Rehabilitation and Therapy Commons^™

Subacute Physical Therapy Management For Abnormalities Of Gait And Mobility Following An Acute Accident With Farm Equipment: A Case Report, Maria Stern

Case Report Posters

Workers in the agricultural industry experience 243 injuries per day that result in lost work time, with five percent of these resulting in permanent impairments. Functional decline can occur as a result of prolonged hospitalizations. Endurance and strength of the lower extremities, mobility, and tolerance for ambulation are decreased in this population. Physical therapy (PT) interventions can target these impairments to improve functional ability. The purpose of this case report is to describe the PT management used in a subacute setting to improve functional ability, mobility, and gait in a patient who experienced deconditioning due to prolonged hospitalization following an …

Profiles Of Fatigue Severity And Variability Among Adolescents And Young Adults With Cerebral Palsy, Laura K. Brunton, Doreen J. Bartlett

Physical Therapy Publications

Background: Individuals with cerebral palsy (CP) experience progressive changes in functional status with the development of secondary impairments such as fatigue. Detailed accounts of the fatigue experience in CP are lacking.

Purpose: This study describes the severity and variability of fatigue in CP using the Fatigue Impact and Severity Self-Assessment.

Methods: This was a descriptive cross-sectional study surveying 130 (61 males) individuals (mean age 18 years, 11 months; SD four years, six months) with CP. Analyses comprised comparisons between two groups (Gross Motor Function Classification System (GMFCS) I and II-V), frequency counts and proportions.

Results: Significant differences exist between GMFCS …

Use Of Functional Strengthening, Balance Training, And Stretching In The Treatment Of A Patient Following A T11-L5 Spinal Fusion: A Case Report, Anna Sidloski, Brian T. Swanson

Case Report Posters

There is abundant evidence available regarding treatment approaches for patients suffering from low back pain (LBP), but limited research focusing on physical therapy (PT) treatment status post-multilevel spinal fusion with postural impairments. The purpose of this case report is to describe the management and functional improvement of a patient s/p spinal fusion with severe postural impairments, elevated fall risk, and high levels of back pain.

Physical Therapy And Cognitive Behavioral Therapy In A Patient With Multiple Co-Morbidities – A Case Report, Jeanine Manubay, Kirsten Buchanan

Case Report Posters

Traditional physical therapy (PT) interventions can be challenging to implement in the complex patient with multiple comorbidities. Cognitive behavioral therapy (CBT) is a behavioral therapy technique used to change obstructive behaviors and improve functional and emotional health. CBT has shown positive outcomes in patients with cancer and elderly patients with depression, but has not been studied in conjunction with PT in medically complex patients. The purpose of this case report was to document the utilization and outcomes of CBT along with traditional physical therapy for a medically complex patient diagnosed with end stage renal disease and multiple co-morbidities.

Physical Therapy And Cognitive Behavioral Therapy In A Patient With Multiple Co-Morbidities – A Case Report, Jeanine Manubay

Case Report Papers

Background and Purpose: Cognitive behavioral therapy (CBT) is grounded in the premise that by altering a patient’s negative thought processes, one can improve functional and emotional health. When multiple co-morbidities limit traditional physical therapy interventions, CBT may be a consideration. While CBT has shown benefits in patients with cancer and others, there is a lack of research investigating its effectiveness in conjunction with physical therapy (PT) in the medically complex patient. The purpose of this case report was to document the outcomes of CBT along with traditional PT for a medically complex patient diagnosed with end stage renal disease and …

Use Of Functional Strengthening, Balance Training, And Stretching In The Treatment Of A Patient Following A T11-L5 Spinal Fusion: A Case Report, Anna Sidloski

Case Report Papers

Background and Purpose: Lumbar spinal fusion surgery has been utilized to manage levels of low back pain and instability. However, pain often persists post-operatively. Evidence supports the use of Transverse Abdominis recruitment in patients with LBP. Research demonstrates strengthening the hip musculature may allow for improved outcomes for those who experience LBP. There is limited research focusing on lower extremity strengthening, flexibility, and balance training in a patient following a T11-L5 spinal fusion. Case Description: The patient was a 68-year-old male presenting to physical therapy eight weeks’ status post T11-L5 spinal fusion with ~45 degrees forward-flexed posture, weak lower extremity …

A Comprehensive Physical Therapy Program For Adult-Onset Dystonia: A Case Report, Karissa Wells, Kirsten Buchanan

Case Report Posters

Dystonia can present with symptoms of involuntary muscle contractions, resting tremors, and diminished muscular control. Patients with dystonia can present similarly to patients with Parkinson’s disease due to the association with the basal ganglia. While there is significant research on physical therapy (PT) interventions for patients with Parkinson’s disease there is limited research on the PT evaluation and treatment of patients with dystonia. The purpose of this case report was to describe a comprehensive PT regimen, based on Parkinson’s disease research, for a patient diagnosed with adult-onset dystonia.

