Rehabilitation and Therapy Commons^™

The Effects Of Blood-Flow Restriction Training On Muscle Hypertrophy, Strength, And Power In College-Age Adults, Meghan Rohde, Lauren Bacsalmasi, Quinton Erhard, Tanner Lung, Whitney Weinert

Internet Journal of Allied Health Sciences and Practice

Purpose: Low load BFR (LLBFR) training can produce similar strength gains as high load resistance (HLR) training, especially in cases where persons may not have the ability to toelrate heavy loads. The purpose of this study was to compare changes in strength, power, and hypertrophy between HLR (70% 1RM) and LLBFR (30% 1RM). Methods: Sixteen healthy individuals, ages 23-21 (8 male, 8 female) were randomized into HLR and LLBFR groups. Obtained baseline measurements included 1-repetition maximum (1RM), thigh circumference, and vertical jump height. Each group performed back squat, Bulgarian split squat, barbell step ups, and lunges. The HL group trend …

Increasing Physical Activity In Older Australians To Reduce Falls: A Program Evaluation, Kristy Robson, Nazmul Ahasan, Carly Barnes, Kylie Murphy, Rodney Pope

Internet Journal of Allied Health Sciences and Practice

Purpose: As people age, they are at greater risk of injurious falls. Falling has a significant impact not only on the individual but also the wider community. Undertaking physical activity is effective in reducing the rate of falls in this population. Therefore, providing targeted education during group-based falls prevention programs may increase the awareness and amount of physical activity older people undertake to assist in reducing their risk of falling. Methods: A longitudinal cohort design involving a pre-post intervention survey was conducted over an eight-month period with community-dwelling older adults who participated in a fall-prevention program. Participants were N = …

Cost Outcomes Of Physical Therapist Providers Compared To Primary Care Providers In The Treatment Of Musculoskeletal Patients In A Military Treatment Facility: A Retrospective Chart Review”, Troy E. Mcgill, Debra F. Stern, Morey J. Kolber, John Mcgee

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to compare the cost of physical therapist (PT) management of patients with musculoskeletal (MSK) disorders to management by traditional primary care managers (PCMs); medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods: This is a retrospective study of electronic medical records using an exploratory, non-experimental, cross-sectional, and quantitative design method. The records of patients with MSK disorders were assessed at an Air Force military medical clinic for 18 months from January 2016 through June 2017. Results: PT management of MSK patients resulted in a …

Empathy Levels Correlate With Practical Examination Scores In Doctor Of Physical Therapy Students, Scott Richardson, Danika Aten, Garrett Bennett, Matthew Koster, Hannah Svilar

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to examine if empathy levels correlate with practical examination scores in DPT students. It was hypothesized that students with higher empathy levels would receive better scores on practical examinations. Methods: Participants were a convenience sample of 49 first and second year DPT students from Franklin Pierce University in Goodyear, AZ. After obtaining informed consent, participants completed the Interpersonal Reactivity Index (IRI) to assess personal empathy. These scores were compared with participants’ practical examination scores using a Spearman Rho statistical test with data analysis completed using SPSS software. Results: 49 participants (26 …

Expanding Rehabilitation Beyond The Clinic—Strategies To Increase Total Restorative Therapy Time For Adults With Hemiplegia, Niamh M. Tunney, Ellen R. Perlow

Internet Journal of Allied Health Sciences and Practice

Background: Positive neuroplastic changes involving cortical reorganization after stroke are experience dependent and are facilitated more effectively when rehabilitation occurs with high volume. Structured experiences to promote adaptive changes can be implemented during scheduled therapies in any rehabilitation setting. However, time spent in supervised restorative therapy is limited regardless of setting. Time spent in therapeutic activity can be extended by a variety of options that patients can engage in independently, that are low-cost, and that have evidence to support their use as a supplement to physical and occupational therapy. Purpose: The purpose of this paper is to present four …

Physical Examination Findings In Patients With Protracted Concussion And The Impact Of An Integrative Concussion Rehabilitation Protocol, Lauren Ziaks, Chelsea Brown, Maura Iversen

