Rehabilitation and Therapy Commons^™

Discussion: Advanced Technologies To Improve Wound Healing: Electrical Stimulation, Vibration Therapy, And Ultrasound-What Is The Evidence?, Luther C. Kloth

Physical Therapy Faculty Research and Publications

No abstract provided.

Muscle-Specific Effective Mechanical Advantage And Joint Impulse In Weightlifting, Kristof Kipp, Chad Harris

Exercise Science Faculty Research and Publications

Lifting greater loads during weightlifting exercises may theoretically be achieved through increasing the magnitudes of net joint impulses or manipulating the joints’ effective mechanical advantage (EMA). The purpose of this study was to investigate muscle-specific EMA and joint impulse as well as impulse-momentum characteristics of the lifter-barbell system across a range of external loads during the execution of the clean. Collegiate-level weightlifters performed submaximal cleans at 65, 75, and 85% of their 1-repetition maximum (1-RM) while data from a motion analysis system and a force plate were used to calculate lifter-barbell system impulse and velocity, as well as net extensor …

Lean Mass Predicts Conditioned Pain Modulation In Adolescents Across Weight Status, Stacy Stolzman, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Background

There is a wide continuum of conditioned pain modulation (CPM) in adults with older adults experiencing an attenuated CPM response compared with younger adults. Less is known for adolescents and the role of anthropometrics.

Methods

Fifty-six adolescents (15.1 ± 1.8 years; 32 normal weight and 24 overweight/obese; 27 boys) completed in a CPM session that included anthropometric testing. Pressure pain thresholds were measured at the nailbed and deltoid muscle (test stimuli) with the foot submerged in a cool or ice water bath (conditioning stimulus). Weight status, body composition (Dual-energy X-ray absorptiometry scan), physical activity levels and clinical pain were …

Only Women Report Increase In Pain Threshold Following Fatiguing Contractions Of The Upper Extremity, Kathy J. Lemley, Jonathon Senefeld, Sandra K. Hunter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Purpose

The perception of pain in response to a noxious stimulus can be markedly reduced following an acute bout of exercise [exercise-induced hypoalgesia (EIH)]. Sex differences in EIH frequently occur after exercise but may be confounded by the sex differences in muscle fatigue. The purpose was to determine if sex differences in pain relief occur after an exercise protocol when muscle fatigue is similar for both young and older men and women.

Methods

Pain perception of 33 men (15 young) and 31 women (19 young) was measured using a pressure pain stimulus on the left index finger before and after …

Effects Of Laryngeal Restriction On Pharyngeal Peristalsis And Biomechanics: Clinical Implications, Rita Shaker, Patrick Sanvanson, Gokulakrishnan Balasubramanian, Mark Kern, Ashley Wuerl, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

To date, rehabilitative exercises aimed at strengthening the pharyngeal muscles have not been developed due to the inability to successfully overload and fatigue these muscles during their contraction, a necessary requirement for strength training. The purpose of this study was to test the hypothesis that applying resistance against anterosuperior movement of the hyolaryngeal complex will overload the pharyngeal muscles and by repetitive swallowing will result in their fatigue manifested by a reduction in pharyngeal peristaltic amplitude. Studies were done in two groups. In group 1 studies 15 healthy subjects (age: 42 ± 14 yr, 11 females) were studied to determine …

Influence Of Visual Feedback On Dynamic Balance Control In Chronic Stroke Survivors, Eric R. Walker, Allison S. Hyngstrom, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Chronic stroke survivors have an increased incidence of falls during walking, suggesting changes in dynamic balance control post-stroke. Despite this increased incidence of falls during walking, balance control is often studied only in standing. The purpose of this study was to quantify deficits in dynamic balance control during walking, and to evaluate the influence of visual feedback on this control in stroke survivors. Ten individuals with chronic stroke, and ten neurologically intact individuals participated in this study. Walking performance was assessed while participants walked on an instrumented split-belt treadmill with different types of visual feedback. Dynamic balance control was quantified …

Role Of Physical Therapists In The Management Of Individuals At Risk For Or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline, Ellen Hillegass, Michael Puthoff, Ethel M. Frese, Mary Thigpen, Dennis Sobush, Beth Auten

