Physical Therapy Commons^™

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Aging With The Fmr1 Gene: A Life Course Perspective, Cornelia Lieb-Lundell

Physical Therapy Collection

Fragile X syndrome (FXS) is one of three syndromes identified as a health condition related to fragile X mental retardation (FMR1) gene dysfunction. The other two conditions are Fragile X-associated primary ovarian insufficiency syndrome (FXPOI) and Fragile X-associated tremor/ataxia syndrome (FXTAS) which together are referred to as Fragile X-associated disorders (FXD). Even though the three conditions share a common genetic defect each one is a separate health condition that results in a variety of body function impairments such as motor delay, musculoskeletal issues related to low muscle tone, coordination limitations, ataxia, tremor, undefined muscle aches and pains; and, …

Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph

Osteopathic Medicine Student Research Posters

Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …

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 …

Early Versus Delayed Rehabilitation After Arthroscopic Rotator Cuff Repair, Abigail Chang, Jessica Dennis

Physician Assistant Capstones, 2016 to 2019

Objective: To determine how the timing of rehabilitation, early versus delayed, affects clinical results and tendon healing rates after arthroscopic rotator cuff repair. Design: Systematic literature review. Methods: Searches were done in PubMed, utilizing the terms arthroscopic rotator cuff repair, rehabilitation, early, and delayed. In PubMed the following filters and terms were used: published in the last 10 years, humans, randomized controlled trial, free full-text articles, and English. Results: The Keener et al study was included because it evaluated clinical results and tendon healing rates after arthroscopic repair using two distinct rehabilitation protocols, early versus delayed …

Differences In Interlimb Performance During A Repetitive Step Test In Older Adults, Harold L. Merriman, Kurt Jackson, Wesley Horn, Jake Jones, Evan Price, Jill Spicer

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Each year, one out of three adults (younger than 65 years old) experiences a fall, resulting in fractures, head injuries, and even death. Falling is the leading cause of death from an injury and causes the greatest number of nonfatal injuries and hospital admissions for trauma. Since balance and muscle performance decrease as one ages, it is vitally important to assess these factors as part of a comprehensive strategy to monitor and predict fall risk. Previous data analysis of the Repetitive Step Test (RST) has shown that there is a correlation between subject performance and fall risk between non-fallers and …

A Comparison Of Arch Height Index Measures Between Collegiate Basketball And National Basketball Association Players, Philip Anloague, N Hess, L Barhorst, G Hock, A Iannarino, A Kelly, C Williams

University of Dayton Doctor of Physical Therapy Annual Research Symposium

The rate of game related basketball injuries is 2xs greater in professionals than collegiate players and the most common injuries occur in the lower extremity. Arch mechanics are often cited as a related factor and the Arch Height Index Measurement System (AHIMS) is a reliable and valid system for quantifying mobility. However, normative or comparative values for basketball athletes have not been reported.

The Effects Of Yoga On Balance, Strength, Flexibility, And Mindfulness In Typical Children Ages 4-9 Years, Betsy Donahoe Fillmore, Mary I. Fisher, Katie Lunsford, Justin Master, Sarahanne Pelkey, Emily Puthoff, Kristen Schulte, Brittany Snider, Jordan Villanueva

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Yoga improves a variety of impairments in typical pediatric populations: cardiovascular, neuromuscular, musculoskeletal, and pulmonary conditions, balance, strength, and flexibility. Yoga improves mindfulness in adult populations, and emerging evidence shows a similar effect among pediatric populations.

The Effect Of Three Different Ankle Braces On Vertical Jump Performance In Female College Volleyball Players, Ashley M. Jefferson

Undergraduate Theses

Background/Purpose: Ankle braces are often used to stabilize the ankle joint of an athlete to reduce the risk of initial injury while participating in athletic activity or to protect the joint from re-injury when returning to play. The purpose of this study was to examine the effects of application of three different braces on vertical jump performance in collegiate female volleyball players. A secondary aim was to compare participant preference and satisfaction on selected characteristics of each of the three different braces.

Subjects: 31 female varsity/club college volleyball players >18 years of age.

Materials/Methods: Health History Assessment and a dynamic …

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.

