Rehabilitation and Therapy Commons^™

Closed Kinetic Chain Exercises Of The Shoulder Joint: Biomechanics And Clinical Implications, Todd L. Gentzler

Physical Therapy Scholarly Projects

The shoulder is a complex joint with many structures located in a small area. The purpose of this paper is to first analyze the shoulder joint mechanics and allow for a more complete understanding of this structure. The anatomical features are defined, including muscles, tendons and ligaments, their attachments and innervations. These structures are often predisposed to injury or pathology.

The second part of this paper introduced a new treatment concept: Closed Kinetic Chain Exercises of the shoulder joint. Closed kinetic chain exercises are defined, including the purpose and rationale behind this new treatment. Closed kinetic chain exercises add variability …

Critical Overview Of Wound Care Modalities, Keith W. Hartnett

Physical Therapy Scholarly Projects

The purpose of this independent study is to explore Physical Therapy modalities used in adjunct to traditional wound management. There are many factors that influence the healing rate. A basic knowledge of the body's healing process is needed in order to understand the affects modalities have on the wound.

The key to wound management is the initial and constant assessment. The patient history, subjective information, and objective measure are critical to the etiology and progression of the wound, and will be discussed.

Modalities can accelerate wound healing. Mechanical and physiological effects of the different modalities will be explored. This study …

Physical Therapy And Internal Derangement Of The Temporomandibular Joint, Kathy Johnson

Physical Therapy Scholarly Projects

In orthopedic literature, internal derangement is considered to be one of the main predisposing factors in the development of temporomandibular joint dysfunction and subsequent arthrosis. Internal derangement can be defined as the abnormal relationship of the articular disc to the condyle and consists of a multitude of disorders.

Physical therapy is well-recognized as an effective, conservative method of treatment for temporomandibular disorders. Early treatment to correct symptomatic internal derangement decreases the possibility of disc deformation and further joint degeneration. However, much of the physical therapy literature consists of uncontrolled case studies and focal clinical technique articles. For this reason, there …

Low Back Pain, Jeff Large

Physical Therapy Scholarly Projects

Low back pain (LBP) is one of the most common disorders seen in the health care setting today. The cost of rehabilitation of LBP makes up a significant proportion of today's health care economy. Both physical and social factors have been associated with the etiology of LBP. Today's advanced diagnostic equipment has allowed the underlying pathologies of LBP to be better understood. In the past, different theories and techniques for rehabilitation have been utilized. Current rehabilitation of LBP has emphasized effective, cost-efficient prevention and education.

The purpose of this independent study is to research current theories of risk factors, pathologies …

The Use Of Lower Extremity Functional Electrical Stimulation In Spinal Cord Injured Patients, Michelle Mccrory

Physical Therapy Scholarly Projects

Spinal cord injury (SCI) is a devastating, life-altering injury that presents a variety of rehabilitative and long-term medical management challenges. Not only must the inability to ambulate, which is generally of primary concern to the patient, be addressed, but also the inherent degenerative and deconditioning effects of SCI which may ultimately lead to various secondary complications.

Recently, functional electrical stimulation (FES) has been the subject of a variety of research concerning the rehabilitation of individuals with SCI. FES is a means of activating alpha motor neurons to stimulate muscular contraction and elicit a therapeutic or functional effect.

The purpose of …

Nonoperative Treatment Of Shoulder Instability In The Throwing Athlete, Whitney A. Meier

Physical Therapy Scholarly Projects

An increase interest of the shoulder complex has led to additional knowledge through research and enhancement of rehabilitation for various shoulder disorders. Shoulder injuries are common for overhead sporting activities, such as pitching. The pitching mechanism combines a high level of neuromuscular coordination between the glenohumeral and scapulothoracic muscles. The intricate balance and timing of these muscles is necessary to allow full mobility and to maintain the dynamic stability throughout the entire throwing motion. Any deficiency in muscular strength or timing can affect shoulder function and potentially cause shoulder instability.

