Rehabilitation and Therapy Commons^™

Biomechanical Effects Of Exercise-Based Interventions In Chronic Nonspecific Low Back Pain: A Systematic Review And Meta-Analysis, Lara De Vecchi Machado

Theses and Dissertations--Kinesiology and Health Promotion

Chronic nonspecific low back pain (CNLBP) is the leading cause of years lived with disability worldwide and represents a complex, multifactorial, and heterogeneous condition. It is characterized by substantial interindividual variability in muscle activation patterns, lumbo-pelvic coordination, and movement strategies. Although exercise is widely recommended as a first-line intervention and its clinical benefits are well established, the biomechanical mechanisms underlying functional improvement remain fragmented in the literature and are rarely synthesized quantitatively.

This dissertation conducted a systematic review with meta-analysis to investigate the biomechanical effects of exercise-based interventions in individuals with CNLBP. A total of 39 studies were included and …

Adsorptive Gas Sensor Response Forecasting To Enable Breath-By-Breath Analysis, Samuel Bellaire, Samir Ahmed Rawashdeh, Kirby P. Mayer, Jamie L. Sturgill

Physical Therapy Faculty Publications

MOS gas sensors have proven to be useful in electronic noses, which utilize these sensors to detect volatile organic compounds in human breath to detect various lung diseases. Unfortunately, the long settling time of MOS gas sensors is ill-suited to measuring human breath, where complete breathing cycles are often shorter than 5 s. Existing studies circumvent this limitation by collecting gas samples and injecting them into a sealed chamber to react with the sensors. However, it would be convenient if breath-by-breath analysis could be conducted without the need to store breath samples. To accomplish this, we present a novel forecasting …

Exploring The Influence Of Quadriceps Peak Torque And Rate Of Torque Development On Running Mechanics After Anterior Cruciate Ligament Reconstruction, Amit M. Gohil, Gregory S. Hawk, Darren L. Johnson, Christopher S. Fry, Brian W. Noehren

Physical Therapy Faculty Publications

Background: After anterior cruciate ligament reconstruction (ACLR), chronic changes in knee joint biomechanics during higher level tasks, such as running, may negatively impact long-term knee joint health. Among the factors that contribute to these chronic changes, the influence of quadriceps strength on knee joint biomechanics during running is not well understood.   Hypothesis: Higher involved limb quadriceps strength (peak torque and rate of torque development [RTD]) and limb symmetry index (LSI) will be positively associated with greater peak knee flexion angle and peak knee extensor moment during running.   Study Design: Cross-sectional study.   Level of Evidence: Level 3.   Methods: Peak knee extensor …

Electromyography Of The Coracobrachialis—Construct Validity And Implications For Rehabilitation Of Anterior Shoulder Dislocation, Alon Rabin, Timothy L. Uhl, Ido Druckmann, Zvi Kozol, Yossi Ruah, Dani Rotman, Dan Stein

Physical Therapy Faculty Publications

Background: The coracobrachialis (CB) is an important anterior shoulder stabilizer, yet no study has previously reported its electromyography (EMG). The purpose of this study was to validate a novel technique for surface EMG (sEMG) of the CB.   Methods: Thirty-two (21 females) healthy individuals participated in this cross-sectional study. A surface landmark for recording the CB was identified within the medial aspect of the proximal arm using real-time ultrasound imaging and cadaver dissection. The EMG from this landmark as well as from the biceps brachii (BB) were simultaneously recorded during shoulder horizontal adduction (SHAd) (a CB-dominant test), and during elbow flexion …

Development And Clinical Validation Of The Sensor-E Exoskeleton For Objective Hand Function Assessment In Stroke Rehabilitation, Madison Bates

Theses and Dissertations--Biomedical Engineering

Hand function is often impaired following neurological trauma or in conditions such as stroke, limiting independence and the ability to perform activities of daily living (ADLs). Current clinical assessments rely heavily on subjective rating scales that lack the resolution to detect subtle changes in motor performance, which can limit access to rehabilitation. Recent advances in wearable technologies highlight the potential for hand-worn devices to provide objective, real-time measures of hand function. However, most systems focus solely on kinematics and rarely capture both movement and exerted force. Moreover, integration into rehabilitation frameworks and brain-computer interface (BCI) protocols remains limited. To address …

The Role Of Self-Efficacy In Rehabilitation And Recovery From Ankle Sprains, Bridget M. Walsh

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are among the most common musculoskeletal injuries in the United States. Approximately 2 million ankle sprains occur annually, with an estimated 46% of affected individuals experiencing residual symptoms and developing chronic ankle instability (CAI). In addition to physical impairments, individuals with CAI may exhibit lower physical and psychological health-related quality of life (HRQL). HRQL integrates the physical, psychological, and social domains of a person’s health and is influenced by their experiences, expectations, and perceptions.

