Rehabilitation and Therapy Commons^™

Walking Pattern In Children With And Without Down Syndrome Via A Force-Driven Harmonic Oscillator Model, Jianhua Wu, Matthew Beerse, Toyin Ajisafe, Huaqing Liang

Physical Therapy Faculty Research

Children with Down syndrome (DS) display poorer kinematic and kinetic patterns of walking than typically developing ( TD) children. However, little is known on neuromuscular control in children with DS during locomotion. A force driven harmonic oscillator (FDHO) model sheds light on general muscular activation with respect to the gravitational load of the thigh-shank-foot system. The K/G ratio derived from this model represents a scaling between the elastic restoring torque from muscles and soft tissues and the gravitational torque from the weight of the leg during walking. The K/G ratio has shown different muscular function in infant walkers and children …

Reliability Of The Berg Balance Scale As A Clinical Measure Of Balance In Community-Dwelling Older Adults With Mild To Moderate Alzheimer Disease: A Pilot Study, Susan W Muir-Hunter, Laura J. Graham, Manuel Montero Odasso

Physical Therapy Publications

Purpose : To measure test-retest and interrater reliability of the Berg Balance Scale (BBS) in community-dwelling adults with mild to moderate Alzheimer disease (AD).

Method : A sample of 15 adults (mean age 80.20 [SD 5.03] years) with AD performed three balance tests: the BBS, timed up-and-go test (TUG), and Functional Reach Test (FRT). Both relative reliability, using the intra-class correlation coefficient (ICC), and absolute reliability, using standard error of measurement (SEM) and minimal detectable change (MDC95) values, were calculated; Bland-Altman plots were constructed to evaluate inter-tester agreement. The test-retest interval was 1 week.

Results : For the BBS, relative …

Stability Of Isometric Strength Asymmetry And Its Relationship To Sprint And Change-Of-Direction Performance Asymmetry In Division-I Collegiate Athletes, Benjamin H. Gleason

Electronic Theses and Dissertations

The purpose of this dissertation was to evaluate the stability of strength asymmetry over a long-term period (1 year) and investigate the relationship of strength asymmetry to field test performance asymmetry in NCAA division-1 athletes. Isometric mid-thigh pull (IMTP) peak force asymmetry, ground contact time and finish time asymmetries on 10m sprint and 505 agility test performances were also observed. The impact of strength was also investigated in these studies to determine its effect on the magnitude of asymmetry.

In the second study, peak force asymmetry over a one-year period was observed to be a rather volatile quality, with ranges …

Grant Application: Effect Of The Prevent Injury Enhance Performance Program On Biomechanical Risk Factors And Performance Variables In Male Collegiate Lacrosse Athletes, Sebastian Stoltzfus, Casey Cottle, Chad Lyons

PEP Program Investigation With Men's Lacrosse Team

IPEC Mini-grant application for funding of UNE student project Effect of The Prevent Injury Enhance Performance Program on Biomechanical Risk Factors and Performance Variables in Male Collegiate Lacrosse Athletes. Two physical therapy students, one applied exercise science student, and the manager of the UNE Motion Analysis Laboratory collaborated to investigate the effectiveness of the Prevent Injury Enhance Performance (PEP) program on reducing undesirable biomechanics and enhancing performance during athletic maneuvers in male lacrosse athletes.

Effects Of Pelvis Impact Angle And Hip Muscle Forces On Hip Fracture Risk During A Fall Using An Advanced Hip Impact Simulator, Woochol J. Choi, Stephen N. Robinovitch

Physical Therapy Faculty Articles and Research

"Over 90% of hip fractures in older adults are caused by falls [1]. Whether a given fall will cause hip fracture depends on bone strength, and on the impact force and stress applied to the bone during impact [2]. Improved understanding is required on how peak bone stresses during a fall depend on the mechanics of a fall, and on the state of contraction at the moment of impact of the muscles spanning the hip. Recently, Choi et al showed that, for lateral impact to the hip, peak stresses decrease with increases in hip abductor muscle force [3]. In the …

