Rehabilitation and Therapy Commons^™

An Investigation Of Differential Diagnosis Of Patellofemoral Pain Syndromes, Shannon Marie Buckmier

Physical Therapy Scholarly Projects

Dysfunction of the patellofemoral joint has long been a topic of discussion and debate for caregivers of patients with this syndrome. Various diagnosis related to the patellofemoral joint of the knee have been reported. Patellofemoral pain refers to the clinical presentation of pain in the anterior region of the knee. It is one of the most common musculoskeletal complaints in children, adolescents, and adults. It is a major source of pain and dysfunction in both genders, but is more common in females.

The purpose of this literature review is to help distinguish between several differential diagnosis included as part of …

Guidelines And Benefits For Exercising The Elderly, Nita Farbo

Physical Therapy Scholarly Projects

The population of elderly individuals is continually growing due to advancements in medicine and technology. Several physiological and psychological changes occur throughout the aging process. Regular physical activity is an effective therapy for slowing the aging process and preventing many of the conditions that occur with aging, such as hypertension, coronary artery disease, obesity, diabetes, depression, and anxiety. In addition, the active individual is more independent and functional in his or her activities of daily living compared to the person who remains sedentary. Older individuals who maintain functional levels of flexibility, strength, and cardiovascular endurance are rarely candidates for nursing …

The Effects Of Family Dynamics On Pediatric Intervention, Michelle L. Jung

Physical Therapy Scholarly Projects

The family unit in America is becoming extremely diverse in its composition, perceptions, and capabilities. It is this diversity which challenges professionals to perceive and interact with each family as an unique entity. Most importantly, though, is the influence of family dynamics on the outcomes of therapeutic interventions for children with disabilities. Since the passage of Public Law 99-457, the focus of intervention has moved from treatment of the individual child to services involving the family as a single functioning unit. . Services are then provided to the child and family, as the family needs influence the child's growth and …

Parkinson's Disease: An Exercise Approach To Treatment, Kara Lynn Klosterman

Physical Therapy Scholarly Projects

Parkinson's Disease (PO) is a common neurological disorder affecting elderly people. Patients suffering from PO typically display three cardinal signs: tremor, rigidity, and bradykinesia. As the disease progresses, secondary symptoms develop. These cardinal signs and secondary symptoms decrease the patient's abilities to function during normal daily activity.

Physical therapists are specially trained in the evaluation and treatment of persons with movement disorders such as PD. Research demonstrates success in the treatment of PO when physical therapy services are utilized. Physical therapists educate patients and their families about PD. Via exercise, physical therapists prevent the onset of complications and improve the …

Fibromyalgia: Diagnosis And Management, Janet Mckinnon Rasmusson

Physical Therapy Scholarly Projects

Fibromyalgia is a nonarticular rheumatic disease of unknown origin. It is diagnosed by the presence of widespread pain of more than three months duration and tenderness at 11 or more of 18 tender point sites. Typical symptoms of this syndrome are generalized pain, stiffness, and chronic fatigue due to sleep disturbances. Other uncommon symptoms include headaches, anxiety, depression, irritable bowel syndrome, and numbness. These symptoms become worse with the presence of modulating factors such as weather, stress, fatigue, overexertion, or inactivity.

The purposes of this independent study are to examine the prevalence and demographics of this disorder, discuss the etiology …

Assessment Of Physical Therapy Needs At Third Street Clinic, Susan Wheeldon

Physical Therapy Scholarly Projects

Health care is being provided free of charge at the Third Street Clinic in Grand Forks, North Dakota, for those people who are uninsured or who do not qualify for Medicare or Medicaid. Physical Therapy is not presently offered as a service at the Clinic.

Physical Therapy is part of comprehensive health care. Therapists provide caring and expertise in the areas of neurological rehabilitation, orthopedic/musculoskeletal problems, pediatrics, and work hardening. As volunteers, therapists are involved in providing care at free clinics across the nation.

