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Physical Therapy Faculty Articles and Research

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Enhancing Physiological Complexity Through Mindfulness: A Wearable-Based Intervention For First Responders And Their Partners, Thurmon Lockhart, Rahul Soangra, Christopher W. Frames, Sun-Kyung Lee, Amberlee Martin, Susanne Lee, Abigail H. Gewirtz May 2026

Enhancing Physiological Complexity Through Mindfulness: A Wearable-Based Intervention For First Responders And Their Partners, Thurmon Lockhart, Rahul Soangra, Christopher W. Frames, Sun-Kyung Lee, Amberlee Martin, Susanne Lee, Abigail H. Gewirtz

Physical Therapy Faculty Articles and Research

Background/Objectives: First responders frequently encounter high-stress environments that challenge physiological resilience and autonomic regulation. Heart rate variability (HRV) complexity is a critical marker of adaptive capacity and stress regulation. This study assessed the impact of a wearable-based mindfulness intervention on HRV complexity among first responders using a smartwatch. Methods: A total of 87 first responders participated in a one-month wearable-based intervention. Participants wore Garmin Vivosmart 5 devices to continuously collect PPG data (photoplethysmogram), focusing on beat-to-beat intervals (BBIs). The intervention involved daily Ecological Momentary Assessments (EMAs) and individual randomization to either a mindfulness message, a prompt to access an audio …


Variation In Prevalence Of Participation Limitation, Injury Location, And Training Habits Between Young And Master Runners: A Cross-Sectional Study, Rachel Berns, Jo Armour Smith, Natalia Sánchez, Samantha N. Jeffcoat, Susan Sigward, Andrew Hooyman, Shawn Farrokhi May 2026

Variation In Prevalence Of Participation Limitation, Injury Location, And Training Habits Between Young And Master Runners: A Cross-Sectional Study, Rachel Berns, Jo Armour Smith, Natalia Sánchez, Samantha N. Jeffcoat, Susan Sigward, Andrew Hooyman, Shawn Farrokhi

Physical Therapy Faculty Articles and Research

Background/Objectives

Running is a popular form of physical activity, but its growing participation has been accompanied by high rates of injury that may limit ongoing engagement, particularly in older runners. This study explored differences in running participation limitation, injury location, and training characteristics between young (18–34 years) and master (>35 years) runners.

Methods

A total of 207 runners (105 young, 102 master) completed an online survey assessing demographics, training habits, and injury-related participation limitations using the updated Oslo Sports Trauma Research Center Overuse Injury Questionnaire.

Results

Master runners reported higher rates of injury-related participation limitation than young runners (51% …


Sedentary Behavior Modifies The Effect Of Balance Rehabilitation On Balance Discordance In Parkinson’S Disease, Franziska Albrecht, Sarah J. Conklin, Andrew Hooyman, Daniel S. Peterson, Jason K. Longhurst, Erika Franzén Apr 2026

Sedentary Behavior Modifies The Effect Of Balance Rehabilitation On Balance Discordance In Parkinson’S Disease, Franziska Albrecht, Sarah J. Conklin, Andrew Hooyman, Daniel S. Peterson, Jason K. Longhurst, Erika Franzén

Physical Therapy Faculty Articles and Research

Individuals with Parkinson’s disease (PD) often experience a misalignment between their perceived and actual balance ability, known as balance discordance, which has been associated with falls. We examined whether high-intensity balance and gait training (HiBalance) alters balance discordance in individuals with PD, and whether baseline sedentary behavior influences these changes. A secondary analysis examining pre- to post-intervention discordance changes of two HiBalance clinical trials (N = 97) using linear regression with interactions between sedentary behavior and pre-intervention discordance. The sample included two cohorts: one clinical and one research based. The model including sedentary behavior and its interaction with pre-intervention …


Using Diffusion Mri To Relate Hippocampal Subfield Microstructure To Delayed Verbal Memory In Cognitively Intact Individuals At Genetic Risk For Developing Alzheimer's Disease, Jennapher Lingo Vangilder, Andrew Hooyman, Sasha Hakhu, Kurt G. Schilling, Leland S. Hu, Yuxiang Zhou, Richard J. Caselli, Leslie C. Baxter, Scott C. Beeman Mar 2026

Using Diffusion Mri To Relate Hippocampal Subfield Microstructure To Delayed Verbal Memory In Cognitively Intact Individuals At Genetic Risk For Developing Alzheimer's Disease, Jennapher Lingo Vangilder, Andrew Hooyman, Sasha Hakhu, Kurt G. Schilling, Leland S. Hu, Yuxiang Zhou, Richard J. Caselli, Leslie C. Baxter, Scott C. Beeman

