Physical Therapy Commons^™

Physical Therapy Considerations For Chronic Kidney Disease And Secondary Sarcopenia, Michael O. Harris-Love, Haniel J. Hernandez, Gideon Obamwonyi

Exercise and Nutrition Sciences Faculty Publications

Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the …

Analytical Cpg Model Driven By Limb Velocity Input Generates Accurate Temporal Locomotor Dynamics, Sergiy Yakovenko, Anton Sobinov, Valeriya Gritsenko

Faculty & Staff Scholarship

The ability of vertebrates to generate rhythm within their spinal neural networks is essential for walking, running, and other rhythmic behaviors. The central pattern generator (CPG) network responsible for these behaviors is well-characterized with experimental and theoretical studies, and it can be formulated as a nonlinear dynam- ical system. The underlying mechanism responsible for locomotor behavior can be expressed as the process of leaky integration with resetting states generating appropriate phases for changing body velocity. The low-dimensional input to the CPG model generates the bilateral pattern of swing and stance modulation for each limb and is consistent with the desired …

Impact Of An Exercise Program On Stress, Fatigue, And Quality Of Life For Individuals Living With Primary Immunodeficiency Disease, Kerri Sowers

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: There are over 300 Primary Immunodeficiency diseases (PID) that are a result of a genetic or idiopathic dysfunction of any aspect of the immune system. These conditions result in a higher frequency of infections, autoimmune conditions, or malignancies. Moderate intensity exercise is thought to help the immune system, while high intensity exercise may have a negative impact on immune function. The impact of exercise on individuals with an impaired immune system due to PID is not yet understood. Purpose: The purpose of this study was to investigate whether a low to moderate intensity exercise program would have an effect …

Differences In Walking Mechanics Between A Traditional Walker And The Kb Balance Trainer, Silvia Zanini

Electronic Theses and Dissertations

INTRODUCTION: Millions of individuals with ambulatory difficulties rely on walking aids to maintain independence and mobility. However, users of traditional walkers typically exhibit increased forward lean of their trunk while using the assistive device. The KB Balance Trainer is a new posterior walker designed to facilitate a more erect position during gait. PURPOSE: To compare gait mechanics across three walking conditions: unassisted, using a traditional walker, and using the KB Balance Trainer. METHODS: Seven adults with experience using walkers due to ambulatory difficulties participated in the study. The study consisted of one training session and one gait analysis session. The …

Changes In Reach To Eat Movement Control After Intensive Training For Children With Unilateral Cerebral Palsy, Yaching Hung, Aryeh D. Spingarn

Publications and Research

Ya Ching Hung EdD. and Aryeh Spingarn EP-C, CSCS, EIM-Level 2 Queens College, City University of New York Department of Family, Nutrition, and Exercise Sciences, Changes in Reach to Eat Movement Control After Intensive Training for Children with Unilateral Cerebral Palsy. Purpose: The current study compares the effects of an intervention on children with Congenital Hemiplegia during a simple eating task using kinematic analyses. Previous studies looked at simple bimanual tasks such as opening a drawer; no studies examined the effects of intensive training on unimanual reach, grasp, and eat movement control. Methods: 20 children with Unilateral Spastic Cerebral Palsy …

The Effect Of Asymmetry On Pregnancy-Related Pain In The Postpartum Period, Krista G. Meder

Graduate Theses, Dissertations, and Problem Reports (ETD)

Nearly 50% of women experience back pain and other lower extremity pain during pregnancy, with many reporting lasting pain postpartum. Pregnant women experience changes to their pelvis and lower extremities that do not always return to pre-pregnancy baseline. Not much is known of the lingering effects of pregnancy related asymmetry and its relationship to pain. Therefore, the purpose of this study was to assess asymmetries of the pelvis and lower extremities to determine whether malalignment is related to areas of pain at the low back, hip, thigh, knee, leg, and foot/ankle. Methods: Seventeen postpartum women and seven nulliparous controls were …

Muscle Synergy During A Single Leg Standing Test In Ambulatory Children With Cerebral Palsy, Brennan L. Smith

