Rehabilitation and Therapy Commons^™

The Importance Of Trunk Motion In Wearable Based Infant Spontaneous Movement Analysis, Pablo Burgos

Faculty Publications - College of Physical Therapy

The characteristics of spontaneous movements in infants are essential for the early detection of neurological pathologies, with the Prechtl method being a widely recognized approach. While the Prechtl method is effective in predicting motor risks, its reliance on the evaluator’s expertise limits its scalability, particularly in low-income areas. In such contexts, the use of inertial sensors combined with automated analysis presents a promising accessible alternative; however, more research is necessary to get results comparable to those of the Precht method. This research aims to determine the more important metrics of trunk and limbs to assess spontaneous movement in healthy infants …

Cognition Is Associated With Daily-Life Mobility In People With Parkinson’S Disease, Pablo Burgos

Faculty Publications - College of Physical Therapy

Introduction: Cognitive impairment is common in people with Parkinson’s disease (PD). Mobility is also impaired in people with PD and functional mobility often requires cognitive dual-tasking to navigate complex environments in daily life. We hypothesized that visuospatial and executive cognitive dysfunction in people with PD will be associated with digital measures of mobility in daily life. Since freezing of gait (FoG) is associated with both cognitive dysfunction and mobility impairments, we also examined the influence of FoG on the cognitionmobility relationship. Here, we investigated, for the first time, the association between cognition and dailylife mobility in PD and the influence …

Responsiveness Of Promis Measures For Hip, Knee, And Shoulder Arthroplasty, Ryan Jacobson

Faculty Publications - College of Physical Therapy

Objectives: In hip, knee, and shoulder arthroplasty, there is evidence that using a broader set of Patient-Reported Outcomes Measurement Information System (PROMIS) measures beyond Physical Function and Pain Interference might improve assessment of patient outcomes. However, the utility and responsiveness of PROMIS domains measuring anxiety, fatigue, sleep, and social participation have been minimally investigated in arthroplasty. This retrospective study aimed to determine the 1) responsiveness of seven PROMIS domains and 2) association between change scores for all seven domains and MCID improvement in Physical Function and/or Pain Interference.

Methods: PROMIS domains of Physical Function, Pain Interference, Depression, Anxiety, Fatigue, Sleep …

The Use Of Virtual Reality To Improve Gait And Balance In Patients With Parkinson’S Disease: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

(1) Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that impairs balance and postural control, gait, overall motor function, and mood, and involves the gradual degradation of several physiologic systems. With limited treatments available, physical therapy (PT)-based exercise is the nonpharmacologic measure of choice. There is a growing interest in using virtual reality (VR) gaming when rehabilitating patients with various acute brain injuries and neurological disorders. The purpose of this scoping review was to examine randomized controlled trials comparing VR-based rehabilitation programs versus traditional PT at improving gait and balance. (2) Methods: PubMed, CINAHL, and the Cochrane Central Register …

Personalized Versus Fixed Tactile Cueing In Parkinson’S Disease: Protocol For A Randomized Controlled Trial On Gait Automaticity, Pablo Burgos

Faculty Publications - College of Physical Therapy

Background

Gait automaticity, the ability of the brain to control locomotion with minimal use of executive-attentional resources, is altered in people with Parkinson’s disease (PD). Recently, we showed that step-synchronized tactile cueing improved gait regularity and freezing of gait in PD; however, it is not known if this cueing mode also improves gait automaticity. Thus, this study investigates the effects of step-synchronized tactile cueing (versus fixed cueing) on gait automaticity in the laboratory and during daily life.