Physical Therapy Faculty Research and Publications

The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular & Pulmonary and Acute Care sections of APTA, have developed this clinical practice guideline to assist physical therapists in their decision-making process when treating patients at risk for venous thromboembolism (VTE) or diagnosed with a lower extremity deep vein thrombosis (LE DVT). No matter the practice setting, physical therapists work with patients who are at risk for or have a history of VTE. This document will guide physical therapist practice in the prevention of, screening for, and treatment of patients at risk for or diagnosed with LE DVT. Through …

Sex Differences In Elite Swimming With Advanced Age Are Less Than Marathon Running, Jonathon Senefeld, Michael J. Joyner, A. Stevens, Sandra K. Hunter

Exercise Science Faculty Research and Publications

The sex difference in marathon performance increases with finishing place and age of the runner but whether this occurs among swimmers is unknown. The purpose was to compare sex differences in swimming velocity across world record place (1st–10th), age group (25–89 years), and event distance. We also compared sex differences between freestyle swimming and marathon running. The world's top 10 swimming times of both sexes for World Championship freestyle stroke, backstroke, breaststroke, and butterfly events and the world's top 10 marathon times in 5-year age groups were obtained. Men were faster than women for freestyle (12.4 ± 4.2%), backstroke (12.8 …

Hip External Rotator Strength Is Associated With Better Dynamic Control Of The Lower Extremity During Landing Tasks, Philip Malloy, Alexander Morgan, Carolyn M. Meinerz, Christopher Geiser, Kristof Kipp

Exercise Science Faculty Research and Publications

Hip external rotator strength is associated with better dynamic control of the lower extremity during landing tasks. J Strength Cond Res 30(1): 282–291, 2016—The purpose of this study was to determine the association between hip strength and lower extremity kinematics and kinetics during unanticipated single-leg landing and cutting tasks in collegiate female soccer players. Twenty-three National Collegiate Athletic Association division I female soccer players were recruited for strength testing and biomechanical analysis. Maximal isometric hip abduction and external rotation strength were measured using a hand-held dynamometer and expressed as muscle torque (force × femoral length) and normalized to body weight. …

Body Composition Measurement In Children With Cerebral Palsy, Spina Bifida And Spinal Cord Injury: A Systematic Review Of The Literature, Michele L. Polfuss, Paula E. Papanek, Fallon Meyer-Wentland, Andrea Moosreiner, Lenore R. Wilkas, Kathleen J. Sawin

Exercise Science Faculty Research and Publications

Pediatric obesity is a major health concern that has an increased prevalence in children with special needs. In order to categorize a child’s weight, an assessment of body composition is needed. Obtaining an accurate body composition measurement in children with special needs has many challenges associated with it. This perplexing scenario limits the provider’s ability to screen, prevent and treat an abnormal weight status in this vulnerable population. This systematic review summarizes common methods of body composition measurements, their strengths and limitations and reviews the literature when measurements were used in children with cerebral palsy, spina bifida and spinal cord …

The Painful Long Head Of The Biceps Brachii: Nonoperative Treatment Approaches, Kevin E. Wilk, Todd R. Hooks

Physical Therapy Faculty Research and Publications

Pain associated with the long head of the biceps (LHB) brachii seems to be increasingly recognized in the past 4 to 5 years. The LHB has long been considered a troublesome pain generator in the shoulder. Abnormality involving the LHB brachii has long been an area of debate, with Codman in 1934 even questioning the specificity of the diagnosis of biceps tendinitis. Biceps tendon abnormality is often associated with rotator cuff impingement. Shoulder pain originating from the biceps tendon can be debilitating, causing a severe decrease in shoulder function. As a result of the frequent clinical presentation of biceps pain, …

Does Exercise Decrease Pain Via Conditioned Pain Modulation In Adolescents?, Stacy Stolzman, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Purpose: Pain relief after exercise, exercise-induced hypoalgesia (EIH), is established across the lifespan. Conditioned pain modulation (CPM: pain inhibits pain) may be a mechanism for EIH.

Methods: In 55 adolescents, pressure pain thresholds were measured before and after exercise (deltoid, quadriceps, and nail bed) and during CPM at the nail bed and deltoid test stimulus sites. The relationship between EIH and CPM was explored.

