Rehabilitation and Therapy Commons^™

Diagnosis Of Internal Carotid Artery Stenosis In A Patient Referred To A Physiotherapist For Dizziness, Ryan Boggs, Michael Ross, Michael Tall

Articles & Book Chapters

PURPOSE: The purpose of this report is to describe the diagnostic focus of the clinical decision-making process for a patient referred to a physiotherapist for treatment of persistent dizziness, who was subsequently diagnosed with severe stenosis of the internal carotid arteries.

CASE DESCRIPTION: The patient was a 79-year-old man who was referred to a physiotherapist by his primary care physician for the treatment of persistent intermittent dizziness. The patient’s dizziness began 6 months prior insidiously; it was worsening over time and now interfered with activities of daily living. The patient denied cervical pain or headaches, numbness or tingling in his …

Impact Of Motor Therapy With Dynamic Body-Weight Support On Functional Independence Measures In Traumatic Brain Injury: An Exploratory Study, Emily F. Anggelis, Elizabeth Salmon Powell, Philip M. Westgate, Amanda C. Glueck, Lumy Sawaki

Physical Medicine and Rehabilitation Faculty Publications

BACKGROUND: Contemporary goals of rehabilitation after traumatic brain injury (TBI) aim to improve cognitive and motor function by applying concepts of neuroplasticity. This can be challenging to carry out in TBI patients with motor, balance, and cognitive impairments.

OBJECTIVE: To determine whether use of dynamic body-weight support (DBWS) would allow safe administration of intensive motor therapy during inpatient rehabilitation and whether its use would yield greater improvement in functional recovery than standard-of-care (SOC) therapy in adults with TBI.

METHODS: Data in this retrospective cohort study was collected from patients with TBI who receive inpatient rehabilitation incorporating DBWS (n = …

Genetic Taster Status As A Mediator Of Neural Activity And Swallowing Mechanics In Healthy Adults, Angela M. Dietsch, Ross M. Westemeyer, William G. Pearson Jr., Douglas H. Schultz

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

As part of a larger study examining relationships between taste properties and swallowing, we assessed the influence of genetic taster status (GTS) on measures of brain activity and swallowing physiology during taste stimulation in healthy men and women. Twenty-one participants underwent videofluoroscopic swallowing study (VFSS) and functional magnetic resonance imaging (fMRI) during trials of high-intensity taste stimuli. The precisely formulated mixtures included sour, sweet-sour, lemon, and orange taste profiles and unflavored controls. Swallowing physiology was characterized via computational analysis of swallowing mechanics plus other kinematic and temporal measures, all extracted from VFSS recordings. Whole-brain analysis of fMRI data assessed blood …

Anterior Talofibular Ligament And Superior Extensor Ankle Retinaculum Thicknesses: Relationship With Balance, Brooke Malloy, David Furrow, Haily Cook, Elizabeth Smoot, Lindsey Cash, Adrian Aron, Kristen Jagger, Brent Harper

Physical Therapy Faculty Articles and Research

Purpose

This study determined if anterior talofibular ligament (ATFL)/superior extensor ankle retinaculum (SEAR) thicknesses are related to dynamic balance in individuals with chronic ankle instability (CAI).

Materials and Methods

The subjects were 14 males and 15 females (age=24.52±3.46 years). Ankle instability was assessed using the Cumberland Ankle Instability Tool (CAIT) with a cut off score of 25 to define two groups. SonoSite MTurbo (Fugifilm Sonosite, Inc.) musculoskeletal ultrasound (MSKUS) unit was used to assess ATFL and SEAR thicknesses. Dynamic balance was measured with the Y Balance Test (YBT) and two NeuroCom balance tests.

Results

There were no significant differences in …

How Degrees Of Freedom Affects Sense Of Agency, Akima Connelly, Jungsu Pak, Tian Lan, Uri Maoz

Student Scholar Symposium Abstracts and Posters

Can the rubber-hand illusion be extended to a moving robotic arm in different degrees of freedom (DOF), inducing sense of ownership & agency over the arm? We hypothesize that DOF closer to what humans possess will result in a stronger sense of ownership and agency.