Rehabilitation and nonoperative management of shoulder pain due to instability …

A Literature Review Of Strengthening And Injury Prevention Techniques As Related To High School Athletes, Matthew Miller

Physical Therapy Scholarly Projects

In the U.S. an estimated 20-25 million youths participate in high school athletics yearly. Of these, nearly 30% will be forced to miss part or all of the season due to injury. It has been speculated that through proper training, many of the injuries seen may be reduced or eliminated. However, most coaches do not have an extensive anatomical and physiological background to provide athletes with these correct training techniques. Although athletic trainers have expertise in this area, they are only employed in approximately 10% of the high school systems in the U.S.

Much of the research to date on …

Functional Knee Bracing: Effects And Efficacy, Lisa A. Philion

Physical Therapy Scholarly Projects

Functional knee braces are intended to provide stability to the unstable knee joint. The purpose of this literature review is to examine available research on functional knee braces in order to summarize their effects and efficacy.

Research indicates that the most effective brace for controlling abnormal knee motions would be a custom designed shell brace with rigid straps and a polycentric hinge. However, individual characteristics of the wearer must also be considered.

Subjective research indicates that functional knee braces improve function and provide support for the unstable knee. However, these findings do not correlate with objective findings.

Results of biomechanical …

Shoulder Pathology In The Pitching Athlete: A Review Of Mechanics Involved In Throwing And Conservative Management, Conny C. Randolph

Physical Therapy Scholarly Projects

The pathological shoulder in the pitching athlete offers a unique challenge to the therapist. Most often, the injury relates to the throwing motion itself. Therefore, for the therapist to efficiently diagnose and treat this patient population, they must be familiar with the normal biomechanics associated with pitching, and be familiar with the structures that are commonly stressed or injured during various phases of the pitch.

Therefore, the purpose of this paper is to outline the normal biomechanics associated with the pitch, review common pathologies as they relate to the stresses imposed by the pitch, and discuss current concepts regarding the …

The Effect Of Therapeutic Horseback Riding Compared To Traditional Physical Therapy On Range Of Motion, Tone, Pulmonary Function, And Balance In Children With Cerebral Palsy, Rene Roze

Physical Therapy Scholarly Projects

Therapeutic horseback riding programs have grown rapidly since 1969, when the first center opened in Michigan. Although therapeutic riding is a growing adjunctive therapy procedure, the claims that the program facilitates musculoskeletal and physiological improvements have never been objectively examined against a control group. The purpose of this independent study was to measure the effect of therapeutic horseback riding compared to traditional therapy on range of motion, pulmonary function, balance and muscle tone in children with cerebral palsy.

Twelve children underwent assessments according to the repeated measures design. Six children who received traditional therapy served as a control group, while …

Factors Related To Functional Recovery After Cns Injury, Traceylin B. Sales

Physical Therapy Scholarly Projects

Factors that act either directly or indirectly, such as the age of the person, the time of injury, the site and size of location, mechanisms of neural repair, therapeutic intervention, and general medical and family support have been suggested to contribute to the overall motor and functional recovery of an individual. This paper is a literature review of these influential factors, with emphasis on restoration of functional skills. Overall, findings have been consistent to some degree. Generally, the more severe and dense the injury, the resulting increase in behavioral and motor deficits. Neural mechanisms of repair have been found to …

A Retrospective Look At The Use Of Manual Therapy, Susan Adele Sollom

Physical Therapy Scholarly Projects

Manual Therapy (MT) has been used extensively since the origin of the Physical Therapy profession and includes massage, traction, exercise, stretching or compression of soft tissue, range of motion tests, manual muscle tests, palpation, joint mobilization and manipulation. Interest and enthusiasm for MT has especially grown among clinicians and educators in the last decade. However, despite its common use, research and documentation involving the efficacy and reliability of MT are extremely rare. Many techniques and concepts have yet to be justified. These concepts need to be critically tested, discussed, and revised, and the profession needs to be challenged to show …

The Efficacy Of Functional Assessments In Rehabilitation Medicine, Keith E. Swanson

Physical Therapy Scholarly Projects

Functional assessment in rehabilitation medicine is not a new concept. Functional assessment measures have, however, experienced increased usage. Health insurance companies and clinicians are now focusing on functional outcomes in addition to objective tests.

