Rehabilitation and Therapy Commons^™

The Appropriateness Of Long-Term Opioids To Treat Chronic Back Pain, Thomas Watanabe, Michael Salino, Adam Schreiber

Department of Rehabilitation Medicine Faculty Papers

Point/Counterpoint Case Scenario: A 55-year old man presents to a pain clinic upon referral from his primary care physician. His symptom is axial low back pain. His pain started approximately 1 year earlier without a specific inciting event. He denies radiation of pain into the lower extremities. There is no bowel or bladder involvement. There is no directional preference. He reports pain "all the time," with minimal specific exacerbating or relieving factors. There is no medical-legal involvement. His medical history is significant for hypertension, hypercholesterolemia, obesity, and sleep apnea. He is a divorced father of 2 adult children. He is …

The Influence Of Interlimb Differences On Anterior Cruciate Ligament Injury Risk Factors In Female Collegiate Soccer Athletes, Eric Kevin Greska

Human Movement Studies & Special Education Theses & Dissertations

Female collegiate soccer athletes suffer anterior cruciate ligament (ACL) injuries at a rate of 0.31 per 1000 athlete-exposures, with 67% of injuries expected to be from a non-contact mechanism. As well, previous studies have demonstrated dissimilarity in non-contact ACL injuries relative to dominant and non-dominant legs; with the non-dominant leg being the involved side in 48-67% of reported incidents. The aim of this study was to examine lower extremity neuromechanics relative to leg dominance during an unanticipated sidestep cutting task, with differing states of fatigue and training.

Twenty female collegiate soccer players performed three valid trials for both the dominant …

Identifying Gaps In Perceived Ability: Promoting Exercise In Young Adults With Disabilities, Briana Terrill

Honors Theses and Capstones

Aim: The purpose of this study was to describe the perceived ability in making health decisions regarding exercise and its congruence between young adults with disabilities and their parents. Methods: The study design used a mixed methods approach. The convenience sample consisted of (N = 10) young adults with disabilities and (N = 9) parents of young adults with disabilities. Qualitative data were gathered using a preliminary structured interview guide for young adults with disabilities consisting of several short answer questions. Quantitative data were gathered from the parents of young adults with disabilities by using Pender’s Health Promotion Questionnaire. Results: …

Evaluating The Effectiveness Of A Goal-Directed Intervention On The Social Interaction Of Children With Neurodevelopmental Disabilities, Natalie Gatlin

Honors Theses and Capstones

This study sought to address social interaction needs of children with neurodevelopmental disabilities through an eight week intervention focusing on social skills at Spaulding Youth Center (SYC), a residential facility in Northeast United States. The study implemented a randomized control design, with a control and intervention group, totaling n=19 students. Results have implications for future practice.

Occupational Nature Of Social Participation For Adolescent Males With Learning Disorders, Megan Murnane

Honors Theses and Capstones

OBJECTIVE. This study explored the effects of community team sports on social participation and life habit development for males ages 12-17 with a documented learning disorder. METHOD. A causal/comparative design compared two groups. A convenient sample of 24 participants completed Life Habits Questionnaire and Community Integration Questionnaire. Chi-square and T-test analysis were used. RESULTS. Results indicated social integration (t=4.56, p=.00) for boys who played a community sport was significantly higher than boys who did not play a community sport. The number and performance level of life habits was also significantly higher for boys who played a community team sport (t=3.23, …

Determining Intensity Levels Of Selected Wii Fit Activities In College Aged Individuals, Joshua D. Griese, Yong Gao, Lynda Ransdell, Shawn R. Simonson

Kinesiology Faculty Publications and Presentations

To determine intensity of Nintendo Wii Fit games using indirect calorimetry. Twenty-five college students completed Wii Fit activity sessions at two difficulty levels within aerobics, strength, and yoga categories. Resting metabolic rate and exercise VO₂ were measured and metabolic equivalents (METs) were calculated. Measured METs and calculated METs ranged from 2.30 ± .42 and 2.44 ± .38 for Yoga to 5.73 ± 1.36 and 6.04 ± 1.09 for aerobics, respectively. All selected Wii Fit activity intensities were significantly higher than resting, p < .001; aerobic and strength activities met the moderate intensity threshold (3 METs, p < .001), yoga activities did not (p < .005); aerobic and yoga activities of medium difficulty were more intense than the corresponding easy-rated activities (p < .005). There were no statistical differences between measured and calculated METs. Wii Fit has potential as an effective tool for helping college-age individuals increase their PA.