The Third Street Clinic agreed to have a needs assessment performed to identify those clients who …

The Impact Of Total Hip Replacement, Teri L. Holwerda

Masters Theses

This descriptive, correlational study replicated an investigation by Selman (1989) exploring the effects of Total Hip Replacement (THR) on quality of life to identify adaptation level in the four effector modes of Roy's Adaptation Model: physiologic function, self-concept, role function and interdependence. The convenience sample consisted of 43 subjects with a mean age of 67 electing to undergo primary TBR at one 410-bed midwestern medical center July, 1994 through December, 1994. Subjects were tested prior to undergoing THR and four months postoperatively. The instrument used was the Arthritis Impact Measurement Scales (AIMS) an arthritis-specific, self-administered questionnaire.; Analysis of data revealed …

Women With Physical Disabilities Choosing To Have Children, Alexia Anne Evans

Senior Honors Theses and Projects

Society views women with physical disabilities as being incapable of competent parenting. Many of these women do, however, choose to have children. This paper, in addition to describing common producers of disability in child-bearing aged women, explores the literature concerning the role of mother and how women with physical disabilities fulfill that role. Two women with postpolio were interviewed about their experiences in raising children. The interviews showed themes of reaction to discouragement, impact on mobility, and individual method of compensation. Implications for occupational therapy intervention are drawn

The Effect Of Backward Treadmill Walking On Lower Extremity Kinetics, Scott Billing

Physical Therapy Scholarly Projects

Many physical therapy diagnoses require minimal anterior loading of the knee in their rehabilitation protocols. These include, but are not limited to, tibial plateau fractures, patellofemoral pain, patellar fractures, quadriceps tendinitis, and status post anterior cruciate ligament reconstruction. In the clinical setting, backward walking (BW), or "retro-walking," is often used during the rehabilitation of such diagnoses. We propose backward walking will initiate greater hamstring recruitment due to the kinematics and kinetics of this gait pattern and thereby result in less anterior knee stress. It is the purpose of this research project to determine if hamstring recruitment can increase in a …

Medical Disease And Low Back Pain: The Physical Therapy Evaluation, Heather Lynn Alderson

Physical Therapy Scholarly Projects

The heightened level of autonomy currently experienced by the profession of physical therapy demands that, in addition to identifying and managing movement dysfunctions of the musculoskeletal system, physical therapists be knowledgeable of signs and symptoms which may indicate medical disease. Individuals who present with low back pain (LBP) are commonly seen in the physical therapy clinic. While most often the source of a patient's LBP is of mechanical musculoskeletal origin, a great number of differential diagnoses classified as medical diseases also exist that are capable of precipitating low back pain. The purpose of this independent study is to: (a) outline …

Management Of Spasticity: A Review Of Two Methods Of Medical Intervention, Andrea Grock

Physical Therapy Scholarly Projects

Spasticity is an entity with which physical therapists are quite frequently faced. It is a common phenomenon among individuals who have sustained central nervous system damage. Spasticity is "associated with a wide variety of neurological diagnoses and may have benefits as well as negative qualities. The negative effects can lead to multiple complications which interfere with functions of every day living. Management of spasticity becomes necessary when it ~causes complications or interferes with function. There are several modes of intervention, including conservative physical therapy approaches and/or medical approaches.

The purpose of this independent study is to review two medical methods …

The Continuum Of Care For The Traumatic Brain Injured, Maile M.K. Collado

Physical Therapy Scholarly Projects

Physical therapists play an important role in the rehabilitation and management of the traumatic brain injured (TBI) patient. Physical therapy is accomplished through therapeutic strategies, intervention techniques, and recommendations for placement and discharge. Many times P.T. services are discontinued for various reasons, two of which are loss of reimbursement or the perception that the patient no longer requires P.T. services. Many times, however, services are discontinued due to a lack of awareness of available services.

