Rehabilitation and Therapy Commons^™

Uneven Terrain Treadmill Training For Lower Limb Prosthesis Users: A Feasibility Study, Brian Diep, Keegan Feroah, Ani Gasparyan, Nevena Jovanovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with lower limb amputation (LLA) face an increased risk for falls which may limit mobility, confidence, and participation in daily activities. Current rehabilitation programs for this population rarely integrate surface training as an intervention, despite walking on different surfaces being a necessity to participate in the real world. This feasibility study aimed to evaluate the practicality, acceptability, and preliminary efficacy of an uneven treadmill training protocol for individuals with LLA. Five adults with LLA (P1: transfemoral, 38 years old, 1.75 m, 88.8 kg; P2: hip disarticulation, 38 years old, 1.60 m, 106.7 kg; P3: transfemoral, 53 years old, 1.81 …

Effects Of A 12-Week Physical Therapy-Based Exercise Intervention On Gait In Adults With Down Syndrome, Samantha Betts, Stephen Kiraly, Paige Lucero, James Malabanan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals with Down Syndrome (Ds) frequently have sedentary lifestyles and Ds-specific physical impairments such as ligamentous laxity and hypotonia. These impairments often contribute to gait deviations that reduce the efficiency of ambulation. Purpose: The purpose of this study was to examine the effects of a 12-week exercise program on spatiotemporal characteristics of gait and kinematic variables at the hip, knee, and ankle in adults with Down syndrome (Ds). Methods: A randomized control trial of 40 participants was conducted with two groups: one group of adults with Ds who participated in a 12-week exercise program, and a control group who …

Stance And Gait Analysis Of Apollo Astronauts On The Moon, Faye Y Chiou-Tan, Conrad Li, Jason P Caffrey, Millard Reschke, Timothy R Macaulay

Faculty, Staff and Students Publications

Introduction/aim: As humans return to the Moon, safe efficient ambulation and fall prevention on the lunar surface are key concerns. The analysis of gait from archived Apollo mission video footage is now possible with pose estimation video analysis software. Thus, this study aims to retrospectively quantify parameters of Apollo astronauts' stance and gait on the Moon.

Methods: Publicly available National Aeronautics and Space Administration (NASA) footage of astronauts ambulating on the Lunar surface was examined using body pose analysis software. Goniometric lower limb joint/torso angles and width of base of stance and gait were derived. Gait cycle stance phase, swing …

A Systemic Review Of Functional Outcomes And Patient Satisfaction Across Lower-Limb Prosthetic Types In Military Personnel And Veterans, Emma Ho Harris, Amir Ghafarian, Sen Gao, Khaled Saleh, Jason Pasley

Medical Student Research Symposium

Background: Military personnel and veterans are at increased risk of lower-limb amputation, often due to combat-related trauma such as improvised explosive devices (IEDs), as well as secondary factors including tobacco use, peripheral artery disease, and diabetes. This study systematically reviews and compares lower-limb prosthetic technologies in military personnel and veterans, focusing on functional outcomes, mobility, and patient satisfaction.

Methods: A comprehensive literature search was conducted using PubMed MeSH terms to identify studies examining lower-limb prosthetic use and outcomes among military personnel and veterans. The final MeSH-based search yielded 27 results.

Results: The review included 27 studies on lower-limb prosthetic use …

Dual-Task Effects On Spatiotemporal, Kinematic, And Kinetic Parameters And Their Variability During Running, Hsiang-Ling Teng, Jo Armour Smith, Will F.W. Wu

Physical Therapy Faculty Articles and Research

Background

Running in real-world environments often requires using cognitive resources simultaneously with the motor task (dual tasking, DT). Limited existing evidence suggests that DT reduces running speed. Movement variability is essential for a healthy, adaptable motor system. DT has been shown to affect movement variability during walking. Nonetheless, it remains unclear how DT affects spatiotemporal, kinematic, and kinetic parameters and their variability during running.

Research question

Does DT affect spatiotemporal, kinematic, and kinetic measures and their variability during running? Does running speed influence DT effects?

Methods

Thirty-one asymptomatic runners participated in this cross-sectional study. Three-dimensional running biomechanics were recorded while …

Clinical Effectiveness Of An Aquatic Exercise Program On Those With Visual Impairment, Mikayla Calitis, Haley Mcmenimen, Isabella Bernitsky, Amelia Gansz, Karol Bialek

Student Research Poster Presentations 2026

No abstract provided.

The Effects Of Virtual Reality Interventions On Gait And Balance In Patients With Chronic Stroke: A Systematic Review, Meghan Darrough, Stephanie Layland, Breena Kravchick

Student Research Poster Presentations 2026

Background: Chronic stroke survivors often experience long-term gait and balance impairments that impact their functional abilities and activities of daily living. Emerging interventions, such as virtual reality (VR), are being evaluated on their potential to enhance rehabilitation outcomes.

Objective: This systematic review aimed to evaluate the effects of virtual reality interventions on gait and balance in individuals with chronic stroke.

Methods: Two literature searches were performed in September 2025 and January 2026 using the CINAHL Complete, MEDLINE, and PubMed databases.

Results: Fourteen studies met the inclusion criteria and were categorized based on balance outcome measures (Berg Balance Scale, Tinetti Performance-Oriented …

The Impact Of A Wellness Program Consisting Of Meditation And Dietary Education On The Symptoms Of Parkinson’S Disease: A Protocol, Kylee Cush, Maureen Romanow Pascal, Genevieve Montanye, Arden Mccoy, Jillian Mallon, Mason Hayward

Student Research Poster Presentations 2026

Individuals with Parkinson’s Disease (PD) often experience many motor and nonmotor symptoms that impact their ability to participate in their daily life. This protocol aims to address the symptoms of PD by utilizing complementary strategies to manage chronic stress and unhealthy dietary lifestyles, both of which have been identified as risk factors for PD. This eight-week mixed-design randomized controlled trial will take place at Misericordia University, Rock Steady Boxing Old Forge, and the University of Scranton, and will utilize convenience sampling through flyer outreach. Individuals will be randomized into two groups: group one will complete a whole foods diet as …

The Differential Effects Of Fast Walking Speed On Muscle Coactivation In The Paretic And Non-Paretic Extremities Post-Stroke, Natalia Sánchez, Andrian Kuch, Samantha N. Jeffcoat, Andrew Hooyman, Aria Haver-Hill, Christina K. Holl, Kristan A. Leech

Physical Therapy Faculty Articles and Research

Background:

Clinical practice guidelines for walking recovery post-stroke recommend high aerobic intensity training, which usually involves walking at fast speeds. However, the acute effect of fast speeds on the neuromuscular control of walking is unclear.

Objectives:

(1) Assess the criterion validity of the Dynamic Motor Control Index (WalkDMC) as a measure of coactivation post-stroke. (2) Assess acute speed-dependent coactivation post-stroke. (3) Assess how clinical characteristics shape the speed-dependent coactivation response. (4) Assess the relationship between heart rate and coactivation post-stroke. We hypothesized that WalkDMC is correlated with function and impairment measures. We also hypothesize that coactivation measured via the WalkDMC …

Assessing The Use Of Marker-Less Motion Capture Systems For Neurological Disorders In Indoor Vs Outdoor Settings., Anjana Ganesh, Kelsey Baker

Research Colloquium

Background: Marker-less motion capture systems have improved the assessment of human movement by allowing for a non-invasive, affordable, quantitative data collection useful in clinical settings. However, their use in real-world community care settings is largely underexplored, presenting a unique opportunity to bridge the gap between controlled laboratory environments and the complexity of providing care in diverse, everyday contexts. This systematic review examines the differential use of MMC systems across real-world indoor environments (clinics, homes, living labs) and outdoor settings (public walkways, community spaces), with a focus on their application to neurological disorders such as stroke and neurodegenerative diseases.

Methods: …

Multitasking While Walking: How Green Noise And Texting Alter Gait, Kirstin Merrill, Kyle Navarro, Raymond Ngu, Nathan Nguyen, Alex Owyang, Anthony Prajin, Karli Slater, Uyen Truong, Ryan Ye, Eileen Zhu, Sebastian Herrera Vargas, Raj Kumar Chauhan, Sivakumar Rajagopal, Seong Hyun Moon, Michael Shiraishi, Rahul Soangra

Physical Therapy Faculty Articles and Research

This study examines the combined effects of green noise and texting on gait to understand how multitasking and auditory stimuli affect walking stability. Green noise, associated with relaxation, was the environmental stimulus; texting the cognitive distractor. We hypothesized texting would reduce cadence and stride length, with green noise either stabilizing or disrupting gait. Ten participants walked on a treadmill under five conditions: normal walking (NW), no texting/sound (WNTNS), sound only (WNTS), texting only (WTNS), and texting with sound (WTS). Gait parameters—step length, step width, single support time, and terminal double support time—were analyzed. Step length decreased in WNTS (p …

Effects Of Different Cannabis Compounds On Balance, Freezing Of Gait, And Bradykinesia In Parkinson’S Disease: Cross-Sectional Analysis Of Self-Report Data From The Fox Insight Study, Alexandria Dockery, Adan Hernandez, Cody Miyashiro

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To explore the effects of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD)) on self-reported balance problems, freezing of gait (FOG), and bradykinesia in Parkinson’s disease (PD).

