Rehabilitation and Therapy Commons^™

Paraplegic Functional Ambulation With Long Leg Braces And Upper Extremity Support: Predicting Long Term Usage Patterns Utilizing The Functional Independence Measure, Karin Copenhaver, Matthew Sherman

Masters Theses

Individuals with a spinal cord injury (SCI) are frequently taught to ambulate with long leg braces and upper extremity support during their post-acute rehabilitation. In many cases this training fails to carry over once these individuals return to their homes after their rehabilitation course has ended. Subsequently, these individuals rely on their wheelchair as their primary mode of ambulation. Is ambulation training an expropriate intervention for patients in these cases? The purpose of this study was to investigate whether utilization of the Functional Independence Measure (FIM) may serve as a predictor of long term functional ambulation with long leg braces …

The Direct And Indirect Patient Benefits Of Orthopedic Physical Therapy Specialization, Amy Lynne Dipman

Masters Theses

This research surveyed 25% of Orthopedic Certified Specialists to determine the direct and indirect patient benefits resulting from the American Physical Therapy Association specialization process. The newly developed questionnaire included questions pertaining to demographics, professional activities, and professional opinions regarding specialty certification. The results showed a statistically significant relationship between the number of PT’s on staff at a facility and the amount of therapist mentoring. Overall, only 50% of the therapists subjectively reported improved patient care secondary to specialization. The qualitative data showed that many therapists reported providing high quality care prior to specialization. Patients are receiving direct and indirect …

The Relationship Between A Functional Throwing Performance Test And Strength Of Various Scapular Muscles, Karen L. Bos, Kellie S. Gehrs, A. Louise C. Hester

Masters Theses

The purpose of this study was to determine the relationship between the strength of the upper trapezius, middle trapezius, lower trapezius, and serratus anterior, and overhead throwing accuracy in 52 female collegiate softball players. The correlation between manual muscle testing (MMT) and hand-held dynamometry (HHD) was also examined. The Functional Throwing Performance Index (FTPI) was used to measure throwing accuracy. Spearman’s correlation analysis demonstrated no correlation between the strength assessments and throwing accuracy, as measured by the FTPI. Moderate correlations were found between MMT and HHD strength assessments of the lower and middle trapezius and serratus anterior muscles. A poor …

Effect Of Asymmetrical Loading And Walking Time On Surface Emg Activity Of The Lumbar Paraspinal Muscles, Michael Aenis, Angela Bueche, Brian Trembly

Masters Theses

BACKGROUND A high incidence of back pain is associated with carrying loads asymmetrically and is believed to be influenced by the amount of weight involved and the distance carried. PURPOSE (1) To study the effects of asymmetrical loading on lumbar paraspinal muscle activity. (2) To document ratings perceived exertion (RPE) for carrying an asymmetrical load. METHODS Electromyography (EMG) readings were obtained at the L2/L3 paraspinal level of 12 males and 12 females. All subjects completed three randomized 9-minute trials consisting of walking on a treadmill while carrying an asymmetrical load of either 0, 10 or 20% of their body weight. …

Advisors' Knowledge Of Requirements For Admission To The Physical Therapy Program At Grand Valley State University, Laura Irrer, Elizabeth Knight, Joel Vander Wall

Masters Theses

The purpose of the study was to identify the accuracy and extent of knowledge among G.V.S.U. academic advisors and the sources used to obtain information regarding the physical therapy (P.T.) admission process. Surveys were distributed to 45 advisors of pre-P.T. students. Nineteen surveys were returned and six respondents were chosen for an interview. Interpretations of the data were made using a qualitative coding system.

The authors found the advisors were inaccurate in their knowledge of the weighting of G.P.A . and interview and the role that physical appearance and leadership plays in the admission process. Advisors were accurate in the …

Emg Measurements Of Paraspinal Muscles And The Implications Of Adapting Hand Placement Protocols When Using Passive Extension Exercises, Mark Randell, Geoff Willson

Masters Theses

The purpose of this study was to determine if there is a significant difference in the EMG activity of the paraspinal musculature, based on the width of hand placement used in the McKenzie prone press-up position.

