Rehabilitation and Therapy Commons^™

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.

The Effect Of Balance Training With An Innovative Approach Compared To Traditional Balance Exercises, Brian Curtis Waite

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the use of an X Box 360 KinectTM game as a modality for improving balance. Specifically, this study explores the use of the Target Kick mini game on Kinect SportsTM as a tool for VR rehabilitation. Subjects (N=18, age 23.3 ±2.87 yrs, mass 71.83 ±15.25 kg, height 168.4 ±7.79 cm) with no lower extremity injury were randomly placed into three groups (X Box n = 6, Traditional n = 6, and Control n = 6). The X Box (XBOX) group performed ten minutes of balance training by playing an X Box game …

Land-Based Exercise And Its Effect On Quality Of Life Outcomes In Patients With Knee Osteoarthritis: A Systematic Review, Cody R. Buckner, Lindsay C. Martin, Michael L. Soukup

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The purpose of this systematic review was to examine effectiveness of land-based exercise interventions for improving quality of life (QOL) of individuals with symptomatic knee osteoarthritis.

Methods: A systematic search included PubMed, CINAHL, Scopus, Academic Search Premier, and the Cochrane Database of Systematic Reviews. Inclusion criteria included land-based exercise interventions aimed to improve lower extremity strength and QOL, published since 2000. Exclusion criteria included OA of joints other than the knee, and aquatic-based and surgical interventions. Studies were evaluated using a modified version of the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) methodology score.

Results: Level of …

Therapeutic Neuroscience Education For Patients With Chronic Low Back Pain And Its Effect On Activity Level, Pain Perception, And Function, Stephen Burton, Amber Domingo, Ryan Spencer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Chronic low back pain (CLBP) is a significant cause of disability and inactivity in the United States. Patients with chronic pain are often symptomatic even in the absence of tissue damage. This is a major reason patients need to be educated about their pain. Cognitions such as fear, anxiety and faulty beliefs may impact the pain experiences and changing cognitions are important in changing pain behavior. If patients understand that the pain they are experiencing may not be a true indication of the health of their tissues, they may experience less fear of their pain, and may be able …

Telecommuting As The Director Of Clinical Education (Dce) In A Doctoral Physical Therapy Program, Sally Mccormack Tutt

Physical Therapy Faculty Posters

Poster describing a case study created to help determine the feasibility of allowing the Director of Clinical Education to telecommute from Florida to Maine as a unique way to retain a valued core faculty member of the DPT department. Concludes there are benefits to departments considering this method of job performance, including: decreasing the turnover of quality faculty at an institution, reducing stress of a vacancy on the department and other faculty, decreasing the cost associated with searching for and hiring a new faculty member, and providing students with consistency with regards to the teaching and advising they receive from …

Effect Of Traumatic Brain Injury Among U.S. Servicemembers With Amputation, Mitchell J. Rauh, Hilary J. Aralis, Ted Melcer, Caroline A. Macera, Pinata Sessoms, Jamie Bartlett, Michael R. Galarneau

Kinesiology & Sport Management Scholarship

Servicemembers with combat-related limb loss often require substantial rehabilitative care. The prevalence of traumatic brain injury (TBI), which may impair cognitive and functional abilities, among servicemembers has increased. The primary objectives of this study were to determine the frequency of TBI among servicemembers with traumatic amputation and examine whether TBI status was associated with discharge to civilian status and medical and rehabilitative service use postamputation. U.S. servicemembers who had a combat-related amputation while deployed in Iraq or Afghanistan between 2001 and 2006 were followed for 2 yr postamputation. Data collected includes injury mechanism; postinjury complications; Injury Severity Score (ISS); and …

Therapist Characteristics Influencing Physical Therapy Non-Treatment In The Acute Care Setting, Daniel Mcgarvey, Colby Olsen, Aaron Van Wagoner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Research has found that participation in physical therapy (PT) services in the acute care setting increases functional outcomes and decreases patient length of stay. Certain physical therapist characteristics could be a potential source of influence on patient non-participation in physical therapy in the acute care setting. The purpose of this study was to determine whether specific characteristics of therapists and patients are predictive of physical therapy non-treatment.