Theses and Dissertations--Kinesiology and Health Promotion

INTRODUCTION: Cerebral Palsy (CP) is a sensorimotor disorder characterized by dysfunctional motor coordination, balance problems, and loss of selective motor control. Motor coordination exhibited as co-contraction, has been subjectively quantified using gait analysis, but recent studies have begun to objectively analyze the amount of co-contraction by collecting electromyography (EMG) data. Center of pressure excursion (COPE) measurements collected during a single leg standing test (SLST) have shown to be more valid measurements of balance in populations with motor disabilities than a SLST alone. A recent study has correlated increased COPE velocity with a lower fall risk as determined by reported fall …

Trunk Postural Balance And Low Back Pain: Reliability And Relationship With Clinical Changes Following A Lumbar Stabilization Exercise Program, Ali Shahvarpour, Dany H. Gagnon, Richard Preuss, Sharon M. Henry, Christian Larivière

Études primaires

Lumbar stabilization programs reduce pain and disability, but the mechanisms of action underlying this treatment are unknown. Trunk postural control during unstable sitting represents a surrogate measure of motor control mechanisms involved to maintain the dynamic stability of the spine. This exploratory study aimed to determine the reliability of trunk postural control measures over an 8-week interval, their sensitivity to low back pain status and treatment and their relationship with clinical outcomes. Trunk postural control measures were determined in patients with low back pain before and after an 8-week lumbar stabilization exercise program. Healthy controls were assessed over the same …

The Effect Of Wearing A Lumbar Belt On Biomechanical And Psychological Outcomes Related To Maximal Flexion-Extension Motion And Manual Material Handling, Ali Shahvarpour, Richard Preuss, Michael J.L. Sullivan, Alessia Negrini, Christian Larivière

Études primaires

Workers with low back pain (LBP) may benefit from wearing a lumbar belt (LB), but the biomechanical and psychological mechanisms involved are not fully understood. Two types of flexible LB (extensible and non-extensible) were compared to a control condition (no LB) regarding pain-related (pain, fear of pain and catastrophizing) and biomechanical (range of motion – ROM) outcomes related to two tasks: maximal trunk flexion-extension and manual material handling. Healthy controls and participants with LBP were tested. During both tasks, the two LBs reduced the lumbar ROM in participants with LBP in the same way as healthy controls. This was observed …

Virtual Reality As A Training Tool To Treat Physical Inactivity In Children, Adam W. Kiefer, David Pincus, Michael J. Richardson, Gregory D. Myer

Psychology Faculty Articles and Research

Lack of adequate physical activity in children is an epidemic that can result in obesity and other poor health outcomes across the lifespan. Physical activity interventions focused on motor skill competence continue to be developed, but some interventions, such as neuromuscular training (NMT), may be limited in how early they can be implemented due to dependence on the child’s level of cognitive and perceptual-motor development. Early implementation of motor-rich activities that support motor skill development in children is critical for the development of healthy levels of physical activity that carry through into adulthood. Virtual reality (VR) training may be beneficial …

Exercise, Cognition, And The Aging Process Among Active, Competitive, And Sedentary Middle-Aged And Older Adults, Katherine Adams

Health, Human Performance and Recreation Undergraduate Honors Theses

Purpose This study aimed to compare the cognitive measures of reaction time and dual-task performance among recreationally active, master athletes, and sedentary older adults aged 50 years or older. Methods 59 late middle-aged and older adults between the ages of 50 to 88 years old participated in reaction time and dual-task tests of which consisted of multiple trials on the same day. Subjects were placed either into the recreationally active, masters athlete, or sedentary activity level group based on the Rapid Assessment of Physical Activity (RAPA) form. For the gait speed with associated dual-task component, subjects walked 10-meters at two …

Effects Of Direction Time Constraints And Walking Speed On Turn Strategies And Gait Adaptations In Healthy Older And Young Adults, Dennis Torre

Seton Hall University Dissertations and Theses (ETDs)

Hip fractures can be life-threatening, debilitating, and costly. The odds for hip fracture increases from impact of sideways falls. While turning has been strongly associated with hip fracture & sideways falls, the distinction between the risks for walking-turns as opposed to low-velocity in-place turning is not clear. The present study sought to fill a gap as previous research had not compared walking-turn performance in young & healthy older adults at low-fall risk within the same study and response-conditions of speed interacting with direction-cue time constraints. Spatial-temporal variables representative of AP braking/propulsion (i.e. stride-length & speed) & ML stability (left/right H-H …

The Motor Cortical Representation Of A Muscle Is Not Homogeneous In Brain Connectivity, Jo Armour Smith, Alaa Albishi, Sarine Babikian, Skulpan Asavasopon, Beth E. Fisher, Jason Kutch