Influence Of Pelvis Impact Angle During A Fall: On The Protective Benefit Of Hip Protectors, Woochol J. Choi, Stephen N. Robinovitch

Physical Therapy Faculty Articles and Research

"Over 90% of hip fractures are due to falls [1]. Laboratory measures have shown that wearable hip protectors reduce impact forces to the proximal femur during a simulated sideways fall on the hip [2, 3]. However, clinical evidence suggests that hip fractures still occur when hip protectors are worn [4]. Furthermore, while falls in real life result in a variety of impact configurations, biomechanical tests to date have focused only on lateral impact to the pelvis. In the current study, we examined how the force reduction provided by wearable hip protectors is affected by pelvis impact configuration during simulated sideways …

Sex Differences In Arm Muscle Fatigability With Cognitive Demand In Older Adults, Hugo M. Pereira, Vincent C. Spears, Bonnie Schlinder-Delap, Tejin Yoon, April L. Harkins, Kristy A. Nielson, Marie K. Hoeger Bement, Sandra K. Hunter

Physical Therapy Faculty Research and Publications

Background

Muscle fatigability can increase when a stressful, cognitively demanding task is imposed during a low-force fatiguing contraction with the arm muscles, especially in women. Whether this occurs among older adults (> 60 years) is currently unknown.

Questions/purposes

We aimed to determine if higher cognitive demands, stratified by sex, increased fatigability in older adults (> 60 years). Secondarily, we assessed if varying cognitive demand resulted in decreased steadiness and was explained by anxiety or cortisol levels.

Methods

Seventeen older women (70 ± 6 years) and 13 older men (71 ± 5 years) performed a sustained, isometric, fatiguing contraction at 20% …

Combined Unilateral Blockade Of Cholinergic, Peptidergic, And Serotonergic Receptors In The Ventral Respiratory Column Does Not Affect Breathing In Awake Or Sleeping Goats, Clarissa Muere, Suzanne Neumueller, Samantha Olesiak, Justin Robert Miller, Thomas Langer, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Previous work in intact awake and sleeping goats has found that unilateral blockade of excitatory inputs in the ventral respiratory column (VRC) elicits changes in the concentrations of multiple neurochemicals, including serotonin (5-HT), substance P, glycine, and GABA, while increasing or having no effect on breathing. These findings are consistent with the concept of interdependence between neuromodulators, whereby attenuation of one modulator elicits compensatory changes in other modulators to maintain breathing. Because there is a large degree of redundancy and multiplicity of excitatory inputs to the VRC, we herein tested the hypothesis that combined unilateral blockade of muscarinic acetylcholine (mACh), …

Improving Outcomes By Implementing A Pressure Ulcer Prevention Program (Pupp): Going Beyond The Basics, Amparo Cano, Debbie Anglade, Hope Stamp, Fortunata Joaquin, Jennifer A. Lopez, Lori Lupe, Steven P. Schmidt, Daniel L. Young

Physical Therapy Faculty Research

A multidisciplinary process improvement program was initiated at the University of Miami Hospital (UMH) in 2009 to identify the prevalence of hospital-acquired pressure ulcers (HAPU) at the institution and to implement interventions to reduce the incidence of HAPU. This deliberate and thoughtful committee-driven process evaluated care, monitored results, and designed evidence-based strategic initiatives to manage and reduce the rate of HAPU. As a result all inpatient beds were replaced with support surfaces, updated care delivery protocols were created, and monitored, turning schedules were addressed, and a wound, ostomy, and continence (WOC) nurse and support staff were hired. These initial interventions …

The Effect Of Antagonist Muscle Sensory Input On Force Regulation, Tanya Onushko, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The purpose of this study was to understand how stretch-related sensory feedback from an antagonist muscle affects agonist muscle output at different contraction levels in healthy adults. Ten young (25.3 ± 2.4 years), healthy subjects performed constant isometric knee flexion contractions (agonist) at 6 torque levels: 5%, 10%, 15%, 20%, 30%, and 40% of their maximal voluntary contraction. For half of the trials, subjects received patellar tendon taps (antagonist sensory feedback) during the contraction. We compared error in targeted knee flexion torque and hamstring muscle activity, with and without patellar tendon tapping, across the 6 torque levels. At lower torque …

