Physical Therapy Commons^™

Play To Win: A Randomized Controlled Trial To Assess The Effects Of Play-Based Training On Upper Extremity Function In Children With Hemiplegia, Vivian London

Honors Scholar Theses

Hemiplegia, or paralysis of one side of the body, is the primary symptom of unilateral cerebral palsy, a subtype of cerebral palsy, the most common movement disorder in children. Standard of care is regular physical and occupational therapy to improve performance in bimanual activities, but conventional therapy can be expensive and draining for caregivers and children, so a need exists for a novel intervention that can take place at home and that is economical for families while being engaging for children. This thesis reports data from a subset of ten children seen as part of a randomized controlled clinical trial …

Sedentary Behavior Modifies The Effect Of Balance Rehabilitation On Balance Discordance In Parkinson’S Disease, Franziska Albrecht, Sarah J. Conklin, Andrew Hooyman, Daniel S. Peterson, Jason K. Longhurst, Erika Franzén

Physical Therapy Faculty Articles and Research

Individuals with Parkinson’s disease (PD) often experience a misalignment between their perceived and actual balance ability, known as balance discordance, which has been associated with falls. We examined whether high-intensity balance and gait training (HiBalance) alters balance discordance in individuals with PD, and whether baseline sedentary behavior influences these changes. A secondary analysis examining pre- to post-intervention discordance changes of two HiBalance clinical trials (N = 97) using linear regression with interactions between sedentary behavior and pre-intervention discordance. The sample included two cohorts: one clinical and one research based. The model including sedentary behavior and its interaction with pre-intervention …

Using Diffusion Mri To Relate Hippocampal Subfield Microstructure To Delayed Verbal Memory In Cognitively Intact Individuals At Genetic Risk For Developing Alzheimer's Disease, Jennapher Lingo Vangilder, Andrew Hooyman, Sasha Hakhu, Kurt G. Schilling, Leland S. Hu, Yuxiang Zhou, Richard J. Caselli, Leslie C. Baxter, Scott C. Beeman

Physical Therapy Faculty Articles and Research

Intervention to delay the onset of Alzheimer's disease (AD) is an important treatment strategy but detecting at-risk individuals before significant disease progression remains challenging. This study evaluates the relationship between hippocampal microstructure and verbal cognition in cognitively intact older adults, focusing on the differences between APOΕ ε4 allele carriers and noncarriers. Participants (n = 41 noncarriers, 33 carriers) over 60 years old (mean ± SD: carriers 71 ± 6.6; noncarriers 71 ± 6.4 years) underwent diffusion-weighted magnetic resonance imaging (dMRI) and volumetric assessments. We assessed hippocampal structure, including microstructure, using Neurite Orientation Dispersion and Density Imaging (NODDI), diffusion tensor …

Discordance Between Actual And Perceived Balance Ability Relates To Quality Of Life And Global Cognition In A Clinical Sample Of Parkinson Patients, Daniel S. Peterson, Jason K. Longhurst, Franziska Albrecht, Joanna Weller, Jennifer Vasquez, Myassar Zarif, Mark Gudesblatt, Andrew Hooyman

Physical Therapy Faculty Articles and Research

Background

Objective

Methods

Interprofessional Collaboration In Inpatient Rehabilitation For Patient With Thiamine Deficiency-Related Sensorimotor And Cognitive Deficits – Case Report, Christina Thomas, Tahreem Hashmi, Joanne Delgado-Lebron, Rania Massad

Journal of Interprofessional Practice and Collaboration

Purpose: We aim to describe the clinical presentation, interprofessional management, and functional outcomes of a patient with thiamine deficiency. Problem: Thiamine deficiency can result in peripheral polyneuropathy and cognitive deficits that limit function and participation. Despite deficits that warrant interprofessional neurorehabilitation, previous reports focus narrowly on medical management. Case: A 36-year-old female was admitted to inpatient rehabilitation with a diagnosis of Guillain Barre. She underwent evaluation by the interprofessional team that revealed cognitive deficits inconsistent with Guillain Barre. Further medical workup identified a thiamine deficiency. Comprehensive treatment included supplementation managed by the physiatrist; promotion of motor learning and neuroplasticity to …

From Fog To Function: An Occupational Therapist's Guide To Evaluating And Treating Cancer-Related Cognitive Impairments, Lauren E. Toner

