Rehabilitation and Therapy Commons^™

Hip And Trunk Muscle Activity During The Star Excursion Balance Test In Healthy Adults, Kunal Bhanot, Navpreet Kaur, Lori Thein Brody, Jennifer Bridges, David C. Berry, Joshua J. Ode

Physical Therapy Collection

CONTEXT: Dynamic balance is a measure of core stability. Deficits in the dynamic balance have been related to injuries in the athletic populations. The Star Excursion Balance Test (SEBT) is suggested to measure and improve dynamic balance when used as a rehabilitative tool.

OBJECTIVE: To determine the electromyographic activity of the hip and the trunk muscles during the SEBT.

DESIGN: Descriptive.

SETTING: University campus.

PARTICIPANTS: Twenty-two healthy adults (11 males and 11 females; 23.3 [3.8] y, 170.3 [7.6] cm, 67.8 [10.3] kg, and 15.1% [5.0%] body fat).

INTERVENTION: Surface electromyographic data were collected on …

Caregiver Perspectives On Body-Weight Supported Treadmill Training As An Intervention For Young Children With Cerebral Palsy, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

PURPOSE/HYPOTHESIS: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and V present with challenges that impact their functional activities and participation in family activities. The purpose of this study was to examine caregivers’ perspectives on body-weight supported treadmill training (BWSTT) as an intervention for their young children with CP.

NUMBER OF SUBJECTS: Participants included 4 caregivers of children with CP in GMFCS levels IV (n = 2) and V (n = 2) who previously participated in 6 weeks of BWSTT.

MATERIALS/METHODS: Three children diagnosed with CP in GMFCS levels IV and V between the …

The Use Of Neuromuscular Electrical Simulation In Glenohumeral Unidirectional Instability When An Exercise-Based Approach Has Failed: A Case Study, Kunal Bhanot, Navpreet Kaur, J Butler

Physical Therapy Collection

Purpose of this case study was to report the role of neuromuscular electrical stimulation (NMES) to restore strength and normal motion in a patient with unidirectional shoulder instability or glenohumeral internal rotation deficit (GIRD).

The High-Level Mobility Assessment Tool (Himat) In Myotonic Dystrophy Type 2: A Case Report, Kim B. Smith, Evan M. Pucillo

Physical Therapy Collection

Myotonic dystrophy type 2 (DM2) is a progressive muscular dystrophy with multi-system manifestations and can affect functional mobility, gait, and balance. Currently, there are few reports of functional outcome measures in this population. This case describes the change in function detected by the High-level Mobility Assessment Tool (HiMAT) and 30-second Chair Stand Test (CST) in a high-functioning adult female with DM2 after physical therapy treatment. The patient’s chief complaint was muscular pain and fatigue that affected activities of daily living (ADLs). Multimodal physical therapy focused on neuromuscular re-education, balance and strength training, patient education, and moderate cardiorespiratory training. Improvements were …

Manual Physical Therapy And Cervical Joint Position Training For Cervicogenic Dizziness Following Whiplash-Associated Disorder: A Case Report, Melanie Friedman, Kayla Smith

Physical Therapy Collection

Background and Purpose Whiplash is defined as an acceleration-deceleration injury to the neck, which may lead to a variety of immediate and/or prolonged symptoms collectively known as whiplash-associated disorder (WAD). Cervicogenic dizziness is one possible sequalae that may arise from dysfunction within the structures of the cervical spine, disrupting the flow of sensory and proprioceptive feedback. The purpose of this case report is to demonstrate the efficacy of combining manual physical therapy and cervical joint position training on a patient with cervicogenic dizziness status-post motor vehicle accident (MVA).

