Rehabilitation and Therapy Commons^™

Feasibility And Preliminary Outcomes Of A Standardized Exercise Program In Adults With Down Syndrome: A Pilot Study, Megan Flores, Kristen Barta, Martha Sneary, Germaine Ferreira, Elizabeth Ardolino

Physical Therapy Collection

Purpose/ Hypothesis: Youth with Down Syndrome (DS) have limited participation in physical activity. When compared to their typically developing peers, adults with DS display decreased functional mobility and strength. Exercise has shown to improve the physical fitness, overall health, and quality of life in people with DS. The Lee Silverman Voice Treatment (LSVT® BIG) is an effective treatment approach designed for patients with Parkinson’s disease. The core components of LSVT® BIG include large amplitude movements, sensory calibration, high intensity, and maximum effort while performing the daily exercises. Due to hypotonicity associated with DS, these individuals typically display kyphotic posture, shortened …

Global Health And Disability: A Review And Call To Action For All Rehabilitation Professions, Evan M. Pucillo, Matthew B. Huish, Quinn Tate, Edward C. O'Bryan, Ty T. Dickerson

Physical Therapy Collection

The World Health Organization estimates 15% of the world’s population is living with disability and anticipates an increase as the population ages. Disability is a growing healthcare concern and presents a tremendous burden to all nations. The world will soon need to provide health and rehabilitative care for an enormous number of persons with disability. The purpose of this article is to provide a brief narrative review pertaining to global health and rehabilitation, and to motivate the rehabilitation professions in taking immediate action through further investment in global health initiatives to manage both the current and projected burden of disability. …

Validation Of The Godin Leisure-Time Exercise Questionnaire Classification Coding System Using Accelerometry In Multiple Sclerosis, Robert W. Motl, Rachel E. Bollaert, Brian M. Sandroff

Exercise Science Faculty Research and Publications

Objective: There have been recent efforts toward creating a health contribution score (HCS) from the Godin Leisure-Time Exercise Questionnaire (GLTEQ) that reflects public-health guidelines for levels of moderate-to-vigorous physical activity (MVPA). The HCS yields categories of insufficiently active (less substantial or low benefits), moderately active (some benefits), and active (substantial benefits). The present study examined the validity of the GLTEQ HCS and its categories as reflecting levels of MVPA in multiple sclerosis (MS). Method: The sample included 684 persons with MS. Participants wore an accelerometer on an elastic belt around the waist above the nondominant hip during the waking hours …

A Randomized, Controlled Clinical Study To Assess The Effect Of Anodal And Cathodal Electrical Stimulation On Periwound Skin Blood Flow And Pressure Ulcer Size Reduction In Persons With Neurological Injuries, Anna Polak, Cezary Kucio, Luther C. Kloth, Malgorzata Paczula, Ewa Hordynska, Tomasz Ickowicz, Edward Blaszczak, Ewa Kucio, Krystian Oleszczyk, Krzysztof Ficek, Andrzej Franek

Physical Therapy Faculty Research and Publications

The use of electrical stimulation (ES) should be considered for treating nonhealing pressure ulcers (PUs), but optimal ES wound treatment protocols have yet to be established. A randomized, controlled, double-blind clinical study was conducted to evaluate the effects of cathodal and anodal high-voltage monophasic pulsed current (HVMPC) on periwound skin blood flow (PSBF) and size reduction of Stage 2 to Stage 4 PUs of at least 4 weeks’ duration.Persons >18 years of age, hospitalized with neurological injuries, at high risk for PU development (Norton scale <14 >points; Waterlow scale >15 points), and with at least 1 Stage 2 to Stage 4 …

Girls In The Boat: Sex Differences In Rowing Performance And Participation, Kevin G. Keenan, Jonathon Senefeld, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Men outperform women in many athletic endeavors due to physiological and anatomical differences (e.g. larger and faster muscle); however, the observed sex differences in elite athletic performance are typically larger than expected, and may reflect sex-related differences in opportunity or incentives. As collegiate rowing in the United States has been largely incentivized for women over the last 20 years, but not men, the purpose of this study was to examine sex differences in elite rowing performance over that timeframe. Finishing times from grand finale races for collegiate championship on-water performances (n = 480) and junior indoor performances (n = 1,280) …

Physical Therapy Considerations For Chronic Kidney Disease And Secondary Sarcopenia, Michael O. Harris-Love, Haniel J. Hernandez, Gideon Obamwonyi

Exercise and Nutrition Sciences Faculty Publications

Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the …

Selection Of Post-Acute Care For Stroke Patients, Kathryn M. Gulfo, Glen Gillen, Lauri Bishop, Clare C. Bassile, Randy B. Kolodny, Joel Stein

The Open Journal of Occupational Therapy

Background: Significant variation exists in post-acute care for stroke survivors. This study examines referral practices of occupational and physical therapists for patients after acute stroke.

