Rehabilitation and Therapy Commons^™

Effects Of Voluntary Breathing On Force Responses To Electrical Stimulation (Es) Of Finger Extensors : A Pilot Study, Shang Li, W. H. Park, Elizabeth Ikeda, Charles Leonard

Physical Therapy and Rehabilitation Science Faculty Publications

Voluntary breathing can influence motor functions of non-respiratory skeletal muscles, e.g., finger muscles. The influence was proposed to be mediated by the ventilation-associated enhancement on corticospinal excitability of the finger muscles, possibly including spinal mechanisms. Force responses to electrical stimulation include spinal mechanisms. The purpose was to investigate the potential spinal mechanism mediating the voluntary breathing effects on responses of finger extension forces to electrical stimulation. A single-pulse electrical stimulation of the same intensity was delivered to the extensor digitorum communis (EDC) during voluntary breathing (forced inspiration, IN and force expiration, OUT) and normal breathing (Norm) across various submaximal levels …

Developing "Human Functioning And Rehabilitation Research" From The Comprehensive Perspective., Gerold Stucki, Jan Dietrich Reinhardt, Gunnar Grimby, John Melvin

Department of Rehabilitation Medicine Faculty Papers

With the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) has prepared the ground for a comprehensive understanding of Human Functioning and Rehabilitation Research, integrating the biomedical perspective on impairment with the social model of disability. This poses a number of old and new challenges regarding the enhancement of adequate research capacity. Here we will summarize approaches to address these challenges with respect to 3 areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programmes and the building of university centres and collaboration networks.

Reference Group Data For The Functional Gait Assessment, Martha L. Walker, Alvis G. Austin, Gina M. Banke, Suzanne R. Foxx, Lynn Gaetano, Laurie A. Gardner, Jill Mcelhiney, Kisiah Morris, Liz Penn

Rehabilitation Sciences Faculty Publications

Background and Purpose: The Functional Gait Assessment (FGA) is a clinical tool for evaluating performance in walking. The purpose of this study was to determine age-referenced norms for performance on the FGA in community-living older adults.

Subjects: Subjects were 200 adults, ages 40 to 89 years, living independently.

Methods: Each subject completed the FGA one time and was scored simultaneously by 2 testers.

Results: The intraclass correlation coefficient for interrater reliability was .93. Mean scores for the FGA ranged from 29/30 for adults in their 40s to 21/30 for adults in their 80s.

Discussion and Conclusion: Patient performance on the …

Assistive Technology Enhancement Of Written Expression For Individuals With Neurodevelopmental Disorders, Laura Greiss Hess, Kerrie Lemons Chitwood, Susan Harris

Collected Faculty and Staff Scholarship

This study involves the use of computer software to assess the use of assistive technology (AT) in individuals with neurodevelopmental disorders. We will present an update of the subjects in the study, including research issues, subject diagnoses and diagnostic trends as assessed through baseline and follow-up testing.

Assistive Technology Enhancement Of Written Expression For Individuals With Neurodevelopmental Disorders [Poster], Laura Greiss Hess, Kerrie Lemons Chitwood, Susan Harris

Collected Faculty and Staff Scholarship

The purpose of this project is to carry out an intensive training program in subjects with a broad range of neurodevelopmental disabilities to assess the efficacy of assistive technology (AT) intervention.

Cec: Clinical Exchange Corner, Mary Lloyd Moore, Laura Reynolds

CEC Publications

No abstract provided.

Mechanisms Of Fatigue Differ After Low- And High-Force Fatiguing Contractions In Men And Women, Tejin Yoon, Bonnie A. Schlinder-Delap, Erin E. Griffith, Sandra K. Hunter

Exercise Science Faculty Research and Publications

The magnitude of failure in voluntary drive after fatiguing contractions of different intensities in men and women is not known. The purpose of this study was to compare the time to task failure and voluntary activation of men and women for a sustained isometric contraction performed at a low and high intensity with the elbow flexor muscles. Nine men and nine women sustained an isometric contraction at 20% and 80% of maximal voluntary contraction (MVC) force until task failure during separate sessions. The men had a shorter time to failure than women for the 20% but not the 80% MVC …

The Realization Of The Rights To Health, Education And Social Welfare Among Disabled Youth In Ingwavuma And Bhambanana, Kwazulu Natal, Ali Mumford

