Rehabilitation and Therapy Commons^™

Constraint Induced Aphasia Therapy In The Very Early Phase Of Recovery Following Stroke, Sarah D'Souza

Theses : Honours

Background and purpose: Research suggests communication outcomes following stroke may be greater when treatment is administered in the acute phase of recovery. In addition, treatment outcomes are improved when therapy is provided at a greater intensity. Constraint Induced Aphasia Therapy (CIAT) has addressed the issue of treatment intensity by delivering therapy for three hours per weekday for two weeks, but its effectiveness has largely been investigated in the chronic phase of recovery. Treatment outcomes have typically been assessed on standardised tests and few studies have used connected speech and discourse measures to assess change. This research investigated daily intervention in …

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 …

Spondylolysis And Spondylolisthesis In Baseball Athletes: Five Casereports, Chun-Yao Yu, Hsiao-Yun Chang, Chuan-Chao Lin, Yi-Luen Hung, Su-Ju Tsai

Rehabilitation Practice and Science

Low back pain is one of the commonest complaints of young athletes who visit the physical medicine and rehabilitation outpatient department. Spondylolysis and spondylolisthesis are frequent causes of low back pain in young athletes. The pain in these conditions is exacerbated by lumbar extension and relieved by rest. Although genetic predisposition plays an important role in the development of pars defect, certain activities involving lumbar hyperextension and rotation movements result in spondylolysis and spondylolisthesis.From December 2005 to March 2009, there were five baseball athletes who visited our outpatient department because of low back pain. The diagnosis was grade I spondylolisthesis …

A Systematic Review Of The Health-Related Quality Of Life Measures Following Total Knee Arthroplasty, Saurabh Mehta, Mary Law, Jean-Sebastian Roy

Physical Therapy Faculty Research

To perform systematic review and appraisal of common patient-reported outcomes (PROs) used in measuring aspects of health-related quality of life (HRQOL) following total knee arthroplasty (TKA). Especially, the study aimed to examine whether these common PROs assess the domains of HRQOL as described in the theoretical frameworks of the HRQOL.

Smart Rehabilitation For The 21st Century: The Tampa Smart Home For Veterans With Traumatic Brain Injury, Jan Jasiewicz, William D. Kearns, Jeffrey Craighead, James L. Fozard, Steven Scott, Jay Mccarthy

Rehabilitation and Mental Health Counseling Faculty Publications

No abstract provided.

Is Gait Training With The Elliptically Based Robotic Gait Trainer (Ebrgt) Feasible In Ambulatory Patients After Stroke?, J. Cortney Bradford

Theses and Dissertations

In response to the potential benefits of task specific training in rehabilitation of gait after stroke and the need for affordable, simple ways to implement it, our group designed the elliptically based robotic gait trainer (EBRGT). A design review of the EBRGT, covering the design goals, an overview of the mechanical and electrical design, and a discussion of the novelty of the device and why it may be beneficial for individuals with hemiparesis secondary to stroke is discussed (Chapter 2). To characterize the new device, a study was performed to determine if the EBRGT produced a gait pattern that mimicked …

Pedaling Alters The Excitability And Modulation Of Vastus Medialis H-Reflexes After Stroke, Dana P. Fuchs, Namita Sanghvi, Jon A. Wieser, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

Objective

Individuals post-stroke display abnormal Group Ia reflex excitability. Pedaling has been shown to reduce Group Ia reflexes and to normalize the relationship between EMG and reflex amplitude in the paretic soleus (SO). The purpose of this study was to determine whether these changes extend to the paretic quadriceps.

Methods

H-reflexes were used to examine Group Ia reflex excitability of the vastus medialis (VM). H-reflexes were elicited in paretic (n = 13) and neurologically intact (n = 13) individuals at 11 positions in the pedaling cycle and during static knee extension at comparable limb positions and levels of …

Pain Perception After Isometric Exercise In Women With Fibromyalgia, Marie K. Hoeger Bement, Andy Weyer, Sarah Hartley, Breanna Drewek, April L. Harkins, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Objective: The purpose of this study was to identify exercise protocols incorporating isometric contractions that provide pain relief in women with fibromyalgia.

