Rehabilitation and Therapy Commons^™

The Effect Of Concussion History On Lower Extremity Injury Risk In College Athletes: A Systematic Review And Meta Analysis, Vanessa Ramirez, Ryan Mccann, Eric Schussler, Jessica Martinez

Rehabilitation Sciences Faculty Publications

INTRODUCTION: Collegiate athletes who suffer a concussion may possess prolonged impairments even after clearance for return-to-participation, which may place them at an increased risk of lower extremity injury.

OBJECTIVE: To conduct a systematic review and meta-analysis of studies examining risk of lower extremity musculoskeletal injury following a concussion in collegiate athletes.

METHODS: A literature search was performed using the following databases: PubMed, CINAHL, SPORTDiscus. The following search terms were used to identify relevant articles, ["concussion" OR "brain injury" OR "mild traumatic brain injury" OR "mTBI"] AND ["lower extremity injury" OR "musculoskeletal injury"]. Articles were included if they were published between …

Characteristics Of Athletic Training Students' Patient Encounters During Immersive And Nonimmersive Clinical Experiences: A Report From The Association For Athletic Training Education Research Network, Bailey C. Jones, Julie M. Cavallario, Cailee E. Welch Bacon, Stacy E. Walker, R. Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The 2020 Standards for the Accreditation of Professional Athletic Training Programs from the Commission on Accreditation of Athletic Training Education require programs to include at least one immersive clinical experience (ICE) in their clinical education curricula. Yet, it is unknown whether ICEs provide more opportunities and benefits than nonimmersive clinical experiences (N-ICEs). The purpose of this study was to compare characteristics of patient encounters (PEs) that occurred during ICEs and N-ICEs.

Design: Multisite panel design.

Setting: Twelve professional programs (5 undergraduate, 7 graduate).

Patients or Other Participants: Three hundred thirty-eight athletic training students logged PEs in the E*Value system. …

Educators' Perceptions Of Characteristics That Define Athletic Training Student Competence: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Alicia M. Pike Lacy, Stacy E. Walker, Lindsey E. Eberman

Rehabilitation Sciences Faculty Publications

Context

As health professions education continues to transition toward competency-based education, it is essential that educators have an in-depth understanding of student competence and how it is achieved. However, little is known concerning the perceptions of educators regarding student competence in athletic training.

Objective

To explore athletic training educators' perceptions of student competence.

Design

Cross-sectional.

Setting

Online survey with open-ended questions.

Patients or Other Participants

In total, 368 of 1577 athletic training educators accessed the survey (23.3% access rate); 327 were included in data analysis because they indicated they served as an athletic training educator at the time of data …

Characteristics Of Patient Encounters For Athletic Training Students During Clinical Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, R.Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients that have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences.

Objective: To describe the characteristics of patient encounters (PEs) ATSs engage in during clinical experiences. Design: Multi-site, panel design.

Setting: 12 professional athletic training programs (ATPs; 5 Bachelor, 7 Master's).

Patients or Other Participants: 363 ATSs from the ATPs that used E*Value software to document PEs during clinical …

Core Competency-Related Professional Behaviors During Patient Encounters: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, it is important that athletic trainers integrate the components of the core competencies (CCs; evidence-based practice [EBP], patient-centered care [PCC], health information technology [HIT], interprofessional education and collaborative practice [IPECP], quality improvement [QI], professionalism) as a part of routine clinical practice. In what ways, if any, athletic training students (ATSs) are currently integrating CCs into patient encounters (PEs) during clinical experiences is unclear.

Objective: To describe which professional behaviors associated with the CCs were implemented by ATSs during PEs that occurred during clinical experiences.

Design: Multisite panel design.

Setting: A total of …

Cross-Education Balance Effects After Unilateral Rehabilitation In Individuals With Chronic Ankle Instability: A Systematic Review, Briana Lawry-Popelka, Sunghoon Chung, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Objective: To conduct a systematic review of existing literature on cross-education balance effects after unilateral training in the population with chronic ankle instability (CAI).

