Rehabilitation and Therapy Commons^™

Central Pontine And Extrapontine Myelinolysis After Surgical Removal Of Pituitary Adenoma: A Casereport, Hui-Tai Yang, Yen-Hung Chang, Hung-Chih Hsu

Rehabilitation Practice and Science

Central pontine myelinolysis(CPM) and extrapontine myelinolysis(EPM), sharing the same pathology, are the same disease, although different symptoms and signs developed according to different lesion sites. The etiology and pathogenesis of CPM/EPM remain unclear, meanwhile rapid correction of the serum sodium level for hyponatremic patient has proven to be one of the major causes of CPM/EPM. Therefore an appropriate correction of the sodium level could prevent the development of CPM/EPM. The incidence of hyponatremia after surgical removal of pituitary adenoma reported varies from 8.4% to 38.8%. Most patients with symptomatic hyponatremia after the surgery recovered without neurological deficits. Only three cases …

Intraarticular Injection Of Sodium Hyaluronate In Adhesive Capsulitis Of The Shoulder, Shu-Fen Sun, Chiao-Wen Hwang, Pei-Te Hsu, Ya-Wen Hsu, Shin-Lung Tsai, Jue-Long Wang, Chien-Wei Hsu, Yi-Jiun Chou

Rehabilitation Practice and Science

The etiology and natural history of adhesive capsulitis remain obscure, which limited subsequent management. Traditional treatments include conservative medical therapy and physical therapy, but severe shoulder pain may constitute an obstacle to joint mobilization. Local steroid injection into or around the shoulder joint has been shown to alleviate pain in early stages of the disease. Late disease appears less responsive and there are many known risks of complications. Many different protocols to treat the disease have been reported, but the results are generally unsatisfatcory and difficult to compare.Our goal was to determine the efficacy of a combined treatment-intraarticular injection of …

Bimalleolar Fracture After Spinal Cord Injury: A Casereport, Shie-Fu Shieh, Huey-Wen Liang, Wen-Hsung Hou, Yen-Ho Wang, Shih-Fong Huang

Rehabilitation Practice and Science

The incidence of fracture is higher in patients with chronic spinal cord injury (SCI), particularly female and elderly patients, than in healthy people. Functional impairment due to SCI may lead to accidental falls and fractures, most of which are due to trivial injury or without known trauma. In addition, the inevitable osteoporosis in the paralyzed limbs of individuals with chronic SCI increases their risk of fracture. The lower limbs are more often involved than the upper limbs. Because of the sensory impairment associated with SCI, fractures may be difficult to diagnose, and treatment may be delayed. The treatment of fractures …

Rehab Exercise Prescription Sequencing For Shoulder External Rotators, Jason Brumitt, Erik Meira

Faculty Publications - College of Physical Therapy

Overhead athletes are susceptible to shoulder injuries. One component of a complete rehabilitation program is a systematic exercise prescription for the shoulder's external rotators. An overhead athlete should be progressed from basic rehab exercise positions to dynamic, sport-specific positions prior to returning to sport.

The Effectiveness Of Aquatic Therapy With Persons Who Have Experienced A Cerebral Vascular Accident, Heather L. Tweedie

Masters Theses

This study examined the effectiveness of using aquatic therapy (AT) as a technique in the treatment of cerebral vascular accidents (CVA). The unique properties of the aquatic environment were manipulated to determine change in range of motion, muscle tone, balance, functional ambulation, and psychological functioning particularly social relationship and positive and negative feelings.

A single subject design was conducted using two subjects that participated in a twelve week aquatic therapy program. Aquatic therapy showed to be effective in treating common symptoms of a CVA. More research needs to be completed to ensure the effectiveness of aquatic therapy in congruency with …

Caregivers’ Perceptions Of Accessibility And Quality Of Services In The Community For Children With Mental Health Diagnoses: A Pilot Survey, Karin E. Brems

Masters Theses

This pilot study was intended to explore caregivers' perceptions of the mental health services available in the community for children with mental health diagnoses. A study-specific survey was developed to look at demographic characteristics, service accessibility, and service quality. This survey was distributed to caregivers through Michigan support groups. Returned surveys were analyzed for themes that could assist in the development of further research to improve community services for children with mental health diagnoses.

