Rehabilitation and Therapy Commons^™

Osteoblast-Derived Fgf9 Regulates Skeletal Homeostasis, Liping Wang, Theresa M. Roth, Marcia J. Abbott, Linh Ho, Lalita Wattanachanya, Robert A. Nissenson

Health Sciences and Kinesiology Faculty Articles

FGF9 has complex and important roles in skeletal development and repair. We have previously observed that Fgf9 expression in osteoblasts (OBs) is regulated by G protein signaling and therefore the present study was done to determine whether OB-derived FGF9 was important in skeletal homeostasis. To directly test this idea, we deleted functional expression of Fgf9 gene in OBs using a 2.3 kb collagen type I promoter-driven Cre transgenic mouse line (Fgf9^{OB −/−}). Both Fgf9 knockout (Fgf9^{OB −/−}) and the Fgf9 floxed littermates (Fgf9^fl/fl) mice were fully backcrossed and maintained in an FBV/N background. Three …

The Recovery Glove System- A Sensor Driven Glove With Interactive Games For Fine Motor Skill Disabilities, Brian Lee, Oscar Ledezma, Jonathan Rey, Nicholas Alvarado, Deborah Won

Biomedical Engineering Western Regional Conference

Hand mobility is commonly impaired in stroke victims. Treatment for hand impairment range from therapist-guided physical exercises to robotically controlled exoskeletons. However, A more effective treatment which actually restores hand mobility is by encouraging patients to carry out hand movements themselves.We have designed an Arduino based hand therapy device in which the user interacts with a computer graphic interface (CGI) game controlled by a glove was embedded with a force sensing resistor (FSR) at each of the fingertips except for the thumb. The interactive therapy guides the user through exercises and provides live, quantitative information by which the stroke patient …

The Effects Of Closed Kinetic Chain And Endurance Exercises On Reducing Pain In A Child With Ehlers-Danlos Syndrome: A Case Report, Linda Duong, Megan Flores

Physical Therapy Collection

Background and Purpose: Ehlers-Danlos syndrome (EDS) is a connective tissue disorder characterized by joint laxity, chronic pain, and joint instability. Often, children with EDS exhibit polyarthralgia and fatigue as their main symptoms. Although physical therapy is a mainstay of treatment for individuals with EDS, evidence is lacking for specific exercises or treatment strategies for management of pain. The purpose of this case report is to describe the effectiveness of closed kinetic chain and endurance exercises on reducing pain in a child with EDS.

Case Description: The child was a 9 year old girl diagnosed with EDS hypermobility type, and …

Experiential Learning Enhances Physical Therapist Student Confidence In Management Of Neurologically-Involved Adults And Children, Kristen Barta, Megan Flores, Anna Edwards

Physical Therapy Collection

Purpose/ Hypothesis: As physical therapy (PT) students advance through an entry-level professional program, clinical decision making skills improve, though self-confidence in treating individuals with neurological impairments does not. One technique to improve PT student self-confidence with this population is the addition of experiential learning opportunities, which uses direct student interaction with community volunteers to simulate clinical application of didactic material. The purpose of this study was to explore the effect of experiential learning using community participants who were neurologically-involved, on PT students’ perceived self-confidence. It was hypothesized that PT students would report greater levels of self-confidence in their neurological …

Effects Of Manual Therapy And Dry Needling Techniques For Managing Hypertonicity In The Male Pelvic Floor: A Case Report, Amy Jane Porter, Suzanne Trotter, Kristen Barta

Physical Therapy Collection

Background: Dry needling is beneficial for decreasing hypertonicity and improving musculoskeletal dysfunction within various tissues of the body. There is limited research using dry needling for pelvic floor hypertonicity. The purpose of this case report is to describe the effectiveness of a multi-modal intervention utilizing dry needling for a 27-year-old male with a hypertonic pelvic floor.

Study Design: Case study with review of literature.