Results: EIH occurred at deltoid and quadriceps; CPM occurred at nail bed and deltoid. CPM and EIH correlated at deltoid; adolescents with greater CPM experienced greater pain relief after exercise. At this site, CPM predicted 5.4% …

Impaired Hyperemic Response To Exercise Post Stroke, Matthew J. Durand, Spencer A. Murphy, Kathleen K. Schaefer, Sandra K. Hunter, Brian D. Schmit, David D. Gutterman, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Individuals with chronic stroke have reduced perfusion of the paretic lower limb at rest; however, the hyperemic response to graded muscle contractions in this patient population has not been examined. This study quantified blood flow to the paretic and non-paretic lower limbs of subjects with chronic stroke after submaximal contractions of the knee extensor muscles and correlated those measures with limb function and activity. Ten subjects with chronic stroke and ten controls had blood flow through the superficial femoral artery quantified with ultrasonography before and immediately after 10 second contractions of the knee extensor muscles at 20, 40, 60, and …

Pain Response After Maximal Aerobic Exercise In Adolescents Across Weight Status, Stacy Stolzman, Michael E. Danduran, Sandra K. Hunter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Introduction

Pain reports are greater with increasing weight status, and exercise can reduce pain perception. It is unknown, however, whether exercise can relieve pain in adolescents of varying weight status. The purpose of this study was to determine whether adolescents across weight status report pain relief after high-intensity aerobic exercise (exercise-induced hypoalgesia (EIH)).

Methods

Sixty-two adolescents (15.1 ± 1.8 yr, 29 males) participated in the following three sessions: 1) pressure pain thresholds (PPT) before and after quiet rest, clinical pain (McGill Pain Questionnaire), and physical activity levels (self-report and ActiSleep Plus Monitors) were measured, 2) PPT were measured with a …

Spinal And Supraspinal Motor Control Predictors Of Rate Of Torque Development, S. T. Johnson, Kristof Kipp, M. F. Norcross, M. A. Hoffman

Exercise Science Faculty Research and Publications

During explosive movements and potentially injurious situations, the ability to rapidly generate torque is critical. Previous research has suggested that different phases of rate of torque development (RTD) are differentiately controlled. However, the extent to which supraspinal and spinal mechanisms predict RTD at different time intervals is unknown. RTD of the plantarflexors across various phases of contraction (i.e., 0–25, 0–50, 0–100, 0–150, 0–200, and 0–250 ms) was measured in 37 participants. The following predictor variables were also measured: (a) gain of the resting soleus H-reflex recruitment curve; (b) gain of the resting homonymous post-activation depression recruitment curve; (c) gain of …

Impaired Regulation Post-Stroke Of Motor Unit Firing Behavior During Volitional Relaxation Of Knee Extensor Torque Assessed Using High Density Surface Emg Decomposition, Spencer A. Murphy, Reivian Berrios, P. Andrew Nelson, Francesco Negro, Dario Farina, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The purpose of this study was to use high density surface EMG recordings to quantify stroke-related abnormalities in motor unit firing behavior during repeated sub-maximal knee extensor contractions. A high density surface EMG system (sEMG) was used to record and extract single motor unit firing behavior in the vastus lateralis muscle of 6 individuals with chronic stroke and 8 controls during repeated sub-maximal isometric knee extension contractions. Paretic motor unit firing rates were increased with subsequent contractions (6.19±0.35 pps vs 7.89±0.66 pps, P

Sex Differences In Arm Muscle Fatigability With Cognitive Demand In Older Adults, Hugo M. Pereira, Vincent C. Spears, Bonnie Schlinder-Delap, Tejin Yoon, April L. Harkins, Kristy A. Nielson, Marie K. Hoeger Bement, Sandra K. Hunter

Physical Therapy Faculty Research and Publications

Background

Muscle fatigability can increase when a stressful, cognitively demanding task is imposed during a low-force fatiguing contraction with the arm muscles, especially in women. Whether this occurs among older adults (> 60 years) is currently unknown.

Questions/purposes

We aimed to determine if higher cognitive demands, stratified by sex, increased fatigability in older adults (> 60 years). Secondarily, we assessed if varying cognitive demand resulted in decreased steadiness and was explained by anxiety or cortisol levels.