Physical Therapy Faculty Articles and Research

Functional connectivity patterns of the motor cortical representational area of single muscles have not been extensively mapped in humans, particularly for the axial musculature. Functional connectivity may provide a neural substrate for adaptation of muscle activity in axial muscles that have both voluntary and postural functions. The purpose of this study was to combine brain stimulation and neuroimaging to both map the cortical representation of the external oblique (EO) in primary motor cortex (M1) and supplementary motor area (SMA), and to establish the resting-state functional connectivity associated with this representation. Motor evoked potentials were elicited from the EO muscle in …

Toward A Research Agenda For Oncology Physical Therapy, Lucinda Pfalzer, Nicole L. Stout, Shana Harrington, Mary Insana Fisher

Physical Therapy Faculty Publications

Research Round-up: Cancer survivors frequently experience cancer treatment–related functional impairments and disability. While a growing body of evidence supports the effectiveness of rehabilitation interventions for these individuals, there are significant gaps in the existing literature and no interdisciplinary agreement on the priorities for cancer rehabilitation research. In 2016, the Oncology Section revised its strategic plan and set an objective to create an oncology rehabilitation research agenda for the physical therapy (PT) profession. To achieve this goal, the scope of the agenda, a development and review process, and dissemination plan need to be developed.

Sex Differences In Neuromuscular Fatigability Of The Knee Extensors Post-Stroke, Meghan Kirking, Reivian B. Barillas, Philip A. Nelson, Sandra K. Hunter, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Background and Purpose: Despite the implications of optimizing strength training post-stroke, little is known about the differences in fatigability between men and women with chronic stroke. The purpose of this study was to determine the sex differences in knee extensor muscle fatigability and potential mechanisms in individuals with stroke. Methods: Eighteen participants (10 men, eight women) with chronic stroke (≥6 months) and 23 (12 men, 11 women) nonstroke controls participated in the study. Participants performed an intermittent isometric contraction task (6 s contraction, 3 s rest) at 30% of maximal voluntary contraction (MVC) torque until failure to maintain the target …

Changes In Postural Sway Behavior Across The Life Span, Maria M B N R Santos

Graduate Student Theses, Dissertations, & Professional Papers

The present study aimed to investigate human balance control by assessing postural sway on three groups representing three stages of life (6-12, 19-40 and 65-74 years old). There were 14 individuals in each group and they were tested during upright bipedal stance with either eyes open or closed. Focus was given to multiple sway indices representing multi-dimensional features of postural sway in quiet stance and included: the center of pressure area, amplitude, root mean square (RMS), velocity, jerkiness, and sample entropy. Results confirmed that children and seniors swayed more (p<.004), faster (p<.001) and their body sway was shakier (p<.001) than young adults. Seniors also presented faster (p<.006) and shakier (p<.001) sway than children and a more unpredictable pattern of body sway in time (p<.002) than children and young adults. In addition, children presented a more random anterior-posterior sway (p<.034) and a more regular medio-lateral sway (p<.043) than young adults, and a higher synchronization between anterior-posterior and medio-lateral body sway (p<.012) than young adults and seniors. We also observed that postural control of children and young adults becomes relatively more challenged in experimental situations when eyes were closed for most postural indices. In conclusion, this study suggests that multi-dimension posturography is sensitive to detect subtle age-related changes in the postural behavior and each stage of life may have their own signature patterns of postural behavior. Therefore, we expect that quantifications of this nature may be used to assess not only postural instability and fall risk but also to aid the testing of the efficacy of balance interventional protocols.

The Effect Of An 8-Week Stabilization Exercise Program On The Lumbopelvic Rhythm And Flexion-Relaxation Phenomenon, Ali Shahvarpour, Sharon M. Henry, Richard Preuss, Hakim Mecheri, Christian Larivière

Études primaires

Background

Lumbar stabilization exercise programs should normalize the aberrant movements patterns often observed in patients with low back pain. This study aimed to determine the effect of an 8-week lumbar stabilization program on EMG/kinematics measures of the aberrant movement patterns in such patients. A secondary goal was to assess the 8-week test-retest reliability of these measures.

