Rehabilitation and Therapy Commons^™

Physical Therapy Management Of A Patient With Chronic Brainstem Stroke Syndrome To Improve Functional Mobility: A Case Report, Kelley Flahaven

Case Report Posters

Strokes are a leading cause of disability, and the fifth leading cause of death in the U.S. Brainstem strokes are much less common and have a higher mortality rate than cortical strokes. Brainstem strokes can lead to physical impairments including gaze palsies, quadriplegia, ataxia, or cranial nerve deficits, which affect balance and safety, decreasing independence. Repetitive task gait training has been shown to create improvements in patients with stroke. Non-specific gait training can have a transfer effect on gait for patients with stroke. There are fewer accounts of brainstem stroke rehabilitation than cortical stroke rehabilitation due to poor prognosis and …

Functional Training In A Patient With Middle Cerebral Artery Stroke With Multiple Comorbidities: A Case Report, Darien Lewis

Case Report Posters

795,000 people experience a stroke yearly, making it the leading cause of long-term disability, costing $34 billion. Strokes affecting the middle cerebral artery (MCA) cause impairments of strength, sensation, coordination, and balance of the contralateral side. Recovery from stroke is affected by premorbid status. Cardiovascular disease causes a majority of strokes. The purpose of this case report is to describe a progressive PT plan of care for a patient following MCA stroke with multiple comorbidities in the skilled nursing setting.

Therapeutic Exercise In The Treatment Of Greater Trochanteric Pain Syndrome S/P Lumbar Discectomy: A Case Report, Sean Jeffrey

Case Report Posters

Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, affecting between 1.8 and 5.6 patients per 1000 annually. Inadequate core stability and gluteal weakness contribute to the probability of developing GTPS. GTPS is more common in patients with coexisting low back pain (LBP). Discectomy is effective in treating LBP pain caused by prolapsed lumbar intervertebral discs, however, it does not correct back muscle function. Lumbar stabilization exercises have demonstrated improved quality of life (QOL) outcomes. As both GTPS and discectomy rehabilitation lack defined treatment guidelines, the purpose of this case report is to describe the physical …

Therapeutic Exercise In The Treatment Of Greater Trochanteric Pain Syndrome S/P Lumbar Discectomy: A Case Report, Sean Jeffrey

Case Report Papers

Background and Purpose: Greater trochanteric pain syndrome (GTPS) is a multifactorial cause of lateral hip pain, affecting between 1.8 and 5.6 patients per 1000 per year. The prevalence of GTPS is more common in patients with coexisting low back pain. Though discectomy is effective in the treatment of prolapsed lumbar intervertebral discs, it does not correct concurrent hip pathology. As GTPS in the setting of discectomy rehabilitation lacks defined treatment guidelines, the purpose of this case report is to display physical therapy (PT) treatment of GTPS in conjunction with simultaneous rehab from lumbar microdiscectomy.
Case Description: A 56-year-old male was …

Adaptations Of Lumbar Biomechanics After Four Weeks Of Running Training With Minimalist Footwear And Technique Guidance: Implications For Running-Related Lower Back Pain, Szu-Ping Lee, Joshua P. Bailey, Jo Armour Smith, Stephanie Barton, David Brown, Talia Joyce

Physical Therapy Faculty Articles and Research

Objectives

To investigate the changes in lumbar kinematic and paraspinal muscle activation before, during, and after a 4-week minimalist running training.

Design

Prospective cohort study.

Setting

University research laboratory.

Participants

Seventeen habitually shod recreational runners who run 10–50 km per week.

Main outcome measures

During stance phases of running, sagittal lumbar kinematics was recorded using an electrogoniometer, and activities of the lumbar paraspinal muscles were assessed by electromyography. Runners were asked to run at a prescribed speed (3.1 m/s) and a self-selected speed.

