Rehabilitation and Therapy Commons^™

Effects Of Electrotherapy On Pain And Mobility, Pablo Mleziva

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Neck chronic pain is one of the most common problems in people today. However, people do not always seek medical treatment for their pain. Subclinical or mild pain generally does not prompt people to seek medical treatment. Consequences of this type of pain can be anxiety, disability and proprioception problems. The American Physical Therapy Association (APTA) recommends transcutaneous electrical nerve stimulation (TENS) as an intervention to treat neck pain with mobility deficits. TENS for the treatment of pain has been used for many years; however, there is still an “efficacy-impasse” for the use of TENS despite half a …

Effect Of Home Exercise Program On Visual Reliance For Balance In Older Adults, Madeha Jaber

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Older adults tend to rely excessively on visual inputs to maintain their balance. This overreliance on visual inputs can increase the risk of falls, particularly when visual inputs are reduced or eliminated. This study aimed to determine the effects of a home exercise program (HEP) on visual reliance for balance and cervical active range of motion (AROM) among older adults.

Patients/Materials and Methods: The study sample consisted of 19 older adults, aged 65-79 years old. Outcome measures included static balance, balance confidence, and cervical AROM. Participants were instructed to follow an 8-week HEP and were provided with …

Effects Of Photobiomodulation Therapy On Muscle Function In Individuals With Multiple Sclerosis, Mitra Rouhani, Miguel Tolentino, Jeri-Anne Lyons, Alexander V. Ng

Exercise Science Faculty Research and Publications

Background

In people with multiple sclerosis (pwMS), muscle fatigue and weakness are common issues that can interfere with daily activities. Photobiomodulation therapy (PBMT), comprising light in a 600–1100 nm bandwidth, is a low-level laser therapy thought to improve muscle performance in non-disease populations, in part, by improving mitochondrial function and thus, might be beneficial in pwMS. Given this potential, we aimed to investigate the effects of PBMT on muscle performance in pwMS, both in the short-term and over an extended period.

Methods

This study consisted of two parts with a randomized double-blind crossover design. In study I, muscle function was …

Physical Therapy For Survivors Of Torture: A Scoping Review, Justine Dee, Nancy Gell, Constance Van Eeghen, Benjamin Littenberg

Department of Physical Therapy Faculty Papers

Background: Torture can result in impaired function, reduced quality of life, and chronic pain. Physical therapy (PT) is recommended for wholistic care of survivors of torture (SOT), however there are limited evidenced-based guidelines. We conducted a scoping review to identify and describe the approach and gaps in knowledge around the PT treatment of SOT.

Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Nine databases were searched from inception to 2023. Eligible sources were those involving PT treatment for SOT. Extracted data included the source of evidence, PT description, mode …

Examining The Diagnostic Accuracy Of A Novel Performance-Based Test For Alzheimer's Disease Screening, A. M. Reed, K. Duff, L. E. Dibble, S. S. Paul, Andrew Hooyman, S. Y. Schaefer

Physical Therapy Faculty Articles and Research

Affordable, rapid methods for identifying mild Alzheimer’s disease (AD) are needed. A simple, brief performance-based test involving the learning of functional upper-extremity movements has been developed and is associated with AD pathology and functional decline. However, its specificity to AD relative to other neurodegenerative diseases that present with motor impairment is unknown. This study examined whether this novel test could distinguish between 34 participants diagnosed with mild AD (Clinical Dementia Rating Scale = 0.5-1) from 23 participants with mild-to-moderate Parkinson’s disease (PD) (Hoehn & Yahr = 2-3) using Receiver Operating Characteristic analysis of secondary data from two separate clinical trials. …

Focused Interdisciplinary Therapy: Making A Case For Group Based Intensive Therapy In Pediatric Neurorehabilitation, Teressa Reidy, Nicole Andrejow, Erin Naber, Joan Carney

