Rehabilitation and Therapy Commons^™

The Feasibility Of Using Metacognitive Strategy Training To Improve Performance, Foster Participation, And Reduce Impairment Following Neurological Injury, Timothy J. Wolf

Arts & Sciences Graduate Student Theses and Dissertations

Executive function is central to our ability to learn and participate in everyday life activities and rehabilitation outcomes for individuals with executive dysfunction after neurological injury are poor. The impairments and performance challenges these individuals experience are typically not identified appropriately so they often do not receive adequate rehabilitation and can have significant challenges returning to complex everyday life activities. The vast majority of rehabilitation efforts to support individuals with neurological injuries with executive dysfunction are based on a restoration model that aims to improve cognitive function with the expectation that these gains will translate to everyday life. The available …

The Impact Of Mild Traumatic Brain Injury On Romantic Relationships, Rylie K. Power

Senior Honors Projects, 2010-2019

Well-documented symptoms of traumatic brain injury (TBI) include acute symptoms such as headaches, dizziness, blurred vision, nausea, and memory loss. However, many TBI survivors also experience changes in cognition, behavior, personality, and mood that challenge interpersonal relationships. These invisible, neurobehavioral symptoms are uniquely challenging for survivors and caregivers of mild TBIs that lack physical, daily reminders that can accompany more severe injuries. The present study focused on the effects of survivors’ mild TBIs on their romantic relationships and the potential for a deteriorating support system. A convergent parallel mixed methods approach quantitatively assessed the environment of romantic relationships after …

Mobility Of Individuals With Multiple Sclerosis And The Influence Of Physical Therapy, Brenda L. Davies

Theses & Dissertations

One main purpose was to explore the compensatory gait strategies of individuals with multiple sclerosis (MS). To address this purpose, we quantified the mechanical work generated by the lower extremity joints during walking. The outcomes from this investi­gation suggested that individuals with MS redistribute positive mechanical work during walking to the hip in order to compensate for a reduced ability of the ankle to generate positive mechanical work. Additionally, we also explored the motor control of the ankle as a potential contributing factor to the mobility limitations of individuals with MS. The outcomes from this investigation indicated that individuals with …

The Psychological And Physical Rehabilitation Of Amputees, Victoria Ramos

Senior Honors Theses

Since physical therapy requires constant interaction with other people, it is a career that requires not only medical knowledge, but knowledge of the human psychology as well. A physical therapist may be well versed in recovery techniques, but how will he or she get the patient motivated if the patient is not motivated to begin with? Every person is different. Rehabilitation of amputees is a delicate process that requires significant work over an extended time period. Many factors are involved during the preoperative phase, as well as the postoperative phase. However, by being aware of the patient’s mental status and …

Spine Biomechanics Associated With The Shortened, Modern One-Plane Golf Swing, R. Barry Dale, Jason Brumitt

Faculty Publications - College of Physical Therapy

The purpose of this study was to compare kinetic, kinematic, and performance variables associated with full and shortened modern backswings in a skilled group of modern swing (one-plane) golfers. Shortening the modern golf backswing is proposed to reduce vertebral spine stress, but supporting evidence is lacking and performance implications are unknown. Thirteen male golfers performed ten swings of each swing type using their own 7-iron club. Biomechanical-dependent variables included the X-Factor kinematic data and spine kinetics. Performance-related dependent variables included club head velocity (CHV), shot distance, and accuracy (distance from the target line). Data were analysed with repeated measures …

Management Of Charcot–Marie–Tooth Disease: Improving Long-Term Care With A Multidisciplinary Approach, Donald Mccorquodale, Evan M. Pucillo, Nicholas E. Johnson

Physical Therapy Collection

Charcot–Marie–Tooth (CMT) disease is the most common inherited neuropathy and one of the most common inherited diseases in humans. The diagnosis of CMT is traditionally made by the neurologic specialist, yet the optimal management of CMT patients includes genetic counselors, physical and occupational therapists, physiatrists, orthotists, mental health providers, and community resources. Rapidly developing genetic discoveries and novel gene discovery techniques continue to add a growing number of genetic subtypes of CMT. The first large clinical natural history and therapeutic trials have added to our knowledge of each CMT subtype and revealed how CMT impacts patient quality of life. In …

Surviving Critical Illness: What Is Next? An Expert Consensus Statement On Physical Rehabilitation After Hospital Discharge, M Major, R Kwakman, M Kho, B Connolly, D Mcwilliams, L Denehy, S Hanekom, S Patman, R Gosselink, C Jones, F Nollett, D Needham, R Engelbert, M Van Der Schaaf

Physiotherapy Papers and Journal Articles

Background: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness?

