Rehabilitation and Therapy Commons^™

A Three-Week Intensive Pediatric Physical Therapy Plan Of Care For A Child With Spastic Quadriplegia Cerebral Palsy: A Case Report, Brandie Schmierer, Kirsten Buchanan

Case Report Posters

The benefits of physical therapy (PT) on gross motor function and general strength in children with spastic quadriplegia cerebral palsy (CP) are well documented. There have been no firm conclusions that have determined the optimal duration and intensity of PT interventions for patients with spastic quadriplegia CP. CP occurs as a result of a brain injury associated with birth. Worldwide the prevalence of CP was 1.5 to 3.0 per 1,000 live births in 2009. Previous research demonstrated that PT intervention in children with CP improved gross motor function and strength, decreased the assistance required for mobility, and decreased step length …

Use Of A Task-Oriented Approach In The Physical Therapy Management Of A Patient Following A Posterior Inferior Cerebellar Artery Stroke: A Case Report, Erika Derks

Case Report Posters

3.4% of the 600,000 strokes that occur annually in the United States are cerebellar strokes. Despite the rarity of cerebellar strokes, their impact can cause severe acute neurological morbidity. The posterior inferior cerebellar artery (PICA) supplies the inferior portion of the cerebellum. PICA infarct can lead to deficits in gait and postural stability, coordination, and Cognition and attention. The task-oriented approach has been demonstrated as an effective intervention for patients with cerebrovascular accidents, but limited research has been done on its use in patients with cerebellar stroke. The purpose of this case report was to provide an overview of the …

Functional Mobility Management Of A Patient With Adult-Onset Hereditary Proximal Motor Neuropathy Following A Tibial Fracture: A Case Report, Timothy Lira, Amy J. Litterini

Case Report Posters

This patient was clinically appealing and complex because of the combination of an acute fracture due to an injurious fall and significant past medical history (PMH) of both the rare condition of adult-onset hereditary proximal motor neuropathy (AHPMN) and congestive heart failure (CHF). The chronic co-morbidities created the need for an innovative approach to treatment sequencing to potentially mitigate the risk for excessive fatigue, such as positional grouping of interventions and prescribed rest periods. This unique opportunity to document the physical therapy (PT) management of a patient with the combination of both rare and chronic conditions makes this case a …

Trunk Control And Standing Tolerance Of A Patient With Paraparesis As A Result Of Transverse Myelitis And Mycotic Aneurysm Rupture: A Case Report, Ashley Tomaswick

Case Report Posters

Transverse myelitis is a condition where a segment of the spinal cord becomes inflamed. This results in impairments below the level of the inflammation, including paraparesis or paraplegia, autonomic dysfunction, and/or pain. Cerebral mycotic aneurysms are a form of brain injury where an artery bursts and diminishes blood supply to the brain. The resulting impairments vary depending on the area of the brain affected. The purpose of this case report was to describe the interventions provided to a patient with paraparesis as a result of transverse myelitis and multiple cerebral mycotic aneurysm ruptures to progress toward achieving his goals of …

Clinical Reasoning And Intervention Selection For A Patient With Lower Extremity Weakness Following Acute Alcoholic Polyneuropathy: A Case Report, Sarah Uzel

Case Report Posters

Alcoholic polyneuropathy is a sensorimotor peripheral polyneuropathy. APN usually affects individuals over 40 years old with a history of chronic alcoholism. Most cases occur chronically over several months. Acute cases of APN may develop over the course of weeks. Symptoms of APN include paresthesia and paralysis. There are a variety of suspected mechanisms for etiology for APN. Literature is sparse in relation to physical therapy management and interventions for a patient with acute alcoholic polyneuropathy. The purpose of this case report was to describe the clinical reasoning behind interventions selected for a patient with acute alcoholic polyneuropathy in the acute …

Acute Care Outcome Measures In A Patient Status-Post Right Total Knee Arthroplasty (Tka) Following A Left Tka Staged Five Weeks Apart: A Case Report, Stephanie Sanderson

Case Report Posters

Total knee arthroplasty (TKA) is one of the most frequently performed orthopedic procedures in the U.S. Osteoarthritis (OA) is the most common reason for a total knee arthroplasty. Cartilage and bone is removed from the distal end of the femur and proximal end of the tibia and is replaced with metal alloy components that recreate the joint surface. Some evidence suggests that staging bilateral TKA within three months of each other may increase the patient’s risk for mortality and complications. The purpose of this case report was to document acute care outcome measures in a patient who underwent bilateral TKA …