Physical Therapy Faculty Articles and Research

Intervention to delay the onset of Alzheimer's disease (AD) is an important treatment strategy but detecting at-risk individuals before significant disease progression remains challenging. This study evaluates the relationship between hippocampal microstructure and verbal cognition in cognitively intact older adults, focusing on the differences between APOΕ ε4 allele carriers and noncarriers. Participants (n = 41 noncarriers, 33 carriers) over 60 years old (mean ± SD: carriers 71 ± 6.6; noncarriers 71 ± 6.4 years) underwent diffusion-weighted magnetic resonance imaging (dMRI) and volumetric assessments. We assessed hippocampal structure, including microstructure, using Neurite Orientation Dispersion and Density Imaging (NODDI), diffusion tensor …


Discordance Between Actual And Perceived Balance Ability Relates To Quality Of Life And Global Cognition In A Clinical Sample Of Parkinson Patients, Daniel S. Peterson, Jason K. Longhurst, Franziska Albrecht, Joanna Weller, Jennifer Vasquez, Myassar Zarif, Mark Gudesblatt, Andrew Hooyman Mar 2026

Discordance Between Actual And Perceived Balance Ability Relates To Quality Of Life And Global Cognition In A Clinical Sample Of Parkinson Patients, Daniel S. Peterson, Jason K. Longhurst, Franziska Albrecht, Joanna Weller, Jennifer Vasquez, Myassar Zarif, Mark Gudesblatt, Andrew Hooyman

Physical Therapy Faculty Articles and Research

Background

Misalignment between actual and perceived balance ability provides relevant information to understand functional deficits and fall risk. However, few studies have provided a continuous quantification of misalignment in neurological populations such as people with Parkinson's disease (PD).

Objective

Determine whether a continuous quantification of misalignment between actual and perceived balance ability, discordance, relates to functional outcomes such as quality of life and cognition.

Methods

Actual (gait velocity), and perceived (Activities of Balance Confidence) balance, cognition (measured via a computer-based cognitive assessment), and mobility-related quality of life were captured in a clinical sample of 95 people with PD. Primary outcomes …


Biomarkers In Alzheimer's Disease Clinical Trials: 2025, Amanda M. Leisgang Osse, Yadi Zhou, Jefferson W. Kinney, Andrew Hooyman, Ayan Sengupta, Jorge Fonseca, Aaron H. Burstein, Laura Nisenbaum, Howard M. Fillit, Feixiong Cheng, Jeffrey L. Cummings Feb 2026

Biomarkers In Alzheimer's Disease Clinical Trials: 2025, Amanda M. Leisgang Osse, Yadi Zhou, Jefferson W. Kinney, Andrew Hooyman, Ayan Sengupta, Jorge Fonseca, Aaron H. Burstein, Laura Nisenbaum, Howard M. Fillit, Feixiong Cheng, Jeffrey L. Cummings

Physical Therapy Faculty Articles and Research

Biomarkers play an important role in Alzheimer's disease (AD) clinical trials in several contexts of use, including defining trial eligibility and serving as outcome measures. Utilizing clinicaltrials.gov, a registry of clinical trials, we assessed biomarker usage across all active AD disease-targeted therapeutic (DTT) trials. Biomarkers are widely used in AD DTT trials, with 84% including a fluid, imaging, and/or digital biomarker, either as an inclusion criterion or as an outcome measure. In DTT trials, biomarkers were included in 83% of Phase 3 trials, 91% of Phase 2 trials, and 72% of Phase 1 trials. Biomarkers were used for trial inclusion …


Dual-Task Effects On Spatiotemporal, Kinematic, And Kinetic Parameters And Their Variability During Running, Hsiang-Ling Teng, Jo Armour Smith, Will F.W. Wu Jan 2026

Dual-Task Effects On Spatiotemporal, Kinematic, And Kinetic Parameters And Their Variability During Running, Hsiang-Ling Teng, Jo Armour Smith, Will F.W. Wu

Physical Therapy Faculty Articles and Research

Background

Running in real-world environments often requires using cognitive resources simultaneously with the motor task (dual tasking, DT). Limited existing evidence suggests that DT reduces running speed. Movement variability is essential for a healthy, adaptable motor system. DT has been shown to affect movement variability during walking. Nonetheless, it remains unclear how DT affects spatiotemporal, kinematic, and kinetic parameters and their variability during running.

Research question

Does DT affect spatiotemporal, kinematic, and kinetic measures and their variability during running? Does running speed influence DT effects?

Methods

Thirty-one asymptomatic runners participated in this cross-sectional study. Three-dimensional running biomechanics were recorded while …


Evaluating The Effect Of Ethnicity And Amyloid On Gait Speed In The Healthy Aging Brain Study-Health Disparities Study, Alexandra M. Reed, Andrew Hooyman, Edward Ofori, Sydney Y. Schaefer Dec 2025

Evaluating The Effect Of Ethnicity And Amyloid On Gait Speed In The Healthy Aging Brain Study-Health Disparities Study, Alexandra M. Reed, Andrew Hooyman, Edward Ofori, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

Background

Many novel Alzheimer's disease (AD) biomarkers have been studied in non-Hispanic White populations, despite Hispanic/Latino adults being 1.5 times more likely to develop AD and receiving a later diagnosis. Equitable, accessible assessments are needed to identify individuals at risk earlier. While cognitive screening monitors early AD signs, neuropsychological tests are often inequitable across ethnicity, race, and other social determinants of health. However, we have shown that performance-based motor assessments may be less susceptible to demographic factors than memory tests, and may be more equitable for screening older adults. Gait speed has been linked to elevated amyloid in non-Hispanic White …


Manual Therapy In Conjunction With Other Multimodal Interventions In A Patient With Chronic Pain And Hypertension: A Case Report, Craig P. Hensley, Renzo Mendoza, Jennifer Ryan, Emmanuel Yung Dec 2025

Manual Therapy In Conjunction With Other Multimodal Interventions In A Patient With Chronic Pain And Hypertension: A Case Report, Craig P. Hensley, Renzo Mendoza, Jennifer Ryan, Emmanuel Yung

Physical Therapy Faculty Articles and Research

Chronic pain and hypertension (HTN) are worldwide epidemics that are difficult to manage and frequently encountered as comorbid conditions in patient care. There is a paucity of information regarding the effect that manual therapy has on blood pressure (BP), particularly in those with chronic pain and HTN. This case report describes the management of a patient with chronic pain and HTN. The patient was a 41-year-old female with chronic multisite pain and multiple comorbidities, including HTN. Her BP at the initial evaluation was 147/78 with an oscillated device and 142/82 with a sphygmomanometer in the right arm and 144/80 in …


Abnormalities In Sensorimotor Brain Function Are Related To Chronicity Of Low Back Pain, Jo Armour Smith, Rongwen Tain, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer Dec 2025

Abnormalities In Sensorimotor Brain Function Are Related To Chronicity Of Low Back Pain, Jo Armour Smith, Rongwen Tain, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Maladaptive plasticity in the brain may contribute to chronic low back pain (LBP) and underlie the altered postural control of the lumbopelvic musculature that is evident in some individuals with LBP. We recently described an MRI-compatible leg-raise paradigm to measure brain activity associated with lumbopelvic postural control. The objective of this study was to compare brain function in young adults with and without a history of LBP and to determine relationships between brain function, pain, and postural control characteristics. We recruited 55 participants with a history of LBP, who were asymptomatic when studied, and 30 healthy controls. Postural control during …


Information About Task Duration Influences Energetic Cost During Split-Belt Adaptation And Retention Of Walking Patterns Post-Adaptation, Samantha N. Jeffcoat, Adrian Aragon, Andrian Kuch, Shawn Farrokhi, Andrew Hooyman, Russell Johnson, Natalia Sanchez Dec 2025

Information About Task Duration Influences Energetic Cost During Split-Belt Adaptation And Retention Of Walking Patterns Post-Adaptation, Samantha N. Jeffcoat, Adrian Aragon, Andrian Kuch, Shawn Farrokhi, Andrew Hooyman, Russell Johnson, Natalia Sanchez

Physical Therapy Faculty Articles and Research

Studies of locomotor adaptation have shown that adaptation can occur in short bouts and can continue for long bouts or across days. Information about task duration might influence the adaptation of gait features, given that task duration influences the time available to explore and adapt the aspects of gait that reduce energy cost. We hypothesized that information about task duration and frequency of updates influences adaptation to split-belt walking based on two competing mechanisms: individuals anticipating a prolonged adaptation period may either (1) extend exploration of energetically suboptimal gait patterns, or (2) adapt toward a more energy-efficient pattern earlier to …


The Differential Effects Of Fast Walking Speed On Muscle Coactivation In The Paretic And Non-Paretic Extremities Post-Stroke, Natalia Sánchez, Andrian Kuch, Samantha N. Jeffcoat, Andrew Hooyman, Aria Haver-Hill, Christina K. Holl, Kristan A. Leech Dec 2025

The Differential Effects Of Fast Walking Speed On Muscle Coactivation In The Paretic And Non-Paretic Extremities Post-Stroke, Natalia Sánchez, Andrian Kuch, Samantha N. Jeffcoat, Andrew Hooyman, Aria Haver-Hill, Christina K. Holl, Kristan A. Leech

Physical Therapy Faculty Articles and Research

Background:

Clinical practice guidelines for walking recovery post-stroke recommend high aerobic intensity training, which usually involves walking at fast speeds. However, the acute effect of fast speeds on the neuromuscular control of walking is unclear.

Objectives:

(1) Assess the criterion validity of the Dynamic Motor Control Index (WalkDMC) as a measure of coactivation post-stroke. (2) Assess acute speed-dependent coactivation post-stroke. (3) Assess how clinical characteristics shape the speed-dependent coactivation response. (4) Assess the relationship between heart rate and coactivation post-stroke. We hypothesized that WalkDMC is correlated with function and impairment measures. We also hypothesize that coactivation measured via the WalkDMC …


Evaluating The Effectiveness Of Clinical Practice Guideline Adherence For Patellofemoral Pain (Knee-Capp): Protocol For A Multisite, Parallel-Arm Randomized Clinical Trial In The Military Health System, Emma H. Beisheim-Ryan, Timothy C. Mauntel, Daniel I. Rhon, Charity G. Patterson, Nathan Parsons, Scott Paradise, Megan H. Roach, Marisa Pontillo, Sara R. Gorczynski, Ariana Emory, Shawn Farrokhi Nov 2025

Evaluating The Effectiveness Of Clinical Practice Guideline Adherence For Patellofemoral Pain (Knee-Capp): Protocol For A Multisite, Parallel-Arm Randomized Clinical Trial In The Military Health System, Emma H. Beisheim-Ryan, Timothy C. Mauntel, Daniel I. Rhon, Charity G. Patterson, Nathan Parsons, Scott Paradise, Megan H. Roach, Marisa Pontillo, Sara R. Gorczynski, Ariana Emory, Shawn Farrokhi

Physical Therapy Faculty Articles and Research

Importance

Patellofemoral pain (PFP) frequently affects military personnel, caused by the physical demands of duty-related training. Clinical practice guidelines (CPG) can guide PFP management, yet physical therapist practice patterns vary and often exclude CPG-recommended, evidence-based interventions. Objective

The Evaluating the Effectiveness of Clinical practice guideline Adherence for Patellofemoral Pain (knEE-CAPP) trial assesses whether a CPG-adherent physical therapy approach more significantly reduces pain, disability, health care utilization, and analgesic medication prescription in Service members with PFP as compared to usual physical therapist care. Design

This is a multisite, parallel arm randomized controlled trial. Setting

The study will be conducted at 4 …


Twenty Minutes Of Corsi Block Tapping Task Training Does Not Improve Mental Rotation In Adults With Stroke, Sarah A. Kettlety, Giuliet L. Kibler, Andrew Hooyman, Christina K. Holl, Sydney Y. Schaefer, Kristan A. Leech Oct 2025

Twenty Minutes Of Corsi Block Tapping Task Training Does Not Improve Mental Rotation In Adults With Stroke, Sarah A. Kettlety, Giuliet L. Kibler, Andrew Hooyman, Christina K. Holl, Sydney Y. Schaefer, Kristan A. Leech

Physical Therapy Faculty Articles and Research

Background: Visuospatial function is commonly impaired post-stroke and is associated with motor learning and recovery. A single, twenty-minute Corsi Block Tapping Task (CBTT) training session improved visuospatial function in young neurotypical adults; however, it is unclear whether this training would improve visuospatial function in adults with stroke.

Objective: To understand if a single, twenty-minute CBTT training session improved visuospatial function in adults with stroke compared to a no-training control group of adults with stroke.

Methods: Participants post-stroke were assigned to one of two groups. The training group completed twenty minutes of computerized CBTT training. The control group completed a survey …


The Association Of Acute Stress And Lower Quarter Emg During A Single Leg Balance Dexterity Task, Ted W. Gehrig Iii, Robert I. Dudley, Jo Armour Smith, Lida Gharibvand, Lee S. Berk, Everett B. Lohman Iii Sep 2025

The Association Of Acute Stress And Lower Quarter Emg During A Single Leg Balance Dexterity Task, Ted W. Gehrig Iii, Robert I. Dudley, Jo Armour Smith, Lida Gharibvand, Lee S. Berk, Everett B. Lohman Iii

Physical Therapy Faculty Articles and Research

Background

There is a well-established connection between psychosocial stress and low back pain, however studies demonstrating a connection between motor control and acute stress are lacking.

Research Question

What is the potential interaction of acute stress (the Feigned Annoyance and Frustration Test, or the FAF Test) with lower quarter motor control and stance stability during a standing lower-extremity dexterity task in individuals with and without low back pain?

Methods

This prospective cohort study included 30 individuals with low back pain (15 men and 15 women) with an equal number of sex-matched controls for a total sample of 60 participants. Participants …


The Impact Of Non-Athletic, Flat-Soled Sneakers On Gait Kinematics: A Comparative Analysis With Socks, Aaron Aguilar, Kharen Bautista, Juan Claros, Raquel Dimaano, Ciara Franke, Mason Huber, Evan Kurishige, Anton Lam, Kevin Le, Alohi Sheung, Raj Kumar Chauhan, Sivakumar Rajagopal, Seong Hyun Moon, Michael Shiraishi, Rahul Soangra Jul 2025

The Impact Of Non-Athletic, Flat-Soled Sneakers On Gait Kinematics: A Comparative Analysis With Socks, Aaron Aguilar, Kharen Bautista, Juan Claros, Raquel Dimaano, Ciara Franke, Mason Huber, Evan Kurishige, Anton Lam, Kevin Le, Alohi Sheung, Raj Kumar Chauhan, Sivakumar Rajagopal, Seong Hyun Moon, Michael Shiraishi, Rahul Soangra

Physical Therapy Faculty Articles and Research

This study investigates the kinematic effects of non-athletic, flat-soled sneakers on lower extremity joints during walking. Ten healthy gym-goers (24.4 ± 1.7 years) underwent treadmill gait analysis under two conditions: wearing non-athletic sneakers and walking with only socks. Gait was captured using the Gait Real-time Analysis and Interactive Lab (GRAIL). Dependent variables included cadence, support times, and stride length. Walking with socks significantly increased cadence (p <  .0001) and single support time (p = .0103), and decreased initial (p = .018), terminal (p = .0056), and total double support times (p = .0092). No significant difference in stride length was observed. These …


Gait Adaptations Under Cognitive And Motor Dual-Task Conditions, Gabriel Coutinho Gazio, Denise Litonjua, Alex Omaszta, Lindsey Perry, Sophia Tsotras, Mason Salazar, Julie Woo, Alicia Qiu, Julian Palmer, Emma Rogers, Christopher Sagahon, Ethan Parker, Ray Kasama, Joonsuk Choi, Raj Kumar Chauhan, Sivakumar Rajagopal, Seong Hyun Moon, Michael Shiraishi, Rahul Soangra Jul 2025

Gait Adaptations Under Cognitive And Motor Dual-Task Conditions, Gabriel Coutinho Gazio, Denise Litonjua, Alex Omaszta, Lindsey Perry, Sophia Tsotras, Mason Salazar, Julie Woo, Alicia Qiu, Julian Palmer, Emma Rogers, Christopher Sagahon, Ethan Parker, Ray Kasama, Joonsuk Choi, Raj Kumar Chauhan, Sivakumar Rajagopal, Seong Hyun Moon, Michael Shiraishi, Rahul Soangra

Physical Therapy Faculty Articles and Research

Modern walking often involves secondary tasks that may increase fall risk, especially in older adults. About one-third of adults aged 65+ fall annually, with dual-tasking further elevating this risk. This study examines how cognitive and motor dual-tasks affect gait variability. Ten healthy young adults completed baseline and three dual-task conditions: (1) walking with a Stroop test, (2) walking while carrying a tray with water, and (3) both tasks combined. Gait parameters—including step length, step width, stride length, and double support time—were analyzed. Significant alterations were observed with P-values of 0.0019 (right step length), 0.004 (step width), 0.0007 (stride length), and …


Multitasking While Walking: How Green Noise And Texting Alter Gait, Kirstin Merrill, Kyle Navarro, Raymond Ngu, Nathan Nguyen, Alex Owyang, Anthony Prajin, Karli Slater, Uyen Truong, Ryan Ye, Eileen Zhu, Sebastian Herrera Vargas, Raj Kumar Chauhan, Sivakumar Rajagopal, Seong Hyun Moon, Michael Shiraishi, Rahul Soangra Jul 2025

Multitasking While Walking: How Green Noise And Texting Alter Gait, Kirstin Merrill, Kyle Navarro, Raymond Ngu, Nathan Nguyen, Alex Owyang, Anthony Prajin, Karli Slater, Uyen Truong, Ryan Ye, Eileen Zhu, Sebastian Herrera Vargas, Raj Kumar Chauhan, Sivakumar Rajagopal, Seong Hyun Moon, Michael Shiraishi, Rahul Soangra

Physical Therapy Faculty Articles and Research

This study examines the combined effects of green noise and texting on gait to understand how multitasking and auditory stimuli affect walking stability. Green noise, associated with relaxation, was the environmental stimulus; texting the cognitive distractor. We hypothesized texting would reduce cadence and stride length, with green noise either stabilizing or disrupting gait. Ten participants walked on a treadmill under five conditions: normal walking (NW), no texting/sound (WNTNS), sound only (WNTS), texting only (WTNS), and texting with sound (WTS). Gait parameters—step length, step width, single support time, and terminal double support time—were analyzed. Step length decreased in WNTS (p …


Identification Of Subtypes Of Post-Stroke And Neurotypical Gait Behaviors Using Neural Network Analysis Of Gait Cycle Kinematics, Andrian Kuch, Nicolas Schweighofer, James M. Finley, Alison Mckenzie, Yuxin Wen, Natalia Sánchez May 2025

Identification Of Subtypes Of Post-Stroke And Neurotypical Gait Behaviors Using Neural Network Analysis Of Gait Cycle Kinematics, Andrian Kuch, Nicolas Schweighofer, James M. Finley, Alison Mckenzie, Yuxin Wen, Natalia Sánchez

