Rehabilitation and Therapy Commons^™

A Multiple Degree Of Freedom Lower Extremity Isometric Device To Simultaneously Quantify Hip, Knee, And Ankle Torques, Natalia Sánchez, Ana Maria Acosta, Arno H. A. Stienen, Julius P. A. Dewald

Physical Therapy Faculty Articles and Research

Characterization of the joint torque coupling strategies used in the lower extremity to generate maximal and submaximal levels of torque at either the hip, knee, or ankle is lacking. Currently, there are no available isometric devices that quantify all concurrent joint torques in the hip, knee, and ankle of a single leg during maximum voluntary torque generation. Thus, joint-torque coupling strategies in the hip, knee, and concurrent torques at ankle and/or coupling patterns at the hip and knee driven by the ankle have yet to be quantified. This manuscript describes the design, implementation, and validation of a multiple degree of …

Motoric Cognitive Risk Syndrome: Multicountry Prevalence And Dementia Risk, Joe Verghese, Cedric Annweiler, Emmeline Ayers, Nir Barzilai, Olivier Beauchet, David A Bennett, Stephanie A Bridenbaugh, Aron S Buchman, Michele L Callisaya, Richard Camicioli, Benjamin Capistrant, Somnath Chatterji, Anne-Marie De Cock, Luigi Ferrucci, Nir Giladi, Jack M Guralnik, Jeffrey M Hausdorff, Roee Holtzer, Ki Woong Kim, Paul Kowal, Reto W Kressig, Jae-Young Lim, Susan Lord, Kenichi Meguro, Manuel Montero-Odasso, Susan W. Hunter, Mohan L Noone, Lynn Rochester, Velandai Srikanth, Cuiling Wang

Physical Therapy Publications

OBJECTIVES: Our objective is to report prevalence of motoric cognitive risk syndrome (MCR), a newly described predementia syndrome characterized by slow gait and cognitive complaints, in multiple countries, and its association with dementia risk.

METHODS: Pooled MCR prevalence analysis of individual data from 26,802 adults without dementia and disability aged 60 years and older from 22 cohorts from 17 countries. We also examined risk of incident cognitive impairment (Mini-Mental State Examination decline ≥4 points) and dementia associated with MCR in 4,812 individuals without dementia with baseline Mini-Mental State Examination scores ≥25 from 4 prospective cohort studies using Cox models adjusted …

Identification Of Functional Parameters For The Classification Of Older Female Fallers And Prediction Of ‘First-Time’ Fallers, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Falls remain a challenge for ageing societies. Strong evidence indicates that a previous fall is the strongest single screening indicator for a subsequent fall and the need for assessing fall risk without accounting for fall history is therefore imperative. Testing in three functional domains (using a total 92 measures) were completed in 84 older women (60–85 years of age), including muscular control, standing balance, and mean and variability of gait. Participants were retrospectively classified as fallers (n = 38) or non-fallers (n = 42) and additionally in a prospective manner to identify first-time fallers (FTFs) (n = 6) within a …

Power Development For Golf, Scot D. Morrison, Eric Chaconas

Physical Therapy Collection

Golf is a popular sport attracting participation from all age groups. The strength and conditioning professional will often encounter golfers who are looking to improve their game through rotational power development. By gaining a sound understanding of the development of rotational power in the golfer, the exercise professional will be better able to address this need. The purpose of this article is to discuss power development principles, address golf-specific power development, and give some specific exercise options that can be implemented.

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …

Off-Season Training Habits And Preseason Functional Test Measures Of Division Iii Collegiate Athletes: A Descriptive Report, Jason Brumitt, Bryan C. Heiderscheit, Robert C. Manske, Paul E. Neimuth, Mitchell J. Rauh

Faculty Publications - College of Physical Therapy

Purpose/Background: Division III (D III) collegiate coaches are challenged to assess athletic readiness and condition their athletes during the preseason. However, there are few reports on off-season training habits and normative data of functional assessment tests among D III athletes. The purpose of this study was to examine off-season training habits of D III athletes and their relationships to the standing long jump (SLJ) and single-leg hop (SLH) tests.

Methods: One-hundred and ninety-three athletes (110 females, age 19.1 ± 1.1 y; 83 males, age 19.5 ± 1.3 y) were tested prior to the start of their sports seasons. Athletes reported …

Quantitative Ultrasound: Measurement Considerations For The Assessment Of Muscular Dystrophy And Sarcopenia, Michael O. Harris-Love, Reza Monfaredi, Catheeja Ismail, Marc R. Blackman, Kevin Cleary

Exercise and Nutrition Sciences Faculty Publications

Diagnostic musculoskeletal ultrasound has potential clinical utility in characterizing pathological muscle tissue. Sonography has been long proposed as method of assessing muscle damage due to neuromuscular diseases such as muscular dystrophy, and more recently, changes in body and tissue composition associated with muscle wasting disorders such as sarcopenia. The use of quantitative ultrasound as an adjunct diagnostic procedure has different technical challenges than the traditional use of ultrasound in clinical medicine. Operator-dependent technique and variation are critical considerations when obtaining measures of echointensity (i.e., tissue composition estimates) and tissue dimensions (i.e., muscle thickness) – key elements of the ultrasound assessment …

Reliability Of Two Alternative Methods For The Standard Mid-Thigh Isometric Pull, Duane A. Williams, Courtney D. Hall, Patsy Cantor, Jennifer Williams, N. Brown, Ryan Dulling, Ogechi Egbujor

ETSU Faculty Works

The purpose of this study was to determine the reliability of two new alternative portable methods for measuring maximal isometric force measures while performing the standard mid-thigh pull. One method, the bar grip method, required the use of the trunk and upper extremity muscles, while the second method, the pelvic belt method, did not. Both methods demonstrated good test-retest reliability via randomized repeated measures over 24-36 hours. Interestingly, the pelvic belt method generally demonstrated average maximal forces up to 65% higher than the bar method. There was a good relationship between both methods. These new alternative methods could provide strength …

Transpinal And Transcortical Stimulation Alter Corticospinal Excitability And Increase Spinal Output, Maria Knikou

Publications and Research

The objective of this study was to assess changes in corticospinal excitability and spinal output following noninvasive transpinal and transcortical stimulation in humans. The size of the motor evoked potentials (MEPs), induced by transcranial magnetic stimulation (TMS) and recorded from the right plantar flexor and extensor muscles, was assessed following transcutaneous electric stimulation of the spine (tsESS) over the thoracolumbar region at conditioning-test (C-T) intervals that ranged from negative 50 to positive 50 ms. The size of the transpinal evoked potentials (TEPs), induced by tsESS and recorded from the right and left plantar flexor and extensor muscles, was assessed following …

Mechanisms Of Isometric Exercise-Induced Hypoalgesia In Young And Older Adults, Kathy J. Lemley

Dissertations (1934 -)

Pain reduction following exercise (exercise-induced hypoalgesia; EIH) is well-established in young adults. Specific to isometric exercise, the greatest EIH follows low intensity contractions held for long duration. The EIH response of older adults is not known; and the mechanisms for EIH are unclear at any age. This dissertation aimed to address these unknowns through a series of three studies. In study one, repeatability of pressure pain reports (pain threshold and pain ratings) was assessed in healthy older adults, including the impact of psychological factors. Pain reports, measured before and after quiet rest, did not change following quiet rest. Higher state …

An Interprofessional Falls Assessment Clinic Model To Develop Collaborative Team Skills Among Health Professional Students, Tracey Vause-Earland, Ms, Otr/L, Leigh Ann Hewston, Pt, Med, Cecilia Borden, Edd, Msn, Brooke Salzman, Md, Emily Hajjar, Pharmd, Ellen Furman, Msw, Christine Hsieh, Md, Susan Parks, Md

Department of Occupational Therapy Posters and Presentations

BACKGROUND

• Older adults are at increased risk for falls and fall related injuries, leading to loss of independence, disability, and increased mortality.
• Preventing injury and falls is a national Healthy People 2010 objective. However, physicians and other health professionals frequently fail to incorporate known evidence into usual care. Screening for falls is not consistently performed as an essential assessment in older adults by primary care providers.
• Multidisciplinary assessment can be an important component in preventing falls in community dwelling adults.
• In new practice models, such as the Chronic Care Model, there is an emphasis on interdisciplinary collaboration, however health professions …

The Effect Of Tdcs On Cd-1 Mouse Behavior Post Induced Sensorimotor Cortex Injury, Michelle Gardella, Natalia Gozias, Kristina Laktionova, Tricia Roehrig

Dissertations, Theses, and Capstone Projects

The functional topography of the motor cortex has been shown to be modifiable by transcranial direct current stimulation (tDCS). tDCS works by directing electrical currents into the brain which induces alterations in neuroplastic cortical excitability. This experiment’s aim was to test the effect of tDCS on recovery of skilled locomotion, recovery of balance, and recovery of grip strength after bilateral electrolytic lesions to sensorimotor cortices in mice. Tests employed in this experiment included the ladder test, grip test, and a balance pole test. We were able to show that 4 days of tDCS post brain injury in mice produced improvements …