Internet Journal of Allied Health Sciences and Practice

Purpose: To describe physical examination (PE) findings of individuals with protracted concussion recovery and evaluate an integrated primitive reflex (PR) disinhibition, vision, and vestibular rehabilitation intervention. Method: Retrospective study of 82 patients with protracted concussion (60.98% female) who received ≥ 2 phases of treatment. Following a baseline PE, patients completed the Post-Concussion Symptom Survey (PCSS), Activities-Based Balance Confidence Questionnaire (ABC), Dizziness Handicap Index (DHI), and Acquired Traumatic Brain Injury (aTBI) Vision Questionnaire. A subset of patients (Group 1), completed a final PE and second questionnaire administration. Descriptive statistics characterized the sample. T-tests and Wilcoxon rank sum tests compared characteristics of …

Therapeutic Management Of A Patient With Necrotizing Fasciitis Resulting In Quadrilateral Amputation And Critical Illness Myopathy In The Intensive Care Setting: A Case Report., Mallory A. Kargela, Annette J. Siebens

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this case is to illustrate the best available evidence to provide early therapeutic intervention for a critically ill patient presenting with cardiovascular and pulmonary complications due to multi-system compromise. Case Description: A 19-year-old male was admitted to the hospital with the diagnosis of necrotizing fasciitis and necrotizing pneumonia. He experienced numerous additional medical complications ultimately leading to tracheostomy, delirium, critical illness myopathy, and quadrilateral amputation secondary to necrotizing fasciitis and critical limb ischemia following prolonged veno-venous extracorporeal membrane oxygenation (VV-ECMO). Outcomes: Patient was discharged to an outside rehabilitation hospital after 103 days in the acute setting …

An Introduction To Interprofessional Education For First Semester Doctoral Occupational Therapy And Physical Therapy Students, Suzanne Trojanowski, Jillian Woodworth, Anna Rose Wiencek, Amy Yorke

Internet Journal of Allied Health Sciences and Practice

Purpose: Interprofessional education (IPE) engages health care professional students in order to develop the knowledge, skills, and attitudes required of a health care practitioner. IPE can be challenging to execute; however, exposing students early in their professional education in IPE has positive results. Occupational therapy (OT) and physical therapy (PT) are health care professions who commonly work with each other. The purpose of this study is to describe the process and outcomes of implementing an IPE experience with first year doctoral OT (OTD) and PT (DPT) students completed within the first six weeks of the first semester of their respective …

The Teaching And Evaluation Of Professionalism For Dpt Students During The Clinical Education Experience, Bruce N. Elliott

Internet Journal of Allied Health Sciences and Practice

Abstract

Purpose: The purpose of this comparative study was to investigate the reports of clinical instructors (CIs) and Doctor of Physical Therapy (DPT) students from two different physical therapy programs in New England regarding their opinions on the teaching and evaluative techniques of professionalism during a clinical education rotation. One program emphasized professionalism prior to the students beginning their clinical rotations, while the other program did not have the same emphasis.

Methods: Three items from the professional practice section of the Clinical Performance Instrument (CPI) (accountability, communication, and professional behavior), were utilized to create the conceptual framework around which the …

Application Of Self-Efficacy Training In Group Aural Rehabilitation: An Interprofessional Collaborative Model, Stephen D. Roberts, Nancy A. Delich

JADARA

Few studies have explored self-efficacy training with persons with hearing loss (PHLs), yet alone with their communication partners (CPs). The purpose of this mixed-method study was to examine the impact of self-efficacy training as a framework for an Interprofessional Psychosocial Group Aural Rehabilitation (IPGAR) workshop with PHLs and their CPs. Four PHLs and their four CPs consented to participate in the IPGAR workshop that employed interventions including short lectures, psychosocial exercises, communication strategies training, speech perception training, adaptive/stress reduction exercises, and group discussions relevant to mutually established shared goals for each couple. The participants reported improved communication abilities in the …

Post-Secondary Employment And Education Outcomes Of Young Adults Reporting Both Vision And Hearing Impairments In The High School Longitudinal Study Of 2009, Emily M. Lund

JADARA

This article reports the post-secondary education and work activities of 43 young adults who reported a history of both hearing and vision disabilities (i.e., deafblindness [DB] in Wave 4 of the High School Longitudinal Study of 2009. Most of the sample reported having worked, attended post-secondary education, or both since completing secondary education. Approximately half of the sample still lived with their parents, and most reported receiving financial support from their parents. Thus, although engagement in work and education was relatively high, most participants had not achieved financial independence.