Background: Recent research has indicated that a high proportion of people with PD are interested in using cannabis for symptom management. Given the known intoxicating and motor impairing properties of THC, it may negatively affect postural instability and increase fall risk in people with PD.

Methods: Data from the Fox Insight online clinical study were analyzed in February 2024. The analysis only included participants with PD who answered questions about cannabis use (n=2754). Responses were …

Effects Of Altered Somatosensory Input On Gait Kinetics And Kinematics Via Different Footwear In Individuals With Chronic Post-Stroke Hemiparesis, Daniela Casillas, Lesley Ruiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Individuals with post-stroke hemiparesis walk with significant asymmetries, leading to slow, effortful walking, and a high risk of falls. One contributing factor is altered sensation on the plantar surface. Studies examining altered somatosensory input via insoles, vibration and other tactile stimuli observed improvements in hemiparesis gait. This study investigates whether altering somatosensory input through different footwear can affect kinetics, kinematics and muscle activity during walking post-stroke. We hypothesized the barefoot conditions would have increased dorsiflexion (heel-strike, swing), increased plantarflexion during toe-off, increased muscle activity and kinetics, compared to memory foam conditions.

Participants: 13 individuals with chronic post-stroke hemiparesis (4F/9M, …

The Effectiveness Of Ras Treatment In Improving Gait Patterns In Patients With Parkinson’S Disease: A Literature Review, Vivian Huang, Andrea Hunt, Alicia Chopyk

Rowan-Virtua Research Day

Parkinson’s Disease (PD) is a neurodegenerative disorder involving the loss of dopaminergic neurons leading to symptoms such as tremor and gait disturbance. This results in the classic shuffling gait: stooped posture, variation in stride length, variation in cadence, reduced gait velocity, inability to maintain a steady rhythm, and an increased fear of falling. This study’s objective is to review the current literature on the use of rhythmic auditory stimulation (RAS)Ⓡ as a treatment option for PD. Previous research has looked at RASⓇ as a potential non-pharmacologic treatment because researchers hypothesize that listening to music produces an external rhythm that the …

Age-Related Balance Control Changes In Constrained-Speed Gait During A Concurrent Cognitive Task, Raymond Chong, Victoria Moore, Hope Brown Sampson, Heather Spears, Manh-Cuong Do

Asian Journal of Physical Therapy

Background: During walking, the center of mass (CoM) oscillates up and down in the sagittal plane. In the late-stance phase, as the CoM descends, its vertical velocity decreases before foot contact, indicating active neural balance control, which we refer to as CoM braking. Young adults tend to increase braking while maintaining step length and speed when performing a cognitive task, such as subtracting numbers. In contrast, older adults maintain consistent braking by reducing step length and speed. This study examined the effects of walking at constant self-selected, slower, or faster speeds on CoM braking and cognitive performance. Methods: Healthy young …

Gait During Community Ambulation And Laboratory-Based Walking In People With Mild Traumatic Brain Injury, Prokopios Antonellis, Jae W. Lee, Peter C. Fino, Margaret M. Weightman, Siting Chen, Margaret Stojak, Mark E. Lester, Carrie W. Hoppes, Leland E. Dibble, Laurie A. King

Physical Therapy Faculty Publications

Background: Gait impairments are common in individuals with mild traumatic brain injury (mTBI), presenting in the acute phase and often persisting in subtle ways over time. Despite the prominence of laboratory gait evaluations, a comprehensive understanding of gait deficits post-mTBI necessitates the examination of various gait domains in real-world environments. Assessing gait during a community ambulation task (CAT) may capture real-world challenges and influence focused interventions or rehabilitation in individuals with mTBI.

