Rehabilitation and Therapy Commons^™

Standing Balance And Spatiotemporal Aspects Of Gait Are Impaired Upon Nocturnal Awakening In Healthy Late Middle-Aged And Older Adults, Amanda L. Mcbean, Raymond P. Najjar, Ronald A. Schuchard, Courtney D. Hall, Cheng-Ann Wang, Ban Ku, Joseph M. Furman

ETSU Faculty Works

Study Objectives: Nocturnal awakenings may constitute a unique risk for falls among older adults. We describe differences in gait and balance between presleep and midsleep testing, and whether changes in the lighting environment during the midsleep testing further affect gait and balance.

Methods: Twenty-one healthy, late middle-aged and older (64.7 ± 8.0 y) adults participated in this repeated-measures design consisting of four overnight laboratory stays. Each night, participants completed baseline visual acuity, gait, and balance testing. After a 2-h sleep opportunity, they were awakened for 13 min into one of four lighting conditions: very dim white light (< 0.5 lux); dim white light (∼28.0 lux); dim orange light (∼28.0 lux); and white room-level light (∼200 lux). During this awakening, participants completed the same sequence of testing as at baseline.

Results: Low-contrast …

Implementation Of The Affordable Care Act In Physical Therapy, Greg Austin

Mahurin Honors College Capstone Experience/Thesis Projects

Introduction: With the implementation of the Affordable Care Act (ACA) in 2010, many medical specialties prepared to see reimbursement rates altered. Not impervious to this trend was the field of physical therapy (PT). This change in reimbursement structure could impact the effectiveness of PT treatment. Under this model, a patient may not be able to receive the appropriate number of visits to a physical therapist, resulting in a loss of utilization in the injured area and, possibly, a loss of independence. Methods: A literature review was performed to determine reimbursement rate impact on PT. A seven-item open-ended survey regarding various …

Multi-Digit Coordination In Absence Of Cutaneous Sensory Feedback During Grasping Tasks, Christina Gioeli, Kerry Mcpartlan, Emily Reid, Matthew Turturro

Dissertations, Theses, and Capstone Projects

Motor learning and adaptation to object properties and task requirements requires integration of cutaneous sensory feedback with motor commands. Joint mechanics constantly change, with individual joints or muscles compensation so performance output is the same per task. Effects of mixed cutaneous sensory feedback on multi-digit coordination is not well understood. Investigators sought to determine the influence absent cutaneous sensory feedback has on motor learning and adaptation, and how the CNS coordinates multi-digit mechanical output to adapt to manual tasks, with partially intact digital sensory feedback. 19 participants were randomly assigned for three-digit anesthesia administration (TIM- thumb, index, middle; TRL- thumb, …

Vestibular Rehabilitation For Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline, Courtney D. Hall, Susan J. Herdman, Susan L. Whitney, Stephen P. Cass, Richard A. Clendaniel, Terry D. Fife

ETSU Faculty Works

Background: Uncompensated vestibular hypofunction results in postural instability, visual blurring with head movement, and subjective complaints of dizziness and/or imbalance. We sought to answer the question, “Is vestibular exercise effective at enhancing recovery of function in people with peripheral (unilateral or bilateral) vestibular hypofunction?” Methods: A systematic review of the literature was performed in 5 databases published after 1985 and 5 additional sources for relevant publications were searched. Article types included meta-analyses, systematic reviews, randomized controlled trials, cohort studies, case control series, and case series for human subjects, published in English. One hundred thirty-five articles were identified as relevant to …

Treatment For Vestibular Disorders: How Does Your Physical Therapist Treat Dizziness Related To Vestibular Problems?, Courtney D. Hall, Susan J. Herdman, Susan L. Whitney, Stephen P. Cass, Richard A. Clendaniel, Terry D. Fife

