Rehabilitation and Therapy Commons^™

Physical Therapy 2013, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Crawling Kinematics In An Early Knee Protocol For Pediatric Prosthetic Prescription, Mark Geil

Faculty Articles

No abstract provided.

Overweight, Obesity, And Neighborhood Characteristics Among Postpartum Latinas, Colleen Keller, Michael Todd, Barbara Ainsworth, Kathryn Records, Sonia Vega-Lopez, Paska Permana, Dean Coonrod, Allison Williams

Nursing Faculty Works

Background. Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in Latinas. Design and Methods. Madres para la Salud (Mothers for Health) is a 12-month prospective, randomized controlled trial exploring a social support intervention with moderate-intensity physical activity to effect changes in body fat, systemic and fat tissue inflammation, and depression symptoms in sedentary postpartum Latinas. This paper describes the initial body composition of the sample, social support, and neighborhood contextual correlations of overweight and obese Latina mothers within the first 6 months after birth. Results. The mean body …

Increased Serum And Musculotendinous Fibrogenic Proteins Following Persistent Low-Grade Inflammation In A Rat Model Of Long-Term Upper Extremity Overuse., Helen G L Gao, Paul W Fisher, Alex G Lambi, Christine K Wade, Ann E Barr-Gillespie, Steven N Popoff, Mary F Barbe

Department of Physical Therapy Faculty Papers

We examined the relationship between grip strength declines and muscle-tendon responses induced by long-term performance of a high-repetition, low-force (HRLF) reaching task in rats. We hypothesized that grip strength declines would correlate with inflammation, fibrosis and degradation in flexor digitorum muscles and tendons. Grip strength declined after training, and further in weeks 18 and 24, in reach limbs of HRLF rats. Flexor digitorum tissues of reach limbs showed low-grade increases in inflammatory cytokines: IL-1β after training and in week 18, IL-1α in week 18, TNF-α and IL-6 after training and in week 24, and IL-10 in week 24, with greater …

"Any Movement At All Is Exercise": A Focused Ethnography Of Rural Community-Dwelling Older Adults' Perceptions And Experiences Of Exercise As Self-Care, Laura J. Graham, Denise M Connelly

Physical Therapy Publications

PURPOSE: To understand rural community-dwelling older adult participants' shared values, beliefs, and behaviours related to exercise as self-care.

METHODS: We conducted a constructivist-focused ethnography involving semi-structured interviews and participant observation with 17 individuals 65 years and older. Interviews were transcribed and inductively coded to develop themes related to exercise, self-care, and exercise as self-care. Field notes were triangulated with follow-up interviews and dialogue between authors to enhance interpretation.

RESULTS: Participants described exercise broadly as movement and not as a central self-care behaviour. However, awareness of the importance and health-related benefits of exercise increased after a significant personal health-related event. Participants …

Clinical Outcomes And Static And Dynamic Assessment Of Foot Posture After Lateral Column Lengthening Procedure, Heather Barske, Ruth Chimenti, Josh Tome, Elizabeth Martin, Adolph S. Flemister, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Lateral column lengthening (LCL) has been shown to radiographically restore the medial longitudinal arch. However, the impact of LCL on foot function during gait has not been reported using validated clinical outcomes and gait analysis.

Methods: Thirteen patients with a stage II flatfoot who had undergone unilateral LCL surgery and 13 matched control subjects completed self-reported pain and functional scales as well as a clinical examination. A custom force transducer was used to establish the maximum passive range of motion of first metatarsal dorsiflexion at 40 N of force. Foot kinematic data were collected during gait using 3-dimensional motion …

The Bodily Experience Of Cerebral Palsy: A Journey To Self-Awareness., Laura K Brunton, Doreen J Bartlett

Physical Therapy Publications

PURPOSE: The aim of the study was to describe the lived bodily experience of cerebral palsy (CP).

METHOD: This was a descriptive phenomenological inquiry. Ten participants were interviewed about their bodily experiences of living with CP. Interviews were semi-structured around pain and fatigue. Inductive thematic analysis was used to identify themes.

RESULTS: The bodily experience of CP centered on issues of fatigue and pain as a feeling of muscle soreness. An overwhelming amount of the discussion on fatigue emphasized the fatigue that occurs with walking and prolonged activity. Self-awareness of the individuals' own bodies and adapting activity to continue to …

Corticospinal Reorganization After Locomotor Training In A Person With Motor Incomplete Paraplegia, Nupur Hajela, Chaithanya K. Mummidisetty, Andrew C. Smith, Maria Knikou

