Rehabilitation and Therapy Commons^™

Combined Exercise/Weight Bearing Program Influences Of Foot Function In People With Asymptomatic Flat Feet, Alison Modafferi, Angela Foster, Brenden Thompson, Jean Jarbath, Shanna Howland, Tyler Whited, Jeff Houck, Marcey Keefer Hutchison

Student-Faculty Research - College of Physical Therapy

No abstract provided.

Sit-To-Stand Symmetry In Individuals With Hip Pathology, Andrew J. Meszaros, Allie Thomas, Alyssa Ware, Craig Hawkinson, Jaydee Romick, Michelle Thoreson

Student-Faculty Research - College of Physical Therapy

Post-hip fracture patients continue to exhibit asymmetries during sit-to-stand task following rehabilitation. While strength is thoroughly addressed, perceptual deficits may be a missing component to rehabilitation post-hip fracture.

Community-Based Exercise & Wellness Program For Chronic Stroke - A Pilot Study, Christen Johnson, Daniel Debates, Meggie Dallas, Morgan Johansen, Morgan Kilgore, Cindy Zablotny, Theresa Raudsepp

Student-Faculty Research - College of Physical Therapy

Purpose: The overall goal of this pilot study was to determine the feasibility and effectiveness of an 8 week university-based community exercise and wellness program designed to provide an opportunity for exercise, social interaction, and education on stroke-related health and wellness topics.

Volumetric Modulated Arc Therapy Treatment Planning Of Thoracic Vertebral Metastases Using Stereotactic Body Radiotherapy, Matthew Mallory, Damodar Pokhrel, Rajeev Badkul, Hongyu Jiang, Christopher Lominska, Fen Wang

Radiation Medicine Faculty Publications

Purpose/Objectives: To retrospectively evaluate the plan quality, treatment efficiency, and accuracy of volumetric modulated arc therapy (VMAT) plans for thoracic spine metastases using stereotactic body radiotherapy (SBRT).

Materials/Methods: Seven patients with thoracic vertebral metastases treated with noncoplanar hybrid arcs (NCHA) (1 to 2 3D-conformal partial arcs +7 to 9 IMRT beams) were re-optimized with VMAT plans using three coplanar arcs. Tumors were located between T2 and T7 and PTVs ranged between 24.3 and 240.1 cc (median 48.1 cc). All prescriptions were 30 Gy in 5 fractions with 6 MV beams treated using the Novalis Tx linac equipped with high definition …

Demographic, Presentation, And Treatment Factors And Racial Disparities In Ovarian Cancer Hospitalization Outcomes, Tomi F. Akinyemiju, Gurudatta Naik, Kemi Ogunsina, Daniel T. Dibaba, Neomi Vin-Raviv

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: This study examines whether racial disparities in hospitalization outcomes persist between African-American and White women with ovarian cancer after matching on demographic, presentation, and treatment factors.

METHODS: Using data from the Nationwide Inpatient Sample database, 5,164 African-American ovarian cancer patients were sequentially matched with White patients on demographic (e.g., age, income), presentation (e.g., stage, comorbidities), and treatment (e.g., surgery, radiation) factors. Racial differences in-hospital length of stay, post-operative complications, and in-hospital mortality were evaluated using conditional logistic regression models.

RESULTS: White ovarian cancer patients had relatively higher odds of post-operative complications when matched on demographics (OR 1.35, 95% CI …

Calculation Of Resistive Loads For Elastic Resistive Exercises, Kelsey J. Picha, Timothy L. Uhl

Physical Therapy Faculty Publications

Context:

What is the correct resistive load to start resistive training with elastic resistance to gain strength? This question is typically answered by the clinician's best estimate and patient's level of discomfort without objective evidence.

Objective:

To determine the average level of resistance to initiate a strengthening routine with elastic resistance following isometric strength testing.

Design:

Cohort.

Setting:

Clinical.

Participants:

Thirty-four subjects (31±13yrs, 73±17kg, 170±12cm).

