Rehabilitation and Therapy Commons^™

How Much Protein Can The Body Use In A Single Meal For Muscle-Building? Implications For Daily Protein Distribution, Brad Jon Schoenfeld, Alan Albert Aragon

Publications and Research

Controversy exists about the maximum amount of protein that can be utilized for lean tissue-building purposes in a single meal for those involved in regimented resistance training. It has been proposed that muscle protein synthesis is maximized in young adults with an intake of ~ 20–25 g of a high-quality protein; anything above this amount is believed to be oxidized for energy or transaminated to form urea and other organic acids. However, these findings are specific to the provision of fast-digesting proteins without the addition of other macronutrients. Consumption of slower-acting protein sources, particularly when consumed in combination with other …

Concussion Competencies: A Framework For School-Based Concussion Management (Flyer), Arthur C. Maerlender, Jonathan Lichtenstein, Jennifer Parent-Nichols

Center for Brain, Biology, and Behavior: Faculty Publications

This volume grew out of many years of clinical practice, research, and program projects. It is the culmination of more than 50 years of work with kids, brains, and schools. While there is research behind the Competencies and the underlying content, the intent was to create a user-friendly manual that cut across levels of responsibility and care. Concussion Competencies was not intended to be a textbook in the traditional manner; however, the Competencies have been shown to be a useful approach to teaching this material.

This volume is organized around a set of Competencies that have been shown to be …

Manual Physical Therapy And Cervical Joint Position Training For Cervicogenic Dizziness Following Whiplash-Associated Disorder: A Case Report, Melanie Friedman, Kayla Smith

Physical Therapy Collection

Background and Purpose Whiplash is defined as an acceleration-deceleration injury to the neck, which may lead to a variety of immediate and/or prolonged symptoms collectively known as whiplash-associated disorder (WAD). Cervicogenic dizziness is one possible sequalae that may arise from dysfunction within the structures of the cervical spine, disrupting the flow of sensory and proprioceptive feedback. The purpose of this case report is to demonstrate the efficacy of combining manual physical therapy and cervical joint position training on a patient with cervicogenic dizziness status-post motor vehicle accident (MVA).

Case Description A 28-year-old female with a history of MVA and chief …

Manual Therapy Interventions In A Complex Case Of Upper Quarter Symptoms In A Professional Violinist, Paul Howard, Pt, Dpt, Phd, Ocs, Faaompt

Department of Pathology, Anatomy, and Cell Biology Posters

This poster illustrates how knowledge of clinical anatomy, biomechanics, and orthopaedic manual therapy can be applied to the examination and treatment of a violinist.

Exploring The Use Of The Timed Up And Go Test To Identify Patient Fall Risk In An Inpatient Geriatric Psychiatry Unit, Danielle Struble-Fitzsimmons

Seton Hall University Dissertations and Theses (ETDs)

Background: Patient falls during hospitalization influence healthcare costs and quality, and hospitals are mandated to complete fall risk assessments on all patients. Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting, and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these two specific functional tasks, and has been used to predict falls in other geriatric populations, but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine if the TUG is a predictive …

Muscle Activity During Maximal Isometric Forearm Rotation Using A Power Grip, Joseph Scott Bader, Michael R. Boland, Desney Greybe, Arthur J. Nitz, Timothy L. Uhl, David A. Pienkowski

Biomedical Engineering Faculty Publications

This study aimed to provide quantitative activation data for muscles of the forearm during pronation and supination while using a power grip. Electromyographic data was collected from 15 forearm muscles in 11 subjects while they performed maximal isometric pronating and supinating efforts in nine positions of forearm rotation. Biceps brachii was the only muscle with substantial activation in only one effort direction. It was significantly more active when supinating (µ = 52.1%, SD = 17.5%) than pronating (µ = 5.1%, SD = 4.8%, p < .001). All other muscles showed considerable muscle activity during both pronation and supination. Brachioradialis, flexor carpi radialis, palmaris longus, pronator quadratus and pronator teres were significantly more active when pronating the forearm. Abductor pollicis longus and biceps brachii were significantly more active when supinating. This data highlights the importance of including muscles additional to the primary forearm rotators in a biomechanical analysis of forearm rotation. Doing so will further our understanding of forearm function and lead to the improved treatment of forearm fractures, trauma-induced muscle dysfunction and joint replacements.

Aphasia Simulation: A Perspective From The Student And Standardized Patient, Suzanne Moineau, Deb Bennett, Alison Scheer-Cohen

Teaching and Learning in Communication Sciences & Disorders

The aim of the current study was to examine student ability, student and standardized patient perceptions of competency, and student perceptions of effectiveness of simulation methodology for conducting language screenings on individuals with aphasia. Graduate students enrolled in a mandatory course on acquired language disorders (n = 36) completed a variety of simulated learning experiences using videos, high-fidelity manikins, and standardized patients, in preparing them for clinical practice with persons with aphasia. 5-point Likert scales and open-ended survey questions relating to student and standardized patients’ perceptions were administered. Results demonstrated a strong positive perception that simulation promotes student understanding of …

Impact And Perceived Benefits Of A Problem-Based Learning Workshop For Continuing Education In Speech-Language Pathology: A Pilot Study, Megan S. Overby, Heather L. Rusiewicz

Teaching and Learning in Communication Sciences & Disorders

Even though speech-language pathologists (SLPs) must participate in continuing education programs, little is known about the effectiveness of these learning opportunities. This preliminary study provides empirical assessment of the impact of a problem-based learning (PBL) CE activity on SLPs as perceived by themselves and their Instructors. Twenty-five experienced SLPs participated in an intensive multi-day, PBL workshop on childhood apraxia of speech. Significant differences in the SLPs’ self-perceived clinical efficacy between T1 and T2, as well as T2 and T3. At T3, Instructors rated the clinical efficacy of the SLPs as “very good” to “excellent.” Qualitatively, SLPs reported increased confidence, critical …

The Impact Of Body-Weight Supported Locomotor Training In A Toddler With Gmfcs Level V Cerebral Palsy: A Case Study, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

BACKGROUND AND PURPOSE: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) level V present with decreased gross motor function and trunk control that impacts their functional activities and participation in family activities. Research indicates body-weight supported locomotor training (BWSLT) may improve motor control for children with neuromotor disabilities. The toddler years present a window of opportunity for developmental changes. The purpose of this case study was to explore the impact of a 6-week BWSLT intervention on postural control, gross motor function, and quality of life in a young child with cerebral palsy in GMFCS level …

We Are Global Health: A Rejuvenating Perspective, Evan M. Pucillo, Edward C. O'Bryan

Physical Therapy Collection

No abstract provided.

Disability And Physical Therapy Services In Rural Nicaragua: A Pilot Study, Evan M. Pucillo, Edward C. O'Bryan

Physical Therapy Collection

The World Health Organization (WHO) estimates that 15% of the world’s population is living with disability, a large majority of which can be found in developing nations. Previous studies in Nicaragua have investigated the perceptions of disability among caregivers and noted limited access to rehabilitative services. However, the general knowledge and perceptions of physical therapy services in Nicaragua remains unclear. As a result, this pilot study sought to explore the local knowledge and perceptions of disability and physical therapy services and to characterize the sample from a remote area of northwestern Nicaragua. Participants were recruited using convenience sampling during multidisciplinary …

Blood Flow Restriction Training For Chronic Quadriceps Weakness And Atrophy: A Case Report, Tobi Baldwin, Fred Baldwin

Physical Therapy Collection

Background and purpose

The high load and intensity of traditional strength training may not always be appropriate or beneficial for certain patient populations such as the elderly or those with orthopedic injuries. In these cases blood flow restriction training with light resistance has been shown to be effective method of increasing strength and hypertrophy. However, what if traditional strength training is tolerated but not effective for an individual? The purpose of this case report is to describe the use of blood flow restriction training in a recreationally active male who was fully functional but continued with chronic unilateral quadriceps weakness …

Effect Of Stable And Unstable Surfaces On The Serratus Anterior Muscle Activation In A Kinetic-Chain Exercise Among Healthy Adults, Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

PURPOSE/HYPOTHESIS: The stabilizing action of the serratus anterior (SA) muscle is vital in maintaining proper scapulothoracic rhythm.^1,2 Poor activation of SA muscle could lead to many shoulder dysfunctions.^1,3 This warrants for exercises that are best to activate the SA muscle. Kinetic-chain recruitment during exercises has demonstrated increased SA activation due to the myofascial connections between various segments of the body.^4–6 Variation of surfaces during an exercise has been shown to alter the muscle recruitment patterns.^7–9 The primary purpose of this study was to determine if the unstable surface can influence SA muscle activity during the kinetic …