The Use Of Manual Therapy In The Treatment Of A Patient With Chronic Low Back Pain And Sciatica: A Case Report, Elia N. Darazi

Case Report Posters

Low back pain (LBP) is the second most common cause of disability in adults with total costs estimated to be between $100 and $200 billion annually on the US economy. The prevalence of chronic LBP rose significantly over a 14-year interval (1992 to 2006), from 3.9% to 10.2%. Treatment of LBP may be conservative or surgical, with conservative being the mainstream initial treatment before a consideration of a surgical option. A surgical option is usually recommended when there is evidence of worsening nerve damage. In a physical therapy (PT) outpatient setting, chronic LBP is one of the most common conditions …

Combining Physical Therapy And Podiatry For A Patient With Plantar Fasciitis: A Case Report, Kathleen Barnes, Kirsten Buchanan

Case Report Posters

One million cases of plantar fasciitis (PF) are reported annually in the United States. Studies have separately investigated the effectiveness of physical therapy (PT) interventions as well as steroid injections from podiatry – but not in conjunction with each other. There is a lack of research investigating an interdisciplinary approach utilizing PT and podiatry for PF. This case report investigated an interdisciplinary approach combining physical therapy and podiatry utilizing steroid injections in the treatment of a patient with plantar fasciitis.

Application Of Manual Therapy Utilizing Maitland Principles In The Rehabilitation Of A Patient Following Rotator Cuff Repair, Kehinde Aderibigbe, Brian T. Swanson

Case Report Posters

In the United States, more than 500,000 rotator cuff repairs and shoulder arthroscopies are performed annually. Following surgery, physical therapy (PT) often utilizes various manual therapy (MT) and therapeutic exercise (TE) interventions. Post-operatively, accessory joint mobilizations (AJM) help to prevent adhesions and may decrease excitability of central nociceptive pathways. However, there is no consensus about the most appropriate postoperative utilization and timing of MT following surgery. Maitland describes a framework for clinical decision making that is patient-centric and focuses on frequent reassessment to guide the application of manual therapy. In this framework, comparable signs are identified at initial evaluation, and …

Restoration Of Functional Mobility For A Young Adult Patient Following A Severe Motor Vehicle Accident: A Case Report, Zachary Mercier

Case Report Posters

Over 50 million people world-wide experience non-fatal injuries, and 1.2 million people die as a result of motor vehicle accidents (MVA) annually. Unintentional injury, including MVA, was the leading cause of death in females age 15-24 in 2014. Higher intensity therapy can result in greater gains in functional mobility in rehabilitation settings. Skilled nursing facilities typically care of older patients, but younger patients can also benefit. The purpose of this case report was to document a young adult patient’s response to skilled physical therapy interventions with the goal of returning the patient to prior level of function.

Physical Therapy Intervention For A Patient With Temporomandibular Joint Dysfunction Caused By Two Traumatic Events: A Case Study, Elyse Detweiler

Case Report Posters

Temporomandibular disorders (TMD) are a collection of pathoanatomical dysfunctions of the temporomandibular joint (TMJ) and are associated with a variety of symptoms throughout the head and neck. There is a severe lack of supportive evidence for physical therapy management used in the conservative and/or post-surgical treatment of TMD. The dental profession provides much of the current literature on TMD but is limited in conservative and surgical interventions. Research has shown arthrocentesis to be a beneficial procedure to perform initially; long-term outcomes for pain and functional impairments were comparable with conservative treatment. The purpose of this case report is to provide …

Manual And Exercise Therapy For The Treatment Of Chronic Costochondritis In A Male Office Worker: A Case Report, John Livecchi

Case Report Posters

For some patients, the use of techniques that typically comprise a physical therapy (PT) treatment plan for costochondritis, such as high-velocity low-amplitude (HVLA) manipulation, can be intolerable due to pain or even contraindicated because of other comorbidities. This case report describes the successful treatment of a patient with chronic costochondritis utilizing gentler, more conservative manual therapy techniques than those that are typically used in PT management of the condition.