Independent Study Project (ISP) Collection

This practicum based study was completed in an effort to explore the realization of the rights to health, education and social welfare for disabled children in Ingwavuma and Bhambana, KwaZulu Natal. Very little research has been done on disabled children in South Africa, and estimations of prevalence range from 3.3-6.4%. The absence of accurate data creates a situation where implementation of policy and delivery of services is slow and does not always address the most urgent needs. The new South Africa aimed to bring rights and freedom to all groups of people, but the question which this study attempts to …

Understanding Ayres' Sensory Integration, Susanne Smith Roley, Zoe Mailloux, Heather Miller-Kuhaneck, Tara J. Glennon

Occupational Therapy Faculty Publications

Occupational therapists and occupational therapy assistants rely on knowledge and skills to guide their intervention planning as they help clients who are experiencing difficulties with engaging in occupation. Sensory integration theory, with its rich history grounded in the science of human growth and development, offers occupational therapy practitioners specific intervention strategies to remediate the underlying sensory issues that affect functional performance.

This article articulates the core principles of sensory integration as originally developed by Dr. A. Jean Ayres, explains the rationale for developing a trademark specifically linked to these core principles, and identifies the impact that this trademark can have …

An Exploratory Survey Of Occupational Therapists' Role In Hippotherapy, Cristina Cerquozzi, Ericka Cerquozzi, Amy Darragh, Heather Miller-Kuhaneck

Occupational Therapy Faculty Publications

The term hippotherapy is derived from the Greek word for horse, or hippos. The American Hippotherapy Association (2007) defines hippotherapy as an occupational, physical, or speech therapy intervention strategy, using the movements of a horse, used as part of an intervention program to facilitate functional gain. In hippotherapy, therapists use the movements of the horse as a vehicle for improving clients' functional limitations. Hippotherapy is an intervention method mentioned in the occupational therapy literature more than 20 years ago (Engel, 1984) that has received minimal research attention within our field. Little is known about the role of occupational therapists in …

Acute Reperfusion Therapy In St-Elevation Myocardial Infarction From 1994-2003, Brahmajee K. Nallamouthu, Martha E. Blaney, Susan M. Morris, Lori Parsons, Dave P. Miller, John G. Canto, Hal V. Barron, Harlan M. Krumholz

Collected Faculty and Staff Scholarship

Background—Appropriate utilization of acute reperfusion therapy is not a national performance measure for ST-elevation myocardial infarction at this time, and the extent of its contemporary use among ideal patients is unknown.

Methods—From the National Registry of Myocardial Infarction, we identified 238,291 patients enrolled from June 1994 to May 2003 who were ideally suited for acute reperfusion therapy with fibrinolytic therapy or primary percutaneous coronary intervention. We determined rates of not receiving therapy across 3 time periods (June 1994–May 1997, June 1997–May 2000, June 2000– May 2003) and evaluated factors associated with underutilization.

Results—The proportion of ideal patients …

Intervention To Enhance Skilled Arm And Hand Movements After Stroke: A Feasibility Study Using A New Virtual Reality System, Jill Campbell Stewart Pt,Phd, Shih-Ching Yeh, Younbo Jung, Hyunjin Yoon

Faculty Publications

Background: Rehabilitation programs designed to develop skill in upper extremity (UE) function after stroke require progressive practice that engage and challenge the learner. Virtual realty (VR) provides a unique environment where the presentation of stimuli can be controlled systematically for optimal challenge by adapting task difficulty as performance improves. We describe four VR tasks that were developed and tested to improve arm and hand movement skills for individuals with hemiparesis. Methods: Two participants with chronic post-stroke paresis and different levels of motor severity attended 12 training sessions lasting 1 to 2 hours each over a 3-week period. Behavior measures and …

The Physiological Consequences Of Bed Rest, Kristin J. Stuempfle, Daniel G. Drury

Health Sciences Faculty Publications

Bed rest often is used to treat a wide variety of medical conditions. However, bed rest results in profound deconditioning of the body. Bed rest reduces the hydrostatic pressure gradient within the cardiovascular system, reduces muscle force production, virtually eliminates compression on the bones, and lowers total energy expenditure. This review focuses on the deconditioning that occurs in the cardiovascular, muscular, and skeletal systems following bed rest. Reduction in plasma volume reduces cardiac preload, stroke volume, cardiac output, and ultimately, maximal oxygen consumption. Skeletal muscle volume, muscle cross sectional area, and fiber cross sectional area decrease, which results in diminished …

Bactericidal And Cytotoxic Effects Of Chloramine-T On Wound Pathogens And Human Fibroblasts In Vitro, Luther C. Kloth, Joseph E. Berman, Linda Jean Laatsch-Lybeck, Phyllis A. Kirchner

Physical Therapy Faculty Research and Publications

OBJECTIVES: To evaluate cytotoxicity and bactericidal effects of chloramine-T.

