Rehabilitation and Therapy Commons^™

Motor Unit Recruitment And Amplitude Of Motor Nerve Evoked Muscle Action Potential For The Assessment Ofaxon Loss In Lumbar Radiculopathy, Ta-Shen Kuan, Shiuauun-Ming Chen, Yen-Chun Wu, Tse-Chieh Hsueh, Chang-Zern Hong

Rehabilitation Practice and Science

Retrospective review of electromyographic (EMG) reports on 98 patients with clinical diagnosis of lumbar radiculopathy was performed to assess the correlation between the mean motor unit recruitment (MUR) of L5 and/or S1 innervated muscles and amplitude of compound muscle action potential (A-CMAP) in motor nerve conduction study (MNCS) of peroneal or tibial nerves. MUR was measured as the ratio of motor units to the number of firing motor units in 4 scales (from 0 to 3: 0= no motor unit potential recorded; 1= a ratio greater than 15; 2 = a ratio between 5 and 15; and 3 = a …

Phrenic Nerve Conduction Study In Male Patients With Cervical Spinal Cord Injury, Chia-En Lee, Mei-Yun Liaw, Pao-Tsai Cheng, May-Kuen Wong, Fuk-Tan Tang, Menz-Chin Lin

Rehabilitation Practice and Science

phrenic nerve paralysis. For analysis influence of different level of C-SCI on phrenic nerve conduction study, we collected 51 cases including 35 cervical spinal cord injury (C-SCI) patients and 16 normal controls in this study. The patients were divided into the group A with C-SCI level above or at C4 (N=18), group B with C-SCI level below or at C5 (N=17)and group C with normal control subjects (N=16).The phrenic nerve was stimulated at the supramaximal level and the onset latency, amplitude and duration of compound muscle action potential (CMAP) were analyzed. The results are as followed : (1) The CMAP …

Study On Disease Study On Disease Classification Of Rehabilitation Patients In Eight Hospitals At Northern And Western Taiwan, Ru-Lan Hsieh, I-Nan Lein, Lin-Fan Hsieh, Yau-Wai Wai, Mei-Hue Hsu, Yueh-Jin Chou, Shih-Ching Chen, Kwang-Hwa Chang, Long-Yang Chu, Wen-Chung Lee

Rehabilitation Practice and Science

In order to obtain the information of disease classification of rehabilitation patients, we conducted disease recording at eight different hospitals in north and east parts of Taiwan for one year. Musculoskeletal disorder was the most common disease which accounts for more than half of total patients (51%) and it was also the most common disease in outpatients, whereas cerebral vascular disease was the most common disease in inpatients.Traumatic brain injury, spinal cord injury, cardiac disease and chronic obstructive pulmonary disease were also common in inpatients. In our study, cancer accounts for only 1% of total patients. As regards to the …

Low Power Laser In The Treatment Of Carpal Tunnel Syndrome, Yueh-Jin Chou, Lin-Fen Hsieh

Rehabilitation Practice and Science

32 subjects were enrolled in this study, all were diagnosed by clinical symptoms and signs and showed electrophysiological evidence of carpal tunnel syndrome. Low power laser treatment were applied to these subjects for 12 weeks(36 sessions).The results revealed the number of subjects with (1)numbness sensation decreased from 30(94%) to 16(50%)(2)pain sensation decreased from 7(22%) to 2 (7%) (3)night discomfort from 12(40%) decreased to 5(15%) (4) Tinel's sign decreased from 16(50%) to 5 (15%) (5) positive Phalen's test decreased from 10( 31%) to 9(28%); all except Phalen's test revealed statistical significance. In the part of electrophysiological study, (1) distal motor latency, …

Clinical Investigation Of A New Design Standing Balance Training Device With Biofeeedback-A Preliminary Report, Jung-Kun Kuo, Alice M. K. Wong, Ming-Yih Lee, Fuk-Tan Tang

Rehabilitation Practice and Science

For the patient with neurological damage of central nervous system, such as CVA or head injury, standing balance training is very important before walking and self-care training. Stance symmetry in hemiplegic patients had been reported to be significantly related to measurement of severity and length of stay.The present equipment for standing balance training in occupational therapy is too simple in design and with limited function, lack of self-feedback system, unable to adjust the slope of the training table. A newly standing biofeedback training device including instrumented sensors of weight bearing under dual force plat-form and a real time visual/auditory feedback …