Case Description: This patient was a 27-year-old Caucasian male with a diagnosis of chronic prostatitis/epididymitis. His primary complaint was pain with prolonged sitting in the right testicle. Treatment consisted of dry needling trigger points, myofascial release, …

Normative Data For The Neurocom Sensory Organization Test In Us Military Special Operations Forces., Erin R. Pletcher, Valerie J Williams, John P Abt, Paul M Morgan, Jeffrey J Parr, Meleesa F Wohleber, Mita Lovalekar, Timothy C Sell

College of Science & Mathematics Departmental Research

CONTEXT: Postural stability is the ability to control the center of mass in relation to a person's base of support and can be affected by both musculoskeletal injury and traumatic brain injury. The NeuroCom Sensory Organization Test (SOT) can be used to objectively quantify impairments to postural stability. The ability of postural stability to predict injury and be used as an acute injury-evaluation tool makes it essential to the screening and rehabilitation process. To our knowledge, no published normative data for the SOT from a healthy, highly active population are available for use as a reference for clinical decision making. …

Eccentric Exercise Program Design: A Periodization Model For Rehabilitation Applications, Michael O. Harris-Love, Bryant Seamon, Tomas I. Gonzales, Haniel J. Hernandez, Donte Pennington, Brian Hoover

Exercise and Nutrition Sciences Faculty Publications

The applied use of eccentric muscle actions for physical rehabilitation may utilize the framework of periodization. This approach may facilitate the safe introduction of eccentric exercise and appropriate management of the workload progression. The purpose of this data-driven Hypothesis and Theory paper is to present a periodization model for isokinetic eccentric strengthening of older adults in an outpatient rehabilitation setting. Exemplar and group data are used to describe the initial eccentric exercise prescription, structured familiarization procedures, workload progression algorithm, and feasibility of the exercise regimen. Twenty-four men (61.8 ±6.3 years of age) completed a 12-week isokinetic eccentric strengthening regimen involving …

Department Integration Of A Community Hospital With A Large Urban Teaching Hospital: A Case Report, Jessica Shank, Pt

Jefferson Hospital Staff Papers and Presentations

Purpose/Background

Healthcare is rapidly changing and community hospitals are no longer able to keep up. Accountable Care Organizations (ACOs) are absorbing many of these hospitals. Rehab departments within these facilities are afforded the opportunity to impact the financial bottom line by removing inefficiencies and promoting higher quality patient care. The purpose of this quality improvement initiative was to develop a process to integrate departments focusing on efficiency, patient care, and employee engagement.

The Effect Of A Single Bout Of Physical Exertion On Expressive Language And Word Finding In Individuals With Multiple Sclerosis, Marissa A. Barrera

Dissertations, Theses, and Capstone Projects

To date, little research has been conducted on the relationship between fatigue and expressive language among Multiple Sclerosis patients (MS). This study was a response to this knowledge gap. A nonrandom, matched- subject, mixed-factor design model was used with a purposive sample of 17 individuals with MS (five had primary-progressive (PP) MS, and 12 had relapsing-remitting (RR) MS). The research design was subjected to pretesting to ensure validity. Participants were assessed on a range of language tasks after undergoing one bout of cardiovascular exercise (NuStep T5 Recumbent Cross Trainer) and asked to provide a subjective fatigue score. The expressive language …

Cardio-Protection Afforded By Β-Blockade Is Maintained During Resistance Exercise, Alexander V. Ng, Jason M. Conviser, Shawn S. Rockey, D. Paul Thomas

Exercise Science Faculty Research and Publications

Objectives

Whether or not the cardio-protective effect of β-adrenergic blockade is retained during resistance exercise has not been systematically evaluated. Therefore the purpose of this study was to measure selected cardiorespiratory responses to isometric exercise involving hand-gripping, single-leg extension, or double-leg dead-lift, under placebo (control), β₁-selective (atenolol), and non-selective (propranolol) adrenergic blockade conditions.

Design

Eleven young male adults were evaluated in a randomized, double-blinded, repeated measures study design and performed all three exercise modalities at 30% of maximal voluntary contraction under placebo, atenolol and propranolol conditions.

Methods

Heart rate, systolic and diastolic blood pressure, rate-pressure product, oxygen uptake, …

State-Dependent And -Independent Effects Of Dialyzing Excitatory Neuromodulator Receptor Antagonists Into The Ventral Respiratory Column, Thomas M. Langer Iii, Suzanne E. Neumueller, Emma Crumley, Nicholas J. Burgraff, Sawan Talwar, Matthew R. Hodges, Lawrence Pan, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Unilateral dialysis of the broad-spectrum muscarinic receptor antagonist atropine (50 mM) into the ventral respiratory column [(VRC) including the pre-Bötzinger complex region] of awake goats increased pulmonary ventilation (V̇i) and breathing frequency (f), conceivably due to local compensatory increases in serotonin (5-HT) and substance P (SP) measured in effluent mock cerebral spinal fluid (mCSF). In contrast, unilateral dialysis of a triple cocktail of antagonists to muscarinic (atropine; 5 mM), neurokinin-1, and 5-HT receptors does not alter V̇i or f, but increases local SP. Herein, we tested hypotheses that 1) local compensatory 5-HT and SP responses to 50 mM atropine …

