shown to normalize gait patterns and increase functional mobility in patients after a total hip replacement (THR), THA revision and/or stroke. There is a lack of research investigating the optimal gait training plan of care (POC) for a patient with …

Conservative Management Of A Complete Rupture Of The Long Head Of The Biceps: A Case Report, Ali Woller

Case Report Posters

The purpose of this case study was to assess conservative management of a complete rupture of the long head of the biceps over a six-week period. The long head of the biceps (LHB) stabilizes the shoulder by reducing anteroposterior and superior inferior translation of the humeral head in the glenoid fossa. A tear of the LHB most commonly occurs when the biceps is suddenly loaded against flexion and supination of the elbow. Surgical repair of the LHB has seen 94% satisfaction rates, but with complications. Fifty-six percent of patients who initially chose conservative methods ultimately choose surgery. There is a …

Functional Mobility For An Elderly Person With Amyotrophic Latera Lsclerosis: A Case Report, Gianna G. Pezzano, Amy J. Litterini

Case Report Posters

The purpose of this case study was to describe a palliative care physical therapy (PT) plan for maintenance of functional mobility and fall risk reduction for a patient with ALS. Ice Bucket Challenge began in 2014 to increase public awareness and funding for ALS. Need for further research was highlighted, in the campaign, for medical treatment and rehabilitation. Typical Presentation for Amyotrophic Lateral Sclerosis (ALS) is male, 60 years old, limb onset. This patient was female, 82 years old, with bulbar onset, limb weakness, and fall risk.

Intra-Rater & Inter-Rater Reliability In 2nd Year Dpt Students Performing The Navicular Drop Test, Kirsten Buchanan, Nick Allard, David Buchan, Mike Curtin, Andrew Dipartolo

Research Report Posters

The Navicular Drop Test (NDT) is used as a clinical measure of mid-foot pronation. Objective measurements are rooted in the trust of the tool. When utilizing the NDT, the tool is the practicing clinician. Research has revealed that experienced clinicians have good-excellent intra- and inter-rater reliability when measuring navicular drop (ND). Current data reports ~25,000 practicing US PTs have < 3 years experience. There is limited research exploring the intra- and inter-rater reliability of less experienced DPTs when performing the NDT. The purpose of this research report was to determine the intra- and inter-rater reliability of three 2^nd year DPT students.

The Effect Of Patterned Sensory Enhancement On Balance And Ambulation In Persons Diagnosed With Parkinson’S Disease, Brittany Barko

Masters Theses

One rehabilitation protocol effective in delaying the symptoms of Parkinson’s Disease (PD) is Lee Silverman Voice Training BIG (LSVT BIG), comprising pre-gait exercises and gait training. This study seeks to determine if combining Patterned Sensory Enhancement (PSE), a music therapy intervention, with LSVT BIG will improve quality of movement. During physical therapy sessions with three participants, a music therapist adapted the PSE stimuli to support each patient’s motor needs, which were then recorded on CD and sent with patients to exercise with at home. Results showed improved balance and ambulation comparing pre- and post- measures of the BERG balance scale …

Identifying Trippers And Non-Trippers Based On Knee Kinematics During Obstacle-Free Walking, Lauren C. Benson, Stephen C. Cobb, Allison S. Hyngstrom, Kevin G. Keenan, Jake Luo, Kristian M. O'Connor

Physical Therapy Faculty Research and Publications

Trips are a major cause of falls. Sagittal-plane kinematics affect clearance between the foot and obstacles, however, it is unclear which kinematic measures during obstacle-free walking are associated with avoiding a trip when encountering an obstacle. The purpose of this study was to determine kinematic factors during obstacle-free walking that are related to obstacle avoidance ability. It was expected that successful obstacle avoidance would be associated with greater peak flexion/dorsiflexion and range of motion (ROM), and differences in timing of peak flexion/dorsiflexion during swing of obstacle-free walking for the hip, knee and ankle. Three-dimensional kinematics were recorded as 35 participants …