Maximum Acceptable Weight Of Handling In Young Taiwanese Nurses, May-Kuen Wong, Wen-Ko Chiou, Yung-Hui Lee

Rehabilitation Practice and Science

Low back pain and injure are very common in all populations as well as among the nursing personnel. The prevalence of low back pain in nurses of Chang Kung Memorial Hospital of Taiwan was reported at 13.9%. The purpose of this study was to establish the handling capacity of nursing profession in prediction model through arthropometry and muscle strength, to keep the nursing management in employment screening, job design/ redesign and establishment of training programs.Twenty-four young female nurses with age of 22.3±2.4 years old, body height of 157.2±4.6 cm and body weight of 51.7±5.5 kg, attended this study. The equipment …

A Study Of Vocational Rehabilitation In Work Injuries: Factors Influencing Rate Of Return-To-Work In Work-Related Injuries, Mann-Tsong Hwang, Jin-Shin Lai, Yuh Jang, Wen-Sheu Lee, Sheau-Ling Huang, Sheu-Shin Cheng, Tsang-Fai Chu

Rehabilitation Practice and Science

Work-related injuries will cause injured worker's role dysfunction, and result in family economic crisis and national productivity loss. The purposes of this research are to investigate the factors affecting ”return to work” after work-related injuries in order to establish the work hardening program in Taiwan R.O.C. in the future.The subjects of mailed survey were 3752 workers who collected occupational disability compensation between January 1，1991 and December31, 1993.The mail returning rate from the injured workers was 25.3%,913 participants completed the ”Injured Worker's Physical and Psychosocial Adaptation Questionnaire”. The SPSS for WINDOWS was used to describe and analyze the data. The results …

Global Aphasia Without Hemiplegia: Three Casereport, Szu-Fu Chen, Tsan-Hon Liou, Zong-Jing Wang, I-Nan Lien

Rehabilitation Practice and Science

Global aphasia is the most severe form of language disorder. It is characterized by an extensive lesion involving the entire left perisylvian lesion and is usually accompanied by a dense right hemiplegia. However, it may be associated with only minimal and transient motor deficit. Most of the previous reports indicated that embolism was the most possible etiology of global aphasia without hemiplegia.Here we present three patients who acutely developed global aphasia without hemiplegia as a result of stroke. These patients were examined in both acute and chronic stages. Computerized tomography and magnetic resonance imaging studies demonstrated that one patient had …

Sudden Death During Sleep In High Cervical Cord Injury Patients: Two Casereport, Hwa Ting, Tyng-Guey Wang, Chi-Chung Her, Liu-Ing Bih

Rehabilitation Practice and Science

The high cervical cord injury patients,who have respiratory muscle dysfunction because of C3-C5 injury , may develop sudden death during sleep. It is commonly caused by chronic alveolar hypoventilation or air way mucus plugging. As it happens, there are usually rare remarkable clinical symptoms and signs. For individuals with spinal cord injury associated with less than 50% of predicted vital capacity, 24 hours' blood gas monitor always showed nocturnal hypoxemia as well as carbon dioxide retention. Early detection of these disorders is crucial to prevent these patients from sudden death.In this study, we proposed two cases of high cervical cord …

Factors Relating Return To Work After Stroke In Keelung, Pong-Yuen Wong, Hsiu-Feng Liu, Yi-Lung Sun, Yun-Chyi Wang, Ngok-Kiu Chu, May-Kuen Wong

Rehabilitation Practice and Science

Patients following stroke were usually affected physically and psychologically, and the ability of these patients in returning to work had great influences in their self-confidence, personality, and domestic economy. Therefore, in this study, we evaluated for the factors that may be related to return to work of patients following stroke.One-hundred and five stroke patients in Keelung Chang Gung Memorial Hospital from August, 1985 to February, 1994, and had regular follow up at least for six months were included in our study. Factors including age, sex, type of occupation, economic status, education, location of stroke, severity of weakness of extremities, urine …

An Inquiry: The Concept And Application Of Empowerment, Pamela Kay Wheelock

Masters Theses

While empowerment is a dominant concern in mental health care, services often reflect the inadequate use of an empowerment-based frame of reference. This study seeks to enlarge the understanding of empowerment so that more effective services can be established.