Subjects: Subjects included 16 physical therapists or physical therapist assistants and 1225 patients at a community acute care hospital.

Methods: Characteristics of each therapist and their corresponding patient data were …

Foot Volume Change During Long Distance Running In Healthy Adults, Meghan Boni, Istvan Takacs, Rebecca Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: Healthy adults frequently engage in running as a means of cardiovascular exercise. Larger running shoes are often chosen based on common beliefs that feet swell during running, yet many continue to encounter foot injuries, such as blisters, as a result of this activity. Previous research has analyzed the changes in foot volume during short bouts of activity. However, there has been limited research on the effect of long distance running on foot volume, which is where many of these injuries are seen. The purpose of this study was to examine the effects of long distance running, defined …

Development Of A Statement On Autonomous Practice: Practice Committee, Section On Geriatrics, Jason Hardage, Stacey Zeigler, Jennifer Blackwood, Tamara Gravano, Greg Hartley, Jill Heitzman, Joe Libera, Ken Miller

Physical Therapy Faculty Research

Vision 2020 is the official vision statement of the American Physical Therapy Association (APTA). Drafted by the APTA House of Delegates in 2000, this statement contains 6 elements: autonomous physical therapist practice, direct access, Doctor of Physical Therapy and lifelong education, evidence-based practice, practitioner of choice, and professionalism. Autonomous practice has been operationally defined by the APTA primarily through its characteristics: “Physical therapists accept the responsibility to practice autonomously and collaboratively in all practice environments to provide best practice to the patient/client. Autonomous physical therapist practice is characterized by independent, self-determined, professional judgment and action.” The Section on Geriatrics has …

The Appropriateness Of Long-Term Opioids To Treat Chronic Back Pain, Thomas Watanabe, Michael Salino, Adam Schreiber

Department of Rehabilitation Medicine Faculty Papers

Point/Counterpoint Case Scenario: A 55-year old man presents to a pain clinic upon referral from his primary care physician. His symptom is axial low back pain. His pain started approximately 1 year earlier without a specific inciting event. He denies radiation of pain into the lower extremities. There is no bowel or bladder involvement. There is no directional preference. He reports pain "all the time," with minimal specific exacerbating or relieving factors. There is no medical-legal involvement. His medical history is significant for hypertension, hypercholesterolemia, obesity, and sleep apnea. He is a divorced father of 2 adult children. He is …

Turf, Team, And Town: A Geriatric Interprofessional Education Program, Nancy Macrae

Occupational Therapy Faculty Publications

Describes the Interprofessional Geriatric Education Program (IGEP) at the University of New England (U.S.). This course involves collaboration among health care students and faculty, including dental, occupational therapy, physician assistant, and physical therapy programs, and is focused on treatment for and feedback from elderly patients, who serve as “teachers” for students in the program.

Reflection In Physical Therapy Practice: A Phenomenological Inquiry Into Oral And Written Narratives, Mary S. Knab

Educational Studies Dissertations

In today’s healthcare system, physical therapists treat an increasingly complex and diverse patient population and face rapidly expanding knowledge, technologies, and evidence for the care they provide. They also face demands for increased efficiency and improved outcomes. Reflection, espoused for its ability to help clinicians convert experience into learning and new knowledge, is widely viewed as being critical to sound clinical practice. There is, however, limited research and little consensus regarding what reflection looks like in the day-to-day practice of physical therapists. This phenomenological inquiry aims to identify the essence of reflection as experienced by physical therapists in clinical practice. …

Effect Of Duration And Amplitude Of Direct Current When Lidocaine Is Delivered By Iontophoresis, Susan A. Saliba, Courtney L. Teeter-Heyl, Patrick O. Mckeon, Christopher D. Ingeroll, Ethan N. Saliba

