Rehabilitation and Therapy Commons^™

Perceptions Of Physical Therapy Clinicians Regarding The Impact Of Covid 19 On Patients’ Mental Health, Brandy Chase, Amy L. Barnett

Faculty Articles & Research

• Research shows that the COVID 19 outbreak can negatively affect a person’s mental health, especially those at a higher risk with debilitating conditions (Javed, Sarwer, & Soto, 2020).
• This alludes to the need to take a closer look at the impact of COVID 19 on physical therapy patients and the amount of mental health training needed by physical therapy clinicians.

Youth Throwing Athletes Do Not Show Bilateral Differences In Medial Elbow Width Or Flexor Tendon Thickness, Rudolph M. Morrow, Gary Mcilvain, Jenifer Johnson, Mark Timmons

Kinesiology Faculty Research

Background: Medial elbow laxity develops in throwing athletes due to valgus forces. Medial elbow instability in professional, collegiate, and high school athletes is well documented; however, the medial elbow of young throwing athletes has received less attention. This study investigated the medial elbow and common flexor tendon during applied elbow valgus stress of youth baseball players.

Methods: The study included 15 participants. The medial elbow width and thickness of the common flexor tendon were measured on ultrasound images.

Results: No significant side differences in medial elbow width or common flexor tendon were found at rest or under applied valgus stress. …

Effect Of Repeated Eccentric Exercise On Muscle Damage Markers And Motor Unit Control Strategies In Arm And Hand Muscle, Sunggun Jeon, Xin Ye, William M. Miller, Jun Seob Song

Faculty and Student Publications

To examine the contralateral repeated bout effect (CL-RBE) on muscle damage markers and motor unit (MU) control strategies, seventeen healthy adults performed two bouts of 60 eccentric contractions with elbow flexor (EF group; n ​= ​9) or index finger abductor (IA group; n ​= ​8) muscles, separated by 1 week. All participants randomly performed eccentric exercise on either the right or left arm or hand muscles, and muscle damage markers and submaximal trapezoid contraction tests were conducted pre, post, 1- and 2-day post eccentric protocol. One week after the first bout, the same exercise protocol and measurements were performed on …

The Perceptions Of Educators On Transition Planning & The Postsecondary Transition Readiness Outcomes Of Students With Disabilities, Marisa Duarte

Dissertations

The purpose of this quantitative descriptive research was to gain the perspective of educators on transition planning for students with disabilities in two public school districts in the state of Kentucky. The Individual Disabilities Education Act and Workforce Innovation Opportunities Act are laws requiring students with disabilities to be transition ready upon their graduation from high school. A sample of 12 educators, representing two Kentucky districts, who participate in transitioning students with disabilities, completed The Secondary Educator Transition Questionnaire survey. Data from the districts’ state report cards indicated students with disabilities were not transition ready in comparison with students without …

Academic Libraries And Athletic Training: Research Preferences Of Athletic Training Students, Daniel G. Kipnis, Lisa A. Adriani, Ronda Kolbin

Libraries Scholarship

To ensure academic standards are met for athletic training curriculums, it is essential that librarians and faculty understand student research habits and information literacy instruction preferences. This article provides results from a survey of undergraduate athletic training students conducted at two universities. Athletic training students prefer information literacy instruction at the beginning of the semester. When seeking research assistance, students ask their classmates first, followed by friends and Google. Most students spend up to 60 minutes researching online before seeking assistance and prefer in-person communication for assistance from the library followed by email.

Databases For Researching Athletic Training Literature, Daniel G. Kipnis, Lisa A. Adriani, Ronda Kolbin

Libraries Scholarship

Searching the athletic training literature can be confusing and overwhelming with many possible databases for locating relevant peer-reviewed scholarship. Finding evidence-based literature from respected publications is helpful in clinical decision-making for athletic training practitioners. This column details recommended databases and search tips to help students, staff, clinicians, and faculty in the field of athletic training find the literature they need to help make evidence-based decisions and to stay current with the published literature. Databases discussed include Cochrane, PubMed, SPORTDiscus, CINAHL, PEDro, Sports Medicine, and Education Index (formerly Physical Education Index), and Google Scholar.

Role Of Surgery In Multifocal Glioblastoma, Syeda Kubra Kishwar Jafri, Syed Sarmad Bukhari, Muhammad Shahzad Shamim

Section of Neurosurgery

The management of multifocal glioblastomas is a point of constant discussion amongst neuro-oncologists. Best outcomes in glioblastoma management come from gross total resection (GTR) followed by concomitant radiation and chemotherapy (CCRT). Multifocal disease is resistant to GTR. Conventional management of these lesion is usually biopsy only followed by CCRT. Recent evidence has shown that there may be some benefit to attempting GTR of the largest lesion whenever safe to do so.