Methods

The patients followed an 8-week lumbar stabilization program while no intervention was carried out on the controls. Before and after this period, kinematics of the spine along with the EMG of paraspinal muscles were recorded during trunk maximal flexion-extension. ANOVAs tested the effect …

The Influence Of Strength-Training Exercises On The Functional Fitness In Older Adults, Susie Engle

Graduate Theses and Dissertations

The purpose of this study was to examine the influence of strength-training exercises on the functional fitness in older adults. The original convenience sample consisted of 658 participants who attended group strength-training classes offered through the Cooperative Extension Service. The Senior Fitness Test was used to assess baseline fitness levels at the beginning and end of the 12-week strength-training program. Data was collected from 2008 to 2015. Of the 658 participants, 110 were aged 60 to 94 and presented posttest scores occurring approximately 12 weeks after pretest dates. Of the 110 subjects, 99 were female and 11 were male. The …

Only Women Report Increase In Pain Threshold Following Fatiguing Contractions Of The Upper Extremity, Kathy J. Lemley, Jonathon Senefeld, Sandra K. Hunter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Purpose

The perception of pain in response to a noxious stimulus can be markedly reduced following an acute bout of exercise [exercise-induced hypoalgesia (EIH)]. Sex differences in EIH frequently occur after exercise but may be confounded by the sex differences in muscle fatigue. The purpose was to determine if sex differences in pain relief occur after an exercise protocol when muscle fatigue is similar for both young and older men and women.

Methods

Pain perception of 33 men (15 young) and 31 women (19 young) was measured using a pressure pain stimulus on the left index finger before and after …

Reliability Of Clinical Evaluators Of Spasticity In Patients With Stroke, Tiffany Alvino, Shiney David, Chelsea Gendvil

Dissertations, Theses, and Capstone Projects

Spasticity is characterized by hyperexcitable stretch reflexes with amplitude increases in response to velocity dependent passive movement and resistance. Spasticity is the result of abnormal function of segmental and suprasegmental neuronal circuits. The objective of this study was to determine any positive correlation between three clinical evaluators of spasticity (i.e., the pendulum test, the patellar tendon tap test (PTT), and the Modified Ashworth scale) in their reliability to assess spasticity in people post-stroke. It was hypothesized that the use of force movement sensors along with surface electromyography increases the reliability of the standardized clinical tests. The results show that all …

Mobility Of Individuals With Multiple Sclerosis And The Influence Of Physical Therapy, Brenda L. Davies

Theses & Dissertations

One main purpose was to explore the compensatory gait strategies of individuals with multiple sclerosis (MS). To address this purpose, we quantified the mechanical work generated by the lower extremity joints during walking. The outcomes from this investi­gation suggested that individuals with MS redistribute positive mechanical work during walking to the hip in order to compensate for a reduced ability of the ankle to generate positive mechanical work. Additionally, we also explored the motor control of the ankle as a potential contributing factor to the mobility limitations of individuals with MS. The outcomes from this investigation indicated that individuals with …

A Prediction Model For Acute Core And Lower Extremity Injuries In Division 1 Collegiate Football Players, Alexandra Aline Mcdonald

Graduate Theses and Dissertations

Context: Various intrinsic factors such as high exposure, poor endurance of core muscles, previous injury, strength deficits, suboptimal neurocognitive function, and orthopedic abnormalities have been found as predictors for sprains and strains among collegiate football players. Objective: Assess the applicability of pre-participation assessments as predictors of core or lower extremity injury. Design: Cohort Study. Setting: National Collegiate Athletic Association Division I football program. Patients or Other Participants: Athletes who underwent mandatory pre-participation examinations before preseason football training over two consecutive seasons (n=225). Main Outcome Measure(s): Associations between preseason protocols and injury incidence for core and lower extremity injuries were established …

The Effects Of External Focus Of Attention Exercise Rehabilitation On Dual Task Walking In Parkinson's Disease, Eric N. Beck

Theses and Dissertations (Comprehensive)

Parkinson’s disease impairs control of well-learned movements, and therefore, individuals with Parkinson’s disease are forced to walk with greater conscious control. This causes difficulties while walking and completing a secondary task simultaneously (dual tasking), in that distractions from conscious control of walking increase the risk of falls and injury. Although, attention-based exercise may be a potential avenue to decrease the demands associated with walking in Parkinson’s disease. For example, an external focus of attention (on manipulated objects) has been found to recruit the networks that are important for walking with little conscious control (automatic control networks). In contrast, an internal …

