Rehabilitation and Therapy Commons^™

Physical Therapy Techniques For Treating Patients With Traumatic Brain Injury (Tbi), Daren M. Flolo

Physical Therapy Scholarly Projects

Traumatic brain injury (TBI) can be devastating. Survivors of TBI and their families face complex needs that challenge physical therapists. To respond to this challenge, physical therapists need specific knowledge in regard to epidemiology, etiology, specialized treatment techniques, and the impact of the TBI on patients and their families.

With improvements in medical technology, the number of children and adults surviving brain injuries has increased. Many of these survivors require specialized training to improve impairments as a result of their injuries.

Physical therapists play a vital role in the evaluation and treatment of the patient with traumatic brain injury. In …

The Role Of Fascia In The Musculoskeletal System, Lori Folkers

Physical Therapy Scholarly Projects

The function of fascia in the human body is poorly understood. This anatomical structure has not been given the clinical significance it may deserve. The purpose of this literature review is to provide a physiological explanation for physical therapy techniques that manipulate fascia. The review is designed to facilitate an understanding of the role of fascia in the' musculoskeletal system.

Physical therapists may deal with musculoskeletal system pathologies on a daily basis. In order for the therapist to utilize soft-tissue techniques, it is necessary to have a working knowledge of the involved structures. Anatomical material is presented to define the …

Nutrition In Rehabilitation, John D. Jr. Haywood

Physical Therapy Scholarly Projects

Diet has been implicated as a risk factor in atherosclerotic cardiovascular diseases, cancer, diabetes, osteoporosis, obesity, high blood pressure and chronic liver and kidney diseases. These diseases include almost all of the most common non-traumatic causes of death in the United States. It has been suggested that many physicians do not have the opportunity for specific training in nutrition while in medical school. Many studies have shown that patients admitted to a hospital are at risk of malnutrition and that this risk will increase as length of hospital stay increases. Other studies suggested nutritional deficiencies may result in delayed wound …

A Review Of The Causes And Treatment Of Low Back Pain During Pregnancy, Dana Krenzel

Physical Therapy Scholarly Projects

Pregnancy is a time of great musculoskeletal change for a woman. Complaints of low back pain are a very common occurrence at this time. Many women regard this type of pain as a normal adjunct to pregnancy. However, most types of low back pain related to pregnancy are either treatable or avoidable. Mechanical, hormonal, and vascular factors may all contribute to low back pain. Differentiation of these different causes of low back pain is crucial to providing the patient with effective intervention plans. Physical therapists can provide evaluation, treatment, and low back pain management techniques to the expectant mother. Exercise, …

Gait Analysis For The Enhancement Of Aka Gait Patterns, Krista Lausen

Physical Therapy Scholarly Projects

The amputation of a body part is both a physically and psychologically traumatic event for an individual. There are a number of gait deviations that often occur when a person has had a lower extremity amputation, especially when that amputation is above the knee. The entire locomotor mechanism of the body is altered by this change. The person must then adjust ahd relearn how to accommodate for the loss.

This literature review will discuss specific causes of certain gait deviations to determine whether the deviation is due to a musculoskeletal deficit or habit pattern on the part of the patient …

Balance Exercise For Fall Prevention In The Elderly, Lorrina Mcclellan

Physical Therapy Scholarly Projects

Falls are a very common and serious problem in the elderly population. Individuals who fall may suffer from physical trauma, psychological problems, and possible death. In the past, falls were thought to be an unavoidable occurrence that accompanied aging. Research has .recently identified risk factors that may predict those who are at risk for falling. By recognizing and then modifying these risk factors, potential falls may be prevented. Examples of risk factors that occur with aging include visual impairments, vestibular decline, deterioration of muscle strength, decrease in joint flexibility, and the loss of sensation. Natural biological declines may have profound …

Meniscal Substitution: A Literature Review, Kerry L. Muir

Physical Therapy Scholarly Projects

With the increased awareness that meniscectomy results in degenerative changes in the knee joint, research is now aimed at substituting the meniscus that had been previously removed. Surgical attempts at replacing the meniscus include the use of autografts, allografts, and artificial synthetic prosthesis.