Predictors Of Success On The National Physical Therapy Licensure Examination, Kristie E. Vinson

Student Theses and Dissertations

This study examined the relationship of the scores on the Practice Exam & Assessment Tool (PEAT) to the scaled scores on the National Physical Therapy Examination (NPTE). A correlation analysis examined the relationship of the exam scores from three cohorts of Doctor of Physical Therapy (DPT) students on the PEAT and NPTE. This study sought to determine if the performance on the PEAT was a predictor of first-time pass rate on the NPTE. It was expected that PEAT scores would have a positive correlation to the NPTE scores. The results indicated a moderate to strong correlation between overall PEAT scores …

Anticipatory Postural Adjustments And Spatial Organization Of Motor Cortex: Evidence Of Adaptive Compensations In Healthy Older Adults, Jo Armour Smith, Beth E. Fisher

Physical Therapy Faculty Articles and Research

During anticipated postural perturbations induced by limb movement, the central nervous system generates anticipatory postural adjustments (APAs) in the trunk and hip musculature to minimize disturbances to equilibrium. Age-related changes in functional organization of the nervous system may contribute to changes in APAs in healthy older adults. Here we examined if altered APAs of trunk/hip musculature in older adults are accompanied by changes in the representation of these muscles in motor cortex. Twelve healthy older adults, 5 with a history of falls and 7 nonfallers, were compared with 13 young adults. APAs were assessed during a mediolateral arm raise task …

Effectiveness Of Therapy Interventions For Heterotopic Ossification About The Elbow: A Systematic Review, Cole Burns

Shared Knowledge Conference

Heterotopic ossification (HO) is the presence of bone where bone normally does not exist. HO forms frequently at the elbow from various conditions including: Fracture, orthopedic surgery, certain genetic disorders, neurological injuries, amputation, and brain injury. A diagnosis of HO at the elbow can lead to decreases in range of motion which effects the person’s functional independence. Surgical excision to remove the bone can be done to improve functional outcomes, but is typically not performed until a year has passed from the time of injury. Even then, there have been instances where people have experienced recurrent HO post-surgery. Because of …

Fatigue In Adults With Cerebral Palsy: A Three-Year Follow-Up Study., Irene L B Oude Lansink, Patrick G Mcphee, Laura Kristine Brunton, Jan Willem Gorter

Physical Therapy Publications

OBJECTIVES: To describe the course of fatigue over a 3-year follow-up period in adults with cerebral palsy and to investigate the association of known determinants of fatigue (i.e. demographic characteristics and/or body composition) with change in fatigue.

METHODS: Forty-one adults with cerebral palsy from a previous study of fatigue were invited to participate in a follow-up study. Twenty-three adults with cerebral palsy (Gross Motor Function Classification System (GMFCS) levels I-V; mean age 38 years 2 months, standard deviation (SD) 14 years 1 month)) agreed to participate (convenience sample). Fatigue was measured with the Fatigue Impact and Severity Self-Assessment (FISSA, range …

Effects Of Pain Neuroscience Education On Physician Assistant Students Understanding Of Pain And Attitudes And Beliefs About Pain., Kory Zimney, Adriaan Louw, Julie Johnson, Suzanne Peppers, Kevin Farrell

Faculty Publications

PURPOSE: Evaluate the effectiveness and efficiency of two different pain neuroscience education (PNE) lectures provided to physician assistant (PA) students. Primary outcomes explored were knowledge of pain and shift in attitudes and beliefs about chronic pain after the lecture.

METHODS: A PNE lecture was provided at two separate university PA programs. One program received a two-hour PNE lecture with a case-based example. The other program received a one-hour PNE lecture without the casebased example. Measurement of change for pre and post-test pain knowledge and attitudes and beliefs about chronic pain were recorded.