Use Of Therapeutic Exercise, Functional Endurance And Gait Re-Training In A Deconditioned Patient With Acute Respiratory Failure: A Case Report, Ellen Forslund

Case Report Posters

The human body requires oxygen-rich blood in order to work efficiently. During respiration, air passes from the nose and mouth and into the alveoli of the lungs. When air reaches the alveoli, oxygen passes into the capillaries as carbon dioxide moves out of the capillaries, otherwise known as gas exchange. Respiratory failure may occur when there is a lack of oxygen passing from the lungs into the blood (hypoxemic), or if the lungs cannot remove carbon dioxide from the blood (hypercapnic). Chronic respiratory failure is caused by conditions such as muscular dystrophy, amyotrophic lateral sclerosis (ALS), spinal cord injuries, or …

Vestibular Rehabilitation For A 17-Year Old Female With Post-Concussion Symptoms: A Case Report, Elizabeth Mosley

Case Report Posters

Post-concussion syndrome is defined as a group of symptoms occurring after a traumatic brain injury (TBI) that can last weeks, months, or years. The diagnosis of post-concussion syndrome is not well agreed upon, but does include at least three of the following symptoms: headache, dizziness, fatigue, irritability, insomnia, concentration or memory difficulty, and intolerance of stress or emotion. The Centers for Disease Control and Prevention estimates that 1.7 million Americans experience TBI annually. The purpose of this case report is to describe the physical therapy management using vestibular rehabilitation of an adolescent female with post-concussion symptoms two months post-injury.

Evaluation And Treatment Of A Patient Diagnosed With Adhesive Capsulitis Classified As A Derangement Using The Mckenzie Method: A Case Report, Ashley Bowser, Brian T. Swanson

Case Report Posters

The McKenzie Method of mechanical diagnosis and therapy (MDT) is supported in the literature as a valid and reliable approach to spine injuries. It can also be applied to the peripheral joints, but has not been explored through research to the same extent. A previous case series detailed the use of MDT in the shoulder; however, the application of MDT in the treatment of adhesive capsulitis has not been previously reported in the literature. The purpose of this report is to demonstrate the assessment, intervention, and clinical outcomes of a patient diagnosed with adhesive capsulitis, who was classified as having …

Reduced Voluntary Running Performance Is Associated With Impaired Coordination As A Result Of Muscle Satellite Cell Depletion In Adult Mice, Janna R. Jackson, Tyler J. Kirby, Christopher S. Fry, Robin L. Cooper, John J. Mccarthy, Charlotte A. Peterson, Esther E. Dupont-Versteegden

Physical Therapy Faculty Publications

BACKGROUND: Satellite cells, or muscle stem cells, have been thought to be responsible for all muscle plasticity, but recent studies using genetically modified mouse models that allow for the conditional ablation of satellite cells have challenged this dogma. Results have confirmed the absolute requirement of satellite cells for muscle regeneration but surprisingly also showed that they are not required for adult muscle growth. While the function of satellite cells in muscle growth and regeneration is becoming better defined, their role in the response to aerobic activity remains largely unexplored. The purpose of the current study was to assess the …

Improving Process And Enhancing Parent And Therapist Satisfaction Through A Coordinated Intake Approach, Sharla Piecowye, Devona Gibson, Janis Carscadden, Kayla Ueland, Gregory Wells, Scott Oddie

Patient Experience Journal

Recent research indicates that, in Canada, approximately one in five children entering school are not meeting age appropriate milestones in physical, social, language, or cognitive development. Even where support services are available families often face barriers in accessing these. With the goals of improving access to programs, reducing barriers and increasing consistency and efficiency, a new Coordinated Intake Approach (CIA) was developed for families accessing Children’s Rehabilitation Services. It was expected that the CIA would result in 1) parents finding the intake process more satisfactory and easier to complete, 2) therapists feeling more supported and satisfied and 3) a decrease …

Application Of A Short-Term Aquatic Physical Therapy Program For A Patient With Chronic Low Back Pain And Radiculopathy: A Case Report, Marc Asta

Case Report Posters

Chronic low back (CLBP) pain is a common referral to outpatient PT. Radiculopathy has the potential to contribute to back pain. Aquatic PT is utilized at select sites to treat patients with various debilitating conditions. Aquatic PT has been shown to improve quality of life, disability and pain. There is limited understanding on the short-term effects of aquatic PT. Must work within the confines of approved PT visits by local and national insurance companies. The purpose of this case report was to investigate if six physical therapy visits with aquatic intervention for a patient with chronic low back pain and …