Chronic Muscle Weakness And Mitochondrial Dysfunction In The Absence Of Sustained Atrophy In A Preclinical Sepsis Model, Allison M. Owen, Samir P. Patel, Jeffrey D. Smith, Beverly K. Balasuriya, Stephanie F. Mori, Gregory S. Hawk, Arnold J. Stromberg, Naohide Kuriyama, Masao Kaneki, Alexander G. Rabchevsky, Timothy A. Butterfield, Karyn A. Esser, Charlotte A. Peterson, Marlene E. Starr, Hiroshi Saito

Physiology Faculty Publications

Chronic critical illness is a global clinical issue affecting millions of sepsis survivors annually. Survivors report chronic skeletal muscle weakness and development of new functional limitations that persist for years. To delineate mechanisms of sepsis-induced chronic weakness, we first surpassed a critical barrier by establishing a murine model of sepsis with ICU-like interventions that allows for the study of survivors. We show that sepsis survivors have profound weakness for at least 1 month, even after recovery of muscle mass. Abnormal mitochondrial ultrastructure, impaired respiration and electron transport chain activities, and persistent protein oxidative damage were evident in the muscle of …

Can Eccentric Exercise Of The Lower Limb Be Made More Efficiently, A Pilot Study, Jerrold S. Petrofsky, Robert Donatelli, James M. Mckivigan, Michael S. Laymon

College of Health & Human Services (TUN) Publications and Research

Abstract Background: Eccentric Exercise has been shown to be more effective in building muscle and healing damaged tissue than concentric or isometric exercise. It has also been shown to be effective in increasing motor control. But the duration of therapeutic exercise in physical therapy is limited by insurance to 30-60 minutes a day. Objectives: Four standard therapy eccentric exercises of the lower limbs were compared (toe raise, ball exercise, side lying eccentric exercise and incline board exercise) to a trainer called the BTE Eccentron to see if the efficiency of exercise could be increased using one exercise session to meet …

Functional Mobility In A Patient With Antiphospholipid Antibody Syndrome Following A Femoral Neck Fracture Surgical Repair: A Case Report, Mckenna Young

Case Report Papers

Background and Purpose: The main focus of chronic disease in healthcare has typically been about treatment of the disease itself, with little attention given to secondary injuries that result from the chronic disease process. As these individuals age, the risk of secondary injuries increases. This is costly and adds to the caregiver burden. The purpose of this case report was to investigate a comprehensive physical therapy (PT) program focused on rehabilitation for a female with chronic disease who sustained a femoral fracture following her most recent fall. Case Description: A 42-year-old female presented to outpatient PT following a right femoral …

Tissue Plasminogen Activator Effects On Stroke And Physical Therapy Outcomes In Acute Care: A Case Report, Lindsey Leboeuf

Case Report Papers

Background and Purpose: An ischemic stroke occurs when blood flow to an area of the brain is restricted and can cause numbness or weakness on one side of the body, facial droop, trouble speaking, and trouble walking. Patients who seek medical attention for symptoms within three hours of their onset can be eligible to receive tissue plasminogen activator (tPA). These patients often have less resultant disability than their counterparts who did not receive the drug. The purpose of this case reports is to display the positive effects of tPA and physical rehabilitation following a stroke in the acute care setting. …

Combining A Comprehensive Physical Therapy Program And Electrocorpeal Shockwave Therapy For Plantar Fasciitis: A Case Report, Kathryn Piersiak

Case Report Papers

Background and Purpose: Plantar fasciitis (PF) is present in 2 million Americans a year, and in 10% of the population over a lifetime. Conventional physical therapy (PT) for PF has included strengthening of foot and hip musculature, and lower extremity stretching. Extracorporeal shockwave therapy (ECSW) has also been utilized with success in treatment of PF. While these two treatments have been used individually, their combined effect has not been studied. The purpose of this case report investigated a combined plan of care utilizing conventional PT, targeted hip strengthening, and ECSW. Case Description: The patient was a 48-year-old female who presented …

Treatment Of A Work-Related Superior Glenoid Labral Repair: A Case Report, Alexandra Touri

Case Report Papers

Background and Purpose: A superior glenoid labrum tear anterior to posterior (SLAP) is a common injury in the shoulder although they are less commonly seen in the workplace. There are many resources for SLAP lesions concerning overhead throwing athletes, however, there are not specific details on return to work rehabilitation activities for the workers’ compensation population. The purpose of this case report is to explore the post-operative physical therapy management of a workers’ compensation patient with a superior glenoid labrum lesion. Case Description: This patient was a 45-year-old Hispanic female diagnosed with a superior glenoid labrum lesion of the left …

A Hip Strengthening Protocol For A Patient Following Achilles Repair: A Case Report, Matthew Morris