Using naturalistic inquiry methodology, this study explores the lived experience of empowerment through direct dialogue with both mental health consumer advocates and mental health occupational therapists. Data were collected and evaluated using a hermeneutic dialectic process. A series of three interviews were done with six respondents.

Analysis of the interviews revealed striking contrasts between the therapists' and advocates' perspectives in relation …

Is The Use Of Life History And Narrative In Clinical Practice Reimbursable? Is It Occupational Therapy?, Janice P. Burke, Stephen B. Kern

Department of Occupational Therapy Faculty Papers

No abstract provided.

Job Accommodation In The Automobile Industry : Addressing The Problem Of Lateral Epicondylitis, Thanigaivel Ashwin Raj

Theses and Dissertations (ETD)

Cumulative trauma disorders are musculoskeletal problems such as carpal tunnel syndrome, rotator cuff tendinitis, and epicondylitis which can affect assembly line workers. The injuries are thought to result from repetitive motions performed under excessive loads in anomalous postures. The project aimed to design, build, install, and evaluate worksite accommodation at the Saturn plant for a worker with right lateral epicondylitis. The goal was to make her fully functional in her original team which required addressing the injurious aspects of the task that caused or aggravated her injury.

A process of observation, interview, and analysis identified “the door mount” operation on …

Subtalar Joint Biomechanics, Tom L. Baumgartner

Physical Therapy Scholarly Projects

Subtalar joint movement is transmitted proximally to the lower extremity and distally to the forefoot during gait. Thus, the entire lower kinetic chain is influenced by abnormal subtalar joint biomechanics. If the subtalar joint is forced to compensate for structural deformities of the foot and leg, various lower extremity injuries are likely to develop. The purpose of this study is to examine the normal and abnormal biomechanics of the subtalar joint. In the process, the clinician will be able to identify various subtalar joint abnormalities and relate these to their respective lower kinetic chain pathologies. By correctly assessing the cause …

Physical Therapy Interventions For Falls In The Elderly, Melanie Benson

Physical Therapy Scholarly Projects

The elderly in America represent a population that is continually growing. As part of the aging process, various changes occur that contribute to falls. Therefore, as the number of elderly people in America increases, the possibility of falls in the elderly also increases.

The consequences of falls in the elderly are significant. Some of the more serious consequences include functional decline, increased medical cost, and death. Therefore, the scope of the problem is clear; strategies to prevent falls and treat those who have fallen are indicated.

The purpose of this independent study is to review the literature pertaining to falls …

The Relationship Between Vertical Jump Scores And Peak Force Measurements Of An Isokinetic Leg Press, David M. Silkey

Physical Therapy Scholarly Projects

This study evaluated potential correlations between related closed kinematic chain strength measurements on a Kin-Com isokinetic machine and a functional strength test. The correlation between standing vertical jump height and isokinetic leg press measurements were statistically analyzed. The following measurements were obtained from 22 subjects (mean age of 24.4 years): a body weight measurement, a vertical jump score, and the force measurements of an isokinetic leg press at 90°/second on each leg. Pearson correlation coefficients were significant (p < .001) when power quotient scores (vertical jump height multiplied by body weight) were compared to leg press results. However, second-order partial correlation coefficients did not find a significance (p > .005) between vertical jump scores and isokinetic leg press results when weight and gender were considered. A significant difference (p < .001) existed between left leg press and right leg press measures. Although isokinetics are useful for lower extremity assessment, this study found that the isokinetic leg press may not be appropriate in determining functional ability.

Functional Electrical Stimulation As A Treatment For Spinal Cord Injuries, Gail Garrett

Physical Therapy Scholarly Projects

Injury of the spinal cord resulting in quadriplegia or paraplegia IS one of the most devastating conditions a person can experience. The majority of these individuals that suffer from a spinal cord injury are young males. The inability to ambulate is generally a major concern for these patients, but there are also degenerative and deconditioning effects of the spinal cord injury which may lead to devastating secondary complications that must be addressed.

Functional electrical stimulation (FES) has been the subject of much research concerning the rehabilitation for patients with spinal cord injury. Functional electrical stimulation is a way to activate …

Shoulder Pain And Subsequent Loss Of Function In Hemiplegic Patients, Kari A. Goetz

Physical Therapy Scholarly Projects

Hemiplegia, caused by a stroke, is one of the most common disorders in which physical therapists are extensively involved in the rehabilitation process. When a stroke occurs, there is damage to the higher centers of the central nervous system resulting in neurologic, unilateral impairment or hemiplegia. The upper extremity is frequently involved and many patients complain of pain, particularly in the shoulder. Etiology and treatment of hemiplegic shoulder pain (HSP) is a challenging symptom that interferes with progressive rehabilitation and the overall quality of life of many patients.

