Rehabilitation and Therapy Commons^™

Randomized Controlled Trial Comparing Orthosis Augmented By Either Stretching Or Stretching And Strengthening For Stage Ii Tibialis Posterior Tendon Dysfunction, Jeff Houck, Christopher Neville, Josh Tome, Adolph Flemister

Faculty Publications - College of Physical Therapy

Background: The value of strengthening and stretching exercises combined with orthosis treatment in a home-based program has not been evaluated. The purpose of this study was to compare the effects of augmenting orthosis treatment with either stretching or a combination of stretching and strengthening in participants with stage II tibialis posterior tendon dysfunction (TPTD).

Methods: Participants included 39 patients with stage II TPTD who were recruited from a medical center and then randomly assigned to a strengthening or stretching treatment group. Excluding 3 dropouts, there were 19 participants in the strengthening group and 17 in the stretching group. The stretching …

Wordless Intervention For Epilepsy In Learning Disabilities (Wield): Study Protocol For A Randomized Controlled Feasibility Trial, Marie-Anne Durand, Bob Gates, Georgina Parkes, Asif Zia

Dartmouth Scholarship

Epilepsy is the most common neurological problem that affects people with learning disabilities. The high seizure frequency, resistance to treatments, associated skills deficit and co-morbidities make the management of epilepsy particularly challenging for people with learning disabilities. The Books Beyond Words booklet for epilepsy uses images to help people with learning disabilities manage their condition and improve quality of life. Our aim is to conduct a randomized controlled feasibility trial exploring key methodological, design and acceptability issues, in order to subsequently undertake a large-scale randomized controlled trial of the Books Beyond Words booklet for epilepsy.

Research Brief: "Effectiveness Of Supported Employment For Veterans With Spinal Cord Injuries: Results From A Randomized Multisite Study", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study was the first of its kind to study the effectiveness of any type of vocational rehabilitation (VR) intervention after a spinal cord injury, and it found that veterans who were provided supported employment were 2.5 times more likely than veterans in the treatment as usual-interventional site (TAU-IS) group and 11.4 times more likely than the treatment as usual-observational site (TAU-OS) group to obtain competitive employment. In practice, veterans seeking employment should enroll in a supported employment program at their local VA. In policy, the VA might recommend that veterans with SCI participate in SE soon after they have …

Home-Based Constraint Induced Movement Therapy Poststroke, Stephen Isbel, Christine Chapparo, David Mcconnell, Judy Ranka

The Open Journal of Occupational Therapy

Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors.

Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL).

Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]): Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 – 10.18, …

An Overview Of Cancer Rehabilitation And Exercise In The Literature: Promoting Increased Referrals To Improve Oncology Outcomes, Leslie J. Waltke

Journal of Patient-Centered Research and Reviews

Medical management for malignant neoplastic diseases includes surgery, chemotherapy, radiation, and hormonal and biological therapies. Each of these antineoplastic interventions has unique impacts on physiological, musculoskeletal and functional performance. Cancer rehabilitation is the area of physical medicine responsible for addressing impairments associated with cancer treatment and survivorship, advanced disease and end of life. Although it is expected that more than one-half of persons being treated for cancer will suffer moderate pain and physical and functional decline, and that most will describe fatigue, referrals to rehabilitation are traditionally low. Evidence suggests that referrals to rehabilitation before, during and after treatment for …

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …

Motor Cortex Electrical Stimulation Augments Sprouting Of The Corticospinal Tract And Promotes Recovery Of Motor Function, Jason B. Carmel, John H. Martin

Publications and Research

The corticospinal system—with its direct spinal pathway, the corticospinal tract (CST) – is the primary system for controlling voluntary movement. Our approach to CST repair after injury in mature animals was informed by our finding that activity drives establishment of connections with spinal cord circuits during postnatal development. After incomplete injury in maturity, spared CST circuits sprout, and partially restore lost function. Our approach harnesses activity to augment this injury-dependent CST sprouting and to promote function. Lesion of the medullary pyramid unilaterally eliminates all CST axons from one hemisphere and allows examination of CST sprouting from the unaffected hemisphere. We …

Low-Cost Strider For Guatemala, Nicole Catherine Cooper, Gonzalo Hernandez, Jared W. Tower