Physical Therapy Faculty Publications

Dosage for the galvanic stimulation for iontophoresis varies. Clinicians manipulate the duration or the amplitude of the current, but it is not known which is more effective. We compared the anesthetic effect of lidocaine HCL (2%) by manipulating the current parameters on 21 healthy volunteers (age: 21.2 ± 4.2, height 170.7 ± 10.2 cm, mass 82.1 ± 19.2 kg). Three conditions were administered in a random order using a Phoresor II^® with 2 mL, 2% lidocaine HCL in an iontophoresis electrode. (1) HASD (40 mA_*min): High amplitude (4 mA), short duration (10 min); (2) LALD (40 mA.min): …

Determining The Validity Of The Nintendo Wii Balance Board As An Assessment Tool For Balance, Sabrina Mae Deans

UNLV Theses, Dissertations, Professional Papers, and Capstones

Context. Application of the Nintendo Wii-fit balance board and its games have been used in Physical Therapy clinics, showing success in individuals with neurological disorders, and has been recommended as a minimum baseline assessment of a symptoms checklist and standardized cognitive and balance assessments for concussion management by the NCAA. However, it still faces challenges of being considered a reliable and consistent tool for producing normative data in the allied healthcare. Because there is little to no evidence for the Wii-fit balance board as a valid balance assessment tool for clinical and/or research usage, the significance of this study is …

Effect Of Aquastretch On Range Of Motion At Knee Joint In Total Knee Arthroplasty Patients, Raja Devinder Kochar

UNLV Theses, Dissertations, Professional Papers, and Capstones

The success of the Total Knee Arthroplasty (TKA) depends upon its functional outcomes of increase in reduction in pain, and gait ambulation and performing functional activities of daily living. Compromised range of motion, pain and weakness can reduce their ability to perform activities of daily living. Aquatic Physical Therapy may offer an alternative intervention to traditional Physical Therapy Rehabilitation and many studies have shown improvements in range of motion, swelling, pain reduction, stiffness and quality of life after TKA. AquaStretch, a relatively new form of aquatic therapy, claims to restore the functional mobility which is lost restrictions caused due to …

Patient Factors And Day Of The Week Influencing Physical Therapy Non-Treatment Events In The Acute Care Setting, Daniel Goodrich, Curtis Doug Jensen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background. In acute care hospitals, scheduled physical therapy visits not resulting in treatment may increase patient length of stay and the financial burden to the hospital. Previous literature has not fully evaluated the occurrence of these events, nor have any associated factors been identified.

Objective. Measure the rate of non-treatment and determine which patient characteristics were most likely to predict a non-treatment event.

Design. Retrospective review of documentation at a suburban hospital.

Methods. Data were collected from records of 1,096 patients, totaling 6,097 scheduled sessions. The rate of non-treatment was calculated and logistic regression used to …

Safety Of Cervical Manipulation: Are Adverse Events Preventable And Are Manipulations Being Performed Appropriately?, Joseph Anders, Jessica March, Amber Perez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: Documented case reports found in medical literature describing adverse events associated with cervical spine manipulation (CSM) were reviewed to determine if the CSM was used appropriately and if the events could have been prevented. Our hypothesis was that CSM had been used inappropriately and that adverse events could have been prevented. This study also looked to identify potential characteristics that may put the patient at risk for injury, or even death as a result of a CSM.

Methods: One hundred and thirty four cases, reported in 93 articles, published between 1950 and 2010, were reviewed. CSMs were categorized as …

Thrust Joint Manipulation Education: Student Perceptions Of Learning And Practical Experiences In Spinal Manipulation Within Entry-Level Physical Therapist Education Programs, Joshua Thomas Marks, Lisa Basl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Spinal thrust joint manipulation (TJM) education is mandatory in all professional entry-level physical therapy programs, yet TJM is under-utilized in daily practice. This descriptive study expands on previous data about how TJM is taught and includes data for the perceived confidence students have when performing TJM.

Methods: A 39-question descriptive survey inquiring about TJM education and selfperceived confidence in performing TJM was distributed via email to 213 accredited physical therapy programs.

