Rehabilitation and Therapy Commons^™

Staff Perceptions Of The Barriers To Mobilizing Icu Patients, Simone Dafoe, Kathy Stiller, Marianne Chapman

Internet Journal of Allied Health Sciences and Practice

Purpose: Whilst early progressive mobilization is known to be safe and beneficial for patients in an intensive care unit (ICU), barriers still exist to its implementation. As part of a broader quality improvement project that had the overall aim of increasing the frequency of mobilization in our ICU, we conducted a survey of ICU staff to investigate their perceptions of the barriers to the early progressive mobilization of ICU patients. Method: A prospective survey of ICU staff in an Australian, tertiary care, public hospital ICU was undertaken. A total of 93 medical, nursing, and physiotherapy staff participated. A purpose-designed survey …

Walking Speed: The Functional Vital Sign, Addie Middletown, Stacy Fritz, Michelle M. Lusardi

All PTHMS Faculty Publications

Walking speed (WS) is a valid, reliable, and sensitive measure appropriate for assessing and monitoring functional status and overall health in a wide range of populations. These capabilities have led to its designation as the “sixth vital sign”. By synthesizing the available evidence on WS, this scholarly review article provides clinicians with a reference tool regarding this robust measure. Recommendations on testing procedures for assessing WS, including optimal distance, inclusion of acceleration and deceleration phases, instructions, and instrumentation are given. After assessing an individual's WS, clinicians need to know what this value represents. Therefore, WS cut-off values and the corresponding …

Mindfulness: Being Present In The Moment, Stephanie Ann Stathas, Christine Frazer

Walden Faculty and Staff Publications

This article serves to enlighten childbirth educators’ knowledge about mindfulness and the mother-baby benefits associated with incorporating mindfulness- based interventions into practice. Jon Kabat-Zinn, who developed the Mindfulness Based Stress Reduction program, brought the concept of mindfulness into the world of healthcare and mainstream society. Mindfulness is the practice of bringing awareness to the here and now using a variety of methods. Nancy Bardacke has taken the practice of mindfulness further and developed a program for expecting mothers, known as Mindfulness Based Childbirth and Parenting. This program has been shown to reduce stress responses that may be harmful to a …

A Study Examining Practice Style Traits Of Physical Therapists: Do They Explain Practice Behaviors And Knowledge Translation?, Kristen M. Johnson

Student Dissertations

Background: The advancement of evidence-based practice (EBP) has generated a flurry of outcome measures (OMs) and continuing education courses to assist in the creation and tailoring of this knowledge to the clinical environment. Despite the development of these resources, little is known about the attributes and behaviors of the physical therapist for knowledge translation (KT) into clinical practice.

Purpose: To determine the practice style traits of physical therapists who attended an evidence-based continuing education course on Oms and to determine their perceived barriers, facilitators, attitudes, knowledge, behaviors, and prerequisites for KT.

Methods: Seventy-nine physical therapists completed two standardized, validated surveys …

Immune Function And Muscle Adaptations To Resistance Exercise In Older Adults: Study Protocol For A Randomized Controlled Trial Of A Nutritional Supplement, Richard A. Dennis, Usha Ponnappan, Ralph L. Kodell, Kimberly K. Garner, Christopher M. Parkes, Melinda M. Bopp, Kalpana P. Padala, Charlotte A. Peterson, Prasad R. Padala, Dennis H. Sullivan

Physical Therapy Faculty Publications

BACKGROUND: Immune function may influence the ability of older adults to maintain or improve muscle mass, strength, and function during aging. Thus, nutritional supplementation that supports the immune system could complement resistance exercise as an intervention for age-associated muscle loss. The current study will determine the relationship between immune function and exercise training outcomes for older adults who consume a nutritional supplement or placebo during resistance training and post-training follow-up. The supplement was chosen due to evidence suggesting its ingredients [arginine (Arg), glutamine (Gln), and β-hydroxy β-methylbutyrate (HMB)] can improve immune function, promote muscle growth, and counteract muscle loss. …

The Use Of Pbl In An Interprofessional Education Course For Health Care Professional Students, Kristine M. L'Ecuyer, David Pole, Sheila A. Leander

Interdisciplinary Journal of Problem-Based Learning

A problem-based learning (PBL) framework was utilized in a series of six interprofessional team seminars (IPTS) for postbaccalaureate students from seven health professions. The goal of IPTS was to develop a collaborative practice-ready workforce prepared to respond to patient care needs through use of concrete examples, skills development, critical thinking, and problem solving in safe, faculty-facilitated small groups. The collaborative nature of PBL closely correlates with teaching methodologies of the IPTS series. This study analyzed critical reflection assignments of nursing students in accelerated programs to determine the effectiveness of IPTS at preparing students for interprofessional collaborative practice. Findings indicated that …