The purpose of this study was to discuss HSP and the subsequent …

Fetal Alcohol Syndrome: Physical Therapy Implications And Treatment Strategies, Mary L. Emerson

Physical Therapy Scholarly Projects

Fetal Alcohol Syndrome (FAS) describes physical and neurological (motor, cognitive, and behavioral) deficits that result from maternal alcohol intake during pregnancy. FAS is the leading cause of mental retardation and birth defects in the U.S., ahead of spina bifida, fragile X syndrome, and down's syndrome. The incidence of FAS increased more than three-fold from 1979 to 1992; this increasing incidence rate, enhances the importance of the Physical Therapists' role in early recognition and intervention of FAS. A review of current F AS research studies, reveals a need for additional resource information on FAS, regarding implications for Physical Therapy and possible …

The Adverse Effects Of Long-Term Corticosteroid Use, Jennifer Ann. Johnston

Physical Therapy Scholarly Projects

Corticosteroids are an often prescribed anti-inflammatory medication. They are used to treat disease processes of every system of the body. Those disease processes or procedures for which corticosteroids are often prescribed are cancer, bone marrow transplants, collagenous diseases (systemic lupus erythematosus), rheumatoid arthritis, leukemia, and anemia.

However, despite the therapeutic benefits of corticosteroids, many adverse effects are possible. Gastrointestinal difficulties, steroid myopathy, hyperglycemia, osteoporosis, impaired cellular immunity, decreased neuropsychological functioning, and avascular necrosis are just a few of the possible adverse effects.

Patients receiving corticosteroids will often be seen by physical therapists for either their primary or secondary diagnoses. Physical …

The Lateral Scapular Slide Test: Is It Valid In Detecting Glenohumeral Impingement Syndrome?, Denise G. Litchfield

Physical Therapy Scholarly Projects

Recent literature has focused on instability of the scapulothoracic joint and on resulting scapular positions. Weakness of the scapular musculature can allow the scapula to slide laterally, leading to abnormal glenohumeral biomechanics and to subsequent shoulder pathology. Kibler1 has described the lateral scapular slide test (LSST) as a method of measuring lateral translation of the scapula. A significant difference between right and left scapular positions, as indicated by a discrepancy of greater than one centimeter side-to-side, may indicate functional scapulothoracic instability. The purpose of this study was to evaluate validity of the LSST, measured in two positions. Modified LSST measurements …

The Use Of Ergogenic Aids In Athletes, Sheri L. Mounteer

Physical Therapy Scholarly Projects

Ergogenic aids are substances purported to enhance athletic performance or improve exercise capacity. The use of ergogenic aids in sports is very widespread. It is common for a physical therapist working in a sports clinic to have patients that are either considering using or using ergogenic aids. Use of these aids by patients being treated might affect the patients' response to treatment. Therapists should be able to recognize the signs of ergogenic aid abuse in individuals under their care, and they should be aware of the side effects of these aids. It is also important for therapists to be able …

Musicians And Performance Related Injuries To The Hand, Leona Pang

Physical Therapy Scholarly Projects

Musicians spend a great amount of energy and time preparing for auditions, competitions, performances, and recitals. The process of developing techniques and learning musical pieces requires practice sessions filled with long hours of repeating musical passages and awkward upper extremity positions. Performance related injuries often result from these conditions. Injuries include joint disorders, musculotendinous disorders, muscle cramps and pain disorders, neurological disorders, and focal dystonia or occupational palsy disorders. Pain, numbness, tingling, muscle cramping, and motor dysfunctions are associated symptoms. If symptoms are ignored and intense performance is continued, the musician can experience tissue damage and permanent loss of function. …

Rural Elderly People's Attitudes And Perceptions About Home Modifications And Assistive Devices, Christine M. Abbott

MUSC Theses and Dissertations

Occupational therapists frequently recommend home modifications and assistive devices to help elderly people remain as safe and independent as possible. Elderly people, however, do not always follow through with such recommendations resulting in unsatisfactory outcomes of occupational therapy. The purpose of this qualitative study was to examine elderly people's attitudes towards home modifications and assistive devices and to determine what they perceived as the barriers and facilitators to using home modifications and assistive devices. Two focus groups were conducted with elderly people in rural Missouri. The main attitudes were (a) determination; (b) positivism, such as feeling fortunate and encouraged; and …