Design: A before-after trial.

Setting: A physical therapy department in an academic setting.

Participants: Fifteen women (mean ± SD, 52 ± 11y) with fibromyalgia.

Interventions: Subjects completed 4 sessions: 1 familiarization and 3 experimental. The following randomized experimental sessions involved the performance of isometric contractions with the elbow flexor muscles that varied in intensity and duration: (1) 3 maximal voluntary contractions (MVCs), (2) 25% MVC held to task failure, and (3) 25% MVC …

The Effect Of Joint Mobilization On Functional Outcomes Associated With Chronic Ankle Instability, Matthew C. Hoch

University of Kentucky Doctoral Dissertations

Ankle sprains are among the most common injuries sustained by physically active individuals. Although ankle sprains are often considered innocuous in nature, a large percentage of individuals experience repetitive sprains, residual symptoms, and recurrent ankle instability following a single acute sprain; otherwise known as chronic ankle instability (CAI). In addition to repetitive ankle trauma, those with CAI experience reductions in functional capacity over the life span. This indicates that current intervention strategies for CAI are inadequate and require further investigation.

The objective of this dissertation was to explore differences in walking and running gait parameters between individuals with and without …

Primary Reasons For Rehabilitation Service Referrals: The Recent Experience Of A Medical Center In Taiwan, Chung-Po Su, Ssu-Yuan Chen, Tyng-Guey Wang, Yen-Ho Wang, I-Nan Lien

Rehabilitation Practice and Science

Objectives: To better understand the current utilization of rehabilitation services and to project future trends, this study investigated the primary reasons for rehabilitation services referrals in a medical center in Taiwan. Methods: We reviewarticleed records of those patients who visited rehabilitation clinics (4,305 new and 12,163 returned patients) or received a rehabilitation consultation during their hospital stay (1,345 patients) between June and October 2007 at the National Taiwan University Hospital. The primary diagnoses of study patients were classified into 12 groups: musculoskeletal and soft tissue diseases, brain diseases, spinal cord diseases, peripheral neuropathy, myopathy, fractures and amputations, language disorders, cardiovascular …

Carpal Tunnel Syndrome As An Initial Presentation Of Glioblastoma Multiforme: A Casereport, Chih-Hung Tseng, Kun-Lin Wu, Sin-Hao Ho, Su-Ju Tsai

Rehabilitation Practice and Science

A 43-year-old woman was clinically diagnosed as carpal tunnel syndrome due to the presentation of intermittent numbness, tingling and pain in her right thumb and index finger. The symptoms gradually exacerbated together with positive Phalen's test and Tinel's sign. Endoscopic carpal tunnel release procedure failed to relieve her symptoms. Ensuing symptoms developed such as headache, extensive numbness and mild weakness in her right upper and lower limbs. MRI of brain revealed a left thalamic tumor. Stereotactic biopsy confirmed the pathologic diagnosis as glioblastoma. Post-operative radiotherapy and temozolomide chemotherapy were performed to suppress disease progression. She also received comprehensive rehabilitation program, …

Posterior Interosseous Neuropathy Related To Cumulative Trauma Disorder: A Casereport, Cheng-Hao Tseng, Tsung-Cheng Huang, Jen-Wen Hung, Bin-Chi Chang

Rehabilitation Practice and Science

Work related cumulative posterior interosseous neuropathy is a rare cumulative trauma disorder. To the best of our knowledge, a locksmith with this kind of disorder has never been reported. The locksmith was a 57-year-old man, and he had to perform repeated supination and pronation movements when working. He complained of weakness of right third and fourth finger extension when typing on a computer keyboard. Radial deviation was also noted when his wrist was extended. Electromyography was performed and right posterior interosseous neuropathy was suspected. Magnetic resonance imaging (MRI) showed perineural muscle edema, obliteration and fluid accumulation at the level of …

Injury In Nevada, Michelle Chino, Jonathon Lavalley, Darlene R. Haff, Deborah A. Harris, Andrea R. Rivers

School of Public Health Faculty Research

Injury is a major threat to health and safety. In a typical day in the US, 400 people will die as the result of an injury, 7,500 will be hospitalized due to an injury, and more than 150,000 will suffer an injury severe enough to restrict activities and seek medical attention. Many of these deaths, hospitalizations, and disabling events will be the result of motor vehicle crashes. Others will result from vio­lence, falls, drowning, and poisoning – all of which are considered injuries.

