Rehabilitation and Therapy Commons^™

Effect Of Exercise On Posture, Neck Proprioception And Balance In Older Adults, Mohammad Khaleghifar

Loma Linda University Electronic Theses, Dissertations & Projects

Background:

Falls are one of the most frequent and serious problems facing older adults. Approximately 30-40% of people over 65 years of age fall each year. The frequency of falls increases with each decade beyond this threshold and approximately 20-30% of older adult fallers require hospitalization, assuming an increased risk of mortality. Postural balance and stability involve cooperation between visual, proprioceptive and vestibular sensory systems to achieve a motor response. Disturbance in any of these systems can result in abnormal postural orientation and lead to instability or dizziness. Among these systems, proprioception provides sensory input from the peripheries to …

Walking Performance Is Worse In Black Than White People With Multiple Sclerosis, Robert W. Motl, Deborah Backus, Jeffrey R. Hebert, Alexander V. Ng, Kevin K. Mccully, Whitney N. Neal, Hollie Schmidt, Robert Mcburney, Prudence Plummer, Francois Bethoux, John Lowman, Gary R. Cutter

Exercise Science Faculty Research and Publications

Background

There is emerging evidence for poor health outcomes among Black people with MS, and Black people with MS may have worse walking performance than White counterparts.

Purpose

The current study examined if Black participants with MS had slower walking speed (timed 25-foot walk, T25FW) and shorter walking distance (six-minute walk, 6MW) than White participants, and if these differences were accounted for by demographic variables, physical activity, disease/clinical characteristics, and Social Determinants of Health (SDOH).

Method

The analysis included samples of Black (N = 105) and White (N = 246) participants with MS who completed the T25FW and 6MW, underwent …

At-Home Stroke Neurorehabilitation: Early Findings With The Neuroexo Bci System, Juan José González-España, Lianne Sánchez-Rodríguez, Maxine Annel Pacheco-Ramírez, Jeff Feng, Kathryn Nedley, Shuo-Hsiu Chang, Gerard E Francisco, Jose L Contreras-Vidal

Faculty, Staff and Student Publications

Background: Democratized access to safe and effective robotic neurorehabilitation for stroke survivors requires innovative, affordable solutions that can be used not only in clinics but also at home. This requires the high usability of the devices involved to minimize costs associated with support from physical therapists or technicians.

Methods: This paper describes the early findings of the NeuroExo brain-machine interface (BMI) with an upper-limb robotic exoskeleton for stroke neurorehabilitation. This early feasibility study consisted of a six-week protocol, with an initial training and BMI calibration phase at the clinic followed by 60 sessions of neuromotor therapy at the homes of …

Using Ai-Generated Scenarios To Enhance Learning Of The Emergency Assessment Process, D Cobble, L Schroeder, J Vaughn, S Ford

Clinical Practice in Athletic Training

Introduction: Rigorous accreditation standards require students to demonstrate competency in various clinical proficiencies through clinical practice or simulation-based educational activities. Therefore, simulation has become an integral component of athletic training education, as scenarios can provide realistic and reproducible experiences for all students. To that end, our study had two primary objectives: investigate the ability of artificial intelligence (AI) to generate accurate and realistic athletic training simulation scenarios and evaluate AI's effectiveness in teaching and reinforcing the emergency assessment process through student-created scenarios. Methods: Phase one, AI developed three different scenarios for patients experiencing (1) an ovarian cyst, (2) a hypoglycemic …

Prevalence, Perceptions, And Attitudes Of Accommodation For Students With Disabilities In Athletic Training Education Programs, T J. Babcock, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Disability accommodation has been widely researched in healthcare education programs, including medical doctor (MD), doctor of osteopathy (DO), and physical therapy (PT). However, little research has been conducted on classroom and clinical education accommodation in athletic training education. The purpose of this study was to explore these settings and gain an understanding of student experiences with accommodation in athletic training education programs. This project was deemed exempt by Indiana State University’s Institutional Review Board. Methods: A cross-sectional 24-question survey was developed and adapted from prior qualitative research on accommodation in physical therapy education. Emails containing a link to the …

Clinat: In Service To Athletic Training Scholarship, Lindsey Eberman, Matthew J. Rivera