Road To Recovery: Dysphagia Treatment With An Adult With Sma Type Ii, Kara Maharay, M.S., Ccc-Slp, Bcs-S, Kelly Salmon, M.A., Ccc-Slp, Bcs-S, Clt-Lana, Ronald S. Kaiser, Ph.D

Department of Rehabilitation Medicine Posters

Objective: Spinal Muscular Atrophy (SMA) is a genetic and degenerative motor neuron disease that affects muscle control including the muscles responsible for head and neck control and swallowing (Kesting, n. d.). There is limited research on the benefits of exercise as a therapeutic modality for people with Spinal Muscular Atrophy (SMA) (Swoboda et al., 2007) and no existing research specifically targeting pharyngeal or laryngeal strengthening to improve swallow function. As demonstrated by the positive outcome in this case study, speech-language pathologists should be aware that various modalities for dysphagia treatment such as biofeedback, neuromuscular electrical stimulation (NMES), and an exercise …

Reliability Of Isometric And Eccentric Isokinetic Shoulder External Rotation, Brianna M. Papotto, Thomas Rice, Terry Malone, Timothy Butterfield, Tim L. Uhl

Physical Therapy Faculty Publications

CONTEXT: Shoulder external rotators are challenged eccentrically throughout the deceleration phase of throwing which is thought to contribute to overuse injuries. In order to evaluate the effectiveness of intervention programs as well as identify deficits, reliable and responsive measures of isometric and eccentric shoulder external rotation are necessary. Previously, isometric measures have primarily tested a single position and eccentric measures have not been found to have high reliability.

OBJECTIVE: To examine the between day reliability of multiple angle isometric and dynamic eccentric isokinetic testing of shoulder external rotation.

DESIGN: Repeated measures Participants: 10 healthy subjects (age: 30 ± 12 years, …

Self-Care Project For Faculty And Staff Of Future Health Care Professionals: Case Report, Nancy Macrae, Kelley Strout

Occupational Therapy Faculty Publications

Self-care among health care providers is an important component of their ability to provide quality health care to patients. Health care institutions have programs in place for students that emphasize health and wellness, but few programs are available for faculty and staff. To address this gap and facilitate modeling health and wellness strategies for students, a New England institution that educates health care practitioners began a pilot self-care project for faculty and staff. Both quantitative and qualitative data were collected. The template used for this project could be used as a stepping-stone for future wellness self-care program in higher education …

Prevalence And Utilization Of Medical Care Services In Persons With Autism Spectrum Disorder Using Medicare Claims, Henry J. Carretta, Phd, Katelyn Graves, Ms, Teal W. Benevides, Phd, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Objective:

To characterize the prevalence of autism spectrum disorder (ASD) among persons in Medicare claims and contrast with prevalence documented during disability determination in Social Security Administration (SSA) Supplemental Security Income (SSI) files.

Poster presented at APHA in Chicago Illinois.

Neuromuscular Strengthening Exercises Following Acl And Meniscal Repair In A 15 Year Old Female Athlete With Generalized Knee Laxity: A Case Report, Alyssa Gardner, Kirsten Buchanan

Case Report Posters

Adolescent females are 4-6 times more likely to sustain a non-contact anterior cruciate ligament (ACL) injury compared to their male counterparts. Generalized knee laxity decreases dynamic knee stability and significantly increases the odds of an ACL injury 5-fold. It is crucial to return the surgically repaired knee to its former function. However, it is just as vital to direct attention to the uninjured knee with joint laxity. Research has found that those who have torn one ACL are six time more likely to tear the contralateral ACL. There is currently a lack of research that directly addresses intervention programs that …

Access Denied: Barriers For Unauthorized Immigrants Pursuing The American Dream, Kristin Mcmillen

OCCUPATION: A Medium of Inquiry about Health through Occupation

Millions of immigrants from all around the world are living in the United States without legal authorization. Most have come in search of a better life for themselves or their children, with the belief that through enough hard work, they can achieve the “American Dream.” However, upon arrival, many unauthorized immigrants face cultural, economic, and political barriers that limit their opportunities for community participation and lead many individuals to live their lives in fear. This paper aims to: (a) explore the barriers encountered by unauthorized immigrants in the United States; (b) consider the occupational significance of these barriers; and (c) …