The Feedforward And Feedback Controls On Gait In Adults With Diabetes, Chun-Kai Huang

Theses & Dissertations

There are nearly 26 million people with diabetes mellitus (DM) in the US, and half of chronic DMs develop somatosensory deficits due to diabetic polyneuropathy or diabetic peripheral neuropathy (DPN). The absence or impaired somatosensory feedback (e.g. touch sensation or joint proprioception) resulted from the damage of large nerve fiber, and motor deficits such as attenuated muscle strength and abnormal plantar pressure of lower extremity have been identified in DPN, and these sensorimotor impairments lead to an increased number of falls. To reduce the risk of falling, a well-coordinated and adapted limb movement driven by the feedforward (anticipatory) and feedback …

Comparing Functional Motor Control And Gait Parameters In Children With Autism To Those Of Age-Matched Peers Who Are Typically Developing, Patricia Stevenson, Samantha Novotny, Jillian May, Christopher Ancell

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare motor performance of children with Autism Spectrum Disorder (ASD) to that of age-matched peers who are typically developing (TD) on motor control tasks plus symmetry and variability of gait parameters across four walking conditions. A sample of convenience of children with ASD (n=6) and peers who are TD (n=6) were recruited. Motor control was assessed using initiation and completion times on the Timed Up and Go (TUG) test. Gait parameters were collected using a computerized walkway under four trial conditions: 1) walking at self-selected velocity (SSV); 2) walking during a tray-carrying task …

The Effect Of Balance-Based Torso-Weighting On Mobility, Gait, Balance, Postural Control, And Falls Efficacy In Mobility Limited Older Adults, Jennifer L. Vincenzo

Graduate Theses and Dissertations

Exercise is a known intervention to prevent fall risk among older adults; however, adherence is poor. Therefore, it is of interest to determine if other interventions improve function and decrease fall risk among older adults. Balance-Based Torso-Weighting (BBTW) is a non-exercise intervention that improves functional measures among adults with multiple sclerosis, yet the effectiveness of BBTW has not been assessed among older adults without progressive neurological disorders. We conducted a double-blind, randomized study to analyze the effect of BBTW on functional measures and falls efficacy among community-dwelling, mobility limited older adults after 5 days of wearing BalanceWear® for 4 hours …

A Qualitative Examination Of Optimal Professional Traits Of Physical Therapists. – An Exploratory Investigation, Nicholas G. Wood

Honors College Theses

Physical therapists are constantly searching for aspects of their professional practice to improve, in order to enhance interactions with patients, eventually leading to a more successful practice (Resnek & Jensen, 2003). Although this is the case, limited research has been found which has examined optimal qualities of physical therapists from neither a qualitative perspective, nor based upon their location. Thus, the purpose of this study is to use a qualitative approach to describe optimal qualities necessary for a successful physical therapy practice. In addition, this study aims to determine if therapists practicing in a rural community describe different qualities than …

The Effect Of Muscle Energy Technique On Forward Shoulder Posture, Pectoralis Minor Length, And Upper Extremity Blood Flow In Collegiate Female Swimmers, Elizabeth Gross

Theses and Dissertations

Context: Overhead sports are at an increased risk of shoulder injury, particularly when scapular posture is restricted. Pectoralis minor length has been linked to scapular malpositioning and forward shoulder posture. Upper extremity blood flow has also been linked to shortened pectoralis minor length, which could lead to thoracic neurovascular occlusion. Swimmers specifically may be at an increased risk for shoulder injury if the pectoralis minor is shortened. Stretching of the pectoralis minor has been suggested as a treatment to correct shortening of the muscle, however research examining muscle energy technique (MET) applied to the pectoralis minor is limited. Objective: To …

Trunk Postural Control In Unstable Sitting: Effect Of Sex And Low Back Pain Status, Christian Larivière, Dany H. Gagnon, Hakim Mecheri

Études primaires

Background

Adequate neuromuscular control of the lumbar spine is required to prevent lumbar injuries. A trunk postural control test protocol, controlling for the influence of body size on performance, was implemented to carry out between-subject comparisons. The aim of this study was to assess the effect of sex and low back pain status with the use of two measures of trunk postural control, the first based on chair motion, and the second based on trunk motion.

Methods

Thirty-six subjects (with and without low back pain) performed three 60-s trunk postural control trials with their eyes closed while seated on an …

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …