Rehabilitation and Therapy Commons^™

Evaluations Of Exercise Intolerance With Cardiopulmonary Exercise Tests In A 24-Year-Old Young Male With Obesity With Tetrahydrobiopterin Deficiency: A Case Report, Chun-Yu Chen, Shin-Tsu Chang, Ko-Long Lin, Mu-Hsun Wu

Rehabilitation Practice and Science

Phenylketonuria (PKU) is a rare amino acid metabolism genetic disorder. Tetrahydrobiopterin (BH4) metabolism defects cause variant PKU. BH4 coenzyme deficiency disables phenylalanine metabolism into tyrosine, causing brain damage and intellectual impairment. Patients follow a low-phenylalanine diet for life, increasing the risk of obesity, hypertension, and metabolic syndrome. A 24-year-old male patient with BH4 deficiency underwent a pulmonary function test and cardiopulmonary exercise test (CPET). Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were within normal values, with an 80.68% ratio. The 20-watt bicycle exercise test indicated moderate functional impairment (27.3 ml/kg/min of peak oxygen intake). The …

Evaluating Dysphagia In Patients With Cervical Spinal Cord Injury Using The Modified Barium Swallow Impairment Profile, Ting-Huan Chen, Bai-Hong Chen, Shih-Chung Chang

Rehabilitation Practice and Science

Background/Purpose: To clarify the characteristics of dysphagia in patients with cervical spinal cord injury (CSCI) by using modified barium swallow impairment profile (MBSImP) scoring in a videofluoroscopic swallowing study (VFSS). Methods: This retrospective study included the data of 10 patients with CSCI (9 men and 1 woman) with dysphagia admitted to the rehabilitation ward of a university medical hospital who had undergone VFSS. The patients’ oral, pharyngeal, and esophageal impairments were evaluated using the MBSImP. Results: Comprising the MBSImP overall score, the median oral impairment total score (OT) was 10.5 (interquartile range [IQR]: 9–11), the median pharyngeal impairment total score …

Effect Of Robotic Training On The Mobility Of Children With Cerebral Palsy: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Fu-An Yang, Ya-Chu Shih, Li-Fong Lin, Chih-Wei Peng, Chien-Hung Lai, Tsan-Hon Liou, Reuben Escorpizo, Hung-Chou Chen

Rehabilitation Practice and Science

In this study, we conducted a systematic review and meta-analysis to investigate the effect of robotic training on the mobility of children with cerebral palsy. The PubMed, Cochrane Library, PEDro, and Embase databases were searched for relevant studies from their inception to June 17, 2023. We selected studies that (1) were randomized controlled trials (RCTs), (2) included patients with cerebral palsy aged years, (3) compared robotic training with conventional rehabilitation alone, and (4) reported mobility outcomes. Continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). The analysis was performed using RevMan 5.4 software. We included …

Effectiveness Of Specialized Oral Care For Post-Acute Stroke Patients, Hui-Chuan Chen, Hsiao-Han Wei, Yi-Hsuan Yang, Hsial-Lun To, Hsiao-Fan Wang, Ying-Han Hong

Rehabilitation Practice and Science

(1) Background: Poor oral health is a common problem in stroke patients. In Taiwan, there are professional oral care processes for patients with special needs such as stroke patients, which are guided by dental hygienists. This study sought to investigate the effectiveness of specialized oral care for hospitalized stroke patients; (2) Methods: This prospective study was conducted in the Rehabilitation ward at the Taipei City Hospital. Sixty-six patients were randomly divided into two groups. The specialized oral care group (n=34) was guided by dental hygienists. The control group (n=32) received only routine oral care. The oral health outcome measure was …

The Effects Of Blood Flow Restriction On Electromyography Activity Of Proximal And Distal Upper Extremity Musculature, Sami Dullum, Clyde Jensen, Connor Remus