Subjects: Respondents ranged in age from 22-45 (mean age=25.61 years). Respondents included 435 professional physical therapy students (84 male, 285 female) who have completed their …

Ultrasound Imaging Of Lumbar Multifidus Immediately Following Three Physical Therapy Techniques In Asymptomatic Individuals, Victoria Byers, Steven Lim, Kathryn Rice

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design

Randomized, blinded, cohort, within subjects design.

Background and Objective

The effects of different manual therapy (MT) techniques on lumbar multifidus (LM) thickness have been investigated in subjects with low back pain (LBP) but have not been investigated in asymptomatic subjects. The objective of this study was to examine the immediate effects of mobilization and manipulation on contraction thickness of LM in healthy individuals.

Methods and Measures

Forty-two healthy individuals participated in the study. Ultrasound imaging techniques were used to record LM thickness (L4-5 level) at rest, during an abdominal drawing in maneuver (ADIM), and during a prone upper …

A Review Of Direct Access To Physical Therapy, Tiffany Basore

Honors Projects

No abstract provided.

Understanding Autonomous Practice, Tamara Gravano, Greg Hartley, Heather Mattingly, Joseph Libera, Sabrina Camilo, Jason Hardage

Physical Therapy Faculty Research

What is autonomous practice? As one of the elements of Vision 2020, au­tonomous practice is one whose mean­ing may not always be readily under­stood. The confusion can stem from the meaning of autonomy, which is sometimes misinterpreted to mean that the physical therapist (PT) practices in a vacuum, without coordinating and com­municating with other health care pro­viders. Nothing could be further from the truth. In fact, many PTs might be surprised to learn that they already prac­tice autonomously.

Building A Bridge Between Physical Therapists And Fitness Professionals: The Development Of A Business Plan For San Luis Sports Therapy Clinics, Ashley August Fittz

Master's Theses

The purpose of this project was to create a business plan for a profitable, self-sustaining, program to build a bridge between physical therapists and fitness professionals.

The Quick Fit Program was a new service for the existing business San Luis Sports Therapy. The program was designed to be implemented within each of the company’s physical therapy clinics in California using existing personnel and resources. The Quick Fit Program is one way in which physical therapy practices can diversify the services they offer to keep pace with the changing landscape of healthcare.

Clients in the Quick Fit Program would receive an …

Observation Of Amounts Of Movement Practice Provided During Stroke Rehabilitation, Catherine E. Lang, Jillian R. Macdonald, Darcy S. Reisman, Lara Boyd, Teresa Jacobson Kimberley, Sheila M. Schindler-Ivens, T. George Hornby, Sandy A. Ross, Patricia L. Scheets

Physical Therapy Faculty Research and Publications

Objective

To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

Design

Observational survey of stroke therapy sessions.

Setting

Seven inpatient and outpatient rehabilitation sites.

Participants

We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

Interventions

Not applicable.

Main Outcome Measures

We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were …

Teaching Professionalism: A Survey Of Physical Therapy Educators, D. Scott Davis

Physical Therapy Faculty Research

This study examined the opinions of physical therapy faculty relative to teaching and fostering professionalism in entry-level physical therapy education. A paper-and-pencil survey was mailed to a random sample of 318 physical therapy educators across the United States. Of the 318 surveys mailed, 166 participants (response rate, 52%) completed and returned the survey. Descriptive analysis revealed that 98% of the physical therapy educators view professionalism as an important component of a physical therapy curriculum. Eighty-nine percent of the respondents expressed concern about the professional behaviors of one or more of their entry-level students; however, based on the frequency of negative …

Characteristics And Outcomes Of Individuals Self-Selecting Yoga Versus Physical Therapy For The Treatment Of Chronic Low Back Pain, Dian Dowling Evans

Theses and Dissertations (ETD)

Chronic low back pain (cLBP) is a significant public health problem that is difficult and costly to treat. Determining whether a patient with cLBP will benefit from a particular treatment approach is challenging, since little is understood about the patient characteristics that predict improved treatment outcomes. Understanding these characteristics could reduce treatment failures and costs of care.