RESULTS: Students at both universities showed medium effect …

A Barefoot Running Program For A College Lacrosse Player With Chronic Exertional Compartment Syndrome: A Case Report, Erica Mazzarelli, Kirsten Buchanan

Case Report Posters

Barefoot running protocols have been effective in decreasing anterior and lateral chronic exertional compartment syndrome (CECS), but they have not been studied in patients with posterior CECS. Additionally, there is a lack of research that has investigated a barefoot running protocol in a college lacrosse athlete. The purpose of this case report was to examine the effects of adopting a forefoot strike pattern, through a barefoot running program, in a 20-year-old college lacrosse player with posterior chronic exertional compartment syndrome.

Mckenzie Approach To Treating Lumbar Radiculopathy With A Lateral Shift: A Case Report, Carly Theriault

Case Report Posters

Lumbar radiculopathy is compression of a spinal nerve root, typically due to a herniated nucleus pulposus. It can present as low back pain (LBP) that radiates to one lower extremity (LE) and may be associated with diminished sensation, strength and reflexes on the affected side. The McKenzie approach is an evaluation and treatment technique that focuses on the movement of the nucleus pulposus within the intervertebral disc during trunk movement. This approach involves having a patient perform repeated motions, while monitoring their symptoms for centralization. Centralization refers to the concept that radiating symptoms into the lower extremities can move proximally …

The Effect Of Medical Therapeutic Yoga On Adhesive Capsulitis: A Case Report, Cameron Vallie, Matthew Somma

Case Report Posters

The number of Americans who practice yoga jumped to 16.5 million between 2004 and 2008 (87% increase), making it a top 10 modality in alternative medicine according to the National Institutes of Health. Medical Therapeutic Yoga is the practice of yoga in medicine, rehabilitation, and wellness settings by a licensed health care professional credentialed by the Professional Yoga Therapy Institute. Shoulder pain has been found to be the third most common site of musculoskeletal pain in the community. Adhesive capsulitis (AC) is a particularly disabling condition whose incidence is estimated to be between 2% and 5% of the general population …

Relieving Low Back Pain And Improving Mobility For An Adult Patient With Progressive Multifocal Leukoencephalopathy: A Case Report, Derek Schwaiger, Matthew Somma

Case Report Posters

Progressive Multifocal Leukoencephalopathy (PML) is a progressive demyelinating disease caused by the John Cunningham Virus (JCV). There is no FDA approved JCV- specific treatment. This case report examines interventions administered to address low back pain (LBP) and functional mobility deficits.

Trunk Control And Gross Motor Outcomes After Body-Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Case Series, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

BACKGROUND AND PURPOSE: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and V present with decreased gross motor function and trunk control that impacts their functional activities and participation in family activities. Research indicates body-weight supported treadmill training (BWSTT) may improve motor control for children with neuromotor disabilities. The toddler years present a window of opportunity for developmental changes. The purpose of this case series was to explore the impact of a 6-week BWSTT intervention on postural control and gross motor function in 3 young children with cerebral palsy in GMFCS levels IV and …

Caregiver Perspectives On Body-Weight Supported Treadmill Training As An Intervention For Young Children With Cerebral Palsy, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

PURPOSE/HYPOTHESIS: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and V present with challenges that impact their functional activities and participation in family activities. The purpose of this study was to examine caregivers’ perspectives on body-weight supported treadmill training (BWSTT) as an intervention for their young children with CP.

NUMBER OF SUBJECTS: Participants included 4 caregivers of children with CP in GMFCS levels IV (n = 2) and V (n = 2) who previously participated in 6 weeks of BWSTT.

MATERIALS/METHODS: Three children diagnosed with CP in GMFCS levels IV and V between the …

Trunk Control And Gross Motor Outcomes After Body Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Non-Experimental Case Series, Megan Flores, Carolyn P Da Silva

Physical Therapy Collection

OBJECTIVE: To explore the impact of a body weight supported treadmill training (BWSTT) intervention on postural control and gross motor function in three young children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels IV or V.