Safety And Improvement Of Movement Function After Stroke With Atomoxetine: A Pilot Randomized Trial, Andrea Ward, Cheryl Carrico, Elizabeth Powell, Philip M. Westgate, Laurie Nichols, Anne Fleischer, Lumy Sawaki

Physical Medicine and Rehabilitation Faculty Publications

Background: Intensive, task-oriented motor training has been associated with neuroplastic reorganization and improved upper extremity movement function after stroke. However, to optimize such training for people with moderate-to-severe movement impairment, pharmacological modulation of neuroplasticity may be needed as an adjuvant intervention.

Objective: Evaluate safety, as well as improvement in movement function, associated with motor training paired with a drug to upregulate neuroplasticity after stroke.

Methods: In this double-blind, randomized, placebo-controlled study, 12 subjects with chronic stroke received either atomoxetine or placebo paired with motor training. Safety was assessed using vital signs. Upper extremity movement function was assessed using Fugl-Meyer Assessment, …

Dual-Task Does Not Increase Slip And Fall Risk In Healthy Young And Older Adults During Walking, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Dual-task tests can identify gait characteristics peculiar to fallers and nonfallers. Understanding the relationship between gait performance and dual-task related cognitive-motor interference is important for fall prevention. Dual-task adapted changes in gait instability/variability can adversely affect fall risks. Although implicated, it is unclear if healthy participants’ fall risks aremodified by dual-task walking conditions. Seven healthy young and seven healthy older adults were randomly assigned to normal walking and dual-task walking sessions with a slip perturbation. In the dual-task session, the participants walked and simultaneously counted backwards from a randomly provided number. The results indicate that the gait changes in dual-task …

Teft Fasi Alpha Test Report, Barbara Gage, Trudy Mallinson, Laurie Lyons, Joyce Maring, Ken Harwood, Anju Paude, Alex Gorsky, Beth Jackson, Pat Rivard, Lisa Gold, Allison Weaver, Kerry Lida

Physical Therapy and Health Care Sciences Faculty Publications

No abstract provided.

Effect Of Life Review On Quality Of Life For Older Adults Living In Nursing Homes, Rene' Wren

Occupational Therapy Collection

Aim: To examine the effects of life review on daily activities, social participation, outlook on life, and perceptions of living in a nursing home measured by life satisfaction and quality of life in older adults.

Method: The study design was a two-phase quasi-experimental pre-post-tests including development and testing of a life review protocol. Nine residents, age ≥65, participated in a life review group once weekly for 6 weeks. Outcomes were analyzed using the Life Satisfaction Index-Z (LSI-Z) and pre-post surveys.

Results: LSI-Z scores improved post-intervention and survey outcomes indicated participation in activities of daily living (ADLs), socialization, …

Research Day Program, 2017, Physical Therapy Department, Arcadia University

Physical Therapy Student Work

Each of the poster presentations and platform sessions summarized in this program represents a collaborative effort between students and faculty in the Physical Therapy Department of Arcadia University, aimed at developing new knowledge to understand mechanisms that inform clinical practice.

Sex Differences In Neuromuscular Fatigability Of The Knee Extensors Post-Stroke, Meghan Kirking, Reivian B. Barillas, Philip A. Nelson, Sandra K. Hunter, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Background and Purpose: Despite the implications of optimizing strength training post-stroke, little is known about the differences in fatigability between men and women with chronic stroke. The purpose of this study was to determine the sex differences in knee extensor muscle fatigability and potential mechanisms in individuals with stroke. Methods: Eighteen participants (10 men, eight women) with chronic stroke (≥6 months) and 23 (12 men, 11 women) nonstroke controls participated in the study. Participants performed an intermittent isometric contraction task (6 s contraction, 3 s rest) at 30% of maximal voluntary contraction (MVC) torque until failure to maintain the target …

