Rehabilitation and Therapy Commons^™

Physical Therapy Management Of A Patient With Chronic Knee Pain: A Case Report, Mohamed Elsaid

Case Report Papers

Background and Purpose: Knee pain affects a large number of adults, and as a result limits their functional mobility and may induce participation restrictions. A number of risk factors may contribute to knee pain, with osteoarthritis (OA) being the most prevalent cause. The rate of knee replacement surgery among individuals 65 and older has increased significantly over the years. Physical therapy (PT) is a non-surgical option that offers individuals relief of their knee pain. Case Description: The patient was a 48-year-old Caucasian female referred to physical therapy with chronic right knee pain. She received PT twice a week for eight …

The Effect Of A Powered Ankle Foot Orthosis On Walking In A Stroke Subject: A Case Study, Ali Pourghasem, Ismail Ebrahimi Takamjani, Mohammad Taghi Karimi, Mohammad Kamali, Mohammad Jannesari, Iman Salafian

Department of Mechanical and Materials Engineering: Faculty Publications

[Purpose] Standing and walking are impaired in stroke patients. Therefore, assisted devices are required to restore their walking abilities. The ankle foot orthosis with an external powered source is a new type of orthosis. The aim of this study was to evaluate the performance of a powered ankle foot orthosis compared with unpowered orthoses in a stroke patient.

[Subjects and Methods] A single stroke subject participated in this study. The subject was fitted with three types of ankle foot orthosis (powered, posterior leg spring, and carbon ankle foot orthoses). He was asked to walk with and without the three types …

Management Of A Patient With Bronchiectasis Using Pulmonary Rehabilitation And Balance Training: A Case Report, Megan Witherow Quarles

Case Report Papers

Background and Purpose: Bronchiectasis is a chronic lung disease defined by permanent, abnormal dilation of the bronchi and accompanied by chronic airway infection which leads to airway inflammation. Bronchiectasis is progressive and leads to a cycle of worsening pulmonary damage. Pulmonary rehabilitation, including progressive gait training, cycling, and stair climbing, is often utilized as treatment for this condition. However, there has been little research conducted on its effectiveness for bronchiectasis. The purpose of this case report is to examine physical therapy (PT) management, utilizing pulmonary rehabilitation with incorporated balance training, for a geriatric patient with bronchiectasis. Description: The patient was …

E For Everyone: Strategic Plan, Lindsay Calcaterra, Kaela Fischer, Kelley Flahaven, Megan Witherow Quarles, Maria Stern, Christina Tilton

Physical Therapy Administration

‘E for Everyone’ is an innovative and unique inclusion program that equalizes the playing field among all people with and without disabilities by creating opportunities to build synergistic relationships through teamwork, fun, and physical activity. Created during the Fall 2016 semester of the course Physical Therapy Administration, this strategic plan summarizes the program.

E For Everyone: Implementation Guide, Lindsay Calcaterra, Kaela Fischer, Kelley Flahaven, Megan Witherow Quarles, Maria Stern, Christina Tilton

Physical Therapy Administration

‘E for Everyone’ is an innovative and unique inclusion program that equalizes the playing field among all people with and without disabilities by creating opportunities to build synergistic relationships through teamwork, fun, and physical activity. Created during the Fall 2016 semester, concurrent with the course Physical Therapy Administration, this implementation guide describes the step by step process for implementing the program.

