Rehabilitation and Therapy Commons^™

Conservative Treatment Of 'Flail Chest' Following Non-Union Fractures Of The Thoracic Rib Cage With Secondary Shoulder Pathology: A Case Report, Chase Kerber

Physical Therapy Scholarly Projects

Background and Purpose - Fractures of the thoracic ribs are common injuries with a high incidence of secondary co-morbidities which may require a slower rehabilitation progression and result in a delayed return to full function. Patients with these diagnoses often seek physical therapy intervention in order to regain their prior level of function.

Case Description - A 51 year-old male sustained multiple rib fractures, pneumothorax, and a left shoulder injury as a result of falling backwards off a 6 foot platform. He presented to physical therapy for evaluation and treatment with the goal of returning to his occupation as a …

Barefoot Versus Shod Training: Effects On Navicular Drop And Foot Pressure Analysis, Evan Condry, Daniel Himmerick, Tiffany Vanhaaften

Physical Therapy Scholarly Projects

Background and Purpose: Running is a popular form of exercise around the world. The running population generally runs in a rear-foot strike pattern (RFSP), yet there is questioning on the possible benefits of running in a forefoot strike pattern (FFSP). The main goal of FFSP is the possible reduction of running related injuries by reducing the stress on the medial longitudinal arch. The purpose of this research study is to determine if a barefoot running retraining program will have an effect on navicular drop height, plantar pressure area, and peak plantar pressure of the medial aspect of the foot.

Material/Methods …

Are Preseason Functional And Biomechanical Measures Associated With Lower Quadrant Injury Risk In Division Iii Athletes?, Natalie Ellis, Jordan Petersen, Jordon Reyes, Victor Wilson, Cj Zita

Student-Faculty Research - College of Physical Therapy

A recent trend in sports medicine research is to determine risk of injury during sport based on preseason functional performance test (FPT) measures.

Equivocal findings associated with prior studies may leave PTs with uncertainty as to which FPT, or combination of FPTs, can best identify athletes who have a greater risk for injury.

Previous studies have utilized "low-tech" FPT measures: standing long jump (SLJ), single-leg hop (SLH), lower extremity functional test (LEFT), and the Y-balance test (YBT) (1,3,4).

These "low-tech" options may not be able to identify potential deficits that could be collected with "high-tech" measures (e.g., DVJ measures collected …

Morphological Changes In Achilles Tendon Thickness Following An 8-Week Heavy Load Eccentric Exercise Program, W. Howe, B. Telfer, J. Leung, M. Suzuki, C. Young, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

• Achilles Tendinopathy (AT) is an overuse injury characterized by pain, focal tenderness, and intratendinous imaging changes.

• Current protocols for treating mid-portion AT are not effective, likely due to not providing sufficient load to the tendon.

• Alfredson’s eccentric protocol, which utilizes high repetition with low load, reduces pain with mid-portion AT in 60.3% of individuals (Van der Plas, 2011)

• Research indicates that heavier loading of the Achilles tendon yields superior results to high repetition with low load (Stevens, 2014)

• Tendons have demonstrated plasticity in their ability to adapt to heavy resistance training. Combined with knowledge that …

Efficacy Of Kinesio Taping As An Adjunct Intervention To Traditional Physical Therapy In The Treatment Of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial, Hossameldien Elkholy

Department of Physical Therapy Student Theses, Dissertations and Capstones

The Efficacy of Kinesio Taping as an Adjunct Intervention to Traditional Physical Therapy in the Treatment of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial Background: Acute low back pain (LBP) is a significant health problem worldwide and is one of the leading causes of disability. Objective: The purpose of this study was to examine the effect of Kinesio Taping (KT) on disability, fear-avoidance beliefs, and pain intensity in patients with acute, nonspecific LBP. Research Design and Methods: A prospective, randomized controlled study of consecutive patients referred to physical therapy with a primary complaint of LBP. Seventy-eight patients …

Are We Armed With The Right Data? Pooled Individual Data Review Of Biomarkers In People With Severe Upper Limb Impairment After Stroke, Kathryn S. Hayward, Julia Schmidt, Keith R. Lohse, Sue Peters, Julia Bernhardt, Natasha A. Lannin, Lara A. Boyd