Injury-related fear is a common psychological impairment in individuals with CAI and has been associated with decreased physical function, reduced physical activity, and greater …

Leveraging Clinical Standards To Improve The Translational Relevance Of Therapies For Experimental Spinal Cord Injury, Aaron L. Silverstein

Theses and Dissertations--Neuroscience

Efforts to improve treatment of spinal cord injury (SCI) often use animals to develop effective therapeutics, intending to improve the survival and the quality of life of persons with SCI. Over half of all SCIs in the United States occur at the cervical level and often cause locomotor deficits and life-threatening breathing dysfunction. Thus, my dissertation is focused on this important patient population.

After beginning with a description of translational research and surveying SCI from a clinical standpoint, I turned to describe experimental models of cervical SCI and more detailed neuroimmunological findings relevant to my work. Then, I conducted a …

Alterations In Whole Muscle Quality And Physiological Cross-Sectional Area Measured With Quantitative Mri Following Acl Injury, Meredith K. Owen, Lauren Richardson, Darren L. Johnson, Moriel H. Vandsburger, Thorsten Feiweier, Katherine L. Thompson, Christopher S. Fry, Peter A. Hardy, Brian W. Noehren

Physical Therapy Faculty Publications

Background: Emerging evidence suggests that there are morphological and physiological changes to the vastus lateralis after an anterior cruciate ligament (ACL) tear. However, it is unclear whether these alterations are limited to just the vastus lateralis or are more representative of widespread changes across the thigh musculature and/or if these changes precede reconstruction. The purpose of this study was to determine T1ρ relaxation time, a measure of extracellular matrix organization in muscle, and physiological cross-sectional area (PCSA) for muscles of the quadriceps and hamstrings of the ACL-deficient and contralateral limbs soon after ACL injury.

Methods: T1ρ and diffusion …

Effects Of An Active Ankle Exoskeleton On The Walking Biomechanics Of Healthy Men, Sridevi Nagaraja, Jose E. Rubio, Junfei Tong, Aravind Sundaramurthy, Anup Pant, Meredith K. Owen, Michael A. Samaan, Brian W. Noehren, Jaques Reifman

Physical Therapy Faculty Publications

Active lower-body exoskeleton devices can decrease the energy requirement of the human body by providing mechanical assistance to lower-body muscles. However, they also alter gait kinematics and kinetics, and it is not well understood whether such alterations are detrimental or beneficial to the human body. In this pilot study, we investigated the impact of walking with an ankle exoskeleton device on the biomechanics of men while carrying a heavy load. We collected computed tomography images and motion-capture data for five young, healthy men who walked 5 km (∼60 min) with a 22.7-kg load, with and without an active ankle exoskeleton …

Effect Of Walking With An Active Ankle Exoskeleton On The Biomechanical Responses Of The Lumbar Spine, Jose E. Rubio, Junfei Tong, Aravind Sundaramurthy, Anup Pant, Sridevi Nagaraja, Meredith K. Owen, Michael A. Samaan, Brian W. Noehren, Jaques Reifman

Physical Therapy Faculty Publications

Objective: Musculoskeletal injuries pose a health threat to U.S. Service members. In particular, the physical demands of walking and running with load carriage contribute to a high incidence of musculoskeletal injuries of the lower back. Active ankle exoskeleton devices are promising technologies that may help mitigate the impact of load carriage on the incidence of these injuries. However, the safe extended use of these devices requires an understanding of their beneficial or detrimental effects on the lumbar spine. In this pilot study, we investigated the impact of walking with an ankle exoskeleton device on lumbar biomechanical responses.

Methods: We collected …

Evaluating The Efficacy Of A Progressive Mobility Protocol Among Adult Icu Patients, Clayton Chroust

DNP Projects

Background: Many intensive care unit (ICU) patients are critically ill and require ventilator support, and they often do not receive any progressive mobility interventions until after they are liberated from the ventilator or receive transfer orders out of the ICU. Current literature suggests that patients in the ICU face deconditioning, increased ventilator days, development of deep vein thrombosis, pressure ulcers, pulmonary embolism, muscular atrophy, and increased days in the ICU which can be attributed to a lack of mobility. Current evidence-based research identifies that utilization of a progressive mobility protocol is one way to improve patient outcomes and reduce …