Motor Imagery And Action Observation As An Alternative Gait Training Intervention For The Elderly, Matthew F. Cirelli, Brian Fettner, Lindita Ismaili, Danielle Jordan

Dissertations, Theses, and Capstone Projects

Motor imagery (MI) is the mental representation of movement without any body movement. Action observation (AO) is a non-physical method of training, in which the learner observes the action of another individual. Eighteen subjects between ages 60-80 were randomly assigned to 3 training groups, the MI, AO and motor training groups. All subjects were assessed and measured with the Expanded Timed-Get Up and Go (TUG) test and Figure-8-Walk (F8W) test. All three groups yielded a significant improvement in difference in total TUG time (<0.05). When individual aspects of the TUG were considered, the sit to stand component improved in the MI and Motor groups. The results of this study suggest that MI and AO can improve cadence and have an effect mirroring that of motor practice. If utilized properly, MI and AO may be indicated as a rehabilitation intervention adjunct to gait training, and potentially decrease the risk of falls in the elderly population.

Corticospinal Integration In Healthy Humans, Amanda Asmar, Leandra Manfredini, Kerri Mclean, Christina Scannapieco

Dissertations, Theses, and Capstone Projects

Synchronized arrival of neuronal signals from the periphery and motor cortex has been associated with neuronal plasticity and motor learning. The main objective of this study was to examine neuronal interactions following excitation of descending motor axons from the primary motor cortex (M1) and spinal neuronal circuits via transcranial magnetic stimulation (TMS) and transcutaneous electric stimulation of the spine (tsESS) in 15 healthy humans while seated semiprone. TMS was delivered below or above the resting motor evoked potential (MEP) threshold, for the tibialis anterior (TA) muscle, while tsESS was delivered at the lowest stimulation intensity that evoked responses in most …

The Long-Term Effects Of Low Level Laser Therapy (Lllt) Combined With Complex Decongestive Therapy (Cdt) In The Treatment Of Breast Cancer Lymphedema: A Double-Blind, Randomized, Placebo-Controlled Study, Olivia Bramlett, Igor Daysudov, Toshi Odaira, Bethany Rodriguez

Dissertations, Theses, and Capstone Projects

Complex Decongestive Therapy (CDT), the gold standard for lymphedema treatment, fails to demonstrate long-term efficacy. The purpose of this study was to determine the long-term efficacy of low level laser therapy (LLLT) in reducing post-mastectomy lymphedema when used with CDT. The experimental group received LLLT and CDT (n = 7) while control group received sham laser and CDT (n = 7), twice a week for 4 to 8 weeks. Percent arm circumference difference between affected and unaffected limbs was collected over 18 months. Results revealed no statistical difference between both groups at all time periods: 1 (p = 0.902), 2 …

Cortical Modulation Of Spinal Reflexes In Healthy Humans, Caitlin Bedell, Joseph Capogrosso, Kristin Thomas, Charlotte Westmoreland

Dissertations, Theses, and Capstone Projects

Considerable evidence suggests that monosynaptic and polysynaptic spinal reflexes are prone to corticospinal inputs. The goal of this study was to establish the cortical modulation of monosynaptic and polysynaptic spinal reflexes in healthy humans. Cutaneomuscular responses were evoked following stimulation of the medial edge of the right foot with a 30 ms pulse train every 10 s via a bipolar electrode and recorded from the ipsilateral tibialis anterior (TA) muscle. Across subjects, medial edge foot stimulation was delivered at 1.2 to 1.5 times the response threshold. The soleus H-reflex was evoked and recorded via conventional methods. The effects of transcranial …

Influences Of Motor Control Instruction And Taping On Center Of Pressure And Scapulothoracic Kinematics During Reaching For Individuals With Hemiparesis, Michelle De Guzman, Tatyana Farber, Anna Kochanova, Jonathan Lazarus

Dissertations, Theses, and Capstone Projects

Purpose: To determine if application of Kinesiotape™ was able to normalize the overall reaching motion by analyzing both surface electromyographic data and force platform feedback. Design: This study utilizes a case-control design.

Subjects: 5 control and 5 stroke survivors age >40 were recruited for this study through flyers at Burke Rehabilitation Hospital, White Plains, NY.