Physical Therapy Publications

To build an understanding of the neurobiology underpinning arm recovery in people with severe arm impairment due to stroke, we conducted a pooled individual data systematic review to: 1) characterize brain biomarkers; 2) determine relationship(s) between biomarkers and motor outcome; and 3) establish relationship(s) between biomarkers and motor recovery. Three electronic databases were searched up to October 2, 2015. Eligible studies included adults with severe arm impairment after stroke. Descriptive statistics were calculated to characterize brain biomarkers, and pooling of individual patient data was performed using mixed-effects linear regression to examine relationships between brain biomarkers and motor outcome and recovery. …

Interhemispheric Pathways Are Important For Motor Outcome In Individuals With Chronic And Severe Upper Limb Impairment Post Stroke, Kathryn S. Hayward, Jason L. Neva, Cameron S. Mang, Sue Peters, Katie P. Wadden, Jennifer K. Ferris, Lara A. Boyd

Physical Therapy Publications

Background: Severity of arm impairment alone does not explain motor outcomes in people with severe impairment post stroke.

Objective: Define the contribution of brain biomarkers to upper limb motor outcomes in people with severe arm impairment post stroke.

Methods: Paretic arm impairment (Fugl-Meyer upper limb, FM-UL) and function (Wolf Motor Function Test rate, WMFT-rate) were measured in 15 individuals with severe (FM-UL ≤ 30/66) and 14 with mild-moderate (FM-UL > 40/66) impairment. Transcranial magnetic stimulation and diffusion weight imaging indexed structure and function of the corticospinal tract and corpus callosum. Separate models of the relationship between possible biomarkers and motor outcomes …

The Comprehensive Professional Behaviours Development Log, Deb Lucy, Doreen J. Bartlett, Tianna D. B. Deluzio

Physical Therapy Publications

No abstract provided.

Development, Implementation, And Outcomes Of An Acute Care Clinician Scientist Clinical Placement: Case Report., Sarah Wojkowski, Janelle Unger, Magda Mccaughan, Beverley Cole, Michelle E Kho

Physical Therapy Publications

Purpose: This article presents the development, implementation, and outcomes of an innovative clinician scientist (CS) placement for a 2nd-year, entry-level MSc(PT) student at McMaster University. Client Description: All physiotherapy students participating in the third 6-week clinical placement at McMaster University were eligible to apply for one CS placement. A placement description and expectations were developed collaboratively by the clinical site and the MSc(PT) programme before placement matching. Intervention: A shared supervisory model between one acute care physiotherapist and a critical care CS was developed to provide supervision in both clinical and research-related activities during the placement. Measures and Outcomes: The …

Clinician's Commentary On Patterson Et Al., Sue Peters

Physical Therapy Publications

No abstract provided.

Career Paths, Barriers, And Professional Experiences: A Comparison Study Of Physical Therapy Program Directors In The United States, Tamara Nancy Gravano

Theses, Dissertations and Capstones

The entry-level degree for physical therapists today is a professional doctoral degree. It is similar to a medical degree program where the expected outcome of its graduates is clinical practice, and there is no formal training in academic teaching or administration. The purpose of this study was to determine the leadership characteristics, styles, and behaviors of accredited Doctor of Physical Therapy (DPT) program directors (PD) and to gain a better understanding of their preparation and path to program leadership. The survey instrument was sent electronically to all program directors of accredited DPT programs in the United States (N=233) and the …

Clinical Guidelines For Low Back Pain: A Critical Review Of Consensus And Inconsistencies Across Three Major Guidelines, N O'Connell, C Cook, B Wand, S Ward

Physiotherapy Papers and Journal Articles

Given the scale and cost of the low back pain problem, it is imperative that healthcare professionals involved in the care of people with low back pain have access to up-to-date, evidence-based information to assist them in treatment decision-making. Clinical guidelines exist to promote the consistent best practice, to reduce unwarranted variation and to reduce the use of low-value interventions in patient care. Recent decades have witnessed the publication of a number of such guidelines. In this narrative review, we consider three selected international interdisciplinary guidelines for the management of low back pain. Guideline development methods, consistent recommendations and inconsistencies …

