Rehabilitation and Therapy Commons^™

Graded Motor Imagery And Pain Neuroscience Education For A Middle-Aged Patient With Chronic Low Back Pain: A Case Report, Brandon Drinan

Case Report Papers

Background and Purpose: Chronic low back pain (LBP), defined as pain that persists for three or more months, is widely considered the leading cause of physical activity limitation and work-related disability in the world. The purpose of this case report was to describe the rehabilitation for a middle-aged male with chronic LBP, emphasizing pain neuroscience education (PNE) and cortical remapping of the brain through Graded Motor Imagery (GMI), with movement being a secondary consideration.

Case Description: The patient was a 51-year-old Caucasian male who suffered a low back injury at work. This was a work-related injury covered under Worker’s Compensation. …

Physical Therapy Management Of Gross Function Loss Following Gunshot Wound To Left Hand: A Case Report, Matthew Freeman

Case Report Papers

Background and Purpose: Nonfatal gunshot emergencies occur regularly within the United States but do not often lead to patients entering outpatient physical therapy clinics for rehabilitation. The complex musculoskeletal injuries which result from gunshot wounds may require prolonged rehabilitative care to best achieve functional outcomes, but clinicians may find a gap in the current literature for guidance. The purpose of this case study is to describe the outpatient rehabilitation treatment interventions for a gunshot wound to the hand, including manual therapy, therapeutic exercise, therapeutic activity, and neuromuscular reeducation.

Case Description: The patient was a 34-year-old, left hand dominant, white male …

Physical Therapy Emphasizing Progressive Weight Bearing And Gait Training Following Chopart Amputation In A Patient With Diabetes: A Case Report, Spenser Lynass

Case Report Papers

Background and Purpose: A Chopart amputation occurs at the Chopart joint that separates the midfoot from the hindfoot and often results from infection secondary to diabetic neuropathy and peripheral vascular disease. Previous studies have examined the associated complications, including the development of equinovarus foot contracture and the corresponding mortality risk. However, little research has been done to establish optimal rehabilitation protocols following surgery. The purpose of this case report was to describe a successful initial outpatient physical therapy intervention program that focuses on progressive weight bearing and gait training for a patient with diabetes who underwent Chopart amputation. Case Description: …

Mobilizations And Strengthening For Radiating Hip And Anterior Knee Pain: A Case Report, Thai Ho

Case Report Papers

Background and Purpose: The most common joint disorder in the United States is osteoarthritis (OA). Knee OA occurs in 10% men and 13% in women aged 60 years or older. Hip instability is commonly defined as hip joint unsteadiness that may cause pain. Joint restrictions and lack of hip strength may be associated with these two conditions. However, there is limited literature on hip strengthening and mobilizations on positive outcomes with hip instability. Therefore, the purpose of this case report was to utilize hip strengthening and mobilizations interventions on a patient with hip instability and knee OA. Case Description: The …

The Challenges Of Exercise Selection For A Post-Operative Patient With Severe Deconditioning And Longstanding Neurogenic Claudication: A Case Report, Madison Lostra

Case Report Papers

Background and Purpose: Lumbar spinal stenosis is an increasingly common diagnosis due to its association with degenerative changes of the lumbar vertebrae and the advancing age of our population. This condition may lead to neurogenic claudication which often results in significant pain and disability. Due to the negative impact on quality of life, surgical intervention is often utilized to reduce symptoms. However, post-surgical management is highly variable. The purpose of this case report was to examine a rehabilitation program used to address functional limitations and reverse impairments in a patient with severe deconditioning due to neurogenic claudication as a result …

Physical Therapy Interventions Via Telehealth For A Child With Developmental Delay During The Covid-19 Pandemic: A Case Report, Julie Sullivan

Case Report Papers

Background and Purpose: During the Covid-19 pandemic of 2020, telehealth became widely used as an alternative delivery method of health care services. Due to its infrequent use prior to the pandemic, there is a gap in knowledge regarding the use of telehealth services for physical therapy (PT) in the pediatric population. The purpose of this case report is to discuss the use of PT telehealth services in pediatrics while describing the PT management of a child with gross motor delays in order to enhance care management in this population.

