Rehabilitation and Therapy Commons^™

Simulation Enhances Soft Skills Among Inter-Professionals Participating In An International Service-Learning Experience To A Resource-Limited Country, Suzanne Trotter, Sharon Dunnivan-Mitchell

Physical Therapy Collection

Soft skills are the hallmark of a master healthcare provider. One of the most effective ways to teach soft skills is through service-learning. Evidence suggests that adding simulation as part of a service-learning team’s pre-departure training (PDT) will better prepare them to resolve ethical and cultural dilemmas plus facilitate soft skills. We hypothesized that simulation could improve soft skills of healthcare providers delivering rehabilitation services on a one-week service-learning experience in Guatemala

A convenience sample of 21 physical and occupational therapy students and clinicians who participated in four 1-hour PDTs were included in this qualitative study using grounded-theory methods. Training …

Using The Backward Design Process To Integrate Interprofessional Education Utilizing Simulation In Ot And Pt Educational Curricula, Norman C. Belleza, Maureen Johnson

Physical Therapy Collection

Interprofessional simulation education (IPSE) has been integrated into the OT and PT curriculum. Having a dedicated simulation center on-site allows for continued use of IPSE for regular monitoring and assessment of student achievement in interprofessional exchanges. Additional healthcare disciplines can also integrate IPSE including nursing, nurse practitioner, physician’s assistant, post-graduate professionals, athletic trainers, and speech and langue pathology. Inclusion of IPSE will augment the collaborative effort for increased interactions among various health care providers.

Interrater Reliability Of The Pediatric Neuromuscular Recovery Scale In Children With Spina Bifida, Elizabeth Ardolino, Megan Flores, Germaine Ferreira, Susan Jeantete, Kathleen Manella

Physical Therapy Collection

Purpose: There is a paucity of outcome measures to assess the quality of functional mobility in children with spina bifida¹. The Pediatric Neuromuscular Recovery Scale (Peds NRS) is a valid and reliable outcome measure that was developed to assess the motor capacity of children with spinal cord injury^2-6. The purpose of this study was to examine the interrater reliability of the Pediatric Neuromuscular Recovery Scale (Peds NRS) to classify motor capacity in children with myelomeningocele (MMC) form of spina bifida.

Subjects: Twenty-one children with MMC (1.4- 10 years of age; mean age of 5.3 …

Integrating Interprofessional Education With Simulation Experiences Within Ot And Pt Curricula: A Look At The Backwards Design Process, Nicole Rodriguez, Norman C. Belleza, Maureen Johnson

Physical Therapy Collection

Interprofessional education has become a significant focus across healthcare disciplines noting the benefits that can be achieved through improving patient outcomes, increasing awareness for potential referral to other providers, and fostering collaboration.

The integration of simulation into established OT and PT curriculum was a less daunting task by using the backward design process. Continued growth and the addition of Speech Therapy, Nursing, and Physician’s Assistant programs will further necessitate use of backward design to integrate meaningful multidisciplinary activities for students.

Trunk Control And Gross Motor Outcomes After Body-Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Case Series, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

BACKGROUND AND PURPOSE: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and 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 treadmill training (BWSTT) 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 series was to explore the impact of a 6-week BWSTT intervention on postural control and gross motor function in 3 young children with cerebral palsy in GMFCS levels IV and …

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 …

Trunk Control And Gross Motor Outcomes After Body Weight Supported Treadmill Training In Young Children With Severe Cerebral Palsy: A Non-Experimental Case Series, Megan Flores, Carolyn P Da Silva

Physical Therapy Collection

OBJECTIVE: To explore the impact of a body weight supported treadmill training (BWSTT) intervention on postural control and gross motor function in three young children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels IV or V.

METHOD: Children (N = 3) between the ages of 2-3 years who were diagnosed with CP classified as GMFCS levels IV and V participated in BWSTT three times per week. The Segmental Assessment of Trunk Control (SATCo) and the gross motor function measure (GMFM-66) were assessed before and after the 6-week intervention.

RESULTS: Final testing revealed …

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 …

The Modified Dynamic Gait Index And Limits Of Stability In Myotonic Dystrophy Type 1, Evan M. Pucillo, Melissa M. Mcintyre, Mary Pautler, Man Hung, Jerry Bounsanga, Maren W. Voss, Heather Hayes, Deanna Dibella, Caren Trujillo, Melissa Dixon, Russell Butterfield, Nicholas E. Johnson

Physical Therapy Collection

INTRODUCTION:

The purpose of this study was to describe and compare the performance of balance and walking tests in relation to self-reported fall history in adults with myotonic dystrophy type 1 (DM1).