Physical Therapy Faculty Articles and Research

Gait impairment post-stroke is highly heterogeneous. Prior studies classified heterogeneous gait patterns into subgroups using peak kinematics, kinetics, or spatiotemporal variables. A limitation of this approach is the need to select discrete features in the gait cycle. Using continuous gait cycle data, we accounted for differences in magnitude and timing of kinematics. Here, we propose a machine-learning pipeline combining supervised and unsupervised learning. We first trained a Convolutional Neural Network and a Temporal Convolutional Network to extract features that distinguish impaired from neurotypical gait. Then, we used unsupervised time-series k-means and Gaussian Mixture Models to identify gait clusters. We tested …


Quantifying The Functional Impact Of Chronic Patellofemoral Pain And Its Relationship To Perceived Duty-Related Medical Readiness Among Active Duty Service Members, Emma H. Beisheim-Ryan, Sara R. Gorczynski, Ryan W. Smith, Shawn Farrokhi Apr 2025

Quantifying The Functional Impact Of Chronic Patellofemoral Pain And Its Relationship To Perceived Duty-Related Medical Readiness Among Active Duty Service Members, Emma H. Beisheim-Ryan, Sara R. Gorczynski, Ryan W. Smith, Shawn Farrokhi

Physical Therapy Faculty Articles and Research

Introduction

Chronic patellofemoral pain (PFP) is a heterogeneous pain condition that may significantly burden active duty service members, whose rigorous physical training demands include activities such as running and heavy load carriage. While chronic PFP is often defined by its pathoanatomical characteristics, evidence from other pain conditions (e.g., chronic low back pain) suggests classifying pain by its functional impact on work, social, and self-care activities may better inform personalized treatment approaches. As this approach has not been previously undertaken in chronic PFP or younger populations with chronic pain, this study aimed to characterize the global impact of PFP on day-to-day …


Gray Matter Morphology And Pain-Related Disability In Young Adults With Low Back Pain, Jo Armour Smith, Rongwen Tain, Isaac Chrisman, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer Apr 2025

Gray Matter Morphology And Pain-Related Disability In Young Adults With Low Back Pain, Jo Armour Smith, Rongwen Tain, Isaac Chrisman, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Structural neuroplasticity in the brain may contribute to the persistence of low back pain (LBP) symptoms and the disability associated with them. It is not known if structural adaptations are evident early in the lifespan in young adults with LBP. This study compared gray matter in cortical sensorimotor regions in young adults with and without persistent LBP and identified gray matter and clinical predictors of pain-related disability. Eighty-two individuals with and without a history of LBP participated. Peak and average gray matter density in cortical sensorimotor regions of interest was quantified using voxel-based morphometry. Pain-related disability, pain intensity, pain duration, …


Technical Note: What Exercises Are Appropriate For Managing Back Pain In Persons With Lower Limb Amputation?, M. Jason Highsmith, Shawn Farrokhi, John M. Mayer Jan 2025

Technical Note: What Exercises Are Appropriate For Managing Back Pain In Persons With Lower Limb Amputation?, M. Jason Highsmith, Shawn Farrokhi, John M. Mayer

Physical Therapy Faculty Articles and Research

Individuals with lower extremity amputation (LLA) have high rates of low back pain (LBP) and related disability. The purpose of this technical note is to discuss considerations and provide initial recommendations about what exercises may be appropriate for management of LBP in persons with LLA. Five commonly prescribed motor control and strengthening exercises (cat-camel, curl-up, bird dog, side bridge, and Roman chair extensor exercise) were examined for use in the LLA population. Each exercise seemed to be safe and appropriate for use in persons with LLA yet required additional considerations for use in this population. For example, some of the …


Two-Year Follow-Up Of Gait And Postural Control Following Initiation Of Recombinant Human Tripeptidyl Intracerebroventricular Enzyme Replacement Therapy In Two Atypical Cln2 Patients, Rahul Soangra, Marybeth Grant-Beuttler, Harriet Chang, Raymond Y. Wang Jan 2025

Two-Year Follow-Up Of Gait And Postural Control Following Initiation Of Recombinant Human Tripeptidyl Intracerebroventricular Enzyme Replacement Therapy In Two Atypical Cln2 Patients, Rahul Soangra, Marybeth Grant-Beuttler, Harriet Chang, Raymond Y. Wang

Physical Therapy Faculty Articles and Research

Neuronal ceroid lipofuscinosis type 2 (CLN2) is a rapidly progressive neurodegenerative disorder leading to premature mortality. Ambulatory CLN2 patients typically receive standard of care treatment through biweekly intracerebroventricular (ICV) enzyme replacement therapy (ERT) involving recombinant human tripeptidyl peptidase 1, known as cerliponase alfa (Brineura®, Biomarin Pharmaceuticals). This study longitudinally assessed the impact of ICV cerliponase alfa ERT on gait, and postural control across a two-year span in two siblings diagnosed with atypical CLN2 disease. Both participants, ID01 (18 years and 8 months old at enrollment) and ID02 (13 years and 3 months old at enrollment), exhibited symptomatic characteristics …


