Rehabilitation and Therapy Commons^™

Implementing The Weefim System In Outpatient Pediatric Rehabilitation, Chelsea Ratilainen

Master's Projects and Capstones

Abstract

This project was designed to achieve an unmet criteria in the accreditation process for the outpatient pediatric rehabilitation program at a local, community hospital in the greater Bay Area. The clients range from 6 months old to 20 years old with functional disabilities. The Commission of Accreditation of Rehabilitation Facilities (CARF) requires that applicants demonstrate outcome measure data over a 6 month time period. During the self-evaluation process this was noted to be a deficiency in the department’s efforts. The WeeFIM system was chosen as the first tool to implement in the department. This is a functional improvement measurement …

Evidence Of Energetic Optimization During Adaptation Differs For Metabolic, Mechanical, And Perceptual Estimates Of Energetic Cost, Natalia Sánchez, Sungwoo Park, James M. Finley

Physical Therapy Faculty Articles and Research

The theory that the sensorimotor system minimizes energetic cost during locomotion has long been supported by both computational models and empirical studies. However, it has yet to be determined if the behavior to which people converge when exposed to a novel perturbation during locomotion is also energetically optimal. We address this issue in the context of adaptation to walking on a split-belt treadmill, which can impose a left-right asymmetry in step lengths. In response to this asymmetry, participants gradually adjust their foot placement to adopt steps of equal length. Here, we characterized metabolic, mechanical, and perceptual estimates of energetic cost …

Lower Extremity Motor Impairments In Ambulatory Chronic Hemiparetic Stroke: Evidence For Lower Extremity Weakness And Abnormal Muscle And Joint Torque Coupling Patterns, Natalia Sánchez, Ana Maria Acosta, Roberto Lopez-Rosado, Arno H. A. Stienen, Julius P. A. Dewald

Physical Therapy Faculty Articles and Research

Although global movement abnormalities in the lower extremity poststroke have been studied, the expression of specific motor impairments such as weakness and abnormal muscle and joint torque coupling patterns have received less attention. We characterized changes in strength, muscle coactivation and associated joint torque couples in the paretic and nonparetic extremity of 15 participants with chronic poststroke hemiparesis (age 59.6 ± 15.2 years) compared with 8 age-matched controls. Participants performed isometric maximum torques in hip abduction, adduction, flexion and extension, knee flexion and extension, ankle dorsi- and plantarflexion and submaximal torques in hip extension and ankle plantarflexion. Surface electromyograms (EMGs) …

Investigating The Needs Of Parents Of Premature Infants’ Interaction In The Neonatal Intensive Care Unit, Maureen A. Rinehimer

Seton Hall University Dissertations and Theses (ETDs)

Parents and/or caregivers of premature infants provide the interaction needed to promote better outcomes for these challenged infants at risk for developmental delays. This descriptive, exploratory study utilized convenience sampling. Inclusion criteria consisted of parents/caregivers who were at least 18 years of age and older with infants born 35 weeks gestation or less and currently in the NICU. This study focused on the research question: What do parents perceive they need in the NICU to enjoy interacting with their infant in the home? To collect the data needed to capture the perceptions of parent’s needs of infants in the NICU, …

Motor Strategy And Locomotor Adjustments In Children With And Without Down Syndrome While Negotiating Stairs, Huaqing Liang, Xiang Ke, Jianhua Wu

Physical Therapy Faculty Research

Children with Down Syndrome (DS) often show impaired motor control, and walk with a slower speed and a shorter step length than typically developing (TD) children. When negotiating an obstacle, children with DS often stop for a longer duration, choose a more conservative crawling strategy and display a smaller toe clearance than their TD peers.

Center Of Mass Control And Multi-Segment Coordination In Children During And After Whole-Body Vibration, Huaqing Liang, Jianhua Wu

Physical Therapy Faculty Research

Maintaining upright posture under external perturbations requires the coordination between the nervous system and the musculoskeletal system, and it is a milestone of motor development in early childhood. Whole-body vibration (WBV) has acute effect on postural control and muscular activation during standing, resulting in an increased sway velocity and sway area of center-of-mass (COM), and the residual effect usually vanishes within 20 minutes after the vibration exposure. In quiet standing, a human body can be considered as a multi-segment linked system, and an uncontrolled manifold (UCM) approach has been used to examine how this multi-joint motor redundancy is utilized to …

Parents' Experiences And Perceptions When Classifying Their Children With Cerebral Palsy: Recommendations For Service Providers., Natalie V Scime, Doreen J Bartlett, Laura K Brunton, Robert J Palisano

Physical Therapy Publications

AIMS: This study investigated the experiences and perceptions of parents of children with cerebral palsy (CP) when classifying their children using the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The second aim was to collate parents' recommendations for service providers on how to interact and communicate with families.