Results

For the 3.1 m/s running speed, significant differences were found in the calculated mean lumbar posture …

Use Of The Task-Oriented Approach For Chronic Inflammatory Demyelinating Polyneuropathy: A Case Report, Alison Newell, Amy J. Litterini

Case Report Posters

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an acquired neurological disorder similar to Guillain-Barre Syndrome (GBS) with rare a prevalence of 2-7.7/100,000.7. Etiology and pathogenesis are largely unknown but are thought to be immunological, targeting the myelin of peripheral nerves. Extensive literature exists regarding medical management of CIDP, but limited research exists regarding physical therapy (PT) management for patients with CIDP. Task-Oriented Approach (TOA) is based upon systems theory with influence from motor learning and motor control theories. Systems theory states abnormal movements are related to deficits in one or more system(s) and are comprised of the body’s existing systems’ attempts …

Physical Therapy Intervention For A Patient With Temporomandibular Joint Dysfunction Caused By Two Traumatic Events: A Case Study, Elyse Detweiler

Case Report Papers

Background and Purpose: Temporomandibular disorders (TMD) are pathoanatomical dysfunctions of the temporomandibular joint (TMJ) associated with symptoms throughout the head and neck.Limited information exists regarding conservative physical therapy (PT) and post-surgical management of TMD. The dental profession is the main source of published literature specific to TMD. This paper describes a conservative and post-surgical PT plan of care (POC) for TMD. Case Description: A 32-year old female experienced two separate traumatic events at work resulting in TMD. She was referred to PT after the second assault because of symptoms of severe pain, limited range of motion, and jaw locking. She …

A Comparison Of Multipath And Conventional Neuromuscular Electrical Stimulation, Cody Brian Bremner

Dissertations

Neuromuscular electrical stimulation (NMES) is the use of an electrical current for the purpose of eliciting a muscular response, and these treatments are most often used clinically for the specific purpose of increasing quadriceps strength. It is commonly accepted that the effectiveness of NMES for this purpose is primarily determined by the NMES training intensity. However, spatially limited motor unit recruitment, fatigue and discomfort negatively impact NMES-induced torque, which subsequently reduces NMES training intensities. Due to the importance of NMES training intensity, a substantial amount of research has focused on strategies designed to increase NMES-induced torque production, as well as …

Ot Department News- Issue #1

Department of Occupational Therapy Newsletter

No abstract provided.

Perceptual Variations In Thermoregulation During Exercise In A Hot Environment, William C. Alger

Electronic Theses and Dissertations

ABSTRACT

Professionals are seeking to find ways to prevent exertional heat illness (EHI) in populations working in hot environments as well as populations that are physically active. The purpose of the present study was to evaluate individuals’ ability to accurately perceive core temperature ranges associated with homeothermic and EHI temperatures during exercise. Ten physically active males exercised on a treadmill at a self-selected rate until core temperature reached 39°C. Participants rated perceived core and skin temperature on 100 mm scales each time core temperature increased 0.25˚ C (37.5-39.0˚ C), along with thermal comfort and sweating sensation. During exercise core temperature …

Conquering The Kitchen: Cooking And Older Adult Male Caregivers, Miranda Jenkins, George Kukich

Older Adult

Older adult men who have taken on an unfamiliar role as a caregiver find themselves at a loss with how to conduct meal preparation and cooking (Russell, 2007). The purpose of this study was to explore the effects of a specialized cooking class on the perceptions of older adult male caregivers. Method: This mixed method, retrospective study analyzed surveys from subjects who attended a cooking class designed specifically for male caregivers. Participants were 60 years of age or older and were required to be living in one of nine participating local counties. Results: The participants reported that the course expanded …

Evaluating Cardiovascular Dysfunction During Increased Activity And Exercise Rehabilitation Following Incomplete Thoracic Spinal Cord Injury In The Adult Rat., Kathryn A. Harman

Electronic Theses and Dissertations

Spinal cord injury (SCI) results in whole-body dysfunction. While the majority of SCI research is focused on improving locomotor function after injury, cardiovascular (CV) disease continues to be the leading cause of morbidity in the chronic SCI patient population. The combination of injury-induced destruction of autonomic pathways, maladaptive plasticity within lumbosacral circuits, and the progressive decline in physical fitness contribute to the poor CV status of SCI individuals. Currently, there is little emphasis on implementing appropriately-timed acute rehabilitation techniques aimed to curtail maladaptive remodeling and improve CV outcomes. Furthermore, no pre-clinical or clinical studies have investigated the most appropriate time-course …

Preseason Jump And Hop Measures In Male Collegiate Basketball Players: An Epidemiologic Report, Jason Brumitt, Amy Engilis, Dale Isaak, Amy Briggs, Alma Mattocks

Faculty Publications - College of Physical Therapy

Background: Injuries are inherent in basketball with lower extremity (LE) injury rates reported as high as 11.6 per 1000 athletic exposures (AEs); many of these injuries result in time loss from sport participation. A recent trend in sports medicine research has been the attempt to identify athletes who may be at risk for injury based on measures of preseason fitness.