Interventions:

The force produced was measured in Newtons (N) with an isometric dynamometer. The force distance was the distance from center of joint to location of force applied was measured in meters to calculate torque …

A Retrospective Cohort Study Of Quickdash Scores For Three Hand Therapy Acute Upper Limb Conditions, Enrique V. Smith-Forbes, Dana M. Howell, Jason Willoughby, Donald G. Pitts, Timothy L. Uhl

Physical Therapy Faculty Publications

Introduction: The QuickDASH is a valid and reliable outcome measure widely used to assess the function and pain in arm, shoulder, and hand disabilities. A recent study introduced a QuickDASH 80% cut point test to gauge patients at risk of poor outcomes. However, the utility of this test has not been validated.

Purpose: To determine typical QuickDASH scores for three upper limb conditions and to test the sensitivity and specificity of the QuickDASH 80% cut point test in predicting patients at risk of poor outcomes.

Methods: This is a retrospective study with a total of 406 patient records for whom …

National Athletic Trainers' Association Position Statement: Evaluation, Management, And Outcomes Of And Return-To-Play Criteria For Overhead Athletes With Superior Labral Anterior-Posterior Injuries, Lori A. Michener, Jeffrey S. Abrams, Kellie C. Huxel Bliven, Sue Falsone, Kevin G. Laudner, Edward G. Mcfarland, James E. Tibone, Charles A. Thigpen, Timothy L. Uhl

Physical Therapy Faculty Publications

Objective: To present recommendations for the diagnosis, management, outcomes, and return to play of athletes with superior labral anterior-posterior (SLAP) injuries.

Background: In overhead athletes, SLAP tears are common as either acute or chronic injuries. The clinical guidelines presented here were developed based on a systematic review of the current evidence and the consensus of the writing panel. Clinicians can use these guidelines to inform decision making regarding the diagnosis, acute and long-term conservative and surgical treatment, and expected outcomes of and return-to-play guidelines for athletes with SLAP injuries.

Recommendations: Physical examination tests may aid diagnosis; 6 tests are recommended …

Effect Of Haptic Feedback On Static Standing Sway, Andrew J. Meszaros, Alyssa Carey, Jessica Hund, Morgan Mccann, Kindra Mcdougall

Student-Faculty Research - College of Physical Therapy

Study Goal: To explore the use of proprioceptive input as a means of attenuating postural sway through the development and implementation of a hands-free device, with the ultimate goal of providing sway-reference haptic input located at the upper trunk and shoulders to determine: Does sway-referenced haptic input improve static standing stability?

Changes In Achilles Tendon Thickness Following A 10-Week Heavy Load Eccentric Exercise Program, Tyler Cuddeford, Marcey Keefer Hutchison, Annika Piros, Jessica London, Andi Maleike, Tiffany Schoonover, Madison Eymann

Student-Faculty Research - College of Physical Therapy

Achilles tendinopathy often presents with increased tendon thickness, lower echogenicity, and decreased stiffness. Interestingly, tendons are also able to adapt their structural and mechanical characteristics in response to loading.

Eccentric exercise for Achilles tendinopathy continues to be the recommended treatment. The majority of individuals with midportion achilles tendinopathy have shown favorable response to eccentric exercise.

Predicting Patients Acceptable Symptom State At Short Term Follow Up Of A Collaborative Primary Care Pt/Md Service, Catherine Vandehaar, Kevin Morikawa, Andrea Mulligan, Amador Marcano, Ceci Gutierrez, Jeff Houck, Daniel Kang, Tyler Cuddeford, Sarah Rahkola

Student-Faculty Research - College of Physical Therapy

Hypothesis: Patient Reported Outcome Tools will predict a patient’s acceptable symptom state (PASS)

Kinetic And Kinematic Analysis Of Male Collegiate Basketball Players With Patella Tendinosis, Dacia Heckendorf, Luke Hammer, Matthew Jeppson, Nicole Jones, Katherine Porter

Student-Faculty Research - College of Physical Therapy

Patellar tendinopathy (PT) occurs in approximately 40% of elite jumping athletes. Players will typically play through the pain; however, if the condition is not successfully treated some are forced to retire from sport. Research has shown that there are no signs of chemical inflammation in the tendon, but rather the presence of a degenerative tendon with collagen disorientation and disorganization.

