Rehabilitation and Therapy Commons^™

Physical Therapy Non-Treatment Of The Acute Hospital Inpatient, Daniel Lee Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detrimental effects of inactivity and mobility extend to the most ill and injured patients in the acute hospital setting. Facilitating the activity and exercise of these most critical patients often requires the skill and expertise of a physical therapist. When physical therapists are involved in the care of hospital inpatients they experience significant benefits; patients experience fewer secondary complications related to their primary illness or injury, they spend less time in critical care units and less time in the hospital overall, and when they leave they go to less restrictive environments and more comfortable care settings. These known benefits …

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …

The Percussionist Bodybuilder: Optimizing Performance Through Exercise And Nutrition, Anthony Joseph Merlino

UNLV Theses, Dissertations, Professional Papers, and Capstones

Do preventive therapies have the potential to help avoid common injuries among percussionists? This document investigates physiological therapy and nutrition in relation to percussion performance. My interest in this subject matter is derived from my personal experiences with injuries related to the performance of percussion. Although I have studied and played percussion professionally for more than a decade, I was unaware of certain methods of rehabilitation that were available to me prior to my injuries. As I learned about the rehabilitation process through first hand experience, I discovered that my injuries were very common among percussionists. This raised the question: …

The Effects Of A Progressive Exercise Program On Functional Activity And Quality Of Life For Older Overweight Women With Knee Osteoarthritis, Ty Carlson, Devin Edvalson, Tyler Peck, Brad Robison

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose Osteoarthritis (OA) is a common symptomatic condition experienced by older adults, especially in the overweight population, that affects the knees in particular. This study compares the effectiveness of two progressive exercise protocols (walking and stepping) on function and quality of life in older, overweight women with OA. This study includes self-management training and assesses participant selfperceived efficacy in managing OA.

Subjects This is a quasi-experimental design utilizing 16 women ≥ 50 years of age (60.44 ± 6.04) with a BMI > 25 (34.21 ± 7.28) and radiographic diagnosis of OA in at least one knee.

Methods and Measures …

The Effects Of A Single Bout Of Self-~Myofascial Release On Flexibility And Maximum Voluntary Contraction, Jonathan Robert Garcia

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to determine the effect of foam rolling on hamstrings flexibility, isometric and isokinetic torque. Participants: Thirteen female participants (N = 13; age: 28.5 + 6.8 years of age; height: 165.5 + 6.7 cm; mass: 64.2 + 8.4 kg) volunteered to participate in the study.

Methods: Hamstring flexibility was assessed using a sit and reach test; muscle strength was assessed by having participants complete a maximal voluntary isometric contraction (MVIC) of the hamstrings and maximal effort isokinetic knee flexion test using an isokinetic dynamometer. Participants completed these tests prior to any intervention (pre-rolling 1), …

Development Of A Tool To Assess Children’S Perceptions Of Their Own Balance (The Pediatric Balance Perception Battery): A Pilot Study, Jillian L. Beckett, Ashlee A. Harmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Psychosocial aspects of balance including self-perception, behaviors, and experiences, have been found to contribute to activity limitations and participation restrictions in adults. Clinical tools have been established to measure how adults feel about their own balance and the extent to which fear of falling and other related characteristics interfere with participation. There are no clinical tools presently available to explore these relationships and quantify the extent to which they interfere with activity and participation in children.

Purpose: To develop and test reliability and validity of a tool to evaluate balance self-perception in a pediatric population.

Participants: This sample of …

Evidence For The Validity Of A Tool For Improved Pressure Ulcer Staging By The Non-Expert In The Live Patient, Janelle Borg, Carrie Johnston, Megan Lucke, Jordan Sinclair

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses.

Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada.

Methods: Subjects assessed 11 wounds on the patients independently. They …

Blended Pedagogy Pathophysiology Course: Effectiveness And Student Satisfaction, Betsy Botsford, Samantha Corn, Alanna Keenan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Evidence supports the effectiveness of computer-assisted instruction (CAI) versus a traditional face-to-face teaching model, but little is known regarding the effectiveness of a blended pedagogy. The purpose of this study is to determine the effectiveness of a blended learning format in a pathophysiology course for entry-level Doctorate of Physical Therapy (DPT) students, to evaluate their level of satisfaction of a podcast formatted course, and to observe changes in cohort performance over time.