Certain measurement criteria must be satisfied before a measurement tool may be successfully implemented into the clinical setting. Variable standardization, reliability, and validity are necessary for accurate measurement. The term function, however, deals with many variables leading to definitional difficulty.

The purpose of the functional assessment is to describe, screen and assess, and monitor. Although many functional assessments are available for clinical use, most lack scientific …

Fetal Tissue Transplantation In Parkinson's Disease: A Literature Review, Kathleen Thompson

Physical Therapy Scholarly Projects

Parkinson's disease (PD) is a common progressive neurological disorder. It affects the central nervous system by depleting the basal ganglia of dopamine. To date, the standard treatment is drug therapy to replace the lacking dopamine. However, this treatment is problematic as there are many side effects to the drugs. Also, this treatment does not effect the progression of this disease. Therefore, drug therapy becomes continuously less effective in treating PD. For this reason, new forms of therapy are being researched for the treatment of advanced PD. One of the most recent therapeutic interventions is fetal tissue transplantation.

The purpose of …

Rehabilitation Following Anterior Cruciate Ligament Reconstruction: A Comparison Of Traditional And Accelerated Approaches, Michael S. Wanbaugh

Physical Therapy Scholarly Projects

Rehabilitation following Anterior Cruciate Ligament (ACL) reconstruction has become an area of controversy in recent years. Most clinicians have used the traditional rehabilitation protocols which correlate mobility, weightbearing, and strength training with the bio-mechanical and surgical constraints of graft fixation and healing. However, a trend towards the use of accelerated protocols is more evident today. The accelerated approach stresses activity and weightbearing in the early periods of the rehabilitation process following the reconstructive surgery. The proponents of the accelerated protocol believe that earlier activity will enhance the healing of the graft without causing an increase in knee instability.

The purpose …

Treatment Of Urinary Incontinence In Females: A Physical Therapist's Guide, Natalie R. Wells

Physical Therapy Scholarly Projects

p>Urinary incontinence is a common problem for many females in the united states. Most people with this problem believe that their main options for treatment are surgery or medications. People with incontinence, along with their attending physician, often do not realize the types of conservative therapy that are available for the treatment of urinary incontinence in females. As the understanding of urinary incontinence has increased, there has also been an increased awareness of the role of physical therapy in the conservative treatment of the problem.

The purpose of this paper is to review the literature regarding the assessment and …

A Critical Review Of The Human Immunodeficiency Virus (Hiv) Infection And The Most Common Clinical Manifestations Of Acquired Immune Deficiency Syndrome (Aids), Randy Willman

Physical Therapy Scholarly Projects

The purpose of this independent study is to review the viral and immunologic factors in human immunodeficiency virus (HIV) infection and present the clinical manifestations most commonly associated with acquired immune deficiency syndrome (AIDS). As physical therapists, we will thus increase our knowledge base of this complex disease and understand the many opportunistic infections associated with HIV infection and the various aspects of AIDS. In addition, by having a better understanding of the disease, we may overcome our fears, improve our personal attitudes toward patients with HIV/AIDS, and improve and prolong the quality of life of individuals with the disease.