EMG recordings were taken using surface electrodes placed on the lumbar paraspinal musculature of thirty normal, volunteer subjects. These recordings were taken while the subject was in the prone press-up position. This was repeated three times with different widths of lateral hand placement. The resultant EMG recordings were normalized using a recording from a maximal effort of an isometric contraction. The mean EMG recording …

The Effects Of Prosthesis Use Versus Non-Use On Forward Reach Distance In Children Ages 5 To 15 With Unilateral Upper Extremity Amputation As Measured By The Functional Reach Test, Mary E. Weber, Scot G. Smith

Masters Theses

The purpose of this study was to investigate the possible differences in maximal forward reaching distance in children with unilateral upper extremity amputations while wearing and not wearing a prosthesis using the Functional Reach (FR) test. Trends were noted between FR scores of these children and children without disabilities.

Four children, ages 5-8, completed the FR test using the intact arm under two conditions, “prosthesis-off” and “prosthesis-on”. A paired, two-tailed t test (a = .05) was used to determine the statistical significance of the means of differences in FR scores between the two conditions.

No statistically significant difference was found …

The Life Experiences Of Male Occupational Therapists As It Relates To Career Choice: A Qualitative Study, Jason R. Bomia

Masters Theses

This study examined the life experiences of male occupational therapists and how various life experiences influenced their choice of career. Research in occupational therapy has not addressed this topic, focusing instead on external influences, such as salary, advancement and prestige on career choice for male therapists. In order to study more intrinsic influences of male occupational therapists, this study interviewed male therapists using semi-structured interviews and hermeneutic data collection and analysis techniques. The results indicate a dynamic relationship between personal history, selfexpression and professional issues that contribute to how meaningful occupational therapy is to the males in this study. This …

The Effects Of Animal-Assisted Therapy At A Long Term Care Facility, Sarah Kendziorski, Carol Treacy

Masters Theses

This thesis is a qualitative study on how resident pets impacted the lives of residents in a nursing home. Through the hermeneutic process, ten participants were interviewed to determine their relationships with the animals. Five common themes emerged from this study; (a) the participants enjoyed the companionship of pets, (b) the participants found pleasure in feeding the pets, (c) the participants enjoyed petting the animals, (d) most of the participants were unable to care for the animals, and (e) a resident animal would be an important factor in choosing a new nursing home for these participants. This thesis supports the …

Functional Effects Of Botulinum Toxin-A Intramuscular Injections In A Patient With Traumatic Brain Injury: A Single Subject Case Design, Christina M. Higel, Molly L. Arndt

Masters Theses

This single subject case design sought to evaluated the long-term and short-term effectiveness of Botulinum Toxin-A (BTXA) treatment in conjunction with directed physical therapy on spasticity, active range of motion (AROM), passive range of motion (PROM), Functional Independence Measurement (FIM) scores, and motor performance in a patient with TBI. Researchers hyopothesized that directed physical therapy in conjunction with BTXA would maximize a subject’s motor control and performance. An "A₁-BC-B-A₂” single subject design, scheduled to last six months and three weeks, was proposed. Clinically significant changes were defined as: a decrease by one point for the Modified …

Perceived Concerns Surrounding The Utilization Of Physical Therapy Aides In Michigan, Jill Bydalek, Greta Swasey-Hadlock

Masters Theses

Utilization of support personnel to perform physical therapy treatments has been a controversial topic in the physical therapy profession for many years. As Managed Care and other health care changes emerged, physical therapists have been pressured to cut costs while maintaining productivity. The use of non-licensed personnel became common place to meet these demands. The purpose of this study was to investigate five research questions. First, to what extent do physical therapists delegate patient treatment and utilize physical therapy aides in Michigan? Secondly, does aide utilization differ based on: the ways in which aides are identified to patients, various settings …

Examination Of The Reliability And Validity Of Rancho Los Amigos Observational Gait Analysis, Heather Groth, Sarah Novak

Masters Theses

The Rancho Los Amigos Observational Gait Analysis system (Rancho OGA) is a standardized approach utilized to assess gait impairment for various diagnoses. Physical therapists, orthotists, and physicians utilize Rancho OGA for clinical decision making and recommending treatment interventions for gait disability. This study examined the reliability and concurrent validity of Rancho OGA from gait files obtained from the GVSU/Mary Free Bed Center for Human Kinetic Studies. Comparisons were made between computerized 3-D gait analysis and Rancho OGA data from videotaped records of cerebral palsy gait to determine the level of agreement utilizing the Kappa statistic and percent agreement. Results indicated …

Validation Of The "Timed Up And Go" Test As A Functional Mobility Assessment Tool In The Pediatric Population, Susan Carman, Christina Rook, Cathy Ruprecht

