Rehabilitation and Therapy Commons^™

A Speed-Based Approach To Vestibular Rehabilitation For Peripheral Vestibular Hypofunction: A Retrospective Chart Review, Robert Alen Roller, Courtney D. Hall

ETSU Faculty Works

BACKGROUND: Current vestibular rehabilitation for peripheral vestibular hypofunction is an exercise-based approach that improves symptoms and function in most, but not all patients, and includes gaze stabilization exercises focused on duration of head movement. One factor that may impact rehabilitation outcomes is the speed of head movement during gaze stability exercises.

OBJECTIVE: Examine outcomes of modified VOR X1 exercises that emphasize a speed-based approach for gaze stabilization while omitting substitution and habituation exercises. Balance training focused on postural realignment and hip strategy performance during altered visual and somatosensory inputs.

METHODS: A retrospective chart review of 159 patients with vestibular deficits …

Biomarkers Of Rehabilitation Therapy Vary According To Stroke Severity, Erin Burke Quinlan, Lucy Dodakian, Jill See, Alison Mckenzie, Jill Campbell Stewart Pt,Phd, Steven C. Cramer

Faculty Publications

Biomarkers that capture treatment effects could improve the precision of clinical decision making for restorative therapies. We examined the performance of candidate structural, functional, and angiogenesis-related MRI biomarkers before and after a 3-week course of standardized robotic therapy in 18 patients with chronic stroke and hypothesized that results vary significantly according to stroke severity. Patients were 4.1 ± 1 months poststroke, with baseline arm Fugl-Meyer scores of 20–60. When all patients were examined together, no imaging measure changed over time in a manner that correlated with treatment-induced motor gains. However, when also considering the interaction with baseline motor status, treatment-induced …

Biomarkers Of Rehabilitation Therapy Vary According To Stroke Severity, Erin Burke Quinlan, Lucy Dodakian, Jill See, Alison Mckenzie, Jill Campbell Stewart, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Biomarkers that capture treatment effects could improve the precision of clinical decision making for restorative therapies. We examined the performance of candidate structural, functional,and angiogenesis-related MRI biomarkers before and after a 3-week course of standardized robotic therapy in 18 patients with chronic stroke and hypothesized that results vary significantly according to stroke severity. Patients were 4.1 ± 1 months poststroke, with baseline arm Fugl-Meyer scores of 20–60. When all patients were examined together, no imaging measure changed over time in a manner that correlated with treatment-induced motor gains. However, when also considering the interaction with baseline motor status, treatment-induced motor …

Dating As An Occupation: Swipe Right For Occupational Therapy, Karen Mccarthy

Collected Faculty Scholarship

At a first glance, these may look like personal ads you might in the past have found in any newspaper classified section, yet they could be mini occupational profiles that represent your clients. Each profile contains information about the client, their interests and passions, their values, and their goals and dreams for meeting a partner.

Personal ads, once so public for everyone who opened a newspaper to read, have now moved onto the vast and complicated world of online dating. The game has changed, with 15% of adults in the United States reporting they have used online dating sites or …

Table Of A Second Chance, Jean P. Belizaire Mr.

National Youth Advocacy & Resilience Conference

This presentation will help to empower those who work with the drug addicted population to identify, increase, and incorporate better means of services.

Stereotactic Body Radiation Therapy For Locally Progressive And Recurrent Pancreatic Cancer After Prior Radiation, Philip Sutera, Mark E. Bernard, Hong Wang, Nathan Bahary, Steven Burton, Herbert Zeh, Dwight E. Heron

Radiation Medicine Faculty Publications

Introduction: Pancreatic adenocarcinoma is an aggressive malignancy that has consistently demonstrated poor outcomes despite aggressive treatments. Despite multimodal treatment, local disease progression and local recurrence are common. Management of recurrent or progressive pancreatic carcinomas proves a further challenge. In patients previously treated with radiation therapy, stereotactic body radiation therapy (SBRT) is a promising modality capable of delivering high dose to the tumor while limiting dose to critical structures. We aimed to determine the feasibility and tolerability of SBRT for recurrent or local pancreatic cancer in patients previously treated with external beam radiation therapy (EBRT).

