Rehabilitation and Therapy Commons^™

Range Of Motion And Walking Distances In Subjects With Peripheral Artery Disease, Henamari Ybay

UNO Student Research and Creative Activity Fair

Peripheral artery disease (PAD) is caused by blockages in the lower extremity arteries that results in pain during walking known as claudication. Gait variability has emerged as a functional assessment in older and pathological groups1. A healthy gait pattern demonstrates stride-to-stride fluctuations within a certain range of values.2 This study uses standard deviation (SD) and coefficient of variation (CV) to assess the magnitude of variability in the time series. . We compared variability before and after surgery that restores blood flow to the legs of patients with PAD.. Thirty-nine subjects were recruited from the Veteran’s Affairs Medical Center. The setup …

Role Of Corpus Callosum Integrity In Arm Function Differs Based On Motor Severity After Stroke, Jill Campbell Stewart, Pritha Dewanjee, George Tran, Erin Burke Quinlan, Lucy Dodakian, Alison Mckenzie, Jill See, Steven C. Cramer

Physical Therapy Faculty Articles and Research

While the corpus callosum (CC) is important to normal sensorimotor function, its role in motor function after stroke is less well understood. This study examined the relationship between structural integrity of the motor and sensory sections of the CC, as reflected by fractional anisotropy (FA), and motor function in individuals with a range of motor impairment level due to stroke. Fifty-five individuals with chronic stroke (Fugl-Meyer motor score range 14 to 61) and 18 healthy controls underwent diffusion tensor imaging and a set of motor behavior tests. Mean FA from the motor and sensory regions of the CC and from …

What Is The Contribution Of Ia-Afference For Regulating Motor Output Variability During Standing?, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Motor variability is an inherent feature of all human movements, and describes the system‘s stability and rigidity during the performance of functional motor tasks such as balancing. In order to ensure successful task execution, the nervous system is thought to be able to flexibly select the appropriate level of variability. However, it remains unknown which neurophysiological pathways are utilized for the control of motor output variability. In responding to natural variability (in this example sway), it is plausible that the neuro-physiological response to muscular elongation contributes to restoring a balanced upright posture. In this study, the postural sway of 18 …

Using A Multifaceted Approach To Working With Children Who Have Differences In Sensory Processing And Integration, Stacey Reynolds, Tara J. Glennon, Karla Ausderau, Roxanna M. Bendixen, Heather Miller-Kuhaneck, Beth Pfeiffer, Renee Watling, Kimberly Wilkinson, Stefanie C. Bodison

Occupational Therapy Faculty Publications

Pediatric occupational therapy practitioners frequently provide interventions for children with differences in sensory processing and integration. Confusion exists regarding how best to intervene with these children and about how to describe and document methods. Some practitioners hold the misconception that Ayres Sensory Integration intervention is the only approach that can and should be used with this population. The issue is that occupational therapy practitioners must treat the whole client in varied environments; to do so effectively, multiple approaches to intervention often are required. This article presents a framework for conceptualizing interventions for children with differences in sensory processing and integration …

Exploring The Activity Of Daily Living Of Sexual Activity: A Survey In Occupational Therapy Education, Helene L. Lohman, Alexandra Kobrin, Wen-Pin Chang

Occupational Therapy Faculty Publications

This study aimed to query occupational therapy educators in professional programs in the United States about the amount of time spent addressing sexual activity and the type and depth of education related to sexual activity. The study aims to inform educators about how sexual activity is taught. A cross-sectional survey research design was used with both closed-and open-ended questions. A total of 51 educators participated. An average of 3.5 hr was spent teaching sexual activity. Many of the participants were comfortable teaching sexual activity. However, some reported that sexual activity was often an overlooked topic in occupational therapy curriculum and …

Different States, Common Issues: Moving Mountains One Service At A Time., Suzzanne Freeze, Allison Hall, Stacy Collins, Duane Shumate, Cindy Thomas, Barbara Brent, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

No abstract provided.

Guidepost 1: Individualize Supports For Each Person, Hannah Curren, Oliver Lyons, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Community Life Engagement refers to how people with intellectual and developmental disabilities (IDD) access and participate in their communities outside of employment as part of a meaningful day. (See “What Is Community Life Engagement?” in the box on page 3.) The Community Life Engagement team has been conducting research to identify the elements of high-quality Community Life Engagement (CLE) supports. We have created a series of four Engage Briefs to examine the guideposts in detail.