A Randomized Controlled Trial Of Exercise In Spinal And Bulbar Muscular Atrophy., Joseph A Shrader, Ilona Kats, Angela Kokkinis, Cris Zampieri, Ellen Levy, Galen O Joe, Joshua G. Woolstenhulme, Bart E Drinkard, Michaele R Smith, Willie Ching, Laboni Ghosh, Derrick Fox, Sungyoung Auh, Alice B Schindler, Kenneth H Fischbeck, Christopher Grunseich

Physical Therapy and Health Care Sciences Faculty Publications

OBJECTIVE: To determine the safety and efficacy of a home-based functional exercise program in spinal and bulbar muscular atrophy (SBMA).

METHODS: Subjects were randomly assigned to participate in 12 weeks of either functional exercises (intervention) or a stretching program (control) at the National Institutes of Health in Bethesda, MD. A total of 54 subjects enrolled, and 50 completed the study with 24 in the functional exercise group and 26 in the stretching control group. The primary outcome measure was the Adult Myopathy Assessment Tool (AMAT) total score, and secondary measures included total activity by accelerometry, muscle strength, balance, timed up …

Commentary: Considering Educational Perspectives And Their Relevance To Allied Health Professional Education: Using Physical Therapy As An Example, Jennifer Audette, Susan Roush

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this article is to introduce readers to three educational perspectives: progressive, critical, and professional, and explain their relevance to allied health professional education. Faculty in allied health professional education are often solely educated as clinicians and not as teachers, entering academia with limited background in educational theory. Professional organizations and accrediting bodies, however, are highlighting the need for evidence and theory-based pedagogy and practice in educational settings. Method: An overview of three educational perspectives is provided, as is a discussion of their relevance to allied health professional education, using physical therapist education as an example. Conclusion: …

The Use Of Parkinson’S Disease Specific Rehabilitative Interventions To Treat A Patient With Lewy Body Dementia: A Case Report, Cassandra Dawley

Case Report Papers

Background and Purpose: (Lewy Body Dementia) LBD is commonly known as a differential diagnosis of Parkinson’s Disease (PD) as they both have a similar epidemiology and present with similar symptoms. Due to the paucity of research on physical therapy (PT) interventions for LBD, it may be suitable to use PD specific interventions as a treatment. The proposal to use Parkinson specific interventions, primarily Lee Silverman Voice Treatment-Big (LSVT BIG), may be considered. The purpose of this case study was to provide information about what LBD is, how it presents, and how PD specific interventions were used as a treatment. Case …

Effect Of Tactile Feedback On Reducing Body Sway In Elderly, Faris Shuleih Alshammari

Loma Linda University Electronic Theses, Dissertations & Projects

Context: Body sway increases in the elderly due to normal aging and a high incidence of disease such as diabetes. Increased body sway is associated with an elevated risk of falling. Falling is one of the major causes of morbidity and mortality in the elderly. Objectives: The purpose of this study was to examine the effect of 6 minutes training of tactile feedback (novel intervention) compared to visual feedback on body sway in the elderly with or without diabetes to develop a new technique for balance training. Design: A single blinded randomized controlled trial. Setting: Loma Linda University, Loma Linda, …

The Effect Of Cervical Muscle Fatigue On Postural Stability During Immersion Virtual Reality, Mazen M. Alqahtani

Loma Linda University Electronic Theses, Dissertations & Projects

The visual system is part of the nervous system that enables an individual to scan their environment and assess distance to and from objects. The information captured form our navigating environment is communicated to the brain, which in turn makes the decision on how we respond to spatial orientation. This is particularly useful in helping with balance and determining direction of movement. Our posture and visual stability rely heavily on an efficient and processing of visual, vestibular, and proprioception afferent input. Erroneous sensory information from defective sensory organs may cause a person to experience feelings of lightheadedness, spinning and whirling …