Case Description: A five-year-old male being treated in outpatient PT transitioned …

Restoring Functional Mobility In A 51-Year-Old Male Post Intramedullary Limb Lengthening Surgery Following Helicopter Crash: A Case Report, Shawn Novella

Case Report Papers

Background and Purpose: The annual incidence of femoral shaft fractures is about 10 per 100,000. When these injuries prompt bone to be resected, limb lengthening surgery may be utilized. However, the surgery takes a toll on the patient’s postoperative functional mobility. There is limited information regarding specific home health rehabilitation programs post surgery. The purpose of the report was to investigate the effect of a comprehensive home health PT program on the patient’s LE functional mobility, post bilateral limb lengthening surgery. Case Description: The case report details a 51-year-old male patient’s traumatic bilateral femoral fractures, osteomyelitis, and intramedullary limb lengthening …

A Systematic Review Of The Effects Of Blood Flow Restriction Training On Quadriceps Muscle Atrophy And Circumference Post Acl Reconstruction, Derek Charles, Ryan White, Caleb Reyes, Drew Palmer

Physical Therapy Faculty Research

Background:

ACL reconstruction often results in an extended period of muscle atrophy and weakness. Blood flow restriction (BFR) training is a technique that has been shown to decrease muscle atrophy in a variety of populations.

Purpose:

The purpose of this systematic review was to analyze the research presented on the effect of blood flow restriction training on quadriceps muscle atrophy and circumference post ACL reconstruction.

Study Design:

Systematic Review

Methods:

Articles were reviewed using the databases Google Scholar, PubMed, and EBSCO. Keywords included blood flow restriction training, ACL reconstruction, and quadriceps.

Inclusion criteria included:

English language, peer-reviewed journals; randomized control …

Mobilizations And Strengthening For Radiating Hip And Anterior Knee Pain: A Case Report, Thai Ho

Case Report Presentations

Research presentation slides:

Background and Purpose: The most common joint disorder in the United States is osteoarthritis (OA). Knee OA occurs in 10% men and 13% in women aged 60 years or older. Hip instability is commonly defined as hip joint unsteadiness that may cause pain. Joint restrictions and lack of hip strength may be associated with these two conditions. However, there is limited literature on hip strengthening and mobilizations on positive outcomes with hip instability. Therefore, the purpose of this case report was to utilize hip strengthening and mobilizations interventions on a patient with hip instability and knee OA. …

Assessment Of Performance Measures, Gait, And Rehabilitation Of A 68- Year Old Female With A Transtibial Amputation: A Case Report, Kellie Guillies

Case Report Presentations

Research presentation:

Background and Purpose: With 1.6 million Americans living with limb loss, transtibial amputations (TTA) are the most common type of below the knee amputations, and may contribute to concomitant musculoskeletal impairments, gait deviations, and decreased community ambulation. The purpose of this report was to describe the use of specific functional outcome measures, gait training with a prosthetic, and physical therapy (PT) intervention for functional mobility of a patient following a TTA. Case Description: The patient was a 68-year old female referred to outpatient PT 3 months following a right TTA. She presented with left lower leg pain and …

Ieat, Vannida Nguyen, Elly Lara, Felicia Markfield, Jesus Aguilar, Joshua Ulloa, Justine Manalo, Richelle Talamantes, Tailar Johnson

Occupational Therapy Student Research

What: iEAT is a meal ordering service and database for school meal distribution, accessible via a smart device.

Why: Interactive way to increase awareness of portion control and appropriate nutrition in an effort to build autonomy in elementary and middle school age children.

Problem Solved: Research indicates that young children are highly susceptible to overeating when given larger portion sizes, eating about 16% more. iEAT addresses proper portion control sizes pertinent to the child’s age. Further, it increases a child’s autonomy and health knowledge when making dietary decisions impacting health outcomes.

How: iEAT’ features an empty plate compartmentalized into five …

Proprioceptive Neuromuscular Facilitation And Overground Gait Training For A Patient Following A Left Central Medullary Stroke: A Case Report, Shelby Stegemann

Case Report Papers

Background and Purpose: Central medullary stroke is a rare type of stroke that is characterized by contralateral hemiplegia sparing the face, contralateral loss of deep sensation, and ipsilateral hypoglossal paralysis. It makes up a small percentage of the types of strokes that affect nearly 795,000 Americans every year. While there has been extensive research on rehabilitation principles for the general treatment of stroke, there has been little research on rehabilitation for patients following a central medullary stroke. The purpose of this case report was to describe a multifaceted intervention program with the emphasis on proprioceptive neuromuscular facilitation (PNF) and overground …

The Creation Of An Algorithm To Assist Survivorship Clinics Identify The Rehabilitation Needs Of Cancer Survivors: An Administrative Case Report, Joseph Connor

