Rehabilitation and Therapy Commons^™

Non-Invasive Brain Stimulation Techniques For Chronic Pain. A Cochrane Systematic Review And Meta-Analysis, Neil E. O'Connell, Louise Marston, Benedict M. Wand, Sally Spencer, Lorraine H. De Souza

Physiotherapy Conference Papers

Poster Presentation

Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES) and transcranial direct current stimulation (tDCS). These approaches to pain treatment are relatively novel. It is important to assess the existing literature robustly to ascertain the current level of supporting evidence and to inform future research and potential clinical use.

Evaluation Of A Treatment-Based Classification Algorithm For Low Back Pain, Tasha R. Stanton, Julie Fritz, Mark J. Hancock, Jane Latimer, Chris G. Maher, Benedict M. Wand, Eric Parent

Physiotherapy Conference Papers

Poster Presentation

Theme: How can we better translate evidence into clinical practice?

Background: Several studies have investigated criteria for classifying patients with low back pain into treatment-based subgroups. A comprehensive algorithm was recently created to translate these criteria into a clinical decision-making guide. This study investigated the translation of the individual subgroup criteria into a comprehensive algorithm by studying the prevalence of patients meeting each treatment subgroup, more than one treatment subgroup, and none of the treatment subgroups. The reliability of the classification decision was also investigated.

Transcranial Direct Current Stimulation Of The Motor Cortex In The Treatment Of Chronic Non-Specific Low Back Pain. A Randomised, Double-Blind Exploratory Study, Neil E. O'Connell, John Cossar, Louise Marston, Benedict M. Wand, David Bunce, Lorraine H. De Souza, David W. Maskill, Andrew Sharp, G Lorimer Moseley

Physiotherapy Conference Papers

This exploratory study aimed to test the proof of principle that active anodal transcranial direct current stimulation (tDCS) applied to the motor cortex reduces pain significantly more than sham stimulation in a group of participants with chronic non-specific low back pain.

What Factors Determine Patient Satisfaction With Musculoskeletal Physiotherapy Care In Australia?, Julia Hush, Vivian Yung, Martin Mackey, Benedict M. Wand, Roger Adams, Roger Nelson, Paul Beattie

Physiotherapy Conference Papers

Patient satisfaction is an important patient-focussed indicator of the quality of physiotherapy care. We have completed an evaluation of patient satisfaction with musculoskeletal physiotherapy in Australia using the 20-item MedRisk Instrument for Measuring Patient Satisfaction With Physical Therapy Care (MRPS). In this paper we report on factors that influence patient satisfaction in this cultural context.

Treating Chronic Nonspecific Low Back Pain With A Sensorimotor Retraining Approach: An Exploratory Multiple-Baseline Study Of 3 Participants, Benedict M. Wand, Neil E. O'Connell, Flavia Di Pietro, Max Bulsara

Physiotherapy Conference Papers

Chronic nonspecific low back pain (CNSLBP) is a common healthcare problem for which current interventions are only moderately successful [1]. There is growing evidence of extensive cortical reorganisation and perceptual disturbances which may contribute to the condition [2]. The aim of this study was to test whether a graded sensorimotor retraining program, aimed at influencing cortical representation, would reduce pain intensity, interference of pain on daily life and self reported disability.

Changes In Evidence-Based Practice Skills Of First-Year Dpt Students, Michael Fillyaw, Elizabeth Dyer, Sally Mccormack Tutt

Physical Therapy Faculty Posters

Poster presentation describing the outcomes for 30 first-year DPT students instructed in the elements of Evidence-Based Practice in a 2 credit course - Scientific Inquiry 1 (SI1). Faculty evaluated changes in: (1) DPT students’ knowledge and skills of EBP, as measured by the Adapted Fresno Test of Competence in Evidence-Based Practice (AFT) and (2) students’ self-confidence in EBP skills. This is the first study to use the AFT to evaluate changes in DPT students’ knowledge and skills related to EBP after formal instruction. The observed 24 point increase in the mean total score is educationally important and comparable to the …

Web-Based Interventions For Weight Loss And Weight Maintenance Among Rural Midlife And Older Women: Protocol For A Randomized Controlled Trial., Patricia A. Hageman, Carol H. Pullen, Melody Hertzog, Linda S, Boeckner, Susan Noble Walker

Journal Articles: Physical Therapy

BACKGROUND: Weight loss is challenging and maintenance of weight loss is problematic among midlife and older rural women. Finding effective interventions using innovative delivery methods that can reach underserved and vulnerable populations of overweight and obese rural women is a public health challenge.