Degenerative Cervical Myelopathy Delays Responses To Lateral Balance Perturbations Regardless Of Predictability, T. F. Boerger, L. Mcginn, M. C. Wang, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The aim of this study was to quantify balance impairments in standing in people with degenerative cervical myelopathy (PwDCM) in response to external perturbations. PwDCM have damage to their spinal cord due to degeneration of the cervical vertebral column, but little is known about balance. Balance was quantified by capturing kinetics, kinematic, and electromyographic data during standing in response to lateral waist pulls. Participants received pulls during predictable and unpredictable contexts in three stance widths at two magnitudes. In response to lateral waist pulls, PwDCM had larger center of mass excursion (P < 0.001) and delayed gluteus medius electromyography onset (P < 0.001) and peak (P < 0.001) timing. These main effects of history of myelopathy were consistent across predictability, stance width, and magnitude. A multilinear regression determined that gluteus medius peak timing + tibialis anterior peak timing most strongly predicted center of mass excursion (R2 = 0.50, P < 0.001). These data suggest that PwDCM have delays in generating voluntary and reactive motor commands, contributing to balance impairments. Future rehabilitation strategies should focus on generating rapid muscular contractions. Additionally, frontal plane postural control is regulated by the gluteus medius and the tibialis anterior, whereas other muscles (e.g. gluteus minimus, ankle invertors/evertors) not studied here may also contribute.

Prospective Telehealth Analysis Of Functional Performance, Frailty, Quality Of Life, And Mental Health After Covid-19 Hospitalization, Jacob J. Capin, Melissa P. Wilson, Kristine Hare, Swati Vempati, Carley E. Little, Donna Mcgregor, Jose Castillo-Mancilla, Jennifer E. Stevens-Lapsley, Sarah Jolley, Kristine M. Erlandson

Physical Therapy Faculty Research and Publications

Background

COVID-19 is a global pandemic with poorly understood long-term consequences. Determining the trajectory of recovery following COVID-19 hospitalization is critical for prioritizing care, allocating resources, facilitating prognosis, and informing rehabilitation. The purpose of this study was to prospectively evaluate recovery following COVID-19 hospitalization.

Methods

Participants age 18 years or older who were hospitalized for ≥24 h due to COVID-19 completed phone/video call virtual assessments (including the 10-time chair rise test) and survey forms at three time points (2–6, 12, and 18 weeks) after hospital discharge. Univariate logistic and linear regression models assessed the associations of the outcomes with primary …

High Definition Tdcs Effect On Postural Control In Healthy Individuals: Entropy Analysis Of A Crossover Clinical Trial, Diandra B. Favoretto, Eduardo Bergonzoni, Diego Carvalho Nascimento, Francisco Louzada, Tenysson W. Lemos, Rosangela A. Batistela, Renato Moraes, João P. Leite, Brunna P. Rimoli, Dylan J. Edwards, Taiza G.S. Edwards

Research outputs 2022 to 2026

Objective: Converging evidence supporting an effect of transcranial direct current stimulation (tDCS) on postural control and human verticality perception highlights this strategy as promising for post-stroke rehabilitation. We have previously demonstrated polarity-dependent effects of high-definition tDCS (HD-tDCS) on weight-bearing asymmetry. However, there is no investigation regarding the time-course of effects on postural control induced by HD-tDCS protocols. Thus, we performed a nonlinear time series analysis focusing on the entropy of the ground reaction force as a secondary investigation of our randomized, double-blind, placebo-controlled, crossover clinical trial. Materials and Methods: Twenty healthy right-handed young adults received the following conditions (random order, …

Improving Prediction Of Amyloid Deposition In Mild Cognitive Impairment With A Timed Motor Task, Sydney Y. Schaefer, Kevin Duff, Andrew Hooyman, John M. Hoffman

Physical Therapy Faculty Articles and Research

Cortical amyloid deposition is one of the hallmark biomarkers of Alzheimer’s disease (AD). However, given how cost- and time-intensive amyloid imaging can be, there is a continued need for a low-cost, non-invasive, and accessible enrichment strategy to pre-screen individuals for their likelihood of amyloid prior to imaging. Previous work supports the use of coordinated limb movement as a potential screening tool, even after controlling for cognitive and daily function. Thirty-six patients diagnosed with amnestic mild cognitive impairment over the age of 65 underwent 18F-Flutemetamol amyloid-positron emission tomography Cortical amyloid deposition is one of the hallmark biomarkers of Alzheimer’s disease (AD). …