Masters Theses

The purpose of this study is to determine the concurrent validity of the Timed Up and Go (TUG) as an assessment of functional mobility in the pediatric population. The TUG scores were correlated with the Pediatric Evaluation of Disability Inventory (PEDI). Eighteen subjects with a variety of cognitive and physical disabilities, aged 6 to 7 years, were recruited. A one-tailed Spearman’s Rank Correlation Coefficient was used to analyze the scores. A weak inverse relationship between the TUG and PEDI scores (r_s = -0.386, p = 0.075) was found when the scores from all participants were analyzed. A moderate inverse …

The Relationship Between A Functional Throwing Performance Test And Strength Of Various Scapular Muscles, Karen L. Bos, Kellie S. Gehrs, A. Louise C. Hester

Masters Theses

The purpose of this study was to determine the relationship between the strength of the upper trapezius, middle trapezius, lower trapezius, and serratus anterior, and overhead throwing accuracy in 52 female collegiate softball players. The correlation between manual muscle testing (MMT) and hand-held dynamometry (HHD) was also examined. The Functional Throwing Performance Index (FTPI) was used to measure throwing accuracy. Spearman’s correlation analysis demonstrated no correlation between the strength assessments and throwing accuracy, as measured by the FTPI. Moderate correlations were found between MMT and HHD strength assessments of the lower and middle trapezius and serratus anterior muscles. A poor …

Functional Outcome Measures Following Isometric Quadriceps Strengthening In Individuals With Knee Osteoarthritis, Rochelle Cibor, Damon Collier, Kris Cooper

Masters Theses

The purpose of this study was to determine if the strength gained from the performance of a six week isometric training program for the quadriceps femoris would result in improvements in the disability level, strength, pain, stiffness, and functional abilities of patients with knee osteoarthritis (OA). Twelve subjects with symptomatic knee OA were randomly assigned to either control or experimental groups, with the experimental group completing a six week isometric program. Pre- and post-test measures included strength assessment on the Biodex and completion of the WOMAC Osteoarthritis Index. Results indicate that experimental subjects had significant improvements in strength and disability …

A Comparison Of The Health Belief Model And Stages Of Change In Exercise Behavior Construct In Cardiac Rehabilitation Patients, Tracey Phillips

Masters Theses

The purpose of this study was to compare the Health Belief Model (HBM) and the STAGES theoretical constructs in the uncovering of influencing factors associated with exercise compliance behaviors in cardiac rehabilitation subjects.

Sixty subjects who had experienced a cardiac event and who were attending a phase II outpatient cardiac rehabilitation program participated in this study. A questionnaire regarding health beliefs and exercise behavior classification was administered. Questions pertained to general health motivations, effectiveness of the intervention, perception of disease severity, perception of susceptibility and the stage of exercise behavior.

An analysis of variance and Tukey's post hoc comparison statistical …

Physical Therapist Characteristics And Practices That Affect Patient Willingness To Comply With Home Exercise Programs, Greg Angell, Andrea Glaspie, Melinda Winters

Masters Theses

Home exercise programs are a vital part of sustaining physical therapy treatment effectiveness and encourages the patient to become an active participant in their care. The purpose of this study was to examine the relationship between compliance with therapeutic home exercise programs (HEP) and the patient’s perception of a physical therapist’s characteristics such as appearance, demeanor, role modeling behaviors, and humanistic traits. 250 survey questionnaires were distributed to seven outpatient physical therapy clinics in west Michigan with a 49.6% return rate. The results of this study demonstrate physical therapist personality traits and clinical practices were perceived by patients to be …

The Pre-Absorptive, Instantaneous Effects Of Natural And Refined Sugar On Quadriceps Peak Torque, Brian Adams, Kevin Valdes, Scott Vanzanten

Masters Theses

The purpose of this study was to compare the effect of natural and refined sugar at an instantaneous, pre-absorptive level on quadriceps peak torque and to measure any prolonged effect on normal, healthy subjects. The experimental group (n=40) was randomly assigned to sugar testing order, with refined sugar testing occurring on one day and natural sugar testing occurring on the opposite day. The control group (n=10) followed the same protocol but held distilled water in their mouth. Isokinetic peak torque was recorded for each subject at three intervals, pretest, post-test I (~1 min.), and posttest n (-15 min.). Results showed …