METHODS: A purposive sample of seven parents participating in the On Track study was recruited. Semi-structured interviews were conducted orally and were audiotaped, transcribed, and coded openly. A descriptive interpretive approach within a pragmatic perspective was used during analysis.

RESULTS: …

Sex Differences In Spatial Accuracy Relate To The Neural Activation Of Antagonistic Muscles In Young Adults, Agostina Casamento-Moran, Sandra K. Hunter, Yen-Ting Chen, Min-Hyuk Kwon, Emily J. Fox, Basma Yacoubi, Evangelos A. Christou

Exercise Science Faculty Research and Publications

Sex is an important physiological variable of behavior, but its effect on motor control remains poorly understood. Some evidence suggests that women exhibit greater variability during constant contractions and poorer accuracy during goal-directed tasks. However, it remains unclear whether motor output variability or altered muscle activation impairs accuracy in women. Here, we examine sex differences in endpoint accuracy during ankle goal-directed movements and the activity of the antagonistic muscles. Ten women (23.1 ± 5.1 years) and 10 men (23 ± 3.7 years) aimed to match a target (9° in 180 ms) with ankle dorsiflexion. Participants performed 50 trials and we …

The Efficacy Of Pressure Ulcer Treatment With Cathodal And Cathodal-Anodal High-Voltage Monophasic Pulsed Current: A Prospective, Randomized, Controlled Clinical Trial, Anna Polak, Luther C. Kloth, Edward Blaszczak, Jakub Taradaj, Agnieszka Nawrat-Szoltysik, Tomasz Ickowicz, Ewa Hordynska, Andrzej Franek, Cezary Kucio

Physical Therapy Faculty Research and Publications

Background. Studies show that anode and cathode electrical stimulation (ES) promotes the healing of wounds, but specific protocols for both electrodes are not available.

Objective. To compare the effectiveness of cathodal versus cathodal+anodal ES in the treatment of Category II-IV pressure ulcers (PrUs).

Design. Prospective, randomized, controlled, clinical study.

Setting. Three nursing and care centers.

Patients. Sixty-three participants with PrUs were randomly formed into a cathodal ES group (CG: N = 23; mean age of 79.35; SD 8.48), a cathodal+anodal ES group (CAG: N = 20; mean age of 79.65; SD 11.44) and a placebo ES group (PG: N = …

Physical Activity Modulates Corticospinal Excitability Of The Lower Limb In Young And Old Adults, Hamidollah Hassanlouei, Christopher W. Sundberg, Ashleigh E. Smith, Andrew Kuplic, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Aging is associated with reduced neuromuscular function, which may be due in part to altered corticospinal excitability. Regular physical activity (PA) may ameliorate these age-related declines, but the influence of PA on corticospinal excitability is unknown. The purpose of this study was to determine the influence of age, sex, and PA on corticospinal excitability by comparing the stimulus-response curves of motor evoked potentials (MEP) in 28 young (22.4 ± 2.2 yr; 14 women and 14 men) and 50 old adults (70.2 ± 6.1 yr; 22 women and 28 men) who varied in activity levels. Transcranial magnetic stimulation was used to …

Use Of A Team Building Activity To Teach Clinical Decision-Making Concepts To Physical Therapy Students, Robert Fuchs, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE : The purpose of this research was to find out if a team building exercise carried out by student groups will facilitate learning how to make clinical decision involving concepts from the International Classification of Function (ICF).

SIGNIFICANCE: Scant literature exists regarding the concept of integrating student and expert team case-based learning with the ICF to develop clinical decision-making skills.

SUBJECTS: Subjects were 213 first-year physical therapy students in the DPT program at UNMC in the first semester of the curriculum of years 2013-2016.