Case Report Papers

Background and Purpose: The Achilles tendon is the strongest, yet most frequently ruptured, tendon in the body. Hip strength has been associated with various lower extremity (LE) conditions. However, there is a lack of literature regarding hip strengthening and its impact on Achilles injuries. Therefore, the purpose of this case report was to describe the rehabilitation of a patient following a left Achilles tendon repair utilizing a comprehensive hip strengthening protocol. Case Description: The patient was a 32-year-old female who ruptured her Achilles playing tennis. She underwent surgical repair three weeks later and was immobilized and non-weightbearing for a total …

Restoring Functional Mobility For A Geriatric Patient Following Open Repair Of A Ruptured Abdominal Aortic Aneurysm: A Case Report, Grace Laughlin

Case Report Papers

Background and Purpose: Each year 200,000 people are diagnosed with an abdominal aortic aneurysm (AAA) in the United States and the mortality rate for ruptured AAA is estimated to be 80%. There are two surgical options to treat ruptured AAA, an open repair and an endovascular aneurysm repair (EVAR). The incidence of rupture following an EVAR is 0.9%. The purpose of this case report was to describe the physical therapy (PT) plan of care of an elderly patient following an open repair of a ruptured AAA with a history of EVAR. Case Description: The patient was an 86-year-old female admitted …

Physical Therapy Management Of Low Back Pain In A Young Female With Ankylosing Spondylitis Associated With Hla-B27 Antigen: A Case Report, Jake Adkins

Case Report Papers

Background and Purpose: Ankylosing spondylitis (AS) is a form of arthritis characterized by chronic inflammation of the axial skeletal system that causes back pain and loss of mobility with strong potential for slow, eventual spinal fusion. The condition affects 0.2-0.5% of the United States population. There is no known cure for AS and the cause is unknown. The purpose of this case report is to describe a comprehensive approach for physical therapy (PT) management of AS in order to assist clinical reasoning and clinical decision-making and enhance care management in this patient population. Case description: A 27-year old female referred …

Gait, Strength, And Balance Training For A 43-Year-Old Male Following An Acute Right Middle Cerebral Artery Stroke: A Case Report, Victoria Dwyer

Case Report Papers

Background and Purpose: Although many patients who have had a stroke receive inpatient rehabilitation treatment, there is limited literature that investigates the interventions utilized to treat this population. The purpose of this case study was to describe the inpatient rehabilitation treatment interventions including body weight supported treadmill training (BWSTT), functional electrical stimulation (FES), balance, and lower extremity (LE) strengthening on a patient with a sub-acute right middle cerebral artery (R MCA) stroke. Case description: The patient was a 43-year-old male who recently had a R MCA stroke. He presented with significant expressive aphasia, left-sided hemiparesis, balance and transfer deficits, and …

Functional School-Based Physical Therapy Management For A Child With Pallister-Killian Syndrome: A Case Report, Cheryl R. Espinosa

Case Report Papers

Background and Purpose: Pallister-Killian Syndrome (PKS) is a rare genetic disorder resulting from an additional short arm in chromosome 12. This condition leads to varying levels of multi-system impairments that impact a child’s development in gross motor skills yielding functional limitations. Pediatric physical therapy (PT) management is crucial for these children to facilitate improvements in sitting, standing, and ambulation. The purpose of this case report was to describe functional school-based PT management for a child with PKS. Case Description: The child was a seven-year-old male diagnosed with PKS at 20 weeks’ gestation. The child was seen for PT five times …

Muscle Activation Patterns During Movement Attempts In Children With Acquired Spinal Cord Injury: Neurophysiological Assessment Of Residual Motor Function Below The Level Of Lesion., Darryn A Atkinson, Laura Mendez, Natalie Goodrich, Sevda C Aslan, Beatrice Ugiliweneza, Andrea L Behrman

Physical Therapy Collection

Introduction: Characterization of residual neuromotor capacity after spinal cord injury (SCI) is challenging. The current gold standard for measurement of sensorimotor function after SCI, the International Society for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam, seeks to determine isolated intentional muscle activation, however many individuals with SCI exhibit intentional movements and muscle activation patterns which are not confined to specific joint or muscle. Further, isolated muscle activation is a feature of the neuromuscular system that emerges during development, and thus may not be an appropriate measurement standard for children younger than 6.