Data Sources: PubMed, SPORTDiscus, CINAHL Plus.

Study Selection: To be included in the systematic review, studies were required to have been published in English, included participants with CAI, had participants undergo a unilateral therapeutic exercise for the lower extremity, and measured balance performance of the untrained lower extremity before and after the intervention.

Data Extraction: The certainty of evidence in each included study was assessed via the Downs and Black checklist. A score of 24 to …

Corticospinal Activity During A Single-Leg Stance In People With Chronic Ankle Instability, Masafumi Terada, Kyle B. Kosik, Ryan S. Mccann, Colin Drinkard, Phillip A. Gribble

Rehabilitation Sciences Faculty Publications

Purpose: The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls.

Methods: Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.

Results: Participants with CAI had significantly longer CSP at 100% of AMT and lower normalized MEP at 120% of AMT compared to …

Executive Functions And Student Success During Physical Therapist Education: An Exploratory Study, Jane Roitsch, Martha L. Walker, Anastasia M. Raymer

Communication Disorders & Special Education Faculty Publications

BACKGROUND: Clinical reasoning relies on executive functions (EFs) that manage attention, inhibition, organization, and decision-making. Assessment of EFs may help identify students who excel at clinical reasoning, yet data showing this relationship in physical therapy (PT) education programs are lacking. The primary purpose of this exploratory study was to examine EFs in relationship to success in PT educational programs. METHODS: Thirteen third-year PT graduate students completed two EF tests which were compared to culminating scores in the program and admissions scores. RESULTS: A relationship existed between National Physical Therapy Examination (NPTE) and comprehensive exam results and one EF test score; …

Identification Of Opportunity Barriers And Supports For Individuals Using Augmentative And Alternative Communication (Aac) And Stakeholders, Meredith K. Gohsman

Rehabilitation Sciences Theses & Dissertations

Individuals using augmentative and alternative communication (AAC) are supported by many AAC stakeholders and communication partners. Clinical decision making and AAC assessment models consider the capabilities and access needs of the individual using AAC, as well as opportunity barriers and supports imposed by communication partners and environments. The purpose of this research was to investigate opportunity barriers and supports identified by two critical AAC stakeholders: speechlanguage pathologists and caregivers. The first study investigated characteristics of AAC service provision reported by post-professional speech-language pathologists. Speech-language pathologists reported lack of perceived knowledge related to AAC service delivery, inconsistent use of AAC modalities, …

Injury-Related Fear In Individuals With Chronic Ankle Instability, Ashley Marie Brawford Suttmiller

Rehabilitation Sciences Theses & Dissertations

About 40% of individuals who suffer a lateral ankle sprain develop chronic ankle instability (CAI). The mechanisms for developing CAI is believed to be multi-factorial, however, most literature has focused on the physical manifestations of the condition, leaving our understanding of psychological manifestations of the condition fairly unclear. Injury-related fear has been identified as a psychological factor that may be relevant to the condition, but our understanding is limited. Therefore, the purpose of this dissertation was to better understand injury-related fear in patients with CAI through three studies.

The first study systematically reviewed the literature to understand differences in injury-related …

The Influence Of Lumbopelvic Function On Perceived Ankle Function In Individuals With Chronic Ankle Instability, Sunghoon Chung, A. M. B. Suttmiller, K. R. Johnson, R. S. Mccann

College of Health Sciences Posters

Perceived functional impairments measured via patient-reported outcomes (PROs) are associated with reduced postural control ability in CAI patients. Furthermore, hip and trunk neuromuscular impairments are critical factors that can cause decreased postural stability in those with CAI. Identifying the relevance between reduced lumbopelvic function and impaired sensory-perceptual outcomes might direct clinicians to novel methods for CAI patients to improve postural control ability and perceived ankle function. Therefore, the aim of this study was to examine the relationship between tests of lumbopelvic function and PROs in individuals with CAI. Thirty-three individuals with CAI underwent assessment of transversus abdominis and lumbar multifidus …