Journal of Interprofessional Practice and Collaboration

Intensive therapy models for children with chronic disabilities are gaining popularity in clinical practice. This paper outlines an intensive, interdisciplinary group intervention protocol targeting functional mobility and occupational performance of three teenage participants diagnosed with cerebral palsy (CP) (GMFCS levels 1-3). Participants demonstrated gains in function as measured by the Canadian Occupational Performance Measure (COPM), Gross Motor Function Measure-88 (GMFM), Six Minute Walk Test (6MWT), Timed Up and Down Stairs (TUDS), and grip strength. These gains indicate that intensive group-based interdisciplinary therapy programs may improve the mobility and occupational performance of ambulatory teens with CP. A significant limitation of this …

Optimal Duration Of Physical Therapy Following Total Knee Arthroplasty, Gregory Benes, Zachary Adams, Michael Dubic, Justin David, Claudia Leonardi, Amy Bronstone, Vinod Dasa

School of Medicine Faculty Publications

Aims & Objectives: The purpose of this study was to identify patient characteristics associated with engagement and completion of physical therapy (PT) following total knee arthroplasty (TKA) and examine the relationship between number of PT sessions attended and outcomes during the first 12 weeks after surgery. Methods: Patients underwent unilateral primary TKA by a single surgeon and were advised to complete 17 PT sessions over 6 weeks at a hospital-affiliated facility. Analyses examined predictors of PT engagement (attendance of ≥ 2 sessions) and completion (attendance of 17 ± 1 sessions) within 6 weeks and associations between number of PT sessions …

Bowel Clean Out Prior To Intrathecal Baclofen Pump Implantation: Effects On Acute Post-Operative Gastrointestinal Complications, Amanda Lindenberg, Sathya Vadivelu, Brittni Walton, Matthew J. Mclaughlin

Research Days

Background: Intrathecal baclofen (ITB) pumps have been used for management of spasticity and dystonia There is limited data on immediate post-operative complications such as GI adverse events after surgery for ITB pump related procedures. This study aimed to compare patients who underwent a pre-operative bowel cleanout to those who did not and the relationship with post-operative nausea, vomiting and constipation requiring an escalation of their bowel regimen.

Design: Retrospective cohort study.

Setting: Pediatric acute care hospital.

Participants: All patients who underwent new ITB pump and/or catheter placement from January 2015-December 2022.

Interventions: Preoperative bowel clean out. Main

Outcome Measure: Quantity …

Assessment Of Gait, Balance, And Falls In Individuals With Neurodegenerative Diseases, Lauren Tueth

WUSM Theses and Dissertations – All Programs

Neurodegenerative diseases are a group of disorders that impact the brain and lead to neuronal degeneration. This degeneration causes many different symptoms, which are often grouped into motor, cognitive, and psychiatric domains. Individuals with these disorders can experience symptoms from multiple domains at the same time, but little is known about how these distinct symptoms may impact each other.

In Chapter 2, we explored the intersection of balance and cognitive impairment in individuals with Alzheimer disease (AD). AD is traditionally discussed in the context of the dementia symptoms, but people with AD also experience motor deficits. Falls are a huge …

Measurement Of And Contributors To Developmental Coordination Impairment, Jeffrey D. Konrad

WUSM Theses and Dissertations – All Programs

Movement drives childhood development. As motor skills improve across development, a child becomes capable of greater interactions with their physical and social environment. Children with motor impairments miss out on these interaction opportunities and their development across a variety of domains can suffer. There is accumulating evidence that poor motor competence relates to an array of developmental outcomes such as educational achievement, reading skills, social development, and emotional regulation. Two developmentally important motor impairments are poor motor competence and hyperactivity which are associated with Autism Spectrum Disorder (ASD), Developmental Coordination Disorder (DCD), and/or Attention Deficit Hyperactivity Disorder (ADHD). Critical to …

Improving Access To Mainehealth Care At Home, Amanda Kunkel, Mhcah Intake Department, Mhcah Scheduling Department, Mhcah Clinical Leadership Team

Operations Transformation

It is known that there are capacity limitations at MaineHealth Care at Home caused by a decrease in staffing. This leads to limited availability of home health services to patients in the community and can also contribute to increased length of stay for patients in acute care hospitals. MaineHealth Care at Home needs a way to measure current capacity to accept referrals and improved systems for communicating with referral sources.