METHOD: Children (N = 3) between the ages of 2-3 years who were diagnosed with CP classified as GMFCS levels IV and V participated in BWSTT three times per week. The Segmental Assessment of Trunk Control (SATCo) and the gross motor function measure (GMFM-66) were assessed before and after the 6-week intervention.

RESULTS: Final testing revealed …

Tips For Allied Health Professionals To Successfully Engage With Research: A Commentary, Siti Nurliyana Abdullah, Saravana Kumar

Internet Journal of Allied Health Sciences and Practice

While allied health professionals are encouraged to engage with research, there are numerous challenges to do so in practice. In this commentary, we reflect on some of these challenges and provide some simple tips on strategies that can be used by allied health professionals to overcome these challenges. These tips may provide a starting point for allied health professionals to successfully engage with research.

Force Steadiness During A Cognitively Challenging Motor Task Is Predicted By Executive Function In Older Adults, Hugo M. Pereira, Bonnie A. Schlinder-Delap Mrs., Kristy A. Nielson, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Motor performance and cognitive function both decline with aging. Older adults for example are usually less steady for a constant-force task than young adults when performing low-intensity contractions with limb muscles. Healthy older adults can also show varying degrees of cognitive decline, particularly in executive function skills. It is not known, however, whether age-related changes in steadiness of low-force tasks and cognitive function are independent of one another. In this study, we determined if executive function skills in aging are associated with the steadiness during a low-force muscle contraction performed with and without the imposition of a cognitive challenge. We …

The Use Of Neuromuscular Electrical Simulation In Glenohumeral Unidirectional Instability When An Exercise-Based Approach Has Failed: A Case Study, Kunal Bhanot, Navpreet Kaur, J Butler

Physical Therapy Collection

Purpose of this case study was to report the role of neuromuscular electrical stimulation (NMES) to restore strength and normal motion in a patient with unidirectional shoulder instability or glenohumeral internal rotation deficit (GIRD).

A Collaborative Approach To Decision Making Through Developmental Monitoring To Provide Individualized Services For Children With Cerebral Palsy., Doreen J Bartlett, Sarah W Mccoy, Lisa A Chiarello, Lisa Avery, Barbara Galuppi, On Track Study Team

Physical Therapy Publications

In this Perspective, we suggest a process to improve physical and occupational therapists’ and families’ collaboration to provide appropriate, efficient, and effective evidence-based services to improve motor function, self-care performance, and participation in family and recreation activities for children with cerebral palsy (CP). This process is informed by 2 multisite prospective cohort studies (Move & PLAY and On Track). The heterogeneity of children with CP is described, limiting the utility of evidence from randomized controlled trials and systematic reviews to inform service planning for children with CP. An evidence-based alternative using prospective cohort studies that produce knowledge of determinants of …

Stability Of The Gross Motor Function Classification System, Manual Ability Classification System, And Communication Function Classification System., Robert J Palisano, Lisa Avery, Jan Willem Gorter, Barbara Galuppi, Sarah Westcott Mccoy

Physical Therapy Publications

AIM: To determine the stability of the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) over 1-year and 2-year intervals using a process for consensus classification between parents and therapists.

METHOD: Participants were 664 children with cerebral palsy (CP), 18 months to 12 years of age, one of their parents, and 90 therapists. Consensus between parents and therapists on level of function was ≥92% for the GMFCS, MACS, and CFCS. A linearly weighted kappa coefficient of ≥0.75 was the criterion for stability.

RESULTS: Kappa coefficients varied from 0.76 to 0.88 for …

Core Stabilization And Pelvic Motility Training For A 28-Week Pregnant Female With Low Back Pain And Sciatic Nerve Pain, Jenna Belser, Anne H. Boddy

St. Augustine, Fall 2018

The purpose of this case study is to determine the effects of core stabilization and pelvis mobility training for a 28-week pregnant female to improve function and decrease pain.