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Cancer – related cognitive impairment (CRCI) is a common side effect of cancer treatment that interferes with cancer survivors’ occupational performance, independence, and quality of life. Despite its high prevalence, CRCI remains under recognized and inconsistently addressed within oncology care. About 70% of individuals diagnosed with cancer report cognitive changes during or after treatment, yet many do not receive treatment. Occupational therapists are clinically trained to evaluate and treat functional cognition, activities of daily activities, instrumental activities of daily living, and client centered goals, positioning them as key providers in addressing CRCI. However, limited occupational therapy specific resources have hindered …

Biomechanical Effects Of Exercise-Based Interventions In Chronic Nonspecific Low Back Pain: A Systematic Review And Meta-Analysis, Lara De Vecchi Machado

Theses and Dissertations--Kinesiology and Health Promotion

Chronic nonspecific low back pain (CNLBP) is the leading cause of years lived with disability worldwide and represents a complex, multifactorial, and heterogeneous condition. It is characterized by substantial interindividual variability in muscle activation patterns, lumbo-pelvic coordination, and movement strategies. Although exercise is widely recommended as a first-line intervention and its clinical benefits are well established, the biomechanical mechanisms underlying functional improvement remain fragmented in the literature and are rarely synthesized quantitatively.

This dissertation conducted a systematic review with meta-analysis to investigate the biomechanical effects of exercise-based interventions in individuals with CNLBP. A total of 39 studies were included and …

Evaluating The Effect Of Ethnicity And Amyloid On Gait Speed In The Healthy Aging Brain Study-Health Disparities Study, Alexandra M. Reed, Andrew Hooyman, Edward Ofori, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

Background

Many novel Alzheimer's disease (AD) biomarkers have been studied in non-Hispanic White populations, despite Hispanic/Latino adults being 1.5 times more likely to develop AD and receiving a later diagnosis. Equitable, accessible assessments are needed to identify individuals at risk earlier. While cognitive screening monitors early AD signs, neuropsychological tests are often inequitable across ethnicity, race, and other social determinants of health. However, we have shown that performance-based motor assessments may be less susceptible to demographic factors than memory tests, and may be more equitable for screening older adults. Gait speed has been linked to elevated amyloid in non-Hispanic White …

Manual Therapy In Conjunction With Other Multimodal Interventions In A Patient With Chronic Pain And Hypertension: A Case Report, Craig P. Hensley, Renzo Mendoza, Jennifer Ryan, Emmanuel Yung

Physical Therapy Faculty Articles and Research

Chronic pain and hypertension (HTN) are worldwide epidemics that are difficult to manage and frequently encountered as comorbid conditions in patient care. There is a paucity of information regarding the effect that manual therapy has on blood pressure (BP), particularly in those with chronic pain and HTN. This case report describes the management of a patient with chronic pain and HTN. The patient was a 41-year-old female with chronic multisite pain and multiple comorbidities, including HTN. Her BP at the initial evaluation was 147/78 with an oscillated device and 142/82 with a sphygmomanometer in the right arm and 144/80 in …

Finding A Certified Lymphedema Therapist: Access To Lymphedema Treatment In Minnesota, Emma M. Tsai, Linda Koehler

Oncology Rehabilitation in Practice

Introduction

Lymphedema is a progressive disease that leads to chronic swelling. Lymphedema treatment includes complete decongestive therapy (CDT) provided by a certified lymphedema therapist (CLT). Locating CLTs can be difficult for patients and providers. Our aims were to 1) describe a method for assessing accessibility of lymphedema treatment in a specific region, and 2) apply this method to a specific region (Minnesota) to describe the lymphedema care in that region.

Methods

This cross-sectional study searched therapist directories on websites related to lymphedema and lymphatic diseases (e.g. lymphedema training programs, professional associations) to assess the current distribution of CLTs in Minnesota. …

Patient- And Proxy-Reported Outcome Measures For Use In Pulmonary Hypertension: Study Protocol For A Cosmin-Based Systematic Review, Meredith T. Yeung, Melissa Y. Chan

Internet Journal of Allied Health Sciences and Practice

Purpose: Pulmonary hypertension (PH) is a severe and progressive disease that significantly affects patients' physical, emotional, and social well-being. Despite advances in medical therapies, managing PH remains challenging, and the need for practical, patient-centred tools to evaluate therapeutic outcomes is critical. Patient-reported outcome measures (PROM) and proxy-reported outcome measures (proxy ROM) are pivotal in assessing the therapeutic impacts of interventions, including symptom relief, treatment efficacy, and quality of life. However, there has yet to be a comprehensive review of the psychometric properties of these tools in PH, hindering their optimal use in both clinical practice and research. This protocol outlines …