Physical Therapy Management Of A Patient With Chronic Brainstem Stroke Syndrome To Improve Functional Mobility: A Case Report, Kelley Flahaven

Case Report Papers

Background and Purpose: Brainstem strokes are much less common and have a higher mortality rate than cortical strokes. Brainstem strokes can lead to several physical impairments, including gaze palsies, quadriplegia, ataxia, or cranial nerve deficits, leading to decreased balance and safety as well as decreased independence with functional activities. The purpose of this case report is to provide an overview of the physical therapy care plan created for a patient with chronic brainstem strokes. Case Description: The patient is a middle-aged man who had two brainstem strokes over two years ago. He initially received physical, occupational, and speech therapies, then …

Functional Training In A Patient With Middle Cerebral Artery Stroke With Multiple Comorbidities: A Case Report, Darien Lewis

Case Report Papers

Background and Purpose: Strokes affecting the middle cerebral artery (MCA) cause impairments of recovery affected by the patient’s premorbid status. Although there is a significant amount of research detailing physical therapy (PT) interventions for patients with hemiplegia, there is a lack of evidence supporting interventions for patients with hemiplegia following stroke that have multiple comorbidities. The purpose of this case report is to describe a progressive PT plan of care (POC) for a patient following MCA stroke with multiple comorbidities in the skilled nursing setting. Case Description: The patient was a 71-year-old male admitted to the skilled nursing facility (SNF) …

The Use Of Manual Therapy In The Treatment Of A Patient With Chronic Low Back Pain And Sciatica: A Case Report, Elia N. Darazi

Case Report Papers

Background: Chronic low back pain (CLBP) is one of the most common conditions encountered in an outpatient physical therapy (PT) setting. While there are many different approaches used in the treatment of CLBP, the purpose of this case report is to detail the successful utilization of a short-course of manual therapy (MT) for a patient with CLBP and sciatica. Case Description: The patient was a 60-year-old male who presented to PT with a medical diagnosis of nerve root compression-left sciatica. At the initial evaluation, he presented with radiating left sided low back and lower extremity pain of approximately six months …

Restoring Gait And Functional Mobility For A Patient With An Ischemic Stroke Through Physical Therapy: A Case Report, Colleen Kelly

Case Report Papers

Stroke is the primary cause of disability and care dependency in adults in the United States. Research has found that the risk of mortality post stroke can be greatly reduced through stroke rehabilitation. The purpose of this case report is to provide a framework of physical therapy rehabilitation that facilitated functional mobility and gait in a patient who experienced a stroke. The patient was a 50-year old male who was admitted to an inpatient rehabilitation hospital for physical therapy following a left middle cerebral artery ischemic stroke four days prior. The patient received three weeks of physical therapy after displaying …

Profiles Of Fatigue Severity And Variability Among Adolescents And Young Adults With Cerebral Palsy, Laura K. Brunton, Doreen J. Bartlett

Physical Therapy Publications

Background: Individuals with cerebral palsy (CP) experience progressive changes in functional status with the development of secondary impairments such as fatigue. Detailed accounts of the fatigue experience in CP are lacking.

Purpose: This study describes the severity and variability of fatigue in CP using the Fatigue Impact and Severity Self-Assessment.

Methods: This was a descriptive cross-sectional study surveying 130 (61 males) individuals (mean age 18 years, 11 months; SD four years, six months) with CP. Analyses comprised comparisons between two groups (Gross Motor Function Classification System (GMFCS) I and II-V), frequency counts and proportions.

Results: Significant differences exist between GMFCS …

Physical Therapy And Cognitive Behavioral Therapy In A Patient With Multiple Co-Morbidities – A Case Report, Jeanine Manubay

Case Report Papers

Background and Purpose: Cognitive behavioral therapy (CBT) is grounded in the premise that by altering a patient’s negative thought processes, one can improve functional and emotional health. When multiple co-morbidities limit traditional physical therapy interventions, CBT may be a consideration. While CBT has shown benefits in patients with cancer and others, there is a lack of research investigating its effectiveness in conjunction with physical therapy (PT) in the medically complex patient. The purpose of this case report was to document the outcomes of CBT along with traditional PT for a medically complex patient diagnosed with end stage renal disease and …

Use Of Functional Strengthening, Balance Training, And Stretching In The Treatment Of A Patient Following A T11-L5 Spinal Fusion: A Case Report, Anna Sidloski

Case Report Papers

Background and Purpose: Lumbar spinal fusion surgery has been utilized to manage levels of low back pain and instability. However, pain often persists post-operatively. Evidence supports the use of Transverse Abdominis recruitment in patients with LBP. Research demonstrates strengthening the hip musculature may allow for improved outcomes for those who experience LBP. There is limited research focusing on lower extremity strengthening, flexibility, and balance training in a patient following a T11-L5 spinal fusion. Case Description: The patient was a 68-year-old male presenting to physical therapy eight weeks’ status post T11-L5 spinal fusion with ~45 degrees forward-flexed posture, weak lower extremity …

Therapeutic Exercise In The Treatment Of Greater Trochanteric Pain Syndrome S/P Lumbar Discectomy: A Case Report, Sean Jeffrey

Case Report Papers

Background and Purpose: Greater trochanteric pain syndrome (GTPS) is a multifactorial cause of lateral hip pain, affecting between 1.8 and 5.6 patients per 1000 per year. The prevalence of GTPS is more common in patients with coexisting low back pain. Though discectomy is effective in the treatment of prolapsed lumbar intervertebral discs, it does not correct concurrent hip pathology. As GTPS in the setting of discectomy rehabilitation lacks defined treatment guidelines, the purpose of this case report is to display physical therapy (PT) treatment of GTPS in conjunction with simultaneous rehab from lumbar microdiscectomy.
Case Description: A 56-year-old male was …

Adaptations Of Lumbar Biomechanics After Four Weeks Of Running Training With Minimalist Footwear And Technique Guidance: Implications For Running-Related Lower Back Pain, Szu-Ping Lee, Joshua P. Bailey, Jo Armour Smith, Stephanie Barton, David Brown, Talia Joyce

Physical Therapy Faculty Articles and Research

Objectives

To investigate the changes in lumbar kinematic and paraspinal muscle activation before, during, and after a 4-week minimalist running training.

Design

Prospective cohort study.

Setting

University research laboratory.

Participants

Seventeen habitually shod recreational runners who run 10–50 km per week.

Main outcome measures

During stance phases of running, sagittal lumbar kinematics was recorded using an electrogoniometer, and activities of the lumbar paraspinal muscles were assessed by electromyography. Runners were asked to run at a prescribed speed (3.1 m/s) and a self-selected speed.

Results

For the 3.1 m/s running speed, significant differences were found in the calculated mean lumbar posture …

Physical Therapy Intervention For A Patient With Temporomandibular Joint Dysfunction Caused By Two Traumatic Events: A Case Study, Elyse Detweiler

Case Report Papers

Background and Purpose: Temporomandibular disorders (TMD) are pathoanatomical dysfunctions of the temporomandibular joint (TMJ) associated with symptoms throughout the head and neck.Limited information exists regarding conservative physical therapy (PT) and post-surgical management of TMD. The dental profession is the main source of published literature specific to TMD. This paper describes a conservative and post-surgical PT plan of care (POC) for TMD. Case Description: A 32-year old female experienced two separate traumatic events at work resulting in TMD. She was referred to PT after the second assault because of symptoms of severe pain, limited range of motion, and jaw locking. She …

Ot Department News- Issue #1

Department of Occupational Therapy Newsletter

No abstract provided.

Preseason Jump And Hop Measures In Male Collegiate Basketball Players: An Epidemiologic Report, Jason Brumitt, Amy Engilis, Dale Isaak, Amy Briggs, Alma Mattocks

Faculty Publications - College of Physical Therapy

Background: Injuries are inherent in basketball with lower extremity (LE) injury rates reported as high as 11.6 per 1000 athletic exposures (AEs); many of these injuries result in time loss from sport participation. A recent trend in sports medicine research has been the attempt to identify athletes who may be at risk for injury based on measures of preseason fitness.

Hypothesis/Purpose: The purpose of this prospective cohort study was to determine if the standing long jump (SLJ) and/or the single-leg hop (SLH) for distance functional performance tests (FPT) are associated with non-contact time loss lower quadrant (LQ, defined as lower …

Patient Experiences Of Recovery After Autologous Chondrocyte Implantation: A Qualitative Study, Jenny L. Toonstra, Dana Howell, Robert A. English, Carl G. Mattacola

EKU Faculty and Staff Scholarship

Context: The recovery process after autologous chondrocyte implantation (ACI) can be challenging for patients and clinicians alike due to significant functional limitations and a lengthy healing time. Understanding patients' experiences during the recovery process may assist clinicians in providing more individualized care.

Objective: To explore and describe patients' experiences during the recovery process after ACI.

Design: Qualitative study.

Setting: Orthopaedic clinic.

Patients or Other Participants: Participants from a single orthopaedic practice who had undergone ACI within the previous 12 months were purposefully selected.

Data Collection and Analysis: Volunteers participated in 1-on-1 semistructured interviews to describe their recovery experiences after ACI. …

Letter To The Editor Regarding “Clinical Effectiveness And Safety Of Powered Exoskeleton-Assisted Walking In Patients With Spinal Cord Injury: Systematic Review With Meta-Analysis”, Marcel P. Dijkers, Katherine G. Akers, Sujay S. Galen, Diane E. Patzer, Phuong T. Vu

Library Scholarly Publications

No abstract provided.

Development, Validation And Application Of A New Fornix Template For Studies Of Aging And Preclinical Alzheimer's Disease, Christopher A. Brown, Nathan F. Johnson, Amelia J. Anderson-Mooney, Gregory A. Jicha, Leslie M. Shaw, John Q. Trojanowski, Linda J. Van Eldik, Frederick A. Schmitt, Charles D. Smith, Brian T. Gold

Physical Therapy Faculty Publications

We developed a merged younger-older adult template of the fornix and demonstrated its utility for studies of aging and preclinical Alzheimer's disease (AD). In Experiment 1, probabilistic tractography was used to reconstruct the fornix in younger and older adults and successful streamlines were then averaged to create a merged template in standard space. The new template includes the majority of the fornix from the hippocampal formation to the subcallosal region and the thalamus/hypothalamus. In Experiment 2, the merged template was validated as an appropriate measure for studies of aging, with comparisons against manual tracing measures indicating identical spatial coverage in …

Temporary Nerve Block At Selected Digits Revealed Hand Motor Deficits In Grasping Tasks, Aude Cateron, Kerry Mcpartlan, Christina Gioeli, Emily Reid, Matt Turturro, Barry Hahn, Cynthia Benson, Wei Zhang

Publications and Research

Peripheral sensory feedback plays a crucial role in ensuring correct motor execution throughout hand grasp control. Previous studies utilized local anesthesia to deprive somatosensory feedback in the digits or hand, observations included sensorimotor deficits at both corticospinal and peripheral levels. However, the questions of how the disturbed and intact sensory input integrate and interact with each other to assist the motor program execution, and whether the motor coordination based on motor output variability between affected and non-affected elements (e.g., digits) becomes interfered by the local sensory deficiency, have not been answered. The current study aims to investigate the effect of …

Methylphenidate And Memory And Attention Adaptation Training For Persistent Cognitive Symptoms After Traumatic Brain Injury: A Randomized, Placebo-Controlled Trial, Brenna C. Mcdonald, Laura A. Flashman, David B. Arciniegas, Robert J. Ferguson, Li Xing, Jaroslaw Harezlak, Gwen C. Sprehn, Flora M. Hammond, Arthur C. Maerlender, Carrie L. Kruck, Karen L. Gillock, Kim Frey, Rachel N. Wall, Andrew J. Saykin, Thomas W. Mcallister