Blockade Of Neurokinin-1 Receptors In The Ventral Respiratory Column Does Not Affect Breathing But Alters Neurochemical Release, Clarissa Muere, Suzanne Neumueller, Samantha Olesiak, Justin Miller, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Substance P (SP) and its receptor, neurokinin-1 (NK1R), have been shown to be excitatory modulators of respiratory frequency and to stabilize breathing regularity. Studies in anesthetized mice suggest that tonic activation of NK1Rs is particularly important when other excitatory inputs to the pre-Bötzinger complex in the ventral respiratory column (VRC) are attenuated. Consistent with these findings, muscarinic receptor blockade in the VRC of intact goats elicits an increase in breathing frequency associated with increases in SP and serotonin concentrations, suggesting an involvement of these substances in neuromodulator compensation. To gain insight on the contribution to breathing of endogenous SP and …

Differential Effects Of Cardiovascular And Resistance Exercise On Functional Mobility In Individuals With Advanced Cancer: A Randomized Trial, Amy J. Litterini, Vickie Fieler, James T. Cavanaugh, Jeannette Lee

Physical Therapy Faculty Posters

Objective: To compare the effects of resistance and cardiovascular exercise on functional mobility in individuals with advanced cancer.
Design: Prospective, 2-group pretest-posttest pilot study with randomization to either resistance or cardiovascular exercise mode.
Setting: Comprehensive community cancer center and a hospital-based fitness facility.
Demographics: Volunteer sample of individuals with advanced cancer recruited through the cancer center, palliative care service, rehabilitation department, and a local hospice.
Outcome Measures: Functional mobility was assessed using the Short Physical Performance Battery (SPPB); self-reported pain and fatigue were assessed secondarily using visual analog scales. Data were analyzed using a split plot 2x2 analysis of variance …

Determinants Of Adherence To Living On Dialysis For Mexican Americans, Shirley A. Wells

Occupational Therapy Faculty Publications

This study explores perceptions that affect adherence behaviors among Mexican Americans living with dialysis. In-depth narrative interviews were conducted with 15 Mexican Americans with end-stage renal disease (ESRD) living on dialysis, 15 family members, and 6 health care personnel who provided care to them. Four themes emerged: (a) positive influences to adherence, (b) obstacles to adherence, (c) daily activity losses, and (d) fears about living with dialysis. From the findings, the perceptions given for non-adherence with the dialysis regimen ranged from denial of the condition, lack of pre-education, to cultural factors. Those given for adherence included prolonged life, family, and …

Mitochondria-Associated Micrornas In Rat Hippocampus Following Traumatic Brain Injury, Wang-Xia Wang, Nishant P. Visavadiya, Jignesh D. Pandya, Peter T. Nelson, Patrick G. Sullivan, Joe E. Springer

Sanders-Brown Center on Aging Faculty Publications

Traumatic brain injury (TBI) is a major cause of death and disability. However, the molecular events contributing to the pathogenesis are not well understood. Mitochondria serve as the powerhouse of cells, respond to cellular demands and stressors, and play an essential role in cell signaling, differentiation, and survival. There is clear evidence of compromised mitochondrial function following TBI; however, the underlying mechanisms and consequences are not clear. MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate gene expression post-transcriptionally, and function as important mediators of neuronal development, synaptic plasticity, and neurodegeneration. Several miRNAs show altered expression following TBI; however, the …

A Teaching Tool To Visually Illustrate How Manipulating The Physiology Of The Ventilatory Muscle Pump Alters Functional Performance, Dennis Sobush

Physical Therapy Faculty Research and Publications

This clinical perspective article describes an inexpensive pedagogical tool intended for use in a laboratory setting as part of a cardiovascular and pulmonary physical therapy course. It uses a dual balance scale schematic/model. As a teaching resource, physical therapy students can use it to visually reinforce their understanding of the complex cause-and-effect interplay between physiological factors that affect ventilatory muscle pump (VMP) performance for sustained breathing or contribute to VMP fatigue/failure.