Mechanical Engineering

The purpose of this project was to create a strider, a type of standing rehabilitation device, for children in developing countries who have trouble walking and supporting their full body weight. The project was initially brought to us by Cal Poly professor Brian Self, who had visited a clinic in San Marcos and determined that there were children there who had difficulties with walking and were a need for a rehabilitation device. The team discussed the problem with Dr. Self, Matt Robinson (a local San Luis Obispo prosthetist), and Cal Poly physics professor Pete Schwartz, all of whom had visited …

Safety Of Infusing Rituximab At A More Rapid Rate In Patients With Rheumatoid Arthritis: Results From The Rate-Ra Study, Charles H. Pritchard, Maria W. Greenwald, Joel M. Kremer, Norman B. Gaylis, William Rigby

Dartmouth Scholarship

As recommended in the current prescribing information, rituximab infusions in patients with rheumatoid arthritis (RA) take 4.25hours for the first infusion and 3.25hours for subsequent infusions, which is a burden on patients and the health care system. We therefore evaluated the safety of infusing rituximab at a faster rate for an infusion period of 2hours in patients with RA.

Technology-Supported Art As A "Way To Participation", Molly Bathje

The Open Journal of Occupational Therapy

Brianna Vitale provided the painting featured on the cover of the Spring 2014 issue of The Open Journal of Occupational Therapy. Brianna completed the painting, titled “Flamingo,” using a mouth joystick (joust) to draw the image on her computer and an assistive device to translate her computer artwork into the watercolor painting. At 12 years old, Brianna has been living for the past 9 years with tetraplegia, the result of a spinal cord injury (SCI). Through technology and with the support of family, friends, and health care professionals, Brianna energetically engages in a variety of creative, social, and philanthropic activities.

Conservative Treatment Of Anterior Cruciate Ligament Deficiency, Brandan Holmquist

Thinking Matters Symposium Archive

The purpose of this literature review is to present a simple protocol for the treatment of Anterior Cruciate Ligament deficiency for one plane athletes like some track athletes and baseball and softball designated players whom defer surgical intervention until after the season is completed.

Medial Tibial Stress Syndrome, Jacqueline Knowles

Thinking Matters Symposium Archive

The purpose of this project is to examine an exercise-­‐based approach to rehabilitating an athlete with medial tibial stress syndrome. It presents specific exercises that can be used, and focuses on resolving the core of the problem instead of just addressing the symptom. This review attempts to provide a long-­‐term solution rather than providing a quick fix.

Muscle Activity During The Star Excursion Balance Test In Healthy Adults, Kunal Bhanot, Navpreet Kaur, Lori Thein Brody, Jennifer Bridges, David C. Berry, Joshua J. Ode

Physical Therapy Collection

Purpose: To determine electromyographic (EMG) activity of the hip and the trunk muscles during the Star Excursion Balance Test (SEBT) performance in 8 reach directions.

Illusory Touch Temporarily Improves Sensation In Areas Of Chronic Numbness: A Brief Communication, Benedict Martin Wand, Samantha Eve Stephens, Effie Ida Marquita Mangharam, Pamela Jane George, Max Bulsara, Neil Edward O'Connell, G Lorimer Moseley

Physiotherapy Papers and Journal Articles

Background. Creating the visual illusion of touch can improve tactile perception in healthy subjects. Objective. We were interested in seeing if creating the illusion of touch in an insensate area could improve sensation in that area. Methods. Fourteen people with chronic numbness participated in a randomized crossover experiment. The 4 conditions were the following: (a) stimulation over the unaffected limb with mirror visual feedback (experimental condition), (b) stimulation over the affected limb with mirror visual feedback, (c) stimulation over the unaffected limb without mirror visual feedback, and (d) stimulation …

Anomia Treatment Platform As Behavioral Engine For Use In Research On Physiological Adjuvants To Neurorehabilitation, Diane Kendall, Anastasia Raymer, Miranda Rose, Joellen Gilbert, Leslie J. Gonzalez Rothi

Communication Disorders & Special Education Faculty Publications

The purpose of this study was to create a "behavioral treatment engine" for future use in research on physiological adjuvants in aphasia rehabilitation. We chose the behavioral target anomia, which is a feature displayed by many persons who have aphasia. Further, we wished to saturate the treatment approach with many strategies and cues that have been empirically reported to have a positive influence on aphasia outcome, with the goal being to optimize the potential for positive response in most participants. A single-subject multiple baseline design with replication across eight participants was employed. Four men and four women, with an average …

Health-Related Quality Of Life In Individuals With Chronic Ankle Instability, Megan N. Houston, Bonnie L. Van Lunen, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: Individuals with chronic ankle instability (CAI) have reported decreased global and regional function. Despite the identification of functional deficits in those with CAI, more research is required to determine the extent to which CAI influences the multidimensional profile of health-related quality of life.