Access To Eye Care Before And After Vision Loss: A Qualitative Study Investigating Eye Care Among Persons Who Have Become Blind, Tosha Zaback, Stephanie Lam, Joan Randall, Teresa Field, Mitchell V. Brinks

The Qualitative Report

Navigating access to eye care requires that patients recognize the need for screening and care, employ limited financial and social resources, manage complex health insurance policies, and access specialty clinical care. We investigated the experience of patients through the progression of vision loss to blindness, utilizing qualitative methods. We conducted structured telephone interviews with 28 persons with blindness throughout Oregon. Utilizing closed and open-ended questions, we explored patient experience on the events preceding avoidable blindness. Coding for emergent themes was conducted independently by two researchers using a constant comparative method. Participants described important barriers to accessing eye care: at the …

From Isolation To Communication: Connecting Adults Who Have Hearing Loss With Their Communication Partners, Stephen D. Roberts, Nancy A. Delich

JADARA

As Baby Boomers enter the late adulthood stage of life, hearing loss continues to be one of the most prevalent, chronic, and isolating conditions facing older adults today. Research has focused on the negative consequences of hearing loss on the health and the person’s well-being, but it is equally important to recognize that hearing loss also leads to communication loss. The resulting social isolation and the collateral effects of hearing loss on the communication partner are the focus of this mixed-method study that explored the hearing loss-related quality of life for both parties. Five overarching themes emerged from the analysis, …

Development Of The Steppin' Up For Success Program, Darlene F. Guckenberger

Occupational Therapy Program Student Theses, Dissertations and Capstones

School transitions can be challenging for students, especially when students enter junior high school. Junior high school students experience significant developmental growth in the areas of autonomy, relationships, acceptance, cognitive skills, as well as physical differences associated with hormonal changes. When a student transitions into junior high school, evidence indicates possible declines in motivation, school interest, and academic achievement. Personal relationships, self-worth, and coping skills are essential for a successful transition between schools. Adolescents engage in the occupations of education, leisure, social participation, and activities of daily living. Occupational therapy is perfectly positioned as a support service within the school …

Depression Screening In Outpatient Neurology, Lakicia Foster

Student Theses, Dissertations and Capstones

Depression is the preeminent cause of disability internationally. Support-based depression screening is a nationally recommended means of detecting and treating patients with this disabling illness. The purpose of the doctor of nursing practice (DNP) practice change project was to implement an outpatient neurology depression screening protocol so that depressed patients were identified and received intervention. The project answered whether implementation of an 8- to 12-week systematic depression screening protocol in a neurology practice increased the incidence of accurate depression identification and treatment in this patient population as compared to the 3-month prior baseline. The DNP depression screening project was based …

Are Finger Width Palpation, Tape Measure, And Caliper Reliable, Valid, And Accurate To Diagnose Diastasis Recti Abdominis (Dra)?, Tamara L. Roehling

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: Diastasis recti abdominis (DRA) is a condition where the medial rectus bellies separate at the linea alba. A DRA can negatively impact posture, trunk and pelvic stability, pelvic floor muscular control, respiration, trunk movement, and abdominal viscera support. The purpose of this research is to determine whether tools used in the clinic effectively screen for DRA. Specifically, this study compared the reliability, validity, and diagnostic accuracy of finger width, tape measure, and calipermeasurements to the clinical best standard, ultrasound imaging. Additionally, the study investigates whether there is a correlation between DRA and low back pain and pelvic floor dysfunction. …

Impact Of Psychological Factors On Adolescents With Anterior Knee Pain, Mitchell Selhorst

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem and purpose: Psychological factors impact self-report measures of pain and function among adults with anteriorknee pain (AKP), but we do not know (1) if psychological factors also impact pain, self-reported function, and objective measures of function among adolescents with AKP and (2) if a psychological intervention would affect function. The purpose of this dissertation is to determine the impact of psychological factors on pain, self-reported function, and objective measures of function in adolescents with AKP.

Methods: This dissertation was prospective, with three separate studies. Two were cross-sectional observational studies, and the third was a randomized-controlled trial. Patient questionnaires were …

Development And Validation Of The Self-Management Assessment For The Residuum And Prosthesis (S.M.A.R.T.), Daniel Joseph Lee

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Self-management is the process of preventing complications through meticulous self-care and vigilant self-inspection. Persons with long-term impairments or diseases must follow an effective self-management routine as part of their care regimen to reduce the risk of injury. Assessment of knowledge as it relates to self-management is standard care forpersons with chronic disease and long-term impairments. Identifying knowledge gaps allows for patient-centered educational interventions to be targeted to the person’s area of deficit. Despite the importance of self-management in persons with limb loss, there is currently no valid and reliable way to objectively assess knowledge specific to this population.