Subjects: Five University of Nevada, Las Vegas (UNLV) DPT cohorts (n = 139) participated in the study. Some cohorts were taught in a traditional classroom …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …

Conceptual Framework Of A Novel Intervention To Improve Mobility In Children With Cerebral Palsy: The Successes And Challenges Of Implementing A Large Amplitude Movement Protocol, Tania Goodwill, Erin Jarrett, Beren Shah, Alanna Stockford

UNLV Theses, Dissertations, Professional Papers, and Capstones

While cerebral palsy remains one of the most common childhood disabilities, clinicians continue to face significant challenges developing effective treatment strategies for the widely variable presentation of motor function impairments associated with cerebral palsy. A large gap exists between current research based evidence and feasible clinical practice. The purpose of this paper is to introduce a novel intervention protocol, explore the theoretical framework behind the protocol and provide insight to clinicians about the successes and challenges faced while pilot testing the intervention. The novel intervention was adapted and implemented by researchers combining a large amplitude movement protocol with the well-researched …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …

The Effect Of Balance Training With An Innovative Approach Compared To Traditional Balance Exercises, Brian Curtis Waite

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the use of an X Box 360 KinectTM game as a modality for improving balance. Specifically, this study explores the use of the Target Kick mini game on Kinect SportsTM as a tool for VR rehabilitation. Subjects (N=18, age 23.3 ±2.87 yrs, mass 71.83 ±15.25 kg, height 168.4 ±7.79 cm) with no lower extremity injury were randomly placed into three groups (X Box n = 6, Traditional n = 6, and Control n = 6). The X Box (XBOX) group performed ten minutes of balance training by playing an X Box game …

Anterior Cervical Decompression And Fusion On Neck Range Of Motion, Pain And Function: A Prospective Analysis, Kate Addis, Jason Longhurst, Bree-Lyn Vom Steeg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Summary of background data: Intractable cervical radiculopathy secondary to stenosis or herniated nucleus pulposus is commonly treated with an anterior cervical decompression and fusion procedure (ACDF). However, there is little evidence in the literature that demonstrates the impact such surgery has on long term range of motion outcomes

Study Design: Prospective, non--‐experimental.

Objective: The objective of this study was to compare cervical range of motion and patient reported outcomes in patients before and after a 1, 2 or 3 level ACDF.

Patient Sample: 46 patients.

Methods: Patients undergoing an ACDF for cervical radiculopathy had their cervical range …

Land-Based Exercise And Its Effect On Quality Of Life Outcomes In Patients With Knee Osteoarthritis: A Systematic Review, Cody R. Buckner, Lindsay C. Martin, Michael L. Soukup

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The purpose of this systematic review was to examine effectiveness of land-based exercise interventions for improving quality of life (QOL) of individuals with symptomatic knee osteoarthritis.

Methods: A systematic search included PubMed, CINAHL, Scopus, Academic Search Premier, and the Cochrane Database of Systematic Reviews. Inclusion criteria included land-based exercise interventions aimed to improve lower extremity strength and QOL, published since 2000. Exclusion criteria included OA of joints other than the knee, and aquatic-based and surgical interventions. Studies were evaluated using a modified version of the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) methodology score.

Results: Level of …

Therapeutic Neuroscience Education For Patients With Chronic Low Back Pain And Its Effect On Activity Level, Pain Perception, And Function, Stephen Burton, Amber Domingo, Ryan Spencer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Chronic low back pain (CLBP) is a significant cause of disability and inactivity in the United States. Patients with chronic pain are often symptomatic even in the absence of tissue damage. This is a major reason patients need to be educated about their pain. Cognitions such as fear, anxiety and faulty beliefs may impact the pain experiences and changing cognitions are important in changing pain behavior. If patients understand that the pain they are experiencing may not be a true indication of the health of their tissues, they may experience less fear of their pain, and may be able …

Reliability And Validity Of The Ne1 Wound Assessment Tool (Wat), Stephanie Coon, Faustina Tran, Melinda Vicencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current literature indicates a lack of reliability and validity of existing pressure ulcer (PrU) staging systems. This prompted the development of the N.E. One Can Stage (NEOCS). Recently this tool was modified and renamed, the NE1 Wound Assessment Tool (NE1 WAT). The purpose of this study is to test the reliability and validity of the NE1 WAT.

Subjects:

A sample of convenience of nine physical therapists (PTs) and 11 nurses (RNs) with PrU staging as part of their routine work duties were included in this study.