Current Music Therapy Practice With Adolescents With Emotional And Behavioral Disorders In The United States: A Survey Of The Profession, Melinda K. Murray

Masters Theses

The purpose of this study was to survey Board Certified Music Therapists in the US to examine (a) the demographics of the music therapists working with this population in a non-school setting, (b) assessments used by the music therapists, (c) goals for clients, and (d) treatment methods used in the treatment of adolescents with emotional and/or behavioral disorders. The participants in this study were board certified music therapists working with emotional and/or behavioral impairments outside of the school setting. Of the total of 111 surveys sent to music therapists who possibly met the inclusion criteria, 27 were returned (N=27). The …

An Investigation Of Occupation-Based Practice In Upper Extremity Intervention - A Pilot Study, Amy Ma

Honors Theses and Capstones

The primary purpose of this study was to explore the extent to which therapists focused on functional occupation-based performance in both assessments and goals, and whether this was related to client satisfaction and perceived self-efficacy. Researchers found that while most therapists demonstrated inconsistent occupation-based practices, therapists were most occupation-focused during goal writing and in their clinical reasoning. Results also suggest that clients responded well to client-centered practices.

The Effect Of Movement Rate And Complexity On Functional Magnetic Resonance Signal Change During Pedaling, Jay P. Mehta, Matthew D. Verber, Jon A. Wieser, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

We used functional magnetic resonance imaging (fMRI) to record human brain activity during slow (30 RPM), fast (60 RPM), passive (30 RPM), and variable rate pedaling. Ten healthy adults participated. After identifying regions of interest, the intensity and volume of brain activation in each region was calculated and compared across conditions (p < .05). Results showed that the primary sensory and motor cortices (S1, M1), supplementary motor area (SMA), and cerebellum (Cb) were active during pedaling. The intensity of activity in these areas increased with increasing pedaling rate and complexity. The Cb was the only brain region that showed significantly lower activity during passive as compared with active pedaling. We conclude that M1, S1, SMA, and Cb have a role in modifying continuous, bilateral, multijoint lower extremity movements. Much of this brain activity may be driven by sensory signals from the moving limbs.

Corticomotor Excitability During A Noxious Stimulus And Following Exercise In Women With Fibromyalgia, Marie K. Hoeger Bement, Andy Weyer, Tejin Yoon, Sandra K. Hunter

Physical Therapy Faculty Research and Publications

No abstract provided.

Push-Pull Control Of Motor Output, Michael D. Johnson, Allison S. Hyngstrom, Marin Manuel, C J. Heckman

Physical Therapy Faculty Research and Publications

Inhibition usually decreases input–output excitability of neurons. If, however, inhibition is coupled to excitation in a push–pull fashion, where inhibition decreases as excitation increases, neuron excitability can be increased. Although the presence of push–pull organization has been demonstrated in single cells, its functional impact on neural processing depends on its effect on the system level. We studied push–pull in the motor output stage of the feline spinal cord, a system that allows independent control of inhibitory and excitatory components. Push–pull organization was clearly present in ankle extensor motoneurons, producing increased peak-to-peak modulation of synaptic currents. The effect at the system …

The Graded Redefined Assessment Of Strength Sensibility And Prehension: Reliability And Validity., Sukhvinder Kalsi-Ryan, Dorcas Beaton, Armin Curt, Susan Duff, Milos R Popovic, Claudia Rudhe, Michael G Fehlings, Mary C Verrier

Department of Physical Therapy Faculty Papers

Abstract With the advent of new interventions targeted at both acute and chronic spinal cord injury (SCI), it is critical that techniques and protocols are developed that reliably evaluate changes in upper limb impairment/function. The Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) protocol, which includes five subtests, is a quantitative clinical upper limb impairment measure designed for use in acute and chronic cervical SCI. The objectives of this study were to: (1) establish the inter-rater and test-retest reliability, and (2) establish the construct and concurrent validity with the International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI), …

Cranial Electrotherapy Stimulation In The Treatment Of Posttraumatic Stress Disorder: A Pilot Study Of Two Military Veterans, Alfred G. Bracciano, Wen-Pin Chang, Stephanie Kokesh, Abe Martinez, Melissa Meier, Kathleen Moore

Occupational Therapy Faculty Publications

This case study investigated the effects of cranial electrotherapy stimulation (CES) on the prevalence and intensity of posttraumatic stress disorder (PTSD) symptoms and self- perceived improvement of performance and satisfaction in daily activities in war veterans. Two male Caucasian veterans (ages 54 and 38) diagnosed with PTSD participated in these case studies with a pretest–posttest design. The Canadian Occupational Performance Measure (COPM) and the PTSD Symptom Scale–Interview (PSS-I) were administered before and after the 4-week CES treatment. The participants self-administered the 4-week CES treatment protocol using Alpha-Stim SCS CES device in their home for 20 to 60 min a day, …

Effect Of A Single High-Fat Meal And Vitamins On The Circulatory Response To Local Heat In Koreans And Caucasians, Jongeun Yim