Physical Activity And Annual Medical Outlay In U.S. Colorectal, Breast And Prostate Cancer Survivors, Alice F. Yan, Yang Wang, Alexander V. Ng

Exercise Science Faculty Research and Publications

Multiple chronic conditions in cancer survivors are highly prevalent and may increase health care costs for both patients and the health care system. Studies of cancer survivors reveal positive effects of physical activity (PA) on reducing risk of cancer recurrence, other chronic conditions, and secondary cancer. Few nationally representative studies have examined how physical activity levels have affected survivors' annual economic burden in the United States.

Leisure-time physical activity data from the National Health Interview Survey was linked to health care expenditure data from the Medical Expenditure Panel Survey data (2008–2012). We calculated per-person annual total medical expenditures for identified …

Mechanisms For The Increased Fatigability Of The Lower Limb In People With Type 2 Diabetes, Jonathon Senefeld, Steven B. Magill, April L. Harkins, Alison R. Harmer, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Fatiguing exercise is the basis of exercise training and a cornerstone of management of type 2 diabetes mellitus (T2D), however, little is known about the fatigability of limb muscles and the involved mechanisms in people with T2D. The purpose was to compare fatigability of knee extensor muscles between people with T2D and controls without diabetes and determine the neural and muscular mechanisms for a dynamic fatiguing task. Seventeen people with T2D (10 men, 7 women: 59.6{plus minus}9.0 years) and 21 age-, BMI- and physical activity-matched controls (11 men, 10 women: 59.5{plus minus}9.6 years) performed 120 high-velocity concentric contractions (1 contraction/3 …

Six-Minute Walk Test Performance In Persons With Multiple Sclerosis While Using Passive Or Powered Ankle-Foot Orthoses, Morgan K. Boes, Rachel E. Bollaert, Richard M. Kesler, Yvonne C. Learmonth, Mazharul Islam, Matthew N. Petrucci, Robert W. Motl, Elizabeth T. Hsiao-Wecksler

Exercise Science Faculty Research and Publications

Objective

To determine whether a powered ankle-foot orthosis (AFO) that provides dorsiflexor and plantar flexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS).

Design

Short-term intervention.

Setting

University research laboratory.

Participants

Participants (N=16) with a neurologist-confirmed diagnosis of MS and daily use of a prescribed custom unilateral passive AFO.

Interventions

Three 6-minute walk tests (6MWTs), 1 per footwear condition: shoes (no AFO), prescribed passive AFO, and portable powered AFO (PPAFO). Assistive devices were worn on the impaired limb.

Main Outcome Measures

Distance walked and metabolic cost of transport were recorded during each 6MWT and …

Collaborative Documentation For Behavioral Healthcare Providers: An Emerging Practice, Suzanne Maniss Ph.D., Lcdc, Ncc, Amanda G. Pruit Lpc

Journal of Human Services: Training, Research, and Practice

This article considers the practice of collaborative documentation (CD) for behavioral healthcare providers; the legislative, technological, and philosophical milieu in which it developed; the attributed benefits for providers and clients; and the peer-reviewed research supporting its use. Collaborative documentation has emerged following significant legislative and technological changes in healthcare delivery and shifts toward client-centered healthcare practices including more shared decision-making between clients and practitioners.

How Much Protein Can The Body Use In A Single Meal For Muscle-Building? Implications For Daily Protein Distribution, Brad Jon Schoenfeld, Alan Albert Aragon

Publications and Research

Controversy exists about the maximum amount of protein that can be utilized for lean tissue-building purposes in a single meal for those involved in regimented resistance training. It has been proposed that muscle protein synthesis is maximized in young adults with an intake of ~ 20–25 g of a high-quality protein; anything above this amount is believed to be oxidized for energy or transaminated to form urea and other organic acids. However, these findings are specific to the provision of fast-digesting proteins without the addition of other macronutrients. Consumption of slower-acting protein sources, particularly when consumed in combination with other …

Concussion Competencies: A Framework For School-Based Concussion Management (Flyer), Arthur C. Maerlender, Jonathan Lichtenstein, Jennifer Parent-Nichols

Center for Brain, Biology, and Behavior: Faculty Publications

This volume grew out of many years of clinical practice, research, and program projects. It is the culmination of more than 50 years of work with kids, brains, and schools. While there is research behind the Competencies and the underlying content, the intent was to create a user-friendly manual that cut across levels of responsibility and care. Concussion Competencies was not intended to be a textbook in the traditional manner; however, the Competencies have been shown to be a useful approach to teaching this material.