Purposes: …

Impact Of Physical Therapist Attitudes And Beliefs On The Outcomes Of Patients With Low Back Pain, Adam P. Rufa

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction: Physical therapist attitudes and beliefs about low back pain (LBP) have been shown to influence patientbeliefs and affect clinician behavior. The purpose of this project was to investigate physical therapist attitudes and beliefsabout LBP, identify factors that influence those beliefs, and determine if attitudes and beliefs have an impact on patientoutcomes. Methods: This study was a retrospective cohort design that included a survey of physical therapists and thecollection of patient outcomes from Focus on Therapeutic Outcomes, Inc. (FOTO). Attitudes and beliefs were measured using the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain Attitudes and …

Impact Of Strength And Range Of Motion On Loss Of Ambulation And Functional Change Measures In Boys With Dmd, Tina Duong

Department of Physical Therapy Student Theses, Dissertations and Capstones

Duchenne muscular dystrophy (DMD) is an x-linked lethal progressive disorder affecting boys who are typically diagnosed due to motor delays or weakness. Key features include loss of motor function throughout the lifetime resulting in early mortality from cardiopulmonary complications in the late 2nd and 3rd decades of life. Rates of progression are variable yet sequential due to a typical pattern of motor weakness that occurs from proximal to distal muscle groups. Current standards of care include contracture management and Glucocorticosteroids (GC). Timed function tests have been used to understand and predict loss offunctional milestones such as walking, getting off the …

Effects Of Cueing On Sit To Stand Transfers In Parkinson Disease, Rebecca Ann Martin

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Individuals with Parkinson Disease (PD) often experience difficulty transferring from sit to stand (STS). Current evidence suggests cues which promote an external attentional focus improve gait and transfers for individuals with PD. However, this research utilizes cues which are difficult to replicate in clinical or natural environments making the findings difficult to generalize or implement. Purpose: The primary purpose of this study is to determine the effect of 3 different explicit cues on STS for individuals with PD. Additionally we sought to determine if, in this population, a relationship exists between latency of movement initiation and postural sway …

Financial Impact Associated With Implementation Of The Low Back Pain Clinical Practice Guideline In Outpatient Physical Therapist Practice, Heidi Kosakowski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Dysfunction and disability arising from low back pain (LBP) affects more people than any other condition globally, and results in changes to the quality of life for many individuals. The financial burden of managing low back pain is among the highest both in the United States and globally. Clinical practice guidelines (CPGs) provide recommendations on patient management strategies and have the potential to simultaneously improve patient outcomes and lower health care costs. Limited evidence exists on the impact of CPG implementation on downstream medical costs that are incurred after physical therapist care. A retrospective observational study was conducted that examined …

Neurophysiological Effects Of Dry Needling To The Thoracolumbar Junction Multifidi In Subjects With Low Back Pain And Decreased Hamstring Length, Nicole Ginette Clark

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: Dry needling is becoming increasingly popular in the treatment of neuromusculoskeletal conditions. The neurophysiological effect of treatment, specifically those related to the sympathetic nervous system (SNS) is considered a relevant physiological mechanism contributing to a patient’s rehabilitation. The primary purpose of this study was toinvestigate the neurophysiological effects of dry needling, as measured by sympathetic outflow and muscular flexibility. A secondary purpose of this study was to determine if changes in SNS activity correlate with clinically meaningful improvements in pain and disability. Design: This was a prospective, double-blind randomized clinical trial. Subjects: The study sample consisted of …

Correlation Of Trust And Outcomes Following Physical Therapy For Chronic Low Back Pain, Kory J. Zimney

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Trust is a key component for developing therapeutic alliance. Improvements in trust have been found to improve outcomes forpatients receiving psychiatric and medical physician care. Current trust measurement scales have not been utilized in a physical therapy setting and no studies have explored the relation of trust in provider to physical therapy outcomes.

Purpose: The primary goal was to explore the correlation of patient trust measured at various points within the therapeutic encounter to the change in outcome measurements after receiving physical therapy care.