Effectiveness Of A Home-Based Eccentric-Exercise Program On The Torque-Angle Relationship Of The Shoulder External Rotators: A Pilot Study, Timothy L. Uhl, Thomas Rice, Brianna M. Papotto, Timothy A. Butterfield

Physical Therapy Faculty Publications

Context: The role of the rotator cuff is to provide dynamic stability to the glenohumeral joint. Human and animal studies have identified sarcomerogenesis as an outcome of eccentric training indicated by more torque generation with the muscle in a lengthened position. Objective: The authors hypothesized that a home-based eccentric-exercise program could increase the shoulder external rotators’ eccentric strength at terminal internal rotation (IR). Design: Prospective case series. Setting: Clinical laboratory and home exercising. Participants: 10 healthy subjects (age 30 ± 10 y). Intervention: All participants performed 2 eccentric exercises targeting the posterior shoulder for 6 wk using a home-based intervention …

Clinical Observation On Palipeddone Sustained Release Tablet In The Treatment Of Schizophrenia, Dian-Zhang Xiong, Yu-Ru Yuan, Rong Gao, Qing Wang, Wen-Pin Chang

Occupational Therapy Faculty Publications

Objective of this study was to evaluate the efficacy and adverse drug reactions (ADR) of palipeddone sustained release tablet in the treatment of schizophrenia in outpatients. Outpatients with schizophrenia treated with palipeddone sustained release tablet (observation group)in our hospital from Apr. to Sep. in 2009 were followed up and compared with those treated with risperidone (control group) during the same period. PANSS and TESS were applied to evaluate efficacy and ADR. Results suggest that the cure rates were 42.4% for control group and 49.6% for observation group. The effective rates were 74.8% for control group and 80.3% for observation group …

Utilization Of Postural Control Training To Improve Gait Symmetry And Walking Ability In A Patient Following A Lacunar Stroke: A Case Report, Hannah C. Wilder

Case Report Papers

Background and Purpose: Stroke affects approximately 800,000 people annually and alterations in gait is one of the most noted impairments following stroke. The purpose of this case report is to outline physical therapy (PT) rehabilitation that utilized postural control training, task-oriented training, and visual feedback to address walking ability and functional capacity in a patient following a stroke. Case Description: The patient was a 67-year-old male apple orchard owner three months post a lacunar ischemic stroke affecting the posterior limb of the internal capsule, the basal ganglia, and part of the cerebellum. His initial examination revealed impaired strength, sensation, range …

The Use Of Therapeutic Exercises And Manual Stretching For A Patient Following A Total Knee Arthroplasty (Tka) Revision: A Case Report, Nicholas Cebula

Case Report Papers

Background and Purpose: Total knee arthroplasty (TKA) ranks among the most frequently performed orthopedic procedures in the United States. Approximately 581,000 people undergo TKA annually, and the number of procedures is expected to increase significantly by 2030. The purpose of this case report was to document the potential benefits of prescribed physical therapy (PT) interventions for a patient following TKA revision. Case Description: The patient was a 69-year-old female post her eighth right (R) knee surgery, a TKA revision, due to an aseptic loosening of components from a previously placed artificial joint. The original TKA was eleven years prior. She …

Restoration Of Functional Mobility For A Young Adult Patient Following A Severe Motor Vehicle Accident: A Case Report, Zachary Mercier

Case Report Papers

Background and Purpose: Motor vehicle accidents are a common occurrence causing increased morbidity and possible mortality, thus, increasing lifetime medical costs for those affected. The purpose of this case report is to document the selected patient's response to skilled physical therapy (PT) interventions, ranging from bed mobility tasks to ambulation, following a motor vehicle accident. Case Description: A 20-year-old female was a passenger in a severe motor vehicle versus tree accident with fatalities. The patient suffered multiple fractures throughout her skeleton and spent 20 days in a hospital prior to presenting to the skilled nursing facility. Care included high intensity …

Osteoblast-Derived Fgf9 Regulates Skeletal Homeostasis, Liping Wang, Theresa M. Roth, Marcia J. Abbott, Linh Ho, Lalita Wattanachanya, Robert A. Nissenson