Does Insertion Of Intramuscular Electromyographic Electrodes Alter Motor Behavior During Locomotion?, Jo Armour Smith, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Intramuscular electromyography (EMG) is commonly used to quantify activity in the trunk musculature. However, it is unclear if the discomfort or fear of pain associated with insertion of intramuscular EMG electrodes results in altered motor behavior. This study examined whether intramuscular EMG affects locomotor speed and trunk motion, and examined the anticipated and actual pain associated with electrode insertion in healthy individuals and individuals with a history of low back pain (LBP). Before and after insertion of intramuscular electrodes into the lumbar and thoracic paraspinals, participants performed multiple repetitions of a walking turn at self-selected and controlled average speed. Low …

Age And Sex Differences In Steadiness Of Elbow Flexor Muscles With Imposed Cognitive Demand, Hugo M. Pereira, Vincent C. Spears, Bonnie Schlinder-Delap, Tejin Yoon, Kristy A. Nielson, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Purpose: These studies determined (1) age and sex-related differences in steadiness of isometric contractions when high cognitive demand was imposed across a range of forces with the elbow flexor muscles (study 1) and, (2) sex differences in steadiness among older adults when low cognitive demand was imposed (study 2).

Methods: 36 young adults (18–25 years; 18 women) and 30 older adults (60–82 years; 17 women) performed isometric contractions at 5%, 30% and 40% of maximum voluntary contraction (MVC). Study 1 involved a high-cognitive demand session (serial subtractions by 13 during the contraction) and a control session …

Investigating The Effects Of Combining Treadmill Training With Trans-Spinal Direct Current Stimulation On Motor Skill Recovery After Spinal Cord Injury, Jennifer Blake, Rebecca Bullen, Jeremy Pahl, Samantha Scicchigno

Dissertations, Theses, and Capstone Projects

This study assessed the effect of treadmill training with or without trans-spinal direct current stimulation on motor recovery following a T13/L1 spinal cord hemi section in CD-1 mice. Mice all received the same spinal cord injury, which resulted in left hind limb paralysis, and were assigned to one of three groups. Control animals received no treatment. Treadmill only mice were treated with 5 sessions of treadmill training. Treadmill + stimulation animals were treated with concurrent treadmill training and trans-spinal direct current stimulation. Progress was assessed by analyzing each subject’s steps on a horizontal ladder test, which the animals performed both …

Implications Of Muscle Activation Patterns On Balance In The Elderly, Arielle Bailey, Goldie Baum, Hadassa Radzik, Aruna Woods

Dissertations, Theses, and Capstone Projects

More than one third of adults ages 65 years old and older fall each year in the United States. This can result in trauma, hospital admissions, and potential death. The purpose of this study was to investigate the effects of waist-pull perturbation training on balance in the elderly. There were two experimental groups, elderly non-fallers (n=9) and elderly fallers (n=5) between ages 65-86, and a control group comprised of young, healthy subjects (n=10) ages 21-31. All subjects underwent baseline and post-training measurements using EMG recordings of the tibialis anterior, gastrocnemius, vastus lateralis and semimembranosus. Training was performing using repeated waist-pull …

Use Of The Bioness L300® Functional Electrical Stimulator In Acute Stroke Rehabilitation, Christine Flanigan, Colleen M. Martinez, Beth N. Terranova, Nicholas Wildi

Dissertations, Theses, and Capstone Projects

Purpose. Over 150,000 people in the U.S. every year experience foot drop following a stroke, slowing their ambulation and increasing their falls risk. We explore whether the use of functional electrical stimulation (FES) to the common fibular nerve during acute rehabilitation can maximize ambulation gains. Methods. Five in-patients admitted at Burke Rehabilitation Hospital experiencing foot drop participated. While receiving conventional physical therapy, four subjects wore the Bioness L300® device, and one subject used an elastic figure-8 wrapped elastic bandage. Gait parameters were evaluated at initial evaluation, an intermittent evaluation, and discharge. Results. During their stay, subjects significantly improved in gait …

The Influence Of Forward Head Posture On Suprahyoid Activity During Oropharyngeal Swallowing: A Surface Electromyographic Analysis, Brianne Carroll, Sierra Hunt, Katherine Sheeleigh, Mark Wnukowski

Dissertations, Theses, and Capstone Projects

STUDY DESIGN: Within subjects repeated measures design.