Increased Perceived Confidence In Professional Role Skills Among Undergraduate Dietetic Students Following Simulation-Based Learning Experiences, Makenzie Barr-Porter, Elizabeth Combs, Lauren Batey, Dawn Brewer, Aaron Kyle Schwartz, Tammy Stephenson

UK CARES Faculty Publications

Simulation-based learning experiences (SBLEs) are effective for teaching healthcare students clinical and communication skills. The current study assessed self-perceived clinical and communication confidence among dietetics students completing a series of four SBLEs (3 group, 1 individual) across nine months. Dietetics students were recruited in February 2023 prior to their first SBLE. Simultaneously through the academic year, students completed clinical and communication courses. Students were invited to complete an online, anonymous self-reported survey regarding confidence with nutrition care and communication prior to their first SBLE (Time 1), prior to their third SBLE (Time 2), and following their final SBLE (Time 3). …

Relationships Between Cognitive And Physical Performance And Readiness In Military Populations, Lina Ochoa

Theses and Dissertations--Rehabilitation Sciences

Military missions and operations expose warfighters to stressful and demanding situations and dynamic environments. These situations and environments require that warfighters have optimal performance in several dimensions of human performance, such as cognitive and physical performance. Military readiness is the potential these military units or personnel have to successfully deploy and sustain assigned operational missions worldwide. Military readiness is essential for increased physical and cognitive performance, ensuring augmented individual and unit effectiveness, lethality, and national security. The primary challenge is understanding and finding ways to measure and assess the cognitive, behavioral, and physical performance effects of complex and challenging environments …

“Your Legs Don’T Look All That Good” An Analysis Of Impoliteness And Politeness In Individuals With Traumatic Brain Injuries In The Workplace, Grace Kozal

Theses and Dissertations--Communication Sciences and Disorders

Background: Social communication disorders are a common outcome from traumatic brain injury (TBI). This social communication disorder can be seen through impolite speech acts during conversation. While politeness is a social norm for workplace discourse, instances of impoliteness may have poor consequences. This research explores the use of impoliteness in persons with TBI within computer generated work-based conditions.

Methods: Language samples from the Voicemail Elicitation Task (VET) and Feedback/Advice Spoken Task (FAST) were transcribed word-for-word. Transcripts from all 62 participants were coded for impoliteness using a developed Impoliteness Codebook and were analyzed to identify significant differences in the number of …

Investigating The Use Of Serious Games For Cancer Control Among Children And Adolescents: Scoping Review, Sunghak Kim, Ebling Library, Olufunmilola Abraham

Pharmacy Practice and Science Faculty Publications

Background: Effective health care services that meet the diverse needs of children and adolescents with cancer are required to alleviate their physical, psychological, and social challenges and improve their quality of life. Previous studies showed that serious games help promote people’s health. However, the potential for serious games to be used for successful cancer control for children and adolescents has received less attention.

Objective: This scoping review aimed to map the use of serious games in cancer prevention and cancer care for children and adolescents, and provide future directions for serious games’ development and implementation within the context of cancer …

The Health Literacy Practices Of Rehabilitation Providers Of Perioperative Orthopedic Education, Allen Keener

Theses and Dissertations--Rehabilitation Sciences

Health literacy is the ability to utilize information to make decisions about one’s health or the health of others. It is estimated that a large percentage of the population has inadequate health literacy, yet healthcare professionals, including rehabilitation providers often do not have procedures in place for assessing and addressing the health literacy of their patients. Related to orthopedic patients, a large portion of the interventions are educational in nature. Therefore, it is important that the health literacy of orthopedic patients be considered when addressing their needs perioperatively. There is little currently published related to health literacy among rehabilitation providers …

Physical And Psychosocial Factors Related To Firefighter Musculoskeletal Disorders, Jennifer Ellen Tinsley Kubala

Theses and Dissertations--Rehabilitation Sciences

Career firefighters must perform physically and psychologically challenging duties in unpredictable and dangerous conditions. Previous investigations have found that firefighters suffer nearly 4 times the recorded musculoskeletal disorders (MSD) and workplace injuries compared to private and public sector workers, and take approximately 1.5 days longer to return to normal work. Thus, the burden of firefighter MSD experiences has been a growing area of exploration. The few investigations that have concurrently examined physical and psychosocial consequences experienced by firefighters have found a positive relationship between increased occupational stress reports and MSD experiences. However, these investigations, as well as those that individually …

The Role Of Social Determinants Of Health On Patient Recovery After Critical Illness, Lindsey E. Fresenko