Health Sciences and Kinesiology Faculty Articles

FGF9 has complex and important roles in skeletal development and repair. We have previously observed that Fgf9 expression in osteoblasts (OBs) is regulated by G protein signaling and therefore the present study was done to determine whether OB-derived FGF9 was important in skeletal homeostasis. To directly test this idea, we deleted functional expression of Fgf9 gene in OBs using a 2.3 kb collagen type I promoter-driven Cre transgenic mouse line (Fgf9^{OB −/−}). Both Fgf9 knockout (Fgf9^{OB −/−}) and the Fgf9 floxed littermates (Fgf9^fl/fl) mice were fully backcrossed and maintained in an FBV/N background. Three …

The Recovery Glove System- A Sensor Driven Glove With Interactive Games For Fine Motor Skill Disabilities, Brian Lee, Oscar Ledezma, Jonathan Rey, Nicholas Alvarado, Deborah Won

Biomedical Engineering Western Regional Conference

Hand mobility is commonly impaired in stroke victims. Treatment for hand impairment range from therapist-guided physical exercises to robotically controlled exoskeletons. However, A more effective treatment which actually restores hand mobility is by encouraging patients to carry out hand movements themselves.We have designed an Arduino based hand therapy device in which the user interacts with a computer graphic interface (CGI) game controlled by a glove was embedded with a force sensing resistor (FSR) at each of the fingertips except for the thumb. The interactive therapy guides the user through exercises and provides live, quantitative information by which the stroke patient …

The Effects Of Closed Kinetic Chain And Endurance Exercises On Reducing Pain In A Child With Ehlers-Danlos Syndrome: A Case Report, Linda Duong, Megan Flores

Physical Therapy Collection

Background and Purpose: Ehlers-Danlos syndrome (EDS) is a connective tissue disorder characterized by joint laxity, chronic pain, and joint instability. Often, children with EDS exhibit polyarthralgia and fatigue as their main symptoms. Although physical therapy is a mainstay of treatment for individuals with EDS, evidence is lacking for specific exercises or treatment strategies for management of pain. The purpose of this case report is to describe the effectiveness of closed kinetic chain and endurance exercises on reducing pain in a child with EDS.

Case Description: The child was a 9 year old girl diagnosed with EDS hypermobility type, and …

Experiential Learning Enhances Physical Therapist Student Confidence In Management Of Neurologically-Involved Adults And Children, Kristen Barta, Megan Flores, Anna Edwards

Physical Therapy Collection

Purpose/ Hypothesis: As physical therapy (PT) students advance through an entry-level professional program, clinical decision making skills improve, though self-confidence in treating individuals with neurological impairments does not. One technique to improve PT student self-confidence with this population is the addition of experiential learning opportunities, which uses direct student interaction with community volunteers to simulate clinical application of didactic material. The purpose of this study was to explore the effect of experiential learning using community participants who were neurologically-involved, on PT students’ perceived self-confidence. It was hypothesized that PT students would report greater levels of self-confidence in their neurological …

Effects Of Manual Therapy And Dry Needling Techniques For Managing Hypertonicity In The Male Pelvic Floor: A Case Report, Amy Jane Porter, Suzanne Trotter, Kristen Barta

Physical Therapy Collection

Background: Dry needling is beneficial for decreasing hypertonicity and improving musculoskeletal dysfunction within various tissues of the body. There is limited research using dry needling for pelvic floor hypertonicity. The purpose of this case report is to describe the effectiveness of a multi-modal intervention utilizing dry needling for a 27-year-old male with a hypertonic pelvic floor.

Study Design: Case study with review of literature.

Case Description: This patient was a 27-year-old Caucasian male with a diagnosis of chronic prostatitis/epididymitis. His primary complaint was pain with prolonged sitting in the right testicle. Treatment consisted of dry needling trigger points, myofascial release, …

Normative Data For The Neurocom Sensory Organization Test In Us Military Special Operations Forces., Erin R. Pletcher, Valerie J Williams, John P Abt, Paul M Morgan, Jeffrey J Parr, Meleesa F Wohleber, Mita Lovalekar, Timothy C Sell

College of Science & Mathematics Departmental Research

CONTEXT: Postural stability is the ability to control the center of mass in relation to a person's base of support and can be affected by both musculoskeletal injury and traumatic brain injury. The NeuroCom Sensory Organization Test (SOT) can be used to objectively quantify impairments to postural stability. The ability of postural stability to predict injury and be used as an acute injury-evaluation tool makes it essential to the screening and rehabilitation process. To our knowledge, no published normative data for the SOT from a healthy, highly active population are available for use as a reference for clinical decision making. …