Methods

This is a pilot, randomized, double-blinded study where sixty participants with PD will be randomized into one of two, cueing interventions: 1) …

Prevalence Of Stress Urinary Incontinence In Female Strength Athletes, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background: Stress urinary incontinence (SUI) is a symptom during pregnancy and in the postpartum period, but a high prevalence of SUI is experienced in sports involving running and jumping. Objectives: Identify the scope of the problem of SUI in women participating in strength sports, movement patterns that elicit SUI, and the impact on quality of life in female athletes with SUI. Study Design: Survey mixed methods with qualitative focus groups. Methods: The International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and a sport-specific and obstetric/gynecological history questionnaire were sent to women who are United States citizens, age 18-65, and members …

Weight Stigma In Physical And Occupational Therapy: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background: Weight stigma describes the negative attitudes held toward people with obesity. Weight bias stereotypes have been previously reported in physicians, physician assistants, nurses, registered dieticians, psychologists, and students enrolled in healthcare professional education programs. Physical and occupational therapists (PTs and OTs) are healthcare providers who evaluate and treat individuals across their lifespan. A PT or an OT who harbors weight bias may create an environment where the patient may fail to optimize their rehabilitation recovery. The first purpose of this scoping review was to identify the prevalence of weight bias in PT and OT clinicians and students. The second …

Floor-To-Stand Transfers In Older Adults: Insights Into Strategies And Lower Extremity Demands, Lyndsay Stutzenberger, Tyler Whited

Faculty Publications - College of Physical Therapy

Background/Objectives: Getting up from the floor is an important functional skill for independence in older adults but is not often assessed clinically. The purpose of this study was to investigate how floor-to-stand transfer (FTS) ability is related to self-report measures and five-time sit-to-stand (5XSTS) performance, as well as compare peak joint angles during common FTS strategies and lower extremity demands between the 5XSTS and a commonly instructed FTS strategy. Methods: Thirty-four community-dwelling older adults completed self-report measures and performed the 5XSTS, a FTS in a self-selected manner, and an instructed FTS strategy. Biomechanical analysis of the lower extremities was used …

Predicting Student Success In Entry-Level Doctor Of Physical Therapy Courses, Lyndsay Stutzenberger, Tess Swake

Faculty Publications - College of Physical Therapy

Early identification of students at risk for academic challenges in a Doctor of Physical Therapy (DPT) program may allow for timely intervention and support. Little is known about the ability of the Motivated Strategies for Learning Questionnaire (MSLQ) to predict academic success in firstyear courses in a DPT program. Participants were 33 firstyear DPT students from a single cohort. Student demographics, previous academic performance, and responses to the MSLQ for Anatomy and Biomechanics courses were collected early in each semester. Spearman correlations determined associations between undergraduate grade point average (GPA) or MSLQ responses and grades for Fall and Spring semesters. …

Polycystic Ovary Syndrome And The Effects Of A Ketogenic Diet: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background/Objectives: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy experienced by females. Diagnosis of PCOS is established when at least two of the following are present: hyperandrogenism, oligo-anovulation, and/or polycystic ovaries. Conservative treatment for PCOS includes dietary modifications and physical activity. The purpose of this scoping review was to evaluate the efficacy of a ketogenic diet in improving biochemical measures and reducing the severity of PCOS symptoms. Methods: CINAHL, PubMed, and Google Scholar databases were searched to find research published in peer-reviewed journals between 2019 and 2025. An article was included in this scoping review if the study assessed …

Running Biomechanical And Isokinetic Strength Differences In Masters Runners With And Without Achilles Tendinopathy, Matthew Klein, Christopher Patterson, Annette Karim, Tyler Cuddeford

Faculty Publications - College of Physical Therapy

Masters runners are an increasing proportion of the running com-munity. The most significant musculoskeletal changes in runners occur after the age of 50 in addition to changes in injury rates and types, the most common being Achilles tendinopathy (AT). Previous evidence has suggested similarities between risk factors for AT and age-related changes that are focused at the hip and the ankle during the propulsive stage of running. The purpose of this study was to investigate biomechanical and peak torque association to AT in masters runners. Thirty-two masters runners over age 50 with AT(60.31 ± 8.37, n = 16) and without …

Changes In Quadriceps Strength In Recreationally Active Individuals Using Single-Limb Or Double-Limb Blood Flow Restriction, Brogan Boen, Logan Cockrell, Olivia Aho, Taylor Bryant, Bethany Nguyen, Jason Brumitt

Student-Faculty Research - College of Physical Therapy

Blood flow restriction training utilizes a tourniquet system to occlude arterial and venous flow while one performs exercises. This training strategy allows one to exercise using loads at a lower percentage of 1RM while experiencing physiological change similar to those achieved when training at a higher percentage of 1RM.