This volume is organized around a set of Competencies that have been shown to be …

Manual Physical Therapy And Cervical Joint Position Training For Cervicogenic Dizziness Following Whiplash-Associated Disorder: A Case Report, Melanie Friedman, Kayla Smith

Physical Therapy Collection

Background and Purpose Whiplash is defined as an acceleration-deceleration injury to the neck, which may lead to a variety of immediate and/or prolonged symptoms collectively known as whiplash-associated disorder (WAD). Cervicogenic dizziness is one possible sequalae that may arise from dysfunction within the structures of the cervical spine, disrupting the flow of sensory and proprioceptive feedback. The purpose of this case report is to demonstrate the efficacy of combining manual physical therapy and cervical joint position training on a patient with cervicogenic dizziness status-post motor vehicle accident (MVA).

Case Description A 28-year-old female with a history of MVA and chief …

Manual Therapy Interventions In A Complex Case Of Upper Quarter Symptoms In A Professional Violinist, Paul Howard, Pt, Dpt, Phd, Ocs, Faaompt

Department of Pathology, Anatomy, and Cell Biology Posters

This poster illustrates how knowledge of clinical anatomy, biomechanics, and orthopaedic manual therapy can be applied to the examination and treatment of a violinist.

Exploring The Use Of The Timed Up And Go Test To Identify Patient Fall Risk In An Inpatient Geriatric Psychiatry Unit, Danielle Struble-Fitzsimmons

Seton Hall University Dissertations and Theses (ETDs)

Background: Patient falls during hospitalization influence healthcare costs and quality, and hospitals are mandated to complete fall risk assessments on all patients. Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting, and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these two specific functional tasks, and has been used to predict falls in other geriatric populations, but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine if the TUG is a predictive …

Muscle Activity During Maximal Isometric Forearm Rotation Using A Power Grip, Joseph Scott Bader, Michael R. Boland, Desney Greybe, Arthur J. Nitz, Timothy L. Uhl, David A. Pienkowski

Biomedical Engineering Faculty Publications

This study aimed to provide quantitative activation data for muscles of the forearm during pronation and supination while using a power grip. Electromyographic data was collected from 15 forearm muscles in 11 subjects while they performed maximal isometric pronating and supinating efforts in nine positions of forearm rotation. Biceps brachii was the only muscle with substantial activation in only one effort direction. It was significantly more active when supinating (µ = 52.1%, SD = 17.5%) than pronating (µ = 5.1%, SD = 4.8%, p < .001). All other muscles showed considerable muscle activity during both pronation and supination. Brachioradialis, flexor carpi radialis, palmaris longus, pronator quadratus and pronator teres were significantly more active when pronating the forearm. Abductor pollicis longus and biceps brachii were significantly more active when supinating. This data highlights the importance of including muscles additional to the primary forearm rotators in a biomechanical analysis of forearm rotation. Doing so will further our understanding of forearm function and lead to the improved treatment of forearm fractures, trauma-induced muscle dysfunction and joint replacements.

Aphasia Simulation: A Perspective From The Student And Standardized Patient, Suzanne Moineau, Deb Bennett, Alison Scheer-Cohen

Teaching and Learning in Communication Sciences & Disorders

The aim of the current study was to examine student ability, student and standardized patient perceptions of competency, and student perceptions of effectiveness of simulation methodology for conducting language screenings on individuals with aphasia. Graduate students enrolled in a mandatory course on acquired language disorders (n = 36) completed a variety of simulated learning experiences using videos, high-fidelity manikins, and standardized patients, in preparing them for clinical practice with persons with aphasia. 5-point Likert scales and open-ended survey questions relating to student and standardized patients’ perceptions were administered. Results demonstrated a strong positive perception that simulation promotes student understanding of …

Impact And Perceived Benefits Of A Problem-Based Learning Workshop For Continuing Education In Speech-Language Pathology: A Pilot Study, Megan S. Overby, Heather L. Rusiewicz