This study was designed to explore the demographic, clinical and treatment- related characteristics of individuals self-selecting yoga versus physical therapy (PT) for treatment of cLBP. A growing body of research demonstrates that yoga reduces pain and improves function in persons with cLBP. However, …

A Mounted Strengthening And Stretching Program To Prevent Musculoskeletal Injury In Equestrians, Abigail Guy

Senior Honors Projects

Equestrian sports use muscles uncommon to most normal daily activities. In beginning or returning riders this can lead to muscle strain and pain, and if not addressed, even to serious injury. This program is designed to stretch and strengthen the main muscle groups used in horseback riding: quadriceps, hamstrings, abdominals and obliques, and the lower back. The program is designed to be carried out during fifteen minutes of an hour-long riding lesson to prevent undue discomfort or injury. The counsel of a professional horseback riding instructor and a physical therapist was integrated with exercises from physical therapy resources. Proven stretching …

Outpatient Physical Therapy Management Of A Patient Who Is Status Post Right Lunate: Open Reduction Internal Fixation With Hardware Removal: A Case Report, Jaime Garness

Physical Therapy Scholarly Projects

Background and Purpose: This case report follows a 20 year old male through his five week out patient rehabilitation for an open reduction internal fixation (ORIF) pinning of his right lunate and subsequent hardware removal following a motor vehicle accident. The patient presented with pain, decreased strength and range of motion of his right wrist. A deficit was also identified in his right shoulder stemming from decreased use of his right upper extremity. The reason for this case study is to look into benefits of physical therapy interventions as well as their functional outcomes.

Interventions: Patient warmed up on …

The Impact Of Nhi Co-Payment Policy On The Utilization Pattern Of Hospital Outpatient Rehabilitation Services, Huang-Chung Chen, Fei-Lin Chang, Jui-Fen Rachel Lu, Ngok-Kiu Chu, Wen-Chung Tsai, Lin-Na Shih, Yiu-Chung Lau, Fuk-Tan Tang

Rehabilitation Practice and Science

In response to pressing financial distress as a result of escalating health care expenditures, Bureau of National Health Insurance (NHI) has adopted various deliberate policy interventions to increase the sources of incomes and meanwhile enhance cost containment. Co-payment policy is one measure often taken when focusing on demand-side mechanism, which aims to reduce the potential misuse of medical resources by the insured through cost sharing. The co-payment policy for outpatient rehabilitation services implemented since August, 1999 is one good example.The purpose of this study is to assess the impact of the co-payment policy on the utilization pattern of hospital outpatient …

The Geriatric Residency Experience, Sabrina Camilo, Tamara Gravano, Karen Lagares, Gemma Longfellow

Physical Therapy Faculty Research

The Geriatric Residency in Physical Therapy program at St. Catherine's Rehabilitation Hospital and Villa Maria Nursing Center has graduated 4 residents since its inception in 2003. Recently, the 4 of us program graduates convened to talk about our experiences and discovered several similarities. We laearned about our individual reasons for choosing the residency, our experiences during the time we were residents, and our plans for continued professional development. But, of course, there were some differences that made the experience unique for each of us.

Test-Retest Reliability Of Temporal And Spatial Gait Characteristics Measured With An Instrumented Walkway System (Gaitrite®), Cornelius J.T. Van Uden, Marcus P. Besser

Department of Physical Therapy Faculty Papers

Background
The purpose of this study was to determine the test-retest reliability of temporal and spatial gait measurements over a one-week period as measured using an instrumented walkway system (GAITRite®).

Methods
Subjects were tested on two occasions one week apart. Measurements were made at preferred and fast walking speeds using the GAITRite® system. Measurements tested included walking speed, step length, stride length, base of support, step time, stride time, swing time, stance time, single and double support times, and toe in-toe out angle.

Results
Twenty-one healthy subjects participated in this study. The group consisted of 12 men and 9 women, …