Rehabilitation and Therapy Commons^™

Perceived Exertion During Moderate And Vigorous Physical Activity While Mask Wearing: A Quantitative And Qualitative Pilot Study, Jennifer L. Scheid, Corinne Edwards, Michael Seils, Sarah L. West

Articles & Book Chapters

There is limited research examining the perception of exertion during exercise while wearing a facemask. The current study examined if mask usage during moderate or vigorous physical activity (MVPA) changed the self-reported perception of exertion. Seventy-two adults (18 years and older) who were physically active before the COVID-19 pandemic completed a questionnaire that assessed exercise habits and perceptions of mask wearing during MVPA. Participants reported their ratings of perceived exertion (RPE, on a scale of 1–10) while exercising. Wearing a mask resulted in higher RPE vs. no mask during both vigorous (8.4 ± 0.2 vs. 7.4 ± 0.1; p < 0.001) and moderate PA (6.6 ± 0.2 vs. 5.6 ± 0.2; p < 0.001). Qualitative analysis revealed mostly negative perceptions of exercising while wearing a mask, including respiratory issues, detriments to cardiovascular endurance, and general discomfort. A total of 40% of participants reported that they stopped exercising in an indoor/public setting because of a mask mandate in their region. Participants reported participating in less vigorous PA (4.7 ± 0.4 vs. 4.0 ± 0.4 h/week; p = 0.046), but not less moderate PA (3.3 ± 0.3 vs. 3.0 ± 0.3 h/week; p = 0.443) pre vs. during the pandemic. Our study suggests that facemask usage during MVPA causes an increase in RPE and may be one reason for a decrease in vigorous PA during the COVID-19 pandemic.

Assessment Of Differences In Inpatient Rehabilitation Services For Length Of Stay And Health Outcomes Between Us Medicare Advantage And Traditional Medicare Beneficiaries, Ying Cao, Jing Nie, Sue Ann Sisto, Paulette Niewczyk, Katia Noyes

Articles & Book Chapters

Importance: Enrollment in Medicare Advantage (MA) has been increasing and has reached one-third of total Medicare enrollment. Because of data limitations, direct comparison of inpatient rehabilitation services between MA and traditional Medicare (TM) beneficiaries has been very scarce. Subgroups of elderly individuals admitted to inpatient rehabilitation facilities (IRFs) may experience different care outcomes by insurance types.

Objective: To measure the differences in length of stay and health outcomes of inpatient rehabilitation services between TM and MA beneficiaries in the US.

Design, setting, and participants: This multiyear cross-sectional study used the Uniform Data System for Medical Rehabilitation to assess rehabilitation services …

Telehealth And Physical Therapy Clinical Decision Making In A Patient With A Falcine Meningioma, Ryan Boggs, Nicholas Frappa, Michael Ross, Michael Tall

Articles & Book Chapters

Telehealth utilizes information technologies and communication networks to deliver healthcare and education with lower costs and improved access, quality, and efficiency of healthcare services. This report describes the application of telehealth for medical screening, clinical decision making, and medical referral in a physical therapy practice. The patient described was a 50-year old man who contacted his physical therapist via telephone for a chief complaint of worsening left sided numbness and tingling that began insidiously 2 days prior. Further questioning revealed that the patient also complained of left ankle weakness, and slight unsteadiness with walking. He had not been feeling well …

The Relationship Between Disability And Hop Performance In Subjects Following Anterior Cruciate Ligament Reconstruction, Joshua Prall, Michael Ross

Articles & Book Chapters

Background and purpose: The purpose of this study was to determine the relationship between patient disability levels following anterior cruciate ligament reconstruction (ACLR) and closed kinetic chain performance as measured through a single leg hop for distance test, a 45-second sagittal plane hop test, and a 45-second frontal plane hop test.

Methods: Sixteen subjects, all cadets at the U.S. Air Force Academy who had undergone unilateral ACLR, participated in this study (10 males, 6 females, age=21.7±1.2 years, height=178.3±8.7 cm, weight=79.8±14.3 kg). The Knee Outcome Survey Sports Activity Scale (SAS) was used as our disability measure. The tests used to measure …

Diagnosis Of Internal Carotid Artery Stenosis In A Patient Referred To A Physiotherapist For Dizziness, Ryan Boggs, Michael Ross, Michael Tall

Articles & Book Chapters

PURPOSE: The purpose of this report is to describe the diagnostic focus of the clinical decision-making process for a patient referred to a physiotherapist for treatment of persistent dizziness, who was subsequently diagnosed with severe stenosis of the internal carotid arteries.