Methods: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record. A literature review determined five themes, forming the basis for Delphi round one, which was aimed at generating ideas. Statements were drafted and ranked on a 5-point Likert scale in two …

Specificity Of The Minimal Clinically Important Difference Of The Quick Disabilities Of The Arm Shoulder And Hand (Qdash) For Distal Upper Extremity Conditions, Enrique V. Smith-Forbes, Dana M. Howell, Jason Willoughby, Donald G. Pitts, Timothy L. Uhl

Physical Therapy Faculty Publications

Retrospective cohort design. The minimal clinically important difference (MCID) for the quick Disabilities of the Arm, Shoulder and Hand (QDASH) has been established using a pool of multiple conditions, and only exclusively for the shoulder. Understanding diagnoses-specific threshold change values can enhance the clinical decision-making process. Before and after QDASH scores for 406 participants with conditions of surgical distal radius fracture, non-surgical lateral epicondylitis, and surgical carpal tunnel release were obtained. The external anchor administered at each fourth visit was a 15-point global rating of change scale. The test-retest reliability of the QDASH was moderate for all diagnoses: intraclass correlation …

The Painful Long Head Of The Biceps Brachii: Nonoperative Treatment Approaches, Kevin E. Wilk, Todd R. Hooks

Physical Therapy Faculty Research and Publications

Pain associated with the long head of the biceps (LHB) brachii seems to be increasingly recognized in the past 4 to 5 years. The LHB has long been considered a troublesome pain generator in the shoulder. Abnormality involving the LHB brachii has long been an area of debate, with Codman in 1934 even questioning the specificity of the diagnosis of biceps tendinitis. Biceps tendon abnormality is often associated with rotator cuff impingement. Shoulder pain originating from the biceps tendon can be debilitating, causing a severe decrease in shoulder function. As a result of the frequent clinical presentation of biceps pain, …

The Effects Of External Focus Of Attention Exercise Rehabilitation On Dual Task Walking In Parkinson's Disease, Eric N. Beck

Theses and Dissertations (Comprehensive)

Parkinson’s disease impairs control of well-learned movements, and therefore, individuals with Parkinson’s disease are forced to walk with greater conscious control. This causes difficulties while walking and completing a secondary task simultaneously (dual tasking), in that distractions from conscious control of walking increase the risk of falls and injury. Although, attention-based exercise may be a potential avenue to decrease the demands associated with walking in Parkinson’s disease. For example, an external focus of attention (on manipulated objects) has been found to recruit the networks that are important for walking with little conscious control (automatic control networks). In contrast, an internal …

Deep Vein Thrombosis In An Ambulatory Hemiparetic Stroke Patient Probably Due To Exercise-Related Repetitive Impact: A Casereport, Kun-Chang Lee, Chien-Ting Liu, Pi-Wei Wang, An-Fang Hsiao, Yi-Shiung Horng

Rehabilitation Practice and Science

Deep vein thrombosis (DVT) of the lower extremity is a multifactorial and potentially fatal complication following stroke. However, repetitive impact on the lower extremity is a relatively uncommon risk factor for DVT. We report an ambulatory hemiparetic stroke patient who, without classic DVT risk factors, developed a lower extremity DVT probably due to repetitive impact on the popliteal fossa after the inappropriate use of a seated leg flexion machine. This case can remind physiatrists and therapists of the importance of preventing patients from using non-ergonomic postures during training sessions.

Early Intervention For A Baby With Syndactyly: A Casereport, Chi-Min Yang, Shu-Yu Yang, Yu-Pei Tsai, Yu-Tin Tseng, Yu-Tin Tseng

Rehabilitation Practice and Science

Syndactyly is the most common congenital malformation of the limbs. Syndactyly refers to the clinical appearance of fingers or toes that have not undergone the normal process of separation and can be classified as simple, complex, complete or incomplete according to clinical severity and involvement. Clinically, syndactyly has primarily been treated with surgery. However, few studies have investigated relevant postsurgical rehabilitation interventions. This study reported a case involving an infant with severe syndactyly. After surgery, the infant received early rehabilitation intervention. We provided health education to caregivers to instruct them scar treatment on the hands, joint range of motion exercise, …

Community-Based Rehabilitation Supports For Social Inclusion And Work Participation Of Young Adults With Visual Impairment In Kenya: A Case Study, Philomena Jepkemboi Tanui