Physical Therapy Scholarly Projects

Purpose/Hypothesis: Blood flow restriction therapy (BFR) has become a popular strength training and intervention method. Research shows BFR increases muscular hypertrophy and strength, mostly attributed to vascular occlusion. The purpose of this study is to examine BFR effects on proximal and distal muscle electromyography (EMG) activity to evaluate characteristics of fatigue in the infraspinatus (INFRA) and extensor carpi radialis brevis (ECRB) during resistive side-lying shoulder external rotation (ER). Number of Subjects: 51

Materials/Methods: Fifty-one college students, 31 females, and 20 males participated in the study. Shoulder ER peak force was identified in side-lying utilizing a MicroFET. Participants completed shoulder …

The Association Of Acute Stress And Single Leg Balance, Theodore W. Gehrig Iii

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic low back pain is a widespread and expensive societal burden that is routinely near the top of the list of reasons people live with a disability. There is an undeniable connection between low back pain and psychological stress, and it has long been accepted that stress comes as a consequence of the burden of pain. Our group sought to determine if the inverse of this paradigm might be true: that stress may actually play a role in the etiology of low back pain through its influence on neuromuscular control and strategies for balance stability. In this dissertation, we include …

Effects Of Electrotherapy On Pain And Mobility, Pablo Mleziva

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Neck chronic pain is one of the most common problems in people today. However, people do not always seek medical treatment for their pain. Subclinical or mild pain generally does not prompt people to seek medical treatment. Consequences of this type of pain can be anxiety, disability and proprioception problems. The American Physical Therapy Association (APTA) recommends transcutaneous electrical nerve stimulation (TENS) as an intervention to treat neck pain with mobility deficits. TENS for the treatment of pain has been used for many years; however, there is still an “efficacy-impasse” for the use of TENS despite half a …

Effect Of Home Exercise Program On Visual Reliance For Balance In Older Adults, Madeha Jaber

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Older adults tend to rely excessively on visual inputs to maintain their balance. This overreliance on visual inputs can increase the risk of falls, particularly when visual inputs are reduced or eliminated. This study aimed to determine the effects of a home exercise program (HEP) on visual reliance for balance and cervical active range of motion (AROM) among older adults.

Patients/Materials and Methods: The study sample consisted of 19 older adults, aged 65-79 years old. Outcome measures included static balance, balance confidence, and cervical AROM. Participants were instructed to follow an 8-week HEP and were provided with …

Application Of Intravenous Laser Irradiation Of Blood (Ilib) In Physical Medicine: A Narrative Review, Ya-Chi Chuang, Yuan-Yang Cheng

Rehabilitation Practice and Science

Intravenous laser irradiation of blood (ILIB) involves a type of intravascular treatment which applies a helium-neon laser possessing a wavelength of 632.8nm. Since its first use in 1981 by Russian scientists, it is now widely applied in the treatment of various diseases, including chronic musculoskeletal pain, wound healing, spinal cord injury, stroke, traumatic brain injury, coronary artery disease, type 2 diabetes mellitus, rheumatoid arthritis and acute kidney injury. The underlying mechanism for ILIB may be associated with its anti-oxidative (through regulating the reactive oxygen species systems) and anti-inflammatory effects (by reducing the production of inflammatory cytokines). Moreover, positive effects on …

Incarceration Vs Treatment: Is One More Effective Than The Other In Preventing Recidivism For Drug Abuse?, Scott G. Kang

Student Theses

This study aims to determine the most effective approach for reducing recidivism among drug offenders, comparing incarceration with treatment. Two hypotheses were formulated for this research: 1) Drug offenders undergoing residential treatment will experience lower recidivism rates compared to those sentenced to incarceration. 2) Extended therapeutic treatment is more likely to positively influence behavior change among drug abusers compared to longer prison sentences. These hypotheses were tested using data from 263 participants in the Drug Treatment Alternative-to-Prison (DTAP) program, analyzed through logistic regression in SPSS. The results indicate that therapeutic interventions, specifically rehabilitative treatment, are more effective than incarceration in …