Methods: Surface EMG electrodes were applied to upper extremity (UE) and lower extremity (LE) muscles and an accelerometer placed on the reaching UE. Subjects stood on a force platform and reached towards a target at shoulder height. The task was repeated 5-7 times with right …

Comparing Nmes Stimulation Intensity At Various Lengths Of The Tibialis Anterior, Brent Brookbush, Maya Hakami, Jennifer Wolff, Amy Zelin

Dissertations, Theses, and Capstone Projects

The purpose of this study was to determine if placement of electrodes at various distances along the Tibialis Anterior muscle belly had a significant effect on the intensity of stimulation needed to evoke a contraction using neuromuscular electrical stimulation (NMES). Twenty subjects between the ages of 21-65 in good health and presented with no precautions to NMES were recruited from the CUNY Hunter College physical therapy department. Two reference lines were drawn on subjects’ legs, one outlining the tibial crest (L1), and another from the most lateral portion of the tibial plateau to the center of the lateral malleolus (L2). …

Falls Prevention Training At New York Presbyterian Hospital: Does Education Regarding Fall Prevention Reduce Incidence Of Falls After Discharge To Home From An Acute Rehabilitation Facility?, Yuning Chiu, Michelle Frager, Hyunseok Lee, Solange Wong

Dissertations, Theses, and Capstone Projects

The objective of this study was to determine the compared effectiveness of different instruction types for fall prevention training in an inpatient rehabilitation setting based on 6-month falls incidence. This study included 89 English-speaking patients aged 18-90 who participated in a fall prevention training program at New York Presbyterian Hospital’s inpatient rehabilitation center. Patients were divided into two class types, a group or an individual class. Both classes were subdivided into with and without a caregiver. A 10-Meter Walk Test, the Montreal Cognitive Assessment (MoCA), and admission and discharge Functional Independence Measure (FIM™) scores were recorded for baseline comparisons among …

The Performance Of Dancers On The Lower Quadrant Y Balance Test, Heather Cole, Jinny Mcgivern, Anna Morejon, Tiffany Sudol

Dissertations, Theses, and Capstone Projects

The Lower Quadrant Y-Balance Test (YBT-LQ) is an evidence-based screening tool that measures one’s ability to maintain unilateral stance while reaching the contralateral leg in the anterior (ANT), posteromedial (PM), and posterolateral (PL) directions. The purpose of this study was to observe the performance of collegiate dancers on the YBT-LQ and compare it with that of other athletic populations from previously published studies. 39 healthy collegiate dance majors at the Purchase College Conservatory of Dance (ages 17-24 years; mean years of dance training 12.9 ± 3.9 years) participated in this study. Subjects stood on the central platform of the YBT-LQ …

Research Components In Curriculum Of Doctor Of Physical Therapy Programs, Stephen Ingrassia, Gary Mulligan, Roman Tverdovskiy, Andy Zhu

Dissertations, Theses, and Capstone Projects

PURPOSE: The purpose of the study is to determine the current Doctor of Physical Therapy program curriculum, as it applies to research classes and research projects. We investigated the current research requirements of various DPT programs nationwide to determine DPT graduates’ preparedness to conduct research post-graduation.

METHODS: Participants of the current study were recent DPT college graduates selected from DPT programs across the United States. Subjects were asked to participate in a brief online survey questionnaire in reference to their DPT program research curriculum.

RESULTS: A total of 215 DPT programs contacted, out of which 39 schools were able to …

The Effects Of Morning Versus Evening Stretching Exercises In Hamstrings Flexibility Gains, Camron Einerman, Emily Eleff, Ana Ilijeska, Aliza Zinberg

Dissertations, Theses, and Capstone Projects

Many human physiological functions, including muscle flexibility, exhibit a pattern over a 24-hour period, known as circadian rhythm. Muscle flexibility and its circadian rhythm have been researched, though much more information is needed, especially regarding the hamstring muscle group. The object of this study was to determine if stretching at different times of the day results in differences in hamstring flexibility. Since muscles and joints are most flexible at night, greater ranges of motion should be available, allowing for a greater degree of stretching to take place. We hypothesize that when utilizing the optimal type, duration, and frequency of stretch, …

Comparison Of An Intermittent Vs. Continuous Walking Program In Persons With Multiple Sclerosis Using The 6 Minute Walk Test: A Randomized Crossover Pilot Study, Stefanie Dicarrado, Bridget Dungan, Elizabeth Huallpa, Jacob Potrzeba

Dissertations, Theses, and Capstone Projects

Background: Difficulty with gait is one of the most common complaints of persons with MS (pwMS) and can be due to many causes, including neurogenic fatigue. Neurogenic fatigue is one of the most common MS symptoms, and can prevent pwMS from walking longer distances, thus limiting their ability to improve gait endurance. Intermittent walking, a technique where persons take breaks during walking rather than walking continuously, may allow for pwMS to walk longer distances due to less accrual of fatigue.