Methods: We utilized neurophysiological assessment …

Early Mobilization And Functional Mobility Training For A Patient With Triple Vessel Coronary Artery Bypass Grafting: A Case Report, Cody Hall

Case Report Papers

Background and Purpose: Coronary artery disease (CAD) is the buildup of plaque in coronary blood vessels and is the most common type of heart disease in the United States. Coronary artery bypass grafting (CABG) is an invasive surgical procedure used to provide alternate blood supply to cardiac tissue in individuals with CAD using autografts. The goals of the surgery are often to prolong life, reduce symptoms, improve functioning, and improve vocational status. The purpose of this case report was to document the outcomes of a physical therapy (PT) plan of care for a complex patient after undergoing CABG. Case Description: …

Regaining Independence In Ambulation For A Visually Impaired Patient With Rhabdomyolysis: A Case Report, Brandon Bourgoin

Case Report Papers

Background and Purpose: Rhabdomyolysis is a myopathic condition that causes significant muscle wasting following an acute onset. This condition elevates creatine kinase in the bloodstream, and commonly causes the patient to have muscle pain, swelling, and weakness, as well as dark “tea” colored urine. The purpose of this study was to describe physical therapy (PT) interventions used treating a legally blind (LB) elderly male with rhabdomyolysis and multiple comorbidities. Case Description: A 78-year-old male referred to PT with a diagnosis of rhabdomyolysis following a fall in the home. He presented with muscle soreness, decreased lower extremity (LE) strength, and impaired …

Faculty Learning Community: Approaches To Teaching In Kinesiology, Nicole Dabbs

Q2S Enhancing Pedagogy

This is a syllabus for our new course in the kinesiology department for the semester system for KINE 3200, Principals of Human Movement. This course will go over basic mechanical principles and their application in the study of human movement and an introduction to basic principles of biomechanics. Specifically, this course is designed to provide an advanced analysis of human functional anatomy, with primary emphasis being placed on the articular, skeletal, muscular, and nervous systems. We developed a course outline related to specific joints (shoulder, elbow, wrist, hip, knee, ankle, trunk and spine), our plan is to go over each …

Calcium Pyrophosphate Deposition Disease In The Achilles Tendon, Kai-Yu Ho, Jing Nong Liang

Physical Therapy Faculty Publications

The classic sonographic presentation of calcium pyrophosphate dihydrate crystal deposits in the Achilles tendon is reported.

Characteristics Of Medial-Lateral Postural Control While Exposed To The External Perturbation In Step Initiation, Yun-Ju Lee, Jing Nong Liang, Bing Chen, Alexander S. Aruin

Physical Therapy Faculty Publications

Controllability of posture in the medial-lateral direction is critical for balance maintenance, particularly in step initiation. The objective of the current study was to examine the effects of external perturbation and landing orientation on medial-lateral control stability in step initiation. Eleven young healthy participants stood on the force platform and waited for the instruction of taking a step while experiencing a pendulum perturbation applied at the lateral side of the right shoulder. Eight experimental conditions were conducted by two levels of step side (right or left), two levels of perturbation (with or without), and two levels of landing orientation (forward …

Comparison Of Functional And Patient-Reported Outcomes Between Direct Anterior And Lateral Surgical Approach One-Year After Total Hip Arthroplasty In A Canadian Population: A Cross-Sectional Study., Susan W. Hunter, Pavlos Bobos, Lyndsay Somerville, James Howard, Edward Vasarhelyi, Brent Lanting

Physical Therapy Publications

Background: From a clinical perspective, it is important to understand the outcomes that occur after total hip arthroplasty (THA) and do these vary with surgical approach. The objective of the study was to compare physical performance-based and patient-report outcomes between the Direct Anterior (DA) and Direct Lateral (DL) surgical approach at one-year after THA surgery.

Methods: We evaluated patients attending their one-year follow-up assessment after primary elective unilateral THA surgery for osteoarthritis of the hip. The Activities-specific Balance Confidence Scale, Falls Risk in Older People in a Community Setting, Timed Up and Go Test, 30-Second Chair Stand Test, Step Test, …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes In Paraspinal Muscle Strength After Intramuscular Fine Wire Electrode Insertion, Szu-Ping Lee, Vincent Dinglasan, Anthony Duong, Russell Totten, Jo Armour Smith

Physical Therapy Faculty Articles and Research

Objective

To examine how insertion and presence of intramuscular fine‐wire electromyography electrodes (IFWE) in lumbar multifidus affect paraspinal muscle strength, endurance, and activation in persons with and without recurrent lower back pain (RLBP) during activities that require high levels of muscle contraction.

Design

Case‐control with randomization of conditions.

Setting

Clinical Research Laboratory.

Participants

Forty participants age 18‐40 were recruited (18 female; mean age = 25.5 yr); 20 with a history of RLBP were compared to a matching control group of 20 without RLBP.