Loma Linda University Electronic Theses, Dissertations & Projects

Blood flow mediated by the vascular endothelium plays an important role in removing heat from the skin. Asians who have thrifty genes have impaired endothelial function (EF) due to the westernized high fat (HF) dietary lifestyle. Hypertriglyceridemia (HTG) can produce free radicals which reduces the bioavailability of the endothelium derived relaxing factor, nitric oxide (NO). EF, as measured by the blood flow response (BFR) to heat, occlusion and the free radical concentration after a single HF meal has not been studied in Korean-Asians compared to Caucasians. The purpose of this study was to evaluate baseline and postprandial EF as related …

Supraspinal Fatigue Impedes Recovery From A Low-Intensity Sustained Contraction In Old Adults, Tejin Yoon, Bonnie Schlinder-Delap, Manda L. Keller, Sandra K. Hunter

Exercise Science Faculty Research and Publications

This study determined the contribution of supraspinal fatigue and contractile properties to the age difference in neuromuscular fatigue during and recovery from a low-intensity sustained contraction. Cortical stimulation was used to evoke measures of voluntary activation and muscle relaxation during and after a contraction sustained at 20% of maximal voluntary contraction (MVC) until task failure with elbow flexor muscles in 14 young adults (20.9 ± 3.6 yr, 7 men) and 14 old adults (71.6 ± 5.4 yr, 7 men). Old adults exhibited a longer time to task failure than the young adults (23.8 ± 9.0 vs. 11.5 ± 3.9 min, …

Vitamin D And Brain Imaging In The Elderly: Should We Expect Some Lesions Specifically Related To Hypovitaminosis D?, Cédric Annweiler, Manuel Montero-Odasso, Susan W Muir, Olivier Beauchet

Physical Therapy Publications

Hypovitaminosis D is associated with cognitive decline in the elderly, but the issue of causality remains unresolved. Definitive evidence would include the visualization of brain lesions resulting from hypovitaminosis D. The aim of the present article is to determine, through a literature review, the location and nature of possible brain disorders in hypovitaminosis D. We found limited brain-imaging data, which reported ischemic infarcts and white matter hyperintensities in hypovitaminosis D, though did not provide their specific location or report any focal atrophy. Based on the finding of executive dysfunctions (i.e., mental shifting and information updating impairments) in the presence of …

Bmi-1 Absence Causes Premature Brain Degeneration, Guangliang Cao, Minxia Gu, Min Zhu, Junying Gao, Ying Yin, Charles Marshall, Ming Xiao, Jiong Ding, Dengshun Miao

Physical Therapy Faculty Publications

Bmi-1, a polycomb transcriptional repressor, is implicated in cell cycle regulation and cell senescence. Its absence results in generalized astrogliosis and epilepsy during the postnatal development, but the underlying mechanisms are poorly understood. Here, we demonstrate the occurrence of oxidative stress in the brain of four-week-old Bmi-1 null mice. The mice showed various hallmarks of neurodegeneration including synaptic loss, axonal demyelination, reactive gliosis and brain mitochondrial damage. Moreover, astroglial glutamate transporters and glutamine synthetase decreased in the Bmi-1 null hippocampus, which might contribute to the sporadic epileptic-like seizures in these mice. These results indicate that Bmi-1 is required for maintaining …

Surf Lifeguard Perceptions And Practice Of Cardiopulmonary Resuscitation (Cpr), Kevin Moran, Jonathon Webber

International Journal of Aquatic Research and Education

While the importance of lifeguards in providing immediate and effective basic life support (BLS) in drowning has been well reported, not a lot is known about how lifeguards perceive the relative value of CPR as a lifeguard skill, their training in it, and the likelihood of resuscitation being successful. A self-complete questionnaire was completed by 252 volunteer surf lifeguards at 16 surf beaches in the Greater Auckland,NZ region. Results show that most lifeguards (65%) had received training in the 3 months before the survey, 83% were willing to perform CPR, few (9%) had used CPR in an emergency, and many …

Perceived Facilitators And Barriers To Physical Activity For Rural Youth: An Exploratory Study Using Photovoice, Saagar Walia, Beverly Liepert

Nursing Publications

Introduction: Decreasing physical activity levels, particularly among youth, continue to be a prominent health concern in Canada, and youth living in rural areas may encounter unique facilitators and barriers to physical activity. In addition, current research suggests that overweight and obesity rates are higher for youth in some rural areas compared with urban areas. The goal of this study was to identify the perceived facilitators and barriers to physical activity for a selected sample of rural youth at a rural secondary school in south-western Ontario and examine how rural barriers and facilitators affect rural youth physical activity. Current Canadian literature …

A Prototype Head-Motion Monitoring System For In-Home Vestibular Rehabilitation Therapy, Pamela T. Bhatti, Susan J. Herdman, Siddarth Datta Roy, Courtney D. Hall, Ronald J. Tusa

ETSU Faculty Works

This work reports the use of a head-motion monitoring system to record patient head movements while completing in-home exercises for vestibular rehabilitation therapy. Based upon a dual-axis gyroscope (yaw and pitch, ± 500-degrees/sec maximum), angular head rotations were measured and stored via an on-board memory card. The system enabled the clinician to document exercises at home. Several measurements were recorded in one patient with unilateral vestibular hypofunction: The total time of exercise for the week (118 minutes) was documented and compared with expected weekly exercise time (140 minutes). For gaze stabilization exercises, execution time of 60 sec was expected, and …

Aging And The Motor Unit, J. Bunn

Physical Therapy

No abstract provided.