ETSU Faculty Works

Dizziness is very common, but it is never normal. Dizziness can make performing daily activities, work, and walking difficult. Many people get dizzy when they turn their head, which can cause problems with walking and makes people more likely to fall. Most of the time dizziness is not from a life-threatening disease. Often dizziness is because of a disorder of the vestibular (or inner ear balance) system. People can get vestibular disorders from infections in the ear, problems with the immune system, medications that harm the inner ear, and rarely from diabetes or stroke because of a lack of blood …

Ua61/16 Class Of 2016, Wku Physical Therapy

WKU Administration Documents

Physical Therapy Class of 2016 yearbook. Features the following students:

• Allen, Whitney
• Anderson, Alexis
• Baston, Allison
• Bell, Devin
• Coode, Rett
• Dahl, David
• DiTommaso, Katie
• Ford, April
• Fortney, Brianne
• Fuller, Megan
• Goutsis, Dominque
• Gunn, Lorelei
• Hall, Timothy
• Harlan, James
• Hicks, Jacob
• Hubbuch, Emily
• Jones, Tom
• Macke, Cristina aka Vegas(?)
• McKinney, Kelli
• McReynolds, Lauren
• Muse, Terrell
• Reece, Melissa
• Sims, Shannon
• Smith, Laura
• Smith, Wesley
• Stalcup, Patrick
• Vittitow, Kristi
• Wilson, Kimberley
• Wright, Emily
• Wright, William aka Jason

Piecing The Puzzle Together With The Use Of Physical Therapy, Mikayla Pruitt

Honors Projects

For my Honors Project I decided to create a set of exercise cards for children with autism. The front of each card had a picture symbolizing the exercise/activity, and on the back included directions, supplies and tips to complete the activity. The following is a selection of a few exercise cards from each of the four exercise sections, as well as the title card, table of contents cards, information cards, and source cards.

Improving Interdisciplinary Communication To Improve Patient Satisfaction, Jennifer J. Barnes

Master's Projects and Capstones

The Clinical Nurse Leader project took place at a Magnet Hospital in Northern California. It involved the nursing staff on a 23-bed Post-Surgical Medical Surgical unit, as well as the therapists providing care to their diverse patient population. The goal was to improve interdisciplinary communication to decrease the frequency of missed or postponed therapy sessions. A review of literature revealed that this preventable issue could be the most significant factor resulting in an extended length of stay and affecting overall patient satisfaction. Project data was gathered from a variety of sources, including a unit assessment, shadowing therapists, interviews with key …

Reliability Of Two Alternative Methods For The Standard Mid-Thigh Isometric Pull, Duane A. Williams, Courtney D. Hall, Patsy Cantor, Jennifer Williams, N. Brown, Ryan Dulling, Ogechi Egbujor

ETSU Faculty Works

The purpose of this study was to determine the reliability of two new alternative portable methods for measuring maximal isometric force measures while performing the standard mid-thigh pull. One method, the bar grip method, required the use of the trunk and upper extremity muscles, while the second method, the pelvic belt method, did not. Both methods demonstrated good test-retest reliability via randomized repeated measures over 24-36 hours. Interestingly, the pelvic belt method generally demonstrated average maximal forces up to 65% higher than the bar method. There was a good relationship between both methods. These new alternative methods could provide strength …

Integrating Guided Motor Imagery And Cross Education Into Rehabilitation: Scientific Review And Clinical Application, Emily Bouchard

Mahurin Honors College Capstone Experience/Thesis Projects

BACKGROUND: Guided motor imagery and cross education are two concepts that build upon motor programs. Guided motor imagery consists of imagining a specific action, thereby activating the respective motor program without an actual movement. Cross education incorporates contralateral training to activate the motor program of an action to the resting limb. These techniques yield neurological actions that can lead to improved performance outcomes when integrated into physical therapy programs. PURPOSE: This literature review investigated guided motor imagery and cross education within the scientific literature, identified and summarized evident themes and provided suggestions for incorporating these methods into rehabilitation programs. METHODS: …

