Rehabilitation and Therapy Commons^™

The Combined Effects Of Physical Therapy And Music Therapy For An Older Adult With Chronic Left-Sided Hemiparesis: A Case Report, Nicholas Holkup, Scott Syverson

Physical Therapy Scholarly Projects

Background and Purpose: Stroke and other disorders that involve the neurological system can have adverse effects such as hemiparesis, spasticity, hypertonicity, and gait and balance deficits. Due to neurological disorders being so prevalent, proper rehabilitative treatments are necessary to return to a functional lifestyle. Multiple approaches across the therapy spectrum have been utilized, but rarely are these therapeutic approaches completed concurrently among different disciplines. The purpose of this case report is to address the interdisciplinary co-treatment by students of music therapy and physical therapy for a patient exhibiting chronic left-sided hemiparesis.

Case Description: This case report describes a …

Effectiveness Of Intermittent Mechanical Traction In Cervical Radiculopathy: A Systematic Review, Gilmour Gregory, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

The aim of this review was to assess the effectiveness of intermittent mechanical traction (IMT) in treating cervical radiculopathy (CR). A literature search was conducted electronically, and the data were extracted from the available papers that evaluated IMT and its combination with other therapies. The risk of bias was assessed using the criteria recommended by the Cochrane Back Review Group. The quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation method (GRADE). Nine of the articles met the inclusion criteria and were included in the review. Results showed that four studies with very low level …

Mobility Boost: A Quality Improvement Project To Bridge A Gap In Care For Hospitalized Adults, Audrey M. Johnson

Theses and Dissertations--Rehabilitation Sciences

Early mobility quality improvement (QI) projects are leading the charge to shift the prevailing culture in acute care from a culture of immobility to a culture of mobility. Low mobility and hospital acquired functional decline is a persistent problem, especially for older adults, often leading to increased post acute care costs, increased risk of hospital readmission and increased mortality. Transition of care programs designed to improve care transitions and prevent hospital readmission exist but fail to include rehabilitation professionals or to adequately consider patient functional status during hospitalization. The goal of this research was to implement and evaluate an early …

The Assessment And Utilization Of Patients’ Self-Efficacy For Exercise During Rehabilitation, Kelsey J. Picha

Theses and Dissertations--Rehabilitation Sciences

Patient adherence to in-clinic rehabilitation is between 30-70% and even lower for home exercise programs (HEPs). Barriers to patient adherence have been identified and include but are not limited to anxiety, depression, lack of positive feedback, lack of social support, lack of time, low levels of physical activity at baseline, pain during exercise, and low self-efficacy. As clinicians prescribing rehabilitation may not be able to influence all of the identified barriers, they may positively influence others. Self-efficacy, or an individual’s belief in his/her ability to successfully complete a task, is a patient barrier that may be addressed by a clinician …

Tissues And Trauma: Pain Neuroscience Education For Veterans With Post-Traumatic Stress And Low Back Pain, Timothy Mark Benedict

Theses and Dissertations--Rehabilitation Sciences

Low back pain (LBP) is the top reason for Soldiers to seek medical care and one of the top reasons to be medically discharged. Mental health problems and psychosocial stressors have been increasing in Soldiers and are also top causes for medical discharge. Dysregulated stress has contributed to many Soldiers and Veterans to develop chronic LBP as well as mental health disorders like post-traumatic stress disorder (PTSD). Research suggests that psychosocial characteristics, as opposed to physical factors or tissue health, contribute to chronic pain the most. Focusing entirely on tissues for individuals seeking care for LBP can increase disability and …

Can Women Live With More Symptoms Than Men?: Defining Gender Differences In The Patient Acceptable Symptom State (Pass) In Orthopaedic Foot And Ankle Surgery, Judith Baumhauer, Adolph Flemister, Irvin Oh, Benedict Digiovanni, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Over the last few years an increasing focus has been directed to define cut-off points for important health improvement. Minimal clinically important difference (MCID) values have traditionally been used to determine if a statistical change translates to a clinical improvement to the patient. Although MCID is helpful, it may be even more important to identify if the current treatment is adequate or that the patient has achieved an acceptable symptom state (symptoms minimal enough to live with). The purpose of this study was to determine if gender influenced patient reported outcomes (patient acceptable symptom state (PASS) and PROMIS Physical …