Is Sway-Referenced Haptic Assistance Sensitive To Perceptual Context, Andrew Meszaros, Robin Dorociack, Peter Jang, Tanner Lehr, Bayli Mohl

Student-Faculty Research - College of Physical Therapy

Falls account for >$50 billion of medical spending in 2015 (CDC). Real-time haptic feedback shows promise at reducing static standing COM sway (Meszaros, 2019). Pilot data variability suggests that some haptic-wearers ‘over-correct’ (unnecessarily reducing available degrees of freedom), when haptic correction is perceived as ‘a mistake. Does over-correction reduce multi-segment control and impair sway stability (Hsu, Scholz, et al. 2007)?

Factors Affecting Peak Effort In Max Effort Tests, Amanda Pardue, Michael Forster, Taylor Kopecky, Zoralei Dayley, Jeff Houck, Rebecca Dobler

Student-Faculty Research - College of Physical Therapy

Challenging older adults to execute peak effort functional tests is not common. A peak effort test pushes patients to the point of not sustaining the task. The Wingate test is a peak effort test that measures the amount of revolutions per second a participant can perform over 30s. Older adults with knee osteoarthritis (OA) may regulate their effort during the Wingate. Alternatively, high exertion during the Wingate test may yield high value in influencing attitudes related to pain and aging. The purpose of this study was to develop themes of what influences peak effort during the Wingate test in participants …

40-Day Fit, A Journey For Heroes, Michael B. O'Neill

Doctor of Leadership

This project is a collective portfolio of discovery and development that explores the intersection of societal health and the vitality of the church, recognizing a state of decline in both areas. This critical, yet often overlooked issue, is the foundation of this research-driven initiative. It is a practical process of diagnosis and treatment of a problem or an opportunity, in context, leading to application. The portfolio project represents a journey of discovery and reframing, where research methods, strategic objectives, and project milestones guide the identification of needs, problems, and opportunities. These elements serve as the driving forces behind crafting solutions …

Running Shoes For Posterior Tibial Tendon Problems, Matthew Klein

Faculty Publications - College of Physical Therapy

Our perspective on stability and guidance are one of the many things that make Doctors of Running unique. I, Matt Klein, generally need at least mild stability in my footwear. Like many of our readers, I have continued to navigate and understand what a stability shoe is, what options there are out there, what actually provides stability/guidance and who stability actually works best for. Recent research has suggested that stability shoes tend to benefit those with a history of pronation-related injuries or who are unable to control the natural pronation motion during gait (Malisoux et al., 2016; Williems et al., …

Effect Of Perturbation-Based Balance Training On Fall Risk And Fear Of Falls In Community-Dwelling Older Adults – A Pilot Study, Lindsey Kelly, Casey Kostecki, Garrett Markham, Conner Morris, Trevor Strem, Lyndsay Stutzenberger, Gabe Haberly

Student-Faculty Research - College of Physical Therapy

Falls are a major health concern among adults ≥65 years as it is the leading cause of injury and injury related death in the United States. Perturbation-based training (PBT) has been shown to reduce rate of falls by 50% and 24 slips has been shown to be optimal. It is unknown whether falls reduction would be greater with one session or spread out over multiple sessions. The purpose of this study was to determine the effects of PBT dosage (12 slips over 2 sessions vs. 24 slips in one session) on falls incidence, fear of falling, and reactive stepping in …

Implementing Pt In Pediatric Primary Care, Juliann Fronius, Scout Cai, Courtney Hoffman, Carlee Martin, Joel Wiley, Chris Yuen, Ryan Jacobson

Student-Faculty Research - College of Physical Therapy

Patients are referred to PT everyday, but referrals can delay care. Early care is preferred, but getting to the right healthcare provider at the right time is ideal. Upstream PT improves patient care and clinician experience. Purpose: Implement PT within pediatric primary care.