Multimodal Assessment Battery And Heart Rate Variability Enhance Clinical Utility Of Buffalo Concussion Treadmill Test, Daniel Miner, Michael Shiraishi, Pamela Gibbons, Rahul Soangra, Brent Harper Dec 2024

Multimodal Assessment Battery And Heart Rate Variability Enhance Clinical Utility Of Buffalo Concussion Treadmill Test, Daniel Miner, Michael Shiraishi, Pamela Gibbons, Rahul Soangra, Brent Harper

Physical Therapy Faculty Articles and Research

Context: The Buffalo Concussion Treadmill Test (BCTT) for exercise intolerance following concussion may highlight underlying autonomic dysfunction. Autonomic function at rest and with exertion may be predictive of neurocognitive performance for individuals with sports-related concussion. The purpose of this study is to explore the feasibility and utility of combining multimodal assessments with heart rate variability (HRV) measures during the BCTT for individuals with a remote history of concussion. Design: Prospective cohort study design, pretest/posttest. Methods: Participants included 5 males and 5 females (N = 10, age: 25.2 [3.3] y old, height: 173.2 [11.2] cm, mass: 73.4 [13.7] …


The Dual Timescales Of Gait Adaptation: Initial Stability Adjustments Followed By Subsequent Energetic Cost Adjustments, Sasha A. Brinkerhoff, Natalia Sánchez, Meral N. Culver, William M. Murrah, Austin T. Robinson, J. Danielle Mccullough, Matthew W. Miller, Jaimie A. Roper Nov 2024

The Dual Timescales Of Gait Adaptation: Initial Stability Adjustments Followed By Subsequent Energetic Cost Adjustments, Sasha A. Brinkerhoff, Natalia Sánchez, Meral N. Culver, William M. Murrah, Austin T. Robinson, J. Danielle Mccullough, Matthew W. Miller, Jaimie A. Roper

Physical Therapy Faculty Articles and Research

Gait adaptation during bipedal walking allows people to adjust their walking patterns to maintain balance, avoid obstacles and avoid injury. Adaptation involves complex processes that function to maintain stability and reduce energy expenditure. However, the processes that influence walking patterns during different points in the adaptation period remain to be investigated. We assessed split-belt adaptation in 17 young adults aged 19–35. We also assessed individual aerobic capacity to understand how aerobic capacity influences adaptation. We analyzed step lengths, step length asymmetry (SLA), mediolateral margins of stability, positive, negative and net mechanical work rates, as well as metabolic rate during adaptation. …


Discordance Between Balance Ability And Perception Is Associated With Falls In Parkinson’S Disease: A Coordinated Analysis, Jason K. Longhurst, Andrew Hooyman, Merrill R. Landers, Martina Mancini, Erika Franzén, Breiffni Leavy, Hanna Johansson, Daniel Peterson Nov 2024

Discordance Between Balance Ability And Perception Is Associated With Falls In Parkinson’S Disease: A Coordinated Analysis, Jason K. Longhurst, Andrew Hooyman, Merrill R. Landers, Martina Mancini, Erika Franzén, Breiffni Leavy, Hanna Johansson, Daniel Peterson

Physical Therapy Faculty Articles and Research

Background: The congruence or discordance between actual and perceived balance ability has been proposed to be linked to functional outcomes such as falls. However, gaps remain in our ability to quantify discordance, and its relationship to relevant outcomes.

Objective: To investigate a novel quantification of concordance/discordance between balance performance and perception and determine the relationship to falls among people with Parkinson’s disease (PwPD).

Methods: Data from 244 PwPD were aggregated from 5 previously conducted studies. Variables extracted included age, sex, Activities-Specific Balance Confidence scale (ABC; perceived balance), Timed Up and Go (TUG; balance performance), Movement Disorder Society Unified Parkinson Disease …


Toward Facilitating The Collection And Utilization Of Patient-Reported Outcomes In The Military Health System: Lessons Learned From A Pragmatic Clinical Trial On Physical Therapy Management For Low Back Pain, Emma H. Beisheim-Ryan, Brad D. Hendershot, Timothy C. Mauntel, Sara R. Gorczynski, Ryan W. Smith, Andrea Crunkhorn, Shawn Farrokhi, Christopher L. Dearth Nov 2024

Toward Facilitating The Collection And Utilization Of Patient-Reported Outcomes In The Military Health System: Lessons Learned From A Pragmatic Clinical Trial On Physical Therapy Management For Low Back Pain, Emma H. Beisheim-Ryan, Brad D. Hendershot, Timothy C. Mauntel, Sara R. Gorczynski, Ryan W. Smith, Andrea Crunkhorn, Shawn Farrokhi, Christopher L. Dearth