Comprehensive Physical Therapy Treatment Following A Surgical Repair Of A Flexor Hallucis Longus Tendon In A Skateboarder: A Case Report, Joseph Marcil, Kirsten Buchanan

Case Report Posters

Flexor Hallucis Longus (FHL) injuries occur when stress is placed on the great toe. FHL tendinopathies are common in ballet dancers, however, not often seen in skateboarders. The most effective physical therapy (PT) rehabilitation protocol for an FHL tendinopathy and subsequent repair in a skateboarding athlete has not been well documented. The purpose of this case report is to investigate a comprehensive PT protocol, including video feedback after an FHL repair in a skateboarding athlete.

Physical Therapy Management Of A Patient With Chronic Brainstem Stroke Syndrome To Improve Functional Mobility: A Case Report, Kelley Flahaven

Case Report Posters

Strokes are a leading cause of disability, and the fifth leading cause of death in the U.S. Brainstem strokes are much less common and have a higher mortality rate than cortical strokes. Brainstem strokes can lead to physical impairments including gaze palsies, quadriplegia, ataxia, or cranial nerve deficits, which affect balance and safety, decreasing independence. Repetitive task gait training has been shown to create improvements in patients with stroke. Non-specific gait training can have a transfer effect on gait for patients with stroke. There are fewer accounts of brainstem stroke rehabilitation than cortical stroke rehabilitation due to poor prognosis and …

Functional Training In A Patient With Middle Cerebral Artery Stroke With Multiple Comorbidities: A Case Report, Darien Lewis

Case Report Posters

795,000 people experience a stroke yearly, making it the leading cause of long-term disability, costing $34 billion. Strokes affecting the middle cerebral artery (MCA) cause impairments of strength, sensation, coordination, and balance of the contralateral side. Recovery from stroke is affected by premorbid status. Cardiovascular disease causes a majority of strokes. The purpose of this case report is to describe a progressive PT plan of care for a patient following MCA stroke with multiple comorbidities in the skilled nursing setting.

Therapeutic Exercise In The Treatment Of Greater Trochanteric Pain Syndrome S/P Lumbar Discectomy: A Case Report, Sean Jeffrey

Case Report Posters

Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, affecting between 1.8 and 5.6 patients per 1000 annually. Inadequate core stability and gluteal weakness contribute to the probability of developing GTPS. GTPS is more common in patients with coexisting low back pain (LBP). Discectomy is effective in treating LBP pain caused by prolapsed lumbar intervertebral discs, however, it does not correct back muscle function. Lumbar stabilization exercises have demonstrated improved quality of life (QOL) outcomes. As both GTPS and discectomy rehabilitation lack defined treatment guidelines, the purpose of this case report is to describe the physical …

Therapeutic Exercise In The Treatment Of Greater Trochanteric Pain Syndrome S/P Lumbar Discectomy: A Case Report, Sean Jeffrey

Case Report Papers

Background and Purpose: Greater trochanteric pain syndrome (GTPS) is a multifactorial cause of lateral hip pain, affecting between 1.8 and 5.6 patients per 1000 per year. The prevalence of GTPS is more common in patients with coexisting low back pain. Though discectomy is effective in the treatment of prolapsed lumbar intervertebral discs, it does not correct concurrent hip pathology. As GTPS in the setting of discectomy rehabilitation lacks defined treatment guidelines, the purpose of this case report is to display physical therapy (PT) treatment of GTPS in conjunction with simultaneous rehab from lumbar microdiscectomy.
Case Description: A 56-year-old male was …

Adaptations Of Lumbar Biomechanics After Four Weeks Of Running Training With Minimalist Footwear And Technique Guidance: Implications For Running-Related Lower Back Pain, Szu-Ping Lee, Joshua P. Bailey, Jo Armour Smith, Stephanie Barton, David Brown, Talia Joyce

Physical Therapy Faculty Articles and Research

Objectives

To investigate the changes in lumbar kinematic and paraspinal muscle activation before, during, and after a 4-week minimalist running training.

Design

Prospective cohort study.

Setting

University research laboratory.

Participants

Seventeen habitually shod recreational runners who run 10–50 km per week.