METHODS AND MATERIALS: A patient case was developed which included clinical decision-making steps using concepts …

Aging With The Fmr1 Gene: A Life Course Perspective, Cornelia Lieb-Lundell

Physical Therapy Collection

Fragile X syndrome (FXS) is one of three syndromes identified as a health condition related to fragile X mental retardation (FMR1) gene dysfunction. The other two conditions are Fragile X-associated primary ovarian insufficiency syndrome (FXPOI) and Fragile X-associated tremor/ataxia syndrome (FXTAS) which together are referred to as Fragile X-associated disorders (FXD). Even though the three conditions share a common genetic defect each one is a separate health condition that results in a variety of body function impairments such as motor delay, musculoskeletal issues related to low muscle tone, coordination limitations, ataxia, tremor, undefined muscle aches and pains; and, …

Three Faces Of Fragile X Syndrome, Cornelia Lieb-Lundell

Physical Therapy Collection

Fragile X Syndrome (FXS) is well known and widely recognized in pediatrics. Less well known is that FXS, as an X-linked disorder of the FMR1 gene, is but one of three impairments that all have a common single-gene genetic basis. These three are labeled Fragile X-associated Disorders (FXD) and are, in turn, a part of a large group of impairments which have a collective name of trinucleotide repeat expansion disorders. Common to all three FXD disorders is that the x-gene carries a characteristic CGG expansion (of the DNA) that can range from 50-+200 (5-45 is normal) with premutation carriers having …

Attitudes And Beliefs Regarding Pain In Interprofessional Education: A Multifaceted Dilemma, Annie Burke-Doe, Kayla Smith, Kristen M. Johnson, Anna Edwards, Christopher J. Ivey, Ellen Lowe, Steve Laslovich, Christopher M. Ingstad, Jonathan P. Warren, Susan Mcnulty, Terri Roberts

Physical Therapy Collection

Purpose: To evaluate entry-level physical and occupational therapy student attitudes and beliefs toward treating a person with pain, at various levels of their didactic learning.

Description: Across health professions, pain education varies considerably with its curricula of pain definitions, management principles, and interprofessional collaboration. The result of this discord has led to a broad range of behaviors and attitudes among health professions and their students, which can ultimately affect a person’s participation in society. Literature supports the importance of a curriculum that addresses students’ attitudes and beliefs toward treating people in pain in an attempt to preclude the formation of …

Construction And Validation Of The Fatigue Impact And Severity Self-Assessment For Youth And Young Adults With Cerebral Palsy., Laura K Brunton, Doreen J Bartlett

Physical Therapy Publications

Purpose: The Fatigue Impact and Severity Self-Assessment (FISSA) was created to assess the impact, severity and self-management of fatigue for individuals with cerebral palsy (CP) aged 14-31.

Methods Used: Items were generated from a review of measures and interviews with individuals with CP. Focus groups with healthcare professionals were used for item reduction. A mailed survey was conducted (n=163/367) to assess the factor structure, known-groups validity and test-retest reliability.

Results Obtained: The final measure contained 31-items in two factors and discriminated between individuals expected to have different levels of fatigue. Individuals with more functional abilities reported less fatigue (p< 0.002) and those with higher pain reported higher fatigue (p< 0.001). The FISSA was shown to have adequate test-retest reliability, ICC(3,1)=0.74 (95% CI 0.53-0.87).

Conclusions …

Atrophy Of Gluteus Maximus Among Women With A History Of Chronic Low Back Pain., Amy H. Amabile, John H. Bolte, Saskia D. Richter

Department of Physical Therapy Faculty Papers

BACKGROUND: Although the relationship between low back pain (LBP) and the size of certain trunk muscles has been extensively studied, the relationship between gluteus maximus (GM) size and LBP has been only minimally examined. Determining whether such a relationship exists would help improve our understanding of the etiology of LBP, and possibly provide a rationale for the use of therapeutic exercise interventions targeting GM with LBP patients. The objective of this study was to compare gluteus maximus cross-sectional area in individuals with chronic LBP, and in a group of individuals without LBP. Our hypothesis was that individuals with LBP would …

Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph

Osteopathic Medicine Student Research Posters

Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …

Neuromuscular Function In Women Postpartum, Rita Deering

Dissertations (1934 -)

Efficient abdominal muscle function is important for functional mobility in men and women, and dysfunction of these muscles has been associated with impaired function such as low back pain. This dissertation explored abdominal muscle function in healthy young men and young women who have never been pregnant (nulligravid). As pregnancy and child birth also impact the tissues of the abdominal wall, this dissertation will also explore abdominal muscle function in postpartum women. This dissertation involved three primary aims. Aim1 compared abdominal muscle function and experimental pain perception in males and nulligravid females. Maximal strength over a range of trunk angles, …