The Effect Of Cognitive Load On Stance Width Of Healthy Older Adults, Susan Brown, Amy Thackery

Masters Theses

Research has shown that narrower stance widths lead to increased postural sway. There is also evidence of increased postural sway with cognitive loading. However, no research has been done to investigate the effect of a cognitive load on stance width. The purpose of this study was to determine if a cognitive task affected the stance widths of healthy, community dwelling 65-80 year old adults. Subjects underwent six task trials (three cognitive, three non-cognitive) after which their stance width was measured. Cognitive task trials required subjects to count backwards by 7's; non-cognitive task trials required subjects to look at a picture …

The Effect Of Nutritional Supplementation And Exercise On Subjective Pain And Function In People With Osteoarthritis Of The Knee, Anna Power, Dan Scheffer

Masters Theses

Nutritional Supplementation of glucosamine sulfate and chondroitin sulfate are being promoted in the treatment of osteoarthritis. Recent research has indicated that gelatin was found effective. Moderate exercise is also being advocated. The purpose of this eight week double blind study was to examine the effects of the inexpensive nutritional supplement gelatin, in the form of Knox Nutrajoint, and exercise on pain and functional activity in 49 subjects with osteoarthritis in one or both knees. Subjects were randomly assigned to one of four groups: placebo, placebo plus exercise, gelatin supplement plus exercise and exercise. Exercise consisted of a progressive walking program. …

Exploration Into The Validity Of Use Of The Bruininks-Oseretsky Test Of Motor Proficiency In Assessing The Adolescent With Down Syndrome, Robin J. Essebaggers, Wynne M. Martin, Gina E. Smies

Masters Theses

The purpose of this study was to investigate the validity of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) in assessing the adolescent with Down syndrome. Thirteen individuals with Down syndrome ages 13 to 20 years with an IQ of at least 35 were administered the short form of the BOTMP (BOTMP-SF). The functional abilities of these subjects were assessed using the Pediatric Evaluation of Disability Inventory (PEDI). Four parts of the PEDI were utilized: 1) Self-Care Functional Skills, 2) Self- Care Caregiver Assistance, 3) Mobility Functional Skills, and 4) Mobility Caregiver Assistance. No evidence of significant correlation existed between the …

Research Based Practice Among Members Of The Michigan Physical Therapy Association, Sarah M. Bennett, James D. Courter, Rachel E. Hastings

Masters Theses

The purpose of this study was to investigate the extent to which research based practice (RBP) is employed by Michigan Physical Therapy Association Members by assessing attitudes toward research, level of research involvement/scholarly pursuit, and reasons for using or not using treatment interventions.

Three hundred and thirty questionnaires were distributed by mail to a random sample of Michigan Physical Therapy Association Members. A total of 133 questionnaires were used for analysis. Descriptive frequencies were calculated for each section of the questionnaire. Chi-square and Fischer's Exact tests were used to examine significant relationships.

Respondents in the present study overwhelmingly supported (~90%) …

The Identification Of Domains And Competencies For Community Practice Occupational Therapy, Lisa Anne Werner

Masters Theses

Literature shows evidence of a shift in occupational therapy from traditional institutional settings to community-based settings. As increasing numbers of new and expert occupational therapists enter community-based practice, the need for competency identification for practice, education, and reimbursement becomes paramount. This qualitative research study sought to identify domains and competencies of community-based occupational therapy practice by interviewing three expert occupational therapists using the critical incident method in which each therapist described one therapeutic intervention with a client. This method, as seen in nursing studies (Benner, 1982, 1984), serves to elicit competencies embedded in expert practice. Thirty-nine competencies were described in …

The Effect Of Familiar And Novel Testing Environments On The Gross Motor Function Measure Scores Of Developmentally Normal Children 17-37 Months Old, Tracey Blain, Jean Angel

Masters Theses

Our purpose in this research was to compare the reliability of the Gross Motor Function Measure in familiar and unfamiliar environments. Discrepancy between clinical assessment results and true motor functional ability may give false information leading to inefficient treatment sessions. Our research gives therapists information about optimal assessment site choice. Subjects included sixteen developmentally normal children between the ages of 17 and 37 months. Our study fit a repeated measure counterbalanced design, and ANOVA was used to analyze our data. We did not reject our null hypothesis that the child’s score on the GMFM in the familiar environment would equal …