METHODS: In vitro study of various concentrations and exposure times to preparations containing human fibroblasts or 1.5 x 10⁸ colony forming units per milliliter (CFU/mL) of 3 gram-positive bacteria-Staphylococcus aureus, methicillin-resistant S aureus, and vancomycin-resistant Enterococcus faecalis-and 2 gram-negative bacteria-Escherichia coli and Pseudomonas aeruginosa-with and without fetal bovine serum present.

MAIN OUTCOME MEASURES: Percentage reduction of bacterial growth and percentage of viable fibroblasts 48 hours after exposure.

RESULTS: All gram-positive growth was reduced by 95% to 100%, regardless of dose, with or without serum. …

Concept Mapping 101, Heather Miller-Kuhaneck, Joanne M. Bortone, Lenore Frost

Occupational Therapy Faculty Publications

Concept maps are visual depictions of information, generally in diagram form, that are used to enhance and document learning (Novak, 1990; Whiteley, 2005). As a learning tool, concept maps have been used for many years in the fields of education and nursing (Novak, 1990; Schuster, 2002). The methods and uses of concept mapping have evolved in the areas of academic education, clinical education, and research since the 1970s (All & Havens, 1997; Novak, 1990; Schuster, 2002; Whiteley, 2005). This article discusses the use of concept mapping in occupational therapy education.

Co-Localization Of P-Creb And P-Nr1 In Spinothalamic Neurons In A Chronic Muscle Pain Model, Marie K. Hoeger Bement, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Activation of the cAMP pathway is an important mediator of chronic muscle pain. This study examined phosphorylation of the transcription factor cAMP-response-element-binding protein (p-CREB) and the NR1 subunit of the NMDA receptor (p-NR1) in the spinal cord. Bilateral mechanical hyperalgesia of the paw was induced by administering two injections of acidic saline, 5 days apart, into the gastrocnemius muscle of male Sprague–Dawley rats. The proportion of spinothalamic neurons that expressed p-NR1 or p-CREB did not change in the dorsal horn 24 h after the second intramuscular acid injection compared with animals that received pH 7.2 injections. This lack of change …

Antibacterial Activity Of Positive And Negative Polarity Low-Voltage Pulsed Current (Lvpc) On Six Typical Gram-Positive And Gram-Negative Bacterial Pathogens Of Chronic Wounds, Georg Daeschlein, Ojan Assadian, Luther C. Kloth, Christina Meinl, Frank Ney, Axel Kramer

Physical Therapy Faculty Research and Publications

The positive effect of electrical stimulation (ES) on wound healing has been shown in vitro and in vivo. On the basis of increased blood flow, protein denaturation, and stimulation of cellular defense, an antibacterial effect of ES is to be expected. Although the antibacterial effect of ES already has been demonstrated in vitro, little attention has been paid to the direct antibacterial effect of changing polarity of the applied current. The aim of this study was to investigate the antibacterial effect of positive and negative monophasic low-voltage pulsed current on typical Gram-positive and Gram-negative pathogens of chronic wounds. Using the …

A Case Study Of School Age Female Minority Athletes Who Became Pregnant, Floyd Jones Phd, Jennifer Y. Mak, Phyllis A. Jones Ed

Management Faculty Research

The purpose of this study is to provide an in-depth understanding of ''What had happened to the urban minority female athletes who became pregnant while playing high school basketball?'' The study wanted to provide a qualitative analysis of rich narrative data collected from questionnaire interviews of two separate groups (one in Pittsburgh, the other in New York City). The findings of this study suggest that in fact urban female African-Americans athletes still received benefits from sports participation.

Preventing And Treating Type 2 Diabetes Through A Physically Active Lifestyle, Raymond W. Leung, Jim Kamla, Man-Cheong Lee, Jennifer Y. Mak

Management Faculty Research

By the late 1960s, the increasing number of type 2 diabetic cases in children and adolescents rapidly presented a signifi cant public health issue recognized by the American Diabetes Association (2000). Since then, the prevalence of pediatric type 2 diabetes appears to be on the rise not only in the United States but all around the world (Gungor et al., 2005). In the United States, an increase from fewer than four percent to more than 50 percent of new cases of type 2 diabetes in the pediatric population was reported between the years of 1982 and 1998 (American Diabetes Association, …

The Relationship Between Ankle, Hindfoot, And Forefoot Position And Posterior Tibial Muscle Excursion, Adolph S. Flemister, Christopher G. Neville, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: The purpose of this study was to examine the relationship of forefoot position in the transverse plane (abduction/adduction), hindfoot position in the frontal plane (eversion/inversion), and ankle position in the sagittal plane (plantarflexion/dorsiflexion) with posterior tibialis (PT) muscle excursion using an in vitro cadaver model.

Methods: Seven fresh-frozen cadaver specimens were potted and mounted on a frame. The PT tendon was dissected 15 cm proximal to the medial malleolus, and a 5-kg weight was sutured to the tendon. A six-camera motion analysis system (Optotrak, Northern Digital, Inc.) was used to track three-dimensional (3D) motion of the tibia, calcaneus (hindfoot) …

Smoking During Pregnancy Affects Speech-Processing Ability In Newborn Infants, Alexandra P.F. Key, Melissa Ferguson, Dennis L. Molfese, Kelley Peach, Victoria J. Molfese

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

BACKGROUND: Tobacco smoking during pregnancy is known to adversely affect development of the central nervous system in babies of smoking mothers by restricting utero–placental blood flow and the amount of oxygen available to the fetus. Behavioral data associate maternal smoking with lower verbal scores and poorer performance on specific language/auditory tests.

OBJECTIVES: In the current study we examined the effects of maternal smoking during pregnancy on newborns’ speech processing ability as measured by event-related potentials (ERPs).

METHOD: High-density ERPs were recorded within 48 hr of birth in healthy newborn infants of smoking (n = 8) and nonsmoking …

Occupational Therapy Using A Sensory Integrative Approach: A Case Study Of Effectiveness., Roseann C. Schaaf, Kathleen Mckeon Nightlinger

Department of Occupational Therapy Faculty Papers

OBJECTIVE: This article presents a case report of a child with poor sensory processing and describes the disorders impact on the child's occupational behavior and the changes in occupational performance during 10 months of occupational therapy using a sensory integrative approach (OT-SI).

METHOD: Retrospective chart review of assessment data and analysis of parent interview data are reviewed. Progress toward goals and objectives is measured using goal attainment scaling. Themes from parent interview regarding past and present occupational challenges are presented.

RESULTS: Notable improvements in occupational performance are noted on goal attainment scales, and these are consistent with improvements in behavior. …

Lessons Learned: A Pilot Study On Occupational Therapy Effectiveness For Children With Sensory Modulation Disorder., Lucy Jane Miller, Sarah A. Schoen, Katherine James, Roseann C Schaaf

Department of Occupational Therapy Faculty Papers

OBJECTIVE: The purpose of this pilot study was to prepare for a randomized controlled study of the effectiveness of occupational therapy using a sensory integration approach (OT-SI) with children who have sensory processing disorders (SPD).

METHOD: A one-group pretest, posttest design with 30 children was completed with a subset of children with SPD, those with sensory modulation disorder.

RESULTS: Lessons learned relate to (a) identifying a homogeneous sample with quantifiable inclusion criteria, (b) developing an intervention manual for study replication and a fidelity to treatment measure, (c) determining which outcomes are sensitive to change and relate to parents' priorities, and …

Fidelity In Sensory Integration Intervention Research., L Diane Parham, Ellen S. Cohn, Susan Spitzer, Jane A. Koomar, Lucy Jane Miller, Janice P Burke, Barbara Brett-Green, Zoe Mailloux, Teresa A. May-Benson, Susanne Smith Roley, Roseann C. Schaaf, Sarah A. Schoen, Clare A. Summers

Department of Occupational Therapy Faculty Papers

OBJECTIVE: We sought to assess validity of sensory integration outcomes research in relation to fidelity (faithfulness of intervention to underlying therapeutic principles).

METHOD: We identified core sensory integration intervention elements through expert review and nominal group process. Elements were classified into structural (e.g., equipment used, therapist training) and therapeutic process categories. We analyzed 34 sensory integration intervention studies for consistency of intervention descriptions with these elements.