Physical Therapy Faculty Articles and Research

"In pursuit of delivering 'the right care to the right patient at the right time,' the Military Health System (MHS) advocates for collecting and using patient-reported outcomes (PROs) to help demonstrate value-based care.1 PROs identify patients’ perceptions of their health, function, and well-being, which can enhance patient-centered communication and guide data-driven healthcare. 2 The MHS recognizes the value of incorporating PRO data into clinical decision-making and has established a number of platforms for PRO collection across health conditions (eg, behavioral health, traumatic brain injury, musculoskeletal injuries). The Military Orthopedics Tracking Injuries and Outcomes Network (MOTION)3 was started as a research …


Duration, Cost, And Escalation Of Care Events For Physical Therapy Management Of Low Back Pain In Service Members With Limb Loss, Brittney M. Gunterstockman, Brad D. Hendershot, Joseph Kakyomya, Charity G. Patterson, Christopher L. Dearth, Shawn Farrokhi Oct 2024

Duration, Cost, And Escalation Of Care Events For Physical Therapy Management Of Low Back Pain In Service Members With Limb Loss, Brittney M. Gunterstockman, Brad D. Hendershot, Joseph Kakyomya, Charity G. Patterson, Christopher L. Dearth, Shawn Farrokhi

Physical Therapy Faculty Articles and Research

Introduction Physical therapy (PT) is recommended as a primary treatment for low back pain (LBP), a common and impactful musculoskeletal condition after limb loss. The purpose of this brief report is to report the duration and cost of PT care, and subsequent escalation of care events, for LBP in service members with and without limb loss. Materials and Methods This was a retrospective cohort, descriptive study. Service members with and without limb loss (matched) who received PT for LBP at a military treatment facility from 2015 to 2017 were included. Duration of PT care, number of PT visits, and escalation …


The Influence Of Active, Passive, And Manual Therapy Interventions On Escalation Of Health Care Events After Physical Therapist Care In Veterans With Low Back Pain, John M. Mayer, M. Jason Highsmith, Jason Maikos, Charity G. Patterson, Joseph Kakyomya, Bridget Smith, Nigel Shenoy, Christopher L. Dearth, Shawn Farrokhi Jul 2024

The Influence Of Active, Passive, And Manual Therapy Interventions On Escalation Of Health Care Events After Physical Therapist Care In Veterans With Low Back Pain, John M. Mayer, M. Jason Highsmith, Jason Maikos, Charity G. Patterson, Joseph Kakyomya, Bridget Smith, Nigel Shenoy, Christopher L. Dearth, Shawn Farrokhi

Physical Therapy Faculty Articles and Research

Objective The objective of this study was to examine the associations between active, passive, and manual therapy interventions with the escalation-of-care events following physical therapist care for veterans with low back pain (LBP). Methods A retrospective cohort study was conducted in 3618 veterans who received physical therapist care for LBP between January 1, 2015 and January 1, 2018. The VA Corporate Data Warehouse was utilized to identify LBP-related physical therapist visits and procedures, as well as opioid prescription and non-physical therapy clinic encounters. The association between physical therapist interventions with 1-year escalation-of-care events were assessed using adjusted odds ratios from …


A Single-Center, Assessor-Blinded, Randomized Controlled Clinical Trial To Test The Safety And Efficacy Of A Novel Brain-Computer Interface Controlled Functional Electrical Stimulation (Bci-Fes) Intervention For Gait Rehabilitation In The Chronic Stroke Population, Piyashi Biswas, Lucy Dodakian, Po T. Wang, Christopher A. Johnson, Jill See, Vicky Chan, Cathy Chou, Wendy Lazouras, Alison L. Mckenzie, David J. Reinkensmeyer, Danh V. Nguyen, Steven C. Cramer, An H. Do, Zoran Nenadic Jun 2024

A Single-Center, Assessor-Blinded, Randomized Controlled Clinical Trial To Test The Safety And Efficacy Of A Novel Brain-Computer Interface Controlled Functional Electrical Stimulation (Bci-Fes) Intervention For Gait Rehabilitation In The Chronic Stroke Population, Piyashi Biswas, Lucy Dodakian, Po T. Wang, Christopher A. Johnson, Jill See, Vicky Chan, Cathy Chou, Wendy Lazouras, Alison L. Mckenzie, David J. Reinkensmeyer, Danh V. Nguyen, Steven C. Cramer, An H. Do, Zoran Nenadic

Physical Therapy Faculty Articles and Research

Background

In the United States, there are over seven million stroke survivors, with many facing gait impairments due to foot drop. This restricts their community ambulation and hinders functional independence, leading to several long-term health complications. Despite the best available physical therapy, gait function is incompletely recovered, and this occurs mainly during the acute phase post-stroke. Therapeutic options are limited currently. Novel therapies based on neurobiological principles have the potential to lead to long-term functional improvements. The Brain-Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) system is one such strategy. It is based on Hebbian principles and has shown promise …