Theses and Dissertations--Rehabilitation Sciences

Patients who survive critical illness have a prolonged recovery which impacts their quality of life and outcomes. The sudden life changes from being critically ill may create or exacerbate social factors or needs also known as social determinants of health. Patients’ SDOH are defined as the environments in which we live, work and play that impact health outcomes. Patients’ SDOH impact their life in early recovery from changes in previous roles to their need for increased financial, physical and emotional support. During this early recovery, patients are often recommended to participate in rehabilitation to improve their physical function. Although, accessing …

Key To Success: A Comprehensive Examination Of Support Personnel In School-Based Speech-Language Telepractice, Hannah Douglass

Theses and Dissertations--Rehabilitation Sciences

In the school setting, the telepractice team primarily consists of the clinician and a support person known as a telefacilitator. Though telepractice is an accepted method for delivering school-based speech-language therapy, many barriers to the integration of telepractice as routine care persist. A major barrier is clinicians' acceptance of telehealth. However, there has been limited investigation of factors that influence clinician acceptance. Another barrier is related to support personnel. Telefacilitators have been shown to be an integral part of the telepractice program. Yet there are significant gaps in knowledge regarding the roles and responsibilities, staffing and management, and barriers/facilitators to …

A Mixed Methods Exploration Of Occupational Therapy Pratice And Multiple Sclerosis Specialization, Dana Alghadban

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation is to increase the body of research of how occupational therapists can address multiple sclerosis rehabilitation through occupational therapy services. Multiple sclerosis is a neurodegenerative disease that creates challenges for individuals to engage in meaningful occupations and significantly affects many areas of their lives. Occupational therapists play a role in the rehabilitation process for people with multiple sclerosis by providing occupation-focused interventions that may improve the health and well-being of clients living with the disease. As a result of the unpredictability of symptoms experienced by this population, individualized approaches to addressing participation and occupational performance …

Biomechanics, Strength, And Physical Function After Surgical Repair Of Rotational Ankle Fractures, Benjamin Brightwell

Theses and Dissertations--Kinesiology and Health Promotion

Ankle Fractures account for approximately 9% of all lower extremity fractures and incidence continues to rise. Up to 53% of ankle fractures require surgical intervention. Impaired physical function is one of the most reported and observed lasting effects of surgically repaired ankle fractures. Additionally, limited physical capacity and function have been identified as the primary threats to health-related quality of life after surgical repair of ankle fractures. These impairments to physical capacity and functionality can last longer than 5 years after surgery. Since surgery typically successfully restores stability and congruency of the talocrural joint, these poor long-term outcomes are an …

The Relationship Between Sleep, Physical Activity, And Musculoskeletal Injury, In Us And Saudi College Students, Abdulaziz Hasan Alameer

Theses and Dissertations--Rehabilitation Sciences

According to the National Sleep Foundation, individuals should sleep 7-9 hours every night. Recently, insufficient or poor sleep has been linked to diabetes, cardiovascular illness, stroke, obesity, and Alzheimer's disease. Insufficient sleep for college students can negatively impact academic performance and mental health. In addition, especially for collegiate athletes, there is evidence that insufficient sleep is associated with an increased risk of musculoskeletal injury. However, it is uncertain if the link between sleep and injury varies between populations, types of individuals (athletes vs non-athletes), sports or types of exercise, or training volume. Despite the health risks of inadequate sleep, up …

Exploration Of Burn Survivors’ Experiences With Nutrition During The Rehabilitation Phase Of Burn Injury Recovery: A Qualitative Study, Alyaa M. Zagzoog

Theses and Dissertations--Rehabilitation Sciences

Approximately 500,000 people in the United States are affected by a burn injury and seek care every year. With medical innovation, however, the burn injury survival rate has increased to 97% in the United States. Burn survivors undergo two phases of recovery: acute and rehabilitation.With advances in burn treatment and care, the focus has shifted from the expectation of survival to improving outcomes. Nutritional care, including assessment and education, plays a major role in burn survivors’ wellness, facilitating wound healing and promoting recovery, but nutritional guidelines and polices appear limited during the rehabilitation phase,with literature suggesting nutritional assessment has historically …

Association Of Race, Ethnicity, And Gender To Disparities In Functional Recovery And Social Health After Major Lower Limb Amputation: A Cross-Sectional Pilot Study, Sheila M. Clemens, Kiarri N. Kershaw, Zoran Bursac, Szu Ping Lee

Physical Therapy Faculty Publications

Objective: To assess if evidence of disparities exists in functional recovery and social health post-lower limb amputation.

Design: Race-ethnicity, gender, and income-based group comparisons of functioning and social health in a convenience sample of lower limb prosthetic users.

Setting: Prosthetic clinics in 4 states.

Participants: A geographically diverse cohort of 56 English and Spanish speaking community-dwelling individuals with dysvascular lower limb amputation, between 18-80 years old.

