Rehabilitation and Therapy Commons^™

Commentary On “Infants With Torticollis Who Changed Head Presentation During A Physical Therapy Episode”, Kathryn Knudsen, Ryan Jacobson, Kirsten Pepperling

Faculty Publications - College of Physical Therapy

This article highlights the importance of differential diagnosis in infants with congenital muscular torticollis (CMT), particularly those with atypical presentation or change of side for range-of-motion (ROM) restriction. Per the clinical practice guideline (CPG), patients who change sidedness with CMT should be reevaluated by the physical therapist and referred back to the primary care provider for consideration of other diagnoses.1 This recommendation is important to parents who are seeking accurate information on cause and severity and who want to know that the home exercises being prescribed for their infant are effective

Improving Interpretation Of The Patient-Reported Outcomes Measurement Information System (Promis) Physical Function Scale For Specific Tasks In Community-Dwelling Older Adults, Jeff Houck, Ryan Jacobson, Michael Bass, Chris Dasilva, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background and purpose: New generic patient-reported outcomes like the Patient-Reported Outcomes Measurement Information System (PROMIS) are available to physical therapists to assess physical function. However, the interpretation of the PROMIS Physical Function (PF) T-score is abstract because it references the United States average and not specific tasks. The purposes of this study were to (1) determine convergent validity of the PROMIS PF scale with physical performance tests; (2) compare predicted performance test values to normative data; and (3) identify sets of PROMIS PF items similar to performance tests that also scale in increasing difficulty and align with normative data.

Methods: …

Telehealth Assessment Of Frailty In Community Dwelling Older Adults Using The Modified Physical Performance Test (Poster), Sara Duran, Jessica Yeadon, Forest Bingham, Kordell Mcpherson, Elyse Grant, Jaime Ball, Lyndsay Stutzenberger

Faculty Publications - College of Physical Therapy

Frailty in Older Adults

● Frailty is a health condition that effects increasing numbers of the population past the age of 65

● The modified Physical Performance Test (mPPT) is a test that assesses multiple dimensions of physical function with different levels of difficulty. It has been shown to assess frailty in an older adult population.

● Due to health care barriers, it may be advantageous to assess individuals via telehealth.

● It is critical to determine the concurrent validity of telehealth delivery of mPPT with that of a clinical setting to determine if it can increase access to care

Positive Psychosocial Attributes Associated With Parent-Appraised Quality Of Life In Children With Movement Limitations (Poster), Ryan Jacobson, Rebecca Giglio, Carolyn Grimm, Sarah Kotel, Kylie Ronning

Faculty Publications - College of Physical Therapy

No abstract provided.

In Primary Care, Are Health Outcomes Consistent With Physical Therapists Judgement For Musculoskeletal Care? (Poster), Ross Dixon, Sheila Perkins, Brian Schaudt, Josh Thoreson, Kendra Woodson, Jeff Houck

Faculty Publications - College of Physical Therapy

No abstract provided.

Sway-Referenced Haptic Input Improves Static Standing Stability (Poster), Andrew Meszaros, Robin Dorociak, Cameron Hofer, Joshua Todd, Emma Powley

Faculty Publications - College of Physical Therapy

No abstract provided.

Biomechanical Foot Factors, Social Participation, And Self-Participation In Sedentary Versus Non-Sedentary Adults (Poster), Sarah Jones, Amanda Mcconaughey, Kelly Milliken, Lindsey Wallace, Beau Yamamura, Marcey Keefer Hutchison, Jeffrey Houck, Rebecca Dobler

Faculty Publications - College of Physical Therapy

Purpose:

Compare biomechanical foot factors, activity level, satisfaction with participation in social roles, and self-related level of activity between sedentary and non-sedentary adults

Hypotheses:

1. Step count will positively correlate with: Medial longitudinal arch (MLA) recoil, intrinsic and extrinsic muscle strength, muscle CSA, neutral foot posture, satisfaction with participation in social roles, and self-efficacy

2. Step count will negatively correlate with: Plantar fascia thickness. self-reported pain interference, and BMI.

Size-Weight Illusion With A Squatting Task (Poster), Amanda Laron, Maryssa Becker, Mason Flores, Mikaela Raudsepp, Nicole Seidl, Robin Dorociak, Andrew Meszaros

Faculty Publications - College of Physical Therapy

Hypothesis:

The SWI will be observed during a squat movement, resulting in initially a larger GRF through the lower extremity on the side of the larger cube and more vertical displacement of the side of the bar with the large cube.

The bilateral GRF and bar displacement will become symmetrical after 10 repetitions.

Participants will initially predict the larger cube is heavier and after completing the squatting task will perceive the smaller cube as heavier.

What Unique Skills Are Associated With Strong Psychosocial Beliefs In Orthopedic Physical Therapists? (Poster), Jeff Houck, Grace Atherton, Maggie Haworth, Casey Ebelt, Sally Guildehaus, Fred Chang, Chris Hoekstra, Daniel Kang

Faculty Publications - College of Physical Therapy

No abstract provided.

Achilles Tendon Stiffness And Muscle Length Changes During Dynamic Exercises (Poster), Ami Hanks, Bailey Mcdevitt, Ellie Townsend, Shelby Bartram, Steven Andrews, Tyler Cuddeford

Faculty Publications - College of Physical Therapy

No abstract provided.

In-Season Rehabilitation Program Using Blood Flow Restriction With Therapy For Two Decathletes With Patellar Tendinopathy: A Case Report, Tyler Cuddeford, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background and Purpose: Patellar tendinopathy is an overuse injury experienced primarily by athletes; especially athletes who participate in sports that involve frequent jumping. Therapeutic exercise is the primary conservative treatment for patients with this condition. However, some patients with patellar tendinopathy may be unable to tolerate the loading that occurs during exercise. The use of blood flow restriction (BFR) therapy for patients with patellar tendinopathy may allow the athlete to exercise with a lower load while still experiencing the physiological benefits associated with training at a higher intensity. The purpose of this case report was to detail the outcomes from …

Pattern Of Recovery And Outcomes Of Patient Reported Physical Function And Pain Interference After Ankle Fusion: A Retrospective Cohort Study, Jessica M. Kohring, Jeff Houck, Irvin Oh, Adolf S. Flemister, John P. Keptz, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: Research on outcomes after ankle fusion focuses on basic activities of daily living, fusion rates, and gait parameters. Little has been reported on the patient’s perspective after surgery. The purpose of this study was to determine the change in patient reported physical function and pain interference after ankle fusion surgery to guide patient expectations and improve provider communication.

Methods: This was a retrospective review of prospectively collected patient reported outcome measurement information system (PROMIS) data in 88 ankle arthrodesis procedures performed from May 2015 to March 2018. The PROMIS Physical function (PF) and pain interference (PI) measures were collected …

O-Season Training Habits And Bmi, Not Preseason Jump Measures, Are Associated With Time-Loss Injury In Female Collegiate Soccer Players, Jason Brumitt, Alma Mattocks, Amy Engilis, Jill A. Sikkema, Jeremy Loew

Faculty Publications - College of Physical Therapy

The primary purpose of this study was to determine the effectiveness of the standing long jump (SLJ) and the single-leg hop (SLH) tests to discriminate lower quadrant (low back and lower extremities) injury occurrence in female collegiate soccer players. The secondary purpose of this study was to determine associations between injury and o-season training habits or anthropometric measures. SLJ, SLH, and anthropometric measures were collected during a preseason screening clinic. Each subject completed a questionnaire providing demographic information and o-season training habits. Each athlete performed three SLJ and three SLH per leg. SLJ and SLH scores were not associated with …

Role Of Patient-Reported Outcome Measures On Predicting Outcome Of Bunion Surgery, Ashlee Macdonald, Jeff Houck, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: Prior studies have suggested preoperative patient-reported outcome scores could predict patients who would achieve a clinically meaningful improvement with hallux valgus surgery. Our goal was to determine bunionectomyspecific thresholds using Patient-Reported Outcomes Measurement Information System (PROMIS) values to predict patients who would or would not benefit from bunion surgery.

Methods: PROMIS physical function (PF), pain interference (PI), and depression assessments were prospectively collected. Forty-two patients were included in the study. Using preoperative and final follow-up visit scores, minimally clinically important differences (MCID), receiver operating characteristic (ROC) curves, and area under the curve (AUC) analyses were performed to determine if …

Is There A Difference In Outcomes Between Patients Who Received A Double Or Triple Arthrodesis For Hindfoot Arthritis?, Amanda H. Holleran, Judith F. Baumhauer, Jeff Houck, Daniel Homeier, Adolph S. Flemister, John P. Ketz, Benedict F. Digiovanni, Irvin Oh