Management Of Dysphagia In Tracheostomized Patients: A Narrative Review, Chih-En Liu, Shu-Mei Yang, Ming-Yen Hsiao

Rehabilitation Practice and Science

Swallowing disorders are prevalent in tracheostomized patients and are associated with a high incidence of aspiration. This narrative review discusses the primary causes and subsequent management strategies for dysphagia in this population. Factors such as reduced laryngeal elevation, compromised hypopharyngeal and laryngeal sensations, impaired vocal cord function, loss of glottic airflow and subglottic pressure, weakened cough reflex, increased respiratory secretions, and disuse muscle atrophy have been identified as major contributors. These challenges can lead to severe complications, including aspiration pneumonia and respiratory failure. Comprehensive evaluations that combine clinical assessments with a thorough review of a patient’s medical history are crucial. …

Pseudomeningocele Following Traumatic Brachial Plexus Injury: A Case Report, Shih-Ting Huang, Ming-Hsun Lee, Simon-Fuk Tan Tang, Ching-Yu Wang, Yu-Ting Hsieh

Rehabilitation Practice and Science

An injury to the brachial plexus can lead to the development of a pseudomeningocele, a buildup of cerebrospinal fluid (CSF) in the subarachnoid space caused by tears in the affected root sleeves. External forces acting on the brachial plexus represent the main mechanism of injury. The resulting stretching and tearing of the meninges outside the nerve root led to the pseudomeningocele. Although often initially asymptomatic, a pseudomeningocele can eventually cause pain, paresthesia, muscle weakness, and paralysis. The nerve conduction studies (NCS), electromyography (EMG), and magnetic resonance imaging (MRI) can be used to identify the injury, and treatment can involve either …

Clinical Multimedia: Ultrasound Examination Of Medial Meniscus Posterior Root Tear, Yu-Xuan Wu, Chien-Ping Chen, Hung-Jui Chuang

Rehabilitation Practice and Science

This report outlines the case of a 52-year-old woman with continuous left knee pain. An initial assessment, suggesting a meniscal tear based on joint line tenderness and a positive McMurray test, led to an ultrasonographic investigation. The ultrasound revealed left medial meniscus extrusion without positional change from full extension to 90° flexion, a hypoechoic cleft in the medial meniscus posterior root (MMPR) area, and the notable absence of the MMPR anterior to the posterior cruciate ligament (PCL), identified as the ultrasonographic ghost sign. A subsequent MRI confirmed a medial meniscus posterior root tear (MMPRT). MMPRT is known to cause biomechanical …

Effects Of Photobiomodulation Therapy On Muscle Function In Individuals With Multiple Sclerosis, Mitra Rouhani, Miguel Tolentino, Jeri-Anne Lyons, Alexander V. Ng

Exercise Science Faculty Research and Publications

Background

In people with multiple sclerosis (pwMS), muscle fatigue and weakness are common issues that can interfere with daily activities. Photobiomodulation therapy (PBMT), comprising light in a 600–1100 nm bandwidth, is a low-level laser therapy thought to improve muscle performance in non-disease populations, in part, by improving mitochondrial function and thus, might be beneficial in pwMS. Given this potential, we aimed to investigate the effects of PBMT on muscle performance in pwMS, both in the short-term and over an extended period.

Methods

This study consisted of two parts with a randomized double-blind crossover design. In study I, muscle function was …

Systematic Review And Dosage Analysis: Hyperbaric Oxygen Therapy Efficacy In The Treatment Of Posttraumatic Stress Disorder, Susan R. Andrews, Paul G. Harch

School of Medicine Faculty Publications

Background: Studies of hyperbaric oxygen therapy (HBOT) treatment of mild traumatic brain injury persistent postconcussion syndrome in military and civilian subjects have shown simultaneous improvement in posttraumatic stress disorder (PTSD) or PTSD symptoms, suggesting that HBOT may be an effective treatment for PTSD. This is a systematic review and dosage analysis of HBOT treatment of patients with PTSD symptoms. Methods: PubMed, CINAHL, and the Cochrane Systematic Review Database were searched from September 18 to November 23, 2023, for all adult clinical studies published in English on HBOT and PTSD. Randomized trials and studies with symptomatic outcomes were selected for final …