Graduate Theses and Dissertations

Young adults with a visual impairment (VI) experience less interaction with the community that impacts the way they relate to the world as they transition to the larger society where they face significant barriers of adjustment, exclusion, and work participation. Young adults with VI contend with cultural stigma, inequality, poor self-esteem caused by marginalization, a low quality of life (QOL), and lack of Social support systems that exist beyond the home. The aim of this study was to understand the perceptions of young adults with VI in Elgeyo-Marakwet and Kisumu Counties of Kenya concerning the barriers to community inclusion and …

Church Pew Exercise Integrated With Conventional Physical Therapy Following Total Knee Arthroplasty (Tka): Case Report, Randell Gonzales, Jerome Danoff

Internet Journal of Allied Health Sciences and Practice

Background and Purpose: Physical therapy treatment following Total knee Arthroplasty (TKA) consists of a combination of strengthening and range of motion exercises. The exercise technique, church pew exercise (CPE), has been proposed to enhance quadriceps facilitation and improve function. This is a technique that has the patient standing and rocking forward/back. The backward motion is arrested by engagement of the upper calf against a solid object, creating a sudden flexion torque at the knee and a sudden extension torque at the hip. The combination of CPE with standard physical therapy is claimed to provide better quadriceps control and faster walking …

Advancements In Treatment For Sensorineural Hearing Loss: Implications For Rehabilitation Professionals, Shawn P. Saladin, Yasar Tasnif, Bianca Cruz, Robert B. Perez

JADARA

Rehabilitation professionals often work with individuals with sensorineural hearing loss. Sometimes the hearing loss is due to ototoxic medications that are prescribed as treatments for other conditions. An understanding of the types of ototoxic medications at the root of the sensorineural hearing loss combined with an understanding of the advancements in treatments will help the rehabilitation professional better serve consumers who fit this description.

Assessment Of Accelerometers For Measuring Upper-Extremity Physical Activity, Elizabeth Lawinger, Timothy L. Uhl, Mark Abel, Srinath Kamineni

Physical Therapy Faculty Publications

Objective: The overarching goal of this study was to examine the use of triaxial accelerometers in measuring upper-extremity motions to monitor upper-extremity-exercise compliance. There were multiple questions investigated, but the primary objective was to investigate the correlation between visually observed arm motions and triaxial accelerometer activity counts to establish fundamental activity counts for the upper extremity.

Study Design: Cross-sectional, basic research.

Setting: Clinical laboratory.

Participants: Thirty healthy individuals age 26 ± 6 y, body mass 24 ± 3 kg, and height 1.68 ± 0.09 m volunteered.

Intervention: Participants performed 3 series of tasks: activities of …

Factors Impacting Vocational Rehabilitation Employment Outcomes: An Analysis Of State-Federal Service Provision, Valerie Jeannette Rodriguez

Theses and Dissertations - UTB/UTPA

State-federal vocational rehabilitation (VR) programs are widely recognized for providing various services to individuals with disabilities to help them reach their goals of independence and employment. Because rehabilitation programs are required to meet federal and state goals, standards, and indicators, thorough and ongoing program evaluation is necessary to identify predictors of successful and unsuccessful employment outcomes in order to determine best practices in vocational rehabilitation service delivery.

In the large southwestern state examined in this research study, there is an estimated return on investment of $9 for each dollar spent on successful VR cases. Cases closed successfully by state-federal VR …

How The Phoenix Took Wing: An Examination Of The Humanities Canon As It Relates To The Psychology Of Posttraumatic Growth, Stephen Dalton

Senior Theses

The investigation of posttraumatic growth as a psychological principle is giving researchers new ways to understand how it is that some people seem to thrive following events that are normally perceived as tragic and wholly negative. These survivors do not just bounce back from their tragedies; the researchers describe these people as “bouncing forward” – that is, the survivors report that their lives now are profoundly better than they were before the trauma. While the psychological research into posttraumatic growth is relatively new, the field of Humanities has conducted this same inquiry for several thousand years. For example, Friedrich Nietzsche …

Evidence Based Design In Healthcare: An Applied Study On The Impacts Of Interior Design For Cerebral Palsy, Katie D. Phillips

Honors College Theses

Evidence Based Design (EBD) is an informed approach to design where designers base their decisions on quantitative and qualitative research. The design of the Universal Access Center for United Cerebral Palsy, discussed in this paper, encapsulates this approach to design. The five stages of EBD and how they were achieved within this project is defined. In the first phase, programming, current trends in healthcare as well as issues surrounding design for adults with Cerebral Palsy (CP) are discussed. In schematic design, initial issues of the project are resolved, and creative ideas are explored leading to the design development stage. In …