Hypothesis/Purpose: The purpose of this prospective cohort study was to determine if the standing long jump (SLJ) and/or the single-leg hop (SLH) for distance functional performance tests (FPT) are associated with non-contact time loss lower quadrant (LQ, defined as lower …

Patient Experiences Of Recovery After Autologous Chondrocyte Implantation: A Qualitative Study, Jenny L. Toonstra, Dana Howell, Robert A. English, Carl G. Mattacola

EKU Faculty and Staff Scholarship

Context: The recovery process after autologous chondrocyte implantation (ACI) can be challenging for patients and clinicians alike due to significant functional limitations and a lengthy healing time. Understanding patients' experiences during the recovery process may assist clinicians in providing more individualized care.

Objective: To explore and describe patients' experiences during the recovery process after ACI.

Design: Qualitative study.

Setting: Orthopaedic clinic.

Patients or Other Participants: Participants from a single orthopaedic practice who had undergone ACI within the previous 12 months were purposefully selected.

Data Collection and Analysis: Volunteers participated in 1-on-1 semistructured interviews to describe their recovery experiences after ACI. …

Effect Of Heavy Lifting With A Head Strap On The Pelvic Floor Across The Menstrual Cycle, Yvonne Biswokarma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Pelvic organ prolapse (POP) occurs in 10% of women in Nepal, even 6% of nulliparous women have symptomatic POP.1 This may be linked to the heavy lifting tasks performed by women using a head strap.2 This study explored the impact of hormonal changes on the pelvic floor when performing these tasks during each phase of the menstrual cycle. Methods: The study included 22 female Nepali participants with a mean age of 27.4(3.6) years; all were from rural villages and frequently carried with a head strap. Using intravaginal pressure transducers (IVT), the mean change in intraabdominal pressure (IAP) was found …

Factors Affecting Community Participation In Young Adults With Intellectual And Developmental Disabilities, Molly Bathje

Dissertations

Young adults with intellectual and developmental disabilities (IDD) participate less frequently in communities than other disabled and non-disabled peers (Verdonschot, de Witte, Reichrath, Buntinx, & Curfs, 2009) even though they express a desire to participate (Kampert & Goreczny, 2007) and federal policy mandates community inclusion (Haertl, 2014). Participation in one’s community is linked to health and quality of life (World Health Organization, 2002). The broad goal of this three paper dissertation is to contribute to a deeper understanding of what facilitates and impedes community participation for young adults with IDD by (1) developing a new conceptual model, (2) evaluating a …

Letter To The Editor Regarding “Clinical Effectiveness And Safety Of Powered Exoskeleton-Assisted Walking In Patients With Spinal Cord Injury: Systematic Review With Meta-Analysis”, Marcel P. Dijkers, Katherine G. Akers, Sujay S. Galen, Diane E. Patzer, Phuong T. Vu

Library Scholarly Publications

No abstract provided.

Temporary Nerve Block At Selected Digits Revealed Hand Motor Deficits In Grasping Tasks, Aude Cateron, Kerry Mcpartlan, Christina Gioeli, Emily Reid, Matt Turturro, Barry Hahn, Cynthia Benson, Wei Zhang

Publications and Research

Peripheral sensory feedback plays a crucial role in ensuring correct motor execution throughout hand grasp control. Previous studies utilized local anesthesia to deprive somatosensory feedback in the digits or hand, observations included sensorimotor deficits at both corticospinal and peripheral levels. However, the questions of how the disturbed and intact sensory input integrate and interact with each other to assist the motor program execution, and whether the motor coordination based on motor output variability between affected and non-affected elements (e.g., digits) becomes interfered by the local sensory deficiency, have not been answered. The current study aims to investigate the effect of …

Development, Validation And Application Of A New Fornix Template For Studies Of Aging And Preclinical Alzheimer's Disease, Christopher A. Brown, Nathan F. Johnson, Amelia J. Anderson-Mooney, Gregory A. Jicha, Leslie M. Shaw, John Q. Trojanowski, Linda J. Van Eldik, Frederick A. Schmitt, Charles D. Smith, Brian T. Gold

Physical Therapy Faculty Publications

We developed a merged younger-older adult template of the fornix and demonstrated its utility for studies of aging and preclinical Alzheimer's disease (AD). In Experiment 1, probabilistic tractography was used to reconstruct the fornix in younger and older adults and successful streamlines were then averaged to create a merged template in standard space. The new template includes the majority of the fornix from the hippocampal formation to the subcallosal region and the thalamus/hypothalamus. In Experiment 2, the merged template was validated as an appropriate measure for studies of aging, with comparisons against manual tracing measures indicating identical spatial coverage in …