Neurorehabilitation With Vagus Nerve Stimulation: A Systematic Review, Radha Korupolu, Alyssa Miller, Andrew Park, Nuray Yozbatiran

Faculty, Staff and Student Publications

OBJECTIVE: To systematically review vagus nerve stimulation (VNS) studies to present data on the safety and efficacy on motor recovery following stroke, traumatic brain injury (TBI), and spinal cord injury (SCI).

METHODS: Data sources: PubMed, EMBASE, SCOPUS, and Cochrane.

STUDY SELECTION: Clinical trials of VNS in animal models and humans with TBI and SCI were included to evaluate the effects of pairing VNS with rehabilitation therapy on motor recovery.

DATA EXTRACTION: Two reviewers independently assessed articles according to the evaluation criteria and extracted relevant data electronically.

DATA SYNTHESIS: Twenty-nine studies were included; 11 were animal models of stroke, TBI, and …

Physical Therapy For Survivors Of Torture: A Scoping Review, Justine Dee, Nancy Gell, Constance Van Eeghen, Benjamin Littenberg

Department of Physical Therapy Faculty Papers

Background: Torture can result in impaired function, reduced quality of life, and chronic pain. Physical therapy (PT) is recommended for wholistic care of survivors of torture (SOT), however there are limited evidenced-based guidelines. We conducted a scoping review to identify and describe the approach and gaps in knowledge around the PT treatment of SOT.

Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Nine databases were searched from inception to 2023. Eligible sources were those involving PT treatment for SOT. Extracted data included the source of evidence, PT description, mode …

Intimacy Following Cerebral Vascular Accident, Hannah Caitlyn Guschel, Sarah Hendrickson

Graduate Student Scholarship

In the United States, a cerebral vascular accident (CVA) is a leading cause of death and a significant contributor to severe disabilities for adults (Centers for Disease Control and Prevention, 2022a). Two areas of post-stroke deficits and changes that are not frequently addressed in treatments are sexual activity dysfunctions and challenges with intimacy after stroke. Occupational therapy practitioners have the education, training, and practice areas within our framework to address issues relating to sexuality and provide education on the matter. Sexuality should be addressed, like all other activities of daily living, thorough and assiduous. This study was a cross-sectional design …

Promoting Engagement Of Male Individuals With Alzheimer’S In A Memory Day Care, Tara Brophy

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Alzheimer’s and related dementias impact an individual's cognitive, psychological, social, and physical functions resulting in impairments within the engagement of activities. Activities offer many therapeutic benefits including improvements in mood, alertness, communication, socialization, sleep, cognitive function, and quality of life. The focus of this quality improvement capstone project was to address the decreased level of engagement in male members within a memory day care center setting through engaging them in male-tailored activities. The project included the development of a website that provided tailored male-oriented activities and educational resources that were shared with the staff to revise their day care activity …

Examining The Diagnostic Accuracy Of A Novel Performance-Based Test For Alzheimer's Disease Screening, A. M. Reed, K. Duff, L. E. Dibble, S. S. Paul, Andrew Hooyman, S. Y. Schaefer

Physical Therapy Faculty Articles and Research

Affordable, rapid methods for identifying mild Alzheimer’s disease (AD) are needed. A simple, brief performance-based test involving the learning of functional upper-extremity movements has been developed and is associated with AD pathology and functional decline. However, its specificity to AD relative to other neurodegenerative diseases that present with motor impairment is unknown. This study examined whether this novel test could distinguish between 34 participants diagnosed with mild AD (Clinical Dementia Rating Scale = 0.5-1) from 23 participants with mild-to-moderate Parkinson’s disease (PD) (Hoehn & Yahr = 2-3) using Receiver Operating Characteristic analysis of secondary data from two separate clinical trials. …