Case Description A 28-year-old female with a history of MVA and chief …

The Impact Of Body-Weight Supported Locomotor Training In A Toddler With Gmfcs Level V Cerebral Palsy: A Case Study, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

BACKGROUND AND PURPOSE: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) level V present with decreased gross motor function and trunk control that impacts their functional activities and participation in family activities. Research indicates body-weight supported locomotor training (BWSLT) may improve motor control for children with neuromotor disabilities. The toddler years present a window of opportunity for developmental changes. The purpose of this case study was to explore the impact of a 6-week BWSLT intervention on postural control, gross motor function, and quality of life in a young child with cerebral palsy in GMFCS level …

Disability And Physical Therapy Services In Rural Nicaragua: A Pilot Study, Evan M. Pucillo, Edward C. O'Bryan

Physical Therapy Collection

The World Health Organization (WHO) estimates that 15% of the world’s population is living with disability, a large majority of which can be found in developing nations. Previous studies in Nicaragua have investigated the perceptions of disability among caregivers and noted limited access to rehabilitative services. However, the general knowledge and perceptions of physical therapy services in Nicaragua remains unclear. As a result, this pilot study sought to explore the local knowledge and perceptions of disability and physical therapy services and to characterize the sample from a remote area of northwestern Nicaragua. Participants were recruited using convenience sampling during multidisciplinary …

Blood Flow Restriction Training For Chronic Quadriceps Weakness And Atrophy: A Case Report, Tobi Baldwin, Fred Baldwin

Physical Therapy Collection

Background and purpose

The high load and intensity of traditional strength training may not always be appropriate or beneficial for certain patient populations such as the elderly or those with orthopedic injuries. In these cases blood flow restriction training with light resistance has been shown to be effective method of increasing strength and hypertrophy. However, what if traditional strength training is tolerated but not effective for an individual? The purpose of this case report is to describe the use of blood flow restriction training in a recreationally active male who was fully functional but continued with chronic unilateral quadriceps weakness …

Effect Of Stable And Unstable Surfaces On The Serratus Anterior Muscle Activation In A Kinetic-Chain Exercise Among Healthy Adults, Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

PURPOSE/HYPOTHESIS: The stabilizing action of the serratus anterior (SA) muscle is vital in maintaining proper scapulothoracic rhythm.^1,2 Poor activation of SA muscle could lead to many shoulder dysfunctions.^1,3 This warrants for exercises that are best to activate the SA muscle. Kinetic-chain recruitment during exercises has demonstrated increased SA activation due to the myofascial connections between various segments of the body.^4–6 Variation of surfaces during an exercise has been shown to alter the muscle recruitment patterns.^7–9 The primary purpose of this study was to determine if the unstable surface can influence SA muscle activity during the kinetic …

Feasibility And Preliminary Outcomes Of A Standardized Exercise Program In Adults With Down Syndrome: A Pilot Study, Megan Flores, Kristen Barta, Martha Sneary, Germaine Ferreira, Elizabeth Ardolino

Physical Therapy Collection

Purpose/ Hypothesis: Youth with Down Syndrome (DS) have limited participation in physical activity. When compared to their typically developing peers, adults with DS display decreased functional mobility and strength. Exercise has shown to improve the physical fitness, overall health, and quality of life in people with DS. The Lee Silverman Voice Treatment (LSVT® BIG) is an effective treatment approach designed for patients with Parkinson’s disease. The core components of LSVT® BIG include large amplitude movements, sensory calibration, high intensity, and maximum effort while performing the daily exercises. Due to hypotonicity associated with DS, these individuals typically display kyphotic posture, shortened …

Gross Motor Outcomes After Dynamic Weight-Bearing In 2 Children With Trunk Hypotonia: A Case Series, Elizabeth Ardolino, Megan Flores, Kathleen Manella

Physical Therapy Collection

NTRODUCTION:

Children with trunk hypotonia may have limited ability to maintain an upright weight-bearing position, resulting in decreased postural control and a delay in achieving gross motor milestones.

PURPOSE:

The purpose of this case series is to report the effect of a home-based dynamic standing program on postural control and gross motor activity in 2 children with trunk hypotonia.

DESCRIPTIONS:

Child 1 (aged 24 months, Gross Motor Function Classification Scale Level IV) and Child 2 (aged 21 months, Gross Motor Function Classification Scale Level V) participated in a standing program using the Upsee harness at home 3 days per week …

The Effects Of Spinal Mobilizations, Manual Stretching, And Exercises In The Treatment Of Testicular Pain: A Case Report, Kunal Bhanot, Navpreet Kaur, R Chambers

Physical Therapy Collection

The purpose of this case report was to describe the PT management in relieving testicular pain related to genitofemoral nerve entrapment.