There is limited research available that follows the TBI patient along the continuum of care towards reintegration into society .. Thus, the purpose of this …

Total Quality Management In Physical Therapy: A Primer For Physical Therapists In Search Of Quality, Brian C. Kittelson

Physical Therapy Scholarly Projects

Total quality management (TQM), a management system first successfully utilized in the manufacturing industry, has gained much popularity in the healthcare industry over the past few years. Books, articles, conferences, workshops, and video tapes that teach health care executives how to utilize TQM in their organizations abound. Unfortunately, resources which specifically apply the TQM philosophy and tools to the practice of physical therapy are few. The purpose of this project is to provide a resource that introduces the philosophy, methods, and tools of TQM with applications to the physical therapy setting.

Chapter one briefly discusses the general history of TQM …

Patient Compliance With Medical Regimens, Stacie R. Lund

Physical Therapy Scholarly Projects

Patient compliance is defined as the patients' following a request, wish, or demand that a health care provider has decided is necessary and beneficial for the improvement of the health of the patient. Oftentimes, though suggestions by providers are in the patient's best interest, patients will instead either disregard what has been told to them or actively go against the suggestions. Certainly, the patient is the manager of his/her own health care program, however, noncompliance is a very common problem. There are several reasons for noncompliance, including the psychological make-up of the patient, the patient's social environment, the nature of …

A Review Of Chronic Lateral Ankle Instability, Marcy K. Narum

Physical Therapy Scholarly Projects

Ankle injuries constitute one of the most common and most frequent injuries affecting the lower extremities, with lateral ligament sprains comprising the majority of the ankle injuries. The development of chronic lateral ankle instability is a relatively common occurrence following an acute ankle sprain. Previously the treatment of chronic lateral ankle instability has been primary surgical intervention, but more recently the initial treatment is shifting toward a conservative approach emphasizing functional rehabilitation of the unstable ankle. Frequently the treatment of recurrent sprains and chronic instability addresses only the symptoms; however, a treatment program addressing the underlying causes of instability needs …

Multiple Sclerosis: A Literature Review, Jody E. Price

Physical Therapy Scholarly Projects

Multiple Sclerosis (MS), a demyelinating disease of the Central Nervous System (CNS), is the most common cause of nontraumatic disability affecting young adults in the United States. The resultant lesions lead to a variety of symptoms which include: weakness, sensory disturbances, visual problems, spasticity, fatigue, and paralysis. There are also a number of psychological and emotional issues that the MS patient must face. The cause of MS remains unknown and the diagnosis is often difficult. The course and severity of the disease varies from patient to patient. There is no known cure or prevention.

Current treatments include drug therapy, physical …

Diagnostic Criteria And Management Of Carpal Tunnel Syndrome, Holly Rogers

Physical Therapy Scholarly Projects

Carpal tunnel syndrome (CTS) is an entrapment neuropathy involving the median nerve as it passes through the carpal tunnel. CTS is widely recognized as the most common of all nerve entrapment syndromes. CTS develops when irritation causes the tendon sheaths passing through the carpal tunnel to swell, constricting the tunnel and compressing the median nerve. Manifestations of CTS are varied, but usually include pain, numbness and weakness of the hand. Incidence of CTS has risen sharply in the past five years. Prevention of CTS and reduction of it's effects appears to be the best solution for this disorder. Physical therapists …

Overview Of The Flaccid Hemiplegic Shoulder Following A Stroke, Tricia R. Pederson

Physical Therapy Scholarly Projects

Stroke may cause long-term disability and impairment in the hemiplegic shoulder. Problems may develop early in the flaccid phase of recovery and complicate the entire rehabilitation process. The etiology and treatment of shoulder complications remains uncertain. Contributing factors include inappropriate handling and positioning, abnormal muscle tone, impaired sensation, and musculoskeletal pathology.

Prevention and treatment of shoulder dysfunction begins with positioning, early range of motion, and education. Physical therapists play an important role in stroke management by administering therapeutic positioning programs, teaching appropriate exercise regimens, and instructing in proper handling techniques.

The purpose of this paper is to review methods being …

Hippotherapy: A Survey Of Therapists Nationwide, Yvette J. Normandin

Physical Therapy Scholarly Projects

The purpose of this study was to survey physical therapists nationwide who are involved with North American Riding for the Handicapped Association (NARHA) certified centers to obtain their perspectives regarding the need for more empirical research and outcome studies, benefits of Therapeutic Horseback Riding, and methods of objective evaluation utilized when determining patient improvement. Of the 261 surveys mailed, 125 (48.8%) were returned with 110 utilized for data interpretation.

Respondents indicated a large need for more empirical research to support therapeutic horseback riding as a treatment method and to facilitate increased acceptance by the medical field in general. Only a …

A Detailed Look At The Innovative Manual Therapy Technique: Strain/Counterstrain, Rochelle Skarperud

Physical Therapy Scholarly Projects

The purpose of the following literature review is to provide the reader with information regarding the manual therapy technique of strain/counterstrain. The review will describe the origin, theory, rationale, and methods associated with the treatment technique of strain/counterstrain. The role of the muscle spindle and trigger point as utilized in the technique are discussed in detail, along with a comparison of strain/counterstrain to similar manual therapy techniques. Several of the techniques discussed are: acupressure, acupuncture, osteopathic manipulation, and muscle energy techniques. To further support the authors' viewpoints, several case studies are presented and reviewed. The general treatment techniques and guidelines …

The Effects Of Supramalleolar Orthoses On The Biomechanics Of The Knee, Foot, And Ankle During Gait: A Single-Subject Design, Jennifer Ruth Stauffer

Physical Therapy Scholarly Projects

Gait deviations are a common problem associated with disorders of movement and posture such as cerebral palsy (CP). Inhibitive casts and ankle-foot orthoses have been used to treat gait deviations in children with CP, but they have not satisfied the needs of children who are able to achieve active dorsiflexion and plantarflexion but lack stability at the subtalar joint. Supramalleolar orthoses (SMOs) were developed to address that need. SMOs, along with physical therapy, have been used to treat children with CP, but little research has been conducted to determine the actual effects of the SMO on lower extremity biomechanics during …

A Literature Review On Wheelchair Products And Fitting, Lee M. Werchau

Physical Therapy Scholarly Projects

Physical therapists are often involved in wheelchair prescription. An important factor when recommending or prescribing a wheelchair is proper fit. Proper wheelchair fitting is critical when attempting to get maximum independence, normalize tone in spastic or low tone clients, as well as decreasing bony deformities and pressure ulcers. Crucial measurements for wheelchair fitting include backrest height and seat width, depth, and height. To assure ultimate independence an individuals mental competence, ROM in upper extremities, cardiopulmonary health, and coordination must be evaluated prior to prescribing a wheelchair. Options to consider are the type of seat cushion, wheelchair frame, peripherals, and safety. …

Occupational Cumulative Trauma Disorders: Prevention And Treatment, Michelle Uyeno

Physical Therapy Scholarly Projects

Cumulative Trauma Disorders (CTDs) consist of a group of musculoskeletal injuries caused by overuse or repetitive strain. The purpose of this Independent Study was to review the literature concerning occupational CTDs, the methods of prevention, and treatment as it related to physical therapy. The most beneficial means of controlling CTDs appear to be taking preventative measures with jobsite analysis and employee education. Treatment is varied and dependent upon the actual diagnosis and causative factor. Therapists may attempt heat or cold modalities, work hardening programs, or manual therapy such as strain-counterstrain. An important aspect to treatment is early intervention. Due to …

A Literature Review Of The Results Of Traditional Versus Accelerated Anterior Cruciate Ligament (Acl) Rehabilitation In Treatment Following Acl Reconstruction, Cara L. Conway

Physical Therapy Scholarly Projects

In recent years, the rehabilitation of the anterior cruciate ligament (ACL) has undergone changes in its protocol. The changes in ACL rehabilitation protocol are due to clinical observations and trends in ACL rehabilitation across the country. The traditional and presently used accelerated ACL rehabilitation programs are not much different in the activities performed as in the time frames when each activity is permitted.