Interprofessional Peer Teaching: Physical Therapy Students Teaching Dental Students To Transfer Patients, Kim Dunleavy, Pt, Phd, Ocs, Venita Sposetti, Dmd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Background While the need for interprofessional education (IPE) has been clearly elucidated, (Interprofessional Education Collaborative, 2016), one of the major barriers is the logistical challenge of meeting curricular requirements for all involved. The organization and time required in an already full schedule are often deterrents. Ideal opportunities meet specific program curricular requirements as well as enhancing interprofessional competencies. Interprofessional competencies include developing skills to teach other health care providers about profession-specific skills and enhancing communication across the professions (Bridges, 2011; Interprofessional Education Collaborative, 2016). Active learning techniques have been advocated for adult learners to promote motivation and engagement (Knowles, 1984), …

Pre- Versus Post-Exercise Protein Intake Has Similar Effects On Muscular Adaptations, Brad J. Schoenfeld, Alan A. Aragon, Colin Wilborn, Stacie L. Urbina, Sara E. Hayward, James Kriegor

Publications and Research

The purpose of this study was to test the anabolic window theory by investigating muscle strength, hypertrophy, and body composition changes in response to an equal dose of protein consumed either immediately pre- versus post-resistance training (RT) in trained men. Subjects were 21 resistance-trained men (>1 year RT experience) recruited from a university population. After baseline testing, participants were randomly assigned to 1 of 2 experimental groups: a group that consumed a supplement containing 25 g protein and 1 g carbohydrate immediately prior to exercise (PRE-SUPP) (nD9) or a group that consumed the same supplement immediately post-exercise (POST- SUPP) …

The Reciprocal Relationship Between Art And Occupational Therapy Practice, Jennifer Fortuna

The Open Journal of Occupational Therapy

Susan Burwash, Ph.D., OTR/L, an occupational therapy professor and artist based in Washington State, provided the cover art for the Winter 2017 issue of the Open Journal of Occupational Therapy (OJOT). The featured piece contains Professor Burwash’s signature fauxpals, lampwork glass beads made from molten glass and pure silver foil. Art creates balance between traditional medicine and personal medicine, those meaningful activities that give life purpose. Professor Burwash’s personal medicine is making beautiful things that can be given away.

Changes In Knowledge, Skills, And Confidence In Fieldwork Educators After An Evidence-Based Practice Short Course, Alison Nichols

The Open Journal of Occupational Therapy

Background: It is critical that fieldwork educators demonstrate effective use of evidence for clinical decision making so that occupational therapy (OT) students learn to apply concepts from the classroom to everyday practice.

Method: OT fieldwork educators completed a 3-hour short course designed to provide instruction on the first three steps of the evidence-based practice (EBP) process: developing a clinical question, searching the literature, and assessing the evidence. The participants completed a pretest on site and posttest 3 weeks after the course to assess their knowledge, skills, and confidence when using EBP. The Adapted Fresno Test was used to …

Generation Y Health Professional Students’ Preferred Teaching And Learning Approaches: A Systematic Review, Caroline Mary Hills, Tracy Levett-Jones, Samuel Lapkin, Helen Warren-Forward

The Open Journal of Occupational Therapy

Generation Y or Millennials are descriptors for those born between 1982 and 2000. This cohort has grown up in the digital age and is purported to have different learning preferences from previous generations. Students are important stakeholders in identifying their preferred teaching and learning approaches in health professional programs. This study aimed to identify, appraise, and synthesize the best available evidence regarding the teaching and learning preferences of Generation Y health professional students. The review considered any objectively measured or self-reported outcomes of teaching and learning reported from Generation Y health professional student perspectives. In accordance with a previously published …

International Service Learning: Occupational Therapists' Perceptions Of Their Experiences In Guatemala, Jason C. Lawson, Myrna R. Olson

The Open Journal of Occupational Therapy

The U.S. is fast becoming more culturally diverse, creating a greater need for entry-level occupational therapists to be culturally competent. In order to increase students’ cultural competence, there is a growing support for international service learning (ISL). The purpose of this qualitative research study was to explore the perspectives of occupational therapy practitioners who engaged in ISL as occupational therapy students. Interviews were conducted with nine practicing occupational therapists, all of whom graduated from the same occupational therapy program in the U.S. and participated in an ISL experience in Guatemala. Phenomenological methods were used to analyze the transcribed interviews for …

Using High Fidelity Simulation To Impact Occupational Therapy Student Knowledge, Comfort, And Confidence In Acute Care, Debra M. Gibbs, Mary Dietrich, Emmy Dagnan

The Open Journal of Occupational Therapy

Background: As the demand for occupational and physical therapists in acute care settings is increasing, students are reporting a need for increased educational preparation to handle the complexities they may face in this setting. This pretest/posttest study examines the impact of an inter-professional high fidelity simulation experience on perceived levels of knowledge, comfort, and confidence among occupational therapy doctorate students when handling an acutely ill patient in an ICU setting.