Objectives: The purpose of this pilot study was to examine whether a program of intermittent walking will result in a …

Pilot Study To Assess Benefit Of Virtual Reality Game System, Wii, On Balance And Gait In Persons With Parkinson's Disease, Peter J. Barbour Md, Amy L. Kerstetter Pt, Allyn Danni Pt, Ncs, Atp, Mscs, Jolene Hammer Pt, Michael J. Weiss Mph, Sandra M. Tremblay Pt, Ms, Cws, Mscs

Department of Medicine

No abstract provided.

Low-Cost Strider For Guatemala, Nicole Catherine Cooper, Gonzalo Hernandez, Jared W. Tower

Mechanical Engineering

The purpose of this project was to create a strider, a type of standing rehabilitation device, for children in developing countries who have trouble walking and supporting their full body weight. The project was initially brought to us by Cal Poly professor Brian Self, who had visited a clinic in San Marcos and determined that there were children there who had difficulties with walking and were a need for a rehabilitation device. The team discussed the problem with Dr. Self, Matt Robinson (a local San Luis Obispo prosthetist), and Cal Poly physics professor Pete Schwartz, all of whom had visited …

Effect Of Monophasic Pulsed Current On The Treatment Of Plantar Fasciitis, Abdullah Alotaibi

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Plantar fasciitis (PF) is one of the most common soft tissue disorders that causes inferior heel and rear foot pain. Monophasic pulsed current (MPC) is a method of electrical stimulation (ES) clinically used to promote and accelerate wound healing processes. The aim of this prospective clinical trial was to investigate the effect of MPC and MPC coupled with plantar fascia specific stretching exercises (SE) in the treatment of PF. Methods: Forty four participants (twenty- two subjects were women; 22 were men with a mean age of 49 ± 10.6 years) diagnosed with PF were randomly allocated to receive MPC …

Screening For Torticollis And Plagiocephaly: The Role Of The Pediatrician, Lisa Ann Change-Yee Hwang

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine the effects of providing a standardized screening examination to a group of attending and resident physicians on the rate of torticollis and plagiocephaly diagnoses, the age at time of diagnosis, and the attitudes and practice patterns of the physicians. All subjects were given a standardized screening procedure by verbal instruction and handout, and also completed a pre-­‐ and post-­‐intervention questionnaire, which assessed the 􀂕􀂗􀂄􀂌􀂇􀂅􀂖􀂕􀇯􀀃 practice regarding the diagnosis and management of torticollis and plagiocephaly. A retrospective chart review was conducted to ascertain the changes in frequency and mean age of patients diagnosed …

Changes In Glutamate Receptor Subunits Within The Medulla In Goats After Section Of The Carotid Sinus Nerves, Justin Robert Miller, Suzanne Neumueller, Clarissa Muere, Samantha Olesiak, Lawrence Pan, John D. Bukowy, Asem O. Daghistany, Matthew Hodges, Hubert Forster

Physical Therapy Faculty Research and Publications

The mechanisms which contribute to the time-dependent recovery of resting ventilation and the ventilatory CO₂ chemoreflex after carotid body denervation (CBD) are poorly understood. Herein we tested the hypothesis that there are time-dependent changes in the expression of specific AMPA, NMDA, and/or neurokinin-1 (NK1R) receptors within respiratory-related brain stem nuclei acutely or chronically after CBD in adult goats. Brain stem tissues were collected acutely (5 days) or chronically (30 days) after sham or bilateral CBD, immunostained with antibodies targeting AMPA (GluA1 or GluA2), NMDA (GluN1), or NK-1 receptors, and optical density (OD) compared. Physiological measurement confirmed categorization of each …

Fall Risk Prediction Using Wearable Wireless Sensors, Thurmon Lockhart, Chris Frame, Rahul Soangra, John Lach

Physical Therapy Faculty Articles and Research

Wearable wireless sensors and nonlinear dynamics identify postural characteristics relevant to balance control and dynamic stability, revealing predictive risk of falls among older adults.

Integrating Guided Motor Imagery And Cross Education Into Rehabilitation: Scientific Review And Clinical Application, Emily Bouchard

Mahurin Honors College Capstone Experience/Thesis Projects

BACKGROUND: Guided motor imagery and cross education are two concepts that build upon motor programs. Guided motor imagery consists of imagining a specific action, thereby activating the respective motor program without an actual movement. Cross education incorporates contralateral training to activate the motor program of an action to the resting limb. These techniques yield neurological actions that can lead to improved performance outcomes when integrated into physical therapy programs. PURPOSE: This literature review investigated guided motor imagery and cross education within the scientific literature, identified and summarized evident themes and provided suggestions for incorporating these methods into rehabilitation programs. METHODS: …