Methods

Seventeen older women (70 ± 6 years) and 13 older men (71 ± 5 years) performed a sustained, isometric, fatiguing contraction at 20% …

Combined Unilateral Blockade Of Cholinergic, Peptidergic, And Serotonergic Receptors In The Ventral Respiratory Column Does Not Affect Breathing In Awake Or Sleeping Goats, Clarissa Muere, Suzanne Neumueller, Samantha Olesiak, Justin Robert Miller, Thomas Langer, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Previous work in intact awake and sleeping goats has found that unilateral blockade of excitatory inputs in the ventral respiratory column (VRC) elicits changes in the concentrations of multiple neurochemicals, including serotonin (5-HT), substance P, glycine, and GABA, while increasing or having no effect on breathing. These findings are consistent with the concept of interdependence between neuromodulators, whereby attenuation of one modulator elicits compensatory changes in other modulators to maintain breathing. Because there is a large degree of redundancy and multiplicity of excitatory inputs to the VRC, we herein tested the hypothesis that combined unilateral blockade of muscarinic acetylcholine (mACh), …

The Effect Of Antagonist Muscle Sensory Input On Force Regulation, Tanya Onushko, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The purpose of this study was to understand how stretch-related sensory feedback from an antagonist muscle affects agonist muscle output at different contraction levels in healthy adults. Ten young (25.3 ± 2.4 years), healthy subjects performed constant isometric knee flexion contractions (agonist) at 6 torque levels: 5%, 10%, 15%, 20%, 30%, and 40% of their maximal voluntary contraction. For half of the trials, subjects received patellar tendon taps (antagonist sensory feedback) during the contraction. We compared error in targeted knee flexion torque and hamstring muscle activity, with and without patellar tendon tapping, across the 6 torque levels. At lower torque …

Age And Sex Differences In Steadiness Of Elbow Flexor Muscles With Imposed Cognitive Demand, Hugo M. Pereira, Vincent C. Spears, Bonnie Schlinder-Delap, Tejin Yoon, Kristy A. Nielson, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Purpose: These studies determined (1) age and sex-related differences in steadiness of isometric contractions when high cognitive demand was imposed across a range of forces with the elbow flexor muscles (study 1) and, (2) sex differences in steadiness among older adults when low cognitive demand was imposed (study 2).

Methods: 36 young adults (18–25 years; 18 women) and 30 older adults (60–82 years; 17 women) performed isometric contractions at 5%, 30% and 40% of maximum voluntary contraction (MVC). Study 1 involved a high-cognitive demand session (serial subtractions by 13 during the contraction) and a control session …

Blockade Of Neurokinin-1 Receptors In The Ventral Respiratory Column Does Not Affect Breathing But Alters Neurochemical Release, Clarissa Muere, Suzanne Neumueller, Samantha Olesiak, Justin Miller, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Substance P (SP) and its receptor, neurokinin-1 (NK1R), have been shown to be excitatory modulators of respiratory frequency and to stabilize breathing regularity. Studies in anesthetized mice suggest that tonic activation of NK1Rs is particularly important when other excitatory inputs to the pre-Bötzinger complex in the ventral respiratory column (VRC) are attenuated. Consistent with these findings, muscarinic receptor blockade in the VRC of intact goats elicits an increase in breathing frequency associated with increases in SP and serotonin concentrations, suggesting an involvement of these substances in neuromodulator compensation. To gain insight on the contribution to breathing of endogenous SP and …

A Teaching Tool To Visually Illustrate How Manipulating The Physiology Of The Ventilatory Muscle Pump Alters Functional Performance, Dennis Sobush

Physical Therapy Faculty Research and Publications

This clinical perspective article describes an inexpensive pedagogical tool intended for use in a laboratory setting as part of a cardiovascular and pulmonary physical therapy course. It uses a dual balance scale schematic/model. As a teaching resource, physical therapy students can use it to visually reinforce their understanding of the complex cause-and-effect interplay between physiological factors that affect ventilatory muscle pump (VMP) performance for sustained breathing or contribute to VMP fatigue/failure.

Reliance On Auditory Feedback In Children With Childhood Apraxia Of Speech, Jenya Iuzzini-Seigel, Tiffany P. Hogan, Anthony J. Guarino, Jordan R. Green

Speech Pathology and Audiology Faculty Research and Publications

Children with childhood apraxia of speech (CAS) have been hypothesized to continuously monitor their speech through auditory feedback to minimize speech errors. We used an auditory masking paradigm to determine the effect of attenuating auditory feedback on speech in 30 children: 9 with CAS, 10 with speech delay, and 11 with typical development. The masking only affected the speech of children with CAS as measured by voice onset time and vowel space area. These findings provide preliminary support for greater reliance on auditory feedback among children with CAS.