Societal Statement On The Role Of Occupational Therapy With Survivors Of Human Sex Trafficking In The United States, Chelsea Bryant, Lillian Freeman, Meghan Granata, Annie He, Hillarie Hough, Shree Patel, Ashley Stedman, Stephanie Silvia, My-Lynn Tran

OCCUPATION: A Medium of Inquiry about Health through Occupation

As part of a specialized course, OTD 8340 Wellness and Health Promotion in Occupational Therapy, students from the Nova Southeastern University Entry Level Doctor of Occupational Therapy program, drafted a Societal Statement on the role of occupational therapy with survivors of human sex trafficking in the United States. The students explored the issue of domestic human sex trafficking from an occupational perspective, under the guidance of their professor, Mirtha Montejo Whaley, PhD, OTR/L. As of the publication of this journal, the document is under review by the American Occupational Therapy Association (AOTA)

Global Issue Of Clean Water As It Impacts Occupation, Hillary E. W. Anderson

OCCUPATION: A Medium of Inquiry about Health through Occupation

The purpose of this position paper is to explore the global impact of the lack or limited access to clean water on occupational engagement. The majority of the developed world has access to clean water, however, an alarming number of individuals do not have access to s governs, and impedes occupational engagement of millions globally. In order to enforce occupational justice, afforded from clean water, on a global scale, a fueling passion for change must be experienced by a collaborative force in a focused effort. Ultimately, access to clean water should be a basic human right propagated to all.

Primary Care Fall Risk Assessment For Elderly West Virginians, Vivian M. Minkemeyer, Matt Meriweather, Franklin D. Shuler, Saurabh P. Mehta, Zain N. Qazi

Orthopaedics

West Virginia is ranked second nationally for the percent of its population .65 years of age. The elderly are especially susceptible to falls with fall risk increasing as age increases. Because falls are the number one cause of injury-related morbidity and mortality in the West Virginia elderly, evaluation of fall risk is a critical component of the patient evaluation in the primary care setting. We therefore highlight fall risk assessments that require no specialized equipment or training and can easily be completed at an established office visit. High quality clinical practice guidelines supported by the American Geriatric Society recommend yearly …

Residual Impact Of Previous Injury On Musculoskeletal Characteristics In Special Forces Operators, Jeffrey J. Parr, Nicholas C. Clark, John P. Abt, Julie Y. Kresta, Karen A. Keenan, Shawn F Kane, Scott M. Lephart

Physical Therapy Faculty Publications

Background: Musculoskeletal injuries are a significant burden to United States Army Special Operations Forces. The advanced tactical skill level and physical training required of Army Special Operators highlights the need to optimize musculoskeletal characteristics to reduce the likelihood of suffering a recurrent injury.

Purpose: To identify the residual impact of previous injury on musculoskeletal characteristics.

Study Design: Cross-sectional study; Level of evidence, 3.

Methods: Isokinetic strength of the knee, shoulder, and back and flexibility of the shoulder and hamstrings were assessed as part of a comprehensive human performance protocol, and self-reported musculoskeletal injury history was obtained. Subjects were stratified based …

Pain Response After Maximal Aerobic Exercise In Adolescents Across Weight Status, Stacy Stolzman, Michael E. Danduran, Sandra K. Hunter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Introduction

Pain reports are greater with increasing weight status, and exercise can reduce pain perception. It is unknown, however, whether exercise can relieve pain in adolescents of varying weight status. The purpose of this study was to determine whether adolescents across weight status report pain relief after high-intensity aerobic exercise (exercise-induced hypoalgesia (EIH)).

Methods

Sixty-two adolescents (15.1 ± 1.8 yr, 29 males) participated in the following three sessions: 1) pressure pain thresholds (PPT) before and after quiet rest, clinical pain (McGill Pain Questionnaire), and physical activity levels (self-report and ActiSleep Plus Monitors) were measured, 2) PPT were measured with a …

Current Concepts Of Muscle And Tendon Adaptation To Strength And Conditioning, Jason Brumitt, Tyler Cuddeford

Faculty Publications - College of Physical Therapy

Injuries to the muscle and/or associated tendon(s) are common clinical entities treated by sports physical therapists and other rehabilitation professionals. Therapeutic exercise is a primary treatment modality for muscle and/or tendon injuries; however, the therapeutic exercise strategies should not be applied in a “one-size-fits-all approach”. To optimize an athlete’s rehabilitation or performance, one must be able to construct resistance training programs accounting for the type of injury, the stage of healing, the functional and architectural requirements for the muscle and tendon, and the long-term goals for that patient. The purpose of this clinical commentary is to review the muscular and …