The Effects Of Abdominal Strength Exercises And Testing On Posture In School Children, Greta L. Mcdonald, Kristin L. Nederveld

Masters Theses

The purpose of this study was to compare an abdominal strength testing method used in school systems to tests used in the physical therapy profession. Results were associated with lumbar lordosis. The study included 58 female and 5 male subjects between 10-11 years old from two school districts. Kendall’s Upper Abdominal Test, Kendall’s Lower Abdominal Test and The Presidential Physical Fimess Test were performed in random order. Lumbar lordosis was measured before and afrer abdominal testing by recording the curvature of the low back using a flexible ruler. A Chi-square analysis was used to demonstrate the association of abdominal strength …

The Efficacy Of A T’Ai Chi Intervention On Functional Balance And Walking Speed In The Elderly, Melanie Mckimmy, Sarah Teubert

Masters Theses

This study assessed the efficacy of a T’ai Chi exercise intervention on functional balance and walking speed. Twenty-two volunteer subjects over the age of 65 were included and categorized as near-frail or well elderly, based on their functional status. Subjects randomly selected for the intervention group participated in a 45 minute T’ai Chi group exercise class, bi-weekly for six weeks. Pre- and post-intervention data was on the Berg Balance Scale, and on self-selected and maximum walking speed. Analysis of Covariance (ANCOVA) revealed no statistical significant differences between the intervention group and the control group. Likewise, there was no statistical significant …

The Effect Of Eccentric Fatigue Of The Hamstrings On Knee Joint Proprioception, Kenneth M. Arends, Scott T. Miller, John T. Vandermaas

Masters Theses

The purpose of this study is to determine the effects of eccentric hamstring fatigue on the ability to accurately reproduce different knee joint angles. Thirty-one males and 29 females, 18-40 years old, were randomly assigned to treatment and control groups. Using the Biodex®, proprioceptive pre-test and post-test measurements were taken having the blindfolded participant replicate predetermined angles of 25°, 45°, and 65°. The control group underwent a passive movement protocol and the treatment underwent a fatigue protocol. Data Analysis was performed using 2-tailed t-test comparing the means of pre-test and post-test angle accuracy measurements for the control and treatment groups. …

Knee Flexion Angle And Its Influence On Vmo:Vl Ratios During Isometric Quadriceps Contraction, Jeffrey P. Hendra, William D. Allan

Masters Theses

Patellofemoral Pain Syndrome (PFPS) is a major cause of knee pain and is caused by lateral patellar tracking. Treatment consists of strengthening the vastus medialis obliquus (VMO). While many exercises strengthen the VMO, simultaneous vastus lateralis (VL) strengthening often occurs and patellar malalignment remains. The VMO must, therefore, be strengthened independently or to a greater extent than the VL. Thus, the VMO:VL ratio of activity must be considered rather than VMO activity alone. This study compared isometric knee extension electromyographically at 0, 20, 60, and 90 degree angles to determine which angle produced the greatest VMO:VL ratio of activity. Results …

Relationship Between Sensibility Loss And Performance On The Jebsen-Taylor Hand Function Test In Non-Surgical Carpal Tunnel Syndrome Patients, Bethany J. Navarre, Elizabeth A. Ware

Masters Theses

The assumed correlation between sensibility loss in carpal tunnel syndrome (CTS) and hand function has not been supported by research. The purpose of this study is to examine this relationship. Thirteen subjects with CTS, no previous hand surgeries, hypothyroidism, or diabetes participated. The Weinstein Enhanced Sensory Test was used to assess sensibility and the Jebsen-Taylor Hand Function Test was used to assess hand function. No correlations were found between sensibility loss and hand function. Despite a small sample, lack of correlation between sensibility loss in CTS and hand function is significant. It suggests that further research is needed.

Real And Perceived Barriers To Evaluation And Treatment Of Urinary Incontinence In Nulliparous Women, Roxanne R. Kudwa, Kelli J. Thompson

Masters Theses

The incidence of urinary incontinence (UI) in women has been estimated to be as high as 50%, and ranges from 17-52% in nulliparous women (women who have never been pregnant). The purpose of this study was to describe real and perceived barriers for UI affected women to seeking evaluation and treatment. Seventeen women were interviewed. 410 surveys were sent to women living in Southern Michigan to identify participants. Twenty-one met the inclusion criteria and seventeen were purposively interviewed regarding their experiences with UI. Themes were identified and generated to increase awareness of attitudes toward UI.