Interprofessional Education Through Home Modification, Cathey P. Norton, Kelly R. Gore

Faculty Scholarship Symposium

Creating safe and accessible environments for all people, including physical, sensory, and cognitive disabilities is an important part of training students in occupational therapy, physical therapy, and interior design. Approximately 125 students from these disciplines worked together during a unique interprofessional experience, to perform everyday tasks with a simulated disability, then collaborated as interprofessional teams to make recommendations for home environment modifications to improve safety and accessibility for individuals with physical challenges. This was a unique opportunity for all the students to learn about other disciplines and the expertise that each brings to the table to help our clients.

Physical Activity And Knee Health Outcomes After Anterior Cruciate Ligament Reconstruction, David Werner

Theses & Dissertations

Anterior cruciate ligament reconstructions (ACLR) have increased in incidence worldwide. After ACLR, individuals are at higher risk for developing early onset knee osteoarthritis. Individuals after ACLR also participate in less physical activity (PA), contributing to an increased risk for early onset knee osteoarthritis and poor overall health outcomes.

The two goals of this work were to 1) determine the relationship between PA and knee health outcomes 18 months after ACLR and 2) determine the feasibility and acceptability of a PA intervention early after ACLR that considered participant thoughts and feelings.

Findings for the first goal suggest that there is no …

Short-Term Benefits From Manual Therapy As An Adjunct Treatment For Persistent Postural-Perceptual Dizziness Symptoms: A Preliminary Prospective Case Series, Brent A. Harper, Larry Steinbeck

Physical Therapy Faculty Articles and Research

Persistent dizziness and balance deficits are common, often with unknown etiology. Persistent Postural-Perceptual Dizziness (3PD) is a relatively new diagnosis with symptoms that may include dizziness, unsteadiness, or non-vertiginous dizziness and be persistent the majority of time over a minimum of 90 days. The purpose of this case series was to investigate short-term outcomes of reducing dizziness symptoms using a manual therapy intervention focused on restoring mobility in the fascia using a pragmatically applied biomechanical approach, the Fascial Manipulation^® method (FM^®), in patients with 3PD. The preliminary prospective case series consisted of twelve (n = 12) patients …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

How Does The Integration Of Wearable Sensor Technology Into Upper Extremity Rehabilitation Impact Functional Outcomes In Stroke Patients?, Kylon T. Coombs, Shikhar Manchanda, Cheryce Daniel

Rowan-Virtua Research Day

A literature review was done to assess effectiveness of wearable sensors in stroke rehabilitation. There is a scarcity of clinical trials evaluating their effectiveness from a clinical standpoint. Wearable sensors present an opportunity to collect patient data objectively outside of clinical settings, allowing a more comprehensive analysis of patient rehabilitation in the future.

A search of PUBMED and Scopus was conducted. Keywords “Stroke Rehabilitation”, “Wearable Sensor”, and “Upper Limb” were used to find articles. Inclusion criteria included peer-reviewed, and not limited to research within the U.S. Two independent reviewers completed the screening of articles, selecting articles that fit the criteria …

A Literature Review Of Current Treatments For The Hypermobility Subtype Of Ehlers-Danlos Syndrome, John Gericke, Mary Zsolway, Chelsea Reyes, Pooja Patel, Saad Ahmed, Julia Hwang, Venkateswar Venkataraman

Rowan-Virtua Research Day

Purpose: The purpose of this study is to compare pharmacologic intervention, neurocognitive therapy, physical therapy, and orthotics in treating the hypermobility subtype of Ehlers-Danlos Syndrome (hEDS) and determine which has the most positive effect on symptoms.

Introduction: Ehlers-Danlos Syndrome is an inheritable connective tissue disorder which results from a genetic mutation that alters the body’s ability to produce collagen. The most common subtype of Ehlers-Danlos Syndrome is hEDS, which leads to hypermobility and hyperextensibility and can cause frequent joint dislocations.

Methods: A review of literature was performed to compare each treatment based on reported results. The types of studies reviewed …

Effects Of Doctoral Program Education On Cardiovascular And General Health Outcomes Of Physical Therapy Students, Luzarianna Galindo, Laramie Tesillo, Carlos Quintana

DPT Capstones

No abstract provided.

Using Cognitive Dual-Task To Evaluate Individuals With Mild Traumatic Brain Injuries: A Pilot Study, Michelle Galvan, Maryam Buazza, Jacob Mendoza, Jallycia Pearson

DPT Capstones

Background: Traumatic Brain Injury (TBI) presents significant challenges, with cognitive and motor deficits often persisting long after the initial injury. Current assessment methods may fail to detect subtle impairments, highlighting the need for more comprehensive evaluation techniques. This pilot study aims to investigate the efficacy of cognitive dual-task assessments in detecting subtle gait deficits associated with concussion/mild Traumatic Brain Injury (c/mTBI), with a focus on identifying which cognitive dual task would provide the most cognitive cost and afford motion capture sensors the ability to detect subtle gait changes.

Methods: Twenty-two participants without prior concussion or mTBI history underwent dual-task assessments …

Enhancing Post-Injury Rehabilitation: A Focus On Prehabilitation For Athletes, Kariya Jennings, Kyanne Crockarell, Rishi Gulati, Mallory Rae, Dakota Hill, Deborah Edmondson

Physical Therapy Student Research

No abstract provided.

Functional Movement Screen: Exploring Interrater Reliability Between Students, Katie Biegel, Maari Dolan, Sidni Kast, Abi Kuznia, Blake Sjostrom

Physical Therapy Scholarly Projects

Purpose/Hypothesis: The purpose of this study was to assess the interrater reliability between five second-year physical therapy students on the scoring of the Functional Movement Screen (FMS) on 45 participants via pre-recorded videos. To our knowledge, few studies have been completed regarding interrater reliability on the FMS with the new criteria on the ankle mobility clearing test and updated criteria on the rotary stability test.

Materials/Methods: The students and an FMS expert reviewed grading criteria for each test and clearing test. Each student rater was allowed to watch each video once to score the motion to the best of …

Outpatient Physical Therapy Treatment For A Patient With A Transtibial Amputation: A Case Report, Cade D. Salentine

Physical Therapy Scholarly Projects

Introduction: Transtibial amputations (TTA) impose significant functional difficulty on those who undergo the procedure. Physical therapy is one of the resources that can be used to maximize a patient's outcomes following surgery. Physical therapists play a vital role in the improvement of strength, functional mobility, and independence following a TTA. This report covers the outpatient physical therapy evaluation and treatment of a patient status post-TTA. The purpose of this case was to identify different treatments, considerations, and outcome measures, that can be used when treating a patient with a TTA.

Case Description: The patient is a 66-year-old male who …

Physical Therapy Interventions And Outcomes For A Patient With Multiple Co-Morbidities: A Case Study, Morgan M. Johnson

Physical Therapy Scholarly Projects

Introduction. Multimorbidity is present in a significant percentage of hospital admissions with 84.1% involving one or more co-morbidities leading to longer, more expensive stays and higher inpatient mortality rates. The purpose of this case study is to evaluate physical therapy’s effects, interventions and outcomes for a patient with common co-morbidities to determine physical therapy outcomes.

Case Description. The patient was a 75-year-old female who presented to physical therapy with an admitting diagnoses of congestive heart failure and acute kidney injury. Her additional relevant medical diagnoses were hypertension, diabetes mellitus type 2, obesity, depression, 2-month status post ORIF of right ankle …

A Comparison Of Senior Athlete Data To Normative Values: A Research Study, Brooke M. Flicek, Kailen G. Halvorson, Ashley J. Schuster, Kacee J. White

Physical Therapy Scholarly Projects

It is common to develop certain conditions with aging that can include but not limited to: osteoarthritis, cardiovascular disease, osteoporosis, falls, and general geriatric syndromes (delirium, dementia, depression, pressure ulcers, urinary incontinence, sarcopenia, chronic pain). Physical activity can help prevent many conditions. This is where the Senior Athlete Fitness Exam (SAFE) becomes relevant. It is specifically designed by physical therapist Becca Jordre, in order to evaluate cardiovascular, muscular, flexibility, and balance fitness within the older adult population. At the Senior Games, the SAFE is used as a screening tool designed to identify health and risk factors for the senior athlete. …