This pilot study yielded rich qualitative data. Upon review and analysis, five themes emerged: (1) bureaucratic hassles and getting the runaround, (2) closed doors, (3) support …

Wound Debridement With 25 Khz Ultrasound, Margaret Mccarty Stanisic, Barbara Provo, David L. Larson, Luther C. Kloth

Physical Therapy Faculty Research and Publications

Several methods of wound debridement are described in the literature and are available to health care providers who specialize in wound management. Methods include the use of sharp surgical instruments; mechanical methods, such as whirlpool and pulsed lavage with suction; proteolytic and collagenolytic enzymes; autolysis; and sterile fly larvae (maggots). The use of surgical debridement is generally considered the most efficient method when performed by a skilled physician, who may in one session use his or her discretion to excise some viable tissue along with necrotic tissue in the wound. Sharp debridement performed in a clinical setting is a less …

The Influence Of Concurrent Cognitive Tasks On Postural Sway In Children, Yvette Blanchard, Shannon Carey, Jocelyn Coffey, Alison Cohen, Trisha Harris, Stephanie Michlik, Geraldine Pellecchia

All PTHMS Faculty Publications

Purpose: The purpose of this study was to examine the influence of concurrent tasks on postural sway in children.

Methods: Nineteen fourth-grade students, while standing on a balance platform, were asked to stand still, count backward, and read second-grade level sentences. The AMTI Accusway System was used to calculate the length of center of pressure path (LCOP), sway range (SR), and variability (SV) in mediolateral (ML) and anteroposterior (AP) directions of sway.

Results: Analysis of variance revealed a main effect of cognitive task condition for SR-AP, SR-ML, SV-AP, and SV-ML. Post hoc comparisons revealed lower values of those four dependent …

Variability Of Motor Unit Discharge And Force Fluctuations Across A Range Of Muscle Forces In Older Adults, Brian L. Tracy, Katrina S. Maluf, Jennifer L. Stephenson, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Variability of motor unit discharge is a likely contributor to the greater force fluctuations observed in old adults at low muscle forces. We sought to determine whether the variability of motor unit discharge rate underlies the fluctuations in force during steady contractions across a range of forces in young (n = 11) and old (n = 14) adults. The coefficient of variation (CV) for discharge rate and force were measured during a force-matching task as the first dorsal interosseous muscle performed isometric contractions. The recruitment thresholds of the 78 motor units ranged from 0.04% to 34% of maximal …

A Comparison Of Outcomes After 8 And 12 Weeks Of Pulmonary Rehabilitation, Michael Fillyaw, Kim Hasegawa, Mary Anne Riley, Burton D. Tepfer

Physical Therapy Faculty Publications

Purpose: To compare changes in functional exercise capacity, dyspnea, functional status, and depression in patients after 8 weeks (24 sessions) and 12 weeks (36 sessions) of pulmonary rehabilitation (PR). Methods: A prospective sample of 31 participants in our PR program completed outcome measures prior to and during the eighth and twelfth weeks of the program. The 6-minute walk test (6MWT) and a stairs climbing test (ST) measured functional exercise capacity. Perceived dyspnea (PD) was measured with a 6-20 scale. The Pulmonary Function Status Scale (PFSS) measured functional status, and the Cardiac Depression Scale (CDS) measured depression. Results : Statistically significant …

Isokinetic Knee Strength In Females With Fibromyalgia, Flora F. Shafiee

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: To compare knee flexors and extensors muscle strength, total work, and power between females with fibromyalgia (FM) and matched healthy controls.

Methods: This is the first study to measure knee muscle power and total work in females with FM. Thirty-one females with FM and thirty-one healthy females completed isokinetic testing of knee flexors and extensors of their dominant leg using a Cybex Norm Isokinetic Dynamometer. Two knee muscle groups (flexors and extensors) at two angular velocities (607sec and 1807sec) were tested for both groups. Both muscle groups were assessed continuously using five reciprocal concentric-concentric cycles, followed by five eccentric-eccentric …

Creating A Curriculum To Integrate Augmentative And Alternative Communication In A Preschool Setting, Megan R. Graham

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

Background/Introduction: Augmentative and Alternative Communication (AAC) devices are tools used to help individuals with speech difficulties to communicate. The University of Arkansas AAC Lab is designed to develop and evaluate technology and implementation strategies for people with intellectual and developmental disabilities. In this research setting, we used Proloquo2Go, TouchChat, and a developing AAC program. I have created a curriculum for this Lab that integrates this AAC program into a preschool setting for preschoolers with extensive support needs. Purpose: This project was meant to create a pre-school curriculum for special needs preschoolers implementing models of Applied Behavior Analysis (ABA) Therapy, Occupational …