Preventing Muscle Atrophy With Protein And Amino Acid Supplementation, J. Bunn

Physical Therapy

No abstract provided.

Reliability Of A Seated Three-Dimensional Passive Intervertebral Motion Test For Mobility, End-Feel, And Pain Provocation In Patients With Cervicalgia, D. M. Manning, G. S. Dedrick, P. S. Sizer, J. M. Brismée

Physical Therapy

No abstract provided.

Chronic Female Pelvic Pain; Part Ii: Differential Diagnosis And Management, P. Nelson, G. Apte, R. Justiz, J. M. Brismée, G. S. Dedrick, P. S. Sizer

Physical Therapy

No abstract provided.

Chronic Female Pelvic Pain; Part I: Clinical Pathoanatomy And Examination Of The Pelvic Region, G. Apte, P. Nelson, J. M. Brismée, G. S. Dedrick, R. Justiz, P. S. Sizer Jr.

Physical Therapy

No abstract provided.

The Effect Of Isometric Shoulder Internal And External Rotation On The Acromiohumeral Distance, C. White, G. S. Dedrick, P. S. Sizer, G. G. Apte, J. M. Brismée

Physical Therapy

No abstract provided.

The Effect Of An Elastic Eccentric Extensor Mechanism On Hamstring Function, Anna Elizabeth Sutton

Theses, Dissertations and Capstones

Hamstring strains have a long recovery time, a high rate of recurrence, and are very common injuries in sports. Fatigue, improper warm-up, previous injury, strength imbalance, and poor flexibility have all been linked to hamstring injuries. Initial treatment of the hamstring typically consists of rest, ice, compression, elevation, and pain relief. However, no optimal treatment regimen has been developed based on carefully designed clinical trials. This study tested fourteen college-aged male and female subjects. Their gait was recorded using video tracking software with and without an elastic band (Theraband® Akron, Ohio) attached to the anterior surface of their waist and …

Chronic Lower Back Pain: A Maladaptive Perceptions Model, Benedict M. Wand

Physiotherapy Conference Papers

High quality evidence suggests that current approaches to the management of CLBP show only limited effectiveness; one explanation of this finding is that current models of management are misdirected or incomplete. This talk proposes a model of CLBP underpinned by data on the psychological contributors to the LBP experience and recent evidence of neuroplastic changes in the brains of people with CLBP (see below). The model suggests that maladaptive cognitive perception about the nature of the back problem and future consequences drive behaviours that might bring about maladaptive neuroplastic changes. These central nervous system changes may enhance sensitivity, influence normal …

Moving In An Environment Of Induced Sensory-Motor Incongruence Does Not Influence Pain Sensitivity In Healthy Volunteers: A Randomised Within-Subject Cross-Over Experiment, Benedict M. Wand, Lareina Szpak, Pamela George, Max Bulsara, Neil E. O'Connell, G Lorimer Moseley

Physiotherapy Conference Papers

A mismatch between the brain's motor control and sensory systems has been suggested as one mechanism whereby maladaptive neuroplastic changes contribute to the experience of chronic pain. Several studies have investigated this hypothesis by artificially inducing a state of sensory-motor incongruence using mirrors. The data to date appear to suggest that creating an environment of sensori-motor incongruence induces various sensory changes and feeling of peculiarity, however the effect on pain is less clear. The aim of this study was to test the hypothesis that healthy participants would demonstrate reduced pain thresholds and report greater intensity of pain in a condition …

Treatment-Based Classification Of Low Back Pain – Who Are The Unclear Classifications?, T R. Stanton, J M. Fritz, A T. Apeldoorn, Benedict M. Wand, M J. Hancock

Physiotherapy Conference Papers

A recent focus in low back pain research has been to identify patient subgroups that respond best to certain treatments. To integrate these subgroup findings into a useable form, a treatment-based classification algorithm for LBP was created.^1,2 To allow the algorithm to be comprehensive – eg, provide a classification for all patients – additional criteria are provided to assist therapists’ decisions for patients who do not clearly meet a treatment subgroup (unclear classifications).

Recent research found that approximately 34% of patients will receive unclear classifications using the algorithm.³ It has also been shown that the reliability of the …