Three Faces Of Fragile X Syndrome, Cornelia Lieb-Lundell

Physical Therapy Collection

Fragile X Syndrome (FXS) is well known and widely recognized in pediatrics. Less well known is that FXS, as an X-linked disorder of the FMR1 gene, is but one of three impairments that all have a common single-gene genetic basis. These three are labeled Fragile X-associated Disorders (FXD) and are, in turn, a part of a large group of impairments which have a collective name of trinucleotide repeat expansion disorders. Common to all three FXD disorders is that the x-gene carries a characteristic CGG expansion (of the DNA) that can range from 50-+200 (5-45 is normal) with premutation carriers having …

Upsee Daisy! Gross Motor Outcomes After Dynamic Weight Bearing In Two Children With Truncal Hypotonia: A Case Series, Megan Flores, Kathleen Manella, Elizabeth Ardolino

Physical Therapy Collection

PURPOSE: The purpose of this case series was to report the impact of a home-based dynamic standing program on postural control and gross motor activity in two children with truncal hypotonia.

BACKGROUNDS/SIGNIFICANCE: Poor postural control associated with central hypotonia limits a child’s ability to interact with the environment, delaying attainment of developmental milestones such as sitting, crawling, standing and walking. Participation in social interactions with peers and caregivers may be restricted resulting in a decreased quality of life. Supported standing programs are commonly used to ameliorate impairments and optimize function in children with poor postural control. Increased social interactions, …

The Effects Of Closed Kinetic Chain And Endurance Exercises On Reducing Pain In A Child With Ehlers-Danlos Syndrome: A Case Report, Linda Duong, Megan Flores

Physical Therapy Collection

Background and Purpose: Ehlers-Danlos syndrome (EDS) is a connective tissue disorder characterized by joint laxity, chronic pain, and joint instability. Often, children with EDS exhibit polyarthralgia and fatigue as their main symptoms. Although physical therapy is a mainstay of treatment for individuals with EDS, evidence is lacking for specific exercises or treatment strategies for management of pain. The purpose of this case report is to describe the effectiveness of closed kinetic chain and endurance exercises on reducing pain in a child with EDS.

Case Description: The child was a 9 year old girl diagnosed with EDS hypermobility type, and …

Effects Of Manual Therapy And Dry Needling Techniques For Managing Hypertonicity In The Male Pelvic Floor: A Case Report, Amy Jane Porter, Suzanne Trotter, Kristen Barta

Physical Therapy Collection

Background: Dry needling is beneficial for decreasing hypertonicity and improving musculoskeletal dysfunction within various tissues of the body. There is limited research using dry needling for pelvic floor hypertonicity. The purpose of this case report is to describe the effectiveness of a multi-modal intervention utilizing dry needling for a 27-year-old male with a hypertonic pelvic floor.

Study Design: Case study with review of literature.

Case Description: This patient was a 27-year-old Caucasian male with a diagnosis of chronic prostatitis/epididymitis. His primary complaint was pain with prolonged sitting in the right testicle. Treatment consisted of dry needling trigger points, myofascial release, …

Rehabilitation After Glenohumeral Microfracture And Type Ii Slap Repair Surgery: A Case Report, Judson Williams, Eric Chaconas

Physical Therapy Collection

Background and Purpose: There are few rehabilitation protocols for patients who have undergone glenohumeral microfracture procedure. The purpose of this paper is to present a patient case after both glenohumeral microfracture and Type II SLAP repair procedures and present a rehabilitation protocol.

Methods: The patient in this case is a 41-year-old male who had a sudden onset of pain, mechanical catching, and audible popping in his right shoulder, particularly with athletic activities. This patient was seen for 27 treatments and progressed per the presented protocol.

Findings: The overall improvement when combining the sections of the Quick- DASH was 72.96%, the …

Same-Day Physical Therapy Consults In An Outpatient Neuromuscular Disease Physician Clinic, Evan M. Pucillo, Nancy Christensen-Mayer, Shelly D. Poole, Denise M. Whitten, Danielle Freeman, Blake R. Bohe, Brandon R. Swensen, A Gordon Smith, Nicholas E. Johnson

Physical Therapy Collection

Background: Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT) consults within a daily outpatient neuromuscular disease (NMD) physician clinic.