Clinical Practice in Athletic Training

To be of service to others means to help others without expecting anything in return. The ClinAT, or Clinical Practice in Athletic Training journal, is an online, open-access outlet for the dissemination of practice-based research in health care, and a donation of time, effort, and energy to the profession of athletic training. In 2018, when Indiana State University created its first issue of ClinAT, we were a faculty of 3 with 5 PhD students supporting the journal, one of whom was wholly dedicated to the effort. As the higher education landscape has changed, and the roles and responsibilities of our …

Barriers To The Implementation Of The Amsterdam 2022 Statement In The Secondary School Setting, L Torres, J L. Baldari, F A. Gardin, A M. Price

Clinical Practice in Athletic Training

Introduction: The Amsterdam 2022 International Consensus Statement on Concussion in Sport provides a summary of contemporary best practice recommendations for healthcare providers who are involved in the care of athletes at risk of sport-related concussion (SRC). Given that athletic trainers (ATs) have a professional responsibility to continually educate themselves on topics of great importance to the population that they care for, such as SRC management, it is reasonable to expect them to evolve their concussion management protocols to better align themselves with the recommendations found this statement. The purpose of this study was to identify the barriers associated with the …

Exploring The Vitality Of Athletic Training: Insights Into Professional Identity, Commitment, And Retention, L E. Eberman, M J. Rivera, K E. Games, M J. Drescher, J P. Young, J Clifton-Gaw, K Condrey, H Mccarn, N Mondelli, X Yuan

Clinical Practice in Athletic Training

Introduction: The confluence of fluctuating retention, fewer students entering professional programs, and the profession’s identity crisis (conflict between being a sports profession or a health profession) has created a serious question about the vitality of the athletic profession. However, research on the vitality of the profession has often focused on singular variables influencing professional identity, burnout, and commitment. The purpose of this project was to explore multiple factors influencing the vitality of the profession across professional identity and commitment in athletic training. Methods: We used a convergent parallel mixed-methods design, including surveys and interviews with athletic training students and athletic …

Escape From Diabetes, J E. Jochum, J Carmack, J Toon

Clinical Practice in Athletic Training

Introduction: In the past decade, interprofessional education (IPE) to promote interprofessional collaborative practice has become an integral component of pre-licensure education in the health professions. Research shows that IPE activities involving problem-solving in patient care that requires cooperation and communication among the professions is most effective. An effective activity to meet interprofessional competencies is the use of escape rooms. Escape rooms are team-based games where groups of individuals solve puzzles to accomplish a specific goal, typically in a limited amount of time. There are many benefits to using escape rooms in education, including promoting problem-solving, teamwork, and creativity, improving focus …

Athletic Trainer Compensation Characteristics, J P. Young, K Ef Mair, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Athletic trainers (ATs) are integral to healthcare yet face ongoing challenges that affect job satisfaction and retention. Factors such as long work hours, low pay, and work-family conflict contribute to dissatisfaction and a desire to leave the profession. Salary disparities and lack of administrative support are key factors impacting professional fulfillment and career longevity. Identifying how compensation influences job satisfaction is essential for improving retention and advancing the profession. Our study aimed to examine the compensation characteristics of ATs and determine the key factors that predict gross income. Methods: A cross-sectional, web-based survey was conducted. The survey was validated …

Preceptor Development: Identifying The Best Modality For Building Clinical Educators, G W. Cohen, R M. Lopez, A J. Tritsch

Clinical Practice in Athletic Training

Introduction: Preceptor training and development are not standardized within the athletic training profession. The Commission on Accreditation of Athletic Training Education (CAATE) requires that Athletic Training Programs provide an ongoing education plan for preceptors to promote a constructive learning environment for students. However, with the rapid expansion of clinical education opportunities outside of institutions' immediate area, programs must identify how to reach all their preceptors and uphold their programmatic expectations for clinical educators. Methods: The investigators conducted a cohort pre-test-post-test design study. A preceptor development program (PDP) was created and grounded in the theory of gamified learning and adult learning …

The Financial Stresses That Affect Athletic Training Students: A Qualitative Investigation, C Kuehner-Boyer, E León Zaragoza