Publications and Research

Activity-dependent plasticity as a result of reorganization of neural circuits is a fundamental characteristic of the central nervous system that occurs simultaneously in multiple sites. In this study, we established the effects of subthreshold transcranial magnetic stimulation (TMS) over the primary motor cortex region on the tibialis anterior (TA) long-latency flexion reflex. Neurophysiological tests were conducted before and after robotic gait training in one person with a motor incomplete spinal cord injury (SCI) while at rest and during robotic-assisted stepping. The TA flexion reflex was evoked following nonnociceptive sural nerve stimulation and was conditioned by TMS at 0.9 TA motor …

First Rib Mobilization In The Treatment Of Thoracic Outlet Syndrome, Chad C. Boehm

Physical Therapy Scholarly Projects

Background and Purpose: Thoracic outlet syndrome (TOS) is one of the most controversial clinical entities in medicine. It encompasses three related syndromes: compression of the brachial plexus (neurogenic TOS), compression of the subclavian artery or vein (vascular TOS), and a non-specific or disputed type of TOS.s Neurovascular compression may be observed most commonly in the interscalene triangle, but has also been described in the costoclavicular space and subcoracoid space.6 The purpose of this case study is to further explore the efficacy of manual therapy, specifically mobilization of the 1st rib, to relieve the symptoms of a 43 year old …

Mcl Sprain In Young Athlete: A Case Report, Anna Johnson

Physical Therapy Scholarly Projects

Background and Purpose: This is a case report that looks at the examination, evaluation, and treatment of a medial collateral ligament (MCL) sprain in a high school football player.

Case Description: The patient presented with pain in his left knee one day after playing in a high school football game. It was found that he had a grade II MCL sprain with possible medial meniscal involvement.

Outcomes: The patient was able to fully return to his sport by the end of 8 treatment sessions over the course of 5 weeks. He met all of the goals set by the therapist …

Conservative Physical Therapy Treatment For Posterolateral Derangement Of The Lumbar Spine: A Case Report, James Muir

Physical Therapy Scholarly Projects

Background and Purpose: The McKenzie approach to the treatment of low back pain has been shown to be an effective tool in reducing disc derangements. The purpose of this study was to demonstrate the effectiveness of stabilization exercises in conjunction with McKenzie techniques for the treatment and management of a patient with posterior lumbar disc derangement.

Case Description: A 25-year-old male suffered acute low back pain with intermittent leg pain radiating down to the dorsum of his right foot. After the assessment using McKenzie principles was performed, it was determined that the patient’s directional preference was with extension. The patient …

Tailored Education For Older Patients To Facilitate Engagement In Falls Prevention Strategies After Hospital Discharge—A Pilot Randomized Controlled Trial, Anne-Marie Hill, Christopher Etherton-Beer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Background

The aims of the study were to evaluate the effect of providing tailored falls prevention education in hospital on: i) engagement in targeted falls prevention behaviors in the month after discharge: ii) patients’ self-perceived risk and knowledge about falls and falls prevention strategies after receiving the education.

Methods

A pilot randomized controlled trial (n = 50): baseline and outcome assessments conducted by blinded researchers. Participants: hospital inpatients 60 years or older, discharged to the community. Participants were randomized into two groups. The intervention was a tailored education package consisting of multimedia falls prevention information with trained health professional follow-up, …

Measurement Of Localized Tissue Water - Clinical Application Of Bioimpedance Spectroscopy In Wound Management, L C. Ward, K Sharpe, Dale Edgar, V Finlay, F Wood

Physiotherapy Papers and Journal Articles

Wound healing is a complex process which can be impeded by the presence of accumulated cell fluid or oedema. A simple and convenient method for the assessment of wound oedema would aid improvement in patient care. In this proof of concept study we investigated whether bioelectrical impedance spectroscopy has the potential to provide such a tool. A number of important observations were made. Firstly, the method was highly reproducible and data can be obtained from electrodes located at different positions around the region of interest; important given the highly variable topography of surface wounds, e.g. burns. Secondly, the method was …

Effect Of Frontal Plane Foot Position On Lower Extremity Muscle Activation And Limb Positioning In A Single Leg Squat, Brian Bolin

Physical Therapy Scholarly Projects

Purpose: There is a high prevalence of ACL injury in the athletic populations, which can carry out short and long term debilitative effects. Most ACL injuries involve minimal to no contact and female athletes sustain a two to eightfold greater rate of injury than male athletes. Not much research has been conducted to see if foot position directly affects the lower extremity muscles, which could result in altered biomechanics at the knee.

Methods: Twelve subjects 18-30 years old participated in the study. EMG analysis measured differences of muscle contractions for the gluteus maximus, gluteus medius, biceps femoris, rectus femoris, lateral …

Making A Difference, Ashleigh Jardine

Lake Union Herald

No abstract provided.