Ability Of Patient-Reported Outcomes To Characterize Patient Acceptable Symptom State (Pass) After Attending A Primary Care Physical Therapist And Medical Doctor Collaborative Service: A Cross-Sectional Study, Jeff Houck, Daniel Kang, Tyler Cuddeford, Sarah Rahkola

Faculty Publications - College of Physical Therapy

Objectives: To determine if the Patient-Reported Outcome Measurement Information System (PROMIS) physical function, pain interference, self-efficacy, and global rating of normal function (GRNF) scales are able to accurately characterize a patient’s acceptable symptom state (PASS).

Design: A cross-sectional analysis, using receiver operator curves and chi-square analysis to explore criteria to determine thresholds (80% and 95% sensitivity/specificity) for PASS that are applicable to PROMIS and GRNF scales.

Setting: Phone survey after primary care. Participants: Patients (NZ94) attending primary care for musculoskeletal problems. Interventions: Not applicable. Main Outcomes Measures: Accuracy and proportion of patients classified as PASS Yes or No.

Results: Receiver …

Comparison Of Jump And Hop Test Measures Between Naia And Division Iii Male Collegiate Basketball Players, Jason Brumitt, Amy Engilis, Alma Mattocks, Natalie Ellis, Jordon Reyes

Faculty Publications - College of Physical Therapy

Purpose: To report normative data for two functional performance tests (FPTs) (the standing long jump [SLJ] and the single-leg hop [SLH]) in a population of male collegiate basketball players and to identify differences in measures between athletes based on level of competition, starter status, and position.

Methods: Eighty-six male collegiate basketball players from six teams were recruited for this study. Each athlete performed three SLJs and three SLHs (bilaterally).

Results: Mean (± SD) FPT measures (normalized to height) for all basketball players were: SLJ = 1.0 ± 0.1, right SLH = 0.84 ± 0.1, and left SLH = 0.85 ± …

Asymmetry After Hip Fracture: A Multi-Factorial Problem, Andrew J. Meszaros, Cindy Zablotny, Paul A. Shew, Bret Reordan

Faculty Publications - College of Physical Therapy

Background and Purpose: Sit-to-stand (STS) and static standing mechanics are related to fall risk and function after hip fracture. Often, these patients avoid weight bearing on the fracture side after rehabilitation. The purpose of this study was to use a novel clinically-relevant protocol to examine standing and STS vertical ground reaction force (vGRF) in light of perceptual measures of loading symmetry and muscle torque production in this population. Methods: A person post hip fracture performed 3 different STS conditions and 2 simple load-matching tasks. Motion, force plate, and perceptual data on weight distribution and load were collected. Findings: Standing and …

What Maximum Ankle Torque Is Appropriate For Training Patients With Non-Insertional Achilles Tendinopathy?, Tyler Cuddeford, Jeff Houck, Derek Palmer, Jason Beilstein, Jordan Visser

Faculty Publications - College of Physical Therapy

Background and Purpose: The capacity of the Achilles tendon during a 1-repetition eccentric maximum contraction is largely unknown. This study examined the maximum ankle torque during a concentric/ eccentric heel raise/lowering task and while running in healthy individuals and participants with chronic Achilles tendinopathy. These findings were applied to a 10-week training program for a patient with chronic Achilles tendinopathy.

Methods: A total of 13 subjects (9 healthy and 4 with Achilles tendinopathy) participated in this study. Subjects were asked to perform a maximum eccentric contraction wearing a weighted vest while collecting 3-dimensional biomechanical variables. Subjects also ran along an …

A Study Of Outcomes Following Collaborative Medical Doctor/Physical Therapist Primary Care Service For Musculoskeletal Problems, Daniel Kang, Sarah Rahkola, Catherine Vandehaar, Andrea Mulligan, Kevin Morikawa, Amador Marcano, Tyler Cuddeford, Jeff Houck