METHODS/DESIGN: This Women Weigh-In for Wellness (The WWW study) randomized-controlled trial is designed to compare the effectiveness of theory-based behavior-change interventions using (1) website only, (2) website with peer-led support, or (3) website with professional email-counseling to facilitate initial weight loss (baseline to 6 months), guided continuing weight loss and maintenance (7-18 months) and self-directed weight maintenance …

Muscle Activity In Lower Extremity During Single-Leg Squat: Role Of Supination And Pronation, Brett J. Debele

Physical Therapy Scholarly Projects

Introduction: Literature has consistently reported a high prevalence of ACL injury rates. A correlation between excessive subtalar joint pronation and ACL injury rates has been noted but research into plausible reasons for this relationship is limited. The purpose of this study was to establish potential cause-and-effect relationships between foot position and ACL injury risk.

Methods: This study used single leg squats with simulated foot positions and examined resulting knee joint forces from motion and lower extremity muscle activation patterns that may cause ACL injury risk. Methods: This study recruited male and female participants aged 18 to 30 from campus at …

Comparação Das Habilidades Motoras Em Crianças Com Síndrome De Down E Crianças Sem Distúrbios De Desenvolvimento [Comparison Of Motor Skills In Children With Down Syndrome And Children Without Developmental Disorders], Laura De Moura Rodrigues, Edla Da Silva, Juliana Saccol Martins, Patricia Pereira

Other Topics

The aim of this study was to assess gross motor abilities, classifying them in stages, of children with Down syndrome and children without developmental disorders, and to compare them with each other. Twelve children with Down syndrome, from two special schools and twelve children without development disorders, from a regular school of Caxias do Sul city, in Brazil, were evaluated.

Six gross motor abilities were assessed: balance in one foot, walking on straight line, running, jumping on one foot, throwing and catching, through the tables of Gallahue and Ozmun (2001).

The children with Down syndrome could not keep up with …

Residency Corner, Tamara Gravano

Physical Therapy Faculty Research

The new Residency Corner will feature articles written by residents that describe topics such as in-depth case analysis, problem solving, and practice as nonphysician primary care providers. Here residents will get to discuss their findings and thought-processes with an audience of their peers--those clinicians and academics interested in the advancement of geriatric health care. Also, for those who may be interested to see what geriatric residency education is really all about, these clinical snapshots can help remove the veil and provide a glimpse into the level of practice our residents are experiencing. Yet, this is only one half of the …

Influence Of Foot Position On Lower Extremity Muscle Activation, Erin L. Wessman

Physical Therapy Scholarly Projects

With sports participation be it from children, teenagers, or adults; injuries will occur. In 2008-2009 an increase in high school sports participation was at an all-time high increasing to just above 7.5 million. Within this population, knee injuries ranked 3rd, with anterior cruciate ligament (ACL) injuries ranking 4th among all knee injuries. The purpose of this study was to compare muscle activation of six lower extremity muscles in five different foot positions during a single-leg squat in attempts to associate a certain foot position with an increase/decrease in muscle activation, which could then be proposed as a risk factor for …

Muscle Fiber Type Characterization In The Ames Dwarf Mouse: A Model Of Delayed Aging, Angela M. Williams

Physical Therapy Scholarly Projects

Introduction: Normal muscle wasting due to aging, known as sarcopenia, has many implications in society, especially with a growing population of elderly people. In this study, muscle fiber size and count, nuclei count, and ratio of fast- to slow-twitch fibers was studied between Ames dwarf mice (df), an established model of aging, and wild-type mice (WT) to learn more about the mechanisms of aging, specifically related to skeletal muscle.