Transcutaneous Electrical Nerve Stimulation (Tens) For Neuropathic Pain In Adults, W Gibson, B Wand, N O'Connell

Physiotherapy Papers and Journal Articles

Background: Neuropathic pain, which is due to nerve disease or damage, represents a significant burden on people and society. It can be particularly unpleasant and achieving adequate symptom control can be difficult. Non-pharmacological methods of treatment are often employed by people with neuropathic pain and may include transcutaneous electrical nerve stimulation (TENS). This review supersedes one Cochrane Review ’Transcutaneous electrical nerve stimulation (TENS) for chronic pain’ (Nnoaham 2014) and one withdrawn protocol ’Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults’ (Claydon 2014). This review replaces the original protocol for neuropathic pain that was withdrawn.

Objectives: To determine the …

The Development Of The Dutch Version Of The Fremantle Back Awareness Questionnaire, Lotte Janssens, Nina Goossens, Benedict M. Wand, Madelon Pijnenburg, Tinne Thys, Simon Brumagne

Physiotherapy Papers and Journal Articles

Background: Disturbed body perception may play a role in the aetiology of chronic low back pain (LBP). The Fremantle Back Awareness Questionnaire (FreBAQ) is currently the only self-report questionnaire to assess back-specific body perception in individuals with LBP.

Objectives: To perform a cross-cultural adaptation of the FreBAQ into Dutch.

Design: Psychometric study.

Methods: A Dutch version of the FreBAQ was generated through forward-backward translation, and was completed by 73 patients with LBP and 73 controls to assess discriminant validity. Structural validity was assessed by principal component analysis. Internal consistency was assessed by the Cronbach's alpha coefficient. Construct validity was assessed …

Increased Burn Healing Time Is Associated With Higher Vancouver Scar Scale Score, Vidya Finlay, Sally Burrows, Maddison Burmaz, Hussna Yawary, Johanna Lee, Dale Edgar, Fiona M. Wood

Physiotherapy Papers and Journal Articles

Increased burn wound healing time has been shown to influence abnormal scarring. This study hypothesized that scar severity increases commensurate to the increase in time to healing (TTH) of the wound. Wound healing and scar data from burn patients treated by the Burn Service of Western Australia at Royal Perth Hospital were examined. The relationship between TTH and scar severity, as assessed by the modified Vancouver Scar Scale (mVSS), was modelled using regression analysis. Interaction terms evaluated the effect of surgery and total body surface area – burn (TBSA) on the main relationship. Maximum likelihood estimation was used to account …

Total Knee Arthroplasty Rehabilitation Case Report, Abby R. Brenner

Physical Therapy Scholarly Projects

Background & Purpose Total knee arthroplasties (TKAs) are the most commonly performed elective surgery in the United States. Osteoarthritis (OA) is the most common diagnosis treated with a TKA, which aims to restore an individual's functional ability by improving joint biomechanics and decreasing pain. The purpose of this case report is to describe the progression of physical therapy rehabilitation for a patient status post total knee arthroplasty.

Case Description The patient was a 64 year old male who underwent a TKA surgery to resolve the complications from severe osteoarthritis (OA) of his left knee. He presented to physical therapy with …

Validation Of The Japanese Version Of The Fremantle Back Awareness Questionnaire In Patients With Low Back Pain, T Nishigami, A Mibu, K Tanaka, Y Yamashita, M Shimizu, B Wand, M Catley, T Stanton, G Moseley

Physiotherapy Papers and Journal Articles

Background: There is a growing interest in the role of disturbed body perception in people with persistent pain problems such as chronic low back pain (CLBP). A questionnaire, the Fremantle Back Awareness Questionnaire (FreBAQ), was recently developed as a simple and quick way of assessing disturbed perceptual awareness of the back in people with CLBP and appears to have acceptable psychometric properties. The aim of the present study was to develop a Japanese version of the FreBAQ (FreBAQ-J) and evaluate its psychometric properties in a sample of Japanese people with low back pain (LBP).