OBJECTIVE: The aim of this research is to explore the effect that Forward Head Posture has on the mylohyoid muscle during swallowing in a healthy population.

BACKGROUND: Forward Head Posture (FHP) is the most common deviation from ideal head posture, and has become more prominent due to the rise of smart phones and the prevalence of computers in the household and workplace. FHP is associated with a variety of detrimental effects on the musculoskeletal system that arise from the abnormal positioning of the cranial and cervical bones and joints. In particular, the muscles …

An Electromyographic Comparison Of The Functional Performance Of The Gluteus Maximus Muscle In Prolonged Sitting Versus Standing Populations, Kerry Campagnola, Giusi Gerbino, Erica Johnson, Adrienne O’Keefe

Dissertations, Theses, and Capstone Projects

PURPOSE: A common clinical concern of Physical Therapists is the inexplicably weak gluteus maximus (GM) muscle; we hypothesized that this may be linked to the popular habit of prolonged sitting. The purpose of this study was to determine if surface electromyography (sEMG) output and timing of the GM and hamstrings muscles differed between people who sit for prolonged periods of time and people who stand for prolonged periods of time. METHODS: The design of our study was a single session case-control study. Subjects were 22 healthy adults (23-36 years old) who either sat or stood for 8-10 hours a day …

Dancer Performance On The Lower Quarter Y Balance Test: A Longitudinal Study, Megan Dehey, Kelly Kaems, Molly Saunders, Gabrielle Schneider

Dissertations, Theses, and Capstone Projects

Purpose: There is a need in the current literature for further information regarding dancer performance on the Y Balance Test (YBT). This study tracked the test scores of a group of dancers to assess change over time and relationship of balance scores to injury risk. It is hoped that clinicians may be able to use the information found in this study to more accurately screen dancers for asymmetries, deficits, and changes over time using the YBT. Such screenings would allow for more effective care and better assessment of readiness to return to dance. Method: A group of 12 dancers between …

The Effects Of Cooling During Gait On Gait Endurance In Persons With Multiple Sclerosis Using The Six Minute Walk Test, Meghan Higgins, Esther Sosowsky, Elisheva Zinberg

Dissertations, Theses, and Capstone Projects

Background: Persons with MS (pwMS) are limited in their mobility due to thermosensitivity. Exercising at a sufficient volume and intensity to increase mobility can result in increased core temperatures and resultant worsening of symptoms. The use of cooling garments to lower core temperature has been found to be a successful means of allowing pwMS to exercise for longer periods. Previous studies have relied on precooling for an extended period of time prior to activity, to achieve improved exercise performance. Cooling during the performance itself, or pericooling, may allow for similar performance gains to be realized without spending the time needed …

Interactions Between Descending And Somatosensory Inputs In Humans, Lisa Krivis, Ann Mackey, Maureen Mcdonough, Denise Uttaro

Dissertations, Theses, and Capstone Projects

In this study, we assessed the corticospinal integration in healthy people while seated. Corticospinal integration was assessed by establishing the latency and amplitude of motor evoked potentials (MEPs) evoked following transcranial magnetic stimulation (TMS) of the primary motor cortex area representing the leg muscles, and the latency and amplitude of spinally-mediated reflex responses. Further, the modulation pattern of the spinally-mediated reflex responses were determined following subthreshold and suprathreshold TMS. All compound muscle action potentials, descending motor or spinally-mediated reflexes were recorded from the leg muscles through surface electromyography. Both subthreshold and suprathreshold TMS induced a similar modulation pattern on the …