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Triple arthrodesis has historically been considered the standard of treatment for arthritis of the hindfoot with or without deformity. The complications of this surgery including non-union, malunion, nerve injury, infection and wound healing problems can occur at any of the three joints. Double arthrodesis is capable of producing a similar reduction in degrees of motion and correction of foot deformity but may also cause less patient morbidity in regard to these complications due to one less joint being incorporated into the fusion procedure. What is unknown is the patient reported outcomes, specifically physical function (PF) and pain interference (PI) …

What Is The Responsiveness And Quality Of Life “Utility” For Promis Outcomes In Foot And Ankle Patients Following Physical Therapy?, Christopher G. Neville, Judith F. Baumhauer, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Patients with foot and ankle conditions have been shown to demonstrate improvement in their generic outcomes using the Patient Reported Outcome Measurement Information System (PROMIS). However, the responsiveness to change and the impact change may have on quality of life has not been explored following non-operative care with physical therapy. The effect size (ES) is an assessment of the magnitude of change while the impact of change in physical function can be assed with quality of life utility scores. Therefore, the purpose of this analysis was to investigate the responsiveness of the PROMIS physical function (PF) scale on changes …

Do Patients Judge Success Of Treatment And Patient Acceptable Symptom State Based On Current Self-Reported Health Status?, Ryan Jacobson, Daniel Kang, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Value-based care models call for better interpretation of patient-reported outcomes. Patients may reference health status differently when appraising if an intervention was successful versus if their current state is acceptable. The purpose of this study was to determine the association between success of treatment (SOT), patient acceptable symptom state (PASS), and PROMIS measure T-scores, following a single primary care physical therapy encounter.

Methods: Cross-sectional study. Ninety-two patients with musculoskeletal complaints were administered standard SOT and PASS questions, and PROMIS Physical Function, Pain Interference, and Self-Efficacy for Managing Symptoms measures. Association of PASS and SOT was determined using rank biserial …

Validity Of The Paper Pull Test For Strength In Patients With Hallux Valgus, Marcey Keefer Hutchison, Jeff Houck, Jaymee Kau, Kristen E. Omohundro, Alex Hughes, Kara Oshiro, Taylor Eckel

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The purpose of this study was to explore validity of the paper pull test (PPT) to assess hallux flexion strength and function in persons with hallux valgus (HV). The following hypotheses were tested: 1) The PPT is valid for inferring 1st MTP flexion strength and heel rise (HR) performance (e.g. heel height). 2) A specified threshold of force during the PPT can be identified that discriminates patients with HV. 3) Muscle activity (abductor hallucis [AH], flexor hallucis brevis [FHB]), in patients with HV will be distinct from controls across three tasks: 1) PPT, 2) lowering phase of a HR, …

Overall Health And The Influence Of Physical Therapy On Physical Function Following Total Ankle Arthroplasty, Frank E. Diliberto, Daniel H. Aslan, Jeff R. Houck, Bryant S. Ho, Anand M. Vora, Steven L. Haddad

Faculty Publications - College of Physical Therapy

Background: The overall health and the importance of physical therapy for people following total ankle arthroplasty (TAA) have been understudied. Our purpose was to characterize the overall health of patients following TAA, and explore the frequency, influence, and patient-perceived value of physical therapy.

Methods: People who received a TAA participated in this retrospective cohort online survey study. The survey included medical history questions and items from the Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms. Seven PROMIS domains, reflecting the biopsychosocial model of care (physical, mental, social), were included to examine participant overall health status in comparison to the general …

Operative Intervention Does Not Change Pain Perception In Patients With Diabetic Foot Ulcers, Olivia V. Waldman, Stephanie P. Hao, Jeff R. Houck, Nicolette J. Lee, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Researchers investigated pain perception in patients with diabetic foot ulcers (DFUs) by analyzing pre- and postoperative physical function (PF), pain interference (PI), and depression domains of the Patient-Reported Outcome Measurement Information System (PROMIS). They hypothesized that 1) because of painful diabetic peripheral neuropathy (DPN), a majority of patients with DFUs would have high PROMIS PI scores unchanged by operative intervention, and 2) the initially assessed PI, PF, and depression levels would be correlated with final outcomes. Seventy-five percent of patients with DFUs reported pain, most likely because of painful DPN. Those who reported high PI and low PF were likely …