Main outcome measures

During stance phases of running, sagittal lumbar kinematics was recorded using an electrogoniometer, and activities of the lumbar paraspinal muscles were assessed by electromyography. Runners were asked to run at a prescribed speed (3.1 m/s) and a self-selected speed.

Results

For the 3.1 m/s running speed, significant differences were found in the calculated mean lumbar posture …

Use Of The Task-Oriented Approach For Chronic Inflammatory Demyelinating Polyneuropathy: A Case Report, Alison Newell, Amy J. Litterini

Case Report Posters

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an acquired neurological disorder similar to Guillain-Barre Syndrome (GBS) with rare a prevalence of 2-7.7/100,000.7. Etiology and pathogenesis are largely unknown but are thought to be immunological, targeting the myelin of peripheral nerves. Extensive literature exists regarding medical management of CIDP, but limited research exists regarding physical therapy (PT) management for patients with CIDP. Task-Oriented Approach (TOA) is based upon systems theory with influence from motor learning and motor control theories. Systems theory states abnormal movements are related to deficits in one or more system(s) and are comprised of the body’s existing systems’ attempts …

Physical Therapy Intervention For A Patient With Temporomandibular Joint Dysfunction Caused By Two Traumatic Events: A Case Study, Elyse Detweiler

Case Report Papers

Background and Purpose: Temporomandibular disorders (TMD) are pathoanatomical dysfunctions of the temporomandibular joint (TMJ) associated with symptoms throughout the head and neck.Limited information exists regarding conservative physical therapy (PT) and post-surgical management of TMD. The dental profession is the main source of published literature specific to TMD. This paper describes a conservative and post-surgical PT plan of care (POC) for TMD. Case Description: A 32-year old female experienced two separate traumatic events at work resulting in TMD. She was referred to PT after the second assault because of symptoms of severe pain, limited range of motion, and jaw locking. She …

Preseason Jump And Hop Measures In Male Collegiate Basketball Players: An Epidemiologic Report, Jason Brumitt, Amy Engilis, Dale Isaak, Amy Briggs, Alma Mattocks

Faculty Publications - College of Physical Therapy

Background: Injuries are inherent in basketball with lower extremity (LE) injury rates reported as high as 11.6 per 1000 athletic exposures (AEs); many of these injuries result in time loss from sport participation. A recent trend in sports medicine research has been the attempt to identify athletes who may be at risk for injury based on measures of preseason fitness.

Hypothesis/Purpose: The purpose of this prospective cohort study was to determine if the standing long jump (SLJ) and/or the single-leg hop (SLH) for distance functional performance tests (FPT) are associated with non-contact time loss lower quadrant (LQ, defined as lower …

Effect Of Heavy Lifting With A Head Strap On The Pelvic Floor Across The Menstrual Cycle, Yvonne Biswokarma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Pelvic organ prolapse (POP) occurs in 10% of women in Nepal, even 6% of nulliparous women have symptomatic POP.1 This may be linked to the heavy lifting tasks performed by women using a head strap.2 This study explored the impact of hormonal changes on the pelvic floor when performing these tasks during each phase of the menstrual cycle. Methods: The study included 22 female Nepali participants with a mean age of 27.4(3.6) years; all were from rural villages and frequently carried with a head strap. Using intravaginal pressure transducers (IVT), the mean change in intraabdominal pressure (IAP) was found …

Temporary Nerve Block At Selected Digits Revealed Hand Motor Deficits In Grasping Tasks, Aude Cateron, Kerry Mcpartlan, Christina Gioeli, Emily Reid, Matt Turturro, Barry Hahn, Cynthia Benson, Wei Zhang

Publications and Research

Peripheral sensory feedback plays a crucial role in ensuring correct motor execution throughout hand grasp control. Previous studies utilized local anesthesia to deprive somatosensory feedback in the digits or hand, observations included sensorimotor deficits at both corticospinal and peripheral levels. However, the questions of how the disturbed and intact sensory input integrate and interact with each other to assist the motor program execution, and whether the motor coordination based on motor output variability between affected and non-affected elements (e.g., digits) becomes interfered by the local sensory deficiency, have not been answered. The current study aims to investigate the effect of …

Influence Of Posture-Cuing Shirt On Tennis Serve Kinematics In Division Iii Tennis Players, Joseph Zappala, Caroline Orrego, Emily Boe, Heather Fechner, Derek Salminen, Daniel Cipriani