Clinical Practice in Athletic Training

Introduction: A recent survey examining barriers that affect athletic training students found that financial-related barriers created significant stress for students in professional athletic training programs. The need to work while attending a professional athletic training program was the highest reported barrier with 54.82% of respondents indicating that this was a barrier for them during their program. Beyond the overall reporting rate, the need to work while completing a professional athletic training program was indicated by athletic training students to be the barrier that they encountered the most frequently with respondents reporting that this was a stress for them between monthly …

Musculoskeletal Tumors Disguised As Orthopedic Injuries: A Case Report, A Summers

Clinical Practice in Athletic Training

Background: Musculoskeletal tumors are relatively rare, accounting for only 0.2 to 0.5% of all malignancies across all age groups. More specifically, Pigmented Villonodular Synovitis, a type of musculoskeletal tumor, has an incidence rate of 1.8 cases per one million people in a population. This benign, proliferative disease is a type of tenosynovial giant cell tumor that can affect the soft tissue lining of joints, bursae, and tendon sheaths. These joint-related tumors often present with an insidious onset and non-specific physical exam findings. Therefore, they are often mistaken for other, more common orthopedic injuries, making them difficult to diagnose. Patient Information: …

Enhancing Clinic Efficiency: A Quality Improvement Initiative For Postoperative Patient Care In An Outpatient Orthopedic Physician Practice Setting, D Stepan, T Jp Greffly, R M. Williams

Clinical Practice in Athletic Training

Introduction: Following orthopedic surgery, patient post-operative (post-op) visits are deemed global surgical observations where day 00 to day 90 are appointments that cannot be billed. Patients are typically seen 3 times during this global period. Thus, the outpatient clinic needs to have non-billable time slots each day for these patients. The current scheduling model double books patients every 15 minutes, with the physician being the primary provider seeing patients for post-op visits. Therefore, the clinic has demonstrated inefficiencies with scheduling these patients while having sufficient appointments available for billable patients. This quality improvement initiative aimed to decrease post-op patient visits …

Adolescent Femoral Neck Fractures: A Case Study On Initial Surgical Intervention, Avascular Necrosis Development, And Subsequent Total Hip Arthroplasty, K A. Fisher

Clinical Practice in Athletic Training

Background: The patient sustained a femoral neck fracture at the age of 13 after slipping and falling in his home. He was seen in the Emergency Department the same day and underwent a closed reduction and percutaneous pinning procedure the following morning. Ten weeks after returning to full weightbearing, and 13.5 weeks after his initial fracture, he developed stress fractures of the medial distal femoral and proximal tibial metaphyses. He experienced gradual worsening of hip pain and difficulty with ambulation between 11 to 13 months post-closed reduction and percutaneous pinning (CRPP). Avascular necrosis and collapse of the femoral head was …

Modification Of Ergonomics For A World-Class Brass Instrumentalist With A Congenital Limb Difference: Level 3 Case, O G. Newhouse

Clinical Practice in Athletic Training

Background: A drum and bugle corps is a musical marching organization that consists of approximately 160 brass, percussion, and color guard performers. There are currently twenty-one drum corps organizations at the world-class level that compete. Organizations learn their 8–10-minute show in the late spring and begin traveling the country performing and competing in the early summer until August. Rehearsal days can be up to 10 hours of practice including visual and music. It has been reported that the incidence of upper limb pain is higher in those who have longer practice times, in which is a symptom of overuse. These …

Title: Professional Socialization And Development Of Athletic Training Professional Program Directors, N A. Wilkins, K D. Pagnotta, L Kunkel, S David, A B. Thrasher

Clinical Practice in Athletic Training

Introduction: The role of Program Directors (PD) has vastly expanded over the last decade to meet the evolving demands of athletic training education and higher education. While specific responsibilities such as programmatic planning and accreditation maintenance are directly outlined in accreditation standards, PDs often assume additional institutional and programmatic responsibilities that now include recruitment and retention efforts, mentorship of faculty and students, curriculum design and mapping, and other administrative tasks. Previous research demonstrates athletic training faculty have little formalized training in administrative roles, and Coordinators of Clinical Education (CCEs) desired more support and development for that role. Little research exists …

Strength Assessment Protocol In Pre-Professional Ballet Dancers, Simona Di Nardo, Ivan Mascio