The Effect Of Concussion History On Lower Extremity Injury Risk In High School And Collegiate Athletes: A Systematic Review And Meta-Analysis, Vanessa Ramirez, Ryan Mccann, Eric Schussler, Jessica Martinez

College of Health Sciences Posters

Sport-related concussions are a prevalent injury that result in sensorimotor dysfunction and altered neuromuscular control. Individuals recovering from a concussion display decreased postural sway during balance assessment and may possess prolonged balance deficits after return-to-play (RTP). Athletes who are experiencing impairments following RTP after a concussion may be at increased risk of lower extremity (LE) injury. The purpose of this study was to conduct a systematic review and meta-analysis of studies examining risk of LE musculoskeletal injury following a concussion in high school and collegiate athletes. An electronic database search of PubMed, CINAHL, MEDLINE, and SPORTDiscus was conducted on November …

Lumbopelvic Stability And Trunk Muscle Contractility Of Individuals With Chronic Ankle Instability, Ryan S. Mccann, Kelly Johnson, Ashley M.B. Suttmiller

Rehabilitation Sciences Faculty Publications

BACKGROUND: Chronic ankle instability (CAI) results in hip neuromuscular impairments that can perpetuate dysfunction through reduced lumbopelvic stability and subsequent malpositioning of the lower body during functional movement. Lumbopelvic stability might be further impaired through changes in trunk muscular contractility. However, lumbopelvic stability and trunk muscle morphology have not been compared between individuals with and without CAI.

PURPOSE: To compare lumbopelvic stability and trunk muscle contractility between individuals with and without chronic ankle instability (CAI) and determine if lumbopelvic stability and trunk muscle contractility are associated with self-reported function.

STUDY DESIGN: Case-control study.

METHODS: Ten individuals with CAI, 10 …

Footwear Affects Conventional And Sumo Deadlift Performance, Kevin A. Valenzuela, Kellie A. Walters, Elizabeth L. Avila, Alexis S. Camacho, Fany Alvarado, Hunter J. Bennett

Human Movement Studies & Special Education Faculty Publications

Barefoot weightlifting has become a popular training modality in recent years due to anecdotal suggestions of improved performance. However, research to support these anecdotal claims is limited. Therefore, the purpose of this study was to assess the differences between the conventional deadlift (CD) and the sumo deadlift (SD) in barefoot and shod conditions. On day one, one-repetition maximums (1 RM) were assessed for thirty subjects in both the CD and SD styles. At least 72 h later, subjects returned to perform five repetitions in four different conditions (barefoot and shod for both CD and SD) at 70% 1 RM. A …

Wearing Knee Sleeves During Back Squats Does Not Improve Mass Lifted Or Affect Knee Biomechanics, Hunter J. Bennett, Alexandria Trypuc, Kevin A. Valenzuela, Zachary A. Sievert

Human Movement Studies & Special Education Faculty Publications

Purpose:
Knee sleeves have become widely popular in the exercise realm, especially for knee support during back squats. Knee sleeves are successful in providing frontal plane knee support during functional tasks, but have not been investigated in back squats. Knee wraps, a somewhat similar elastic material, provide elastic energy that increases weight lifted during back squats. Thus, it is possible the thick neoprene knee sleeves could prove advantageous for back squats. The purpose of this study was to examine the effects of knee sleeves on weight lifted, knee biomechanics, and muscle activations during back squats.