Can Patient-Reported Outcomes Measurement Information System® (Promis) Measures Accurately Enhance Understanding Of Acceptable Symptoms And Functioning In Primary Care?, Ryan Jacobson, Daniel Kang, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Value-based healthcare models will require prioritization of the patient’s voice in their own care toward better outcomes. The Patient-Reported Outcomes Measurement Information System® (PROMIS) gives patients a voice and leads providers to actionable treatments across a broad range of diagnoses. However, better interpretation of PROMIS measures is needed. The purpose of this study was to evaluate the accuracy of PROMIS Physical Function (PF), Self-Efficacy for Managing Symptoms (SE), Pain Interference (PI), Fatigue, and Depression measures to discriminate patient acceptable symptom state (PASS) in primary care, determining if that accuracy is stable over time and/or retained when PROMIS score thresholds …

Preseason Y Balance Test Scores Are Not Associated With A Lower Quadrant Sports Injury In A Heterogeneous Population Of Division Iii Collegiate Athletes, Jason Brumitt, Jill A. Sikkema, Saiko Mair, Cj Zita, Victor Wilson, Jordan Peterson

Faculty Publications - College of Physical Therapy

Functional performance tests, such as the Y Balance Test-Lower Quarter (YBT-LQ), hold promise as screening tools to identify athletes at risk for injury. The ability of the YBT-LQ to discriminate injury risk in Division III collegiate athletes is unknown. The purpose of this study was to determine if preseason YBT-LQ scores are associated with noncontact time-loss lower-quadrant (low back or lower extremities) injury in a heterogeneous population of Division III collegiate athletes. Two hundred and fourteen athletes (females = 104) performed the YBT-LQ test. Preseason YBT-LQ scores, analyzed by the total population, were not associated with noncontact time-loss lower-quadrant injury. …

Blood Flow Restriction Training For The Rotator Cuff: A Randomized Controlled Trial, Jason Brumitt, Marcey Keefer Hutchison, Daniel Kang, Zach Klemmer, Mike Stroud, Edward Cheng, Neil Patrick Cayanan, Sheldon Shishido

Faculty Publications - College of Physical Therapy

Context: Blood flow restriction (BFR) training utilizes a tourniquet, applied to the proximal portion of one or more extremities, to occlude blood flow during exercise. Significant gains in strength and cross-sectional area can be achieved in muscles, both distal and proximal to BFR cuff application. Purpose: To compare strength gains of the rotator cuff and changes in tendon size in subjects who performed side-lying external-rotation exercise with or without BFR. Methods: Forty-six subjects (mean age 25.0 [2.2] y) were randomized to either a BFR + exercise group or to the exercise-only group. Subjects performed 4 sets of the exercise (30/15/15/15 …

Do Patient Sociodemographic Factors Impact The Promis Scores Meeting The Patient-Acceptable Symptom State At The Initial Point Of Care In Orthopaedic Foot And Ankle Patients?, David N. Bernstein, Kiah Mayo, Judith F. Baumhauer, Chris Dasilva, Kathleen Fear, Jeff Houck

Faculty Publications - College of Physical Therapy

Background

Patient-reported outcome measures such as the Patient-Reported Outcomes Measurement Information System (PROMIS) allow surgeons to evaluate the most important outcomes to patients, including function, pain, and mental well-being. However, PROMIS does not provide surgeons with insight into whether patients are able to successfully cope with their level of physical and/or mental health limitations in day-to-day life; such understanding can be garnered using the Patient-acceptable Symptom State (PASS). It remains unclear whether or not the PASS status for a given patient and his or her health, as evaluated by PROMIS scores, differs based on sociodemographic factors; if it does, that …

Responsiveness Of The Promis And Its Concurrent Validity With Other Region- And Condition-Specific Proms In Patients Undergoing Carpal Tunnel Release, David N. Bernstein, Jeff R. Houck, Bilal Mahmood, Warren C. Hammert

Faculty Publications - College of Physical Therapy

Background

The Patient-reported Outcome Measurement Information System (PROMIS) continues to be an important universal patient-reported outcomes measure (PROM) in orthopaedic surgery. However, there is concern about the performance of the PROMIS as a general health questionnaire in hand surgery compared with the performance of region- and condition-specific PROMs such as the Michigan Hand Questionnaire (MHQ) and the Boston Carpal Tunnel Questionnaire (BCTQ), respectively. To ensure that PROMIS domains capture patient-reported outcomes to the same degree as region- and condition-specific PROMs do, comparing PROM performance is necessary.