Feasibility And Preliminary Outcomes Of A Standardized Exercise Program In Adults With Down Syndrome: A Pilot Study, Megan Flores, Kristen Barta, Martha Sneary, Germaine Ferreira, Elizabeth Ardolino

Physical Therapy Collection

Purpose/ Hypothesis: Youth with Down Syndrome (DS) have limited participation in physical activity. When compared to their typically developing peers, adults with DS display decreased functional mobility and strength. Exercise has shown to improve the physical fitness, overall health, and quality of life in people with DS. The Lee Silverman Voice Treatment (LSVT® BIG) is an effective treatment approach designed for patients with Parkinson’s disease. The core components of LSVT® BIG include large amplitude movements, sensory calibration, high intensity, and maximum effort while performing the daily exercises. Due to hypotonicity associated with DS, these individuals typically display kyphotic posture, shortened …

Global Health And Disability: A Review And Call To Action For All Rehabilitation Professions, Evan M. Pucillo, Matthew B. Huish, Quinn Tate, Edward C. O'Bryan, Ty T. Dickerson

Physical Therapy Collection

The World Health Organization estimates 15% of the world’s population is living with disability and anticipates an increase as the population ages. Disability is a growing healthcare concern and presents a tremendous burden to all nations. The world will soon need to provide health and rehabilitative care for an enormous number of persons with disability. The purpose of this article is to provide a brief narrative review pertaining to global health and rehabilitation, and to motivate the rehabilitation professions in taking immediate action through further investment in global health initiatives to manage both the current and projected burden of disability. …

Ureteral Tunnel Length Versus Ureteral Orifice Configuration In The Determination Of Ureterovesical Junction Competence: A Computer Simulation Model, Carlos A. Villanueva, J. Tong, Carl A. Nelson, Linxia Gu

Department of Mechanical and Materials Engineering: Faculty Publications

Introduction The long-held belief that a ureteral re-implant tunnel should be five times the diameter of the ureter, as proposed by Paquin in 1959, ignores the effect of the orifice on the occurrence of reflux. In 1969, Lyon proposed that the shape of the ureteral orifice (UO) is more important than the intravesical tunnel. However, both theories missed quantitative evidence from principles of physics. The goal of the current study was to test Lyon’s theory through numerical models (i.e. to quantify the sensitivity of ureterovesical junction (UVJ) competence to intravesical tunnel length and to the UO).

Materials and methods The …

Sensory, Motor And Process Skills As Compared To Symptom Severity In Adult Patients With Schizophrenia, Lola Halperin

Occupational Therapy Faculty Publications

Schizophrenia is a serious mental illness affecting millions of Americans. It is characterized by positive and negative symptoms; cognitive impairments; and sensory, motor, and process skill deficits; as well as compromised motor learning, functional difficulties, and diminished quality of life. Neuroscientists attribute the above deficits to abnormal brain development, exaggerated synaptic pruning, and neurodegenerative processes, causing disrupted connectivity and diminished plasticity in the brain, neurotransmitter dysfunction, and impaired sensory processing.

Presently, there is no cure for schizophrenia. Numerous medications and rehabilitation modalities exist; however, many of the affected individuals continue to struggle daily. Recovery of these individuals implies symptom management …

A Randomized, Controlled Clinical Study To Assess The Effect Of Anodal And Cathodal Electrical Stimulation On Periwound Skin Blood Flow And Pressure Ulcer Size Reduction In Persons With Neurological Injuries, Anna Polak, Cezary Kucio, Luther C. Kloth, Malgorzata Paczula, Ewa Hordynska, Tomasz Ickowicz, Edward Blaszczak, Ewa Kucio, Krystian Oleszczyk, Krzysztof Ficek, Andrzej Franek