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

The purpose of this multicenter, prospective, randomized, placebo-controlled study was to evaluate and compare the efficacy of two cognitive rehabilitation interventions (Memory and Attention Adaptation Training (MAAT) and Attention Builders Training (ABT)), with and without pharmacologic enhancement (i.e., with methylphenidate (MPH) or placebo), for treating persistent cognitive problems after traumatic brain injury (TBI). Adults with a history of TBI at least four months prior to study enrollment with either objective cognitive deficits or subjective cognitive complaints were randomized to receive MPH or placebo and MAAT or ABT, yielding four treatment combinations: MAAT/MPH (N=17), ABT/MPH (N=19), MAAT/placebo (N=17), and ABT/placebo (N=18). …

Influence Of Posture-Cuing Shirt On Tennis Serve Kinematics In Division Iii Tennis Players, Joseph Zappala, Caroline Orrego, Emily Boe, Heather Fechner, Derek Salminen, Daniel Cipriani

Physical Therapy Faculty Articles and Research

Objective: Injuries to the shoulder complex are common in overhead athletes, often related to kinematics of the shoulder complex. This study evaluated the influence of a posture-cuing shirt on internal rotation velocity of the shoulder during a tennis swing and to determine this influence on shoulder external rotation position. Methods: Nine healthy competitive college tennis players from a Division III college participated in this study. High speed motion capture allowed for 3-D analysis of shoulder kinematics during a tennis serve. Two conditions were evaluated while the athletes performed a high velocity tennis serve: standard tennis shirt and a …

Standing Balance And Spatiotemporal Aspects Of Gait Are Impaired Upon Nocturnal Awakening In Healthy Late Middle-Aged And Older Adults, Amanda L. Mcbean, Raymond P. Najjar, Ronald A. Schuchard, Courtney D. Hall, Cheng-Ann Wang, Ban Ku, Joseph M. Furman

ETSU Faculty Works

Study Objectives: Nocturnal awakenings may constitute a unique risk for falls among older adults. We describe differences in gait and balance between presleep and midsleep testing, and whether changes in the lighting environment during the midsleep testing further affect gait and balance.

Methods: Twenty-one healthy, late middle-aged and older (64.7 ± 8.0 y) adults participated in this repeated-measures design consisting of four overnight laboratory stays. Each night, participants completed baseline visual acuity, gait, and balance testing. After a 2-h sleep opportunity, they were awakened for 13 min into one of four lighting conditions: very dim white light (< 0.5 lux); dim white light (∼28.0 lux); dim orange light (∼28.0 lux); and white room-level light (∼200 lux). During this awakening, participants completed the same sequence of testing as at baseline.

Results: Low-contrast …

The Nature Of Movement Symmetry: Implications For Function And Injury Risk, Laura Broudy, Spt, Aerie Glowka, Spt, Katie Schaner, Spt, Michelle Wrigley, Spt, Danny Mcmillian, Dsc, Mpt, Cscs

Physical Therapy Research Symposium

Human movement requires an equipoise of mobility, strength, and neuromuscular control for optimal performance and injury protection. When certain movement asymmetries are present they create functional impairments that can negatively impact an individual’s performance and increase the likelihood for injury. This results in decreased quality of life due to missed time from work, sport, or social interaction and increased financial burden. There is limited evidence addressing what degree of asymmetry impacts functional performance or increases injury risk. Some activities such as throwing are naturally asymmetrical, thus asymmetry of the upper extremity may be beneficial in specific occupations or sporting professions. …

The Safety And Efficacy Of Physical Agents On Cancer Survivors: An Update, Katelyn Ratliff Spt, Gentry Ensign Spt, Kathryn Flyte Spt, Michael Moore Spt, Ann Wilson Pt, M.Ed., Gcs

Physical Therapy Research Symposium

Title: The Safety and Efficacy of Physical Agents on Cancer Survivors: An Update

Authors: Gentry Ensign, SPT¹; Kathryn Flyte, SPT¹; Michael Moore, SPT¹; Katelyn Ratliff, SPT¹; Ann Wilson, P.T., M.Ed., GCS¹