Learning outcomes: Readers of this article should be able to (i) …

Stroke-Related Effects On Maximal Dynamic Hip Flexor Fatigability And Functional Implications, Henry Kuhnen, Megan M. Rybar, Tanya Onushko, Ryan E. Doyel, Sandra K. Hunter, Brian D. Schmit, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Introduction: Stroke-related changes in maximal dynamic hip flexor muscle fatigability may be more relevant functionally than isometric hip flexor fatigability. Methods: Ten chronic stroke survivors performed 5 sets of 30 hip flexion maximal dynamic voluntary contractions (MDVC). A maximal isometric voluntary contraction (MIVC) was performed before and after completion of the dynamic contractions. Both the paretic and nonparetic legs were tested. Results: Reduction in hip flexion MDVC torque in the paretic leg (44.7%) was larger than the nonparetic leg (31.7%). The paretic leg had a larger reduction in rectus femoris EMG (28.9%) between the first and last …

The Current State Of Physical Therapy Pain Curricula In The United States: A Faculty Survey, Marie K. Hoeger Bement, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Insufficient pain education is problematic across the health care spectrum. Recent educational advancements have been made to combat the deficits in pain education to ensure that health care professionals are proficient in assessing and managing pain. The purpose of this survey was to determine the extent of pain education in current Doctorate of Physical Therapy schools in the United States, including how pain is incorporated into the curriculum, the amount of time spent teaching about pain, and the resources used to teach about pain. The survey consisted of 10 questions in the following subject areas: basic science mechanisms and concepts …

Physiological And Self-Report Instruments To Measure Fatigue In Older Adults, Christopher Sundberg

Maria Dittman Library Research Competition: Student Award Winners

No abstract provided.

Evaluation Of Pediatric Manual Wheelchair Mobility Using Advanced Biomechanical Methods, Brooke A. Slavens, Alyssa J. Schnorenberg, Christine M. Aurit, Adam Graf, Joseph J. Krzak, Kathryn Reiners, Lawrence C. Vogel, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

There is minimal research of upper extremity joint dynamics during pediatric wheelchair mobility despite the large number of children using manual wheelchairs. Special concern arises with the pediatric population, particularly in regard to the longer duration of wheelchair use, joint integrity, participation and community integration, and transitional care into adulthood. This study seeks to provide evaluation methods for characterizing the biomechanics of wheelchair use by children with spinal cord injury (SCI). Twelve subjects with SCI underwent motion analysis while they propelled their wheelchair at a self-selected speed and propulsion pattern. Upper extremity joint kinematics, forces, and moments were computed using …

Evidence For Respiratory Neuromodulator Interdependence After Cholinergic Disruption In The Ventral Respiratory Column, Clarissa Muere, Suzanne Neumueller, Justin Robert Miller, Samantha Olesiak, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Reverse dialysis of the muscarinic receptor antagonist, atropine (ATR, 50 mM), into the pre-Bötzinger Complex region of the ventral respiratory column (VRC) of awake and sleeping goats increases breathing frequency and serotonin (5-HT), substance P (SP), glycine, and GABA concentrations in the effluent dialysate. Herein, we report data from goats in which we reverse dialyzed 5 mM ATR or specific antagonists of M2 or M3 muscarinic receptors into the VRC. The effects on frequency of all three antagonists were not significantly different from time control studies. 5 mM ATR and the M3 antagonist increased SP sevenfold less than 50 mM …

A Novel Fmri Paradigm Suggests That Pedaling-Related Brain Activation Is Altered After Stroke, Nutta-On Promjunyakul, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

The purpose of this study was to examine the feasibility of using functional magnetic resonance imaging (fMRI) to measure pedaling-related brain activation in individuals with stroke and age-matched controls. We also sought to identify stroke-related changes in brain activation associated with pedaling. Fourteen stroke and 12 control subjects were asked to pedal a custom, MRI-compatible device during fMRI. Subjects also performed lower limb tapping to localize brain regions involved in lower limb movement. All stroke and control subjects were able to pedal while positioned for fMRI. Two control subjects were withdrawn due to claustrophobia, and one control data set was …

Mechanisms Of Isometric Exercise-Induced Hypoalgesia In Young And Older Adults, Kathy J. Lemley

Dissertations (1934 -)

Pain reduction following exercise (exercise-induced hypoalgesia; EIH) is well-established in young adults. Specific to isometric exercise, the greatest EIH follows low intensity contractions held for long duration. The EIH response of older adults is not known; and the mechanisms for EIH are unclear at any age. This dissertation aimed to address these unknowns through a series of three studies. In study one, repeatability of pressure pain reports (pain threshold and pain ratings) was assessed in healthy older adults, including the impact of psychological factors. Pain reports, measured before and after quiet rest, did not change following quiet rest. Higher state …