A Prospective Analysis Of Factors Associated With Decreased Physical Activity In Patients With Cirrhosis Undergoing Transplant Evaluation, Anna Christina Dela Cruz, Valery Vilchez, Sooyeon Kim, Benjamin Barnes, Abhishek Ravinuthala, Anthony Zanni, Roberto Galuppo, Achuthan Sourianarayanane, Trushar Patel, Erin Colleen Maynard, Malay B. Shah, Michael F. Daily, Timothy L. Uhl, Karyn A. Esser, Roberto Gedaly

Internal Medicine Faculty Publications

BACKGROUND: Physical activity has been associated with improved recovery time after transplantation. Handgrip strength has been related to post-transplant outcomes.

AIM: To evaluate predictors of physical activity and grip strength in cirrhotic patients undergoing liver transplant evaluation.

METHODS: Single center, prospective analysis.

RESULTS: A hundred patients were evaluated (54% male, mean age 53 ± 9). Common etiologies of liver disease were non-alcoholic hepatitis (27%), hepatitis C (22%), and alcoholic liver disease (21%). Mean MELD score was 13.5. Forty one percent had a history of smoking. Ninety-three patients completed the International Physical Activity Questionnaire. The median total physical activity score of …

Living The Implicit Curriculum, Leaving A Legacy, Ricardo Carrasco

OCCUPATION: A Medium of Inquiry about Health through Occupation

This paper introduces the inaugural issue of OCCUPATION: A Medium of Inquiry for Stu dents, Faculty & Other Practitioners Advocating for Health through Occupational Studies. The paper asserts that implicit or hidden curriculum partners with the implicit curriculum, especially in health care education that promotes the students’ journey that employs doing, in the transfor - mative process in being and becoming entry-level practitioners.

The Occupational Benefits Of Children Farming, Ellie Edrissi

OCCUPATION: A Medium of Inquiry about Health through Occupation

This paper analyses the positive outcomes of youth responsibilities, routines, autonomy, youth programs and scholarships, cultural identity, educational and life experiences through the occupation of farming during seasonal and/or after school hours. The multidimensional context of children willingly working in the agricultural industry allows positive psychological, economical, and cultural experiences while building a stronger family unity. The occupation of farming allows youth participation with the environment, social skills, inter-generational transfer of skills, and increased confidence for future aspirations as they mature to adulthood.

November 2015 Issue, Occupation: A Medium Of Inquiry For Students, Faculty & Other Practitioners Advocating For Health Through Occupational Studies

OCCUPATION: A Medium of Inquiry about Health through Occupation

No abstract provided.

A Review Of Transcranial Magnetic Stimulation And Multimodal Neuroimaging To Characterize Post-Stroke Neuroplasticity, Angela M. Auriat, Jason L. Neva, Sue Peters, Lara A. Boyd

Physical Therapy Publications

Following stroke, the brain undergoes various stages of recovery where the central nervous system can reorganize neural circuitry (neuroplasticity) both spontaneously and with the aid of behavioral rehabilitation and non-invasive brain stimulation. Multiple neuroimaging techniques can characterize common structural and functional stroke-related deficits, and importantly, help predict recovery of function. Diffusion tensor imaging (DTI) typically reveals increased overall diffusivity throughout the brain following stroke, and is capable of indexing the extent of white matter damage. Magnetic resonance spectroscopy (MRS) provides an index of metabolic changes in surviving neural tissue after stroke, serving as a marker of brain function. The neural …

The Lifestyle-Integrated Functional Exercise Program For Older Adults, Jessica Lim, Courtney Beyer, Anna Lee, Sienna Anderson

Student Research Posters

According to the Centers for Disease Control and Prevention, falls are the most common cause of fatal and non-fatal injuries among older adults over the age of 65 (Centers for Disease Control and Prevention [CDC], 2009). Falls can lead to a myriad of traumatic physical and emotional consequences. Integrated exercise programs such as the Lifestyle-integrated Functional Exercise (LiFE) program are effective in preventing falls and increasing fall efficacy in individuals who have previously fallen (Clemson et al., 2012). The purpose of our study was to examine if the LiFE program is as effective in reducing fall risk and increasing fall …