Effect Of Frontal Plane Foot Position On Lower Extremity Muscle Activation And Limb Positioning In A Single Leg Squat, Brady Stokes

Physical Therapy Scholarly Projects

PURPOSE: Anterior cruciate ligament (ACL) injuries at the knee are quite common, especially in the athletic population involved in sports in which jumping, landing, and cutting activities occur frequently. Previous studies have suggested that lower extremity muscle control plays a role in preventing these injuries. This study set out to determine if foot position influences muscle activation in the lower extremity and, by extension, possibly contributes to the risk of ACL injury. This project examined the activity of lower extremity muscles and the kinematics (movement patterns) of the lower extremity in various foot positions during a single-leg body lowering action. …

Whiplash And Post-Concussion Syndrome Following Mva, Tyler Wegscheid

Physical Therapy Scholarly Projects

Background and Purpose: Neck pain is one of the most prevalent musculoskeletal conditions in today’s world affecting individuals of all ages. More specifically, Whiplash Associated Disorders (WAD) is a major classification of neck pain that is often caused by motor vehicle accidents (MVA). The purpose of this case report is to reflect and examine the available evidence relevant to the examination, evaluation, and treatment procedures that were used for a patient following a MVA.

Case Description: The patient was a 52 year old female with COPD that presented with whiplash, post-concussion syndrome, and various soft tissue injuries following a motor …

Cognitive Assessment In The Acute Care Patient Postoperative Craniotomy, Melissa Carmody Motrl/L, Mscs, C/Ndt, Sandra M. Tremblay Pt, Ms, Cws, Mscs

Department of Medicine

No abstract provided.

Assessment Of Postural Stability Using Inertial Measurement Unit On Inclined Surfaces In Healthy Adults, Chris Frames, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Fatal and nonfatal falls in the construction domain remain a significant issue in today’s workforce. The roofing industry in particular, annually ranks amongst the highest in all industries. Exposure to an inclined surface, such as an inclined roof surface, has been reported to have adverse effects on postural stability. The purpose of this preliminary study was to investigate the intra-individual differences in stability parameters on both inclined and level surfaces. Postural Stability (PS) and Limit of Stability (LOS) were assessed in seven healthy subjects (aged 25-35 years) on inclined and level surfaces using embedded force plates and an Inertial Measurement …

Developing The Rehabilitation Education For Caregivers And Patients (Recap) Model: Application To Physical Therapy In Stroke Rehabilitation, Megan M. Danzl

Theses and Dissertations--Rehabilitation Sciences

Patient and caregiver education is recognized as a critical component of stroke rehabilitation and physical therapy practice yet the informational needs of stroke survivors and caregivers are largely unmet and optimal educational interventions need to be established. The objective of this dissertation was to develop a theory and model of “Rehabilitation Education for Caregivers and Patients” (RECAP) in the context of physical therapy and stroke rehabilitation, grounded in the experiences and perceptions of stroke survivors, their caregivers, and physical therapists.

Qualitative research methods with a novel grounded theory approach were used. Potential constructs of RECAP were identified from existing research. …

A Comparison Of Upper Extremity Function Between Female Breast Cancer Survivors And Healthy Controls: Typical Self- Report Of Function, Motion, Strength And Muscular Endurance, Mary Insana Fisher

Theses and Dissertations--Rehabilitation Sciences

Many women who have experienced breast cancer (BC) report continued impairments in upper extremity (UE) function beyond the time required for normal healing after surgical treatment. Most research supporting this has not made comparisons between survivors of breast cancer (BCS) to a sample of healthy women. This lack of comparison to a healthy cohort prevents an understanding of whether continued deficits in UE function are due to normal aging or the BC treatment.

The purpose of this research was to compare quality of life (QOL) and UE function among long term breast cancer survivors and similar aged women without cancer. …

Predictors Of Outcome Following Standardized Rehabilitation For Patients With Shoulder Pain, Stephanie D. Moore

Theses and Dissertations--Rehabilitation Sciences

Shoulder dysfunction is frequently treated and persistent symptoms are common. Differential diagnosis of shoulder injuries can be challenging and knowledge of a diagnosis alone does not appear to be enough information to predict outcomes. Determination of a set of factors that predict outcome would assist clinicians in making the most effective treatment decision for patients with shoulder pain. The purposes of this dissertation were to investigate patient-clinician agreement in an orthopedic population of patients with shoulder pain and to determine what combination of factors best predicts positive patient-reported outcome following standardized rehabilitation in patients with shoulder pain.