Research Design and Methods: Non-experimental correlational quantitative analysis of patient trust in their physical therapist …

Does The Range Of Walking Speeds Produced By Community-Dwelling Older Adults Relate To Or Predict Function, Disability, And Community Mobility?, Michelle Germaine Criss

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Self-selected (SSWS) and maximum walking speeds (MWS) are frequently studied and related to multiple body systems, function, falls, and mortality. Walking at a slow speed voluntarily or measuring a range of walking speeds (WS), however, has rarely been investigated. Purpose: The aims ofthis project were to explore a proposed measure of WS adaptability called total walking speed range(TWSR), to assess the reliability and validity of slow walking speed (slowWS) as a component of TWSR, to assess if TWSR could predict function, disability or community mobility, and finally, to compare thepredictive ability of TWSR to single walking speeds. Methods: This …

Comprehensive Physical Function Measure For The Intensive Care Unit: The Use Of Rasch Analysis And Item Response Theory, Michelle Lynn Peterson

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction: This dissertation study provides an in-depth examination of current intensive care unit (ICU) physical function assessment measures and synthesizes these into one comprehensive measurement tool that addresses multiple areas of function.

Background: A recent systematic review identified 26 measures being used in ICU clinical research, although a subsequent systematic review revealed only 14 of those physical function assessment measures have psychometric properties evaluated specifically for the ICU setting. A robust physical function assessment measure for use in the ICU, allows for determination of efficacy of treatment, comparison of studies across settings, and broader interpretation of results.

Specific Aims: Aim …

Can A Prescribed Walking Program With Or Without Monitoring Impact Dizziness In The Older Adults? A Pilot Study, Amie Marie Jasper

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background. Dizziness, a common complaint among older adults, is associated with multiple falls, loss of function and independence, and reduced balance confidence. The Clinical Practice Guideline for Peripheral Vestibular Hypofunction recommends walking for endurance as a component of vestibular rehabilitation (VR). However, studies on VR in the olderadults do not include walking in the intervention.

Research Design: 1) A pragmatic, randomized, experimental design to evaluate the impact of walking on vestibular outcomes, length of stay, and number of visits, and to examine whether pedometers increase the adherence of older adults with vestibular issues to a walking program; 2) a descriptive …

Does The Type Of Dual Cognitive Task Impact Gait Variability Using The Quantitative Timed Up And Go (Qtug) In Community-Dwelling Adults?, Laurie G. Hiatt

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: The purpose of this study was to determine how different cognitive dual-tasks impact gaitvariability in community-dwelling adults using the Quantitative Timed Up and Go (QTUG).

Methods: Participants aged 65 and older were recruited from two communities in Iowa and Wisconsin. Inclusion criteria: theability to stand and ambulate without an assistive device, having no orthopedic surgical procedures in the previous six weeks, living independently in the community, demonstrating corrected vision and ability to read, sufficient auditory function to carry on a conversation and ability to follow directions. Participants needed to follow three step commands and have no history …

Pediatric Insomnia And Sensory Processing: Exploring The Role Of Occupational Therapy Practitoners In Sleep Medicine, Jason Browning

Occupational Therapy Program Student Theses, Dissertations and Capstones

Background. Since the founding of occupational therapy, the occupation of sleep has existed within the scope of practice for practitioners. Sleep disturbances in pediatric clients are estimated to be between 20% and 40% (Galland, Taylor, Elder, & Herbison, 2012; Mindell, Telofski, Wiegand & Kurtz, 2009; Meltzer, Johnson, Crosette, Ramos, & Mindell, 2010; Owens & Mindell, 2011; Sadeh, Mindell, & Owens, 2011). Deficits insensory processing of pediatric clients play a role in daily functioning and possibly in the ability to settle and transition to sleep (Dunn, 2001; Foitzik & Brown, 2018). Purpose. The purpose of this study is to explore the …

Implications Of A Multicomponent Sleep Program After Brain Injury: A Mixed Methods Study, Brandi M. Fulwider

Occupational Therapy Program Student Theses, Dissertations and Capstones

Decreased sleep can negatively affect mental and physical health and can significantly disrupt participation in daily occupations and leisure interests. Even though sleep is an area of occupation, there is limited evidence on the effectiveness of occupational therapy interventions for sleep. The purpose of this embedded mixed methods research study was to identify how disruptions in sleep affected daily occupational performance and to understand the effectiveness of occupational therapy- directed non-pharmacological sleep interventions for three participants in a community re-entry program for brain injury. This study utilized a single-subject research design during a 4- to 5-week multicomponent sleep program using …