Teaching and Learning in Communication Sciences & Disorders

Even though speech-language pathologists (SLPs) must participate in continuing education programs, little is known about the effectiveness of these learning opportunities. This preliminary study provides empirical assessment of the impact of a problem-based learning (PBL) CE activity on SLPs as perceived by themselves and their Instructors. Twenty-five experienced SLPs participated in an intensive multi-day, PBL workshop on childhood apraxia of speech. Significant differences in the SLPs’ self-perceived clinical efficacy between T1 and T2, as well as T2 and T3. At T3, Instructors rated the clinical efficacy of the SLPs as “very good” to “excellent.” Qualitatively, SLPs reported increased confidence, critical …

The Impact Of Body-Weight Supported Locomotor Training In A Toddler With Gmfcs Level V Cerebral Palsy: A Case Study, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

BACKGROUND AND PURPOSE: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) level V present with decreased gross motor function and trunk control that impacts their functional activities and participation in family activities. Research indicates body-weight supported locomotor training (BWSLT) may improve motor control for children with neuromotor disabilities. The toddler years present a window of opportunity for developmental changes. The purpose of this case study was to explore the impact of a 6-week BWSLT intervention on postural control, gross motor function, and quality of life in a young child with cerebral palsy in GMFCS level …

We Are Global Health: A Rejuvenating Perspective, Evan M. Pucillo, Edward C. O'Bryan

Physical Therapy Collection

No abstract provided.

Disability And Physical Therapy Services In Rural Nicaragua: A Pilot Study, Evan M. Pucillo, Edward C. O'Bryan

Physical Therapy Collection

The World Health Organization (WHO) estimates that 15% of the world’s population is living with disability, a large majority of which can be found in developing nations. Previous studies in Nicaragua have investigated the perceptions of disability among caregivers and noted limited access to rehabilitative services. However, the general knowledge and perceptions of physical therapy services in Nicaragua remains unclear. As a result, this pilot study sought to explore the local knowledge and perceptions of disability and physical therapy services and to characterize the sample from a remote area of northwestern Nicaragua. Participants were recruited using convenience sampling during multidisciplinary …

Blood Flow Restriction Training For Chronic Quadriceps Weakness And Atrophy: A Case Report, Tobi Baldwin, Fred Baldwin

Physical Therapy Collection

Background and purpose

The high load and intensity of traditional strength training may not always be appropriate or beneficial for certain patient populations such as the elderly or those with orthopedic injuries. In these cases blood flow restriction training with light resistance has been shown to be effective method of increasing strength and hypertrophy. However, what if traditional strength training is tolerated but not effective for an individual? The purpose of this case report is to describe the use of blood flow restriction training in a recreationally active male who was fully functional but continued with chronic unilateral quadriceps weakness …

Effect Of Stable And Unstable Surfaces On The Serratus Anterior Muscle Activation In A Kinetic-Chain Exercise Among Healthy Adults, Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

PURPOSE/HYPOTHESIS: The stabilizing action of the serratus anterior (SA) muscle is vital in maintaining proper scapulothoracic rhythm.^1,2 Poor activation of SA muscle could lead to many shoulder dysfunctions.^1,3 This warrants for exercises that are best to activate the SA muscle. Kinetic-chain recruitment during exercises has demonstrated increased SA activation due to the myofascial connections between various segments of the body.^4–6 Variation of surfaces during an exercise has been shown to alter the muscle recruitment patterns.^7–9 The primary purpose of this study was to determine if the unstable surface can influence SA muscle activity during the kinetic …

Feasibility And Preliminary Outcomes Of A Standardized Exercise Program In Adults With Down Syndrome: A Pilot Study, Megan Flores, Kristen Barta, Martha Sneary, Germaine Ferreira, Elizabeth Ardolino

Physical Therapy Collection

Purpose/ Hypothesis: Youth with Down Syndrome (DS) have limited participation in physical activity. When compared to their typically developing peers, adults with DS display decreased functional mobility and strength. Exercise has shown to improve the physical fitness, overall health, and quality of life in people with DS. The Lee Silverman Voice Treatment (LSVT® BIG) is an effective treatment approach designed for patients with Parkinson’s disease. The core components of LSVT® BIG include large amplitude movements, sensory calibration, high intensity, and maximum effort while performing the daily exercises. Due to hypotonicity associated with DS, these individuals typically display kyphotic posture, shortened …