Methods: Translation of the FreBAQ into …

Physiotherapy In Upper Abdominal Surgery - What Is Current Practice In Australia?, S Patman, A Bartley, A Ferraz, C Bunting

Physiotherapy Papers and Journal Articles

Background: Upper abdominal surgery (UAS) has the potential to cause post-operative pulmonary complications (PPCs). In the absence of high-quality research regarding post-operative physiotherapy management, consensus-based best practice guidelines formulated by Hanekom et al. (2012) are available to clinicians providing recommendations for post-UAS treatment. Such best practice guidelines have recommended that physiotherapists should be using early mobilisation and respiratory intervention to minimise risk of PPCs. However, recent evidence supports the implementation of mobilisation as a standalone treatment in PPC prevention, though the diversity in literature poses questions regarding ideal current practice. This project aimed to document and report the assessment measures …

Resistance Training For Rehabilitation After Burn Injury: A Systematic Literature Review And Meta-Analysis, P Gittings, T Grisbrook, Dale Edgar, F Wood, B Wand, N O'Connell

Physiotherapy Papers and Journal Articles

Background/aim: Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury.

Methods: Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and …

Developing Minimum Clinical Standards For Physiotherapy In South African Icus: A Qualitative Study, H Van Aswegen, S Patman, N Plani, S Hanekom

Physiotherapy Papers and Journal Articles

Rationale, aims, and objectives: Physiotherapists are integral members of the intensive care unit (ICU) team. Clinicians working in ICU are dependent on their own experience when making decisions regarding individual patient management thus resulting in variation in clinical practice. No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for ICU physiotherapy. This study explored perceptions of physiotherapists on minimum clinical standards that ICU physiotherapists should adhere to for delivering safe, effective physiotherapy services to critically ill patients.

Method: Experienced physiotherapists offering a service to South African ICUs were purposively sampled. Three focus …

After-Hours Respiratory Physiotherapy For Intubated And Mechanically Ventilated Patients With Community-Acquired Pneumonia: An Australian Perspective, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Introduction: Community acquired pneumonia (CAP) is a common reason for admission to an intensive care unit for intubation and mechanical ventilation, and results in high morbidity and mortality. The primary aim of the study was to investigate availability and provision of respiratory physiotherapy, outside of normal business hours, for intubated and mechanically ventilated adults with CAP in Australian hospitals.

Materials and methods: A cross-sectional, mixed methods online survey was conducted. Participants were senior intensive care unit physiotherapists from 88 public and private hospitals. Main outcome measures included presence and nature of an after-hours physiotherapy service and factors perceived to influence …

The Effect Of Complex Falls Prevention Interventions On Falls In Residential Aged Care Settings: A Systematic Review Protocol, Jacqueline Francis-Coad, Christopher Etherton-Beer, Debbie Nobre, Chiara Naseri, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident.

Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings?

Can A Web-Based Community Of Practice Be Established And Operated To Lead Falls Prevention Activity In Residential Care?, Jacqueline Francis-Coad, Christopher Etherton-Beer, Caroline Bulsara, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted …

Somatosensory Deficits In Post-Acl Reconstruction Patients: A Case-Control Study, Johanna M. Hoch, William O. Perkins, Jonathan R. Hartman, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Introduction: Diminished cutaneous detection thresholds have been identified in patients with multiple orthopedic conditions, and these phenomena may occur in postanterior cruciate ligament reconstructed (ACLR) patients. The purpose of this study was to determine if differences in lower extremity cutaneous detection thresholds exist in post-ACLR patients when compared with healthy controls. Methods: Fifteen individuals who were post-ACLR and 15 individuals who had no history of knee injury participated. Light touch cutaneous detection thresholds were assessed at 4 locations on the foot and ankle (first metatarsal, fifth metatarsal, medial malleolus, and lateral malleolus). Nonparametric statistics examined group differences between the …

The Effect Of An Interprofessional Registered Nurse-Physical Therapist Team On Reducing Prescribed Opioid Dependence In Patients With Chronic Lower Back Pain, Amber Chesney, Stephanie Jan, Amanda Pedrazoli, Brandon Simmons, Kaylene Woods, Nicole Yeats

OUR Journal: ODU Undergraduate Research Journal

Long-term prescribed opioid use for chronic pain is shown to reduce recovery potential and increase risk for dependence, which is contributing to the nationwide opioid crisis. There is a need for an innovative, multidisciplinary approach to address prescription opioid dependence. We propose implementation of a community-based interprofessional registered nurse-physical therapist team (IRNPTT) focused on reduction of opioid dependence in adult patients with chronic lower back pain.