The main purpose of this literature review is to provide material for clinicians to have accurate and recent knowledge of ACL rehabilitation. This knowledge will allow the clinician to provide the best and most beneficial treatment to …

A Review Of The Utilization Of Emg Biofeedback, Jeanine Lee Forsgren

Physical Therapy Scholarly Projects

Electromyographic (EMG) biofeedback is gaining popularity as a treatment modality in physical therapy. It is used in the areas of neurological and orthopedic rehabilitation as well as injury prevention and performance improvement. The use of this modality can aid in the rehabilitation process by identifying weak muscles which need to be strengthened. Physical therapy also utilizes EMG biofeedback to identify and change movement patterns which may contribute to injury through the overuse or incorrect use of various muscles. EMG biofeedback is used to assist the patient in learning how to control muscular movement to correct the problems which are identified. …

An Overview Of Multidirectional Instability Of The Shoulder, Troy Ivesdal

Physical Therapy Scholarly Projects

Multidirectional instability (MOl) of the shoulder is an increasingly recognized clinical entity to physical therapists, yet it remains poorly defined and not fully understood. The clinical importance of correct diagnosis is necessary for rehabilitation and surgical procedures. The purpose of this paper is to address the issue of MOl and its importance in the field of physical therapy.

General anatomy will be presented with attention given to biomechanics which may lead to this pathology. Etiological factors will be discussed including symptoms and proper diagnostic procedures for instability. Finally, treatment of multidirectional instability will be reviewed with a focus on proprioceptive …

A Historical Perspective Of Medical Care Coverage In The United States, Rhonda Noyes

Physical Therapy Scholarly Projects

Reimbursement of medical services by third-party payers is becoming more contingent upon the effectiveness of services at an affordable cost. The push for cost containment brings about the need for the health care professional to have a sound understanding of medical care coverage to provide quality services at an affordable price.

The present coverage of medical care in the united States is largely dependent upon medical benefits offered by employers. In order to understand current trends in medical care coverage and the reliance on employer based coverage, this independent study explores the origins and development of the current medical care …

A Review Of The Sacroiliac Joint With Emphasis On Evaluation And Treatment, Rachele Reber

Physical Therapy Scholarly Projects

Low back pain is a common reason for referral to physical therapy. Although the role of the sacroiliac joint in low back pain remains controversial, many physical therapists frequently evaluate and treat biomechanical lesions of the sacroiliac joint. It is important to have keen evaluation skills to pinpoint the type of sacroiliac joint lesion present. Having a good knowledge and understanding of the anatomy, movement, and function of the joint will aid the therapist to correlate the findings of the evaluation with the proper treatment regimen. The purpose of this independent study is to describe current evaluation techniques, pathological conditions, …

Survey Of Pharmacology Education In Entry-Level Physical Therapy Programs, Daniel C. Weaver

Physical Therapy Scholarly Projects

The purpose of this survey research is to document the current status of education in pharmacology in the curriculum of entry-level physical therapy programs. A questionnaire was sent to the 135 entry-level physical therapy programs located in the United States and accredited by the American Physical Therapy Association. The director or faculty member responsible for pharmacology instruction in 96 (71.1 %) of the entry-level physical therapy programs participated in the five-part survey.

The questionnaire results indicate that nearly all of the program respondents (98.9%) incorporate pharmacology content into existing required courses and/or have in his or her curriculum a required …

Debridement Teaching Aid, Katharine E. Ward

Physical Therapy Scholarly Projects

Physical therapists treat patients with wounds. Debridement is one area of wound care which physical therapists frequently perform. Debridement is a particularly difficult skill to learn in the classroom due to the inability to simulate authentic conditions.

This study is intended to be a debridement teaching aid in the physical therapy classroom and/or the professional setting. Written text discusses the classification, healing, assessment, debridement, and dressing of wounds. Photographs of wounds and wound care clarify the written text.

The purpose of this teaching module is to help students and professional staff feel more comfortable with wound care and debridement upon …