Focused Interdisciplinary Therapy: Making A Case For Group Based Intensive Therapy In Pediatric Neurorehabilitation, Teressa Reidy, Nicole Andrejow, Erin Naber, Joan Carney

Journal of Interprofessional Practice and Collaboration

Intensive therapy models for children with chronic disabilities are gaining popularity in clinical practice. This paper outlines an intensive, interdisciplinary group intervention protocol targeting functional mobility and occupational performance of three teenage participants diagnosed with cerebral palsy (CP) (GMFCS levels 1-3). Participants demonstrated gains in function as measured by the Canadian Occupational Performance Measure (COPM), Gross Motor Function Measure-88 (GMFM), Six Minute Walk Test (6MWT), Timed Up and Down Stairs (TUDS), and grip strength. These gains indicate that intensive group-based interdisciplinary therapy programs may improve the mobility and occupational performance of ambulatory teens with CP. A significant limitation of this …

Assessing Health Needs In A Dominican Republic Community During An Interprofessional Service-Learning Trip, Gabriela Andonie, Hanna Rotundo, Ashanti Jones, Logan Dugas, Shylon Francis

Journal of Interprofessional Practice and Collaboration

Purpose: International medical missions may increase access to medicines and care, but international teams must understand local needs to implement appropriate services. In 2023, a multidisciplinary team from our institution partnered with a nonprofit organization in the barrio of Cienfuegos, Dominican Republic with the goal of strengthening local health services. The primary objective of this study was to identify health-related needs in Cienfuegos from the perspective of community members and local health care workers.

Methods: A qualitative study was conducted as part of a service-learning initiative. After obtaining informed consent, the investigators conducted individual semi-structured interviews facilitated by multi-lingual interpreters. …

The Perceived Impact Of Direct Patient Care During The Covid-19 Pandemic On Occupational Therapy Practitioners’ Mental Health Status, Emilee N. Sasser, Kathleen French, Alison Lecompte, Carrie C. Slade, Jasper Queen

Journal of Interprofessional Practice and Collaboration

Aim: To identify the impact of severe acute respiratory syndrome-related coronavirus 2 (COVID-19) on the mental health status of occupational therapy (OT) practitioners providing direct patient care.

Methods: The researchers administered a survey to identify OT practitioners’ perceptions of mental health prior to and during the pandemic. The survey was posted online via a link on social media pages related to occupational therapy professional groups. Participants completed the self-administered survey consisting of 16 questions. Some participants provided narrative responses to select survey questions, which asked about their mental health prior to and during the COVID-19 pandemic.

Results: One hundred and …

Feldenkrais And Music Informed Listening: A Neurophenomenological Perspective On Autism, Arona Primalani

Expressive Therapies Capstone Theses

Phenomenologists identify the subjective body and its felt-senses as the basis for human development and consciousness, including mental health. Several mental health disorders, when viewed from a phenomenological perspective, share common symptomology related to varying extents of fractured selves, which in turn hinders dynamic interaction between individuals, their actions, and their relationships with their social and material worlds. Autism is one such condition. Hence, I created an intervention to investigate how listening, which foster subjective and intersubjective experiences, lies at the heart of somatic and arts-based interventions. This thesis, first, begins with a summary of the presenting symptoms observed in …

Optimal Duration Of Physical Therapy Following Total Knee Arthroplasty, Gregory Benes, Zachary Adams, Michael Dubic, Justin David, Claudia Leonardi, Amy Bronstone, Vinod Dasa

School of Medicine Faculty Publications

Aims & Objectives: The purpose of this study was to identify patient characteristics associated with engagement and completion of physical therapy (PT) following total knee arthroplasty (TKA) and examine the relationship between number of PT sessions attended and outcomes during the first 12 weeks after surgery. Methods: Patients underwent unilateral primary TKA by a single surgeon and were advised to complete 17 PT sessions over 6 weeks at a hospital-affiliated facility. Analyses examined predictors of PT engagement (attendance of ≥ 2 sessions) and completion (attendance of 17 ± 1 sessions) within 6 weeks and associations between number of PT sessions …