Muscle Endurance Is Greater For Old Men Compared With Strength-Matched Young Men, Sandra K. Hunter, Ashley Critchlow, Roger M. Enoka

Exercise Science Faculty Research and Publications

The purpose was to compare the time to task failure for a sustained isometric contraction performed at a submaximal intensity with the elbow flexor muscles by young and old men who were matched for strength. Eight young men (18–31 yr) and eight old men (67–76 yr) sustained an isometric contraction at 20% of maximal voluntary contraction (MVC) torque until the target torque could no longer be achieved for at least 5 s. The maximal torque exerted at the wrist was similar for the young and old men before the fatiguing task (65.9 ± 8.0 vs. 65.4 ± 8.7 N·m; P …

The Effects Of An Analgesic (Biofreeze®) On The Motoneuron Pool Excitability Of The Soleus Muscle, Desiree R. Barth

All-Inclusive List of Electronic Theses and Dissertations

Objective: The purpose of this study was to determine the effects on the Hoffman reflex and motor response with an analgesic (Biofreeze®). Design: The study was a 2X6 design. The independent variables in this study were treatment and time. The dependent variables were the H-reflex (volts) and the M response (volts). Treatment was randomly assigned to control for the effects of order. Setting: This study took place in the Exercise Physiology Laboratory located in the Health and Human Performance Building at Indiana State University. Subjects: 14 volunteers who were physically active and had no known neurological problems. Measurements: Skin and …

Central Somatosensory Changes And Altered Muscle Synergies In Subjects With Anterior Cruciate Ligament Deficiency, Carol Courtney, Rose Marie Rine, Penny G. Kroll

Physical Therapy Faculty Research

To clarify the mechanisms of compensation in subjects with anterior cruciate ligament deficiency (ACL-D), we examined proprioception, quadriceps strength, somatosensory evoked potentials (SEPs) and muscle responses during gait in varied combinations of speed and incline. Seventeen subjects with ACL-D were grouped by functional level and report of giving way. Seven subjects without ACL-D served as a control sample for muscle response measures. ACL-D subjects with quadriceps weakness experienced giving way and could not resume sport activities. Those without weakness fell into one of two groups: (1) copers, who had full return to previous activity and no giving way despite proprioceptive …

An Electromyographic Assessment Of Lumbar Paraspinal Muscles During Core Stability Exercises, Alicia Marleina Osuna

All-Inclusive List of Electronic Theses and Dissertations

Objective: Clinicians often use Swiss balls in exercise regimens to recruit activity of the paraspinal musculature. However, we do not know if muscle activity differences exist while performing an exercise on a stable or unstable surface. Design and Settings: A 1 X 2 factorial with repeated measures design guided this study. The single within-subjects factor was a core stability exercise with 2 levels: a stable condition (chair) and an unstable condition (Thera-band® exercise ball). The dependent variables were the integrated electromyography (I-EMG) amplitude of the left and right lumbar paraspinal musculature. Subjects: Sixteen moderately active and healthy male subjects (age: …

Therapeutic Benefits Of Ultrasound Can Be Achieved And Maintained With 1 Mhz, 4 Era Ultrasound Treatment, Lori B. Meyer

All-Inclusive List of Electronic Theses and Dissertations

Context: Thermal ultrasound has been used for the past two decades because of its ability to increase underlying local tissue temperatures promoting healing. It is recommended that ultrasound treatment be performed on a 2-3 ERA area for 10 minutes. However, clinicians often need to treat larger areas using ultrasound, clinicians may add to the possible treatment sights and not rely on or purchase other machines. Research has yet to investigate if therapeutic levels can be obtained by increasing the treatment time. Objective: To investigate if increasing the duration of an ultrasound treatment with a treatment area of 4 timesthe sound …

The Importance Of Athletic Training Students Performing On-Field Evaluations, Amisha Patel

All-Inclusive List of Electronic Theses and Dissertations

Context: It is unclear the frequency with which athletic training students perform on-field evaluations. Objective: The purpose of this study is to: (1) quantify the frequency senior ATSs observe, assist, and perform on-field evaluations during their clinical rotations; and (2) assess the senior ATSs perceptions of their experiences during on-field evaluations. Design: A 28-item survey entitled Survey of Senior Level Athletic Training Students Perceptions of Quality and Quantity of On-Field Evaluations During Clinical Rotations was developed based on a comprehensive literature review. The survey was grouped as follows: 3 demographic questions, 8 Likert scale statements, 9 "check all that apply", …

Knee And Hip Angle And Moment Adaptations During Cutting Tasks In Subjects With Anterior Cruciate Ligament Deficiency Classified As Noncopers, Jeff R. Houck, Andrew Duncan, Kenneth E. De Haven

Faculty Publications - College of Physical Therapy

Study Design: Two-factor mixed-design study, with factors including group (control and noncoper) and task (sidestep, crossover, and straight).