Method: Occupational therapists (OTs) and physical therapists (PTs) were surveyed either electronically or in person at a national conference. The respondents selected the most appropriate referral for each of five case vignettes. The referral choices included Inpatient Rehabilitation Facility (IRF), Skilled Nursing Facility (SNF), Long-Term Acute Care Hospital (LTACH), home with home services, or home with outpatient services. Demographic data included practice location, setting, and duration. The respondents were also asked to rate …

Current State Of Commercial Wearable Technology In Physical Activity Monitoring 2015-2017, J. A. Bunn, J. W. Navalta, C. J. Fountaine, J. D. Reece

Physical Therapy

No abstract provided.

The Comprehensive Pt Management Of A Patient With Chronic Low Back Pain And Lumbar Radiculopathy: A Case Report, Robin Mcguire

Case Report Papers

Background and Purpose: Low back pain is the most common health problem among older adults resulting in pain and disability. Lumbar radiculopathy is a disabling condition causing low back pain that radiates into the lower extremity along the sensory distribution of the spinal nerve root. The purpose of this case report is to describe a comprehensive physical therapy plan for a patient with chronic low back pain and lumbar radiculopathy that included: therapeutic exercises using directional preference, interferential current, and manual traction. Case Description: The patient was a 60-year-old male with lumbar radiculopathy due to nerve root compression. He presented …

Effect Of Individual Height And Testing Methods On Outcome Of The Forward Functional Reach Test, Jill Elaine Heitzman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: With falls a leading cause of injuries among those over age 65, early recognition of risk is imperative to reduce rising rates. The Forward Functional Reach test (FFRT) (Duncan et al., 1990) is frequently used to identify fall risk, however, the variability in cut values found in the research may be related to height and reach strategies.

Purpose: The purpose of this study was to determine if FFRT is affected by an individual’s height and if bilateral reach to height ratio could more accurately identify fall risk.

Methods: Sixty-six participants (60 and older) were recruited from a senior center …

Use Of A Telerehabilitation Delivery System For Fall Risk Screening, Robert W. Nithman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem: The Centers for Disease Control and Prevention indicates that falls are the “leading cause of injury death and the most common cause of nonfatal injuries and hospital admission for trauma among people ages 65 and older.”1 Falls can have significant economic consequences to the individual and payer sources. To address these consequences, telerehabilitation was hypothesized to be a suitable supplement for fall screening efforts. Several sources concluded that support for synchronous telerehab was underdeveloped in the literature. Purpose: The purpose of this study was to explore the acceptability, feasibility, reliability, and validity of telehealth-delivered fall screening among community-dwelling older …

Predictors Of Shoulder Injuries In Female Collegiate Swimmers, Eric Lee Lippincott

Department of Physical Therapy Student Theses, Dissertations and Capstones

Competitive swimmers frequently injure their shoulders. The risk factors for shoulder injuries in competitive swimmers have not been clearly identified. The primary purposes of this study were to describe the characteristics of female collegiate swimmers at the onset of a swim season, identify the risk factors of shoulder injury in female collegiate swimmers, characterize the swim volume of female collegiate swimmers, and determine if swim volume is a predictor of shoulder injury.

A prospective longitudinal cohort multi-center design was utilized. Female collegiate swimmers [n=53, mean age=19.3+/– 1.2] from four NCAA Division II universities were recruited to participate in this study. …

Diagnostic Musculoskeletal Imaging: How Physical Therapists Utilize Imaging In Clinical Decision-Making, Hilmir Agustsson

Department of Physical Therapy Student Theses, Dissertations and Capstones

This qualitative study describes how physical therapist experts in musculoskeletal disorders evaluate and interpret imaging studies and how they employ imaging in clinical decision-making. The informants are physical therapists who are certified orthopedic clinical specialists (OCS) and/or fellows of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). The study employed web conferencing to display patient cases, record screen-capture videos, and to conduct interviews. Informants were observed and their activity video-captured as they evaluated imaging studies and, afterwards, interviews were employed to explore the processes they utilized to evaluate and interpret the images and to discuss imaging-related clinical decision-making, including …