Objective: To determine whether global, regional, and psychological health-related outcomes differ between individuals with and without CAI.

Design: Case-control study.

Setting: Laboratory.

Patients or Other Participants: Twenty-five participants with CAI (age = 21.9 ± 2.5 years, height = 170.8 ± 8.6 cm, mass = 69.8.0 ± 11.7 kg) were sex- and limb-matched to 25 healthy participants …

The Identity Of The Heart Patient In The Context Of The Gift Economy: Heartnet And Media Framing, Lynsey Uridge

Theses: Doctorates and Masters

This health communication research examines the identity levels of the heart patient on a therapeutic website HeartNET through an empirical investigation of site interactions as manifestations of a gift economy. The thesis also explores the media’s representation of heart health in both television and print.

This research utilised a longitudinal qualitative ethnographic and netnographic approach involving twenty-six participants who completed two in-depth interviews. The first one-on-one interview occurred during the early stages of the participants’ heart journey, explored their heart story and use of interactive technology for heart health support. The second interview occurred six to twelve months later, and …

The Efficacy Of Long-Term Kinesio Tape On Grip Strength In A Healthy Population, Neel Kotrappa

CMC Senior Theses

Kinesio® Tape was invented in 1973, and since has been used in various clinical and therapy settings to prevent and heal a multitude of physical conditions. Kinesio® Tape is a 100% cotton-based elastic tape that when applied to the skin pulls the skin upwards and creates more space by lifting the fascia and soft tissue, thus increasing blood flow and decreasing edema. The tape was also purported to facilitate the strengthening of weakened muscles through neuromuscular facilitation. The objective behind this study was to determine the long-term effects of applied forearm Kinesio® Tape on maximal grip strength when paired with …

The Role Of Rehabilitation Following Autologous Chondrocyte Implantation: A Retrospective Chart Review, Jenny L. Toonstra, Jennifer Sebert Howard, Timothy L. Uhl, Robert A. English, Carl G. Mattacola

Physical Therapy Faculty Publications

PURPOSE/BACKGROUND: Clinical outcomes following autologous chondrocyte implantation (ACI) are influenced by multiple factors, including patient demographics, lesion characteristics, quality of the surgical repair, and post-operative rehabilitation. However, it is currently unknown what specific characteristics of rehabilitation have the greatest influence on clinical outcomes following ACI. The purpose of this study was to conduct a retrospective chart review of patients undergoing ACI with the intent to describe this patient population's demographics, clinical outcomes, and rehabilitation practices. This study aimed to assess the consistency of the documentation process relative to post-operative rehabilitation in order to provide information and guide initiatives for improving …

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 …

Expressing, Responding, Protecting, And Inspiring Through Art, Molly Bathje

The Open Journal of Occupational Therapy

Margy Hunter, MS, MA, LLP, OTR/L, created the cover of the Spring 2013 issue of The Open Journal of Occupational Therapy. She created this untitled work as a personal reflection on the impact of war on individuals and society, as well as on the history of the profession of occupational therapy (OT), which began in response to military service members’ needs. Also embedded in the creation of this piece are the restorative benefits of participation in creative arts for OT practitioners who deliver services to patients experiencing profound life changes. Additionally, this article explores the artists’ use of art …

Applying Principles Of Motor Learning And Control To Upper Extremity Rehabilitation, Lisa M. Muratori, Eric M. Lamberg, Lori Quinn, Susan V. Duff

Physical Therapy Faculty Articles and Research

The purpose of this article is to provide a brief review of the principles of motor control and learning. Different models of motor control from historical to contemporary are presented with emphasis on the Systems model. Concepts of motor learning including skill acquisition, measurement of learning, and methods to promote skill acquisition by examining the many facets of practice scheduling and use of feedback are provided. A fictional client case is introduced and threaded throughout the article to facilitate understanding of these concepts and how they can be applied to clinical practice.