This paper will review the available literature regarding each type of meniscal substitute. Surgical procedures, results, and considerations relating to the different substitutes will be examined.

While studies indicate that meniscal transplantation is technically feasible, the long-term results are unknown. More research is necessary to determine if meniscal substitutes can survive for a prolonged time and function …

The Effects Of Botulinum Toxin Injections On Function In Patients With Spasticity, Leann Pippen

Physical Therapy Scholarly Projects

Spasticity can be one of the most challenging problems for patients with neurologic conditions such as cerebral palsy, spinal cord injuries, cerebrovascular accidents, multiple sclerosis, traumatic brain injuries, etc. It can lead to a wide variety of problems including decreased mobility, decreased quality of movement, interference with normal postural reactions, interference with functional activities, and pressure sores. Therefore, the medical community has focused on effective treatments for spasticity which do not produce overwhelming weakness, spasticity, paralysis, fatigue, and/or muscle atrophy. Since the late 1970's, the use of botulinum toxin (BTX-A) injections to decrease spasticity has been investigated.

The purpose of …

A Review Of Bell's Palsy, Jodi Spicer

Physical Therapy Scholarly Projects

Bell's Palsy is an acute unilateral weakness or paralysis of the facial muscles resulting from peripheral facial nerve dysfunction. Bell's Palsy is the most common cause of unilateral facial weakness. Since idiopathic facial paralysis was first diagnosed, several treatment options have been tried in an effort to influence early and full recovery. The role of physical therapy in the treatment of Bell's Palsy is to exercise the muscle in an attempt to keep the denervated muscle healthy while the injured axons regenerate and reinnervate the muscle. The natural course of Bell's Palsy is a spontaneous return of function in 71 …

The Effects Of A Downhill Skiing Program On Standing Balance In Adults And Children With Various Disabilities, Colleen Kavanaugh, Tara Mcnabb, Tami Revett

Masters Theses

The purpose of this study was to assess possible improvements in balance following a downhill ski program at Cannonsburg Ski Area. The 15 subjects' ages ranged from 7-67 and were obtained by a convenience sample of participants in the Cannonsburg Challenged Ski Association. Diagnoses of the participants included cerebral palsy, traumatic brain injury, cerebral vascular accident, hearing impaired, visually impaired, and developmentally disabled.; A pre-test, post-test design was used to assess the participants balance using the functional reach test--yardstick method. Data was analyzed by computer using the Statistical Package for the Social Sciences (SPSS). Using the t-test for paired comparisons, …

Geriatric Knowledge, Attitudes And Interests Of Physical Therapy Alumni Of Grand Valley State University, Elizabeth Johnson

Masters Theses

Gerontologic knowledge, attitudes and interest in working with the elderly were investigated and potential relationships explored. Six years of Grand Valley State University alumni (3 years Bachelor's {dollar}\{lcub} \rm N=63\{rcub}{dollar} and 3 years Master's {dollar}\{lcub} \rm N=84\{rcub} ){dollar} were surveyed. Questionnaires consisted of: a Personal History Questionnaire, to collect demographic data; the Palmore's Facts on Aging Questionnaire Part 2 with a "don't know" option added; and a modified Semantic Differential by Rosencrantz and McNevin. P-values were set at {dollar}\le{dollar}.05 to determine statistical significance. Correlations were also run on the data. Results indicate a fairly high correlation between people who believe …

The Effects Of Contralateral Limb Strength Training On Muscle Atrophy In An Immobilized Upper Extremity, Robin R. Hlavacek

Masters Theses

Four case studies were used to evaluate the effects of three weeks of isokinetic strength training on retarding muscle atrophy in the contralateral casted limb. The non-dominant arm of each subject was immobilized in a long-arm plaster cast. Two subjects participated in an isokinetic strength training program three times per week for three weeks and two subjects were untrained. Each subject was measured for limb circumference and strength before and after casting. Pre- and post-immobilization values were compared within each subject. The results suggest a possible cross transfer effect of strength from the trained limb to the casted limb in …

Exercise Walking For Obesity Management In Older Adult White Women, Mary I. Dallas