Dirfloortime: An Innovative Approach To Supporting Development Through Connection And Understanding, Jessica Townsend

Department of Occupational Therapy Entry-Level Capstone Projects

Children with developmental delays and neurobehavioral disorders such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), often have social, emotional, or behavioral delays. Children who are not reaching developmental milestones or are reaching them at a slower rate may need extra support and services to reach their full potential. An innovative approach to treatment of developmental delay commonly used among therapists is called DIRFloortime®. DIRFloortime® (also referred to as Floortime) is the application of the Developmental, Individual-Differences, & Relationship-Based (DIR) model in practice. The purpose of this capstone project was to explore Floortime as a holistic intervention …

A Theoretical Framework For Addressing Fear Of Falling Avoidance Behavior In Parkinson’S Disease, Merrill R. Landers, Maria H. Nilsson

Physical Therapy Faculty Research

Postural instability in Parkinson’s disease (PD) is associated with several downstream consequences that ultimately lead to a greater risk of falling. Among the prominent downstream consequences is fear of falling (FOF), which is both common and problematic in PD. It can lead to a vicious cycle of FOF avoidance behavior that results in more sedentary behavior, physical deconditioning, and weakening of already impaired balance systems. This, in turn, may make the person with PD more susceptible to a future fall even with benign daily tasks. While FOF activity avoidance can be adaptive (appropriate), it can also be maladaptive (inappropriate or …

Examining Youth Conceptualizations Of Water Safety Behaviors Among Participants In A Learn-To-Swim Program, Austin R. Anderson, Kristina R. Anderson, William D. Ramos, Angela K. Beale-Tawfeeq

International Journal of Aquatic Research and Education

Drowning represents a leading cause of unintentional deaths among children. Concomitantly, while formal swim instruction often incorporates water safety practices, the efficacy of these messages remains largely unexplored. This qualitative-based study sought to evaluate how youth apply learned water safety concepts when posed with a hypothetical aquatic scenario. Semi-structured interviews, augmented by use of a visual illustration prompt, were conducted with 29 participants of a youth Learn-to-Swim (LTS) program. Interviews assessed participants’ expressed water safety behaviors and were coded based on emergent themes. Findings indicated that most participants were able to identify a “struggling” swimmer in the dramatized illustration. When …

Effect Of Water Depth On Heart Rate And Core Temperature During Underwater Treadmill Walking, Carrie E. Bajenski, Brianna R. Brandon, Cailey A. Curry, Leslie Fajardo, Ryan T. Conners

International Journal of Aquatic Research and Education

Exercising using an underwater treadmill (UTM) has become a popular modality; however, few studies have focused on the physiological demands of UTM walking at varying water depths. Thus, the objective of this study was to investigate changes in heart rate (HR) and core temperature (CT) values in college-aged males and females while exercising at different water immersion depths using an UTM. Twenty participants (age = 21.50 ± 2.19 years; height = 169.04 ± 10.85cm; weight = 75.56 ± 22.28kg) walked at water depths of 10cm below the xiphoid process and at the level of the superior iliac crest (I.C.). Each …

Editor's Note, Rolando Lazaro

Philippine Journal of Physical Therapy

The Editor-in-Chief of the Philippine Journal of Physical Therapy introduces its inaugural issue.

Self-Serving Bias In Performance Goal Achievement Appraisals: Evidence From Long-Distance Runners, Moonsup Hyun, Wonsok F. Jee, Christine Wegner, Jeremy S. Jordan, James Du, Taeyeon Oh

Faculty and Student Publications

While working with a long-distance running event organizer, the authors of this study observed considerable differences between event participants’ official finish time (i.e., bib time) and their self-reported finish time in the post-event survey. Drawing on the notion of self-serving bias, we aim to explore the source of this disparity and how such psychological bias influences participants’ event experience at long-distance running events. Using evidence of 1,320 marathon runners, we demonstrated how people are more likely to be subject to a biased self-assessment contingent upon achieving their best finish time at the event. The study samples were split into record-high-achieved …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Brain And Spinal Cord Adaptations Associated With Patellofemoral Pain: A Systematic Review And Meta-Analysis, Kai-Yu Ho, Jing Nong Liang, Savanna Budge, Austin Madriaga, Kara Meske, Derrick Nguyenton

Physical Therapy Faculty Research

Objective: To evaluate the evidence for altered cortical and spinal cord functions in individuals with patellofemoral pain (PFP).