Objective: To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center.

Design: A qualitative assessment and survey of patient satisfaction.

Methods: An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was …

Mobilization With Movement Symptom Modification Procedure For A 38 Year-Old Male With Patella Femoral Pain Syndrome, Scott Gray, Eric Chaconas, David Kempfert

Physical Therapy Collection

No abstract provided.

The Effectiveness Of Electromyographic Biofeedback, Mirror Therapy, And Tactile Stimulation In Decreasing Chronic Residual Limb Pain And Phantom Limb Pain For A Patient With A Shoulder Disarticulation: A Case Report, Stephanie Thomas, Kayla Smith

Physical Therapy Collection

PURPOSE: Approximately 1.3 million people in the United States live with limb loss, and most experience some form of residual limb pain or phantom limb pain (PLP). The purpose of this case report was to determine the effectiveness of mirror therapy, biofeedback, and tactile stimulation in decreasing chronic residual limb pain and PLP in a patient with an upper limb traumatic amputation.

CASE DESCRIPTION: A 48-year-old male employed as a mechanical construction worker was working on a conveyer belt when the belt caught his arm resulting in a traumatic shoulder disarticulation. According to the International Classification of Functioning, Disability, …

The Management Of Chronic Myofascial Thoracolumbar Pain With Dry Needling, Spinal Manipulation, Cognitive Behavioral Therapy And Exercise: A Case Report, Adam Javate, Kayla Smith, Matthew Anderson

Physical Therapy Collection

Background & Purpose: Chronic pain suffers have been shown to be comorbid with psychosocial impairments such as anxiety, depression and pain catastrophizing. Cognitive Behavioral Therapy (CBT) is a popular non-pharmacological treatment that has shown efficacious outcomes in reducing pain and disability levels in chronic pain suffers.

Myofascial pain syndrome is a pain condition within the soft tissue that is perpetrated by myofascial trigger points (MTrP). MTrPs are associated with greater disability, poorer sleep quality and altered muscle activation patterns. MTrPs are also correlated with the development of central sensitization and chronic pain syndromes. Dry needling (DN) and Spinal Manipulative …

Perspectives On Teaching The International Classification Of Functioning, Disability, And Health Model To Physical Therapy Students, Cherie Peters-Brinkerhof

Physical Therapy Collection

BACKGROUND: During a re-accreditation visit, deficiencies were discovered in the clinical education curriculum regarding patient-centered care in a Doctorate of Physical Therapy program. To understand the problem and address those deficiencies, the clinical internship experience was examined using the International Classification of Functioning, Disability, and Health (ICF) model as a conceptual framework for clinical reasoning.

OBJECTIVE: This qualitative case study aimed to study (1) perceptions of physical therapy (PT) students regarding their knowledge and learning experiences during clinical affiliations and what knowledge they acquired of the ICF as applied to patient-centered care during their internship, and (2) the perceptions of …

Shoulder External Rotator Eccentric Training For Subacromial Pain Syndrome, Eric Chaconas

Physical Therapy Collection

Background and Purpose: Rotator cuff weakness has been associated with subacromial pain syndrome (SAPS). The purpose of this study was to determine the effect of eccentric training, isolated to the shoulder external rotators, on strength, strength ratios, range of motion, upper quarter balance, pain, perceived function and global change.

Methods: Forty-Four participants, 19 females (mean age 46), with greater than 3 months of shoulder pain were randomized into two groups. The experimental group performed an external rotator eccentric training exercise (ETER) for three sets of 15 and a scapular retraction exercise, with a resistance band, for 2 sets of 10, …

Muscle Activity During The Star Excursion Balance Test In Healthy Adults, Kunal Bhanot, Navpreet Kaur, Lori Thein Brody, Jennifer Bridges, David C. Berry, Joshua J. Ode

Physical Therapy Collection

Purpose: To determine electromyographic (EMG) activity of the hip and the trunk muscles during the Star Excursion Balance Test (SEBT) performance in 8 reach directions.