In Vivo Behavior Of The Soleus Muscle During Various Activities In Persons Post-Stroke, Madison Swaney, Molly Carter, Mitchell Mckinley, Joshua Nelson, Robin Dorociak, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

Current protocols for post stroke populations consists of inconsistent and outdated interventions that target less functional strength training through heavier and slower movements. Current research displays a 90/10 principle displaying the tendon as the primary power absorber and generator during ballistic and cyclic movements, supported by a primarily isometric muscle activation. Power generation is key for walking. High angular velocity needed during the gait cycle to be able to produce and absorb power rapidly. Ballistic training requires the perfect tradeoff between speed and force to generate and train populations targeting power absorption and output with greater tendon activity. Therefore, current …

Imu And Markerless Technology In Gait Analysis: Clinical Lessons, Jessa Barendse, Trevor Nannini, Joanna Zuckerman, Tess Swake, Robin Dorociak, Peter Jang, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

- Haptic feedback refers to the external vibratory cue that is activated by data picked up by the haptic device, Inertial Measurement Unit (IMU) (Figure 1), which senses joint position.

- Position-driven haptic touch input can modify movement in real-time (Meszaros, 2019)

- Original goal: to reduce knee hyperextension during gait using a popliteal fossa tactor driven by an IMU-based angle sensor (Sagemotion)

-Concerns arose on the validity of IMU/tactor and markerless motion analysis ❏ Are these algorithm-based data technologies clinic-ready?

- Does Sagemotion IMU fire the tactor at the actual knee angle selected in its software?

- Can markerless …

Hamstring Tendons Don’T Lie #Eccentricsdontexist, Alec Espinoza, Chris Garcia, Enoch Ho, Ian Rousseau, Joel Centeno, Robin Dorociak, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

Research done on the plantarflexor MTU have shown the degree of achilles tendon and muscle fascicle shortening/stretching is specific to demands of the activity. To expand on this principle, we wanted to explore if a similar relationship exists with the Biceps Femoris MTU. We predict that the biceps femoris (long head) muscle tendon unit (MTU) will behave similarly to the Achilles tendon complex exhibiting the 80/20 principle during dynamic activities (jogging, walking) and the muscle fascicle will lengthen more than the MTU during stationary exercise (Nordic hamstring curls, Romanian deadlifts).

Does The Size-Weight Illusion Exist During Deadlift?, Dakota Kerbow, Luke Mallory, Robin Dorociak, Peter Jang, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

Purpose:

to assess whether the SWI exists during deadlift (whole body loading), and identify the mechanical factors that explain or overcome the illusion

Fatigue Changes Biomechanical Variables In Drop Vertical Jump Performance In Competitive Basketball Players, Isabella Bruno, Caroline Linardos, Michala Rennels, Kristina Williams, Robin Dorociak, Jaydee Romick, Jason Brumitt

Student-Faculty Research - College of Physical Therapy

The drop vertical jump (DVJ) has been used as a tool to identify athletes at risk for injury. Initial studies have suggested an association between biomechanical variables and injury (1); however, subsequent research has demonstrated no relationship (2-4). Evaluating variables in fatigued athletes may help clinicians identify athletes at risk. Advances in motion capture technology now allow for assessment of variables after a fatigue protocol.

Comparing Self-Reported Sleep Quality And Sleep Disturbance With Physical Activity In Community Dwelling Older Adults, Sophie Larue, Morgan Hendley, Brandon Tandecki, Kirsten Cabrera, Faerynn Tilgner, Brad Higa, Christen Johnson, Cindy Zablotny, Theresa Raudsepp, Jeff Houck

Student-Faculty Research - College of Physical Therapy

Purpose:

To evaluate physical activity and sleep health in community dwelling older adults through use of activity monitors, physical capacity tests, self-reported sleep health, physical health measures, and participation in social roles. We wanted to know how these measures may or may not play a significant role in future physical therapy treatment. Our hypothesis was that self- reported sleep quality and sleep disturbance is correlated to physical activity in community dwelling older adults.