Methods: We conducted a comprehensive search of databases to appraise and analyze the studies published prior to December 10, 2021 that examined spinal reflex excitability measured using Hoffmann reflex (H-reflex) amplitudes, corticospinal excitability measured using transcranial magnetic stimulation (TMS)-elicited motor evoked potential (MEP) amplitudes, motor threshold (MT), or stimulus-response (SR) curves, cortical reorganization assessed using TMS cortical mapping or structural magnetic resonance imaging (MRI), or functional changes of the brain assessed using functional MRI (fMRI) in individuals with PFP.

Results: Eight studies …

Comparative Analysis Of Gait Interventions For Pediatric Cerebral Palsy, Sydney Ross

Student Scholarship & Creative Works

Spastic cerebral palsy (CP) is the most common motor disability in childhood, affecting 1 in 345 children in the U.S. Functional gait training (FGT) has been used with and without electrical stimulation (ES) to improve gait.The purpose of this study is to evaluate existing research on the effectiveness of FGT with and without ES to improve gait speed and endurance, step length, and gross motor function in young children with spastic CP. The investigators evaluated 6 studies aimed at analyzing the effects of FGT with and without ES on gait function in children with spastic CP. Three of the studies …

Clinical Reasoning Readiness And Confidence Of Dpt Students With Pt Interventions Using Telehealth, Derrick F. Campbell, Jean-Michel Brismee, Brad Allen, Troy L. Hooper, Tony A. Domenech, Kathleen Manella

Physical Therapy Collection

Telehealth service-delivery content has an emerging footprint on entry-level physical therapy programs. This study evaluated clinical reasoning readiness and confidence in third-year DPT students during clinical experiences with and without telehealth.

Students’ clinical reasoning readiness and confidence were determined using the Physical Therapist Self-Efficacy (PTSE) score, self-confidence rating treating patients, and final APTA Clinical Performance Instrument (CPI) clinical reasoning and summative ratings.

DPT students providing PT interventions using telehealth reported lower clinical reasoning self-efficacy (PTSE) when compared to traditional service-delivery. Confidence treating using telehealth was greater at the initial visit compared to subsequent visits, suggesting a lack of student readiness …

Gender-Specific Effects On Muscle Activation During Incline Treadmill Walking: A Virtual Perturbation Study For Future Astronauts, Jie Hao, Robin High, Ka-Chun Siu

Posters and Presentations: Physical Therapy

Introduction Microgravity-induced muscle atrophy is a critical issue for astronauts in spaceflight [1]. To overcome neuromuscular deconditioning, combining virtual reality (VR) with treadmill training protocol could be a promising countermeasure for astronauts to enhance muscle activities and maximize the training effect [2]. Our previous study [3] found the presence of visual perturbation significantly increased muscle activation while walking on incline treadmill, compared with no visual perturbation; surprisingly, we found females had more pronounced muscle responses than males. Based upon these findings, this study aimed to investigate the effects of different visual rotation speeds and different types of visual perturbation on …

Task Effects On Functional Connectivity Measures After Stroke, Kaleb Vinehout, Sheila M. Schindler-Ivens, Jeffrey R. Binder, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Understanding the effect of task compared to rest on detecting stroke-related network abnormalities will inform efforts to optimize detection of such abnormalities. The goal of this work was to determine whether connectivity measures obtained during an overt task are more effective than connectivity obtained during a “resting” state for detecting stroke-related changes in network function of the brain. This study examined working memory, discrete pedaling, continuous pedaling and language tasks. Functional magnetic resonance imaging was used to examine regional and inter-regional brain network function in 14 stroke and 16 control participants. Independent component analysis was used to identify 149 regions …

Disparities In The Allocation Of Inpatient Physical And Occupational Therapy Services For Patients With Covid-19, Sarah Jolley, Amy Nordon-Craft, Melissa P. Wilson, Kyle Ridgeway, Michelle R. Rauzi, Jacob J. Capin, Lauren M. Heery, Jennifer Stevens-Lapsley, Kristine M. Erlandson

Physical Therapy Faculty Research and Publications

Background

Survivors of the novel coronavirus (COVID-19) experience significant morbidity with reduced physical function and impairments in activities of daily living. The use of in-hospital rehabilitation therapy may reduce long-term impairments.