Clinical Practice in Athletic Training

Purpose: This research project aimed to investigate the effects, particularly regarding the ability to generate force, that could emerge following a ballet class. The purpose of the study was to support the thesis that low levels of fitness and performance in professional and amateur dancers, should be considered a significant gap that needs to be addressed. Larger will be the gap and bigger will be the demand of a dancer to be prepared athletically. While the shorter the gap and more efficient the artistic side of the dance performance will be. As a result, a stronger and healthier body will …

Characteristics Of Athletic Trainers That Are Satisfied And Dissatisfied With Their Compensation, K Ef Mair, J P. Young, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Job satisfaction among athletic trainers (ATs), particularly in relation to compensation, is a critical factor influencing retention and career fulfillment. Examining the factors linked to earnings satisfaction may offer insight into how workplace conditions can be improved to better support ATs. The purpose of our study was to investigate the attributes that distinguish ATs content with their compensation from those who are dissatisfied. Methods: We used a cross-sectional, web-based survey to gather AT compensation data, of which 1,887 participants responded to a question regarding their satisfaction with compensation. Respondents were divided into two groups based on their satisfaction with …

The Effects Of A Joint Reduction Trainer On Confidence Levels In Professional Athletic Training Students, T Franklin, S Hacherl

Clinical Practice in Athletic Training

Introduction: Dislocations are common injuries managed by athletic trainers, yet athletic training students are unlikely to practice reduction techniques during clinical experiences. Current standards set by the Commission on Accreditation of Athletic Training Education require accredited programs to prepare students to manage patients with dislocations, including joint reductions. Research indicates the use of simulation techniques, such as joint reduction simulators, in education can fill clinical experience gaps and improve student confidence and skills. Shoulder dislocations make up nearly 50% of dislocations with several reduction techniques identified in the current literature. The use of a joint reduction simulator may provide athletic …

Spatiotemporal Gait Parameter Changes During Walking With Blood Flow Restriction, Tanner Ruda, Christopher S. Wichman, Mike Rosenthal

Posters and Presentations: Physical Therapy

No abstract provided.

Impact Of Educational Models On Student Confidence In Acute Care Physical Therapy: A Comparative Analysis, Robert Dekerlegand, Pt, Mpt, Phd, Ccs

Department of Physical Therapy Posters

Background and Purpose

• Hybrid and blended education have evolved as innovative models to deliver physical therapy (PT) education.¹
• PT faculty rapidly integrated these models into their pedagogy during the COVID pandemic in 2020 and many have retained these methods.¹
• Assessment of these models most frequently use cognitive indicators of learning outcomes (e.g. National Physical Therapy Examination).²
• Noncognitive indicators (e.g. confidence and self-efficacy), should be considered when assessing new educational models in PT given their relationship with competency and career direction.^3-5
• The impact of “distance models” on noncognitive learning indicators is of particular value to acute care …

Adoption And Awareness Of Long-Covid Clinical Practice Guidelines Among Physical Therapists: A Nationwide Survey, Robert Dekerlegand, Pt, Mpt, Phd, Ccs, Malachy Clancy, Phd, Otr/L, Bcpr

Department of Physical Therapy Posters

Background and Purpose

• Approximately 15% of individuals infected with SARS-CoV-2 develop “Long-COVID” with persistent physical, cognitive, and/or mental symptoms potentially amendable to physical therapy.
• Variability exists in the rehabilitation approach for individuals receiving physical therapy for this novel condition.
• Clinical practice guidelines (CPGs) and other evidence-based resources exist to help standardized rehabilitation; however, it is unknown if physical therapists (PTs) are applying them in the management of individuals with Long-COVID.
• We surveyed PTs in the contiguous United States (U.S.) to explore their awareness and application of Long-COVID CPGs along with their general awareness of this condition.

The Efficacy Of Inspiratory Muscle Training Post Covid: A Systematic Review, Robert Dekerlegand, Sydney Brannen, Olivia Bunch, Amrit Deo, Erin Dopke, Kayleigh Moreland

Department of Physical Therapy Posters

Introduction

• Fatigue and dyspnea can persist post COVID infection and negatively impact both functional capacity and quality of life (QOL).^1,2
• Residual pulmonary impairments and/or inspiratory muscle dysfunction associated with COVID infection contribute to these symptoms.^2,3
• Ventilatory demands exceeding the capacity of the inspiratory muscles can exacerbate these symptoms accentuating activity limitations that restrict participation in life roles.
• As symptom-limited exercise and QOL are related to inspiratory muscle function post COVID,^4,5 inspiratory muscle training (IMT) may improve rehabilitation outcomes.³
• The purpose of this systematic review was to determine the potential efficacy of IMT in individuals post-COVID.