The costs of injury are high. In the United States, the cost of injuries is estimated to …

Positioning Techniques To Reduce The Occurrence Of Dequervain’S Tendonitis In Nursing Mothers, Alison Virzi

Dissertations, Masters Theses, Capstones, and Culminating Projects

DeQuervain's tendonitis is an inflammation of two tendons: the extensor pollicis brevis and the abductor pollicis longus as they cross in the first dorsal compartment of the wrist. Symptoms include pain, swelling along the radial aspect of the wrist, and a decrease in thumb motion. A positive Finkelstein's test at examination is seen. Frequently it is caused by repetitively gripping, lifting, and positioning the wrist in flexion, ulnar deviation with thumb extension. It is a common diagnosis in women, referred to as "washerwoman's syndrome". It is also common for new mothers to experience due to the demands their wrists are …

Digital Human Models Of People With Disabilities, Ron Hamameh

Wayne State University Theses

The current state-of-the-art in Digital Human Modeling (DHM) allows for full simulation and analysis of any task a person is required to perform at home, at work, in the military, in space, in sports, etc. The problem is that the software is missing a very important population: people with physical disabilities. What modifications and enhancements must be made to existing, commercially available DHM software to include this population?

Major Depressive Disorder Among Individuals Who Are Deaf: Implications For Rehabilitation Professionals, Sandra Hansmann, Shawn P. Saladin, Diana M. Fraser-Mendez

School of Rehabilitation Services & Counseling Faculty Publications

Major Depressive Disorder (MDD) is a potentially disabling condition which adversely affects psychosocial functioning in the lives of many people. Individuals who are prelingually and/or profoundly Deaf are especially at risk of misdiagnoses, which in turn may prevent them from receiving the treatment needed to reach their full potential in independent living or vocational rehabilitation. This article reviews general depressive symptomology, followed by a discussion of challenges associated with diagnosing MDD in individuals who are Deaf. Suggestions for therapeutic interventions are also included. The article concludes with a summary of the implications of Deafness and MDD for independent living and …

Assessment Of Individual Activities Of Daily Living And Its Association With Self-Rated Health Status In Elderly People, Yu-Ning Hu, Chin-Ching Li, Chia Lee, Rung-Huei Lin, Gwo-Chi Hu

Rehabilitation Practice and Science

Health-related quality-of-life in the elderly generally encompasses freedom from disease, good physical and psycho-social well-being, and preventing the loss of function in activities of daily living (ADL). Some indices of ADL, such as basic ADL and instrumental ADL, are considered to be measures of functional status in the elderly. However, in most studies, functional status is evaluated by either the summed ADL score or disability score in one or more ADLs. No studies have investigated the association between an individual's ADL function and self-rated health status. The purpose of this study was to investigate the relationship of functional status (i.e., …

Clinical Experience Of Ventriculoperitoneal Shunt Dysfunction In A Patient With Hydrocephalus After Brain Injury: A Casereport, Shean-Jing Lin, Yun-Yee Chen, Mu-Jung Kao, Ching-Yang Lin, Sheng-Huang Hsiao

Rehabilitation Practice and Science

We report a case of an adult patient with post-traumatic hydrocephalus who was treated using a ventriculoperitoneal (VP) shunt with a fixed pressure setting valve. Slit ventricle syndrome was found two months later and an antisiphon device (ASD) was added. A fixed pressure valve with ASD was found not to be optimal in terms of improving his neurological symptoms and a programmable valve system was therefore implanted with a pressure setting of 140 mmH2O in the beginning. The valve then was gradually programmed to reduce down to 70 mmH2O over two months. This case demonstrates that selection of a shunting …

Conversion Paraplegia: A Casereport, Chin-Feng Yu Cheng, Shih-Ching Chen, Jiunn-Horng Kang