Physical Therapy Faculty Research and Publications

The use of electrical stimulation (ES) should be considered for treating nonhealing pressure ulcers (PUs), but optimal ES wound treatment protocols have yet to be established. A randomized, controlled, double-blind clinical study was conducted to evaluate the effects of cathodal and anodal high-voltage monophasic pulsed current (HVMPC) on periwound skin blood flow (PSBF) and size reduction of Stage 2 to Stage 4 PUs of at least 4 weeks’ duration.Persons >18 years of age, hospitalized with neurological injuries, at high risk for PU development (Norton scale <14 >points; Waterlow scale >15 points), and with at least 1 Stage 2 to Stage 4 …

Effects Of Aging On Temporal Predictive Mechanisms Of Speech And Hand Motor Reaction Time, Karim Johari, Dirk B. Den Ouden, Roozbeh Behroozmand

Communication Sciences and Disorders Faculty Articles and Research

Evidence from previous studies has suggested that movement execution in younger adults is accelerated in response to temporally predictable vs. unpredictable sensory stimuli. This effect indicates that external temporal information can modulate motor behavior; however, how aging can influence temporal predictive mechanisms in motor system has yet to be understood. The objective of the present study was to investigate aging effects on the initiation and inhibition of speech and hand movement reaction times in response to temporally predictable and unpredictable sensory stimuli. Fifteen younger (mean age 22.6) and fifteen older (mean age 63.8) adults performed a randomized speech vowel vocalization …

Running Economy While Running In Extreme Cushioning And Normal Cushioning Running Shoes, Miles A. Mercer, Tori M. Stone, John C. Young, John Mercer

Kinesiology and Nutrition Sciences Faculty Research

The purpose of the study was to determine if running economy was influenced by wearing maximal cushioning shoes vs. control (neutral cushioning) shoes. (Please see Abstract in text)

Validation Of The Godin Leisure-Time Exercise Questionnaire Classification Coding System Using Accelerometry In Multiple Sclerosis, Robert W. Motl, Rachel E. Bollaert, Brian M. Sandroff

Exercise Science Faculty Research and Publications

Objective: There have been recent efforts toward creating a health contribution score (HCS) from the Godin Leisure-Time Exercise Questionnaire (GLTEQ) that reflects public-health guidelines for levels of moderate-to-vigorous physical activity (MVPA). The HCS yields categories of insufficiently active (less substantial or low benefits), moderately active (some benefits), and active (substantial benefits). The present study examined the validity of the GLTEQ HCS and its categories as reflecting levels of MVPA in multiple sclerosis (MS). Method: The sample included 684 persons with MS. Participants wore an accelerometer on an elastic belt around the waist above the nondominant hip during the waking hours …

In-Home Delivery Of Constraint-Induced Movement Therapy Via Virtual Reality Gaming, Alexandra L. Borstad, Roger Crawfis, Kala Phillips, Linda Pax Lowes, David Maung, Ryan Mcpherson, Amelia Siles, Lise Worthen-Chaudhari, Lynne V. Gauthier

Journal of Patient-Centered Research and Reviews

Purpose: People with chronic hemiparesis are frequently dissatisfied with the recovery of their hand and arm, yet many lack access to effective treatments. Constraint-induced movement therapy (CI therapy) effectively increases arm function and spontaneous use in persons with chronic hemiparesis. The purpose of this study was to determine the feasibility and measure safety and outcomes of an in-home model of delivering CI therapy using a custom, avatar-based virtual reality game.

Methods: Seventeen individuals with chronic hemiparesis participated in this pretest/posttest quasi-experimental design study. The 10-day intervention had three components: 1) high-repetition motor practice using virtual reality gaming; 2) constraint of …

Imagine A World …, David A. Nelson

Journal of Patient-Centered Research and Reviews

The author and issue editor introduces the second half of Journal of Patient-Centered Research and Reviews’ two-part series on health disparities and inequities in the United States. The chasm between an ideal health care system and the current reality may appear vast, and closing it insurmountable at times, but acknowledging and working to address the many health conditions that disproportionately affect specific patient populations is one step health providers and researchers can take toward closing the gap.