Methods:
Fifteen resistance trained men …

Employability In Academe For Athletic Trainers With The Doctor Of Athletic Training Degree, Bonnie L. Van Lunen, Stephanie H. Clines, Tyler Reems, Lindsey E. Eberman, Dorice A. Hankemeier, Cailee E. Welch

Rehabilitation Sciences Faculty Publications

The doctor of athletic training (DAT) degree has recently been introduced into academe. Limited literature exists regarding how individuals with this degree can become part of an athletic training faculty. To identify department chairs' perceptions of the DAT degree and determine whether they viewed the degree as viable when hiring new faculty within a postbaccalaureate professional athletic training program. Cross-sectional study. Online survey instrument. A total of 376 department chairs who had oversight of Commission on Accreditation of Athletic Training Education athletic training programs were invited to participate. Of these, 190 individuals (50.5%) accessed the survey, and 151 of the …

The Role Mentoring Plays In The Transition To Practice Of Newly Credentialed Athletic Trainers, Stacy E. Walker, Stephanie Mazerolle Singe, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Mentoring has been identified as an important method of supporting newly credentialed athletic trainers (ATs) during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs in developing a plan to better facilitate the transition.

Objective: To examine which aspects of the mentoring relationship provided the most benefit during the transition to practice of newly certified ATs.

Design: Qualitative study.

Setting: Individual phone interviews.

Patients or Other Participants: A total of 13 ATs who graduated from a professional master's program, were certified from February through July 2016, …

Electromyographical Assessments Of Recommended Neck And Trunk Positions For Dental Hygienists, Margaret F. Lemaster, Kyle J. Kelleran, Maryam Moeini, Daniel M. Russell

Rehabilitation Sciences Faculty Publications

Purpose: Dental professionals are recommended to limit neck and trunk flexion to within 20° of a neutral (0°) body posture, however empirical support for the recommendations is lacking. The purpose of this study was to determine whether there are differences in muscle workload between a range of neck and trunk postures in a population of dental hygiene students.

Methods: Fifteen first semester senior dental hygiene students with no history of neck and trunk injury volunteered to participate. Surface electromyography was used to record muscle activity from two neck extensors muscles, cervical erector spinae (CES) and upper trapezius (UT), and two …

Upper Limb Rehabilitation For Amputees, Michaela Ramandanes

Virginias Collegiate Honors Council Conference

It is estimated that 75% of the 30 million people that need prosthetic devices lack access to the technologies they need. This suggests a need for solutions outside of standard healthcare models. In this work we present a solution by development of a simple, safe and accessible at-home exercise program for individuals with upper limb loss. It is intended to help amputees strengthen the muscles needed to operate body-powered prostheses when muscles have atrophied from lack of use. Extensive research identified the most effective exercises to hinder overuse injuries. The exercises were compiled and published on a website with a …

Effects Of Increased Attention Allocation On Postural Stability Related To History Of Concussion, Nicholas Reilly, Jessica Prebor, Jacquelyn Moxey, Eric Schussler

College of Health Sciences Posters

Postural instability is among the most common symptoms associated with concussion. However, clinical screenings for concussion are heavily reliant on self-reports of cognitive symptoms such as nausea and headache to determine if a full recovery has been achieved. The objective of this study was to determine if impairments of postural stability that are associated with the acute stages of concussion persist beyond the current clinical standards for determination of recovery from concussion. Fifty-four healthy participants were recruited for the study and divided based on whether they reported having no history of concussion (n = 27) or whether they had been …

Relationships Between Injury-Related Fear, Balance Self-Efficacy, And Dynamic Balance Performance In Those With Chronic Ankle Instability, Ashley M. B. Suttmiller, Kelly Johnson, Ryan S. Mccann

College of Health Sciences Posters

Interactions between sensory-perceptual and motor-behavioral impairments in individuals with chronic ankle instability (CAI) are important for successful assessment and treatment of CAI. One of the most consistently reported motor-behavioral impairments is poor reach performance in a dynamic balance task. Injury-related fear is recognized as an important sensory-perceptual impairment, and those with injury-related fears may engage in protective movement strategies found to be associated with reach deficits. Injury-related fear may also impact one’s perception of ability, or self-efficacy, which has demonstrated positive associations with balance performance in other populations, but these relationships have yet to be investigated in the CAI population. …