Shoulder Symptom Irritability: Development And Testing Of A New Construct, Stephen Michael Kareha

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Physical therapists regularly make decisions regarding intervention intensity based upon pathoanatomy and symptom irritability, but the reliability and validity of classifying patients by symptom irritability are unknown. Purpose: Examine the reliability and construct validity of the shoulder symptom irritability classification (SSIC) system for the purposes of determining an appropriate treatment intensity. Design: Prospective repeated-measures cross-sectional single-blinded design. Methods: 101 consecutive subjects with primary complaints of shoulder pain were assessed by a pair of blinded raters. Raters recorded the SSIC level and selected the appropriate intervention intensities for the subjects. Data Analysis: Prevalence-adjusted, bias-adjusted Kappa for ordinal scales (PABAK-OS) and …

Impact Of An Exercise Program On Stress, Fatigue, And Quality Of Life For Individuals Living With Primary Immunodeficiency Disease, Kerri Sowers

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: There are over 300 Primary Immunodeficiency diseases (PID) that are a result of a genetic or idiopathic dysfunction of any aspect of the immune system. These conditions result in a higher frequency of infections, autoimmune conditions, or malignancies. Moderate intensity exercise is thought to help the immune system, while high intensity exercise may have a negative impact on immune function. The impact of exercise on individuals with an impaired immune system due to PID is not yet understood. Purpose: The purpose of this study was to investigate whether a low to moderate intensity exercise program would have an effect …

Supporting Play Exploration And Early Developmental Intervention Versus Usual Care To Enhance Development Outcomes During The Transition From The Neonatal Intensive Care Unit To Home: A Pilot Randomized Controlled Trial, Stacey C. Dusing, Tanya Tripathi, Emily C. Marcinowski, Leroy R. Thacke, Lisa F. Brown, Karen D. Hendricks-Muñoz

Physical Therapy Publications

Background

While therapy services may start in the Neonatal Intensive Care Unit (NICU) there is often a gap in therapy after discharge. Supporting Play Exploration and Early Development Intervention (SPEEDI) supports parents, helping them build capacity to provide developmentally supportive opportunities starting in the NICU and continuing at home. The purpose of this single blinded randomized pilot clinical trial was to evaluate the initial efficacy of SPEEDI to improve early reaching and exploratory problem solving behaviors.

Methods

Fourteen infants born very preterm or with neonatal brain injury were randomly assigned to SPEEDI or Usual Care. The SPEEDI group participated in …

Can Patient Reported Outcomes Guide Therapy Needs In Foot And Ankle Patients?, Jeff Houck, Jillian Santer, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The patient acceptable symptom state (PASS) is a validated question establishing if patients activity and symptoms are at a satisfactory low level for pain and function. Surprisingly, ~20% of foot and ankle patients at their initial visit present for care with an acceptable symptom state (i.e. PASS yes). These patients are important to identify to prevent over treatment and avoid excessive cost. It is also unclear what health domains (Pain Interference (PI), Physical Function (PF), or Depression (Dep)) influence a patients judgement of their PASS state (i.e. why they are seeking treatment). The purpose of this analysis is to …

A Scoping Review Of Biopsychosocial Risk Factors And Co-Morbidities For Common Spinal Disorders, Bart N Green, Claire D Johnson, Scott Haldeman, Erin Griffith, Michael B Clay, Edward J Kane, Juan M Castellote, Shanmuganathan Rajasekaran, Matthew Smuck, Eric L Hurwitz, Kristi Randhawa, Hainan Yu, Margareta Nordin

Physical Therapy Collection

OBJECTIVE: The purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders.

METHODS: A scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities.