METHODS:

Twenty-two (13 male) participants with DM1 completed, a 6-month fall history questionnaire, the modified Dynamic Gait Index (mDGI), limits of stability (LoS) testing, and 10-m walking tests.

RESULTS:

Mean (SD) falls in 6 months was 3.7 (3.1), and 19 (86%) participants reported at least 1 fall. Significant differences in mDGI scores (P = 0.006) and 10-m fast walking gait velocity (P = 0.02) were found between those …

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 …

We Are Global Health: A Rejuvenating Perspective, Evan M. Pucillo, Edward C. O'Bryan

Physical Therapy Collection

No abstract provided.

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 …

Global Health And Disability: A Review And Call To Action For All Rehabilitation Professions, Evan M. Pucillo, Matthew B. Huish, Quinn Tate, Edward C. O'Bryan, Ty T. Dickerson

Physical Therapy Collection

The World Health Organization estimates 15% of the world’s population is living with disability and anticipates an increase as the population ages. Disability is a growing healthcare concern and presents a tremendous burden to all nations. The world will soon need to provide health and rehabilitative care for an enormous number of persons with disability. The purpose of this article is to provide a brief narrative review pertaining to global health and rehabilitation, and to motivate the rehabilitation professions in taking immediate action through further investment in global health initiatives to manage both the current and projected burden of disability. …

A Scoping Review Of Biopsychosocial Risk Factors And Co-Morbidities For Common Spinal Disorders, Bart N Green, Claire D Johnson, Scott Haldeman, Erin Griffith, Michael B Clay, Edward J Kane, Juan M Castellote, Shanmuganathan Rajasekaran, Matthew Smuck, Eric L Hurwitz, Kristi Randhawa, Hainan Yu, Margareta Nordin

Physical Therapy Collection

OBJECTIVE: The purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders.

METHODS: A scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities.

RESULTS: Of …

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.

Aging With The Fmr1 Gene: A Life Course Perspective, Cornelia Lieb-Lundell

Physical Therapy Collection

Fragile X syndrome (FXS) is one of three syndromes identified as a health condition related to fragile X mental retardation (FMR1) gene dysfunction. The other two conditions are Fragile X-associated primary ovarian insufficiency syndrome (FXPOI) and Fragile X-associated tremor/ataxia syndrome (FXTAS) which together are referred to as Fragile X-associated disorders (FXD). Even though the three conditions share a common genetic defect each one is a separate health condition that results in a variety of body function impairments such as motor delay, musculoskeletal issues related to low muscle tone, coordination limitations, ataxia, tremor, undefined muscle aches and pains; and, …

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 …

Attitudes And Beliefs Regarding Pain In Interprofessional Education: A Multifaceted Dilemma, Annie Burke-Doe, Kayla Smith, Kristen M. Johnson, Anna Edwards, Christopher J. Ivey, Ellen Lowe, Steve Laslovich, Christopher M. Ingstad, Jonathan P. Warren, Susan Mcnulty, Terri Roberts

Physical Therapy Collection

Purpose: To evaluate entry-level physical and occupational therapy student attitudes and beliefs toward treating a person with pain, at various levels of their didactic learning.

Description: Across health professions, pain education varies considerably with its curricula of pain definitions, management principles, and interprofessional collaboration. The result of this discord has led to a broad range of behaviors and attitudes among health professions and their students, which can ultimately affect a person’s participation in society. Literature supports the importance of a curriculum that addresses students’ attitudes and beliefs toward treating people in pain in an attempt to preclude the formation of …

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 …

Experiential Learning Enhances Physical Therapist Student Confidence In Management Of Neurologically-Involved Adults And Children, Kristen Barta, Megan Flores, Anna Edwards

Physical Therapy Collection

Purpose/ Hypothesis: As physical therapy (PT) students advance through an entry-level professional program, clinical decision making skills improve, though self-confidence in treating individuals with neurological impairments does not. One technique to improve PT student self-confidence with this population is the addition of experiential learning opportunities, which uses direct student interaction with community volunteers to simulate clinical application of didactic material. The purpose of this study was to explore the effect of experiential learning using community participants who were neurologically-involved, on PT students’ perceived self-confidence. It was hypothesized that PT students would report greater levels of self-confidence in their neurological …

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 …