Masters Theses

The purpose of this study was to determine if a program of exercise walking would lead to any changes in the level of physical fitness for obese white women, aged fifty and over. Twenty-two women were recruited from three sites located in Holland, Michigan. The ten week program consisted of exercise walking three times a week for forty-five minutes at 60% to 70% maximum heart rate capacity. Subjects' weight, mean percentage of body fat, waist to hip ratio, body mass index, and the step test were found to decrease significantly between the pre- and post-test measures. As a result of …

The Effects Of An Eleven-Week Therapeutic Riding Program On Motor Skills As Measured By The Bruininks-Oseretsky Test Of Motor Proficiency, Angela M. Cripe, Angela A. Schmid

Masters Theses

The purpose of this single-case experimental design study was to determine whether or not therapeutic horseback riding was effective in improving motor skills. The subject was a 7-year-old girl with diplegic cerebral palsy. She participated in a therapeutic riding program for 11 weeks. The Bruininks-Oseretsky Test of Motor Proficiency-Short Form (BOT-SF) was administered a total of seven times (two pretests, three tests during the riding program, and two posttests). Due to the limited number of testing sessions and only having 1 subject, the results of the study are considered inconclusive. However, based on visual analyses of graphs, some improvements in …

Electromyographic Comparison Of Internal And External Obliques Using A Modified Version Of Kendall's Strength Test Positions For Upper And Lower Abdominals, Rebecca A. Currier, Margie L. Johnson

Masters Theses

The purpose of this study was to examine the activity of the internal obliques (upper abdominals) versus the external obliques (lower abdominals) during a modified version of Kendall's upper and lower abdominal strength tests using surface electromyography on adults. The study was not correlated to Kendall's theory due to the necessity to have the internal oblique electrode placed on the anterior abdomen. Twenty-four women and sixteen men participated in the study. All subjects were taught two positions ("easy" and "hard") for both abdominal tests and performed eight trials. A normalized ratio was generated by dividing one "hard" trial by the …

Relationships Among Isokinetic Knee Flexion And Extension Parameters, Three Functional Tests, And Subjective Knee Scores In Acl Reconstructed Patients, Laura Call, Sheryl Chandler

Masters Theses

The purposes of this study were: (1) to investigate the relationships between isokinetically tested quadriceps femoris and hamstring strength, the subjects' self-assessment of knee function, and three functional tests, and (2) to determine the strength and functional differences between the surgical and non-surgical limbs. Subjects included 18 males and 27 females aged 18 to 45 years who had undergone anterior cruciate ligament reconstruction. Knee strength was measured at 180, 300, and 450{dollar}\sp\circ{dollar}/second and normalized to body weight, while functional hop data were normalized to height. Significant differences existed between limbs for the single, triple, and cross-over hops, and all, but …

Effect Of Thirty Second Static Stretch On Hamstring Muscle Flexibility In Subjects Over Age 65, Erin Bloomquist

Masters Theses

The purpose of this study was to determine the effect of a thirty second static stretch on hamstring muscle length in a sample of healthy people over age sixty-five. Twelve individuals between the ages of 65 and 89 were randomly assigned to two groups: a treatment group which performed one repetition of a thirty second static stretch of the hamstrings, one time per day for four weeks, and a control group which did not perform a hamstring stretch. ANCOVA results were calculated as p =.046, implying a significant treatment effect. Overall power was calculated as.541. The results suggest that in …

A Comparison Of The Effectiveness Of Two Modalities In The Treatment Of Delayed Onset Muscle Soreness, Kenneth Newland

Masters Theses

The purpose of this study was to compare the effects of massage and light exercise in alleviating the signs and symptoms of DOMS. Fifteen male and female subjects were recruited. The subjects were divided into two groups. To obtain a DOMS response, each group performed eccentric exercise on a Biodex Isokinetic Dynamometer to both arms. As treatment, one group (N = 7) received massage to one arm and light exercise in the form of upper body ergometry to the other arm. The other group (N = 8) received massage to one arm and light exercise in the form of supine …