RESULTS: Of …

Analytical Cpg Model Driven By Limb Velocity Input Generates Accurate Temporal Locomotor Dynamics, Sergiy Yakovenko, Anton Sobinov, Valeriya Gritsenko

Faculty & Staff Scholarship

The ability of vertebrates to generate rhythm within their spinal neural networks is essential for walking, running, and other rhythmic behaviors. The central pattern generator (CPG) network responsible for these behaviors is well-characterized with experimental and theoretical studies, and it can be formulated as a nonlinear dynam- ical system. The underlying mechanism responsible for locomotor behavior can be expressed as the process of leaky integration with resetting states generating appropriate phases for changing body velocity. The low-dimensional input to the CPG model generates the bilateral pattern of swing and stance modulation for each limb and is consistent with the desired …

The Complementary Health Approaches For Pain Survey (Chaps): Validity Testing And Characteristics Of A Rural Population With Pain, Termeh Feinberg, Dina L. Jones, Christa Lilly, Amna Umer, Kim Innes

Faculty & Staff Scholarship

Objectives

Little is known about patterns and correlates of Complementary Health Approaches (CHAs) in chronic pain populations, particularly in rural, underserved communities. This article details the development and implementation of a new survey instrument designed to address this gap, the Complementary Health Approaches for Pain Survey (CHAPS).

Design

Following pilot-testing using pre-specified criteria to assess quality and comprehension in our target population, and after feedback regarding face-validity from content experts and stakeholders, the final cross-sectional self-report survey required 10–12 minutes to com- plete. It contained 69 demographic, lifestyle and health-related factors, and utilized a Trans- theoretical Model (TTM) underpinning to …

Comparison Of Four Fitbit And Jawbone Activity Monitors With A Research-Grade Actigraph Accelerometer For Estimating Physical Activity And Energy Expenditure, Mary T. Imboden, Michael B. Nelson, Leonard A. Kaminsky, Alexander Hk Montoye

Faculty Publications - Department of Kinesiology

Background/aim Consumer-based physical activity (PA) monitors have become popular tools to track PA behaviours. Currently, little is known about the validity of the measurements provided by consumer monitors. We aimed to compare measures of steps, energy expenditure (EE) and active minutes of four consumer monitors with one research-grade accelerometer within a semistructured protocol.

Methods Thirty men and women (18–80 years old) wore Fitbit One (worn at the waist), Fitbit Zip (waist), Fitbit Flex (wrist), Jawbone UP24 (wrist) and one waist-worn research-grade accelerometer (ActiGraph) while participating in an 80 min protocol. A validated EE prediction equation and active minute cut-points were …

Treatment Of Subacromial Impingement Syndrome In A 53-Year-Old Female: A Case Study, Jarad Syrstad

Physical Therapy Scholarly Projects

Background and Purpose. Subacromial impingement syndrome (SAIS) is a common shoulder pathology. The purpose of this case report is to discuss the outcomes of subsequent physical therapy after operative treatment for SAIS and the clinical decision making involved in seeking surgical intervention.

Case Description. This case report describes a 54 y/o female who participated in eight weeks of physical therapy after undergoing shoulder decompression surgery while failing conservative physical therapy prior to surgical intervention.

Intervention. Physical therapy interventions were designed to strengthen the rotator cuff and shoulder, increase range of motion, decrease pain, and improve functional activity. …

Electromyographic Activity Of Hamstrings And Quadriceps Muscle During Jumping And Landing: Pilot Study, Jayla Greene, Brecca Wahlund, Jay Mittlieder, Adam Lutz

Physical Therapy Scholarly Projects

Background and Purpose. The purpose of this pilot study was to see if there was a difference in amount of electromyographic (EMG) activity in the quadriceps (vastus medialis and vastus lateralis) compared to amount of EMG activity in the hamstrings (biceps femoris and semitendinosus) in active male and female subjects during vertical jumping and landing. In addition, we looked at the amount of knee flexion that occurred in the male and female subjects shortly after landing from a vertical jump.

Methods EMG activity was recorded using a Noraxon TeleMyo DTS telemetry unit with a sampling rate of 1 kHz. EMG …

Effects Of Physical Therapy On An Elderly Patient With L5-S1 Radiculopathy: A Case Study, Mackenzie Mears

Physical Therapy Scholarly Projects

Background and Purpose. Low back pain is a major disabling diagnosis for adults over 60 with 36-70% suffering from this condition. There is little research demonstrating the effectiveness of physical therapy on the outcome of older patients with a lumbar disc herniation resulting in lumbosacral radiculopathy. The purpose of this scholarly project is to use a case report to explore the effectiveness of physical therapy in elderly patients with lumbosacral radiculopathy as the result of a L5-S1 disc herniation.