Methods:

A written exam was administered and consisted of assessment questions …

Effects Of Footstrike Pattern On Low Back Posture, Shock Attenuation, And Comfort During Running, Traci L. Delgado, Emilia Kubera-Shelton, Robert R. Robb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Barefoot running (BF) is popular in the running community. Biomechanical changes occur with BF, especially when initial contact changes from rearfoot strike (RFS) to forefoot strike (FFS). In addition, changes in lumbar spine range of motion (ROM), particularly involving lumbar lordosis, have been associated with increased low back pain (LBP). However it is not known how changing from RFS to FFS affects lumbar lordosis or LBP. Thus, the purpose of this study was to determine if a change from RFS to FFS would change lumbar lordosis, and/or decrease shock attenuation, and/or change comfort levels in healthy recreational/experienced runners.

Methods: …

The Acute Effects Of Upper Extremity Stretching On Throwing Velocity In Untrained Baseball Throwers, Ashley Delobel, Lanisa Harveson, Jason Melton, Michael Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to examine the effects of static and proprioceptive neuromuscular facilitation (PNF) stretching of shoulder internal rotators on throwing velocity as compared to a typical dynamic warm-up.

Subjects: 27 male untrained throwers (mean age = 25.1 years old, SD =2.4) with basic knowledge of throwing mechanics.

Methods:The study was conducted over a series of three sessions with at least one week between each session. During each session, subjects warmed-up, threw 10 pitches, were randomly assigned to one of three separate stretching protocols, and then threw 10 more pitches.The three protocols were static stretching, …

Effects Of Cervical Spine Manipulation On Balance And Joint Proprioception In Asymptomatic Individuals: Plausibility And Pilot Study, Kimberly Drayer, Michael Kauwe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Balance issues are prevalent in all ages of the population and can lead to many debilitating secondary impairments. There are various methods for treating balance problems, one of which is cervical spine manipulation (CSM). It seems to be biologically plausible that CSM would be an effective intervention, as it elicits effects in the same systems that are impaired in people with balance issues: vestibular, visual, and somatosensory.

Objective: The aim of this study is to investigate the immediate differences in balance and proprioception following a CSM in asymptomatic subjects.

Design: An experimental, cross-over study design was used

Methods: …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Russell Gourlie, Spencer Sorensen, Rithea Vong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study is to examine and identify key characteristics of and differences between people with Parkinson’s Disease (PD) who exhibit moderate/high fear of falling avoidance behaviors and those that exhibit low fear of falling avoidance behaviors.

Subjects: A total of 24 subjects (5 females, 19 males; mean age= 72.2, SD=9.1) participated in this study.

Methods: A cross-sectional design was used to identify descriptive characteristics of subjects with PD associated with moderate/high levels of fear avoidance behavior (MHA) or low levels of fear avoidance (LA) as measured by the Fear of Falling Avoidance-Behavior …

Test-Retest Reliability And Responsiveness Of Gaze Stability And Dynamic Visual Acuity In High School And College Football Players, Denise Kaufman, Mallory Puckett, Mitchell Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: The purpose of this study was to establish reliability and responsiveness of the active dynamic visual acuity test (DVAT) at speeds of 150 to 200 degrees per second (deg/sec) and the gaze stabilization test (GST) in high school and college football players.

Design: Reliability design

Setting, Participants, Main Outcome Measures: A total of 50 high school and college football athletes completed vestibulo-ocular reflex testing using the DVAT and GST in the yaw (horizontal) and pitch (vertical) planes on two separate occasions within 14 days.

Results: Test-retest reliability for the DVAT was good in yaw, Intraclass Correlation Coefficient (ICC) (3,3) …

Using Over-The-Counter Ear Filters As A Treatment To Improve Dizziness And Balance In Patients Diagnosed With A Traumatic Brain, Brandy Sue Whitney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: People diagnosed with a Traumatic Brain Injury (TBI) usually have physical, cognitive, emotional, and sleep deficits. Sensory overload is a common symptom of TBI. One treatment prescribed for sensory overload is over the counter ear filters. Ear filters have shown to decrease sensory input. Could the ear filters have an effect on balance and dizziness without much cost to the patient or the clinic?

Subjects: Patients diagnosed with a mild or moderate brain injury, ages of 18-65 years old. They needed to be medically stable, potential to walk, and have complaints of dizziness and/or balance problems.