Reported Barriers To Aac Service Delivery & Post-Professional Learning Preferences Among Speech-Language Pathologists, Meredith Laverdure, Rachel K. Johnson

College of Health Sciences Posters

This mixed methods experimental study used a survey to identify speech-language pathologists’ perceptions, including preparedness to provide augmentative-alternative communication (AAC) services to individuals with complex communication needs and learning preferences for post-professional training. Following certification standard changes in 2005 and 2014, the American Speech-Language-Hearing Association (ASHA) now requires instruction and clinical experiences during graduate studies across nine major content areas, including the use of AAC modalities. Prior to this change, the number of preservice programs reported to offer at least one AAC course increased from 62% (Ratcliff & Beukelman, 1995) to 72% (Ratcliff, Koul, & Lloyd, 2008). Since the certification …

Effects Of A Rehabilitation Program For Individuals With Chronic Spinal Cord Injury In Shanghai, China, Fengshui Chang, Qi Zhang, Haixia Xie, Yuhui Yang, Mei Sun, Airong Wu, Jinghua Wu, Gang Chen, Feng Shen, Chengyue Li, Jun Lu

Community & Environmental Health Faculty Publications

Background: Specialized Institution-Based Rehabilitation (SIBR) is the cornerstone of care and treatment for individuals with spinal cord injury, but most people with chronic spinal cord injury (CSCI) living in China have no SIBR experience after acute care hospital discharge. In 2009, an SIBR facility was set up in Shanghai (China) to fill this important gap in care. The purpose of the study was to evaluate the effectiveness of an integrated rehabilitation training program among individuals with CSCI living in Shanghai.

Methods: A within-subject pre-posttest design was used to evaluate the SIBR. The sample included 455 individuals ≥1 year post-SCI, who …

From Their Perspective: A Qualitative Analysis Of Stroke Survivor’S Motivation To Participate In Rehabilitation, Katie Tinsley, Rachel Johnson

Undergraduate Research Symposium

Introduction: It is common practice for healthcare professionals to make judgments about a patient's motivation based on their demeanor and compliance with therapy. Motivation is one of the predictors used to determine a stroke survivor's rehabilitation potential. There are several theories and constructs for motivation; however, there is limited research applying these concepts in stroke rehabilitation. Rehabilitation clinicians primarily rely on their clinical judgment and consult the evidence from related fields to identify the motivational needs of a stroke survivor. The objective of this study was to understand specific barriers to participation and identify motivational needs to sustain engagement in …

The Role Mentoring Plays In The Transition Of Practice Of Newly Credentialed Athletic Trainers, Stacy E. Walker, Stephanie Mazerolle Singe, Julie M. Cavallario

Ellmer School of Nursing Faculty Publications

Context: Mentoring has been identified as an important method to support newly credentialed athletic trainers during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs to develop a plan, which could better facilitate the transition.

Objective: To examine what aspects of the mentoring relationship provided the most benefit during transition to practice.

Design: Grounded theory.

Setting: Individual phone interviews.

Patients or Other Participants: 13 athletic trainers who graduated from a professional master's program, were certified between February and July of 2016, and obtained employment between July to …

Diagnosing Mild Traumatic Brain Injury Using Saliva Rna Compared To Cognitive And Balance Testing, Steven D. Hicks, Cayce Onks, Raymond Y. Kim, Kevin J. Zhen, Jayson Loeffert, Andrea C. Loeffert, Robert P. Olympia, Gregory Fedochak, Samantha Devita, Aakanksha Rangnekar, John Leddy, Mohammad N. Haider, Zofia Gagnon, Callan D. Mcloughlin, Matthew Badia, Jason Randall, Miguel Madeira, Aaron M. Yengo-Kahn, Justin Wenzel, Matthew Heller, Hallie Zwibel, Aaron Roberts, Samantha Johnson, Chuck Monteith, Michael N. Dretsch, Thomas R. Campbell, Rebekah Mannix, Christopher Neville, Frank Middleton