Eccentric Exercise Program Design: A Periodization Model For Rehabilitation Applications, Michael O. Harris-Love, Bryant Seamon, Tomas I. Gonzales, Haniel J. Hernandez, Donte Pennington, Brian Hoover

Exercise and Nutrition Sciences Faculty Publications

The applied use of eccentric muscle actions for physical rehabilitation may utilize the framework of periodization. This approach may facilitate the safe introduction of eccentric exercise and appropriate management of the workload progression. The purpose of this data-driven Hypothesis and Theory paper is to present a periodization model for isokinetic eccentric strengthening of older adults in an outpatient rehabilitation setting. Exemplar and group data are used to describe the initial eccentric exercise prescription, structured familiarization procedures, workload progression algorithm, and feasibility of the exercise regimen. Twenty-four men (61.8 ±6.3 years of age) completed a 12-week isokinetic eccentric strengthening regimen involving …

Department Integration Of A Community Hospital With A Large Urban Teaching Hospital: A Case Report, Jessica Shank, Pt

Jefferson Hospital Staff Papers and Presentations

Purpose/Background

Healthcare is rapidly changing and community hospitals are no longer able to keep up. Accountable Care Organizations (ACOs) are absorbing many of these hospitals. Rehab departments within these facilities are afforded the opportunity to impact the financial bottom line by removing inefficiencies and promoting higher quality patient care. The purpose of this quality improvement initiative was to develop a process to integrate departments focusing on efficiency, patient care, and employee engagement.

State-Dependent And -Independent Effects Of Dialyzing Excitatory Neuromodulator Receptor Antagonists Into The Ventral Respiratory Column, Thomas M. Langer Iii, Suzanne E. Neumueller, Emma Crumley, Nicholas J. Burgraff, Sawan Talwar, Matthew R. Hodges, Lawrence Pan, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Unilateral dialysis of the broad-spectrum muscarinic receptor antagonist atropine (50 mM) into the ventral respiratory column [(VRC) including the pre-Bötzinger complex region] of awake goats increased pulmonary ventilation (V̇i) and breathing frequency (f), conceivably due to local compensatory increases in serotonin (5-HT) and substance P (SP) measured in effluent mock cerebral spinal fluid (mCSF). In contrast, unilateral dialysis of a triple cocktail of antagonists to muscarinic (atropine; 5 mM), neurokinin-1, and 5-HT receptors does not alter V̇i or f, but increases local SP. Herein, we tested hypotheses that 1) local compensatory 5-HT and SP responses to 50 mM atropine …

The Effect Of A Single Bout Of Physical Exertion On Expressive Language And Word Finding In Individuals With Multiple Sclerosis, Marissa A. Barrera

Dissertations, Theses, and Capstone Projects

To date, little research has been conducted on the relationship between fatigue and expressive language among Multiple Sclerosis patients (MS). This study was a response to this knowledge gap. A nonrandom, matched- subject, mixed-factor design model was used with a purposive sample of 17 individuals with MS (five had primary-progressive (PP) MS, and 12 had relapsing-remitting (RR) MS). The research design was subjected to pretesting to ensure validity. Participants were assessed on a range of language tasks after undergoing one bout of cardiovascular exercise (NuStep T5 Recumbent Cross Trainer) and asked to provide a subjective fatigue score. The expressive language …

Cardio-Protection Afforded By Β-Blockade Is Maintained During Resistance Exercise, Alexander V. Ng, Jason M. Conviser, Shawn S. Rockey, D. Paul Thomas

Exercise Science Faculty Research and Publications

Objectives

Whether or not the cardio-protective effect of β-adrenergic blockade is retained during resistance exercise has not been systematically evaluated. Therefore the purpose of this study was to measure selected cardiorespiratory responses to isometric exercise involving hand-gripping, single-leg extension, or double-leg dead-lift, under placebo (control), β₁-selective (atenolol), and non-selective (propranolol) adrenergic blockade conditions.

Design

Eleven young male adults were evaluated in a randomized, double-blinded, repeated measures study design and performed all three exercise modalities at 30% of maximal voluntary contraction under placebo, atenolol and propranolol conditions.