The Effect Of Anterior Tibial Translation On Quadriceps Recruitment During An Isometric Squat, Natalie K. Howard, Penny P. Tussing

Masters Theses

The purpose of this study was to determine how closed chain anterior tibial translation (ATT) affected quadriceps femoris recruitment as evidenced by electromyography.; Forty-three healthy subjects performed a unilateral squat under two conditions: anterior tibial force (ATF) and no tibial force (NTF). Two adjustable-height pulleys produced ATF by each pulling with ten percent of body weight in opposite directions on the proximal tibia and distal femur. Electromyographic (EMG) activity of the rectus femoris, vastus medialis, and vastus lateralis was monitored using surface electrodes. Percentage change in EMG area between the two squat conditions was averaged across all subjects and muscles. …

The Physical Therapist's Role In Sexual Education Of People With Spinal Cord Injury During Inpatient Rehabilitation, Karen Ellexson

Masters Theses

The purpose of this study was to explore the physical therapist's role in sexual education of spinal cord injured patients during inpatient rehabilitation. Descriptive data were collected by questionnaire from 72 licensed physical therapists working in CARF accredited inpatient spinal cord injury units. The results indicated that although therapists rated sexual education as an important and appropriate topic in physical therapy, they addressed sexual issues only 46% of the time and initiated these discussions only 30% of the time. Significant correlation was present between the frequency of addressing and initiating discussions of sexuality and the therapists' preparedness and comfort level …

The Effect Of Verbal Commands On Muscle Performance, Lisa M. Marichal, Molly K. Veen

Masters Theses

The purpose of this study was to determine if a relationship exists between voice command intensity and maximum torque production of an isometric muscle contraction. Thirty nine healthy subjects ranging in age from 18-30 participated in this study. The maximum torque production of triceps brachii was measured using a Cybex II+ isokinetic dynamometer in response to varied, tape recorded voice commands. Data was analyzed by a series of analysis of covariance (ANCOVA) and analysis of variance (ANOVA) for an unbalanced incomplete-block crossover trial design. No significance was found between voice intensity and peak torque. Gender was found to impact torque …

Use Of Gum Chewing And Electromyography In The Conservative Treatment Of Unilateral Masseter Muscle Hyperactivity, Marc F. Maday, Ben Rentfrow, Nathan T. Tear

Masters Theses

It is estimated that up to 10% of the American public has some form of Temporomandibular Joint Disorder (TMD), of whom perhaps 5% may seek or need treatment. The purpose of this study is to demonstrate that chewing gum for 5 minutes on the involved side at levels less than maximal contraction will decrease resting muscle tone in the masseter muscle as demonstrated through surface electromyography.; This study examined 40 normal subjects as well as 6 people diagnosed with TMD. The results showed that there was a significant decrease in masseter output after the intervention as measured by EMG in …

The Effect Of Intraarticular Injection Of Morphine Following Knee Arthroscopy, Chandel Dietz

Physical Therapy Scholarly Projects

Postoperative pam IS common following knee arthroscopy and has been typically controlled with opioids, the most popular of which is morphine. Morphine has been traditionally administered by intramuscular, intravenous, or epidural injections. These methods of administering morphine have been very effective in producing prolonged analgesia; however, they have also produce negative central nervous system side effects.

Recent research has suggested administering morphine via intraarticular injections to provide postoperative analgesia without the central nervous system side effects. However, there is little evidence to suggest that this method is effective. Therefore, the purposes of this randomized, double-blinded study were to 1) investigate …

Applications Of Iontophoresis And Phonophoresis, Craig Hahn

Physical Therapy Scholarly Projects

Many different drugs are used topically for treatment by the medical field. The benefit of some of these drugs can be enhanced by the use of ultrasound (phonophoresis) or electric current (iontophoresis). These methods have been used for many years by such disciplines as ophthalmology, dermatology, dentistry as well as physical therapy. With the inherent risks of blood borne pathogens, these methods are a great alternative to the injection of drugs into the system.