Rehabilitation Practice and Science

A 21-year-old man had progressive weakness and numbness of bilateral lower extremities and sphincter dysfunction after a traffic accident. The image and electrodiagnostic study showed no significant abnormal findings. Conversion paraplegia was suspected due to unusual clinical presentation, which cannot be explained by neuropathologic lesions. After intensive rehabilitation, patient's functional performance improved significantly and he could walk independently without device. But later, a fibrous dysplasia lesion was found at left sphenoid greater wing. He received an operation to remove it. The relationship between his benign brain tumor and conversion disorder is unknown, but the tumor that compressed temporal lobe might …

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 …

Shoulder Rehabilitation For The Injured Overhead-Throwing Athlete, Joshua M. Raskoff

Recreation, Parks, and Tourism Administration

Baseball incorporates the violent motion of throwing as a main act of physical exertion. The shoulder joint is vulnerable to injury during this movement. The overall purpose of this study was to produce a rehabilitation program for injured overhead-throwing athletes and have it evaluated by healthcare professionals. A paper and pen style questionnaire was sent through the mail to a network of professionals in California. Eighteen of the 20 questionnaires were returned. The quantitative feedback of the Likert scale questions indicated that the program was effective and usable while the qualitative feedback indicated the opposite. The additional comments allowed experts …

In-Season Rehabilitation Of A Division Iii Female Wrestler After A Glenohumeral Dislocation, Jason Brumitt, Alma Sproul, Philip Lentz, Linda Mcintosh, Richard Rutt

Faculty Publications - College of Physical Therapy

Objective: Wrestling is a popular sport in the United States at both the high school and collegiate levels. Traditionally a men’s sport, participation by female athletes in wrestling is increasing. There exists a paucity of literature regarding injury incidence in women’s wrestling. This lack of information challenges the ability of sports medicine and strength training professionals to design optimal injury prevention programs, training routines, and rehabilitation strategies. The objective of this report is to detail the successful conservative rehabilitation of a female wrestler after an initial glenohumeral dislocation.

Design: Case report

Case description: A 20-year-old female wrestling student–athlete presented to …

Psychosocial Aspects Of Deafness: Implications For Rehabilitation Counselors, Diana M. Fraser, Sandra Hansmann, Shawn P. Saladin

School of Rehabilitation Services & Counseling Faculty Publications

Negative societal attitudes toward people with hearing loss can be handicapping. Because of their deafness, people face a multitude of external barriers which become their handicap. The primary barriers or handicaps to this underserved population are two fold, inaccessibility to appropriate services during important milestones in their lives and a misunderstanding of Deaf culture. Rehabilitation counselors are advised to become aware of the types of interventions their Deaf consumers had as children through their education and socialization for in sight to appropriate services. Also discussed is the importance of communication and employer involvement in reducing societal stereotypes.

Rehabilitation In A Patient With Delayed Post-Hypoxic Encephalopathy: A Casereport, Yao-Jen Chen, Su-Ju Tsai, Yueh-Lin Tsai

Rehabilitation Practice and Science

Carbon monoxide poisoning from accidents or suicide attempts often result in delayed post-hypoxic encephalopathy. Patients with delayed post-hypoxic encephalopathy typically present with recurrent apathy, confusion, agitation, and/or progressive neurological deficits, despite apparent transient recovery. Autopsy reports often reveal diffuse demyelination of subcortical white matter, but the exact pathogenesis is not clear. While comprehensive physical examination and history taking is necessary in diagnosing delayed post-hypoxic encephalopathy, magnetic resonance imaging can be very helpful in the diagnostic work-up. Rehabilitation for severe post-hypoxic encephalopathy can prevent complications such as immobilization and can improve patients' functional status.We report the history, diagnosis, and rehabilitative outcome …

Femoral Nerve Injury Following Transfemoral Angiography: A Casereport, Chien-Ching Yu, Ying-Ju Shih, Su-Ju Tsai

Rehabilitation Practice and Science

Femoral nerve injury is a rare complication after femoral angiography. Symptoms including quadriceps weakness and atrophy, absent or reduced knee jerk and sensory impairment along the anterior thigh and medial lower leg have been found. This leads to both muscular weakness and sensory deficit, which impairs walking and interferes with quality of life. Early identification and management of femoral nerve injury could result in better prognosis.We report on the history, diagnosis and rehabilitative outcome of a 54-year-old woman with a medical history of peripheral arterial occlusion disease. She developed significant femoral neuropathy one month after angiography. Severe neurological deficits were …