The Effects Of Low-Intensity Therapeutic Ultrasound On Measurable Outcomes: A Critically Appraised Topic, Sarah Daniels, Gabriela Santiago, Jennifer Cuchna, Bonnie Van Lunen

Ellmer School of Nursing Faculty Publications

Therapeutic ultrasound (US) is a popular modality among health care professionals and is used to treat a variety of musculoskeletal conditions. A new technology has been established to allow for the miniaturization of the US unit. Patients receive treatment with the device secured to them, eliminating the portability constraint of traditional US units. Early studies suggest that this portable unit can deliver low-intensity acoustic energy achieving the same temperature increase and pain relief that come from traditional US units, in a more versatile and patient-friendly manner. Clinical Question: What effects does low-intensity therapeutic ultrasound (LITUS) have on measurable outcomes? Summary …

Effect Of Self-Determination, Motivation, And Dispositional Optimism With Physical Therapy In Geriatric Patients, Leslie Yaneth Urias-Bodnar

Walden Dissertations and Doctoral Studies

Older people are frequently faced with physical conditions that require treatment. A better understanding of the components of engagement relating to the outcomes of treatment was the focus of the study. The purpose of this quantitative study was to examine whether there was an association between the independent variables of optimism, pessimism, motivation, and self-determination and their impact on the dependent variable of achieving physical activity goals in 86 geriatric patients, ages 65 to 80 receiving physical therapy services. The theoretical framework of self-determination, motivation, optimism, and pessimism was assessed by using two self-report questionnaires, The Self-Determination Scale and The …

Evaluation Of Program Satisfaction, Quality Of Life, Strength, And Fall Risk Of Community-Dwelling Older Adults Participating In A Community Exercise Program: Part 2, Marissa Adolphson, Roy Nelson, Jenna Wyffels

Physical Therapy Scholarly Projects

Background and Purpose: Bone Builders is an exercise program that incorporates both lower and upper extremities and is specifically designed for the older adult population. It was originally created for those that wanted to reduce their risk of osteoporosis, but currently there is no evidence that demonstrates these effects. However, exercises that are completed in the class are those that target causes of fall risk such as strengthening of hip abductors and balance activities. Participants have also reported that benefits of the class include improved balance, increased energy and mobility, and social support. Our study consisted of testing the …

Meniscectomy Of A College Athlete, Aaron Bakker

Physical Therapy Scholarly Projects

Background and Purpose: The purpose of this case study is to describe the case of an athlete who sustained a meniscus injury and his subsequent course of physical therapy.

Case Description: The patient in the study is a 20 year old college football player seen by physical therapy following a left knee arthroscopic lateral meniscectomy. He injured his knee while cutting to change direction during football practice.

Intervention: Initial treatment for the patient started off as basic body weight resistance along with modalities and ice to reduce inflammation. Each week he progressed from bodyweight to weighted resistance activities and …

Physical Therapy Interventions Following Acute Traumatic Brain Injury: Early Mobility In The Acute Care Setting, Ashley Hickox

Physical Therapy Scholarly Projects

Background: Approximately 2.5 million individuals suffered from a TBI in the year of 2010. Many individuals who suffer a TBI are hospitalized for extended periods of time. Studies have shown that extended intensive care can result in deleterious and long-lasting side effects. Early mobility has been utilized to combat effects and has been shown to be safe and effective.

Purpose: To examine early mobility use as applied with respect to this case, a patient with a severe, acute TBI.

Case Description: The patient was a 26 year old male who sustained a TBI following a boat accident. …