CASE DESCRIPTION: The patient was a 79-year-old man who was referred to a physiotherapist by his primary care physician for the treatment of persistent intermittent dizziness. The patient’s dizziness began 6 months prior insidiously; it was worsening over time and now interfered with activities of daily living. The patient denied cervical pain or headaches, numbness or tingling in his …

Electroskip Auditory Biofeedback In A Patient With Parkinson Disease: A Case Report, Garrett Szydlowski, Jamie O’Neil, Jon Mrowczynski, Lisa Inglis, Michael Ross

Articles & Book Chapters

The purpose of this case study was to observe the effects of a rehabilitation program with an audio-biofeedback technology device called Electroskip in a patient with Parkinson disease. The patient was a 61-year-old man with moderate Parkinson disease (Hoehn and Yahr Parkinson’s scale stage III) and dementia who had progressive episodes of freezing of gait. The patient also had a history of recent falls. The patient completed a 6-week rehabilitation program focused on functional tasks, balance and gait training while using Electroskip technology, which is a wireless, wearable device that sends a discrete real-time generative audio-biofeedback signal when the user …

Neurorehabilitation For An Individual With Bilateral Thalamic Stroke And Preexisting Visual Impairment Presenting With Impaired Use Of Sensory Cues: A Case Report, Christina Kelly, Jen Meyer, Valery Hanks, Christy Barefield

Articles & Book Chapters

Introduction: Impaired balance is one of the primary causes of functional limitations. Related to sensory deficits specifically, balance disorder in stroke may be caused by decreased central integration of sensory cues, including somatosensory, visual and vestibular input.

Case Presentation: This case describes a 23-year-old male with bilateral thalamic stroke following surgical resection of a recurring optic nerve meningioma. He had a complex medical history and is legally blind. He presented to outpatient neurorehabilitation 5 months following his stroke. He demonstrated absent light touch sensation and absent proprioception and kinesthetic awareness in his upper extremities, lower extremities, and trunk. …

A Critically Appraised Topic On The Tuck Jump Assessment: Does The Tuck Jump Assessment Demonstrate Interrater And Intrarater Reliability In Healthy Individuals?, Marissa L. Mason, Marissa N. Clemons, Kaylyn B. Labarre, Nicole R. Szymczak, Nicole J. Chimera

Articles & Book Chapters

Clinical Scenario: Lower-extremity injuries in the United States costs millions of dollars each year. Athletes should be screened for neuromuscular deficits and trained to correct them. The tuck jump assessment (TJA) is a plyometric tool that can be used with athletes.

Clinical Question: Does the TJA demonstrate both interrater and intrarater reliability in healthy individuals?

Summary of Key Findings: Four of the 5 articles included in this critically appraised topic showed good to excellent reliability; however, caution should be taken in interpreting these results. Although composite scores of the TJA were found to be reliable, individual flaws …

The Management Of Work-Related Musculoskeletal Injuries In An Occupational Health Setting: The Role Of The Physical Therapist, Joshua Prall, Michael Ross

Articles & Book Chapters

With the emergence of work-related musculoskeletal disorders and the associated high cost of injured workers, physical therapists are in a unique position to help employers manage these concerns through multidisciplinary injury prevention programs, education, ergonomics, on-site treatment, and return to work programs. The purpose of this paper, through a review of the literature, is to describe the effect that workplace injuries have on employees and the economic burden on employers. Furthermore, this paper will highlight the effectiveness a physical therapist can have in the occupational health setting as part of a multidisciplinary team on ergonomics, employee health, prevention of work-related …

The Effects Of Cryotherapy On Quadriceps Electromyographic Activity And Isometric Strength In Patient In The Early Phases Following Knee Surgery, William Loro, Mark Thelen, Michael Rosenthal, Paul Stoneman, Michael Ross

Articles & Book Chapters

Purpose: To determine the effects of cryotherapy on quadriceps electromyographic (EMG) activity and isometric strength in early postoperative knee surgery patients.