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. …

Predictors Of Outcome Following Standardized Rehabilitation For Patients With Shoulder Pain, Stephanie D. Moore

Theses and Dissertations--Rehabilitation Sciences

Shoulder dysfunction is frequently treated and persistent symptoms are common. Differential diagnosis of shoulder injuries can be challenging and knowledge of a diagnosis alone does not appear to be enough information to predict outcomes. Determination of a set of factors that predict outcome would assist clinicians in making the most effective treatment decision for patients with shoulder pain. The purposes of this dissertation were to investigate patient-clinician agreement in an orthopedic population of patients with shoulder pain and to determine what combination of factors best predicts positive patient-reported outcome following standardized rehabilitation in patients with shoulder pain.

In the first …

Development Of An Eeg Brain-Machine Interface To Aid In Recovery Of Motor Function After Neurological Injury, Elizabeth Salmon

Theses and Dissertations--Biomedical Engineering

Impaired motor function following neurological injury may be overcome through therapies that induce neuroplastic changes in the brain. Therapeutic methods include repetitive exercises that promote use-dependent plasticity (UDP), the benefit of which may be increased by first administering peripheral nerve stimulation (PNS) to activate afferent fibers, resulting in increased cortical excitability. We speculate that PNS delivered only in response to attempted movement would induce timing-dependent plasticity (TDP), a mechanism essential to normal motor learning. Here we develop a brain-machine interface (BMI) to detect movement intent and effort in healthy volunteers (n=5) from their electroencephalogram (EEG). This could be used in …

A Young Stroke Patient With Bardet-Biedl Syndrome: A Casereport, Erh-Chun Chen, Tien-Wen Chen, Ming-Cheng Weng, Chia-Ling Lee

Rehabilitation Practice and Science

Bardet-Biedl syndrome (BBS) is a rare inherited disease. Up to date, there have been 14 known BBS-related mutation genes, resulting in ciliopathy with multiple abnormalities such as obesity, pigmentary retinopathy, polydactyly, learning disabilities, poor coordination, renal dysfunction, diabetes and hypertension. This case was a 29-year-old male, who was diagnosed as Bardet-Biedl syndrome since childhood and then was followed up for control of complications. He suffered from stroke at age of 29. Risks of young stroke were surveyed. Poorly controlled hypertension, hyperlipidemia, hyperglycemia and hyperfibrinogenemia were noted. No other examination revealed abnormality. He had received treatment of stroke in acute phase, …

Functional Rehabilitation Of Low Back Pain With Core Stabilization Exercises: Suggestions For Exercises And Progressions In Athletes, Joshua Johnson

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

Introduction: Low back pain is very common in the adult population and accounts for more time lost from work than other diagnoses. It also affects athlete's at all different levels of competition and results in missed practice and game time. Diagnosing and treating a specific pathology is often difficult because clinical evaluation and radiologic studies are often unable to find a root cause. A popular treatment approach with a high volume of anecdotal evidence is the use of core stabilization exercise in the treatment of low back pain.

Purpose: To evaluate exercise as a treatment for a low back pain …

Environmental Influences On Occupational Therapy Practice, Camille L. Skubik-Peplaski

Theses and Dissertations--Rehabilitation Sciences

Rehabilitation hospitals serve to foster a client’s independence in preparation to return home after an injury or insult. Having space in rehabilitation environments that is home-like and supportive for each client can facilitate participation in occupations and assist in learning and practicing the skills needed to transition to home. Yet, typically occupational therapists provide interventions to clients in therapy gyms with exercise and impairment based equipment. Currently the stroke population is changing and identifying the optimal rehabilitation environment is imperative to guide occupational therapy practice. This dissertation contains three studies relating to the rehabilitation environment and occupational therapy interventions. The …

The Impact Of Powered Mobility Devices On Occupational Performance : A Systematic Review ; And, The Experience Of Being A Motorised Mobility Scooter User, Ryan Fomiatti

Theses : Honours

The impact of powered mobility devices on occupational performance: A systematic review

Purpose: To systematically review the impact powered mobility devices have on engagement in independent occupations for adults with acquired mobility limitations. Method: The following databases were searched electronically: CINAHL Plus, Medline, PsychInfo, OT Seeker, Joanna Briggs Institute and Physiotherapy Evidence Database. The search terms used a combination of words to encompass all terms which are used for powered mobility. Studies were included if they evaluated adults’ use of a motorised mobility device, and if individuals used a powered mobility device due to acquired mobility limitation. Results: Eleven studies …