Questions/purposes

(1) Which PROMs demonstrate high responsiveness among patients undergoing carpal tunnel release (CTR)? …

Do Patient Reported Outcome Measurement Information System (Promis) Scales Demonstrate Responsiveness As Well As Disease-Specific Scales In Patients Undergoing Knee Arthroscopy?, Raymond J. Kenney, Jeff Houck, Brian D. Giordano, Judith F. Baumhauer, Meghan Herbert, Michael D. Maloney

Faculty Publications - College of Physical Therapy

Background: The Patient Reported Outcomes Information System (PROMIS) is an efficient metric able to detect changes in global health. Purpose: To assess the responsiveness, convergent validity, and clinically important difference (CID) of PROMIS compared with disease-specific scales after knee arthroscopy. Study Design: Cohort study (Diagnosis); Level of evidence, 2.

Methods: A prospective institutional review board–approved study collected PROMIS Physical Function (PF), PROMIS Pain Interference (PI), International Knee Documentation Committee (IKDC), and Knee injury and Osteoarthritis Outcome Score (KOOS) results in patients undergoing knee arthroscopy. The change from preoperative to longest follow-up was used in analyses performed to determine responsiveness, convergent …

Preoperative Patient Reported Outcomes Measurement Information System Scores Assist In Predicting Early Postoperative Success In Lumbar Discectomy, Paul T. Rubery, Jeff Houck, Addisu Mesfin, Robert Molinari, Mark O. Papuga

Faculty Publications - College of Physical Therapy

Study Design. Retrospective review of prospective data.

Objective. Determine whether patient reported outcome (PRO) data collected prior to lumbar discectomy predicts achievement of a minimal important difference (MID) after surgery. Compare ability of PRO and clinical information to predict achievement of MID in short term follow-up after discectomy.

Summary of Background Data. We investigated the ability of patient reported outcomes measurement information system (PROMIS) and clinical factors at the preoperative time point to determine patients achieving MID after surgery.

Methods. PROMIS physical function (PF), pain interference (PI), and depression (D) scores were assessed at evaluation and follow-up for consecutive visits …

Psychometric Evaluation Of The Patient-Reported Outcomes Measurement Information System (Promis) Physical Function And Pain Interference Computer Adaptive Test For Subacromial Impingement Syndrome, Benjamin Strong, Michael Maloney, Judith Baumhauer, Joseph Schaffer, Jeff Houck, Man Hung, Jerry Bounsanga, Maren W. Voss, Yushan Gu, Ilya Voloshin

Faculty Publications - College of Physical Therapy

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Computer Adaptive Test (CAT) was previously validated for rotator cuff disease and shoulder instability. This study evaluated the psychometric properties of the PROMIS Physical Function (PF) CAT, PROMIS Pain Interference (PI) CAT, and the American Shoulder and Elbow Surgeons (ASES) Shoulder Function Score for subacromial impingement syndrome.

Methods: PROMIS PF CAT, PI CAT, and ASES (Pain, Function, Total) were collected on all visits for 2 surgeons between January 2016 and August 2016. New patients, aged 18 years and older, were selected by International Classification of Diseases code for impingement syndrome …

What Are Typical Outcomes Associated With Physical Therapy For Foot & Ankle Patients?, Judith F. Baumhauer, Christopher Neville, Kostantinos Vasalos, Chad Condidorio, Kathleen Fear, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: It is unclear whether patients attending physical therapy, post-op or for conservative care, achieve clinically important differences (CID) on the patient reported outcome information system (PROMIS) scales. Key PROMIS outcomes physical function (PF) and pain interference (PI) match well with treatments provided in physical therapy. Physical therapy may also influence depression (Dep). Documentation of PROMIS outcomes associated with physical therapy are useful to help set patient expectations. The purpose of this analysis was to document expected PROMIS PF, PI, and Dep outcomes after physical therapy for foot and ankle diagnoses by 1) reporting average improvement and 2) examining whether …

Prior History Of Anterior Cruciate Ligament (Acl) Reconstruction Is Associated With A Greater Risk Of Subsequent Acl Injury In Female Collegiate Athletes, Jason Brumitt, Alma Mattocks, Amy Engilis, Dale Isaak, Jeremy Loew

Faculty Publications - College of Physical Therapy

Objectives: The risk of a subsequent anterior cruciate ligament (ACL) sprain is greater in high school aged female athletes with prior history of ACL reconstruction (ACLR) than in age-matched controls. The risk of a subsequent ACL injury in female collegiate athletes with prior ACLR is unknown. The primary purpose of this study was to determine the relative risk of a subsequent ACL injury in female collegiate athletes with prior ACLR when compared to age-matched controls. The secondary purpose of this study was to evaluate the ability of jump and hop tests to discriminate ACL injury risk.

Design: Prospective cohort.

Methods: …