Effect Of Tai Chi Exercise Combined With Mental Imagery In Improving Balance, Abdulrahman Alsubiheen

Loma Linda University Electronic Theses, Dissertations & Projects

Background: One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects feet sensation and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Methods: Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 50-80 years of age were recruited. All subjects in both groups attended a Yang style of TC class, two sessions per week for 8 weeks. Each session was one hour long. Measures …

Muscle Dynamics As The Result Of Whole Body Vibration And Plyometrics, Richard Jeremy Hubbard

Loma Linda University Electronic Theses, Dissertations & Projects

BACKGROUND: Whole body (WBV) vibration and plyometrics are common training techniques which increase strength, blood flow, force and power. The effects these techniques have on sedentary population is unknown. It is our aim to assess the effectiveness of WBV and plyometrics on sedentary population. SUBJECTS: Three groups of nine sedentary subjects were assigned to either the control group (C), jumping only group (J), or jumping with vibration group (JV). METHODS AND PROCEDURES: Measurements included: jump height (Myotest or Vertec), velocity, force, blood lactates, gastrocnemius and quadriceps strength, and exertion (RPE). Subjects were measured at the first, seventh, and eighteenth visits. …

Ot On College Campuses: Emerging Models Faciltitating Student Success Through Occupation, Lisa Crabtree, Carlin Daley, Jeanne Eichler, Karen Mccarthy, Victoria Schindler

Collected Faculty Scholarship

No abstract available

Reliance On Auditory Feedback In Children With Childhood Apraxia Of Speech, Jenya Iuzzini-Seigel, Tiffany P. Hogan, Anthony J. Guarino, Jordan R. Green

Speech Pathology and Audiology Faculty Research and Publications

Children with childhood apraxia of speech (CAS) have been hypothesized to continuously monitor their speech through auditory feedback to minimize speech errors. We used an auditory masking paradigm to determine the effect of attenuating auditory feedback on speech in 30 children: 9 with CAS, 10 with speech delay, and 11 with typical development. The masking only affected the speech of children with CAS as measured by voice onset time and vowel space area. These findings provide preliminary support for greater reliance on auditory feedback among children with CAS.

Learning outcomes: Readers of this article should be able to (i) …

Stroke-Related Effects On Maximal Dynamic Hip Flexor Fatigability And Functional Implications, Henry Kuhnen, Megan M. Rybar, Tanya Onushko, Ryan E. Doyel, Sandra K. Hunter, Brian D. Schmit, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Introduction: Stroke-related changes in maximal dynamic hip flexor muscle fatigability may be more relevant functionally than isometric hip flexor fatigability. Methods: Ten chronic stroke survivors performed 5 sets of 30 hip flexion maximal dynamic voluntary contractions (MDVC). A maximal isometric voluntary contraction (MIVC) was performed before and after completion of the dynamic contractions. Both the paretic and nonparetic legs were tested. Results: Reduction in hip flexion MDVC torque in the paretic leg (44.7%) was larger than the nonparetic leg (31.7%). The paretic leg had a larger reduction in rectus femoris EMG (28.9%) between the first and last …

The Effect Of Muscle Energy Technique On Forward Shoulder Posture, Pectoralis Minor Length, And Upper Extremity Blood Flow In Collegiate Female Swimmers, Elizabeth Gross

Theses and Dissertations

Context: Overhead sports are at an increased risk of shoulder injury, particularly when scapular posture is restricted. Pectoralis minor length has been linked to scapular malpositioning and forward shoulder posture. Upper extremity blood flow has also been linked to shortened pectoralis minor length, which could lead to thoracic neurovascular occlusion. Swimmers specifically may be at an increased risk for shoulder injury if the pectoralis minor is shortened. Stretching of the pectoralis minor has been suggested as a treatment to correct shortening of the muscle, however research examining muscle energy technique (MET) applied to the pectoralis minor is limited. Objective: To …

Postcolonial Disability In Mohesen Makhmalbaf’S Kandahar, Sukshma Vedere

Ray Browne Conference on Cultural and Critical Studies (2015-2021)

Kandahar (2001), an Iranian film directed by Mohsen Makhmalbaf, details the journey of the protagonist, Nafas, to Kandahar to save her sister from committing suicide on the day of the solar eclipse. The film has gained recent attention by disability studies scholars for the representation of disability in Afghanistan; scholars have discussed the significance of prosthetics and international aid for the disabled in post-war zones of the Third World, but little has been said about disability as a postcolonial embodiment. I argue that Kandahar represents the postcolonial state as a disabled space both literally and metaphorically. It projects the veil …

Health Related Quality Of Life In Persons With Type 2 Diabetes In A Rural Community Served By A Critical Access Hospital, Betsy J. Becker, Terry F. Nelson, Robin High, Pat Hauer

Posters and Presentations: Physical Therapy

Purpose

Type 2 diabetes poses significant health concerns and severe complications can result. The prevalence of type 2 diabetes is greater in rural than urban areas with rural populations exhibiting higher blood glucose (A1C). The purpose of this study was to determine whether health related quality of life (QOL) varies by gender and diabetes control (A1C) in rural persons with type 2 diabetes.