Filling The Gap. Clinical Skill Acquisition With Interactive Online Modules To Supplement Traditional Instruction, Keriann Shaw, Betsy J. Becker, Nicole M. Sleddens, Robin High

Posters and Presentations: Physical Therapy

PURPOSE

The purpose of this study was to assess the effectiveness of interactive e-learning modules to supplement traditional instruction for range of motion (ROM) clinical skill acquisition in a doctor of physical therapy(DPT) curriculum.

BACKGROUNDS/SIGNIFICANCE

Online resources have become highly favored to augment learning especially by millennials for convenience, self-paced content, and versatility in learning styles. It has been reported that elearning platforms are as effective as traditional face-to-face instruction, but may be best utilized as an adjunctive resource for teaching psychomotor skills. Student confidence has also been analyzed with reports of increased self-efficacy with use of online learning materials. …

The Motor Cortical Representation Of A Muscle Is Not Homogeneous In Brain Connectivity, Jo Armour Smith, Alaa Albishi, Sarine Babikian, Skulpan Asavasopon, Beth E. Fisher, Jason Kutch

Physical Therapy Faculty Articles and Research

Functional connectivity patterns of the motor cortical representational area of single muscles have not been extensively mapped in humans, particularly for the axial musculature. Functional connectivity may provide a neural substrate for adaptation of muscle activity in axial muscles that have both voluntary and postural functions. The purpose of this study was to combine brain stimulation and neuroimaging to both map the cortical representation of the external oblique (EO) in primary motor cortex (M1) and supplementary motor area (SMA), and to establish the resting-state functional connectivity associated with this representation. Motor evoked potentials were elicited from the EO muscle in …

Evaluation Of A Student-Centered Digital Education Project In Health Science Education, Betsy J. Becker

Posters and Presentations: Physical Therapy

Student-centered learning is essential and evidence shows higher levels of achievement when students are engaged with educational activities that include critical thinking and effective communication in addition to creativity. The aim of this prospective cohort study was to evaluate a student-centered digital education project during a course about physical therapy (PT) management of chronic diseases. The objectives of this student project were to apply content through a well thought-out digital project and critically analyze information considering multiple points of view. Each project was evaluated by faculty using a rubric, and students completed a self- and peer-assessment. All projects were shared …

Upsee Daisy! Gross Motor Outcomes After Dynamic Weight Bearing In Two Children With Truncal Hypotonia: A Case Series, Megan Flores, Kathleen Manella, Elizabeth Ardolino

Physical Therapy Collection

PURPOSE: The purpose of this case series was to report the impact of a home-based dynamic standing program on postural control and gross motor activity in two children with truncal hypotonia.

BACKGROUNDS/SIGNIFICANCE: Poor postural control associated with central hypotonia limits a child’s ability to interact with the environment, delaying attainment of developmental milestones such as sitting, crawling, standing and walking. Participation in social interactions with peers and caregivers may be restricted resulting in a decreased quality of life. Supported standing programs are commonly used to ameliorate impairments and optimize function in children with poor postural control. Increased social interactions, …

Reliability And Validity Of A Biomechanically Based Analysis Method For The Tennis Serve, Natalie L. Myers, W. Ben Kibler, Leah Lamborn, Belinda J. Smith, Tony English, Cale A. Jacobs, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: An observational tennis serve analysis (OTSA) tool was developed using previously established body positions from three-dimensional kinematic motion analysis studies. These positions, defined as nodes, have been associated with efficient force production and minimal joint loading. However, the tool has yet to be examined scientifically.

Purpose: The primary purpose of this investigation was to determine the inter-observer reliability for each node between two health care professionals (HCPs) that developed the OTSA, and secondarily to investigate the validity of the OTSA.