Methods

Heart rate, systolic and diastolic blood pressure, rate-pressure product, oxygen uptake, …

Safety And Improvement Of Movement Function After Stroke With Atomoxetine: A Pilot Randomized Trial, Andrea Ward, Cheryl Carrico, Elizabeth Powell, Philip M. Westgate, Laurie Nichols, Anne Fleischer, Lumy Sawaki

Physical Medicine and Rehabilitation Faculty Publications

Background: Intensive, task-oriented motor training has been associated with neuroplastic reorganization and improved upper extremity movement function after stroke. However, to optimize such training for people with moderate-to-severe movement impairment, pharmacological modulation of neuroplasticity may be needed as an adjuvant intervention.

Objective: Evaluate safety, as well as improvement in movement function, associated with motor training paired with a drug to upregulate neuroplasticity after stroke.

Methods: In this double-blind, randomized, placebo-controlled study, 12 subjects with chronic stroke received either atomoxetine or placebo paired with motor training. Safety was assessed using vital signs. Upper extremity movement function was assessed using Fugl-Meyer Assessment, …

Dual-Task Does Not Increase Slip And Fall Risk In Healthy Young And Older Adults During Walking, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Dual-task tests can identify gait characteristics peculiar to fallers and nonfallers. Understanding the relationship between gait performance and dual-task related cognitive-motor interference is important for fall prevention. Dual-task adapted changes in gait instability/variability can adversely affect fall risks. Although implicated, it is unclear if healthy participants’ fall risks aremodified by dual-task walking conditions. Seven healthy young and seven healthy older adults were randomly assigned to normal walking and dual-task walking sessions with a slip perturbation. In the dual-task session, the participants walked and simultaneously counted backwards from a randomly provided number. The results indicate that the gait changes in dual-task …

Teft Fasi Alpha Test Report, Barbara Gage, Trudy Mallinson, Laurie Lyons, Joyce Maring, Ken Harwood, Anju Paude, Alex Gorsky, Beth Jackson, Pat Rivard, Lisa Gold, Allison Weaver, Kerry Lida

Physical Therapy and Health Care Sciences Faculty Publications

No abstract provided.

Effect Of Life Review On Quality Of Life For Older Adults Living In Nursing Homes, Rene' Wren

Occupational Therapy Collection

Aim: To examine the effects of life review on daily activities, social participation, outlook on life, and perceptions of living in a nursing home measured by life satisfaction and quality of life in older adults.

Method: The study design was a two-phase quasi-experimental pre-post-tests including development and testing of a life review protocol. Nine residents, age ≥65, participated in a life review group once weekly for 6 weeks. Outcomes were analyzed using the Life Satisfaction Index-Z (LSI-Z) and pre-post surveys.

Results: LSI-Z scores improved post-intervention and survey outcomes indicated participation in activities of daily living (ADLs), socialization, …

Research Day Program, 2017, Physical Therapy Department, Arcadia University

Physical Therapy Student Work

Each of the poster presentations and platform sessions summarized in this program represents a collaborative effort between students and faculty in the Physical Therapy Department of Arcadia University, aimed at developing new knowledge to understand mechanisms that inform clinical practice.

Sex Differences In Neuromuscular Fatigability Of The Knee Extensors Post-Stroke, Meghan Kirking, Reivian B. Barillas, Philip A. Nelson, Sandra K. Hunter, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Background and Purpose: Despite the implications of optimizing strength training post-stroke, little is known about the differences in fatigability between men and women with chronic stroke. The purpose of this study was to determine the sex differences in knee extensor muscle fatigability and potential mechanisms in individuals with stroke. Methods: Eighteen participants (10 men, eight women) with chronic stroke (≥6 months) and 23 (12 men, 11 women) nonstroke controls participated in the study. Participants performed an intermittent isometric contraction task (6 s contraction, 3 s rest) at 30% of maximal voluntary contraction (MVC) torque until failure to maintain the target …

Interprofessional Peer Teaching: Physical Therapy Students Teaching Dental Students To Transfer Patients, Kim Dunleavy, Pt, Phd, Ocs, Venita Sposetti, Dmd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Background While the need for interprofessional education (IPE) has been clearly elucidated, (Interprofessional Education Collaborative, 2016), one of the major barriers is the logistical challenge of meeting curricular requirements for all involved. The organization and time required in an already full schedule are often deterrents. Ideal opportunities meet specific program curricular requirements as well as enhancing interprofessional competencies. Interprofessional competencies include developing skills to teach other health care providers about profession-specific skills and enhancing communication across the professions (Bridges, 2011; Interprofessional Education Collaborative, 2016). Active learning techniques have been advocated for adult learners to promote motivation and engagement (Knowles, 1984), …