Embedding Physical Therapy In The Pediatric Primary Care Setting: Qualitative Analysis Of Pediatricians’ Insights On Potential Collaborative Roles And Benefits, Ryan P. Jacobson, Rebecca R. Dobler

Faculty Publications - College of Physical Therapy

The growing need for collaborative healthcare teams to meet complex health challenges has led to physical therapists (PTs) being embedded in adult primary care settings for many years now. However, this model of care has not been found in pediatrics. This qualitative study sought to gain insights from pediatricians on the potential of embedding pediatric PTs in primary care. Participants were nine pediatricians practicing in both urban and rural, hospital-based and private settings. Semi-structured interviews were recorded, transcribed, and analyzed via thematic analysis per published methods, assuring trustworthiness. Three overarching themes emerged: pediatricians’ priorities aligned with the Quadruple Aim of …

It's Time To (Again) Recognize The Considerable Clinical And Public Health Significance Of Cardiorespiratory Fitness, Leonard A. Kaminsky, Mary T. Imboden, Cemal Ozemek

Faculty Publications - Department of Kinesiology

In this issue of the Journal of the American College of Cardiology, Kokkinos et al5 studied the relationship of both a single CRF value, and change in CRF, with all-cause mortality in a large (n 1⁄4 93,060) sample from the ETHOS (Exercise Testing and Health Outcomes Study) cohort. In this cohort, CRF was estimated as the peak metabolic equivalents (METs) derived from the peak speed and grade obtained on a treadmill exercise test. The findings from the single measure of CRF showed, compared with the low-CRF group (w5 METs), reductions in mortality rate across each higher-CRF group in both those …

Perception Of Workload And Task Importance During Complex And Dual Task Conditions, Alicia Maul, Cody Lamont, Erin Zurbrugg, Gillian Berry, Katherine Armstrong, Lea Keenantasker, Patricia Eckart, Cindy Zablotny, Theresa Raudsepp, Ryan Jacobson

Student-Faculty Research - College of Physical Therapy

Background

• "cognitive processes and movement need to occur concurrently as part of social engagement; voluntary movement is not wholly automatic and when movement occurs, it leads to changing cognitive demands." (McIsaac et al, 2015)

• Current practice for creating dual-task challenges in the clinic include serial subtraction and carrying a glass of water (complex walking task) however these do not always translate to a patient's individualized challenges and goals

• Research has shown that a patient's engagement and performance improves when the task they are performing is meaningful in their lives. (McIsaac et al, 2015)

• Would including items …

Effects Of A Parkinson's Disease Community Exercise Group On Self Reported Promis Measures, Desiray Anderson, Alexis Creighton, Jillian Studer, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

Parkinson’s Disease (PD) is an upper motor neuron disorder that results in bradykinesia, rigidity, shuffling gait patterns, and balance impairments. Non-motor issues include depression, anosmia, GI issues, pain, and more. Approximately 90,000 people in the U.S. are diagnosed every year.

Hypothesis: Self efficacy and satisfaction roles will positively correlate with participation in the 6 week exercise program.

Effects Of Context Perception And Haptic Feedback On Sway, Andrew Meszaros, Tess Swake, Robin Dorociack, Catherine Enger, Gavin Boen, Alex Johnston, Braedon Miller

Student-Faculty Research - College of Physical Therapy

The purpose of this research is to assess whether framing the context of haptic feedback as an "error" signal or "helpful" signal can impact sway control.

Perturbation-Based Balance Training Added To A Fall Prevention Exercise Program And Its Effect On Fall Risk And Fear Of Falling In Community-Dwelling Older Adults, Joseph Espero, Jeremiah Everett, Leanne Gehrke, Sage Goodman, Spencer Hall, Melody Hansen, Lyndsay Stutzenberger, Rebecca Dobler, Gabe Haberly

Student-Faculty Research - College of Physical Therapy

Background:

● Falls lead to decreased independence, increased disability, and increased risk of death

● Falls occur in more than one out of four older adults each year

Research Suggests:

● 50 hours of a structured strength and balance exercise program supplemented with fall prevention education over 12 weeks decreases fall risk in community dwelling older adults

● One session of perturbations provided at the appropriate dosage can decrease fall risk by 50%, with multidirectional perturbations having the greatest benefit

Hypothesis:

● Adding one session of perturbation-based training to a structured strength and balance exercise program will reduce the risk …