The purpose of this paper is to review the literature regarding iontophoresis and phonophoresis and present the results as a guide for the practicing physical therapist. …

The Effects Of Velocity On Force Production Of The Elbow Flexors During Eccentric Isokinetic Muscle Contraction, Tracie Hildre

Physical Therapy Scholarly Projects

The traditional eccentric force-velocity curve illustrates a continuous increase in muscle force production as velocity increases. Recently, this curve has been scrutinized by some researchers who have found a plateau or decline in eccentric force production at the higher velocities. The purpose of this study was to examine the eccentric isokinetic force-velocity curve of the elbow flexor muscles over a broad range of velocities to observe whether it follows the traditional force-velocity curve.

Fourteen healthy female and six healthy male volunteers were tested using. the Kinetic Communicator Dynamometer at velocities of 30, 60, 90, 120, 150, 180, and 210 degrees …

Concentric And Eccentric Isokinetic Normative Ratio Values Of The Quadriceps Muscle In Asymptomatic Knee Subjects, Donna Ho

Physical Therapy Scholarly Projects

Technological advances in isokinetic devices allow the clinician to objectively assess and rehabilitate injuries using concentric and eccentric contractions at different speeds. The purpose of this research project is to establish concentric and eccentric normative ratio values of the quadriceps muscle on the Kinetic Communicator (Kin-Com, Chattecx Corp., Chattanooga, TN) dynamometer. A sample of 19 females and 12 males aged 20-38 (mean for females = 24.32 ± 3.87, mean for males = 27.67 ± 5.80) were tested on the KinCom for maximum concentric and eccentric torque values during knee extension using a 70° range of motion at 90 and 1200/sec. …

Patellofemoral Joint Mechanics And Their Clinical Relevance, William S. Hokanson

Physical Therapy Scholarly Projects

Patellofemoral joint dysfunction is a common ailment affecting one in four of the general population and 30% of the athletic population. Patellofemoral dysfunction may stem from a number of different clinical diagnoses. The most common of these is chondromalacia patella. The term chondromalacia patella, however, refers only to a softening or fissuring of the retropatellar surface of the patella and cannot be used to diagnose all patellofemoral pain. Clinical diagnosis is sometimes very difficult because these patients present with a number of vague and nonspecific signs and symptoms.

The purpose of this literature review is to offer a clear, concise …

An Electromyographic Study Of Back And Lower Extremity Muscle Activity During Plyopress Exercises, A Squat Lift, And A Vertical Jump, Melissa K. James

Physical Therapy Scholarly Projects

The ongoing research in the evolution of athlete training continues to reveal new principles and training designs which strive to heighten athletic performance and maximize athletic ability. One example of the application of such research is the Plyo Press machine, a patented device used in the Frappier Acceleration Program for athletes. This device was specifically designed to combine strength training with plyometrics to enhance speed and dynamic muscle activity without the excessive low back stress of traditional training methods.

As the Plyo Press has been recently designed and incorporated into training programs, no research has yet been conducted on the …

Cardiac Rehabilitation: Patient Recall Of Exercise Guidelines And Implications For Physical Therapists, Mary Jones

Physical Therapy Scholarly Projects

The efficacy of a cardiac rehabilitation program depends on adequate patient compliance. Patients with coronary heart disease and those recovering from heart surgery may have a successful recovery from acute episodes of myocardial infarction or following operation. It must be recognized that they may require long-term supervision and support. The purpose of this study was to identify if diagnosis of myocardial infarction or heart surgery was a determinant of compliance with exercise guidelines once a patient has graduated from a level II cardiac rehabilitation program. A retrospective chart audit was performed for the years 1991-1994. A data sheet was used …

Vestibular Disorders And Rehabilitation, Stephanie Ann Jones

Physical Therapy Scholarly Projects

The management of patients with vestibular disorders is a formidable problem. Many individuals present to their physician with symptoms of loss of balance and dizziness. A major contributor to sustaining proper upright balance, the vestibular system, consists of a complex network of fluid-filled canals and organs which aid in orientation of the head to vertical and provide information on head movements. The vestibular system is also involved in the sensation and perception of motion and position. Peripheral vestibular dysfunctions, which involve the vestibular organs and/or nerve, can produce a variety of signs and symptoms.

Physical therapy is a key discipline …