Methods: Twenty-two volunteers with recent knee surgeries were included. EMG readings of the vastus medialis (VM), rectus femoris (RF), and vastus lateralis (VL) from the surgical leg were collected during a maximal voluntary quadriceps setting (QS) activity. Maximum isometric knee extension force measurements were also recorded. Subjects were randomly assigned to receive an ice bag or a sham room-temperature bag to the front of their postsurgical knee for 20 min. After treatment, the subjects repeated the above mentioned maximum …

Acute Progressive Neurological Decline In An Elderly Man, Troy Burley, Michael Ross, Ryan Elliott, Michael Tall

Articles & Book Chapters

The patient was an 88-year-old man referred to a physical therapist by his primary care physician for a 1-week history of severe neck pain of insidious onset. Based upon the history and physical examination, the physical therapist concluded that the patient’s neck pain was mechanical in nature. Initial physical therapist intervention included cervical taping, cervical collar use and instruction in home exercise. At his follow-up visit 4 days after his initial physical therapy visit, the patient reported no improvement. The patient’s son, who accompanied him to this visit, also reported that his father had a recent onset of fever and …

Utility Of Fms To Understand Injury Incidence In Sports: Current Perspectives, Meghan Warren, Monica Lininger, Nicole Chimera, Craig Smith

Articles & Book Chapters

The Functional Movement Screen (FMS) is a popular movement screen used by rehabilitation, as well as strength and conditioning, professionals. The FMS, like other movement screens, identifies movement dysfunction in those at risk of, but not currently experiencing, signs or symptoms of a musculoskeletal injury. Seven movement patterns comprise the FMS, which was designed to screen fundamental movement requiring a balance between stability and mobility. The 7 movement patterns are summed to a composite FMS score. For an instrument to have wide applicability and acceptability, there must be high levels of reliability, validity, and accuracy. The FMS is certainly a …

A Characterization Of Cancer Patients In Inpatient Rehabilitation Facilities: A Retrospective Cohort Study, Jacqueline Mix, Carl Granger, Michael Lamonte, Paulette Niewczyk, Margaret Divita, Richard Goldstein, Jerome Yates, Jo Freudenheim

Articles & Book Chapters

OBJECTIVES: To identify the types of cancer patients admitted to inpatient medical rehabilitation and to describe their rehabilitation outcomes.

DESIGN: Retrospective cohort study.

SETTING: U.S. inpatient rehabilitation facilities (IRFs).

PARTICIPANTS: Adult patients (N=27,952) with a malignant cancer diagnosis admitted to an IRF with a cancer-related impairment between October 2010 and September 2012 were identified from the Uniform Data System for Medical Rehabilitation database.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Demographic, medical, and rehabilitation characteristics for patients with various cancer tumor types were summarized using data collected from the Inpatient Rehabilitation Facility-Patient Assessment Instrument. Rehabilitation outcomes included the percentage of patients …

A Community-Bases Aquatic Exercise Program To Improve Endurance And Mobility In Adults With Mild To Moderate Intellectual Disability, Renée Hakim, Michael Ross, Wendy Runco, Michael Kane

Articles & Book Chapters

The purpose of this study was to investigate the impact of a community-based aquatic exercise program on physical performance among adults with mild to moderate intellectual disability (ID). Twenty-two community-dwelling adults with mild to moderate ID volunteered to participate in this study. Participants completed an 8-week aquatic exercise program (2 days/wk, 1 hr/session). Measures of physical performance, which were assessed prior to and following the completion of the aquatic exercise program, included the timed-up-and-go test, 6-min walk test, 30-sec chair stand test, 10-m timed walk test, hand grip strength, and the static plank test. When comparing participants’ measures of physical …

Physical Therapy In Wound Care A Cost-Effectiveness Analysis, Kehua Zhou, Kenneth Krug, Michael S. Brogan

Articles & Book Chapters

© 2015 Wolters Kluwer Health, Inc. All rights reserved. Management of chronic wounds remains unsatisfactory in terms of treatment cost and time required for complete wound closure (CWC). This study aimed to calculate the healing rates, estimated cost, and time required for CWC in wounds; compare estimated wound care costs between healing and nonhealing wounds; and compare cost effectiveness between venous leg ulcer (VLU) and non-VLU. This was a retrospective cohort study performed at a physical therapy (PT) wound care clinic. Deidentified patient data in the electronicmedical database from September 10, 2012 to January 23, 2015 were extracted. Among 159 …