Case Description. The case study reviews an 81-year-old male who presented to physical therapy with insidious onset of left …

Conservative Treatment Of A 58 Year-Old Male Referred To Physical Therapy With A Knee Sprain And Knee Osteoarthritis, Chase Pruitt

Physical Therapy Scholarly Projects

Background and Purpose: Knee osteoarthritis (OA) is a common condition in people over 50. Although there may be an association between acute knee injuries and knee OA later in life, the occurrence of acute knee injuries in patients with existing OA is less clear. The purpose of this case study is to evaluate the effectiveness of an impairment based therapy program in an individual with an acute knee injury and knee OA.

Case Description: This case follows a 57 year old male referred to physical therapy with an acute knee sprain and tri-compartmental knee OA. Treatment lasted 7 sessions …

A Case Report: Outpatient Physical Therapy Treatment Of A Patient With Unilateral Medial And Posterior Knee Pain And Osteoarthritis, Joseph T. Griffin

Physical Therapy Scholarly Projects

Background & purpose: Meniscus tears are commonly considered to be associated with a traumatic event, but the degenerative nature of osteoarthritis can also damage the cartilage. As meniscal tears are a common orthopedic pathology, choosing the correct treatment can be difficult and involve several factors. Current treatment options include partial or total meniscectomy, meniscal repair, or conservative management. There is growing research supporting the effectiveness in non-operative management of degenerative meniscal tears (DMT). The purpose of this case report was to investigate the non-operative management of a 47-year-old male with a unilateral DMT combined with osteoarthritis.

Case description: …

Physical Therapy Intervention In A Patient With West Nile Meningitis: A Case Approach, Kelsie Gunnufson

Physical Therapy Scholarly Projects

Background and Purpose. West Nile Virus (WNV) is a neurotropic virus capable of causing damage of varying severity. WNV is commonly transmitted to humans from mosquitoes and is most prevalent in the months of August and September due to the method of transmission. The WNV can produce mild systemic symptoms classified as West Nile Fever (WNF). However, it can progress and infiltrate the nervous system, at which point the virus is categorized as neuroinvasive. One classification is West Nile Meningitis (WNM) that involves infection and inflammation of the meninges or coverings surrounding the brain and spinal cord. There is …

Collaboration Of Music Therapy And Physical Therapy: A Case Study For Treatment Of A Patient With Chronic Stroke, Matthew Aymond, Michelle Sanders

Physical Therapy Scholarly Projects

Background and Purpose: Stroke is one of the leading causes of death in the United States and can cause severe, debilitating, and lasting effects. Although a fair amount of research has been performed on treatment of individuals following a stroke, few studies exist looking at the collaborative efforts of physical therapy and music therapy.

Case Description: This case follows the 13-week interdisciplinary care of an 83-year old female patient with chronic impairments following a cerebrovascular accident suffered approximately 2 years prior.

Interventions: Following an initial evaluation, the patient performed 11 one-hour treatment sessions over an 11-week period. …

The Effect Of Socket Tightness In Femur Stability In A Hifi Socket, Mary Bachman, Alicia Beckel, Amanda Belyaks

Physical Therapy Scholarly Projects

Background and Purpose: The introduction of the High-Fidelity (HiFi) interface was developed to help increase the intimacy of the prosthetic interface by using a series of alternating zones of tissue compression and release. The purpose of this study was to utilize motion analysis to measure the stability of the femur in individuals with trans-femoral amputation that utilize the HiFi socket for ambulation.

Methods: The subject was a 62 year old Caucasian female. She had a trans-femoral amputation 35 years prior due to a diagnosis of cancer located in the bone of her femur. Data collection was done with …

Association Of Generalized Joint Hypermobility And The Occurrence Of Musculoskeletal Work-Related Injury In The First Zero To Five Years Of Physical Therapy Practice: A Pilot Study, Mikelle Fetsch, Ashley Naas, Amanda Slaikeu

Physical Therapy Scholarly Projects

Background: Previous research has shown that there is greater prevalence of work-related injuries for Physical Therapists in their early years of practice. However, little evidence has focused on the correlation with the high physical strain and stress of the job to the rate of injury occurrence. Hypermobility has also been researched in regards to an increased risk of sustaining an injury, but no correlation has been found between hypermobility and work-related injury in Physical Therapists.

Purpose: The purpose of this study was to determine if there is a correlation between hypermobility and work-related injury occurrence in the first …