Rehabilitation Sciences Faculty Publications

BACKGROUND: Early, accurate diagnosis of mild traumatic brain injury (mTBI) can improve clinical outcomes for patients, but mTBI remains difficult to diagnose because of reliance on subjective symptom reports. An objective biomarker could increase diagnostic accuracy and improve clinical outcomes. The aim of this study was to assess the ability of salivary noncoding RNA (ncRNA) to serve as a diagnostic adjunct to current clinical tools. We hypothesized that saliva ncRNA levels would demonstrate comparable accuracy for identifying mTBI as measures of symptom burden, neurocognition, and balance.

METHODS: This case‐control study involved 538 individuals. Participants included 251 individuals with mTBI, enrolled …

Medical Specialty Camps: A Holistic Approach To Assist In The Management Of Diabetes, Takeyra Monique Collins

Human Movement Studies & Special Education Theses & Dissertations

From toddlers to adolescents, poor medical regimen and adherence occurs as youth face adversities caused by type 1 diabetes mellitus (T1DM). This inquiry-based research sought to explore the process of promoting resilience to attain personal diabetes management through outcome-focused programming. This dissertation was structured in a three-paper format to highlight three sectors of a medical specialty camp to identify the significance of building resilience among youth with T1DM, incorporating family support, and providing service-learning opportunities for students. The purpose of this study was to examine the impacts associated with campers’ resilience from pre- to post-camp based on their participation in …

A Low-Cost Soft Robotic Hand Exoskeleton For Use In Therapy Of Limited Hand–Motor Function, Grant Rudd, Liam Daly, Vukica Jovanovic, Filip Cukov

Engineering Technology Faculty Publications

We present the design and validation of a low-cost, customizable and 3D-printed anthropomorphic soft robotic hand exoskeleton for rehabilitation of hand injuries using remotely administered physical therapy regimens. The design builds upon previous work done on cable actuated exoskeleton designs by implementing the same kinematic functionality, but with the focus shifted to ease of assembly and cost effectiveness as to allow patients and physicians to manufacture and assemble the hardware necessary to implement treatment. The exoskeleton was constructed solely from 3D-printed and widely available of-the-shelf components. Control of the actuators was realized using an Arduino microcontroller, with a custom-designed shield …

The Impact Of Anterior Cruciate Ligament Reconstructive Surgery On Neuromotor Function, Cortney Noel Armitano

Rehabilitation Sciences Theses & Dissertations

The purpose of this dissertation was to examine the systemic neuromechanical implications in individuals who have had an ACL reconstruction (ACLR) compared to healthy controls. The specific aims addressed were to: 1) examine differences in inter-limb coordination during walking at different speeds, 2) examine differences in trunk, neck and head acceleration during gait, and 3) investigate whether the reaction time responses assessed during stepping are negatively affected by ACLR.

The findings of study 1 revealed that maximal coordination stability was achieved when walking at the person’s preferred gait speed. However, individuals with a previous ACLR exhibited reduced coordination stability between …

The Effect Of Fibular Reposition Taping On Postural Control In Individuals With Chronic Ankle Instability: A Critically Appraised Topic, Bradley C. Jackson, Robert T. Medina, Stephanie H. Clines, Julie M. Cavallario, Mathew H. Hoch

Rehabilitation Sciences Faculty Publications

Clinical Scenario: History of acute ankle sprains can result in chronic ankle instability (CAI). Arthrokinematic changes resulting from CAI may restrict range of motion and contribute to postural control deficits. Mulligan or fibular reposition taping (FRT) has been suggested as a means to realign fibular positional faults and may be an effective way to improve postural control and balance in patients with CAI. Clinical Question: Is there evidence to suggest that FRT will improve postural control for patients with CAI in the affected limb compared with no taping? Summary of Key Findings: Three of the 4 included studies found no …