Interventions: None.

Main Outcomes Measures: Primary outcomes included 2 physical performance measures, the Timed Up and Go test and 2-minute walk test, and thirdly, the Prosthetic Limb Users Survey of Mobility. The PROMIS Ability …

Current Clinical Concepts: Nonoperative Management Of Shoulder Instability, Margie K. Olds, Timothy L. Uhl

Physical Therapy Faculty Publications

Nonoperative management after shoulder dislocation or subluxation remains a challenging and complex task. Accurate diagnosis of the condition and shared decision-making regarding operative and nonoperative management and timing of return to play is required. In this Current Clinical Concepts paper, we introduce a shoulder instability framework that addresses these fundamental clinical dilemmas. Valid clinical prognostic tools that can be used to predict recurrent shoulder instability are reviewed. The process of shared decision-making in the realm of shoulder instability is presented. Finally, a framework for progressive rehabilitation that addresses deficits in motor control, strength, and endurance in scapular and shoulder musculature …

Humor Matters: An Adapted Multiple Case Study Exploring Music Therapists’ Perspectives Of Humor With Older Adults, Caleb M. Posey

Theses and Dissertations--Music

Humor is a ubiquitous human experience and a skill retained in older adulthood. It is also an integral but elusive therapeutic tool with numerous benefits and risks to well-being. Therapeutic humor – the application of humor to client well-being – is an emerging area of study. However, scant music therapy literature on humor is available. The purpose of this qualitative thesis was to explore the use and function of humor in music therapy with older adults from the perspectives of experienced music therapists. There were three research questions: (1) how do music therapists describe their use of humor with older …

Moving Toward And Accessing Adult-Oriented Rehabilitation Therapy Services For Adults With Lifelong Disabilities: A Tale Of Three Studies, Catherine Gohrband

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation was to explore how adults with a Lifelong Disability (LLD) access and experience rehabilitation therapy services across their lives. Many LLD diagnoses such as cerebral palsy and spina bifida are considered non-progressive; however, there are common challenges that occur as people with LLD become adults, including increased pain, fatigue, and functional loss. Literature addressing the needs of people with LLD to access adult-oriented medical providers has focused primarily on medical transitions, which have described the processes for pediatric patients moving to adult-oriented settings from pediatric settings. Few studies have addressed the rehabilitation therapy needs of …

Blood Flow Restrictive Training Following Medial Patellofemoral Ligament And Anterior Cruciate Ligament Reconstruction Rehabilitation, Richard Watson

Theses and Dissertations--Rehabilitation Sciences

Both patellofemoral dislocation and anterior cruciate ligament (ACL) ruptures have a significant impact on an athlete’s ability to regain function and return to play. Surgical repair of the medial patellofemoral ligament (MPFL) and ACL ligament reconstructions result in a sequala of quadriceps weakness. Persistent quadriceps weakness following reconstruction can create a cascade effect of muscular atrophy and weakness resulting in significant knee and leg impairments. An abundance of research has shown that blood flow restrictive training (BFRT) has demonstrated significant results in post-surgical rehabilitation by increasing muscular strength and improving function. What is unclear is the effect of deflating or …

Developing Ecologically Valid Clinical Tools For Persons With Tbi: Understanding The Role And Impact Of Distractions, Deanna Pinnow

Theses and Dissertations--Rehabilitation Sciences

There is a critical need for the development of ecologically valid clinical tools to assess real-life cognitive functioning in persons impacted by traumatic brain injury (TBI). Chronic cognitive impairments that are exacerbated by distractions are one of the core factors contributing to poor home and community re-integration post injury. Simulation-based digital platforms (i.e., virtual reality, augmented reality, and mixed reality) have become potential solutions for eliciting real-world cognitive performance in clinical settings. Yet, there is a paucity of research investigating the role and impact of distractions on cognition. As a result, there is no clear framework of measuring distractions to …

Nonoperative Management Of Shoulder Instability, Margie K. Olds, Timothy L. Uhl

Physical Therapy Faculty Publications

Non-operative management following a shoulder dislocation or subluxation remains a challenging and complex task. Accurate diagnosis of the condition, and shared decision-making regarding operative and non-operative management, as well as timing of return to play is required. This clinical concept paper introduces a shoulder instability framework that addresses these fundamental clinical dilemmas. Valid clinical prognostic tools which can predict recurrent shoulder instability are reviewed. The process of shared decision-making within the realm of shoulder instability is also presented. Finally, a framework for progressive rehabilitation that addresses deficits in motor control, strength, and endurance in scapula and shoulder musculature is presented …