Case Report Papers

Background and Purpose: Approximately 40% of cancer survivors have unmet rehabilitation needs. Cancer survivors not receiving rehabilitation care may be due to survivorship clinics struggling to identify which of their survivors are appropriate for rehabilitation. The purpose of this case report was to review the literature and create an algorithm that could assist survivorship clinics with rehabilitation referrals.
Case Description: A survivorship clinic in Maine was attempting to address the lack of a rehabilitation screening process. A survey done by the clinic showed that approximately 40% of their survivors used rehabilitation services. To address this lack of a screening process, …

Restoring Functional Mobility For A Patient Following A Comminuted Patella Fracture Status Post Open Reduction Internal Fixation: A Case Report, Elaina Cosentino

Case Report Papers

Background and Purpose: The patella serves an important role in the protection and biomechanics of the knee joint. A fracture of the patella typically requires surgery and immobilization, which can have detrimental impacts on functional mobility. The purpose of this case study was to document a rehabilitation program following a comminuted patella fracture status post open reduction internal fixation (ORIF).
Case Description: The patient was a 62-year-old female who sustained a comminuted patella fracture following a traumatic fall down the stairs, and underwent ORIF to her right patella. She was prescribed a straight knee immobilizer for eight weeks leaving her …

Inpatient Rehabilitation For A 75-Year-Old Female Following A Left-Sided Pontine Infarct: A Case Report, Marisa Flores

Case Report Papers

Background and Purpose: Although cerebrovascular accidents (CVAs), or strokes, occur often in the United States, only 7% of those strokes affect the pons, an area of the brainstem that provides life-sustaining functions. Due to the rarity of pontine strokes, there is insufficient evidence supporting successful interventions that yield functional benefits for patients admitted to inpatient rehabilitation units (IRU). The purpose of this case report was to examine gait, balance and functional mobility interventions on the restoration of mobility and functional independence of a patient within an IRU.
Case Description: The patient was a 75-year-old female 3 days status post a …

Physical Therapy Interventions Via Telehealth For A Child With Developmental Delay During The Covid-19 Pandemic: A Case Report, Julie Sullivan

Case Report Presentations

Research presentation slides:

Background and Purpose: During the Covid-19 pandemic of 2020, telehealth became widely used as an alternative delivery method of health care services. Due to its infrequent use prior to the pandemic, there is a gap in knowledge regarding the use of telehealth services for physical therapy (PT) in the pediatric population. The purpose of this case report is to discuss the use of PT telehealth services in pediatrics while describing the PT management of a child with gross motor delays in order to enhance care management in this population.
Case Description: A five-year-old male being treated in …

Physical Therapy Management Of Gross Function Loss Following Gunshot Wound To Left Hand: A Case Report, Matthew Freeman

Case Report Presentations

Research presentation slides:

Background and Purpose: Nonfatal gunshot emergencies occur regularly within the United States but do not often lead to patients entering outpatient physical therapy clinics for rehabilitation. The complex musculoskeletal injuries which result from gunshot wounds may require prolonged rehabilitative care to best achieve functional outcomes, but clinicians may find a gap in the current literature for guidance. The purpose of this case study is to describe the outpatient rehabilitation treatment interventions for a gunshot wound to the hand, including manual therapy, therapeutic exercise, therapeutic activity, and neuromuscular reeducation.
Case Description: The patient was a 34-year-old, left hand …

Mckenzie Based Approach For Screening Lumbar Spine In A Patient With A Hamstring Strain: A Case Report, Daniel Diperna

Case Report Presentations

Research presentation slides:

Background and Purpose: The leading cause of musculoskeletal (MSK) disorders globally is low back pain (LBP). Historically, research efforts have been focused on the pathoanatomical causes of LBP. However, recent evidence found a high prevalence of structural abnormalities in the lumbar spine using magnetic resonance imaging (MRI) in asymptomatic patients and it is common that spinal pathology is the true culprit for patients referred to physical therapy (PT) with extremity diagnoses. Therefore, research has shifted to focus on classification systems to group patients based on subjective responses to specific movement patterns. The purpose of this case report …

Neuromuscular Response To A Single Session Of Whole-Body Vibration In Children With Cerebral Palsy: A Pilot Study, Huaqing (Virginia) Liang, Gena Henderson, Jianhua Wu

Physical Therapy Faculty Research

Background Whole-body vibration (WBV) is a relative new intervention paradigm that could reduce spasticity and improve motor function in children with cerebral palsy (CP). We investigated neuromuscular response to a single session of side-alternating WBV with different amplitudes in children with CP.

Methods Ten children with spastic CP aged 7–17 years at GMFCS level I-III participated in this pilot study. Participants received two sessions of side-alternating WBV with the same frequency (20 Hz) but different amplitudes (low-amplitude: 1 mm and high-amplitude: 2 mm). Each session included six sets of 90 s of WBV and 90 s of rest. Before and …

Sensory Approach To Self-Regulation For Adolescent Survivors Of Sex Trafficking: An Occupational Therapist's Perspective, Elyse Harmon

Student Capstone Papers

Adolescent survivors of sex trafficking (SST) are susceptible to being in a continual dysregulated arousal state due to lack of mastery in self-regulation. During the trafficking experience, many adolescent SST experience severe trauma and are deprived of opportunities that foster essential regulatory capacities needed for occupational engagement. The use of sensory-based approaches that focus on addressing arousal dysregulation and the impact it has on occupation is an evidence-based practice grounded in occupational therapy research.

This capstone sought to support community reintegration for adolescent SST through the development of sensory-based programming that fosters self-regulation, a skill necessary for occupational participation. A …

Biomechanical Properties Of Land Based And Shallow Water Wait: A Comparative Review Of Literature, Mostafa Yaghoubi, Philip Fink, Wyatt H. Page, Sarah P. Shultz

International Journal of Aquatic Research and Education

Aquatic locomotion exercises are frequently used in rehabilitation and cross-training for land-based athletes. Hydrostatic pressure, thermal conductivity and drag force affect a person's ability to move; therefore, it is important to understand differences of biomechanical gait in water vs land. This review investigated biomechanical differences between shallow water and land-based exercises. PubMed, Google Scholar, SPORTDiscus and Scopus were searched; 33 studies included walking forward (27), backward (6) and running (6). Electromyographic amplitude was similar or less in submaximal intensity during aquatic gait, in comparison to on land. At maximal intensities, however, the amplitude was similar (n=5) or higher (n=4) in …

Validation Of An Inertial-Measurement-Unit System For Calculating Hip And Knee Flexion Angles During Gait, Joonsun Park

Master's Theses

Technological advances regarding Inertial Measurements Units (IMUs) have positioned this type of sensor as an alternative for camera-based motion capture. This study introduces a new IMU based system (IMU_sys) to measure hip and knee flexion angles. PURPOSE: To validate the use of a five-sensor IMU_sys for the measurement of knee and hip flexion angles during gait in adults and pediatrics at two different time points. METHODS: Bilateral hip and knee flexion patterns (LH, RH, LK, and RK) of twenty-two healthy participants (12 adults and 10 pediatric) between the ages of 8 – 35 years were investigated. Participants …

Clinical Update For Physical Therapists: Coagulopathy And Covid-19, Kathleen M. Lukaszewicz, Ellen Hillegass, Michael Puthoff, A. Kate Macphedran

Physical Therapy Faculty Research and Publications

Physical therapists have a unique role in both prevention of venous thromboembolism (VTE) through the promotion of early mobility and physical activity and diagnosis through discovery of signs and symptoms of VTE. This Perspective updates clinicians on the latest information regarding pathophysiology of coagulopathy associated with COVID-19 and applies VTE clinical practice guidelines to COVID-19 in order to provide guidance on physical therapist management.

Ampakines Stimulate Phrenic Motor Output After Cervical Spinal Cord Injury, L. B. Wollman, Kristi A. Streeter, A. F. Fusco, E. J. Gonzalez-Rothi, M. S. Sandhu, J. J. Greer, D. D. Fuller

Physical Therapy Faculty Research and Publications

Activation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors increases phrenic motor output. Ampakines are a class of drugs that are positive allosteric modulators of AMPA receptors. We hypothesized that 1) ampakines can stimulate phrenic activity after incomplete cervical spinal cord injury (SCI), and 2) pairing ampakines with brief hypoxia could enable sustained facilitation of phrenic bursting. Phrenic activity was recorded ipsilateral (IL) and contralateral (CL) to C2 spinal cord hemisection (C2Hx) in anesthetized adult rats. Two weeks after C2Hx, ampakine CX717 (15 mg/kg, i.v.) increased IL (61 ± 46% baseline, BL) and CL burst amplitude (47 ± 26%BL) in 8 of 8 …

Two Weeks Of Remote Ischemic Conditioning Improves Brachial Artery Flow Mediated Dilation In Chronic Stroke Survivors, Allison S. Hyngstrom, Jennifer Nguyen, Michael Wright, Sergey Tarima, Brian D. Schmit, David D. Gutterman, Matthew J. Durand

Physical Therapy Faculty Research and Publications

Many stroke survivors have reduced cardiorespiratory fitness as a result of their stroke. Ischemic conditioning (IC) is a noninvasive, cost-effective, easy-to-administer intervention that can be performed at home and has been shown to improve both motor function in stroke survivors and vascular endothelial function in healthy individuals. In this study, we examined the effects of 2 wk of remote IC (RIC) on brachial artery flow mediated dilation (FMD) in chronic stroke survivors. We hypothesized that FMD would be improved following RIC compared with a sham RIC control group. This was a prospective, randomized, double-blinded, controlled study. Twenty-four chronic stroke survivors …

In-Season Rehabilitation Program Using Blood Flow Restriction With Therapy For Two Decathletes With Patellar Tendinopathy: A Case Report, Tyler Cuddeford, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background and Purpose: Patellar tendinopathy is an overuse injury experienced primarily by athletes; especially athletes who participate in sports that involve frequent jumping. Therapeutic exercise is the primary conservative treatment for patients with this condition. However, some patients with patellar tendinopathy may be unable to tolerate the loading that occurs during exercise. The use of blood flow restriction (BFR) therapy for patients with patellar tendinopathy may allow the athlete to exercise with a lower load while still experiencing the physiological benefits associated with training at a higher intensity. The purpose of this case report was to detail the outcomes from …

College Students' And Educators' Attitudes Toward Offenders With Mental Illness, Sulema Perales

Theses and Dissertations

The purpose of the present study was to examine college students’ and college educators’ attitudes toward offenders with mental illness (MI). A non-experimental, exploratory research design was used to measure the following variables: demographics characteristics, academic major/teaching discipline, and personal relationships with offenders. Correlational and regression analyses and a one-way analysis of variance were used to analyze the data for 349 college students and 35 college educator participants. The results of the study showed there was a significant relationship between college students’ attitudes toward offenders with MI and students’ academic major. The results also showed significant relationships between college students’ …

Sex Differences In Fatigability Following Exercise Normalised To The Power–Duration Relationship, Paul Ansdell, Jacob Skarabot, Elliott Atkinson, Sarah Corden, Amber Tygart, Kristy M. Hicks, Kevin Thomas, Sandra K. Hunter, Glyn Howatson, Stuart Goodall

Exercise Science Faculty Research and Publications

Due to morphological differences, females demonstrate greater fatigue resistance of locomotor muscle during single-limb and whole-body exercise modalities. Whilst females sustain a greater relative intensity of single-limb, isometric exercise than males, limited investigation has been performed during whole-body exercise. Accordingly, this study established the power–duration relationship during cycling in 18 trained participants (eight females). Subsequently, constant-load exercise was performed at critical power (CP)-matched intensities within the heavy and severe domains, with the mechanisms of fatigability assessed via non-invasive neurostimulation, near-infrared spectroscopy and pulmonary gas exchange during and following exercise. Relative CP (72 ± 5 vs. 74 ± 2% P …

Curricular Influence On Professional Formation In Physical Therapy Students, Chad W. Jackson

Electronic Theses and Dissertations

Professionalism is needed from each healthcare professional to meet the needs of patients, society, and the expectation that the profession has for its members. Professionalism comprises many attributes and is developed explicitly and implicitly over time through a variety of influential factors. Professional formation education should be an intentional emphasis in any professional program. However, in the academic preparation of healthcare professionals, including physical therapists, a lack of consistency exists in professionalism curricula. It does not appear there are published studies that have specifically compared the effect of curricular approaches in physical therapy education on students’ professional formation. The purpose …

Dynamic Body-Weight Support To Boost Rehabilitation Outcomes In Patients With Non-Traumatic Spinal Cord Injury: An Observational Study, Justin P. Huber, Lumy Sawaki

Neurology Faculty Publications

BACKGROUND: Dynamic body-weight support (DBWS) may play an important role in rehabilitation outcomes, but the potential benefit among disease-specific populations is unclear. In this study, we hypothesize that overground therapy with DBWS during inpatient rehabilitation yields greater functional improvement than standard-of-care in adults with non-traumatic spinal cord injury (NT-SCI).

METHODS: This retrospective cohort study included individuals diagnosed with NT-SCI and undergoing inpatient rehabilitation. All participants were recruited at a freestanding inpatient rehabilitation hospital. Individuals who trained with DBWS for at least three sessions were allocated to the experimental group. Participants in the historical control group received standard-of-care (i.e., no DBWS). …