Blended Pedagogy Pathophysiology Course: Effectiveness And Student Satisfaction, Betsy Botsford, Samantha Corn, Alanna Keenan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Evidence supports the effectiveness of computer-assisted instruction (CAI) versus a traditional face-to-face teaching model, but little is known regarding the effectiveness of a blended pedagogy. The purpose of this study is to determine the effectiveness of a blended learning format in a pathophysiology course for entry-level Doctorate of Physical Therapy (DPT) students, to evaluate their level of satisfaction of a podcast formatted course, and to observe changes in cohort performance over time.

Subjects: Five University of Nevada, Las Vegas (UNLV) DPT cohorts (n = 139) participated in the study. Some cohorts were taught in a traditional classroom …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

The Effects Of A Progressive Exercise Program On Functional Activity And Quality Of Life For Older Overweight Women With Knee Osteoarthritis, Ty Carlson, Devin Edvalson, Tyler Peck, Brad Robison

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose Osteoarthritis (OA) is a common symptomatic condition experienced by older adults, especially in the overweight population, that affects the knees in particular. This study compares the effectiveness of two progressive exercise protocols (walking and stepping) on function and quality of life in older, overweight women with OA. This study includes self-management training and assesses participant selfperceived efficacy in managing OA.

Subjects This is a quasi-experimental design utilizing 16 women ≥ 50 years of age (60.44 ± 6.04) with a BMI > 25 (34.21 ± 7.28) and radiographic diagnosis of OA in at least one knee.

Methods and Measures …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …

Conceptual Framework Of A Novel Intervention To Improve Mobility In Children With Cerebral Palsy: The Successes And Challenges Of Implementing A Large Amplitude Movement Protocol, Tania Goodwill, Erin Jarrett, Beren Shah, Alanna Stockford

UNLV Theses, Dissertations, Professional Papers, and Capstones

While cerebral palsy remains one of the most common childhood disabilities, clinicians continue to face significant challenges developing effective treatment strategies for the widely variable presentation of motor function impairments associated with cerebral palsy. A large gap exists between current research based evidence and feasible clinical practice. The purpose of this paper is to introduce a novel intervention protocol, explore the theoretical framework behind the protocol and provide insight to clinicians about the successes and challenges faced while pilot testing the intervention. The novel intervention was adapted and implemented by researchers combining a large amplitude movement protocol with the well-researched …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …

Evidence For The Validity Of A Tool For Improved Pressure Ulcer Staging By The Non-Expert In The Live Patient, Janelle Borg, Carrie Johnston, Megan Lucke, Jordan Sinclair

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses.

Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada.

Methods: Subjects assessed 11 wounds on the patients independently. They …

The Fenzian Unit: Applications To Physical Therapy And Beyond, Jeshua Paul Spadino Mr.

Senior Honors Theses

The field of physical therapy includes many different treatment options in the form of exercises and modalities. The development of a low electrical stimulation signal through the Fenzian unit has provided a new outlook on healing. This device gives information to and receives information from the central nervous system (CNS) through electro-biofeedback and is separated into its own category of modalities. The device can be used to treat a wide range of ailments, all with no adverse effects. This makes it a promising tool in the medical field. It is currently being validated as an authentic medical device through clinical …

Pelvic Girdle Pain In The Antepartum Population: Physical Therapy Clinical Practice Guidelines Linked To The International Classification Of Functioning, Disability, And Health From The Section On Women’S Health And The Orthopaedic Section Of The American Physical Therapy Association, Susan C. Clinton, Alaina Newell, Patricia A. Downey, Kimberly Ferreira

Capstone Projects DScPT

The purposes of these clinical guidelines are to:

 Describe evidence-based physical therapy practice including diagnosis, prognosis, intervention, and assessment of outcome for musculoskeletal disorders commonly managed by women’s health and/or orthopedic physical therapists