A Review Of The Sacroiliac Joint, Mark Daugherity

Physical Therapy Scholarly Projects

Low back pain is one of the leading causes of lost productivity at work and disability in the United States. There are many factors thought to be involved in this diagnosis. These include intervertebral disc problems, mechanical dysfunctions, muscle sprains, ligament strains, and infectious diseases, such as rheumatoid arthritis and tuberculosis. One area often overlooked in the diagnosis of low back pain is the sacroiliac joint. There is much controversy surrounding the function of this joint. Although some clinicians question if there is any movement at all, many manual therapists evaluate this area in their daily practice and believe that …

Motor Skills And Mental Practice: A Tool For Physical Therapy, Kari L. Drevecky

Physical Therapy Scholarly Projects

The purpose of this Independent Study is to review the literature concerning mental practice and its effects on motor skill performance and retention as important within the field of physical therapy. The study of mental practice as concerned with physical therapy is important as this .modality is not often included in patient treatment programs, despite its potential applications. The content of this paper will consist of. definitions, theoretical explanations, effectiveness of mental practice, and the effects of individual differences on mental practice. The primary research questions were: (1) What is mental practice? (2) How does mental practice work? (3) Does …

The Effect Of Semi-Rigid Foot Orthotics On Subtalar Joint Subluxation And Pain During Three Gait Velocities, Lynnelle A. Gelinske

Physical Therapy Scholarly Projects

It has been established that foot orthotics can effectively control the amount of maximal calcaneal eversion while walking. However, there are conflicting studies about the successfulness of foot orthotics in regulating rearfoot motion during running. The purpose of this study was to determine the effectiveness of standard vertical semi-rigid foot orthotics in controlling subtalar joint subluxation (ST JS) and pain during three gait velocities. The study was also completed to ascertain whether any correlations existed between 8T JS and the static lower extremity measurements of tibio-fibular varum, gastrocnemius flexibility, and navicular drop. The results of this study revealed that pain …

Subjective Functional Knee Outcomes Following Anterior Cruciate Ligament Reconstructive Surgery, Malissa K. Hauser

Physical Therapy Scholarly Projects

It is established in the literature that primary repair of the anterior cruciate ligament (ACL) deficient knee is achieved through means of reconstructive surgery. However, with continuing advances in both the surgical technique performed and, consequently, the rehabilitation program implemented following reconstruction, the need for ongoing research becomes essential in evaluating the long-term effectiveness of such changes. Currently, the longterm follow-up studies available on ACL reconstructive surgery report information through means of clinical evaluation and objective testing measures with little or no emphasis on the value of the patient's subjective responses. The purpose of this study is to determine the …

Open Versus Closed Kinetic Chain Exercise In The Lower Extremity, Christine Krantz

Physical Therapy Scholarly Projects

This study is a literature review comparing and contrasting the advantages of closed kinetic chain exercise over open kinetic chain exercise. It is the purpose of this study to show that open kinetic chain exercise may not be the safest or the most functional way to rehabilitate the lower extremity. It is also the purpose to show the specific advantages of using closed kinetic chain exercise over open kinetic chain exercise to protect the integrity of the ACL deficient or reconstructed knee by decreasing anterior shear forces, increasing joint compression, increasing joint proprioception, increasing muscular joint compression, and increasing the …

Plantar Fasciitis: Etiology And Treatment, Todd M. Leingang

Physical Therapy Scholarly Projects

Plantar fasciitis is a repetitive injury which causes microtrauma to the attachment of the plantar aponeurosis at the medial calcaneous of the foot. This condition is most prevalent among athletes involved in running sports, but can also occur in a sedentary individual who is overweight. Traditional treatments for plantar fasciitis, including rest, ice, anti-inflammatory drugs, and passive modalities, are helpful in temporarily reducing inferior heel pain. However, recurrence of this condition is common because the potential biomechanical causes of plantar fasciitis are often left unidentified. The purpose of this study is to review the anatomical structures and the biomechanical functions …

Iontophoresis In Physical Therapy: A Review Of The Literature, Kurt Olson

Physical Therapy Scholarly Projects

Currently iontophoresis is used by many physical therapists on a variety of pathological conditions. Therefore, therapists must have a thorough understanding of this modality as to provide the best, most efficient care possible to our patients.