Materials and methods: Patients treated with …

A Delayed Diagnosis Of Tarsometatarsal Ligament (Lisfranc) Sprain In A Female College Soccer Athlete And Foot Rehabilitation, Boyoung Park

UNO Student Research and Creative Activity Fair

A Delayed Diagnosis of Tarsometatarsal Ligament (Lisfranc) Sprain in a Female College Soccer Athlete and Foot Rehabilitation

Park B*, Nicola M*, Wilkins S*: *University of Nebraska at Omaha, Omaha, NE

Objective: To emphasize the importance of the correct treatment protocol and the proper rehabilitation exercises based on the patient’s injury condition and healing process. Background: A 22-year-old female division I soccer athlete underwent tarsometatarsal ligament repair to stabilize midfoot. The patient started feeling pain in the dorsal aspect of her left 1st and 2nd metatarsals at the beginning of the season, however, she reported no specific mechanism of injury …

Developing A Footswitch Device To Assess The Likelihood Of Falls In At-Risk Populations, Arash Mohammadzadeh Gonabadi

UNO Student Research and Creative Activity Fair

Falls are one of the major cause of injuries, reduced functioning and even mortality in older adults. Most of the falls occur during walking, so considering the mechanics of gait during walking can provide insight to identify the risk of fall in this population. A component of walking mechanics associated with falling in the elderly is gait variability (i.e. the inherent natural fluctuations between strides). Healthy states are associated with an optimal level of movement variability reflecting the adaptability of the underlying control system, while pathological gait can be either too regular, or periodic, or too random and disordered. In …

Subthreshold Vibration Does Not Affect Walking Performance Of Transtibial Amputees, Charles Sloan

UNO Student Research and Creative Activity Fair

Ian Sloan , Jenny A. Kent, Shane R. Wurdeman, Adam L. Jacobsen, Kota Z. Takahashi, Nicholas Stergiou. Subthreshold vibration does not affect walking performance of transtibial amputees. Objective: To test the hypothesis that adding subthreshold vibrations to the thigh of the affected limb on amputees would allow for better control of the prosthesis. Setting: Biomechanics Research Building at UNO. Participants: 14 transtibial amputees (age range, 33-72y). Intervention: Applying subthreshold vibrations to thigh of affected limb for three different conditions; white noise signal, pink noise signal, and none. Outcome Measures: Step length, step width, and step …

Dynamic Stability Association With Cost Of Transport Is Different In Patients With Copd Compared To Healthy Controls, Farahnaz Fallah Tafti

UNO Student Research and Creative Activity Fair

Patients with chronic obstructive pulmonary disease (COPD), suffer from deficits in their functional performance besides their lung disease. In this situation, increased muscle activity is needed to provide safe walking patterns, stability while walking. This increase in muscle activity leads to increased metabolic cost, i.e., using more oxygen to complete the task. The main objective of this study is to investigate the relationship between walking stability and metabolic cost in patients with COPD in comparison with age-matched controls. Seventeen patients with COPD and 23 healthy controls walked on a treadmill at three different speeds: preferred, fast (+20% preferred) and slow …

Acute Subdural Hematoma In A High School Football Player Requiring Emergent Decompressive Craniecromy, Christine Center

UNO Student Research and Creative Activity Fair

The purpose of this report is to present the case of a high school football player that was injured in a game causing an acute subdural hematoma (SDH). A SDH is a potential life-threatening arterial vessel bleed in the brain, causing increased intracranial pressure. The intervention used to treat the athlete was an emergent decompressive craniectomy. The uniqueness of the case is due to both rare pathology and treatment method used. The athlete had a positive outcome due to prompt on-field assessment, and advanced surgical treatments. Certified Athletic Trainers (ATC) should know how to recognize symptoms of traumatic brain injury, …

Impact Of Real World Environments On Movement Variability, Matt Harrison

UNO Student Research and Creative Activity Fair

Osteoarthritis; OA for short, is the most common form of arthritis and is one of the leading causes of disability. OA is the progressive wearing down of the cartilage covering bones and joints. For those with end stage knee OA, a total knee arthroplasty, or replacement, is the standard treatment with more than 700,000 TKA’s performed annually. While pain is improved in general, the functional performance and activity levels of the joint often do not return to those of healthy individuals. To understand the long-term consequences of poor function post-TKA, we need data that characterizes an individual’s real-world movement and …