Research Question: The aim of the study was to compare gait performance across independent gait domains in individuals with and without mTBI using wearable sensors during both the …

Cognition Is Associated With Daily-Life Mobility In People With Parkinson’S Disease, Pablo Burgos

Faculty Publications - College of Physical Therapy

Introduction: Cognitive impairment is common in people with Parkinson’s disease (PD). Mobility is also impaired in people with PD and functional mobility often requires cognitive dual-tasking to navigate complex environments in daily life. We hypothesized that visuospatial and executive cognitive dysfunction in people with PD will be associated with digital measures of mobility in daily life. Since freezing of gait (FoG) is associated with both cognitive dysfunction and mobility impairments, we also examined the influence of FoG on the cognitionmobility relationship. Here, we investigated, for the first time, the association between cognition and dailylife mobility in PD and the influence …

The Use Of Virtual Reality To Improve Gait And Balance In Patients With Parkinson’S Disease: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

(1) Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that impairs balance and postural control, gait, overall motor function, and mood, and involves the gradual degradation of several physiologic systems. With limited treatments available, physical therapy (PT)-based exercise is the nonpharmacologic measure of choice. There is a growing interest in using virtual reality (VR) gaming when rehabilitating patients with various acute brain injuries and neurological disorders. The purpose of this scoping review was to examine randomized controlled trials comparing VR-based rehabilitation programs versus traditional PT at improving gait and balance. (2) Methods: PubMed, CINAHL, and the Cochrane Central Register …

The Landscape Of Virtual Reality Use In Mobility Rehabilitation From 2010-2023: A Scoping Review, Danielle T. Felsberg, Reza Pousti, Charlend K. Howard, Scott E. Ross, Louisa D. Raisbeck, Jared T. Mcguirt, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Significant advancements in virtual reality (VR) technology have occurred in the past decade, allowing clinical researchers to take advantage of these reduced barriers to explore the use of VR in patient populations. This scoping review on VR interventions to improve mobility in adults and children focuses on the literature from 2010-2023. A total of 2736 articles were screened and 126 articles met the inclusion criteria. Most of the studies were conducted in inpatient clinical settings (n = 41) and investigated VR interventions to improve balance (n = 118). Less immersive (n = 108) products such as Nintendo Wii or Xbox …

How Many Trials Are Needed For Consistent Clinical Gait Assessment?, Charlend K. Howard, Christopher K. Rhea, Jacquelyn R. Moxey, Kyle Langerhans, Paphawee Prupetkaew, Brittany S. Samulski

Rehabilitation Sciences Faculty Publications

Background: Clinical assessment of gait typically consists of patients walking a few trials at various speeds while the clinician assesses performance. Unfortunately, there is no clear guidance on how gait changes across trials, leaving clinicians uncertain about the optimal number of trials needed to observe consistent (non-variable) performance. To address this issue, we examined gait performance from a large dataset of older adults who participated in a community-based comprehensive fall risk assessment. Methods: Community-dwelling, older adults (n = 340; 70.8 ± 7.4 years; 120 men, 220 women) performed gait trials under two conditions: preferred and maximum walking speed. …

Influence Of Virtual Reality On Lower Extremity Joint Kinematics During Overground Walking, Hunter Derby, Nathan Conner, Adam C. Knight, Harish Chander

Funded Scholarship

The inability to regain balance following a trip-induced event is one of the leading causes of falls and fall-related injuries in older adults. Virtual reality (VR) has the potential to expose individuals to realistic environments with minimal injury risk compared to real-world exposures. The purpose of this study was to compare lower extremity joint kinematics during overground walking when exposed to real and virtually generated trip obstacles. A total of 14 healthy participants [7 male, 7 female; age: 23.46 ± 3.31 years; height: 173.85 ± 8.46 cm; mass: 82.19 ± 11.41 kg; shoe size (men’s): 9.03 ± 2.71 s] were …

Whole Body Angular Momentum Characterizes Reactive Balance Adaptations And Perturbation Intensity, Mitchell D. Adam, Delaney Mcelvain, T. George Hornby, Allison S. Hyngstrom, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Identifying measures which accurately quantify reactive balance adaptation during walking is essential to understand how emerging perturbation-based gait paradigms impact stability over the course of an intervention. These perturbation paradigms have shown promise in reducing falls for numerous clinical populations, however tracking progress in objective terms throughout an intervention remains challenging. Whole body angular momentum (H) may be particularly suited to detect subtle adaptations in the reactive balance response and is applicable within numerous perturbation environments. We assessed the ability of young healthy adults to adapt to varying intensities of discrete, unexpected, treadmill-based perturbations directed mediolaterally, anteriorly, and posteriorly during …

Effectiveness Of Using Soft Exosuit In Stroke Case To Improve Walking Speed And Endurance, Aditya Denny Pratama, Rakha Shidqi Widyadhana