Methylphenidate And Memory And Attention Adaptation Training For Persistent Cognitive Symptoms After Traumatic Brain Injury: A Randomized, Placebo-Controlled Trial, Brenna C. Mcdonald, Laura A. Flashman, David B. Arciniegas, Robert J. Ferguson, Li Xing, Jaroslaw Harezlak, Gwen C. Sprehn, Flora M. Hammond, Arthur C. Maerlender, Carrie L. Kruck, Karen L. Gillock, Kim Frey, Rachel N. Wall, Andrew J. Saykin, Thomas W. Mcallister

Center for Brain, Biology, and Behavior: Faculty Publications

The purpose of this multicenter, prospective, randomized, placebo-controlled study was to evaluate and compare the efficacy of two cognitive rehabilitation interventions (Memory and Attention Adaptation Training (MAAT) and Attention Builders Training (ABT)), with and without pharmacologic enhancement (i.e., with methylphenidate (MPH) or placebo), for treating persistent cognitive problems after traumatic brain injury (TBI). Adults with a history of TBI at least four months prior to study enrollment with either objective cognitive deficits or subjective cognitive complaints were randomized to receive MPH or placebo and MAAT or ABT, yielding four treatment combinations: MAAT/MPH (N=17), ABT/MPH (N=19), MAAT/placebo (N=17), and ABT/placebo (N=18). …

Influence Of Posture-Cuing Shirt On Tennis Serve Kinematics In Division Iii Tennis Players, Joseph Zappala, Caroline Orrego, Emily Boe, Heather Fechner, Derek Salminen, Daniel Cipriani

Physical Therapy Faculty Articles and Research

Objective: Injuries to the shoulder complex are common in overhead athletes, often related to kinematics of the shoulder complex. This study evaluated the influence of a posture-cuing shirt on internal rotation velocity of the shoulder during a tennis swing and to determine this influence on shoulder external rotation position. Methods: Nine healthy competitive college tennis players from a Division III college participated in this study. High speed motion capture allowed for 3-D analysis of shoulder kinematics during a tennis serve. Two conditions were evaluated while the athletes performed a high velocity tennis serve: standard tennis shirt and a …

When The Challenges Of Aging And Visual Impairment Collide: Working Together To Build A Toolbox Of Rehab Ideas Of Best Care For Older Adults, Regula H. Robnett, Kathy Clarrage

Occupational Therapy Faculty Presentations

Workshop/presentation by Regi Robnett, Ph.D., OTR/L, FAOTA, professor in the UNE Department of Occupational Therapy and Kathy Clarrage, COMS, Certified Orientation and Mobility Specialist for the State of Maine. Given at the North East Chapter of the Association for Education and Rehabilitation for the Blind and Visually Impaired (NEAER) conference, this presentation encouraged health care providers to work as a team to care for older, visually impaired adults. The professional audience included orientation and mobility specialists, vision rehabilitation therapists, low vision specialists, administrators in the field of blindness, social workers in the field of blindness and vocational rehabilitation counselors.

Exercise As A Form Of Medicine, Steven J. Elmer

TechTalks

My research goals are to find better ways to restore musculoskeletal function, maintain health, and improve mobility in healthy and clinical populations. Students in my laboratory (engineering, kinesiology, physical therapy) investigate how humans move and implement new exercise interventions to improve physical conditioning and performance. We work with populations ranging from individuals living with a spinal cord injury to adults recovering from ACL surgery to elite athletes. Applications for our research range from basic aspects of muscle contraction to applied human performance in a variety of settings including rehabilitation, ergonomics, and sport.

The Debt Burden Of Entry-Level Physical Therapists In Florida, Steven Benton Ambler

USF Tampa Graduate Theses and Dissertations

Despite the education, autonomy, and high demand for physical therapists both nationally and in Florida, recent graduates have seen steadily rising education costs with disproportionate changes in income once they have graduated and entered the workforce. The growing debt burden of physical therapists entering the workforce, coupled with the growth in projected need and stagnant wages, raises concern about where and how entry-level physical therapists will practice and if these choices will be affected by their debt burden. The purpose of this quantitative, cross-sectional survey study was to identify the debt profile of entry-level physical therapists and explore the relationship …