Interventions

Each participant was tested under three conditions over three sessions. On Session 1, the baseline condition, …

Blood Flow Restriction Exercise: A Systematic Review Of The Literature, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Blood flow restriction training is quickly gaining popularity in the United States. However, it is not without controversy. While there are many reported health benefits, there are equally as many risks. Most concerning is the lack of industry standardizations regarding cuff size and pressure. There is no required training to implement blood flow restriction training, which can be problematic when people with little knowledge practice this type of exercise. When blood flow is restricted, there is an impact on the cardiovascular system, nervous system, and muscular system. Damage can be done when blood flow is restricted with too much pressure …

Patellar Tendon Morphology In Trans-Tibial Amputees Utilizing A Prosthesis With A Patellar-Tendon- Bearing Feature, Kai-Yu Ho, Michelle Harty, Jessica Kellogg, Kelly Teter, Szu-Ping Lee, Yu-Jen Chang, Gregory Bashford

Physical Therapy Faculty Publications

A patellar-tendon-bearing (PTB) bar is a common design feature used in the socket of trans-tibial prostheses to place load on the pressure-tolerant tissue. As the patellar tendon in the residual limb is subjected to the perpendicular compressive force not commonly experienced in normal tendons, it is possible for tendon degeneration to occur over time. The purpose of this study was to compare patellar tendon morphology and neovascularity between the residual and intact limbs in trans-tibial amputees and healthy controls. Fifteen unilateral trans-tibial amputees who utilized a prosthesis with a PTB feature and 15 age- and sex- matched controls participated. Sonography …

A Global Perspective Of Postural-Related Shoulder Pain (Prsp), Zoe Geiger, Kiley Pinder, Kasey Cottrill, Holly Roberts

Physical Therapy Research Symposium

Background: During a physical therapy service trip to Zacapa, Guatemala, in March 2019, ten of 106 patients were treated for symptoms of PRSP. Their pain was often exacerbated by repetitive work-related tasks performed with poor posture such as doing laundry by hand, carrying loads overhead, manual labor, and childcare.

Methods: A brief review of the literature was performed to determine global differences in PRSP and effective treatment interventions. PubMed, Collins Memorial Library, and Google Scholar were searched using search terms including “postural-related”, “work-related”, “shoulder pain”, and “global”.

Results: Nine full-text articles were retrieved and reviewed. PRSP was reported in Ethiopian …

A Qualitative Study On The User Acceptance Of A Home-Based Stroke Telerehabilitation System, Yu Chen, Yunan Chen, Kai Zheng, Lucy Dodakian, Jill See, Robert Zhou, Renee Augsburger, Alison Mckenzie, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Objective: This paper reports a qualitative study of a home-based stroke telerehabilitation system. The telerehabilitation system delivers treatment sessions in the form of daily guided rehabilitation games, exercises, and stroke education in the patient’s home. The aims of the current report are to investigate patient perceived benefits of and barriers to using the telerehabilitation system at home.

Methods: We used a qualitative study design that involved in-depth semi-structured interviews with 13 participants who were patients in the subacute phase after stroke and had completed a six-week intervention using the home-based telerehabilitation system. Thematic analysis was conducted to analyze …

Autonomic Nervous System Changes In Individuals With Chronic Pain: A Systematic Review Of The Literature, Dr. Karin Steere, Jason Steere Dpt, Kasey Cottrill, Zoe Geiger

Physical Therapy Research Symposium

PURPOSE: The aim of this review was to investigate the relationship between heart rate (HR) or blood pressure (BP) and chronic pain conditions.

BACKGROUND: Treatment of chronic pain has placed enormous economic burden on the healthcare system. Autonomic nervous system (ANS) dysregulation is correlated to chronic pain. One measure of ANS dysregulation is heart rate variability (HRV), and decreased HRV can predict adverse future prognosis in a variety of conditions. While HRV validly measures ANS dysregulation, inexpensive and quicker measurements of HR and BP have been less investigated.

METHODS: Searches in PubMed, Ovid, Google Scholar, and CINAHL were performed using …

Common Experiences And Beliefs Among Highly Active, Older Adults, Alex Knapp Spt, Dominick Post Spt, Danny Mcmillian Pt Dsc

Physical Therapy Research Symposium

Background: Research on correlates and determinants of physical activity has shown that age and motivation are associated with physical activity. Self-Determination Theory (SDT) provides a well-researched framework for understanding motivation, and proposes that the satisfaction of three primary psychological needs: autonomy, competence, and relatedness, fuels motivation for physical activity and promotes wellness.

Purpose: Use SDT to identify experiences and beliefs that affect motivation for physical activity in older adults and provide a narrative approach to share their “movement stories.”

Methods: Participants were recruited using nominated sampling and a public advertising campaign. Participants were at least 55-years old with International Physical …