In the first …

Alterations In Visual Processing And Its Impact On Upright Postural Stability In Athletes Following Sport-Related Concussion, Andrea E. Cripps

Theses and Dissertations--Rehabilitation Sciences

Athletes are at risk of sustaining a concussion in all sports and at all competitive levels which may lead to balance impairments. Balance results from the integration of visual, vestibular, and somatosensory information. The underlying pathophysiology for balance impairments is not well understood and visuo-motor processing impairments and how these impairments contribute to balance in concussed athletes has not been reported. Objectives: (1) to investigate the influence of visual perturbation on upright postural stability and balance in athletes who have recently suffered a sports-related concussion, (2) to establish the test-retest reliability of a simple visuo-motor processing task. Design: A longitudinal, …

Scapular Muscle Assessment In Patients With Lateral Epicondylalgia, Joseph M. Day

Theses and Dissertations--Rehabilitation Sciences

The role rehabilitation plays in the management of patients with lateral epicondylalgia (LE) remains elusive secondary to high recurrence rates. Addressing scapular muscle deficits may be important in the rehabilitation of patients with LE. However, it is unknown if scapular muscle impairments exist in a working population of patients with LE. The purpose of this dissertation was to assess scapular muscle strength and endurance in a working population of patients with LE.

Clinical scapular muscle assessment tools are limited in their ability to isolate specific muscles. Rehabilitative ultrasound imaging (RUSI) is a potentially useful tool but few studies have investigated …

Comparison Of Intra Individual Physiological Sway Complexity From Force Plate And Inertial Measurement Unit, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Center of Pressure (COP) is a clinical measure to investigate the effect of sensory input disturbances on postural stability in healthy, old population as well in people suffering from neuromuscular disease. Increased center of pressure velocity and sway area are interpreted as decreased stability or poor balance and are associated with fall risk. Body mounted inertial sensors have shown great promise as an easily implemented clinical measure of balance. The aim of the present study is to investigate if force plate and accelerometer measurements provide similar physiological information when approximate entropy (ApEn) are valuated from the time series. Seven Young …

Intramuscular Manual Therapy After Failed Conservative Care: A Case Report, Brent Harper

Physical Therapy Faculty Articles and Research

Background and Purpose: During intramuscular manual therapy (IMT), an acupuncture needle is inserted into the skin and muscle. The direct mechanical stimulation may interrupt the pathogenic mechanisms of myofascial trigger points (MTrPs). The purpose of this study was to demonstrate the application and efficacy of IMT on a patient suffering from right chronic elbow lateral epicondylalgia. Methods: A case study of a 26-year-old male presenting with a 6-month history of right elbow pain who failed 11 conservative physical therapy sessions and previous site-specific acupuncture. The patient received 5 IMT sessions over 4 weeks. Findings: The patient had …

Strain And Counterstrain For Structural Integrators, Caryn Pierce

Faculty Publications

Strain and counterstrain (SCS) is an indirect approach to manipulating fascia. In addition to its usefulness as an integration tool, knowledge of the reflexive mechanisms involved in SCS deepens our understanding of how fascia functions to protect vital structures from injury and how unbalanced posture and movement patterns develop after trauma.

Physiotherapists Have Accurate Expectations Of Their Patients’ Future Health-Related Quality Of Life After First Assessment In A Subacute Rehabilitation Setting, Steven M. Mcphail, Emily Nalder, Anne-Marie Hill, Terry P. Haines

Physiotherapy Papers and Journal Articles

Background.

Expectations held by health professionals and their patients are likely to affect treatment choices in subacute inpatient rehabilitation settings for older adults. There is a scarcity of empirical evidence evaluating whether health professionals expectations of the quality of their patients’ future health states are accurate.

Methods.

A prospective longitudinal cohort investigation was implemented to examine agreement (kappa coefficients, exact agreement, limits-of-agreement, and intraclass-correlation coefficients) between physiotherapists’ (n=23) prediction of patients’ discharge health-related quality of life (reported on the EQ-5D-3L) and the actual health-related quality of life self-reported by patients (n=272) at their discharge assessment (using the EQ-5D-3L). The mini-mental …

Cost Effectiveness Of Patient Education For The Prevention Of Falls In Hospital: Economic Evaluation From A Randomized Controlled Trial, Terry P. Haines, Anne-Marie Hill, Keith D. Hill, Sandra G. Brauer, Tammy Hoffmann, Christopher Etherton-Beer, Steven M. Mcphail

Physiotherapy Papers and Journal Articles

Background

Falls are one of the most frequently occurring adverse events that impact upon the recovery of older hospital inpatients. Falls can threaten both immediate and longer-term health and independence. There is need to identify cost-effective means for preventing falls in hospitals. Hospital-based falls prevention interventions tested in randomized trials have not yet been subjected to economic evaluation.

Methods

Incremental cost-effectiveness analysis was undertaken from the health service provider perspective, over the period of hospitalization (time horizon) using the Australian Dollar (A$) at 2008 values. Analyses were based on data from a randomized trial among n = 1,206 acute and …

Use Of Evidence-Based Practice Among Athletic Training Educators, Clinicians, And Students, Part 2: Attitudes, Beliefs, Accessibility, And Barriers, Cailee W. Mccarthy, Dorice A. Hankemeier, Jessica M. Walter, Eric J. Newton, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students.

Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students.

Design: Cross-sectional study.

Setting: Online survey instrument.

Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training …