Effect Of Lighting On Performance Of Tasks Requiring Near Vision In Older Adults, Karen Leigh James

Occupational Therapy Program Student Theses, Dissertations and Capstones

With age, more light is needed in order to function, but the effect of lighting on occupational performance has received little attention in occupational therapy. The purpose of the study was to determine if lighting affects older adults’ ability to perform selected occupational tasks, which require near vision and if lighting levels affects their perceived effort while performing selected occupational tasks. A quasi-experimental, repeated measures design was used with a convenience sample recruited from a retirement community. Thirty participants met the inclusion criteria, which included visual and cognitive screening. The mean age of the 30 participants was 83 years, and …

A Retrospective Study Of Handwriting Skills Of Kindergarten Students, Danielle Benter, Dawn Fields, Catherine Nichols

Pediatrics

OBJECTIVE: The purpose of this study was to guide teachers and occupational therapist in recognizing handwriting needs in order to provide appropriate early intervention support for handwriting.

METHOD: 218 kindergarten students in a public school district were screened for handwriting ability using the Handwriting Without Tears and the Public School’s copy screeners. Students were assessed three times during the 2014 to 2015 school year on letter memory, line placement, letter orientation, copy legibility, and copy placement skills.

RESULTS: The results indicated that winter scores were a better predictor of spring scores. Significant effects in four out of five variables were …

Standing Balance And Spatiotemporal Aspects Of Gait Are Impaired Upon Nocturnal Awakening In Healthy Late Middle-Aged And Older Adults, Amanda L. Mcbean, Raymond P. Najjar, Ronald A. Schuchard, Courtney D. Hall, Cheng-Ann Wang, Ban Ku, Joseph M. Furman

ETSU Faculty Works

Study Objectives: Nocturnal awakenings may constitute a unique risk for falls among older adults. We describe differences in gait and balance between presleep and midsleep testing, and whether changes in the lighting environment during the midsleep testing further affect gait and balance.

Methods: Twenty-one healthy, late middle-aged and older (64.7 ± 8.0 y) adults participated in this repeated-measures design consisting of four overnight laboratory stays. Each night, participants completed baseline visual acuity, gait, and balance testing. After a 2-h sleep opportunity, they were awakened for 13 min into one of four lighting conditions: very dim white light (< 0.5 lux); dim white light (∼28.0 lux); dim orange light (∼28.0 lux); and white room-level light (∼200 lux). During this awakening, participants completed the same sequence of testing as at baseline.

Results: Low-contrast …

Occupational Therapy Services And Clinical Decision Making In Oncology Care: A Mixed Methods Approach, Sheila M. Longpre'

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this study was to explore the types and patterns of occupational therapy services implemented with clients who are cancer survivors, which utilized a mixed methods approach, specifically an explanatory sequential design. The Occupational Therapy Practice Inventory (OTPI) was used to gather information regarding the type and patterns of occupational therapy services provided for clients receiving oncology care. The results of the OTPI were analyzed and used to further develop semi-structured questions for exploring the perspectives of occupational therapy practitioners who practice in the area of oncology in the United States. The data were analyzed to generate a …

Assets And Barriers To Osteoarthritis, Allison K. Wiles

Scholars Week

Osteoarthritis has remained a prevailing health concern in our society for many years. OA is most commonly seen in middle aged men and women suffering from pain and stiffness in the hip, knee, and thumb areas. Risk factors for OA include age, obesity, previous joint injuries, overuse of joint areas, and weak muscles. If not treated, OA could lead to permanent discomfort and pain, and potentially develop into depression, lowered quality of life, or a need for long-term home health care.

By providing photo footage of every day health care issues, Photo voice persuades community members to change habits and …

Mind And Body Training To Improve Functioning And Coping With Chronic Pain: A Pilot Study, Olga Valieva, Leah M. Welsh, Betty Amuzu, Niraj Nijhawan, Jessica J.F. Kram

Journal of Patient-Centered Research and Reviews

Background: Patients with chronic pain are often crippled by psychological distress, depression and fear. These patients also can develop altered pain perception, with enhanced brain activity in pain-responsive regions and those associated with anxiety/depression. Exercise and meditation can impact pain-reducing brain areas and positively influence pain characteristics.

Purpose: To alter pain center activity by reducing the activation of the higher brain and deactivation of the lower brain with somatocognitive and meditative practices, with secondary aim of reducing anxiety/depression and improve overall quality of life.

Methods: We conducted a pilot study on mentally competent adult women with stable chronic pain who …