Methods: Two cohorts of occupational therapy students participated in an inter-professional acute care scenario with high fidelity simulation mannequins (Cohort 1, n = 19; Cohort 2, n = …

Evaluation Of A Coaching Experiential Learning Project On Ot Student Abilities And Perceptions, Erin A. Phillips

The Open Journal of Occupational Therapy

Innovative teaching methods to address emerging practice needs are critical components of effective occupational therapy education. Experiential learning strategies can enhance skill development and translation of knowledge into OT clinical practice. In addition, skills such as coaching may provide important links to health promotion practices. Thirty-two occupational therapy students took part in an experiential project to connect occupational engagement and health for a community of older adults. A pretest/posttest design was used to evaluate program outcomes in student perceived abilities, and narrative reflection papers provided postexperience qualitative information. The students improved in all 10 areas of abilities self-assessment with …

Adapting To A Challenging Fieldwork: Understanding The Ingredients, Emily Raphael-Greenfield, Ivettedari Miranda-Capella, Myra Branch

The Open Journal of Occupational Therapy

Two occupational therapy students were assigned to an inpatient psychiatric unit for their first Level 1 fieldwork. With limited on-site supervision provided, they looked to each other for peer support and collaboration in assisting one patient with severe depression who was considered the “sickest patient on the unit.” The students were able to work together and make a positive intervention with this patient despite their novice status. Understanding what each of them brought personally to this experience as well as the nature of their working relationship and their use of concepts taught in the classroom has important implications for occupational …

Blended Approach To Occupational Performance (Baop): Guidelines Enabling Children With Autism, Jordan M. Skowronski, Jack R. Engsberg

The Open Journal of Occupational Therapy

The performance of daily activities is impacted by motor impairments in children with autism spectrum disorders (ASD). Research has recently demonstrated the prevalence and specificity of motor impairments in people with ASD. The motor learning of individuals with ASD is partially intact, and evidence suggests that a method to alter skill learning and repeated practice of motor sequences might be beneficial. Aiming to use this knowledge to guide occupational therapy interventions, initial guidelines for children with ASD blended Cognitive Orientation to daily Occupational Performance (CO-OP) with virtual reality (VR) were created. An expert panel reviewed the initial guidelines. The results …

Parental Adherence To A Research Protocol To Investigate The Effect Of The Wilbarger Therapressure Programtm: A Qualitative Study, Hugh Stewart, Kobie Boshoff, Scott Weeks

The Open Journal of Occupational Therapy

Background: The Wilbarger Therapressure Program^TM is a technique applied by parents at home for sensory overresponsivity in children. The program is anecdotally reported to be demanding on parents, which can affect parental adherence. Currently, there is an absence of high quality research to support the use of the program. This pilot study aimed at developing appropriate research protocols to investigate the effectiveness of the program on the stress response of children with sensory overresponsivity. This article reports on the second phase of the project.

Method: After participating in the trial data collection protocols to investigate the effect …

Perceptions Of Occupational Therapy Involvement In School Mental Health: A Pilot Study, Susan M. Cahill, Brad E. Egan

The Open Journal of Occupational Therapy

Background: Mental health providers outside of occupational therapy, including those who work in school systems practice, often do not fully understand the contribution that occupational therapy practitioners can make to the delivery of mental health services.

Method: The purpose of this mixed methods pilot study is to describe how instructional support staff from one special education cooperative learned about occupational therapy’s role in school mental health and to explain how this education changed the instructional support staff members’ perceptions regarding the involvement of occupational therapy practitioners in school-based mental health services.

Results: Instructional support staff's perceptions about …

Continuing Competence Trends Of Occupational Therapy Practitioners, Ketti Johnson Coffelt, Linda S. Gabriel

The Open Journal of Occupational Therapy

The purpose of this pilot study was to examine the perceptions and practices of occupational therapists regarding the types of professional development activities they seek to ensure competency. A self-report survey was used to investigate the therapists’ selection of and engagement in professional learning activities. The results from 43 occupational therapists were analyzed. Descriptive results identified the value of a professional development plan and collaboration with colleagues. Self-assessment and searching for and analyzing journal articles emerged as frequently used continuing competence learning practices. The results showed that therapists actively plan and select formal and informal professional activities to promote meaningful …