Evidence Considerations For Mobile Devices In The Occupational Therapy Process, Kelly Erickson

The Open Journal of Occupational Therapy

Mobile app-based device utilization, including smartphones and handheld tablets, suggests a need to evaluate evidence to guide selection and implementation of these devices in the occupational therapy process. The purpose of the research was to explore the current body of evidence in relation to mobile app-based devices and to identify factors in the use of these devices throughout the occupational therapy process. Following review of available occupational therapy profession guidelines, assistive technology literature, and available mobile device research, practitioners using mobile app-based devices in occupational therapy should consider three areas: client needs, practitioner competence, and device factors. The purpose of …

Outcomes After A Comprehensive Inpatient Rehabilitation Treatment Program For A Patient With A Right Pontine Stroke: A Case Report, Traci Rzeszutko

All Capstone Projects

Background/Purpose: A stroke occurs as a result of decreased blood flow to the brain and can cause serious limitations in mobility, balance, coordination, and strength resulting in functional limitations. The purpose of this case study is to examine the effects of a comprehensive acute inpatient rehabilitation program focusing on gait, balance, lower extremity strengthening, neuromuscular control, bed mobility, coordination, and stair training on a 67-year-old male after a right pontine stroke with a medical history that includes a right stroke eight years ago.

Case Description: The subject was a 67-year-old male with a diagnosis of right pontine stroke. The subject …

Utility Of Ultrasound For Imaging Osteophytes In Patients With Insertional Achilles Tendinopathy, Ruth L. Chimenti, Peter C. Chimenti, Mark R. Buckley, Jeff R. Houck, A. Samuel Fleminster

Faculty Publications - College of Physical Therapy

Objectives: To examine (1) the validity of ultrasound imaging to measure osteophytes and (2) the association between osteophytes and insertional Achilles tendinopathy (IAT).

Design: Case-control study.

Setting: Academic medical center.

Participants: Persons with chronic unilateral IAT (n=20; mean age, 58.7±8.3y; 10 [50%] women) and age- and sex-matched controls (n=20; mean age, 57.4±9.8y; 10 [50%] women) participated in this case-control study (N=40).

Interventions: Not applicable.

Main Outcome Measures: Symptom severity was assessed using the Foot and Ankle Ability Measure, the Victorian Institute of Sport Assessment-Achilles questionnaire, and the numerical rating scale. Length of osteophytes was measured bilaterally in both groups using …

Comparison Of Transcutaneous Electrical Nerve Stimulation And Cryotherapy For Increasing Quadriceps Activation In Patients With Knee Pathologies, Conrad M. Gabler, Adam S. Lepley, Timothy L. Uhl, Carl G. Mattacola

Physical Therapy Faculty Publications

Proper neuromuscular activation of the quadriceps muscle is essential for maintaining quadriceps strength and lower extremity function. Quadriceps activation failure is a common characteristic observed in patients with knee pathologies, and it is defined as an inability to voluntarily activate the entire alpha motor neuron pool innervating the quadriceps. One of the more popular techniques used to assess quadriceps activation is the superimposed burst (SIB) technique. The SIB technique is a force-based technique which uses a supramaximal, percutaneous electrical stimulation to activate all of the motor units in the quadriceps during a maximal, voluntary isometric contraction of the quadriceps. Central …

Successful Management Of Barth Syndrome: A Systematic Review Highlighting The Importance Of A Flexible And Multidisciplinary Approach, Stacey E. Reynolds

Occupational Therapy Publications

This review describes and summarizes the available evidence related to the treatment and management of Barth syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify articles published between December 2004 and January 2015. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach was used to guide the article selection and evaluation process. Of the 128 articles screened, 28 articles matched the systematic review inclusion criteria. The results of this review indicate the need for a flexible and multidisciplinary approach to manage the symptoms most commonly associated with Barth syndrome. It is recommended …

Eccentric Loading Of Triceps Surae Modulates Stretch Shortening Cycle Behaviour - A Possible Therapeutic Mechanism, J Debenham, W Gibson, M Travers, A Campbell, G Allison

Physiotherapy Papers and Journal Articles

Context: Eccentric exercises are increasingly being used to treat lower limb musculoskeletal conditions such as Achilles tendinopathy. Despite widespread clinical application and documented efficacy, mechanisms underpinning clinical benefit remain unclear. Positive adaptations in motor performance are one potential mechanism.