 Classify and define common musculoskeletal conditions using the World Health Organization’s terminology related to impairments of body function and body structure, activity limitations, and participation restrictions

 Identify interventions supported by current best evidence to address impairments of body function and structure, activity limitations, and participation restrictions associated with common musculoskeletal conditions

 Identify appropriate outcome measures to assess changes resulting from physical therapy interventions …

Interdisciplinary Approach To Dizziness: Roles Of Audiology And Physical Therapy, Faith W. Akin, Courtney D. Hall, Kristal M. Riska

ETSU Faculty Works

Dizziness is one of the most common reasons patients seek medical care, and because there are many causes of dizziness, management of these patients requires an interdisciplinary approach. Peripheral vestibular dysfunction is the most common cause of dizziness/vertigo diagnosed in specialty clinics. The purpose of this article is to present an interdisciplinary approach to the management of patients with vestibular dysfunction with a focus on the unique and overlapping contributions of audiology and physical therapy to vestibular assessment and rehabilitation.

Intensive Goal-Directed Treatments In Enriched Environments Augments Patient Outcomes Post-Stroke, Blake A. Kandah, Michael A. Klonowski, Ryan M. Pelo, Nicole M. Williams, Raquel V. Santiago, Christopher K. Thompson, Kristan A. Leech, Carey L. Holleran, Abigail L. Leddy, T. George Hornby

GW Research Days 2013

Objective: Previous research indicates that patients post-stroke, average 400-800 steps within physical therapy sessions and demonstrate heart rate values of 24-35% of HR Max. This dosage and intensity is inadequate to promote neuroplastic changes and maximize recovery. The goal of this study was to quantify and examine the amount of high-intensity stepping practice that was delivered within an Acute Inpatient Rehabilitation (AIR) setting for individuals with sub-acute stroke.

Methods: 14 patients with a diagnosis of sub-acute stroke were admitted to AIR. Standardized outcomes included the 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), the Berg Balance Scale (BBS) and the …

Developing The Rehabilitation Education For Caregivers And Patients (Recap) Model: Application To Physical Therapy In Stroke Rehabilitation, Megan M. Danzl

Theses and Dissertations--Rehabilitation Sciences

Patient and caregiver education is recognized as a critical component of stroke rehabilitation and physical therapy practice yet the informational needs of stroke survivors and caregivers are largely unmet and optimal educational interventions need to be established. The objective of this dissertation was to develop a theory and model of “Rehabilitation Education for Caregivers and Patients” (RECAP) in the context of physical therapy and stroke rehabilitation, grounded in the experiences and perceptions of stroke survivors, their caregivers, and physical therapists.

Qualitative research methods with a novel grounded theory approach were used. Potential constructs of RECAP were identified from existing research. …

A Prototype Head-Motion Monitoring System For In-Home Vestibular Rehabilitation Therapy, Pamela T. Bhatti, Susan J. Herdman, Siddarth Datta Roy, Courtney D. Hall, Ronald J. Tusa

ETSU Faculty Works

This work reports the use of a head-motion monitoring system to record patient head movements while completing in-home exercises for vestibular rehabilitation therapy. Based upon a dual-axis gyroscope (yaw and pitch, ± 500-degrees/sec maximum), angular head rotations were measured and stored via an on-board memory card. The system enabled the clinician to document exercises at home. Several measurements were recorded in one patient with unilateral vestibular hypofunction: The total time of exercise for the week (118 minutes) was documented and compared with expected weekly exercise time (140 minutes). For gaze stabilization exercises, execution time of 60 sec was expected, and …

Comparative Outcomes Assessment Of The C-Leg And X2 Knee Prosthesis, Michael Jason Highsmith

USF Tampa Graduate Theses and Dissertations

Background

There are more than 300,000 persons in the U.S. living with transfemoral amputation (TFA). Persons with TFA use a knee prosthesis for gait and mobility. Presently, the C-Leg microprocessor knee prosthesis is the standard of care. C-Leg has significantly improved safety and cost efficacy and has created modest gains in gait efficiency. Recently, a new prosthesis has introduced a new sensor array and processor that reportedly improves knee motion, stair function and standing stability. Early claims of the reported functional benefits of the new Genium knee (formerly X2) have not been validated in a rigorous clinical trial. Therefore, the …

Physical Therapy News, Volume 1, Issue 1, College Of Health Professions

Physical Therapy News

No abstract provided.