Effect Of Absent Tactile Sensation On Multi-Digit Coordination Underlying Hand Control, Michael P. Alcorn, Bruce Faulkner, Matthew Macina, Brian Sherman

Dissertations, Theses, and Capstone Projects

We investigated the effect of anesthesia, causing absent tactile sensation feedback, on multi-digit coordination underlying hand control. The purpose of the study is to expand our understanding on the essential role of tactile sensation feedback in the sensorimotor integration process by examining the motor coordination patterns during multi-digit forces production tasks. We hypothesized that absent tactile sensation feedback would interrupt the force sharing pattern at local and non-local digits. Twelve participants were utilized for data collection and statistical analysis (25.6 ± 4.1 years old, 6 males and 6 females), right-handed (according to their preferred hand use for writing and eating) …

Assessment Of Physical Performance In Adolescents Of Varying Body Weight, Nicholas Dalonzo, Nicole Liquori, Nicole Savarese

Dissertations, Theses, and Capstone Projects

Fifty-one healthy adolescents of both gender without any neuromuscular, musculoskeletal or cardiopulmonary disorders and between the ages of 12 and 17 with a mean age of 14.09 years (SD: 1.45 years) were recruited to participate in the 6-minute walk test. Several measurements such as height, weight and leg length were taken before testing, along with heart rate, blood pressure and oxygen saturation (SPO2) before, after and 10 minutes post 6-minute walk test. Walk distance was also quantified and used as an outcome measure. The adolescents were divided into two groups prior to statistical testing. The first group was classified as …

The Effects Of Maximal Strength Training On Gait And Balance In Persons With Multiple Sclerosis: A Pretest Posttest Pilot Study, Janet Klein, David Park, Charles Wright, Michael Zervas

Dissertations, Theses, and Capstone Projects

Background: Physical Therapy strength training programs utilizing mild to moderate intensity are commonly prescribed to address many of the deficits found in multiple sclerosis, but studies examining the effectiveness of higher intensity strength training in gait and balance have not been performed. Maximal strength training (MST), which involves lifting nearly maximal weights (85-95% of an individual’s one repetition maximum [1RM]) with low repetitions, has been shown to improve functional abilities in both healthy and non-MS impaired populations. The higher intensity training used in MST may result in greater activation of the CNS, providing a greater stimulus to improvement than …

Retrospective Chart Review Of Patients Following Unilateral Total Knee Replacement To Assess Achievement Of Functional Milestones Based On Type Of Anesthetic Used Intra-Operatively, William S. Benish, Lolline Chong, Elana Kram, Danielle Krieger

Dissertations, Theses, and Capstone Projects

PURPOSE: Given the large number of Total Knee Replacements (TKR) performed annually in the US and the prediction that those numbers will increase, providing optimal analgesia during TKR is an important strategy for reducing cost and improving patient outcomes. Currently, no standard analgesia protocol for TKR exists and facilities in the US and world-wide use varied methods of analgesia. The purpose of the present study is to determine which analgesic technique; femoral nerve block (FNB), saphenous nerve block (SNB) or periarticular injection (PAI), within the context of a multi-modal pain management regimen, results in optimal TKR patient outcomes and achievement …

Evaluating Physical Therapy For Adolescent Patients With Low Back Pain, Kelly Denise Gonzales

Doctor of Nursing Practice Final Manuscripts

Background: Low back pain is a condition affecting many people worldwide. The age of onset is variable, affecting all patient populations from childhood throughout the lifespan. Aims/Purpose: The efficacy of physical therapy for adolescent patients with back pain seen in a pediatric orthopedic clinic was evaluated through comparison of pre and post-intervention pain scores. Patient compliance with physical therapy was monitored and evaluated against outcomes.

Design: A six-month retrospective chart review of adolescent patients with a diagnosis of low back pain. Patients with a diagnosis of low back pain were referred for physical therapy and provided with a home exercise …