Objective: To investigate how an eccentric loading intervention influences measures of stretch-shortening cycle (SSC) behaviour during a hopping task.

Design: Within subjects repeated measures observational study.

Setting: University motion analysis laboratory.

Participants: Healthy adults. Interventions: A single intervention of 5 sets of 10 eccentric plantarflexion contractions at 6 RM using a commercial seated calf raise machine.

Main outcome measures: Lower limb …

Neural Function, Injury, And Stroke Subtype Predict Treatment Gains After Stroke, Erin Burke Quinlan, Lucy Dodakian, Jill See, Alison Mackenzie, Vu Le, Mike Wojnowicz, Babak Shahbaba, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Objective

This study was undertaken to better understand the high variability in response seen when treating human subjects with restorative therapies poststroke. Preclinical studies suggest that neural function, neural injury, and clinical status each influence treatment gains; therefore, the current study hypothesized that a multivariate approach incorporating these 3 measures would have the greatest predictive value.

Methods

Patients 3 to 6 months poststroke underwent a battery of assessments before receiving 3 weeks of standardized upper extremity robotic therapy. Candidate predictors included measures of brain injury (including to gray and white matter), neural function (cortical function and cortical connectivity), and clinical …

The Therapeutic Contributions Of Somatosensory Feedback During Exercise For Those With Parkinson's Disease, Matthew T. Lasswell

Theses and Dissertations (Comprehensive)

Previous research has proposed that the somatosensory feedback generated during exercise is a key component in regards to the mechanism underlying the therapeutic effects of exercise on the motor symptoms of Parkinson’s disease (PD). This thesis aimed to further examine the contributions of different forms of somatosensory feedback during exercise in PD in order to understand the mechanism for symptom improvements that certain exercise studies report.

This randomized, controlled exercise study consisted of three treadmill groups, with the RATE and MAGNITUDE groups serving as the experimental conditions, while the CONTROL condition was an active comparator treadmill walking group. The RATE …

The Effect Of Multidisciplinary Rehabilitation On Brain Structure And Cognition In Huntington's Disease: An Exploratory Study, Travis M. Cruickshank, Jennifer A. Thompson, Juan F. Dominguez D, Alvaro P. Reyes, Mike Bynevelt, Nellie Georgiou-Karistianis, Roger A. Barker, Mel R. Ziman

Research outputs 2014 to 2021

Background: There is a wealth of evidence detailing gray matter degeneration and loss of cognitive function over time in individuals with Huntington's disease (HD). Efforts to attenuate disease-related brain and cognitive changes have been unsuccessful to date. Multidisciplinary rehabilitation, comprising motor and cognitive intervention, has been shown to positively impact on functional capacity, depression, quality of life and some aspects of cognition in individuals with HD. This exploratory study aimed to evaluate, for the first time, whether multidisciplinary rehabilitation can slow further deterioration of disease-related brain changes and related cognitive deficits in individuals with manifest HD. Methods: Fifteen participants who …

Can The Nintendo Wii Be Used As A More Effective Method Of Rehabilitation Than Traditional Physiotherapy Exercises For Patients With Knee Reconstruction Surgery?, Samantha Snyder

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the Nintendo Wii can be used as a more effective method of rehabilitation than traditional physiotherapy exercises for patients with knee reconstruction surgery?

STUDY DESIGN: Review of three English language primary studies, published after 1999.

DATA SOURCES: Two randomized controlled trials (RCTs) and one case study with no comparison group were found using PubMed. These studies analyzed Nintendo Wii intervention in patients that underwent knee reconstructive surgery in need of rehabilitation.

OUTCOME MEASURED: The outcome measured was improvement in balance through use of the Activity-Specific Balance …

A Novel Fmri Paradigm Suggests That Pedaling-Related Brain Activation Is Altered After Stroke, Nutta-On Promjunyakul, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

The purpose of this study was to examine the feasibility of using functional magnetic resonance imaging (fMRI) to measure pedaling-related brain activation in individuals with stroke and age-matched controls. We also sought to identify stroke-related changes in brain activation associated with pedaling. Fourteen stroke and 12 control subjects were asked to pedal a custom, MRI-compatible device during fMRI. Subjects also performed lower limb tapping to localize brain regions involved in lower limb movement. All stroke and control subjects were able to pedal while positioned for fMRI. Two control subjects were withdrawn due to claustrophobia, and one control data set was …