Methods: …

The Use Of A Pylon Mounted Transducer For Investigating The Gait Of Transtibial Amputees, Justin Robert Brink

UNLV Theses, Dissertations, Professional Papers, and Capstones

Two areas of research interest in the design and use of lower limb prosthetic devices are how foot performance varies with design and how prosthesis alignment affects gait. The current study addressed both of these areas through the use of the JR3 triaxial transducer mounted at the base of the socket. The transducer is an innovative form of instrumentation that measures forces and moments at the end of the socket. Traditional measurement of gait uses a force plate buried in the floor of a gait laboratory. The study established that the transducer offers a viable means of instrumentation for amputee …

Population-Based Survey Of Lumbar Surgery Beliefs In The United States, Amanda Elyse Mccauley, Zachery Clark Rasmussen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Studies have shown that poor lumbar surgery outcomes may be influenced by a person’s preconceived perceptions of low back surgery (LBS). However, the perceptions of the general population about issues related to lumbar surgery are not known. Therefore, the purpose of this study was to investigate the general population’s perceptions regarding LBS.

Number of Subjects: This study included 262 participants (Average age: 46.1, SD=16.9; 125 Males, 137 Females) who completed the questionnaire from the general population in the Las Vegas area.

Materials/Methods: Questionnaire development involved expert panel feedback from three physical therapists, three spine surgeons, two surgeon assistants/nurses, two …

Supervised Lower Extremity Strengthening Program To Improve Function In Women Over Fifty With Knee Osteoarthritis: A Time Series Design, Janelle Brooke Lemons, Diane Christine Sheesley, Pamela Reagan Sutton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Develop a simple, self-paced lower extremity strengthening program incorporating functional activities for women over the age of fifty to reduce limitations associated with knee OA.

Study Design: This was a pilot study utilizing a time series design with 8 women aged 55-65 (M + SD = 60 + 3) meeting the American College of Rheumatology's criteria for clinical diagnosis of knee OA.

Background: Lower extremity weakness in women with knee osteoarthritis is associated with pain and functional limitations.

Methods and Measures: Subjects began the 14-week program with 2 weeks of baseline treadmill walking. The following 12 weeks were divided …

Therapist Characteristics Influencing Physical Therapy Non-Treatment In The Acute Care Setting, Daniel Mcgarvey, Colby Olsen, Aaron Van Wagoner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Research has found that participation in physical therapy (PT) services in the acute care setting increases functional outcomes and decreases patient length of stay. Certain physical therapist characteristics could be a potential source of influence on patient non-participation in physical therapy in the acute care setting. The purpose of this study was to determine whether specific characteristics of therapists and patients are predictive of physical therapy non-treatment.

Subjects: Subjects included 16 physical therapists or physical therapist assistants and 1225 patients at a community acute care hospital.

Methods: Characteristics of each therapist and their corresponding patient data were …

Attentional Focus During Balance Training In Idiopathic Parkinson’S Disease (Pd): A Randomized Clinical Trial, Alyssa Davis, Rebecca Hatlevig, Amanda Richards, Leslee Rosenlof

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare the effects of various attentional focus strategies on balance in people with PD. Forty-nine adults with idiopathic PD were randomized into one of four groups (internal focus, external focus, no focus, and control). The three intervention groups participated in a month-long balance program. The outcomes measured were the Sensory Organization Test, Berg Balance Scale, self selected gait velocity, Dynamic Gait Index, Activities-specific Balance Confidence Scale and obstacle course completion time. These outcomes were measured at baseline, post intervention, 2-weeks post intervention, and 8-weeks post intervention. Statistical analyses yielded no significant differences among …

Immediate Effects Of High Intensity Training In Children With Cerebral Palsy Gmfcs Levels I-Iii: A Pilot Study, Andrea Blahovec, Andrea Kuiken, Jillian Mears, Heather Riggins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cerebral Palsy is one of the most common causes of motor disability in the U.S., but there is still a lack of consensus for best intervention strategies to improve function and gait efficiency.

Objective: Determine if ambulatory children with CP, exposed to a brief, high intensity training session, will: 1) experience changes in temporal-spatial gait characteristics 2) demonstrate increased gait speed and 3) demonstrate improved gait kinematics.

Design: Five participants walked at preferred and fast speeds over an instrumented walkway followed by a 15-minute intervention. After a short rest, post-intervention walking was completed.

Results: Ten dependent variables were extracted …

Foot Volume Change During Long Distance Running In Healthy Adults, Meghan Boni, Istvan Takacs, Rebecca Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: Healthy adults frequently engage in running as a means of cardiovascular exercise. Larger running shoes are often chosen based on common beliefs that feet swell during running, yet many continue to encounter foot injuries, such as blisters, as a result of this activity. Previous research has analyzed the changes in foot volume during short bouts of activity. However, there has been limited research on the effect of long distance running on foot volume, which is where many of these injuries are seen. The purpose of this study was to examine the effects of long distance running, defined …