Methods: Four hind limb muscles were harvested from two Ames dwarf mice and two wildtype mice, sliced cross-sectionally and mounted on slides. After mounting, the slides were stained three different ways …

Factors Associated With Older Patients' Engagement In Exercise After Hospital Discharge, Anne-Marie Hill, Tammy Hoffmann, Steven Mcphail, Christopher Beer, Keith D. Hill, Sandra G. Brauer, Terrence P. Haines

Physiotherapy Papers and Journal Articles

Objectives: To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge.

Design: A prospective observational study using qualitative and quantitative evaluation.

Setting: Follow-up of hospital patients in their home setting after discharge from a metropolitan general hospital.

Participants: Participants (N=343) were older patients (mean age ± SD, 79.4±8.5y) discharged from medical, surgical, and rehabilitation wards and followed up for 6 months after discharge.

Interventions: Not applicable.

Main Outcome Measures: Self-perceived awareness and risk of falls measured at discharge with a survey that addressed elements of the Health Belief Model. Engagement and …

Falls After Discharge From Hospital: Is There A Gap Between Older Peoples’ Knowledge About Falls Prevention Strategies And The Research Evidence?, Anne-Marie Hill, Tammy Hoffmann, Christopher Beer, Steven Mcphail, Keith D. Hill, David Oliver, Sandra G. Brauer, Terry P. Haines

Physiotherapy Papers and Journal Articles

Purpose: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital.

Design and Methods: We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies to utilize in the post-discharge period. The study was part of a prospective cohort study, nested within a larger, randomized controlled trial. Participants (n = 333) were asked to suggest strategies to reduce their falls risk at home after discharge, and their responses were compared with current reported …

Approved Clinical Instructors' Perspectives On Implementation Strategies In Evidence-Based Practices For Athletic Training Students, Dorice A. Hankemeier, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Understanding implementation strategies of Approved Clinibal Instructors (ACIs) who use evidence-based practice (EBP) in clinical instruction will help promote the use of EBP in clinical practice.

Objective: To examine the perspectives and experiences of ACIs using EBP concepts in undergraduate athletic training education programs to determine the importance of using these concepts in clinical practice, clinical EBP implementation strategies for students, and challenges of implementing EBP into clinical practice while mentoring and teaching their students.

Design: Qualitative study.

Setting: Telephone interviews.

Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as a certified athletic trainer = 10 …

Prosthetic Training Following A Transfemoral Amputation: A Case Report, Jonathan Beck

Physical Therapy Scholarly Projects

Background and Purpose: There has been an increase in amputations since the start of the Iraq/Afghanistan war, but thousands of Americans have a limb amputated each year due to peripheral vascular disease, diabetes, or infections. New technology in the field of prosthetics, especially prosthetic knees, has helped improve these individuals’ function. The most recent advancement in prosthetic knees is the C-leg, a micro-processor-controlled knee; however, a wide variety of prosthetic knees are available. Therefore, it is critical to select the right prosthetic knee to meet each individual’s needs and goals.

Case Description: The patient was a 58-year-old gentleman who underwent …

Sarcopenia And Aging: Skeletal Muscle Fiber Type Composition Of The Long-Lived Ames Dwarf Mouse Compared To Its Wild-Type Counterpart, Cory Leier

Physical Therapy Scholarly Projects

Skeletal muscle fiber type composition has not been studied in the long-lived Ames dwarf mouse when compared to its wild-type counterpart. Hindlimb soleus skeletal muscle from two 3-month old dwarf and two 3-month old wild-type mice was analyzed for muscle fiber size, proportion of type I (slow-twitch) and type II (fast-twitch) muscle fibers, myonuclei content per muscle fiber, and total cross sectional area of the muscle. Results revealed a significant difference in muscle fiber size (t(58)=-9.71, p

Successful Rehabilitation Of A Recreational Endurance Runner: Initial Validation For The Bunkie Test, Jason Brumitt

Faculty Publications - College of Physical Therapy

This case report details the musculoskeletal evaluation and the successful rehabilitation of a 24-year-old female recreational distance runner who self-referred to physical therapy with an acute bout of low back pain (LBP). Her LBP was provoked during each distance run. The patient’s musculoskeletal evaluation revealed core weakness, especially on the left. A recently reported functional test, the Bunkie test, was administered as part of the physical evaluation. The scores from the Bunkie test correlated with other quantitative and qualitative findings. A therapeutic exercise program emphasizing core stabilization was prescribed. The patient was able to shortly return to running pain-free.