RESULTS: Most studies described structural elements related to therapeutic equipment and interveners' profession. Of the 10 process elements, only 1 (presentation of sensory opportunities) was addressed in all studies. Most studies described fewer than …

Goal Attainment Scaling As A Measure Of Meaningful Outcomes For Children With Sensory Integration Disorders., Zoe Mailloux, Teresa A. May-Benson, Clare A. Summers, Lucy Jane Miller, Barbara Brett-Green, Janice P. Burke, Ellen S. Cohn, Jane A. Koomar, L Diane Parham, Susanne Smith Roley, Roseann C. Schaaf, Sarah A. Schoen

Department of Occupational Therapy Faculty Papers

Goal attainment scaling (GAS) is a methodology that shows promise for application to intervention effectiveness research and program evaluation in occupational therapy (Dreiling & Bundy, 2003; King et al., 1999; Lannin, 2003; Mitchell & Cusick, 1998). This article identifies the recent and current applications of GAS to occupational therapy for children with sensory integration dysfunction, as well as the process, usefulness, and problems of application of the GAS methodology to this population. The advantages and disadvantages of using GAS in single-site and multisite research with this population is explored, as well as the potential solutions and future programs that will …

Point/Counterpoint: Are Specific Spine Stabilization Exercises Necessary For Athletes?, J. Gray, Jason Brumitt, Loren Z.F. Chiu

Faculty Publications - College of Physical Therapy

The issue of spine stabilization has received considerable attention in recent years; although there are many proponents for specific training of spinal musculature, there is debate as to whether it is beneficial and required for athletes.

Influence Of Anticipation On Movement Patterns In Subjects With Acl Deficiency Classified As Noncopers, Jeff R. Houck, Kenneth E. De Haven, Mike Maloney

Faculty Publications - College of Physical Therapy

Study Design: Two-factor, mixed experimental design.

Objectives: To compare movement patterns of subjects who are anterior cruciate ligament (ACL) deficient and classified as noncopers to controls during early stance of anticipated and unanticipated straight and cutting tasks.

Background: Altered neuromuscular control of subjects that are ACL deficient and noncoper theoretically influences movement patterns during unanticipated tasks.

Methods and Measures: The study included 16 subjects who are ACL deficient, classified as noncopers, and 20 healthy controls. Data were collected using an Optotrak Motion Analysis System and force plate integrated with Motion Monitor Software to generate knee joint angles, moments, and power. …

Bereavement In The Modern Western World, David San Filippo Ph.D.

Faculty Publications

Bereavement is the process of suffering that follows the loss of a living being that is significant to someone. When one suffers, she or he has to endure an unpleasant experience, in the case of bereavement, the loss of something special to the person. This loss most often is a loved one but could also include the loss of a pet, relationship, or physical or mental capability. This state of suffering is called grief. In describing his grief, C. S. Lewis stated, after the loss of his wife, “No one ever told me that grief felt so much like fear. …

Enhancement Of Claims Data To Improve Risk Adjustment Of Hospital Mortality, Michael Pine, Harmon S. Jordan, Anne Elixhauser, Donald E. Fry, David C. Hoaglin, Barbara Jones, Roger Meimban, David Warner, Junius Gonzales

Publications from Provost Junius J. Gonzales

Context Comparisons of risk-adjusted hospital performance often are important components of public reports, pay-for-performance programs, and quality improvement initiatives. Risk-adjustment equations used in these analyses must contain sufficient clinical detail to ensure accurate measurements of hospital quality.

Objective To assess the effect on risk-adjusted hospital mortality rates of adding present on admission codes and numerical laboratory data to administrative claims data.

Design, Setting, and Patients Comparison of risk-adjustment equations for inpatient mortality from July 2000 through June 2003 derived by sequentially adding increasingly difficult-to-obtain clinical data to an administrative database of 188 Pennsylvania hospitals. Patients were hospitalized for acute myocardial …

Effects Of Ingesting Javafit Energy Extreme Functional Coffee On Aerobic And Anaerobic Fitness Markers In Recreationally-Active Coffee Consumers, M. D. Roberts, L. W. Taylor, J. A. Wismann, C. D. Wilborn, R. B. Kreider, D. S. Willoughby

Physical Therapy

No abstract provided.