Clinical Features And Rehabilitation Of Systemic Lupus Erythematosus Complicated With Moyamoya Syndrome: A Casereport, Wei-Chih Lien, Jo-Tong Chen, Shu-Cheng Lin, Nai-Wen Guo, Da-Shen Kuan

Rehabilitation Practice and Science

Moyamoya disease is an uncommon clinical entity characterized by progressive narrowing and occlusion of the bilateral distal internal carotid arteries, as well as the proximal parts of their major branches, namely, the middle and anterior cerebral arteries. Concomitant development of prominent collateral vascularity in the basal regions of the brain results in the typical angiographic appearance of moyamoya, which literally means a wavering puff of smoke. Moyamoya syndrome refers to findings of moyamoya vasculopathy in the context of known systemic disease. We present a 26-year-old woman with systemic lupus erythematosus who had several episodes of ischemic stroke. Her cerebral angiograms …

Spontaneous Spinal Epidural Hemorrhage With Shoulder And Neck Pain As Initial Presentation: A Casereport, Yu-Min Kuo, Wai-Keung Lee, Cheng-Chih Liao, Li-Rong Chen

Rehabilitation Practice and Science

Spontaneous spinal epidural hemorrhage is a very rare disease, with an annual incidence estimated at one per million. Emergency surgery is indicated for a good prognosis, without which the death rate would be higher. Although the initial symptoms of cervical, thoracic, and back pain make it difficult to differentiate spontaneous spinal epidural hemorrhage from other common disease with similar symptoms, magnetic resonance imaging (MRI) is a highly sensitive diagnostic method.We report the case of a 22-year-old male patient who initially complained of pain over the left shoulder and left cervical area. After nine days, numbness was noted in his left …

Self-Assessment Examination For Residents In Physical Medicine And Rehabilitation: First Experience In Taiwan, I-Nan Lien, Tyng-Guey Wang, Shin-Liang Pan, Rai-Chi Chan

Rehabilitation Practice and Science

Objective: The national Self-Assessment Examination (SAE) for residents has been held in the United States for many years. However, no similar test has been held by any medical specialty association in Taiwan. The first national SAE in Physical Medicine and Rehabilitation (PM & R) aimed to provide a benchmark for residents and medical institutes.Material and Methods: The written questions of the Certification Examination 2005 of the Taiwan Board of PM & R were used in the SAE for residents. Participants were first to third year residents in PM & R from various medical institutes and candidates for the board examination …

Developing "Human Functioning And Rehabilitation Research" From The Comprehensive Perspective., Gerold Stucki, Jan Dietrich Reinhardt, Gunnar Grimby, John Melvin

Department of Rehabilitation Medicine Faculty Papers

With the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) has prepared the ground for a comprehensive understanding of Human Functioning and Rehabilitation Research, integrating the biomedical perspective on impairment with the social model of disability. This poses a number of old and new challenges regarding the enhancement of adequate research capacity. Here we will summarize approaches to address these challenges with respect to 3 areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programmes and the building of university centres and collaboration networks.

Trial And Error Versus Errorless Learning Of Functional Skills In Patients With Acute Stroke, Julie Mount, Samuel R. Pierce, Janet Parker, Rebecca Diegidio, Russell Woessner, Lenore Spiegel

Department of Physical Therapy Faculty Papers

Objective: To compare the effectiveness of errorless learning versus trial and error learning for teaching activities of daily living to patients with acute stroke with or without explicit memory impairments.

Design: Randomized crossover.

Setting: Rehabilitation hospital.

Participants: 33 adult subjects following an acute stroke.

Intervention: Subjects were taught to prepare a wheelchair for a transfer and to put on a sock with a sock-donner. Tasks were taught using errorless learning or trial and error learning. Explicit memory was assessed using the Neurobehavioral Cognitive Status Exam.

Main Outcome Measures: Days until subject was able to …