Objectives: To compare the knee and hip joint angles and moments of control subjects and subjects with an anterior cruciate ligament (ACL) deficient knee classified as noncopers, during a sidestep, crossover, and straight-ahead task.

Background: Subjects with ACL deficiency primarily note difficulty with cutting tasks as opposed to straight-ahead tasks. Yet, previous studies have primarily focused on straight-ahead tasks.

Methods and Measures: Fifteen subjects with ACL deficiency classified as noncopers, based on the number of giving-way episodes (1) and global question of …

The Effect Of Positioning On Pelvic Floor Muscle Activity As Evaluated With Surface Electromyography In Normals, Karen R. Whitter-Brandon

Loma Linda University Electronic Theses, Dissertations & Projects

Physical therapists who treat patients with urinary incontinence commonly utilize sEMG biofeedback. Practitioners compare resting tone, maximal contraction, and muscle endurance measures before and after pelvic floor exercise instruction to determine intervention and demonstrate progress. There is little research that supports the use of biofeedback in positions other than supine. The purpose of this study was to examine the effect of positioning on pelvic floor muscle activity as measured by surface electromyography (sEMG) in supine, sitting, and standing. Subjects were healthy nulliparous and multiparous women, 23-74 years old, with no symptoms, history, diagnosis, or treatment of incontinence. Subjects were randomized …

The Effect Of Posterior Versus Anterior Glide Joint Mobilization On External Rotation Range Of Motion Of Patients With Shoulder Adhesive Capsulitis, Andrea J. Johnson

Loma Linda University Electronic Theses, Dissertations & Projects

Study Design: Repeated measures, randomized comparison of two treatment groups.

Objective: To compare effectiveness of two manual therapy procedures, posterior and anterior glide joint mobilization, for improving external rotation in patients with adhesive capsulitis of the shoulder.

Background: Joint mobilization procedures are often used by physical therapists to treat the accessory motion impairments associated with shoulder adhesive capsulitis. However opinions differ regarding the value of posterior versus anterior glide mobilization. especially for improving external rotation.

Methods and Measures: Subjects with idiopathic adhesive capsulitis exhibiting a specific external rotation range deficit, were randomly assigned to one of two treatment groups. For …

The Effect Of Electrical Stimulation On Blood Flow In Chronic Wounds In Patients With And Without Diabetes, Daryl J. Lawson

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Only 3% of the U S population is afflicted by diabetes, yet one of the most common chronic wounds is the diabetic ulcer. Decrease in blood flow may be one reason why only 31% of neuropathic diabetic ulcers heal in 20-weeks. The purpose of this investigation was to compare healing rates and blood flow of chronic stage III and IV wounds in people with diabetes and those without diabetes over four weeks of treatment. Blood flow was measured before, during, and after stimulation using one of two different electrical stimulation waveforms in a 32°C room.

Subjects …

Difference In Transverse Plane Scapular Position Of Professional Baseball Players Relative To Baseball Field Position, James M. Syms

Loma Linda University Electronic Theses, Dissertations & Projects

The objective of this study was to identify the variation of the scaption angle of professional baseball players among field position played. Subjects consisted of 109 minor league professional baseball players reporting for the 2002 spring training season, who were under contract with the Anaheim Angels professional baseball organization. Subjects reported to a sports medicine/physical therapy clinic for their 2002 spring training pre-participation physical examination. The scaption measurements were taken as a component of the examination.

Goniometric measurements were taken with the players in a relaxed standing position. Players were instructed to remain looking forward, roll their shoulders forward three …

The Effects Of Brain Gym® Activities On Second-Grade Students' Academic Performance And Handwriting Skills, Kristen Keinath

Masters Theses

Objective: The purpose of this quantitative study was to determine the effects of Brain Gym® activities on second-grand students' academic performance and handwriting skills.