Faculty Publications - College of Physical Therapy

Background and Purpose: Collaborative medical doctor/physical therapist primary care services are not described in the literature. The 2 purposes of this observational study were to describe a collaborative medical doctor/physical therapist primary care service, and to describe simple, one question, outcomes including patient acceptable symptom state (PASS), global rating of normal function (GRNF), and success of treatment (SOT) at intake, 1 to 7 days, and 45 to 60 days follow-up. Methods: Patients were seen for 1 to 2 visits and typically received exercise, hands on treatment, ie, manual therapy, and education. Medical doctor/physical therapist collaborative encounters and provider training are …

Identifying Foot And Ankle Patients At Risk To Fall Based On Patient Reported Outcomes Assessments, Judith Baumhauer, Jack Teitel, Allison Mciyntyre, David Mitten, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Each year approximately 30-40% of people over the age of 65 fall. Approximately one half of these falls result in an injury with the estimated annual direct medical costs of $30 billion. Pain, mobility issues, neuropathy and post- operative weight bearing limitations make foot and ankle patients particularly vulnerable to falls. Current approaches to determine at risk patients are cumbersome and time consuming requiring performance testing and “hands on” clinical assessment. The efficiency of obtaining PRO, such as PROMIS, in the clinical arena has been well documented. The purpose of this study is determine if patient reported outcomes (PROMIS) …

An Inpatient Rehabilitation Interprofessional Care Pathway For Traumatic Hip Fracture: A Pilot Quality Improvement Project, Sarah Plante

DNP Scholarly Projects

Background: Each year over 300,000 older adults are hospitalized for hip fracture. The impact of the cost of hip fracture on the US health care system is estimated to be as high as $9 billion, with the typical cost of a hip fracture episode around $30,000. Formalized pathways have been developed and successfully utilized for many patient presentations, including hip fracture, in the acute setting. Although this research is important to the comprehensive care of the elderly hip fracture patient, very little research exists that outlines evidence-based best-practice for patients in the post-acute recovery period.

Purpose: The primary aim of …

Muscle Synergy During A Single Leg Standing Test In Ambulatory Children With Cerebral Palsy, Brennan L. Smith

Theses and Dissertations--Kinesiology and Health Promotion

INTRODUCTION: Cerebral Palsy (CP) is a sensorimotor disorder characterized by dysfunctional motor coordination, balance problems, and loss of selective motor control. Motor coordination exhibited as co-contraction, has been subjectively quantified using gait analysis, but recent studies have begun to objectively analyze the amount of co-contraction by collecting electromyography (EMG) data. Center of pressure excursion (COPE) measurements collected during a single leg standing test (SLST) have shown to be more valid measurements of balance in populations with motor disabilities than a SLST alone. A recent study has correlated increased COPE velocity with a lower fall risk as determined by reported fall …

Using Foot Pressure Analysis To Predict Reoccurrence Of Deformity For Children With Unilateral Clubfoot, Juanita Jean Wallace

Theses and Dissertations--Kinesiology and Health Promotion

Reoccurrence of deformity can affect upwards of 64% of children with clubfoot. The ability to use foot function as a measure of reoccurrence has not been previously assessed. The purpose of this investigation was to utilize foot pressure analysis to predict the probability of reoccurrence in children with unilateral clubfoot. Retrospective foot pressure data revealed predictive algorithms detecting the probability of experiencing any type of reoccurrence (overall reoccurrence) and for experiencing a tibialis anterior tendon transfer (TATT). The equation for overall reoccurrence reported sensitivity and specificity of 0.82 and 0.81 and the equation for TATT reported values of 0.81 and …

Small Business Marketing Strategies For Physical Therapy Practice Owners, Matthew Lane Daugherty

Walden Dissertations and Doctoral Studies

The United States economy depends on small businesses, which represent 99% of all businesses in the United States, yet approximately 50% of small businesses cease operations in the first 5 years. The purpose of this multiple case study was to explore the marketing strategies used by owners of small businesses to develop and maintain their organization through the initial 5 years of business operation. The population included 5 physical therapy business owners in northeastern Florida who had sustained their business for a minimum of 5 years. The conceptual framework for this study was the brand equity model, and data were …

Active And Inactive Leg Hemodynamics During Sequential Single-Leg Interval Cycling, Nicole Gordon, Chris R. Abbiss, Mohammed Ihsan, Andrew J. Maiorana, Jeremiah J. Peiffer

Research outputs 2014 to 2021

Introduction Leg order during sequential single-leg cycling (i.e., exercising both legs independently within a single session) may affect local muscular responses potentially influencing adaptations. This study examined the cardiovascular and skeletal muscle hemodynamic responses during double-leg and sequential single-leg cycling. Methods Ten young healthy adults (28 ± 6 yr) completed six 1-min double-leg intervals interspersed with 1 min of passive recovery and, on a separate occasion, 12 (six with one leg followed by six with the other leg) 1-min single-leg intervals interspersed with 1 min of passive recovery. Oxygen consumption, heart rate, blood pressure, muscle oxygenation, muscle blood volume, and …

The Effects Of Massage Therapy On Delayed Onset Muscle Soreness, Carli Mueller

Dissertations and Theses @ UNI

Context: Cupping massage and petrissage may be beneficial in the treatment of DOMS, however, there is limited research on the application and use of cupping massage on DOMS. This study examines the effectiveness of petrissage versus cupping massage on the pain associated with DOMS among a healthy population. Objective: To determine the efficacy of cupping massage in comparison to petrissage on the treatment of pain associated with acute muscle injury. Design: Experimental, single blinded study with stratification of participants. Participants: Thirty-two healthy individuals between the ages of 18 and 22. Methods: Participants underwent a protocol to induce DOMS on the …

Correlation Between The Spirit Bike Maximal Power Output And Other Lower Extremity Power Output Tests, Tyler Adams, Joseph Brown, Gunnar Mendiola, Ryan Sullivan, Cody Williams

Clinical Sciences: Graduate Physical Therapy Capstone Projects (2008-2021)

The assessment of a patient’s lower extremity function is important for physical therapists to make clinical judgements about the subject’s mobility and physical capabilities. For physical therapists to accurately assess a patient’s lower extremity function, clinicians must utilize the most appropriate tests, evaluation techniques, and/or tools. It is not clear that single leg hop tests will provide the most accurate assessment of lower extremity function for patients with hip, knee, ankle, and or foot biomechanical dysfunctions, as in some severe cases, these tests may even be contraindicated.

An Analysis Of Postural Changes Over Time And Their Relationship To Musculoskeletal Pain, Anna Barnes, Anna Dadamio, Suzanne Maggioni, Rebekah Stammer, Sarah Simpson

Clinical Sciences: Graduate Physical Therapy Capstone Projects (2008-2021)

Posture is defined as the relative disposition of the body at any one moment. It is a composite of all body joints during that time and, in its ideal state, minimizes gravitational stresses in an upright position. Spinal curves help to distribute weight and compressive loads and add strength and stability to the vertebral column.1 Ideal static posture has been described as a straight vertical line that passes through the earlobe, just anterior to the lateral malleolus, and falls to the concave side of each spinal curve

Overwhelming Research And Clinical Evidence Of Exercise Medicine Efficacy In Cancer Management—Translation Into Practice Is The Challenge Before Us, Robert Newton

Research outputs 2014 to 2021

The paper “Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement”1 is very timely. As the authors have convincingly demonstrated, rigorous clinical and research evidence support something of which most medical and allied health professionals are cognizant: the benefit of physical activity and exercise for people with cancer.

Baseline Postural Control Measures: An Indicator For Increased Injury Frequency Following Sports Related Concussion, Emily Belson

College of Graduate Studies: Theses & Dissertations

INTRODUCTION: An increase in acute lower extremity (LE) injuries have been observed in athletes following sports-related concussion.^{1, 2, 3} It has been suggested that lingering postural control deficits as a result of concussive injury, may play a role in the increased prevalence of injury.¹ PURPOSE: To investigate the relationship between baseline postural control metrics (Root Mean Square; Peak Excursion Velocity; Sample Entropy) and acute LE injury frequency in NCAA Division I student athletes (SA) with a previous history of concussion. METHODS: Eighty-four NCAA Division I SA were selected from a single university, 42 SA with a previous history …

Changes In Reach To Eat Movement Control After Intensive Training For Children With Unilateral Cerebral Palsy, Yaching Hung, Aryeh D. Spingarn

Publications and Research

Ya Ching Hung EdD. and Aryeh Spingarn EP-C, CSCS, EIM-Level 2 Queens College, City University of New York Department of Family, Nutrition, and Exercise Sciences, Changes in Reach to Eat Movement Control After Intensive Training for Children with Unilateral Cerebral Palsy. Purpose: The current study compares the effects of an intervention on children with Congenital Hemiplegia during a simple eating task using kinematic analyses. Previous studies looked at simple bimanual tasks such as opening a drawer; no studies examined the effects of intensive training on unimanual reach, grasp, and eat movement control. Methods: 20 children with Unilateral Spastic Cerebral Palsy …

Grip And Muscle Strength Dynamometry In Acute Burn Injury: Evaluation Of An Updated Assessment Protocol, Paul M. Gittings, Dana A. Hince, Benedict M. Wand, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry.

Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum …

Non-Invasive Brain Stimulation Techniques For Chronic Pain, Neil E. O'Connell, Louise Marston, Sally Spencer, Lorraine H. Desouza, Benedict M. Wand

Physiotherapy Papers and Journal Articles

Stimulating the brain without surgery in the management of chronic pain in adults

Bottom line: There is a lack of high-quality evidence to support or refute the effectiveness of non-invasive brain stimulation techniques for chronic pain.

Background: Electrical stimulation of the brain has been used to address a variety of painful conditions. Various devices are available that can electrically stimulate the brain without the need for surgery or any invasive treatment. There are five main treatment types: repetitive transcranial magnetic stimulation (rTMS) in which the brain is stimulated by a coil applied to the scalp, cranial electrotherapy stimulation (CES) in …

Is Heavy Eccentric Calf Training Superior To Wait-And-See, Sham Rehabilitation, Traditional Physiotherapy And Other Exercise Interventions For Pain And Function In Mid-Portion Achilles Tendinopathy?, Myles Murphy, Mervyn Travers, William Gibson

Physiotherapy Papers and Journal Articles

Background: Mid-portion Achilles tendinopathy (AT) is prevalent amongst athletic and non-athletic populations with pain, stiffness and impaired function typically reported. While different management options exist, loading protocols remain the best available intervention and have been shown to be effective in the management of AT. Trials investigating loading in AT have used a variety of different protocols, and recent narrative reviews suggest that no protocol is superior to another when comparing outcomes in pain and function. However, there has been no systematic review or meta-analysis completed to determine this. Furthermore, the narrative review did not consider wait-and-see or sham interventions, thus …

An Objective Measure For The Assessment And Management Of Fluid Shifts In Acute Major Burns, Pippa Kenworthy, Michael Phillips, Tiffany L. Grisbrook, William Gibson, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat™ on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns.

Methods: An observational longitudinal cohort study was conducted from December 2014 …

Critically Appraised Paper: Preoperative Physiotherapy Education Halved Postoperative Pulmonary Complications In Patients After Upper Abdominal Surgery [Commentary], Shane Patman

Physiotherapy Papers and Journal Articles

No abstract available for this paper.

Reducing Falls In Older Adults Recently Discharged From Hospital: A Systematic Review And Meta-Analysis, Chiara Naseri, Terry P. Haines, Christopher Etherton-Beer, Steven Mcphail, Meg E. Morris, Leon Flicker, Julie Netto, Jacqueline Francis-Coad, Den-Ching A. Lee, Ronald Shorr, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background: Older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital.

Methods: Literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager®

Results: Sixteen studies (total sample size N= 3,290, from …

Evaluation Of Older People's Knowledge, Awareness, Motivation And Perceptions About Falls And Falls Prevention In Residential Aged Care Homes: A Tale Of Two Cities, Jacqueline Francis-Coad, Tessa Watts, Christopher Etherton-Beer, Gerwyn Panes, Howard Griffiths, Michelle Anderson, Tracy Williams, Beth Griffiths, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Falls prevention strategies can only be effective in reducing falls amongst older people if they are adopted and enacted in their daily lives. There is limited evidence identifying what older people in residential aged care (RAC) homes understand about falls and falls prevention, or what may limit or enable their adoption of strategies. This study was conducted in two countries and explored older people’s knowledge and awareness of falls and their preferences, opportunities and motivation to undertake falls prevention strategies. A cross-sectional survey was administered to participants (N = 70) aged 65 years and over, living in six RAC homes …