The purpose of this study is to provide clinicians with a review of the available literature on iontophoresis in physical therapy. The history and principles of iontophoresis are briefly discussed, followed by a review of the clinically performed studies. This section includes studies related to pain and range of motion, tissue repair, movement of fluids, and other diagnoses. Animal and in vitro experimental studies …

The Exercise Component Of Cardiac Rehabilitation, Thomas H. Olson

Physical Therapy Scholarly Projects

Heart disease is the leading cause of death among all persons in the United States today. Many other people suffer from heart problems or conditions and are fortunate enough to survive. For those who do have nonfatal initial heart problems and complications, exercise will be a significant part of their follow up comprehensive cardiac rehabilitation program.

The cardiac rehabilitation program is determined by many medical professionals all of whom carry various responsibilities and participate in particular stages of a patient's overall program. The physical therapist is a member of the cardiac rehabilitation team and is generally in charge of the …

Physical Therapists' Views On Patient Selection, Assessments, And Treatment Techniques For Children Following Selective Posterior Rhizotomy, Tamara Peden

Physical Therapy Scholarly Projects

Selective posterior rhizotomy (SPR) is a surgical technique that attempts to reduce spasticity by severing sensory nerve roots that fire abnormally. Controversy arises when the procedure is used as an alternative management for spasticity in children with cerebral palsy. The literature cites mixed opinions regarding patient selection, treatment protocols, assessments, and outcomes. A random selection of 500 pediatric physical therapists belonging to the American Physical Therapy Association were surveyed. Responses were received from 237 therapists for a response rate of 47.7%. The results of the survey show that the majority of the therapists worked in nontraditional facilities (defined as school …

Physical Therapy Management Of Rodeo Injuries, Edith Ann Ready

Physical Therapy Scholarly Projects

The sport of rodeo is a high risk event. Each event presents unique dangers creating opportunity for injury. The high injury rate calls for medical intervention for these athletes. However, there are a limited number of publications and research relative to medical care for rodeo athletes.

The purpose of this paper is to inform physical therapists about the sport of rodeo, its members, mode of injury and atmosphere surrounding this sport. By increasing awareness, physical therapists will have a better understanding of rodeo and the special challenges it presents.

Several key points will be discussed. The history of rodeo, as …

Hypermobility And Specific Joint Pathology In Young Competitive Gymnasts, Jonathon M. Weiss

Physical Therapy Scholarly Projects

The purpose of this study was twofold: (1) to study the prevalence of hypermobility in young, competitive gymnasts and (2) to determine if the presence of hypermobility predisposes the athlete to particular joint pathologies. Subjects included 44 female members of the American Gold Gymnastics Club in Fargo, ND. These athletes were divided into three training groups based on age and skill level. All athletes were screened for systemic hypermobility by utilizing the Beighton scale. Lumbar extension, wrist extension, and navicular drop (referred to as range of motion values) were also measured on each subject. Parents and the athletes filled out …

Providing Physical Therapy Services In The Least Restrictive Educational Environment, Judy E. Bahe

Physical Therapy Scholarly Projects

Federal legislation has mandated free appropriate public education for all children with disabilities. Physical therapy is included as one of the related services which must be provided, if needed, to assist students with disabilities to benefit from the educational programs. This creates unique challenges for the physical therapist, who traditionally has provided services in a medical model rather than an educational model. The American Physical Therapy Association has published policies and guidelines for providing physical therapy services in the educational environment; however, each state is encouraged to adapt the guidelines to meet individual needs.

This paper provides a general review …

Determination Of Eligibility For Physical Therapy In The Public School Setting, Margaret Ann Borkowski

Physical Therapy Scholarly Projects

The Individuals with Disabilities Education Act of 1991 (IDEA) includes physical therapy as one of the related services which may be necessary for a student with disabilities to benefit from special education. The determination of eligibility is therefore an important part of the provision of physical therapy in a public school setting. This study investigates how this determination is made across the United States and makes recommendations for physical therapists in the state of North Dakota.

This study consists of a literature review (including medical and educational journals) and two surveys. The requirements for special education and related services under …