Comparative Long-Term Outcomes Of Cell Therapy And Cardiac Rehabilitation In The Treatment Of Non-Ischemic Dilated Cardiomyopathy, Awrush Sean Namazi, Susrut Dube, Jay Kishor Patel

Rowan-Virtua Research Day

This systematic review explores long-term treatment approaches for non-ischemic dilated cardiomyopathy, comparing cell therapy and cardiac rehabilitation. Cardiomyopathy is characterized by the progressive thinning and deterioration of cardiac muscle and is a significant cause of heart failure. Various treatment modalities have been developed to combat cardiomyopathy and prevent the onset of heart failure, with more recent efforts focusing on cell therapy—particularly allogeneic and autologous stem cell transplants. The efficacy of these novel treatments was compared to more established regimens, particularly cardiac rehabilitation. Studies demonstrate that both treatment modalities are associated with a significant overall improvement in ejection fraction (effect size …

Operating Room Acquired Pressure Injury Prevention, Audrey E. Dillon, Lexi K. Johnston, Grace L. Johnston, Amy N. Cochran

SPARK Symposium Presentations

Our change project focuses on preventing pressure injuries in OR patients using an alternating pressure overlay and gel pad system during surgery and recovery. Pressure injuries cost the healthcare system upwards of $26 billion annually, and surgery patients are at high risk due to prolonged immobility, constant pressure on one area, hemodynamic changes, and excessive moisture. Nurses can play a critical role in reducing healthcare costs and improving patient outcomes by utilizing proper training and outcome tracking. The estimated cost of implementing this system is $37,000, significantly lower than the long-term cost of pressure injuries. Key
stakeholders include nurse managers, …

Respiratory Muscle Training Reduces Painful Swallowing And Opioid Use During Radiation Therapy For Head And Neck Cancer: A Matched Pair Analysis, Andrew D. Ray, Chi-Chen Hong, Nicolas F. Schlecht, Han Yu, Kristopher Attwood, Kent L. Nastiuk, Bryan A. Spinelli, Ann Marie Flores, Hillary Jacobson, Julia Fulfaro, M. Jeffrey Mador, Austin J. Iovoli, Mark K. Farrugia, Anurag K. Singh

Department of Physical Therapy Faculty Papers

BACKGROUND: Patients with head and neck cancer (HNC) receiving radiation therapy (RT) are at increased risk for symptoms of oral mucositis (OM), opioid use, and declines in physical function, outcomes that contribute to increased morbidity and mortality. The study objective was to determine the effects of respiratory muscle training (RMT) on OM and opioid use, as well as functional performance in patients with HNC receiving RT with or without concurrent chemotherapy (CCRT).

METHODS: Patients aged ≥ 18 years of age with stage I to IV HNC being treated with RT or CCRT receiving a home-based respiratory muscle training (RMT) (n …

Two-Year Follow-Up Of Gait And Postural Control Following Initiation Of Recombinant Human Tripeptidyl Intracerebroventricular Enzyme Replacement Therapy In Two Atypical Cln2 Patients, Rahul Soangra, Marybeth Grant-Beuttler, Harriet Chang, Raymond Y. Wang

Physical Therapy Faculty Articles and Research

Neuronal ceroid lipofuscinosis type 2 (CLN2) is a rapidly progressive neurodegenerative disorder leading to premature mortality. Ambulatory CLN2 patients typically receive standard of care treatment through biweekly intracerebroventricular (ICV) enzyme replacement therapy (ERT) involving recombinant human tripeptidyl peptidase 1, known as cerliponase alfa (Brineura^®, Biomarin Pharmaceuticals). This study longitudinally assessed the impact of ICV cerliponase alfa ERT on gait, and postural control across a two-year span in two siblings diagnosed with atypical CLN2 disease. Both participants, ID01 (18 years and 8 months old at enrollment) and ID02 (13 years and 3 months old at enrollment), exhibited symptomatic characteristics …

Computational Approaches For Diagnosing Neurological Impairments And Restoring Functional Movement, Serhii Bahdasariants

Graduate Theses, Dissertations, and Problem Reports (ETD)

Movement is the primary means by which the nervous system converts intention into interaction with the environment. Voluntary limb motion enables standing, walking, reaching, and grasping—actions that underpin self‑care, communication, and economic participation. When diseases or injuries disrupt the pathways that couple neural commands to muscle forces—whether through cortical stroke, spinal cord injury, or peripheral nerve damage—mechanical outcomes such as weakness, loss of coordination, and ultimately reduced mobility emerge. These impairments cascade into secondary complications, increased dependence on caregivers, and diminished quality of life. Quantifying how the lesion alters the mechanics of movement is therefore essential for designing targeted interventions …