Methods: Two separate studies were performed to meet these objectives. An inter-observer reliability study preceded the …

Effects Of Head Motion On Postural Stability In Participants With Chronic Motion Sensitivity, Abdulaziz A. Albalwi

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Motion sensitivity, or motion sickness, is common among individuals in modern vehicular and visually stimulating environments; notably, people with normal vestibular function are susceptible to this condition. Motion-provoked dizziness often causes postural instability. Purposes: This study aimed to compare the effects of head motion on postural stability in healthy adults with and without chronic motion sensitivity (CMS) and to determine the effects of head motion direction (horizontal versus vertical) on postural stability. Methods: Sixty healthy adult males and females aged 20 to 40 years old were assigned to two groups, 30 participants with CMS and 30 participants without CMS. …

Relationship Between Vestibular System, Vision, Anxiety, And Chronic Motion Sensitivity, Ahmad A. Alharbi

Loma Linda University Electronic Theses, Dissertations & Projects

BACKGROUND: Chronic motion sensitivity (CMS) has been defined as a feeling of un-wellness elicited by either actual or perceived motion. CMS is a common condition and is more prevalent in females than in males. In addition to a variety of symptoms, young adults with CMS have less postural stability than those without CMS. OBJECTIVE: To determine whether vestibular system integrity, dependence on visual cues for postural stability, and the anxiety level are different between young adults with and without CMS, and whether it differs by gender within each group. METHODS: Sixty young adults (30 females and 30 males) were assigned …

Implementation Of Patient Mobility Assessment Tool: A Clinical Nurse Leader Initiative Towards Improved Patient And Nurse Health Outcomes, Janet Lopez

Master's Projects and Capstones

Abstract

Early ambulation during hospitalization has been recognized as a fundamental and logical intervention to reduce patients functional decline and muscle weakness. Recently, our healthcare system is encouraging nurses to become more actively involved in assessing patient’s mobility status and managing their mobilization. However, since the high nursing workload affects the time that a nurse can assign per task, more often than not they have little time to accurately assess patient’s mobility status; Presenting a safety concern for nurses and patients. In an effort to ease this challenge, the Patient Mobility Assessment Tool (PMAT) is introduced as an efficient nurse-driven …

Ua61/16 Pre-Commencement Hooding & Awards Ceremony, Wku Physical Therapy

WKU Administration Documents

Pre-commencement program for WKU Physical Therapy class of 2017.

The Use Of Emg As A Physical Therapy Learning Aid, Madeline L. Johnson, Rachel C. Cooklin, Erika N. Faria, Taylor M. Schavo, Eric Sternlicht

Student Scholar Symposium Abstracts and Posters

The purpose of this study was to compare the muscle recruitment of an agonist and antagonist muscle during the step up physical therapy exercise with and without visual electromyographic (EMG) biofeedback. 15 healthy, college-aged subjects were recruited to participate in the study. Subjects performed the step up with and without visual feedback in two separate sessions over a four week period. Muscle activity was recorded from the Vastus Medialis (VMO) of the target leg and Medial Gastrocnemius on the contralateral leg. EMG recordings were collected using a BTS FREEEMG system and data was processed using BTS SEMGanalyzer software (BTS Bioengineering, …

Efficacy Of Electromyography And The Dead Bug Exercise, Taylor M. Scavo, Rachel C. Cooklin, Erika N. Faria, Madeline L. Johnson, Eric Sternlicht

Student Scholar Symposium Abstracts and Posters

The Dead Bug exercise is performed in physical therapy clinics to restore lumbar spine stability and core strength in patients with lower back pain (LBP). The aim of this study was to evaluate the efficacy of using electromyography (EMG) feedback to enhance proper mechanics during the Dead Bug exercise. Sixteen healthy, college age students volunteered as subjects for the study. Subjects performed the Dead Bug (Fig. 1a.) with and without visual EMG cues and were given instructions on how to execute the exercise. Data was recorded using a BTS FREEEMG Analyzer and signal processed and data analyzed using the BTS …

Promoting Independent Movers: The Effect Of The Quadriciser On Range Of Motion (Rom), Kristen N. Frank

Senior Honors Projects, 2010-2019

Exercise and movement are pivotal in promoting optimal function for the human body. For individuals with severe orthopedic impairments, attaining the required minimum of 30 minutes of daily exercise is seemingly difficult. The Quadriciser (the “Q”) serves as an alternative method to therapy in attaining daily exercise through promoting passive-active movement of all four limbs. Five middle school and high school subjects with cerebral palsy, severe orthopedic impairments, and multiple disabilities are analyzed to determine if the Q produces increased range of motion (ROM) outcomes for the knee and shoulder joints. A single case AB, pre-post design was utilized where …