A Valid And Reliable Method For Measuring Navicular Drop, Kayla Ellison, Bree Lindley, Ashley Conneran

Physical Therapy Scholarly Projects

Purpose/Hypothesis: Understanding navicular motion during gait is crucial for research and clinical applications. This study aimed to assess a method of measuring navicular drop during dynamic walking trials. Our technique used a two-stage assessment of navicular drop; these stages consisted of an initial static examination of the navicular position in subtalar neutral, combined with a dynamic evaluation of navicular drop during walking gait. These stages were conducted twice, with a week between data collections. This study aimed to determine the reliability of this two-stage method. We hypothesize that a two-stage process, using two independent Vicon systems, will be able …

The Effect Of Physical Therapy Intervention On Fatigue, Balance, Depression And Quality Of Life In Clients Following Medical Treatment For Cancer: A Pilot Study, Elle G. Bryant, Morghan J. Bugge, Riley A. Grube, Megan M. Lacrosse, Hunter M. Lake, Katie J. Leary

Physical Therapy Scholarly Projects

Approximately 18.1 million people living in the United States have survived cancer. The treatment for cancer can be accompanied by many long-lasting residual side effects including fatigue, decreased quality of life, balance deficits, and depression. A current problem that healthcare providers face is understanding these side effects and how to effectively treat the people who experience them.

The purpose of this pilot study is to investigate how cancer treatments affect the human body, specifically with fatigue, balance, quality of life, and depression, and how physical therapy interventions can be used to combat these factors. To assess the effects of physical …

Investigating The Efficacy Of Yoga Vs Traditional Physical Therapy In Chronic Low Back Pain: A Systematic Review, Courtney Andrade, Casey David, Grace Hicks-Green, Riley Young

DPT Capstones

Introduction: Chronic low back pain (CLBP) is a complex diagnosis causing an increase in disability and decreased quality of life. This condition is defined as having low back pain for more than three months, in which an individual experiences a decline in function due to enduring pain. Several factors contribute to CLBP including core muscle weakness and decreased motor control to allow for lumbar stability. Though CLBP can be treated in multiple ways; this systematic review (SR) investigates the treatment effects of yoga combined with physical therapy (PT) vs. PT alone to measure the disability using the Oswestry Disability Index …

Prevalence Of And Influences For Incorporating Clinically-Relevant Spanish Into Doctor Of Physical Therapy Programs, Daniela Quinones, Deyanira Verdeja Sosa, Megan Giron

DPT Capstones

Introduction. The United States has 63.7 million Hispanic/Latino individuals, and approximately 40% of Spanish speakers have limited English proficiency (LEP). Patient-provider language discordance is a major contributor towards health disparities. Hence, many health professions educators offer clinically-relevant Spanish. The primary study purposes were to: 1) identify the prevalence of Doctor of Physical Therapy (DPT) programs in the United States that incorporate clinically-relevant Spanish language learning in their curriculum; and 2) describe how DPT programs incorporate Spanish language learning in their curriculum.

Review of Literature. Researchers in a 2014 report identified 12 DPT programs offering Spanish; however, the current prevalence is …

Effects Of Using External Biofeedback In Improving Ankle Kinematics In Those With Chronic Ankle Instability Compared To Conventional Therapy Without External Biofeedback: A Systematic Review, Lachlan Cubbin, Kelli Kirkpatrick

DPT Capstones

I. Introduction: Lateral ankle sprains are amongst the most common injuries to occur in athletes and the general population alike. While most can recover without complications, there exists a considerable risk of recurrent injury which can result in ongoing difficulties related to pain, function, and overall quality of life. This high recurrence rate is due to excessive lateral deviations in the location of pressure-related variables in the foot. Ongoing instability of the foot, known as chronic ankle instability (CAI), results due to these abnormal gait and ankle kinematics which causes significantly greater inversion of the foot during initial contact of …