The Effects Of Contralateral Exercise On Patient Pain And Range Of Motion, Smokey Fermin, Lindsay Warren, Sarah Beene, David Wetzel

Health Sciences Faculty Scholarship

Clinicians are commonly tasked with treating patients suffering from range of motion (ROM) deficits, pain, or both. Treatment options intended to increase ROM, decrease pain and restore function are vast. Often interventions are used that focus on a singular symptom location (e.g., stretching and joint mobilizations) although a long-standing call exists to utilize global approaches to treating dysfunction. This review was conducted to determine whether evidence exists to support the use of contralateral exercise (CE)to treatROM deficits or pain.

Comparison Of Interactive Video Test Performance To Overall Class Performance In A Biomechanics Course, Guinevere S. Bennett

Occupational Therapy Faculty Research

Objective:

This study compared interactive video test performance and students' overall class performance. The hypothesis was that there would be a difference in video test performance compared to overall class performance.

Methods:

A total of 30 students participated in the pilot study from a master's level biomechanics course. Students completed four interactive video tests using EduCanon; content of videos included base of support, lever systems, scapulohumeral rhythm, and postural analysis. This content was reviewed with class discussion after completion of the interactive video test. The tests administered counted toward the participation portion of the final student grade. Student performance on …

Combined Exercise/Weight Bearing Program Influences Of Foot Function In People With Asymptomatic Flat Feet, Alison Modafferi, Angela Foster, Brenden Thompson, Jean Jarbath, Shanna Howland, Tyler Whited, Jeff Houck, Marcey Keefer Hutchison

Student-Faculty Research - College of Physical Therapy

No abstract provided.

Sit-To-Stand Symmetry In Individuals With Hip Pathology, Andrew J. Meszaros, Allie Thomas, Alyssa Ware, Craig Hawkinson, Jaydee Romick, Michelle Thoreson

Student-Faculty Research - College of Physical Therapy

Post-hip fracture patients continue to exhibit asymmetries during sit-to-stand task following rehabilitation. While strength is thoroughly addressed, perceptual deficits may be a missing component to rehabilitation post-hip fracture.

Community-Based Exercise & Wellness Program For Chronic Stroke - A Pilot Study, Christen Johnson, Daniel Debates, Meggie Dallas, Morgan Johansen, Morgan Kilgore, Cindy Zablotny, Theresa Raudsepp

Student-Faculty Research - College of Physical Therapy

Purpose: The overall goal of this pilot study was to determine the feasibility and effectiveness of an 8 week university-based community exercise and wellness program designed to provide an opportunity for exercise, social interaction, and education on stroke-related health and wellness topics.

Volumetric Modulated Arc Therapy Treatment Planning Of Thoracic Vertebral Metastases Using Stereotactic Body Radiotherapy, Matthew Mallory, Damodar Pokhrel, Rajeev Badkul, Hongyu Jiang, Christopher Lominska, Fen Wang

Radiation Medicine Faculty Publications

Purpose/Objectives: To retrospectively evaluate the plan quality, treatment efficiency, and accuracy of volumetric modulated arc therapy (VMAT) plans for thoracic spine metastases using stereotactic body radiotherapy (SBRT).

Materials/Methods: Seven patients with thoracic vertebral metastases treated with noncoplanar hybrid arcs (NCHA) (1 to 2 3D-conformal partial arcs +7 to 9 IMRT beams) were re-optimized with VMAT plans using three coplanar arcs. Tumors were located between T2 and T7 and PTVs ranged between 24.3 and 240.1 cc (median 48.1 cc). All prescriptions were 30 Gy in 5 fractions with 6 MV beams treated using the Novalis Tx linac equipped with high definition …

Calculation Of Resistive Loads For Elastic Resistive Exercises, Kelsey J. Picha, Timothy L. Uhl

Physical Therapy Faculty Publications

Context:

What is the correct resistive load to start resistive training with elastic resistance to gain strength? This question is typically answered by the clinician's best estimate and patient's level of discomfort without objective evidence.

Objective:

To determine the average level of resistance to initiate a strengthening routine with elastic resistance following isometric strength testing.

Design:

Cohort.

Setting:

Clinical.

Participants:

Thirty-four subjects (31±13yrs, 73±17kg, 170±12cm).