Rehabilitation Treatment Following Total Shoulder Arthroplasty, Debbie Aarhus

Physical Therapy Scholarly Projects

The shoulder is a very complex joint in the human body and, therefore, is easily injured and/or damaged. When conservative methods (pain reducing modalities, exercise, or medication) to treat the injury fail, an alternative method of treatment could be a total shoulder arthroplasty. Corrective surgery alone, however, is not enough. A rehabilitation program involving range of motion and strengthening exercises is fundamental in the successful return of function at the shoulder.

The purpose of this literature review is to provide an overview of shoulder anatomy, surgical procedures of total shoulder arthroplasty, rehabilitation protocols, and outcomes. The information gained from this …

A Review Of Shoulder Impingement Syndrome, Jodee Backhaus

Physical Therapy Scholarly Projects

Shoulder impingement syndrome (IS) is one of the most common shoulder problems seen today in the orthopaedic clinical setting. Patients exhibit symptoms of pain and discomfort due to pathomechanics of increasing pressure under the acromion. Factors related to IS include degeneration of the rotator cuff, vascular insufficiency of the supraspinatus, glenohumeral instability, muscle imbalances, bursitis, and bony impingement.

Impingement syndrome is most often classified as an overuse syndrome, although it can occur from a traumatic episode such as a blow to the shoulder or a fall. The population most affected are those in occupations that require a high number of …

A Review Of Juvenile Rheumatoid Arthritis, Jill C. Ballan

Physical Therapy Scholarly Projects

Juvenile rheumatoid arthritis (JRA) is the most common pediatric rheumatoid disease in North America. and a principle cause of childhood disability. The disease course is unremitting in up to a quarter of the children with JRA, and a small percentage will grow-up with severe functional disabilities.. Physical and occupational therapy, along with prescribed drug and orthopedic provisions, are important in the management of JRA. The therapists, and other medical professionals involved, work toward the following goals: decreasing joint inflammation, relieving pain, achieving or maintaining an optimal level of function, and educating the patient and family on the disease course and …

Isokinetic Ratios Of Concentric And Eccentric Work Production Of Internal And External Rotators In A Simulated Throwing Pattern, Deane M. Chinen

Physical Therapy Scholarly Projects

Shoulder internal and external rotators have been the focus of several isokinetic studies. However, an examination of muscular work in a functional pattern has not been investigated. Therefore, the purpose of this study was twofold: 1) to establish normative ratios of concentric to eccentric work of internal and external shoulder rotators respectively, and 2) to provide information on the balance of strength in shoulder rotators during a simulated throwing pattern.

Twenty-seven subjects without shoulder pathology were tested on the KINCOM isokinetic dynamometer. The statistics for the whole group revealed 55% more concentric internal rotation work in relation to eccentric external …

Crossing The Language Barrier In Physical Therapy Practice, Nancy Ann Feist

Physical Therapy Scholarly Projects

Physical therapists provide health care services to a diverse range of patient populations. Members of these populations may differ in language or culture from the therapists who treat them. If a language barrier is present, vital communication is lost, and there is interference with the implementation of effective physical therapy.

Options in overcoming language barriers include a language assistance department, a bilingual staff directory, a telephone interpreter service, and an outside interpreter. Limitations of these options exist that can lead to ineffective treatment.

This project makes one further option available. This option is translated written material and audiotapes. This project …

An Electromyographic And Goniometric Analysis Of The Lower Extremity During Stair Climbing With And Without The Use Of Ez-Steps® In An Elderly Population, Staci L. Fethkenher

Physical Therapy Scholarly Projects

Purpose: EZ-StepsTM is a device that fits into an existing stairwell which decreases the height, or rise, of each step by half. The purpose of this study was to determine if there is a difference in lower extremity muscle activity and knee joint range of motion (ROM) during stair climbing with and without the use of EZ-StepsTM in an elderly population.

Methods: Eight healthy, elderly (aged 65-89 years) male and female subjects volunteered for the study. Surface electromyography (sEMG) was used to assess muscle activity in four lower extremity muscles during stair climbing standard steps and steps installed with EZ-StepsTM. …