Low back pain during pregnancy is a common occurrence that affects a majority of the population.¹ Over the five treatment sessions, the patient was able to tolerate a full ten-hour work shift and sleep through the night. She also showed improvements in muscle strength and flexibility. As seen in non-pregnant females, the patient was able to have a decrease in pain and improvement in function with these techniques.⁴

Fsm Restores Activity To Trapezius For 67 Y.O. Male, Marilyn Miller, Carolyn R. Mcmakin

San Marcos, Fall 2018

One session of frequency specific microcurrent (FSM) restored voluntary function and muscle definition for a 67 y. o. male DIY enthusiast after 18 mos of disuse.

Service Learning For Balance And Activity Promotion In The Older Adult, Christine Mary Childers

San Marcos, Summer 2018

Barr and Wong¹ challenged faculty to provide creative and innovative ways of teaching meaningful content related to care of the older adult population.¹ Service learning combines community service with learning objectives and reflection, meeting academic and community needs.² Service learning helps students manage the complex care of the older adult stroke population³ and intergenerational programs benefit both generations.⁴ The purpose of this study was to explore and compare student ideas and thoughts regarding balance and activity promotion in the older adult, both with and without a service learning opportunity Falls are a leading concern with …

A Different Instructional Model To Improve Student Learning Outcomes In Gross And Applied Anatomy For Physical Therapy Students, Cherie Peters-Brinkerhof, Christine Mary Childers

San Marcos, Fall 2018

Teaching and learning anatomy in a DPT program poses a challenge to students and faculty because of the volume of material needed as foundational information for a PT curriculum. The aim of this study was to determine if a round-robin model of instruction in anatomy and applied anatomy labs, is more effective to meet the course learning objectives compared to a more traditional, separate class instruction.

Guiding Questions:

1. What were the faculty and students’ perception of the teaching method used for anatomy and applied anatomy?

2. What were the faculty's perceptions of the students’ understanding of the material presented? …

Anti-Gravity Treadmill Training With 19-Year-Old Soccer Player Status Post-Leukemia, Britni Barber, Lisa Chase

St. Augustine, Fall 2018

The purpose of this case report was to describe the effects of anti-gravity treadmill training, in addition to standard treatment protocol, on endurance performance in a 19-year-old female collegiate soccer player following chemotherapy treatment for leukemia.

Physical therapy rehabilitation of patients who are experiencing chemotherapy-related fatigue may benefit from anti-gravity treadmill training. This case report not only identifies a successful outcoming using such intervention but also introduces a more aggressive approach to treatment for a patient whose goals included going back to play division one sports. The patient was not only able to reach her goals of being able to …

Inter-Institutional Collaboration To Benefit Student Learning: A Scenario In Graduate Education, Marilyn Miller, Linda Hill, Nicolas Van Den Heever

San Marcos, Fall 2018

Occupational and Physical Therapists are in a unique role, in which they can assist in the identification and rehabilitation of impairments. The collaboration between UCSD and USAHS is preparing students with the knowledge and skills to assess older persons for driving abilities.

The current content delivery allows the TREDS program to be available to the Gerontology course offering for other USAHS campus locations; and has the potential to be accessed by other institutions of higher education offering courses in Gerontology.

Conservative Therapy Of Patient With Dyspareunia In A Post-Menopausal State With Co-Morbidities Including Previous Breast Cancer And Valve Replacement: A Case Report, D. Ditoro, M. Mason-Cover, C. Hazelton, Annie Burke-Doe, Marilyn Miller

San Marcos, Fall 2018

Dyspareunia is defined as persistent pain in the vaginal area before, during, or after sexual intercourse.^1,2 The etiology is uncertain in the medical literature, but evidence proposes that pain and dysfunction of pelvic floor muscles (PFM) can contribute to dyspareunia and other forms of chronic pelvic pain.^1,2 The information contained in this case report is clinically relevant because it presents evidence that dyspareunia can be treated safely with physical therapy techniques on a patient with a complex medical history.