Affiliations: 1. School of Physical Therapy, University of Puget Sound

Theory: Cancer patients are often referred to physical therapy to treat impairments associated with cancer, its treatment, and the disease progression. Physical therapists sometimes use physical agents as part of a complete rehabilitation program for the purpose of decreasing pain, increasing strength, and facilitating tissue healing while avoiding possible malignant …

Lymphedema Therapy For The Treatment Of Complex Regional Pain Syndrome, Sarah Armstrong, Jake Look, L. Fletcher Christie, Roger Allen

Physical Therapy Research Symposium

Theory:

This proposal presents the theory that the use of early lymphatic management techniques for patients who suffer from complex regional pain syndrome (CRPS) can limit CNS remodeling, preventing progression of the disorder. In absence of high quality evidence, we interviewed multiple lymphedema therapists to assist in the generation of a lymphatic management protocol for use with patients experiencing CRPS-associated pain and edema.

The pathophysiology of CRPS-associated edema is not fully understood. Potential causes may include vasomotor dysregulation or neurogenic inflammation. Regardless of its cause, edema and pain may lead to excessive muscle guarding and kinesiophobia. Targeting edema early may …

Wearable Imu For Shoulder Injury Prevention In Overhead Sports, Samir A. Rawashdeh, Derek A. Rafeldt, Timothy L. Uhl

Physical Therapy Faculty Publications

Body-worn inertial sensors have enabled motion capture outside of the laboratory setting. In this work, an inertial measurement unit was attached to the upper arm to track and discriminate between shoulder motion gestures in order to help prevent shoulder over-use injuries in athletics through real-time preventative feedback. We present a detection and classification approach that can be used to count the number of times certain motion gestures occur. The application presented involves tracking baseball throws and volleyball serves, which are common overhead movements that can lead to shoulder and elbow overuse injuries. Eleven subjects are recruited to collect training, testing, …

Differential Item Functioning In The Patient Reported Outcomes Measurement Information System Pediatric Short Forms In A Sample Of Children And Adolescents With Cerebral Palsy., Wendy J. Coster, Pengsheng Ni, Mary D. Slavin, Pamela A. Kisala, Ratna Nandakumar, Mary Jane Mulcahey, David S. Tulsky, Alan M. Jette

Department of Occupational Therapy Faculty Papers

AIM: The present study examined the Patient Reported Outcomes Measurement Information System (PROMIS) Mobility, Fatigue, and Pain Interference Short Forms (SFs) in children and adolescents with cerebral palsy (CP) for the presence of differential item functioning (DIF) relative to the original calibration sample.

METHOD: Using the Graded Response Model we compared item parameter estimates generated from a sample of 303 children and adolescents with CP (175 males, 128 females; mean age 15y 5mo) to parameter estimates from the PROMIS calibration sample, which served as the reference group. DIF was assessed in a two-step process using the item response theory-likelihood ratio-differential …

Defending The Art Of Physical Therapy: Expanding Inquiry And Crafting Culture In Support Of Therapeutic Alliance, Nicole Brun-Cottan Spt, Jennifer Hastings Pt, Ph.D, Ncs, Danny Mcmillian Pt, Dsc, Ocs

Physical Therapy Research Symposium

Title: Defending the Art of Physical Therapy: Expanding Inquiry and Crafting Culture in Support of Therapeutic Alliance

Authors: Nicole Brun-Cottan¹, SPT, Danny McMillian PT DSc.¹, Jennifer Hastings, PT PhD. ,NCS.¹

Affiliations 1. School of Physical Therapy, University of Puget Sound, Tacoma WA, USA.

Theory/Body: The successful practice of physical therapy within the biopsychosocial construct requires a professional culture that places value on the interpersonal relationships that foster healing and the face time required to build those relationships. The unfortunate truth is that pressures on current practice are not facilitating this dynamic approach. The drive for …