Analysis Of Knee Flexion Angles During 2 Clinical Versions Of The Heel Raise Test To Assess Soleus And Gastrocnemius Function, Kim Hébert-Losier, Anthony G. Schneiders, S John Sullivan, Richard J. Newsham-West, José A. García, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

STUDY DESIGN: Controlled laboratory study, using a repeated-measures, counterbalanced design. OBJECTIVES: To provide estimates on the average knee angle maintained, absolute knee angle error, and total repetitions performed during 2 versions of the heel raise test. BACKGROUND: The heel raise test is performed in knee extension (EHRT) to assess gastrocnemius and knee flexion (FHRT) for soleus. However, it has not yet been determined whether select knee angles are maintained or whether total repetitions differ between the clinical versions of the heel raise test. METHODS: Seventeen healthy males and females performed maximal heel raise repetitions in 0° (EHRT) and 30° (FHRT) …

Overcoming Barriers To Implementation Of Evidence-Based Practice Concepts In Athletic Training Education: Perceptions Of Select Educators, Sarah Manspeaker, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The need to include evidence-based practice (EBP) concepts in entry-level athletic training education is evident as the profession transitions toward using evidence to inform clinical decision making.

Objective: To evaluate athletic training educators' experience with implementation of EBP concepts in Commission on Accreditation of Athletic Training Education (CAATE)-accredited entry-level athletic training education programs in reference to educational barriers and strategies for overcoming these barriers.

Design: Qualitative interviews of emergent design with grounded theory.

Setting: Undergraduate CAATE-accredited athletic training education programs.

Patients or Other Participants: Eleven educators (3 men, 8 women). The average number of years teaching was 14.73 ± …

Mobility, Balance, And Falls In Persons With Multiple Sclerosis, Jacob J. Sosnoff, Michael J. Socie, Morgan K. Boes, Brian M. Sandroff, John H. Pula, Yoojin Suh, Madeline Weikert, Steven Morrison, Robert W. Motl

Rehabilitation Sciences Faculty Publications

Background: There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS).

Methods: 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery.

Results: Over 51% of the participants …

Exercise Habits And Tobacco Use Among Male Latino Farmworkers, Jason Brumitt, Leda I. Garside, Rebecca Reisch, Talina Marshall, Hui En Gilpin, Jessica Kinsey, Kelsey Imondi, Heather Robinson

Faculty Publications - College of Physical Therapy

Migrant farmworkers risk occupational injury and are at risk for developing chronic health conditions. Exercise may enhance health and help to reduce the risk of occupational injury and/or reduce the risk of developing a chronic health condition. Little is known, however, about the exercise habits of Latino migrant farmworkers. Male Latino migrant farmworkers completed an exercise and health habits questionnaire at health screening clinics. One hundred fifty-three (58.2%) subjects reported exercising during the week. There was no difference in age between those who reported exercising and those who did not (p = .78). Only 42 (16%) of all workers reported …

Self-Reported Musculoskeletal Pain In Latino Vineyard Workers, Jason Brumitt, Rebecca Reisch, Karla Krasnoselsky, Amy Welch, Richard Rutt, Leda I. Garside, Carolyn Mckay

Faculty Publications - College of Physical Therapy

The agricultural economy in the United States is dependent on millions of Latino migratory workers. Despite the health risks associated with this line of work, many agricultural workers lack health insurance or access to health care services. The purpose of this study was to collect demographic data and investigate the musculoskeletal health of Latino migratory vineyard workers. A physical therapy team collected demographic data at health clinics held at vineyards in Oregon. Nearly half (48.4%) of all vineyard workers reported experiencing musculoskeletal symptoms (MSS) in at least one region of the body. The primary region of reported MSS was the …

Specificity Of A Back Muscle Roman Chair Exercise In Healthy And Back Pain Subjects, Christian Larivière, Rubens A. Da Silva, A. Bertrand Arsenault, Sylvie Nadeau, André Plamondon, Roger Vadeboncoeur

Études primaires

No abstract provided.