The Magic Wand: A Case Study Of Chronic Neck Pain, Sandra L. Winkler

The Qualitative Report

Medications used to manage chronic pain have documented side effects including drug dependency, drug interaction, and adverse systemic reactions. This case study used Interpretative Phenomenological Analysis to understand how one individual experienced chronic neck pain including pharmaceutical and non-pharmaceutical interventions. Convenience sampling identified Ms. P, an individual with a 10-year history of chronic pain. The research questions were: “How does one individual with chronic neck pain describe their experience living with neck pain?” and “How does one individual with chronic neck pain manage their pain?” Three super-ordinate themes emerged: pain pervades everything, finding relief, and recovery. Findings suggest that living …

Girls In The Boat: Sex Differences In Rowing Performance And Participation, Kevin G. Keenan, Jonathon Senefeld, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Men outperform women in many athletic endeavors due to physiological and anatomical differences (e.g. larger and faster muscle); however, the observed sex differences in elite athletic performance are typically larger than expected, and may reflect sex-related differences in opportunity or incentives. As collegiate rowing in the United States has been largely incentivized for women over the last 20 years, but not men, the purpose of this study was to examine sex differences in elite rowing performance over that timeframe. Finishing times from grand finale races for collegiate championship on-water performances (n = 480) and junior indoor performances (n = 1,280) …

Physical Therapy Considerations For Chronic Kidney Disease And Secondary Sarcopenia, Michael O. Harris-Love, Haniel J. Hernandez, Gideon Obamwonyi

Exercise and Nutrition Sciences Faculty Publications

Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the …

The Art And Science Of Occupation As Therapy, Jennifer Fortuna

The Open Journal of Occupational Therapy

Ashley Woo Lee, an occupational therapy student based in Loma Linda, CA, provided the cover art for the Winter 2018 issue of The Open Journal of Occupational Therapy (OJOT) (Figure 1). The piece, titled “Tree of Life,” is a 11” x 14” drawing made from mixed media. As a child living in Korea, Ashley enjoyed drawing as a favorite pastime. After her family relocated to the United States, art became Ashley’s primary means for self-expression. When a career in art was not an option, the field of occupational therapy satisfied Ashley’s artistic and scientific interests. In a recent interview, Ashley …

Factors Associated With Academic Performance Among Second-Year Undergraduate Occupational Therapy Students, Tore Bonsaksen, Brian J. Ellingham, Tove Carstensen

The Open Journal of Occupational Therapy

Background: Research into occupational therapy education and its outcomes for students is growing. More research is needed to determine the factors of importance for occupational therapy students’ academic outcomes. This study aimed to investigate factors associated with academic performance among second-year undergraduate occupational therapy students in Norway.

Methods: Occupational therapy students (n = 111) from two education programs completed questionnaires asking for sociodemographic, work-related, and education-related information. Hierarchical linear regression analysis was used to examine factors independently associated with the students’ academic performance.

Results: A higher age was associated with better average academic performance among the students, whereas having …

Co-Constructing Simulations With Learners: Roles, Responsibilities, And Impact, Diane E. Mackenzie, Kathleen E. Collins, Mylene J. Guimond, Abby C. Hunter, Kassia J. Jurcina, Johanna L. Mcdonald, Nikki L. Richards, Stephanie. H. Sinclair, Kelsey Y. Taylor

The Open Journal of Occupational Therapy

Co-constructed simulations were designed and piloted with senior occupational therapy master’s students in a neurorehabilitation practice module. The instructor served as the guide for the students through all phases of the case creation, simulation development, delivery, and debrief. The instructor facilitation promoted self-regulated learning (SRL) of knowledge and skill development through independent discovery and peer learning. This paper provides an evidence-informed co-construction simulation design with outlined stages, roles, and responsibilities for the instructor and learner. Thematic qualitative analysis of student feedback highlighted enhanced insight and SRL as a result of multiple role preparation, observation and interaction with peers, close interaction …

Pennsylvania Occupational Therapy Fieldwork Educator Practices And Preferences In Clinical Education, Kaitlyn Ryan, Melanie Beck, Lee Ungaretta, Magdalena Rooney, Elaina Dalomba, Leamor Kahanov

The Open Journal of Occupational Therapy

The shortage of clinical education fieldwork sites coupled with a concern over the quality of the required fieldwork experience poses an unintended outcome for the recent changes in the health care system and an increasing number of occupational therapy students. While the Accreditation Council for Occupational Therapy Education (ACOTE) issues standards for fieldwork education, the quality of the experience is known to vary. The present study employed a mixed methods concurrent nested design with a quantitative online survey alongside qualitative individual semi-structured online interviews to examine the practices and preferences of fieldwork educators in Pennsylvania ACOTE accredited programs. From the …