Method: Results were obtained by administering the Test of Handwriting Skills (THS) to two classrooms in a Northern Michigan Elementary School and having both teachers complete a self-developed Academic Performance Form on each student participating in the study. The data from was analyzed using a t-test for the THS and mean scores for the self-developed Academic Performance Form.

Results: Findings suggest a significant difference (p < .05) in the number of letters produced in 20 seconds and spacing of letters. Non-standardized testing showed a decrease in attention to task scores between pre- and post-testing.

Conclusion: Brain Gym® activities were shown to positively effect handwriting …

Time To Task Failure Differs With Load Type When Old Adults Perform A Submaximal Fatiguing Contraction, Sandra K. Hunter, Ludovic Rochette, Ashley Critchlow, Roger M. Enoka

Exercise Science Faculty Research and Publications

Young adults exhibit a longer time to task failure when performing a submaximal isometric contraction by pushing against a force transducer (force task) than when supporting an equivalent inertial load (position task). The purpose of this study was to compare the time to failure for old adults when they performed a force task and a position task with the elbow flexor muscles. Eighteen old adults (72 ± 4 years) performed the force and position tasks at 20% maximal voluntary contraction (MVC) force until task failure. The time to task failure was briefer for the position task (10.6 ± 6.1 min) …

Early Quadriceps Strength Loss After Total Knee Arthroplasty : The Contributions Of Muscle Atrophy And Failure Of Voluntary Muscle Activation, Ryan L. Mizner, Stephanie C. Petterson, Jennifer E. Stevens, Krista Vandenborne, Lynn Snyder-Mackler

Physical Therapy and Rehabilitation Science Faculty Publications

While total knee arthroplasty reduces pain and provides a functional range of motion of the knee, quadriceps weakness and reduced functional capacity typically are still present one year after surgery. The purpose of the present investigation was to determine the role of failure of voluntary muscle activation and muscle atrophy in theearly loss of quadriceps strength after surgery.

Reliability And Validity Of Skinfold Testers When Estimating Body Composition In Indiana High School Wrestlers: A Case Report, William Rowe Mathie Jr.

All-Inclusive List of Electronic Theses and Dissertations

Objective: To determine the reliability and validity of the measurements taken by skin fold testers on Indiana High School wrestlers. Design and Setting: A 2 x 3 x 3 repeated measures design was used for this study. Three independent variables were evaluated. The first independent variable was Body Composition technique (skin fold and hydrostatic weighing), the second is Tester (1 thru 3) and the third is Trial (1 thru 3). The one dependent variable was Body Fat Percentage. Subjects: Three Indiana certified skin fold measurers were recruited to be testers for this study. Twelve male high school wrestlers (age: 16.1±0.9, …

Feasibility Of Electromyography-Triggered Neuromuscular Stimulation As An Adjunct To Constraint-Induced Movement Therapy, Stacy L. Fritz, Yi-Po Chiu, Matthew P. Malcolm, Tara S. Patterson, Kathye E. Light

Physical Therapy Faculty Research

Background and Purpose. The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT).

Case Description. The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient's weaker arm for one half of the CIMT training hours.

Outcomes. The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements …

Cultural Competence And Curricula In Physical Therapist Professional Education, Beth Ernst Jamali

Theses and Dissertations in Urban Services - Urban Education

The purpose of this research was to examine the methods and degree to which content related to cultural competence is incorporated into current entry-level physical therapist education. Face-to-face interviews were performed with 10 program directors from various physical therapist education programs across the country to obtain in-depth information regarding cultural competence in the physical therapy curricula. A questionnaire was sent to all of the 193 accredited physical therapist education programs in the United States as a second means to collect information regarding the methods and extent to which cultural competence is included in the physical therapy curricula. Data were collected …

The Immediate Effect Of Cryotherapy At The Ankle Joint On Postural Control, Bradley W. Sage

Human Movement Studies & Special Education Theses & Dissertations

The purpose of this study was to determine the immediate effect of cryotherapy at the ankle joint on measures of static and dynamic postural control. Scores for the chronically unstable ankle were analyzed during a static and dynamic stability test through the use of video analysis. The static test consisted of each subject performing a single leg stance on a multi-axial progressive balance board for one minute. The dynamic test consisted of each subject performing an agility hop test, in which they "hopped" to each of six squares marked on the floor in sequential order. The dependent measure for each …