Does High Intensity Treadmill Therapy In Infants With Down Syndrome Contribute To Attaining Motor Milestones At An Earlier Age?, Rebekah E. Bennett

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not high intensity treadmill therapy is effective in helping children with Down syndrome attain motor milestones at an earlier age.

An Approach For Identifying Gait Events Using Wavelet Denoising Technique And Single Wireless Imu, Rahul Soangra, Thurmon Lockhart, Nathalie Van De Berge

Physical Therapy Faculty Articles and Research

A new approach is proposed to identify gait events in non-laboratory environments with a single inertial measurement unit (IMU) embedded inside shoe. The aim of our work is to develop a useful clinical tool for monitoring individuals walking disability and detect specific pathological gait patterns. Temporal parameters of gait are determined by classification of accelerations and angular velocities. Wavelets denoising of IMU signals allows for an important amount of information that is exploited in different manners for event identification. It was found that wavelet denoising enhanced specific turning points which could effectively identify gait events. The method is verified by …

Getting To Know You: Key Clinical Concepts In Relationship-Based Interventions And Neurobehavioral Observations With Young Infants, Yvette Blanchard

All PTHMS Faculty Publications

The newborn infant is a social organism, pre-disposed to interact with his caregiver and able to elicit the kind of caregiving necessary for successful adaptation. The earliest developmental task of the newborn is to organize behavior to be able to play an active role in influencing the caregiving environment and eliciting the kind of support needed for development. This task is accomplished through the attainment of self-regulation or balanced neurobehavioral functioning of the infant's autonomic, motor, state, and responsivity behavioral dimensions as described by Als.

Resilient Observer Design For Discrete-Time Nonlinear Systems With General Criteria, Chung Seop Jeong, Edwin E. Yaz, Yvonne I. Yaz

Exercise Science Faculty Research and Publications

A class of discrete-time nonlinear system and measurement equations having incrementally conic nonlinearities and finite energy disturbances is considered. A linear matrix inequality based resilient observer design approach is presented to guarantee the satisfaction of a variety of performance criteria ranging from simple estimation error boundedness to dissipativity in the presence of bounded perturbations on the gain. Some simulation examples are included to illustrate the proposed design methodology.

Pain Perception After Isometric Exercise In Women With Fibromyalgia, Marie K. Hoeger Bement, Andy Weyer, Sarah Hartley, Breanna Drewek, April L. Harkins, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Objective: The purpose of this study was to identify exercise protocols incorporating isometric contractions that provide pain relief in women with fibromyalgia.

Design: A before-after trial.

Setting: A physical therapy department in an academic setting.

Participants: Fifteen women (mean ± SD, 52 ± 11y) with fibromyalgia.

Interventions: Subjects completed 4 sessions: 1 familiarization and 3 experimental. The following randomized experimental sessions involved the performance of isometric contractions with the elbow flexor muscles that varied in intensity and duration: (1) 3 maximal voluntary contractions (MVCs), (2) 25% MVC held to task failure, and (3) 25% MVC …

Influence Of The Hip On Patients With Patellofemoral Pain Syndrome: A Systematic Review, Erik P. Meira, Jason Brumitt

Faculty Publications - College of Physical Therapy

Context: Patellofemoral pain syndrome (PFPS) is one of the most common conditions limiting athletes. There is a growing body of evidence suggesting that dysfunction at the hip may be a contributing factor in PFPS.

Data Sources: MEDLINE (1950–September 2010), CINAHL (1982–September 2010), and SPORTDiscus (1830–September 2010) were searched to identify relevant research to this report. Study Selection: Studies were included assessing hip strength, lower extremity kinematics, or both in relation to PFPS were included.

Data Extraction: Studies included randomized controlled trials, quasi-experimental designs, prospective epidemiology, case-control epidemiology, and cross-sectional descriptive epidemiology in a scientific peer-reviewed journal.

Results: PFPS is associated …