Defining The Peripheral Plasticity Of Nociceptive Afferents Following Spinal Cord Injury And Physical Therapy Intervention., Morgan Julianna Forston

Electronic Theses and Dissertations

The focus of this dissertation is to explore the peripheral plasticity of nociceptive afferents following spinal cord injury (SCI) and whether it is exacerbated or induced when physical therapy-based muscle stretching, a therapy we have shown to be detrimental to locomotor recovery in rodents, is implemented post-SCI. Chapter I provides a brief introduction on sensory afferents with particular emphasis on nociceptive afferents and their multifaceted role within the peripheral and central nervous systems. Chapter II describes SCI epidemiology and common sensory related complications that occur in patients as well and pharmaco- and physical therapies that are employed post-SCI. Chapter III …

Discordance Between Balance Ability And Perception Is Associated With Falls In Parkinson’S Disease: A Coordinated Analysis, Jason K. Longhurst, Andrew Hooyman, Merrill R. Landers, Martina Mancini, Erika Franzén, Breiffni Leavy, Hanna Johansson, Daniel Peterson

Physical Therapy Faculty Articles and Research

Background: The congruence or discordance between actual and perceived balance ability has been proposed to be linked to functional outcomes such as falls. However, gaps remain in our ability to quantify discordance, and its relationship to relevant outcomes.

Objective: To investigate a novel quantification of concordance/discordance between balance performance and perception and determine the relationship to falls among people with Parkinson’s disease (PwPD).

Methods: Data from 244 PwPD were aggregated from 5 previously conducted studies. Variables extracted included age, sex, Activities-Specific Balance Confidence scale (ABC; perceived balance), Timed Up and Go (TUG; balance performance), Movement Disorder Society Unified Parkinson Disease …

Examining The Diagnostic Accuracy Of A Novel Performance-Based Test For Alzheimer's Disease Screening, A. M. Reed, K. Duff, L. E. Dibble, S. S. Paul, Andrew Hooyman, S. Y. Schaefer

Physical Therapy Faculty Articles and Research

Affordable, rapid methods for identifying mild Alzheimer’s disease (AD) are needed. A simple, brief performance-based test involving the learning of functional upper-extremity movements has been developed and is associated with AD pathology and functional decline. However, its specificity to AD relative to other neurodegenerative diseases that present with motor impairment is unknown. This study examined whether this novel test could distinguish between 34 participants diagnosed with mild AD (Clinical Dementia Rating Scale = 0.5-1) from 23 participants with mild-to-moderate Parkinson’s disease (PD) (Hoehn & Yahr = 2-3) using Receiver Operating Characteristic analysis of secondary data from two separate clinical trials. …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

A Literature Review Of Current Treatments For The Hypermobility Subtype Of Ehlers-Danlos Syndrome, John Gericke, Mary Zsolway, Chelsea Reyes, Pooja Patel, Saad Ahmed, Julia Hwang, Venkateswar Venkataraman

Rowan-Virtua Research Day

Purpose: The purpose of this study is to compare pharmacologic intervention, neurocognitive therapy, physical therapy, and orthotics in treating the hypermobility subtype of Ehlers-Danlos Syndrome (hEDS) and determine which has the most positive effect on symptoms.

Introduction: Ehlers-Danlos Syndrome is an inheritable connective tissue disorder which results from a genetic mutation that alters the body’s ability to produce collagen. The most common subtype of Ehlers-Danlos Syndrome is hEDS, which leads to hypermobility and hyperextensibility and can cause frequent joint dislocations.

Methods: A review of literature was performed to compare each treatment based on reported results. The types of studies reviewed …

Step Squad Bundle In Older Adults With Multiple Myeloma Hospitalized For An Autologous Stem Cell Transplant, Nadya Panjwani

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Multiple Myeloma (MM) is a hematological malignancy with demographic disparities. MM is a debilitating cancer mainly affecting older adults, with 66% over the age of 70. Additionally, 33% of older patients with MM are frail with weakness, fatigue, slow gait, weight loss, and malnutrition.