Subjects

We surveyed 615 persons with type 2 diabetes who receive care at a critical access hospital that serves a seven county rural area in a Midwestern state.

Methods

This study was a cross-sectional mail survey including …

Somatic Experiencing: Using Interoception And Proprioception As Core Elements Of Trauma Therapy, Peter Payne, Peter A. A. Levine, Mardi A. Crane-Godreau

Dartmouth Scholarship

Here we present a theory of human trauma and chronic stress, based on the practice of Somatic Experiencing(®) (SE), a form of trauma therapy that emphasizes guiding the client's attention to interoceptive, kinesthetic, and proprioceptive experience. SE™ claims that this style of inner attention, in addition to the use of kinesthetic and interoceptive imagery, can lead to the resolution of symptoms resulting from chronic and traumatic stress. This is accomplished through the completion of thwarted, biologically based, self-protective and defensive responses, and the discharge and regulation of excess autonomic arousal. We present this theory through a composite case study of …

Short-Term Cortical Plasticity Associated With Feedback-Error Learning After Locomotor Training In A Patient With Incomplete Spinal Cord Injury, Amanda E. Chisholm, Sue Peters, Michael R. Borich, Lara A. Boyd, Tania Lam

Physical Therapy Publications

Background and purpose: For rehabilitation strategies to be effective, training should be based on principles of motor learning, such as feedback-error learning, that facilitate adaptive processes in the nervous system by inducing errors and recalibration of sensory and motor systems. This case report suggests that locomotor resistance training can enhance somatosensory and corticospinal excitability and modulate resting-state brain functional connectivity in a patient with motor-incomplete spinal cord injury (SCI).

Case description: The short-term cortical plasticity of a 31-year-old man who had sustained an incomplete SCI 9.5 years previously was explored in response to body-weight-supported treadmill training with velocity-dependent resistance applied …

Reverse Innovation: An Opportunity For Strengthening Health Systems, Anne W Snowdon, Harpreet Bassi, Andrew D. Scarffe, Alexander D Smith

Health and Rehabilitation Sciences Publications

BACKGROUND: Canada, when compared to other OECD countries, ranks poorly with respect to innovation and innovation adoption while struggling with increasing health system costs. As a result of its failure to innovate, the Canadian health system will struggle to meet the needs and demands of both current and future populations. The purpose of this initiative was to explore if a competition-based reverse innovation challenge could mobilize and stimulate current and future leaders to identify and lead potential reverse innovation projects that address health system challenges in Canada.

METHODS: An open call for applications took place over a 4-month period. Applicants …

The Effectiveness Of Whole-Body-Vibration Training In Improving Hamstring Flexibility In Physically Active Adults, Megan N. Houston, Victoria Hodson, Kelda K. E. Adams, Johanna M. Hoch

Human Movement Studies & Special Education Faculty Publications

Clinical Scenario: Hamstring tightness is common among physically active individuals. In addition to limiting range of motion and increasing the risk of muscle strain, hamstring tightness contributes to a variety of orthopedic conditions. Therefore, clinicians continue to identify effective methods to increase flexibility. Although hamstring tightness is typically treated with common stretching techniques such as static stretching and proprioceptive neuromuscular facilitation, it has been suggested that whole-body-vibration (WBV) training may improve hamstring flexibility. Clinical Question: Can WBV training, used in isolation or in combination with common stretching protocols or exercise, improve hamstring flexibility in physically active young adults? Summary of …

The Current State Of Physical Therapy Pain Curricula In The United States: A Faculty Survey, Marie K. Hoeger Bement, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Insufficient pain education is problematic across the health care spectrum. Recent educational advancements have been made to combat the deficits in pain education to ensure that health care professionals are proficient in assessing and managing pain. The purpose of this survey was to determine the extent of pain education in current Doctorate of Physical Therapy schools in the United States, including how pain is incorporated into the curriculum, the amount of time spent teaching about pain, and the resources used to teach about pain. The survey consisted of 10 questions in the following subject areas: basic science mechanisms and concepts …

Utility Of Ultrasound For Imaging Osteophytes In Patients With Insertional Achilles Tendinopathy, Ruth L. Chimenti, Peter C. Chimenti, Mark R. Buckley, Jeff R. Houck, A. Samuel Fleminster

Faculty Publications - College of Physical Therapy

Objectives: To examine (1) the validity of ultrasound imaging to measure osteophytes and (2) the association between osteophytes and insertional Achilles tendinopathy (IAT).

Design: Case-control study.

Setting: Academic medical center.

Participants: Persons with chronic unilateral IAT (n=20; mean age, 58.7±8.3y; 10 [50%] women) and age- and sex-matched controls (n=20; mean age, 57.4±9.8y; 10 [50%] women) participated in this case-control study (N=40).

Interventions: Not applicable.

Main Outcome Measures: Symptom severity was assessed using the Foot and Ankle Ability Measure, the Victorian Institute of Sport Assessment-Achilles questionnaire, and the numerical rating scale. Length of osteophytes was measured bilaterally in both groups using …

Common Threads: An Integrated Hiv Prevention And Vocational Development Intervention For African American Women Living With Hiv/Aids, Liza Marie Conyers, Yung-Chen Chiu, Aisha Shamburger-Rousseau, Vanessa Johnson, Mark Misrok

Journal of Health Disparities Research and Practice

Current policies and initiatives call for the integration of social determinants of health into HIV/AIDS prevention and care interventions. According to the World Health Organization’s Commission on Social Determinants of Health, the lower a person’s socioeconomic status, the worse the health outcomes. One way to alleviate poverty among African American women with HIV/AIDS is to help foster their vocational development and economic empowerment. The National HIV/AIDS Strategy Implementation Plan specifically directs federal agencies to find ways to integrate people living with HIV/AIDS into broader employment initiatives. The purpose of this manuscript is to examine medical, psychosocial, financial/legal and vocational social …

Innovative Evaluation Of Dexterity In Pediatrics, Susan V. Duff, Dorit H. Aaron, Gloria R. Gogola, Francisco J. Valero-Cuevas

Physical Therapy Faculty Articles and Research

Introduction

Hand dexterity is multifaceted and essential to the performance of daily tasks. Timed performance and precision demands are the most common features of quantitative dexterity testing. Measurement concepts such as rate of completion, in-hand manipulation and dynamic force control of instabilities are being integrated into assessment tools for the pediatric population.

Purpose

To review measurement concepts inherent in pediatric dexterity testing and introduce concepts that are infrequently measured or novel as exemplified with two assessment tools.

Methods

Measurement concepts included in common assessment tools are introduced first. We then describe seldom measured and novel concepts embedded in two instruments; …

Clinical Assessment Of The Infant And Child Following Perinatal Brachial Plexus Injury, Susan V. Duff, Carol Dematteo

Physical Therapy Faculty Articles and Research

Introduction

After perinatal brachial plexus injury (PBPI), clinicians play an important role in injury classification as well as the assessment of recovery and secondary conditions. Early assessment guides the initial plan of care and influences follow-up and long-term outcome.

Purpose

To review methods used to assess, classify and monitor the extent and influence of PBPI with an emphasis on guidelines for clinicians.

Methods

We use The International Classification of Functioning, Disability, and Health (ICF) model to provide a guide to assessment after PBPI for rehabilitation clinicians.

Discussion

With information gained from targeted assessments, clinicians can design interventions to increase the …

Designing Electronics For An Artificial Leg, Taylor Barto

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

A regenerative prosthesis is modeled and simulated. The simulation is optimized with the biogeography-based optimization algorithm to obtain desired knee angle tracking with a reference knee trajectory and to regenerate energy. The prosthesis is able to track a reference knee angle with a 5.1 degree error averaged over an entire stride and regenerate some energy throughout the stride.

Spatial And Temporal Characteristics Of Error-Related Activity In The Human Brain, Maital Neta, Francis M. Miezin, Steven M. Nelson, Joseph W. Dubis, Nico U.F. Dosenbach, Bradley L. Schlaggar, Steven E. Petersen

Center for Brain, Biology, and Behavior: Faculty Publications

A number of studies have focused on the role of specific brain regions, such as the dorsal anterior cingulate cortex during trials on which participants make errors, whereas others have implicated a host of more widely distributed regions in the human brain. Previous work has proposed that there are multiple cognitive control networks, raising the question of whether error-related activity can be found in each of these networks. Thus, to examine error-related activity broadly, we conducted a meta-analysis consisting of 12 tasks that included both error and correct trials. These tasks varied by stimulus input (visual, auditory), response output (button …