Interventions:

The force produced was measured in Newtons (N) with an isometric dynamometer. The force distance was the distance from center of joint to location of force applied was measured in meters to calculate torque …

A Retrospective Cohort Study Of Quickdash Scores For Three Hand Therapy Acute Upper Limb Conditions, Enrique V. Smith-Forbes, Dana M. Howell, Jason Willoughby, Donald G. Pitts, Timothy L. Uhl

Physical Therapy Faculty Publications

Introduction: The QuickDASH is a valid and reliable outcome measure widely used to assess the function and pain in arm, shoulder, and hand disabilities. A recent study introduced a QuickDASH 80% cut point test to gauge patients at risk of poor outcomes. However, the utility of this test has not been validated.

Purpose: To determine typical QuickDASH scores for three upper limb conditions and to test the sensitivity and specificity of the QuickDASH 80% cut point test in predicting patients at risk of poor outcomes.

Methods: This is a retrospective study with a total of 406 patient records for whom …

National Athletic Trainers' Association Position Statement: Evaluation, Management, And Outcomes Of And Return-To-Play Criteria For Overhead Athletes With Superior Labral Anterior-Posterior Injuries, Lori A. Michener, Jeffrey S. Abrams, Kellie C. Huxel Bliven, Sue Falsone, Kevin G. Laudner, Edward G. Mcfarland, James E. Tibone, Charles A. Thigpen, Timothy L. Uhl

Physical Therapy Faculty Publications

Objective: To present recommendations for the diagnosis, management, outcomes, and return to play of athletes with superior labral anterior-posterior (SLAP) injuries.

Background: In overhead athletes, SLAP tears are common as either acute or chronic injuries. The clinical guidelines presented here were developed based on a systematic review of the current evidence and the consensus of the writing panel. Clinicians can use these guidelines to inform decision making regarding the diagnosis, acute and long-term conservative and surgical treatment, and expected outcomes of and return-to-play guidelines for athletes with SLAP injuries.

Recommendations: Physical examination tests may aid diagnosis; 6 tests are recommended …

Effect Of Haptic Feedback On Static Standing Sway, Andrew J. Meszaros, Alyssa Carey, Jessica Hund, Morgan Mccann, Kindra Mcdougall

Student-Faculty Research - College of Physical Therapy

Study Goal: To explore the use of proprioceptive input as a means of attenuating postural sway through the development and implementation of a hands-free device, with the ultimate goal of providing sway-reference haptic input located at the upper trunk and shoulders to determine: Does sway-referenced haptic input improve static standing stability?

Changes In Achilles Tendon Thickness Following A 10-Week Heavy Load Eccentric Exercise Program, Tyler Cuddeford, Marcey Keefer Hutchison, Annika Piros, Jessica London, Andi Maleike, Tiffany Schoonover, Madison Eymann

Student-Faculty Research - College of Physical Therapy

Achilles tendinopathy often presents with increased tendon thickness, lower echogenicity, and decreased stiffness. Interestingly, tendons are also able to adapt their structural and mechanical characteristics in response to loading.

Eccentric exercise for Achilles tendinopathy continues to be the recommended treatment. The majority of individuals with midportion achilles tendinopathy have shown favorable response to eccentric exercise.

Predicting Patients Acceptable Symptom State At Short Term Follow Up Of A Collaborative Primary Care Pt/Md Service, Catherine Vandehaar, Kevin Morikawa, Andrea Mulligan, Amador Marcano, Ceci Gutierrez, Jeff Houck, Daniel Kang, Tyler Cuddeford, Sarah Rahkola

Student-Faculty Research - College of Physical Therapy

Hypothesis: Patient Reported Outcome Tools will predict a patient’s acceptable symptom state (PASS)

Kinetic And Kinematic Analysis Of Male Collegiate Basketball Players With Patella Tendinosis, Dacia Heckendorf, Luke Hammer, Matthew Jeppson, Nicole Jones, Katherine Porter

Student-Faculty Research - College of Physical Therapy

Patellar tendinopathy (PT) occurs in approximately 40% of elite jumping athletes. Players will typically play through the pain; however, if the condition is not successfully treated some are forced to retire from sport. Research has shown that there are no signs of chemical inflammation in the tendon, but rather the presence of a degenerative tendon with collagen disorientation and disorganization.