PICOTS: The purpose of this Doctor of Nursing (DNP) scholarly project is to implement an evidence-based practice (EBP) change consisting of a Step Squad Bundle that will identify frailty in older patients with MM hospitalized for an Autologous Stem Cell Transplant (ASCT) to reduce morbidity and mortality and increase the chances of a quality of …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Limb Speed Perception Accuracy In Neurodegenerative Disease, Brandmeir Lynn Cheryl

Graduate Theses, Dissertations, and Problem Reports (ETD)

Movement is a fundamental human activity, enabling us to engage with our surroundings. Consequently, a well-operating neuromuscular system is essential for maintaining quality of life. Motion is not only integral for the basic function of daily living, but also plays a significant role in enhancing our physical, mental, and emotional health. The importance of this system becomes abundantly clear when it is compromised, such as with neurodegenerative disease.

Alzheimer’s disease (AD), followed by Parkinson’s disease (PD) are the two most common neurodegenerative diseases that profoundly affect millions of individuals worldwide (Lamptey et al., 2022). Characterized by distinct but sometimes overlapping …

Multi-Site Identification And Generalization Of Clusters Of Walking Behaviors In Individuals With Chronic Stroke And Neurotypical Controls, Natalia Sánchez, Nicolas Schweighofer, Sara J. Mulroy, Ryan T. Roemmich, Trisha M. Keshar, Gelsy Torres-Oviedo, Beth E. Fisher, James M. Finley, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Background

Objectives

Methods

Lifelong Fitness In Ambulatory Children And Adolescents With Cerebral Palsy I: Key Ingredients For Bone And Muscle Health, Noelle G. Moreau, Kathleen M. Friel, Robyn K. Fuchs, Sudarshan Dayanidhi, Theresa Sukal-Moulton, Marybeth Grant-Beuttler, Mark D. Peterson, Richard D. Stevenson, Susan V. Duff

Physical Therapy Faculty Articles and Research

Physical activity of a sufficient amount and intensity is essential to health and the prevention of a sedentary lifestyle in all children as they transition into adolescence and adulthood. While fostering a fit lifestyle in all children can be challenging, it may be even more so for those with cerebral palsy (CP). Evidence suggests that bone and muscle health can improve with targeted exercise programs for children with CP. Yet, it is not clear how musculoskeletal improvements are sustained into adulthood. In this perspective, we introduce key ingredients and guidelines to promote bone and muscle health in ambulatory children with …

Lifelong Fitness In Ambulatory Children And Adolescents With Cerebral Palsy Ii: Influencing The Trajectory, Susan V. Duff, Justine D. Kimbel, Marybeth Grant-Beuttler, Theresa Sukal-Moulton, Noelle G. Moreau, Kathleen M. Friel

Physical Therapy Faculty Articles and Research

Physical activity of at least moderate intensity in all children contributes to higher levels of physical and psychological health. While essential, children with cerebral palsy (CP) often lack the physical capacity, resources, and knowledge to engage in physical activity at a sufficient intensity to optimize health and well-being. Low levels of physical activity place them at risk for declining fitness and health, contributing to a sedentary lifestyle. From this perspective, we describe a framework to foster a lifelong trajectory of fitness in ambulatory children with CP (GMFCS I–III) as they progress into adolescence and adulthood, implemented in conjunction with a …

Age And Sex Effects On Superg Performance Are Consistent Across Internet Devices, Andrew Hooyman, Sidney Y. Schaefer

Physical Therapy Faculty Articles and Research

There have been recent advances in the application of online games that assess motor skill acquisition/learning and its relationship to age and biological sex, both of which are associated with dementia risk. While this online motor learning assessment (called Super G), along with other computer-based cognitive tests, was originally developed to be completed on a computer, many people (including older adults) have been shown to access the internet through a mobile device. Thus, to improve the generalizability of our online motor skill learning game, it must not only be compatible with mobile devices but also yield replicable effects of various …

Identifying The Neural Correlates Of Anticipatory Postural Control: A Novel Fmri Paradigm, Jo Armour Smith, Rongwen Tain, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Korinne Henslee, Jesse V. Jacobs, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Altered postural control in the trunk/hip musculature is a characteristic of multiple neurological and musculoskeletal conditions. Previously it was not possible to determine if altered cortical and subcortical sensorimotor brain activation underlies impairments in postural control. This study used a novel fMRI-compatible paradigm to identify the brain activation associated with postural control in the trunk and hip musculature. BOLD fMRI imaging was conducted as participants performed two versions of a lower limb task involving lifting the left leg to touch the foot to a target. For the supported leg raise (SLR) the leg is raised from the knee while the …