Jurnal Fisioterapi Terapan Indonesia

Stroke is a clinically defined syndrome of acute, focal nerve discharge caused by vascular injury (infarction, hemorrhage) of the central nervous system. Punches can cause damage to the brain and affect a person's ability to walk, balance and coordinate movements. Impaired gait is common in stroke cases, often resulting in poor recovery of mobility and inability to carry out daily activities without assistance. One of the interventions that can be used is a soft exosuit. This method can help overcome walking problems in stroke patients where soft exosuits are used to increase walking speed and walking endurance. The purpose of …

Wearable Surface Electromyography System To Predict Freeze Of Gait In Parkinson's Disease Patients., Anna Moore, Jinxing Li, Christopher H Contag, Luke J Currano, Connor O Pyles, David A Hinkle, Vivek Shinde Patil

Neuroscience Articles

Freezing of gait (FOG) is a disabling yet poorly understood paroxysmal gait disorder affecting the vast majority of patients with Parkinson's disease (PD) as they reach advanced stages of the disorder. Falling is one of the most disabling consequences of a FOG episode; it often results in injury and a future fear of falling, leading to diminished social engagement, a reduction in general fitness, loss of independence, and degradation of overall quality of life. Currently, there is no robust or reliable treatment against FOG in PD. In the absence of reliable and effective treatment for Parkinson's disease, alleviating the consequences …

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 …

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 …

A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: The hallmark gait deviation in individuals with post-stroke hemiparesis is slow walking speed. Reduction in gait speed after stroke is influenced by decreased propulsive forces, which may likely be related to impaired spinal circuit function and spasticity of the paretic plantarflexors. Chronic muscle tone maladaptations in paretic ankle plantarflexors can result in altered Achilles tendon (AT) morphology, therefore leading to altered mechanical properties, force transmission capabilities and subsequent insufficient propulsive forces during walking. The purpose of this study is to characterize the chronic maladaptations in both the spinal Ia afferent loop excitability and AT morphology after stroke lesions in …

Relation Between Cognitive Assessment And Clinical Physical Performance Measures After Mild Traumatic Brain Injury, Prokopios Antonellis, Margaret M. Weightman, Peter C. Fino, Siting Chen, Mark E. Lester, Carrie W. Hoppes, Leland E. Dibble, Laurie A. King

Physical Therapy Faculty Publications

Objectives

To investigate the relation between cognitive and motor performance in individuals with mild traumatic brain injury(mTBI) and examine differences in both cognitive and motor performance between adults after mTBI and healthy controls.

Design

Multi-center, cross-sectional study.

Setting

Three institutional sites (Courage Kenny Research Center, Minneapolis, MN, Oregon Health & Science University, Portland, OR, and University of Utah, Salt Lake City, UT).

Participants

Data were collected from 110 participants (N=110), including those with mTBI and healthy controls, who completed cognitive and physical performance assessments.

Interventions

Not applicable.

Outcome Measures

Cognitive assessments involved the Automated Neuropsychological Assessment Metrics to evaluate …

Better Gait Quality And Speed In Adults With Down Syndrome When Wearing Supportive Shoes Compared To Unsupportive Shoes And Barefoot, Bailey Gosse, Kimberly Nguyen, Zoe Zelensky

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals with Down syndrome (DS), often experience a slower gait speed and decreased quality of gait. Different types of footwear have shown changes in gait in people without DS. The current study aimed to examine the differences between wearing commercially available supportive shoes, unsupportive shoes, and no footwear on gait quality and speed in people with DS.

Methods: In this repeated measures study, 20 adults with DS walked under three footwear conditions: supportive, unsupportive, and no footwear. Gait deviations were scored according to the Rancho Los Amigos Observational Gait Analysis (OGA) and gait speed was measured using the 10-Meter …

Spatiotemporal Gait Parameter Consistency Across Two Days Of Treadmill Walking In Stroke Survivors, Alejandro Aguirre Ramirez, Samantha N. Jeffcoat, Natalia Sanchez, Andrian Kuch

Student Scholar Symposium Abstracts and Posters

Retraining impaired gait is essential in post-stroke recovery. This project aims to determine between day variability of spatiotemporal gait measures in treadmill walking post-stroke to differentiate between changes due to the intervention and measurement errors due to between day test-retest variability. Six individuals post-stroke performed a two-minute walk test at a self-selected speed (SSS) for two consecutive days. SSS was assessed through the six-minute walk test. Reflective markers were placed on anatomical landmarks (van den Bogert et al. 2013). The heel markers were used for step detection. We calculated spatiotemporal parameters: stride length, stride time, step length, stance time, and …