Objective

To determine the frequency of therapy referral and treatment amongst hospitalized COVID-19 patients, assess for disparities in referral and receipt of therapy, and identify potentially modifiable factors contributing to disparities in therapy allocation.

Design, Setting and Participants

Retrospective cohort study using data collected from the University of Colorado Health Data Compass data warehouse assessing therapy referral rates and estimated delivery based on available administrative billing.

Measurements

Multivariable logistic …

Developing Peri-Operative Rehabilitation In Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 6]: An Unexplored Opportunity?, Timothy F. Boerger, Allison S. Hyngstrom, Julio C. Furlan, Sukhvinder Klasi-Ryan, Armin Curt, Brian K. Kwon, Shekar N. Kurpad, Michael G. Fehlings, James S. Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, James D. Guest, Jefferson R. Wilson, Benjamin M. Davies, Mark R. N. Kotter, Paul A. Koljonen

Physical Therapy Faculty Research and Publications

Study Design

Narrative review.

Objective

Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies.

Methods

Literature search.

Results

In other neurological disorders such as …

Subthreshold Vibration Influences Standing Balance But Has Unclear Impact On Somatosensation In Persons With Transtibial Amputations, Zachary S. Meade, Aaron D. Likens, Jenny A. Kent, Kota Z. Takahashi, Shane R. Wurdeman, Adam L. Jacobsen, Manuel E. Hernandez, Nick Stergiou

Physical Therapy Faculty Research

Stochastic resonance has been successfully used to improve human movement when using subthreshold vibration. Recent work has shown promise in improving mobility in individuals with unilateral lower limb amputations. Furthering this work, we present an investigation of two different signal structures in the use of stochastic resonance to improve mobility in individuals with unilateral lower limb amputations. Cutaneous somatosensation and standing balance measures using spatial and temporal analysis were assessed. There were no differences in the somatosensation measures, but differences in the temporal characteristics of the standing measures were seen with the various vibration structures when compared to no vibration, …

Muscle-Specific Contributions To Lower Extremity Net Joint Moments While Squatting With Different External Loads, Kristof Kipp, Hoon Kim, William I. Wolf

Exercise Science Faculty Research and Publications

The purpose of this study was to determine muscle-specific contributions to lower extremity net joint moments (NJMs) during squats with different external loads. Nine healthy subjects performed sets of the back squat exercise with 0, 25, 50, and 75% of body mass as an added external load. Motion capture and force plate data were used to calculate NJMs and to estimate individual muscle forces via static optimization. Individual muscle forces were multiplied by their respective moment arms to calculate the resulting muscle-specific joint moment. Statistical parametric mapping (α = 0.05) was used to determine load-dependent changes in the time series …

Blood Flow Restriction Training After Patellar Instability (Brains Trial), Benjamin D. Brightwell, Austin V. Stone, Xiaojuan Li, Peter A. Hardy, Katherine L. Thompson, Brian W. Noehren, Cale A. Jacobs

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background

Patellar instability is a common and understudied condition that disproportionally affects athletes and military personnel. The rate of post-traumatic osteoarthritis that develops following a patellar dislocation can be up to 50% of individuals 5–15 years after injury. Conservative treatment is the standard of care for patellar instability however, there are no evidence-informed rehabilitation guidelines in the scientific literature. The purpose of this study is to assess the effectiveness of blood-flow restriction training (BFRT) for patellar instability. Our hypotheses are that this strategy will improve patient-reported outcomes and accelerate restoration of symmetric strength and knee biomechanics necessary to safely return …

Long-Lasting Impairments In Quadriceps Mitochondrial Health, Muscle Size, And Phenotypic Composition Are Present After Non-Invasive Anterior Cruciate Ligament Injury, Steven M. Davi, Ahram Ahn, Mckenzie S. White, Timothy A. Butterfield, Kate Kosmac, Oh Sung Kwon, Lindsey K. Lepley

Center for Muscle Biology Faculty Publications

Introduction: Despite rigorous rehabilitation aimed at restoring muscle health, anterior cruciate ligament (ACL) injury is often hallmarked by significant long-term quadriceps muscle weakness. Derangements in mitochondrial function are a common feature of various atrophying conditions, yet it is unclear to what extent mitochondria are involved in the detrimental sequela of quadriceps dysfunction after ACL injury. Using a preclinical, non-invasive ACL injury rodent model, our objective was to explore the direct effect of an isolated ACL injury on mitochondrial function, muscle atrophy, and muscle phenotypic transitions.

Methods: A total of 40 male and female, Long Evans rats (16-week-old) were exposed to …