Muscle Fatigue And Motor Output Variability With Acute Stress In Healthy Young Adults And Veterans With Posttraumatic Stress Disorder, Manda Linea Keller

Dissertations (1934 -)

Acute stress can alter motor performance differently for men and women. The first aim of this dissertation addresses possible causes for the sex difference in the motor response of a low-intensity fatiguing contraction of the elbow flexor muscles to an acute stressor (difficult mental math) in young, healthy adults. Muscle fatigue increased for men and women when exposed to the stressor, but impairment was more prominent for the women. This work showed that fatigue in the central nervous system, specifically in cortical motor and premotor areas, as well as relaxation rates of the muscle (quantified with cortical stimulation) were not …

A Clincial Outcomes Commentary On "A Longitudinal Study Of Outcome Measures For Children Receiving Early Intervention Services", Marcia Levinson, Pt, Phd, Mft, Rosaleen Creedon Gnoffo, Pt, Ms, Dpt, Pcs

Department of Physical Therapy Faculty Papers

Pediatric physical therapy, especially in early intervention (EI), focuses on children’s function in natural environments and within daily routines. Valid and reliable tests measuring the ICF participation component are important to consider if we are to align our treatment focus and goals to our measures of progress. This article demonstrates that the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skill scaled scores are sensitive to change in children receiving EI with and without motor involvement.

Can Student Reflection Predict Academic Success And Clinical Performance In A Physical Therapist Education Program?, Jeanne L. Cook

Department of Educational Administration: Dissertations, Theses, and Student Research

The purpose of this retrospective study was to determine if a predictive relationship existed between student reflection and student academic and clinical success as determined by student performance on the National Physical Therapy Examination (NPTE) and the Clinical Performance Instrument (CPI). Secondary questions included whether higher and lower reflection scores would correspond with higher and lower NPTE and CPI scores respectively, and whether students’ reflection scores would increase between the first and fourth clinical internships. Journal entries were submitted by students from a physical therapist education program at a large North Central Region university over the course of two clinical …

The Effect Of Direct Access With Direct Reimbursement On Physical Therapy Practice, Heather Lafreniere, Katie Sauvageau

Physical Therapy Scholarly Projects

In 2002, North Dakota passed legislation that allowed physical therapists to be directly reimbursed by Blue Cross Blue Shield of North Dakota for physical therapy services. The purpose of the study is to determine the effects of direct access with direct reimbursement on physical therapy practice. The survey was sent to 400 licensed physical therapists within Arizona, Maryland, and Minnesota. These states were chosen for their experience in utilizing direct access with direct reimbursement and the geographic location.

The survey consisted of 7 categories addressing demographics, clientele changes, marketing strategies, physical therapist/physician relationship, insurance changes, direct effects on patient care …

Conflict Of Interest And Physical Therapy, Mike W. Martin, Donald L. Gabard

Philosophy Faculty Books and Book Chapters

'In a chapter entitled “Conflict of Interest & Physical Therapy”, authors Martin & Gabard offer a cogent definition. They write simply, “conflicts of interest are situations in which individuals have interests that significantly threaten their role responsibilities, or would do so for a typical person having their role.” Likewise, Davis describes the standard view of conflict of interest as a situation in which a person P is in a relationship requiring P to exercise some judgment on another’s behalf and P has an interest “tending to interfere with the proper exercise of that judgment”. With regard to professional conflicts of …