An Investigation Of The Effect Of A Combined Physical Exercise And Counseling As A Therapeutic Approach To Reducing Anxiety Symptoms, Andrea C. Beltran

Doctoral Dissertations and Projects

Mental health issues are on the rise as the increase in emotional, psychological, and social well-being affects how people think, act, or feel toward themselves and others. The topic of physical exercise and mental health services has been researched to show a strong relationship between physical activity and positive mental health outcomes. Anxiety is the most common mental health concern in the United States (Goodwin et al., 2020). This study aims to investigate and quantify the impact and explore the relationships of the combined intervention approach of physical activity and counseling in reducing symptoms of anxiety. This research will utilize …

Bowel Clean Out Prior To Intrathecal Baclofen Pump Implantation: Effects On Acute Post-Operative Gastrointestinal Complications, Amanda Lindenberg, Sathya Vadivelu, Brittni Walton, Matthew J. Mclaughlin

Research Days

Background: Intrathecal baclofen (ITB) pumps have been used for management of spasticity and dystonia There is limited data on immediate post-operative complications such as GI adverse events after surgery for ITB pump related procedures. This study aimed to compare patients who underwent a pre-operative bowel cleanout to those who did not and the relationship with post-operative nausea, vomiting and constipation requiring an escalation of their bowel regimen.

Design: Retrospective cohort study.

Setting: Pediatric acute care hospital.

Participants: All patients who underwent new ITB pump and/or catheter placement from January 2015-December 2022.

Interventions: Preoperative bowel clean out. Main

Outcome Measure: Quantity …

Assessment Of Gait, Balance, And Falls In Individuals With Neurodegenerative Diseases, Lauren Tueth

WUSM Theses and Dissertations – All Programs

Neurodegenerative diseases are a group of disorders that impact the brain and lead to neuronal degeneration. This degeneration causes many different symptoms, which are often grouped into motor, cognitive, and psychiatric domains. Individuals with these disorders can experience symptoms from multiple domains at the same time, but little is known about how these distinct symptoms may impact each other.

In Chapter 2, we explored the intersection of balance and cognitive impairment in individuals with Alzheimer disease (AD). AD is traditionally discussed in the context of the dementia symptoms, but people with AD also experience motor deficits. Falls are a huge …

Measurement Of And Contributors To Developmental Coordination Impairment, Jeffrey D. Konrad

WUSM Theses and Dissertations – All Programs

Movement drives childhood development. As motor skills improve across development, a child becomes capable of greater interactions with their physical and social environment. Children with motor impairments miss out on these interaction opportunities and their development across a variety of domains can suffer. There is accumulating evidence that poor motor competence relates to an array of developmental outcomes such as educational achievement, reading skills, social development, and emotional regulation. Two developmentally important motor impairments are poor motor competence and hyperactivity which are associated with Autism Spectrum Disorder (ASD), Developmental Coordination Disorder (DCD), and/or Attention Deficit Hyperactivity Disorder (ADHD). Critical to …

Exploring Complex Daily Tasks In Preclinical Alzheimer Disease, Audrey A. Keleman

WUSM Theses and Dissertations – All Programs

Alzheimer disease (AD) is a slowly progressive neurodegenerative disorder marked by a gradual decline in cognitive functions and ability to perform daily activities. AD begins with a clinically silent period in which pathological abnormalities accumulate in the brain before cognitive impairments occur (i.e., while individuals remain cognitively normal [CN]). This stage is known as preclinical AD and can last up to two decades. It can be identified by measuring biomarkers of AD using neuroimaging or biofluid techniques. In the United States alone, it is estimated that nearly 46 million individuals are in the preclinical stage of AD and at risk …