Physical Therapy Faculty Articles and Research

Objective: Injuries to the shoulder complex are common in overhead athletes, often related to kinematics of the shoulder complex. This study evaluated the influence of a posture-cuing shirt on internal rotation velocity of the shoulder during a tennis swing and to determine this influence on shoulder external rotation position. Methods: Nine healthy competitive college tennis players from a Division III college participated in this study. High speed motion capture allowed for 3-D analysis of shoulder kinematics during a tennis serve. Two conditions were evaluated while the athletes performed a high velocity tennis serve: standard tennis shirt and a …

The Debt Burden Of Entry-Level Physical Therapists In Florida, Steven Benton Ambler

USF Tampa Graduate Theses and Dissertations

Despite the education, autonomy, and high demand for physical therapists both nationally and in Florida, recent graduates have seen steadily rising education costs with disproportionate changes in income once they have graduated and entered the workforce. The growing debt burden of physical therapists entering the workforce, coupled with the growth in projected need and stagnant wages, raises concern about where and how entry-level physical therapists will practice and if these choices will be affected by their debt burden. The purpose of this quantitative, cross-sectional survey study was to identify the debt profile of entry-level physical therapists and explore the relationship …

Standing Balance And Spatiotemporal Aspects Of Gait Are Impaired Upon Nocturnal Awakening In Healthy Late Middle-Aged And Older Adults, Amanda L. Mcbean, Raymond P. Najjar, Ronald A. Schuchard, Courtney D. Hall, Cheng-Ann Wang, Ban Ku, Joseph M. Furman

ETSU Faculty Works

Study Objectives: Nocturnal awakenings may constitute a unique risk for falls among older adults. We describe differences in gait and balance between presleep and midsleep testing, and whether changes in the lighting environment during the midsleep testing further affect gait and balance.

Methods: Twenty-one healthy, late middle-aged and older (64.7 ± 8.0 y) adults participated in this repeated-measures design consisting of four overnight laboratory stays. Each night, participants completed baseline visual acuity, gait, and balance testing. After a 2-h sleep opportunity, they were awakened for 13 min into one of four lighting conditions: very dim white light (< 0.5 lux); dim white light (∼28.0 lux); dim orange light (∼28.0 lux); and white room-level light (∼200 lux). During this awakening, participants completed the same sequence of testing as at baseline.

Results: Low-contrast …

Mind Mapping: A Strategy To Promote Interprofessional Collaboration Among Health Science Students, Catherine Maher, Pt, Dpt, Genevieve Pinto Zippo, Pt, Edd

JCIPE Conference

Purpose/Background:

This presentation will provide participants with an understanding of what mind mapping is and engage participants in a discussion and hands on experience of how mind mapping can be used to prepare students for interprofessional collaborative practice and integrate patient centered models of care. Managing a patient’s plan of care requires health care practitioners to share and integrate data in order to formulate a plan of care. How to engage with other disciplines is often developed during student’s clinical educational experiences. Assisting and engaging students during the academic portion are essential to prepare them for interprofessional collaborative practice. Mind …

Same-Day Physical Therapy Consults In An Outpatient Neuromuscular Disease Physician Clinic, Evan M. Pucillo, Nancy Christensen-Mayer, Shelly D. Poole, Denise M. Whitten, Danielle Freeman, Blake R. Bohe, Brandon R. Swensen, A Gordon Smith, Nicholas E. Johnson

Physical Therapy Collection

Background: Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT) consults within a daily outpatient neuromuscular disease (NMD) physician clinic.

Objective: To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center.

Design: A qualitative assessment and survey of patient satisfaction.

Methods: An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was …

Click Here! E-Learning Modules For Innovative Instruction And Learning, Nicole M. Sleddens, Betsy J. Becker, Sara E. Bills

Posters and Presentations: Physical Therapy

Purpose: Re-designing all or portions of a course with a fresh perspective can re-energize faculty and make the content more engaging for the learner. Teaching the millennial generation is also prompting faculty to revisit educational strategies. The use of electronic learning platforms, such as eLearning modules, is an innovative learning strategy with several reported benefits including flexibility and convenience for usage, ability for learners to study at their own pace and adaptability to different learning styles. Using technology that is free or already available to faculty, even the novice designer can begin development of these useful study tools. The key …