Demographic, Presentation, And Treatment Factors And Racial Disparities In Ovarian Cancer Hospitalization Outcomes, Tomi F. Akinyemiju, Gurudatta Naik, Kemi Ogunsina, Daniel T. Dibaba, Neomi Vin-Raviv

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: This study examines whether racial disparities in hospitalization outcomes persist between African-American and White women with ovarian cancer after matching on demographic, presentation, and treatment factors.

METHODS: Using data from the Nationwide Inpatient Sample database, 5,164 African-American ovarian cancer patients were sequentially matched with White patients on demographic (e.g., age, income), presentation (e.g., stage, comorbidities), and treatment (e.g., surgery, radiation) factors. Racial differences in-hospital length of stay, post-operative complications, and in-hospital mortality were evaluated using conditional logistic regression models.

RESULTS: White ovarian cancer patients had relatively higher odds of post-operative complications when matched on demographics (OR 1.35, 95% CI …

Mechanisms For The Increased Fatigability Of The Lower Limb In People With Type 2 Diabetes, Jonathon Senefeld, Steven B. Magill, April L. Harkins, Alison R. Harmer, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Fatiguing exercise is the basis of exercise training and a cornerstone of management of type 2 diabetes mellitus (T2D), however, little is known about the fatigability of limb muscles and the involved mechanisms in people with T2D. The purpose was to compare fatigability of knee extensor muscles between people with T2D and controls without diabetes and determine the neural and muscular mechanisms for a dynamic fatiguing task. Seventeen people with T2D (10 men, 7 women: 59.6{plus minus}9.0 years) and 21 age-, BMI- and physical activity-matched controls (11 men, 10 women: 59.5{plus minus}9.6 years) performed 120 high-velocity concentric contractions (1 contraction/3 …

Physical Activity And Annual Medical Outlay In U.S. Colorectal, Breast And Prostate Cancer Survivors, Alice F. Yan, Yang Wang, Alexander V. Ng

Exercise Science Faculty Research and Publications

Multiple chronic conditions in cancer survivors are highly prevalent and may increase health care costs for both patients and the health care system. Studies of cancer survivors reveal positive effects of physical activity (PA) on reducing risk of cancer recurrence, other chronic conditions, and secondary cancer. Few nationally representative studies have examined how physical activity levels have affected survivors' annual economic burden in the United States.

Leisure-time physical activity data from the National Health Interview Survey was linked to health care expenditure data from the Medical Expenditure Panel Survey data (2008–2012). We calculated per-person annual total medical expenditures for identified …

Six-Minute Walk Test Performance In Persons With Multiple Sclerosis While Using Passive Or Powered Ankle-Foot Orthoses, Morgan K. Boes, Rachel E. Bollaert, Richard M. Kesler, Yvonne C. Learmonth, Mazharul Islam, Matthew N. Petrucci, Robert W. Motl, Elizabeth T. Hsiao-Wecksler

Exercise Science Faculty Research and Publications

Objective

To determine whether a powered ankle-foot orthosis (AFO) that provides dorsiflexor and plantar flexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS).

Design

Short-term intervention.

Setting

University research laboratory.

Participants

Participants (N=16) with a neurologist-confirmed diagnosis of MS and daily use of a prescribed custom unilateral passive AFO.

Interventions

Three 6-minute walk tests (6MWTs), 1 per footwear condition: shoes (no AFO), prescribed passive AFO, and portable powered AFO (PPAFO). Assistive devices were worn on the impaired limb.

Main Outcome Measures

Distance walked and metabolic cost of transport were recorded during each 6MWT and …

Collaborative Documentation For Behavioral Healthcare Providers: An Emerging Practice, Suzanne Maniss Ph.D., Lcdc, Ncc, Amanda G. Pruit Lpc

Journal of Human Services: Training, Research, and Practice

This article considers the practice of collaborative documentation (CD) for behavioral healthcare providers; the legislative, technological, and philosophical milieu in which it developed; the attributed benefits for providers and clients; and the peer-reviewed research supporting its use. Collaborative documentation has emerged following significant legislative and technological changes in healthcare delivery and shifts toward client-centered healthcare practices including more shared decision-making between clients and practitioners.