Effect Of Apathy On Exercise Adherence Among Community-Dwelling Older Adults With Chronic Health Conditions, Hiromichi Takeda, Katsuhiko Takatori

Asian Journal of Physical Therapy

Background: The association between apathy and physical activity levels in older adults is well established. It is essential for older adults with chronic health conditions not only to be more active but also to adhere to a personalized exercise prescription. However, the impact of apathy on exercise adherence remains unclear. This study aimed to investigate the effect of apathy on exercise adherence in older adults with chronic health conditions. Methods: This research was a secondary longitudinal data analysis of a behavior change intervention conducted through a randomized controlled trial. The participants included older adults aged 65 years and above (n …

Exploring Leadership In Physical Therapy: How Clarity, Connection, And Communication Influence Team Engagement, Burnout, And Achieving Organizational Objectives, Jason Collin

Dissertations

Purpose: The purpose of this mixed methods study was to identify and describe how highly effective PT leaders use the three competencies of HPTs (clarity, connection, and communication) to increase engagement, prevent burnout, and achieve organizational objectives. The second purpose of this study was to determine the degree of importance that highly effective PT leaders perceive the three HPTE core competencies impact their leadership for creating HPTs.

Methodology: The mixed methods study identified and described eight PT leaders’ perceptions of how they use clarity, connection, and communication to build and sustain HPTs. PT leaders were selected through purposive and snowball …

Influences Of Lower Limb Strength And Rate Of Torque Development On Recovery From A Backwards Balance Loss, Vadim Drake, Julie Gage, Madison Morris, Lyndsay Stutzenberger, Gabe Haberly

Student-Faculty Research - College of Physical Therapy

Falls account for the largest percentage of hip fractures and cause of unintentional death

Falls due to posterior losses of balance are the hardest to prevent and increase the risk of hip fractures

One way to prevent falls is to investigate how lower body strength impacts recovery stepping strategies

Research has not yet determined the extent to which lower body strength impacts stepping strategy during a posterior loss of balance

The purpose of this study is to determine the extent to which rate of peak torque and rate of torque development (RTD) impacts the recovery stepping response from a posterior …

Comparison Of Wingate Bike Test And 1-Min Sit-To-Stand Test Utilizing Blood Lactate And Patient Report, Tyler Whited, Mary Imboden, Jeff Houck, Hannah Quinn, Peter Weiss, Tony Huynh, Garrett Cassio

Student-Faculty Research - College of Physical Therapy

For older adults, performing activities of daily living (ADLs) requires generating short bursts of energy anaerobically.1 The current gold standard for measuring anaerobic threshold (AT) is the Wingate Anaerobic Test, which requires a specialized bicycle. While many tests exist to assess fall risk and submaximal endurance, there is an absence of accessible clinical tools for measuring anaerobic threshold. Measuring AT is an important predictor of an older adult’s ability to perform ADLs safely, allowing physical therapists to tailor interventions to improve function and quality of life.

First Of It's Kind: Primary Care Pt In Pediatrics! Implementing A Walk-In Pediatric Physical Therapy Service Co-Located With Primary Care Pediatrics: A Pilot Study For Possibility, Antonia Duerre, Kierstyn Ray, Taryn Conwell, Ryan Jacobson

Student-Faculty Research - College of Physical Therapy

Pediatric primary care physical therapy does not exist, but has many potential benefits. Primary care PT has been shown to be a successful model of care for meeting needs of adult patients. Purpose: to gather qualitative and quantitative data to better understand the potential of this novel practice model upstream in pediatric healthcare.

Size-Weight Illusion During Whole-Body Loading Via Squat, Aydan Parsons, Robin Dorociak, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

What is the size weight illusion? An item of smaller volume but equal weight is heavier than a larger volume item of the same weight.