Rehabilitation and Therapy Commons^™

A Comparison Of Neuromuscular Control Between Subjects With And Without Chronic Ankle Instability, Hatem Jaber

Loma Linda University Electronic Theses, Dissertations & Projects

Ankle sprains are common and potentially disabling musculoskeletal injuries occur among physically active individuals. A subsequent problem that is commonly encountered by clinicians due to ankle sprains is the development of ongoing instability. The presence of ankle instability has been linked to impairments in postural and neuromuscular control; however, inconsistent findings have been reported. These discrepancies deem the need to further investigate and provide additional knowledge regarding postural and neuromuscular control strategies utilized by this population. This may enhance the current understanding of chronic ankle instability (CAI) and help to understand how rehabilitation can be customized to specifically target and …

Factors That Influence Self-Reported Health Changes With Caregiving, Margaret Danilovich, Xiaoling Xiang, Daniel Pinto

Physical Therapy Faculty Research and Publications

Objective: This study examined factors associated with the self-reported change in health status as a result of caregiving. Method: Multinomial logistic regression were performed to examine the sociodemographic characteristics, care recipients’ characteristics, and caregiving experiences that affect caregivers’ perceptions of health affected by caregiving using data from 1,087 caregiver respondents in the Caregiving in the U.S. 2015 data set. Data were collected through an online or telephone survey of randomly selected adults in 50 states. Results: Worsened self-reported health with caregiving occurred for caregivers aged 50 to 64, racial/ethnic minorities, those who lived within 20 min of the care recipient’s …

Contraction Intensity And Sex Differences In Knee-Extensor Fatigability, Paul Ansdell, Kevin Thomas, Glyn Howatson, Sandra K. Hunter, Stuart Goodall

Exercise Science Faculty Research and Publications

Females are less fatigable than males during isometric contractions across various muscles and intensities. However, sex differences in knee-extensor fatigability remain relatively unexplored. Purpose: To determine the sex difference in performance fatigability for intermittent, isometric contractions of the knee-extensor muscles. Methods: Eighteen participants (10 males, 8 females) performed intermittent, isometric, knee-extensor contractions at 30% of their maximal voluntary force (MVC) for 30 min and in a separate session at 50% MVC until task-failure. During both fatiguing protocols a MVC was performed every 60 s and electromyography (EMG) was recorded during all contractions. Results: At task completion males had a larger …

Association Between Sedentary Time And Quality Of Life From The Osteoarthritis Initiative: Who Might Benefit Most From Treatment?, Daniel Pinto, Jing Song, Jungwha Lee, Rowland W. Chang, Pamela A. Semanik, Linda S. Ehrlich-Jones, Christine A. Pellegrini, Dorothy D. Dunlop

Physical Therapy Faculty Research and Publications

Objective

To investigate the relationship between sedentary behavior and quality-adjusted life years (QALYs) among participants in the Osteoarthritis Initiative.

Design

Longitudinal, observational design.

Setting

Osteoarthritis Initiative cohort.

Participants

Individuals (N=1794) from a prospective, multicenter longitudinal cohort were classified into quantile groups based on average daily sedentary time (most sedentary, quartile 1 [Q1] ≥11.6h; 10.7h≤ Q2

Interventions

Not applicable.

Main Outcome Measures

Individual QALYs were estimated over 2 years from the area under the curve of health-related utility scores derived from the Medical Outcomes Study 12-Item Short-Form Health Survey versus time. The relationship between baseline sedentary behavior and median 2-year QALYs …

Effects Of Direction Time Constraints And Walking Speed On Turn Strategies And Gait Adaptations In Healthy Older And Young Adults, Dennis Torre

Seton Hall University Dissertations and Theses (ETDs)

Hip fractures can be life-threatening, debilitating, and costly. The odds for hip fracture increases from impact of sideways falls. While turning has been strongly associated with hip fracture & sideways falls, the distinction between the risks for walking-turns as opposed to low-velocity in-place turning is not clear. The present study sought to fill a gap as previous research had not compared walking-turn performance in young & healthy older adults at low-fall risk within the same study and response-conditions of speed interacting with direction-cue time constraints. Spatial-temporal variables representative of AP braking/propulsion (i.e. stride-length & speed) & ML stability (left/right H-H …

Pediatric Psychologists’ Career Satisfaction: 2015 Society Of Pediatric Psychology Workforce Survey Results., Marisa E. Hilliard, Andre A.A. Williams, Astrida S. Kaugars, Peggy Christidis, Karen E. Stamm, Cheryl Brosig, Jessica Valenzuela, Paul M. Robins, Tim Wysocki

Physical Therapy Faculty Research and Publications

Little is known about the career satisfaction of pediatric psychologists, who specialize in psychological research, teaching, and clinical service in the context of pediatric health care. As part of the larger Society of Pediatric Psychology Workforce Survey and in collaboration with the American Psychological Association Center for Workforce Studies, this study aimed to (1) describe the career domains which pediatric psychologists perceive to be important and their satisfaction in each domain, and (2) compare satisfaction of pediatric psychologists across work settings, number of positions, appointment duration, professional roles, career stage, academic rank, and gender. Responses from 336 pediatric psychologists demonstrated …

Cortical Contribution To Linear, Non-Linear And Frequency Components Of Motor Variability Control During Standing, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Motor variability is an inherent feature of all human movements and reflects the quality of functional task performance. Depending on the requirements of the motor task, the human sensory-motor system is thought to be able to flexibly govern the appropriate level of variability. However, it remains unclear which neurophysiological structures are responsible for the control of motor variability. In this study, we tested the contribution of cortical cognitive resources on the control of motor variability (in this case postural sway) using a dual-task paradigm and furthermore observed potential changes in control strategy by evaluating Ia-afferent integration (H-reflex). Twenty healthy subjects …

All Limbs Lead To The Trunk, Daniel E. Graves, Phd, Darryn Atkinson, Phd, Pt

Department of Rehabilitation Medicine Posters

This poster describes the development of and the psychometric properties of the trunk scale that measures the voluntary motor ability in the thoracic and upper lumbar regions. The function of the trunk musculature has far reaching implications, particularly in persons with SCI, where postural control and voluntary movement are compromised to varying degrees. Precisely coordinated muscle actions must occur in the appropriate sequence, duration, and combination for the optimal movement function and maintenance of balance and posture during dynamic activities. Trunk mobility is required for nearly all mobility tasks, particularly transitional movements such as rolling, supine to sit, and sit …

Transforming Physical Therapy Education Through The Use Of Social Network Analysis, Betsy J. Becker, Sara E. Bills

Posters and Presentations: Physical Therapy

PURPOSE

Social Network Analysis (SNA) is a quantitative method to study the patterning and effect of relationships and how individual connections form into social structures that influence outcomes of the group. The purpose of this study is to explain the underpinnings of SNA and its application to PT education for student success and faculty development. This study is innovative and will be beneficial to the profession because there is currently no published literature exploring how PT education is influenced by social structures.

METHODS/DESCRIPTION

The aims of this study are to describe SNA and outline its potential to transform PT education. …

An Exploratory Study Of Mobile Messaging Preferences By Age: Middle-Aged And Older Adults Compared To Younger Adults, Alexis Kuerbis, Katherine Van Stolk-Cooke, Frederick Muench

Publications and Research

Introduction: Mobile technologies, such as short message service or text messaging, can be an important way to reach individuals with medical and behavioral health problems who are homebound or geographically isolated. Optimally tailoring messages in short message service interventions according to preferences can enhance engagement and positive health outcomes; however, little is known about the messaging preferences of middle-aged and older adults.

Methods: Utilizing secondary data, global messaging preferences were examined to inform the development of short message service interventions for adults of all ages. Two hundred and seventy-seven adults were recruited through an online labor market. They completed an …

Gross Motor Outcomes After Dynamic Weight-Bearing In 2 Children With Trunk Hypotonia: A Case Series, Elizabeth Ardolino, Megan Flores, Kathleen Manella

Physical Therapy Collection

NTRODUCTION:

Children with trunk hypotonia may have limited ability to maintain an upright weight-bearing position, resulting in decreased postural control and a delay in achieving gross motor milestones.

PURPOSE:

The purpose of this case series is to report the effect of a home-based dynamic standing program on postural control and gross motor activity in 2 children with trunk hypotonia.

DESCRIPTIONS:

Child 1 (aged 24 months, Gross Motor Function Classification Scale Level IV) and Child 2 (aged 21 months, Gross Motor Function Classification Scale Level V) participated in a standing program using the Upsee harness at home 3 days per week …

The Effects Of Spinal Mobilizations, Manual Stretching, And Exercises In The Treatment Of Testicular Pain: A Case Report, Kunal Bhanot, Navpreet Kaur, R Chambers

Physical Therapy Collection

The purpose of this case report was to describe the PT management in relieving testicular pain related to genitofemoral nerve entrapment.

Moving From Parent "Consultant" To Parent "Collaborator": One Pediatric Research Team's Experience., Doreen Bartlett, Lisa A Chiarello, Tina Hjorngaard, Barbara Sieck Taylor

Physical Therapy Publications

We share our experiences as academic physical therapists and parents of young people with cerebral palsy working together as a research team, describe and critically review how our working relationship has evolved and propose further enhancements to realize our shared vision. This manuscript is informed by a call for “family-centered research,” transcripts of face-to-face meetings held over a period of 11/2 days, the INVOLVE document and our experiences over almost a decade, as well as other related literature. Authentic collaborative research partnerships between academic researchers and parents embodying trust, mutual respect and shared social responsibility take time and effort to …

Understanding Participation Of Children With Cerebral Palsy In Family And Recreational Activities., Mohammed S Alghamdi, Lisa A Chiarello, Robert J Palisano, Sarah W Mccoy

Physical Therapy Publications

AIMS: The primary aim of this study was to determine the effect of age, sex, gross motor, manual ability, and communication functions on the frequency and enjoyment of children's participation in family and recreational activities. The secondary aim was to determine the relationships between motor and communication functions and participation.

METHODS: Participants were 694 children, 1.5-12 years old, with cerebral palsy (CP) and their parents across the US and Canada. Parents rated children's frequency and enjoyment of participation using the Child Engagement in Daily Life measure. Parents and therapists identified children's level of function using Gross Motor Function Classification System …

Implementation Of Proprioceptive Neuromuscular Facilitation Post Mesenchymal Stem Cell Procedure Secondary To Legg-Calve-Perthes Disease: A Case Report, Sara Daley, Anne H. Boddy

St. Augustine, Fall 2017

The purpose of this case report is to determine if the PNF rolling technique can improve strength, balance, range of motion, lower extremity power, and gait speed in a male pediatric patient with Legg-Calve-Perthes disease post femoral core decompression with mesenchymal stem cell (MSC) injection.

“Yes I Have Parkinson’S, But I Still Have Low Back Pain”, Logan Rodgers, Anne H. Boddy

St. Augustine, Fall 2017

The purpose of this case report is to describe the efficacy of physical therapy manipulation to the lumbar spine of a Parkinson’s patient suffering from low back pain. Further, this case report seeks to demonstrate the importance of treating musculoskeletal injuries in a neurologically compromised population for the purposes of restoring them to their prior level of activity and participation.

The Kinetic Chain Of Pelvic Pain, Jennifer Flenorl, Anne H. Boddy

St. Augustine, Fall 2017

The purpose of this case study is to examine the effectiveness of traditional pelvic floor rehabilitation and functional activity training in reducing and eliminating pelvic pain in the obese, adolescent female population.

Disability, Mobility & Society [Physical Therapist Assistant Program], Clarence Chan, Debra Engel, May Tom

Open Educational Resources

Disability, Mobility, & Society is a newly developed assignment for a required level II physical therapy course (SCT 221). It is aimed to familiarize students with the psychosocial and socioeconomic challenges faced by people with physical disability/dysfunction and their immediate community. Students work in teams to develop multimedia pre-recorded video presentations based on actual clinical case studies. Each team will identify and discuss issues related to the specific pathology and impairment, and consider the medical/social/behavioral/financial implications for the individual and the society. The team must present a course of physical therapy intervention that illustrates clinical competence and professional standard of …

Mobility Limitations And Fear Of Falling In Non-English Speaking Older Mexican-Americans, Eric G. James, Phillip Conatser, Murat Karabulut, Suzanne G. Leveille, Jeffrey M. Hausdorff, Sarah Cote, Katherine L. Tucker, Bruce Barton, Jonathan F. Bean, Soham Al Snih, Kyriakos S. Markides

Health & Human Performance Faculty Publications

Objective: To determine whether older Mexican-Americans who cannot speak and/or understand spoken English have higher rates of mobility limitations or fear of falling than their English-speaking counterparts.

Design: We conducted a cross-sectional analysis of 1169 community-dwelling Mexican-Americans aged 72–96 years from the 2000–2001 wave of the Hispanic Established Population for the Epidemiological Study of the Elderly. Mobility limitations were defined as having a Short Physical Performance Battery score ≤9, and fear of falling by participant report of being somewhat, fairly, or very afraid of falling. We determined the rates and odds ratios, for having mobility limitations and fear of falling …

Older Adults’ Experience In Owning A Guide Dog, Jeffrey Kou, Yvonne Lam, Patricia Lyons, Susan Nguyen

Student Research Posters

Low vision is an age-related condition that affects many older adults, and may create challenges in everyday activities in older adults. Guide dogs have been shown to be an effective assistive device that can help older adults within their community. Despite vast research on dog companionship, there is limited research on the facilitators and barriers of owning a guide dog among older adults with low vision. The purpose of this qualitative phenomenological study is to explore the facilitators and barriers of owning a guide dog as experienced by older adults with low vision participating in Guide Dogs for the Blind …

The Influence Of Divided Attention On Walking Turns: Effects On Gait Control In Young Adults With And Without A History Of Low Back Pain, Jo Armour Smith, James Gordon, Kornelia Kulig

Physical Therapy Faculty Articles and Research

The cognitive control of gait is altered in individuals with low back pain, but it is unclear if this alteration persists between painful episodes. Locomotor perturbations such as walking turns may provide a sensitive measure of gait adaptation during divided attention in young adults. The purpose of this study was to investigate changes in gait during turns performed with divided attention, and to compare healthy young adults with asymptomatic individuals who have a history of recurrent low back pain (rLBP). Twenty-eight participants performed 90° ipsilateral walking turns at a controlled speed of 1.5 m/s. During the divided attention condition they …

Impacts Of Exercise On Functional Ability Of Recovering Gbs Patients: An Integrative Literature Review, Yasmin Sheriff

Grace Peterson Nursing Research Colloquium

This integrative literature review aimed to investigate the impacts exercise has on functional ability of GBS patients in recovery.

The Effects Of Frequent Smartphone Use On Children’S Upper Posture And Pulmonary Function, Asma Alonazi

Loma Linda University Electronic Theses, Dissertations & Projects

Children are experiencing an increase in sedentary lifestyle as a result of the rising utilization of technology, i.e. smartphones. With the prolonged use of smartphones, increased concerns have been raised regarding constant neck flexion, neck movements limitation, and decreases in pulmonary function due to potential changes in spinal posture. Therefore, the purpose of this research thesis was to evaluate changes in craniovertebral angles (CVA), cervical range of motion (ROM), and pulmonary function among boys and girls 8 to 13 years of age who use smartphones. A cross-sectional study was conducted on a sample of 50 participants (24 boys and 26 …

The Effects Of Wearing Headscarves On Cervical Spine Proprioception And Range Of Motion, Samiah Alqabbani

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Wearing the headscarf is a part of an essential religious practice by females in Islamic cultures. Regular wear of the headscarf might have an influence on cervical proprioception and range of motion (ROM). The cervical spine is unique in providing multidirectional movement as well as providing the sense of awareness of movement of the head and neck in space. Impairments in cervical mobility and proprioception have been reported in subjects with whiplash-associated disorder as well as subjects having neck pain. Objectives: 1) To determine the effects of wearing the headscarf on cervical spine ROM and joint position error …

Physiological Response To Firefighting Activities Of Various Work Cycles Using Extended Duration And Prototype Scba, Richard M. Kesler, Ipek Ensari, Rachel E. Bollaert, Robert W. Motl, Elizabeth T. Hsiao-Wecksler, Karl S. Rosengren, Bo Fernhall, Denise L. Smith, Gavin P. Horn

Exercise Science Faculty Research and Publications

Firefighters’ self-contained breathing apparatus (SCBA) protects the respiratory system during firefighting but increases the physiological burden. Extended duration SCBA (>30 min) have increased air supply, potentially increasing the duration of firefighting work cycles. To examine the effects of SCBA configuration and work cycle (length and rest), 30 firefighters completed seven trials using different SCBA and one or two bouts of simulated firefighting following work cycles common in the United States. Heart rate, core temperature, oxygen consumption, work output and self-reported perceptions were recorded during all activities. Varying SCBA resulted in few differences in these parameters. However, during a second …

Ventilation And Neurochemical Changes During Μ-Opioid Receptor Activation Or Blockade Of Excitatory Receptors In The Hypoglossal Motor Nucleus Of Goats, Thomas M. Langer, Suzanne E. Neumueller, Emma Crumley, Nicholas J. Burgraff, Sawan Talwar, Matthew R. Hodges, Lawrence Pan, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Neuromodulator interdependence posits that changes in one or more neuromodulators are compensated by changes in other modulators to maintain stability in the respiratory control network. Herein, we studied compensatory neuromodulation in the hypoglossal motor nucleus (HMN) after chronic implantation of microtubules unilaterally (n = 5) or bilaterally (n = 5) into the HMN. After recovery, receptor agonists or antagonists in mock cerebrospinal fluid (mCSF) were dialyzed during the awake and non-rapid eye movement (NREM) sleep states. During day studies, dialysis of the µ-opioid inhibitory receptor agonist [d-Ala², N-MePhe⁴, Gly-ol]enkephalin (DAMGO; 100 µM) decreased …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Patient Fall Prevention, R9 West Cardiovascular, Cathy Palleschi, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

PATIENT FALL PREVENTION STRATEGIES IN AN ACUTE HOSPITAL

Every year in the United States, hundreds of thousands of patients fall resulting in injury. Injured patients often require prolonged hospital stays and a resultant increase in medical costs.

The purpose of this study was to identify the current state of fall prevention strategies on a hospital inpatient acute care cardiac unit. Through a root cause analysis, some deficiencies were identified and a process improvement plan was implemented.

Several positive outcomes were attained as a result of the countermeasures initiated. Patient falls per month and total waste in dollars saw a decline …