Post-Surgical Rehabilitation For The Anterior Cruciate Ligament, Daniel Webb, S Dibiase, T Grant

Thinking Matters Symposium Archive

The purpose of this project was to construct a rehabilitation protocol using therapeutic exercises carried out to return to play. The protocol was for a soccer player in the college setting who has sustained a torn ACL. The sources that we use include databases from EBSCO, physiopedia, hindawi and google scholar. ACL injuries are common in soccer players. It is important that the sports medical field has a good understanding on how to preform a rehabilitation protocol for athletes that are recovering from ACL reconstruction. Injuries to the ACL can occur with direct contact or non-contact. A cut-or-plant movement is …

Physician Role In Physical Activity For African-American Males Undergoing Radical Prostatectomy For Prostate Cancer, Faustine Williams, Kellie R. Imm, Graham A. Colditz, Ashley J. Housten, Lin Yang, Keon L. Gilbert, Bettina F. Drake

ETSU Faculty Works

Purpose

Physical activity is recognized as a complementary therapy to improve physical and physiological functions among prostate cancer survivors. Little is known about communication between health providers and African-American prostate cancer patients, a high risk population, regarding the health benefits of regular physical activity on their prognosis and recovery. This study explores African-American prostate cancer survivors’ experiences with physical activity prescription from their physicians.

Methods

Three focus group interviews were conducted with 12 African-American prostate cancer survivors in May 2014 in St. Louis, MO. Participants’ ages ranged from 49 to 79 years, had completed radical prostatectomy, and their time out …

Role Of Corpus Callosum Integrity In Arm Function Differs Based On Motor Severity After Stroke, Jill Campbell Stewart, Pritha Dewanjee, George Tran, Erin Burke Quinlan, Lucy Dodakian, Alison Mckenzie, Jill See, Steven C. Cramer

Physical Therapy Faculty Articles and Research

While the corpus callosum (CC) is important to normal sensorimotor function, its role in motor function after stroke is less well understood. This study examined the relationship between structural integrity of the motor and sensory sections of the CC, as reflected by fractional anisotropy (FA), and motor function in individuals with a range of motor impairment level due to stroke. Fifty-five individuals with chronic stroke (Fugl-Meyer motor score range 14 to 61) and 18 healthy controls underwent diffusion tensor imaging and a set of motor behavior tests. Mean FA from the motor and sensory regions of the CC and from …

What Is The Contribution Of Ia-Afference For Regulating Motor Output Variability During Standing?, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Motor variability is an inherent feature of all human movements, and describes the system‘s stability and rigidity during the performance of functional motor tasks such as balancing. In order to ensure successful task execution, the nervous system is thought to be able to flexibly select the appropriate level of variability. However, it remains unknown which neurophysiological pathways are utilized for the control of motor output variability. In responding to natural variability (in this example sway), it is plausible that the neuro-physiological response to muscular elongation contributes to restoring a balanced upright posture. In this study, the postural sway of 18 …

Somatosensory Deficits In Post-Acl Reconstruction Patients: A Case-Control Study, Johanna M. Hoch, William O. Perkins, Jonathan R. Hartman, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Introduction: Diminished cutaneous detection thresholds have been identified in patients with multiple orthopedic conditions, and these phenomena may occur in postanterior cruciate ligament reconstructed (ACLR) patients. The purpose of this study was to determine if differences in lower extremity cutaneous detection thresholds exist in post-ACLR patients when compared with healthy controls. Methods: Fifteen individuals who were post-ACLR and 15 individuals who had no history of knee injury participated. Light touch cutaneous detection thresholds were assessed at 4 locations on the foot and ankle (first metatarsal, fifth metatarsal, medial malleolus, and lateral malleolus). Nonparametric statistics examined group differences between the …

In Patients Over Sixty Years Old With A Primary Hip Fracture, Is Home Based Therapy Effective For Restoring Functional Abilities?, Florence M. Fournier

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not homebased therapy is effective for restoring functional abilities in patients over sixty with a primary hip fracture.

STUDY DESIGN: This review consists of two RCTs and one randomized clinical trial published in the English language between the years 2014 and 20 15.

DATA SOURCES: Articles were published in peer reviewed journals and compared home-based therapy as an intervention following a primary hip fracture to individuals solely documentation of post-surgical care using Cochrane and PubMed databases.

OUTCOMES MEASURED: The specific outcomes measured varied …

Measuring The Effects Of Therapeutic Listening - Quickshifts, Hannah Tashjian, Phoebe Taasan, Donielle Hair

Student Research Posters

This study examines a structured protocol to measure the effects of daily individualized use of Therapeutic Listening - Quickshifts (TL-Q) used to improve occupational performance in children with learning and developmental disabilities. The study identifies a standardized practice-based evidence procedure to measure the outcomes of implementing TL-Q within traditional OT practice. OTs worldwide are using sound-based therapies (SBTs) despite limited supporting evidence available regarding the productivity of these interventions. Even fewer studies have been published on the effects of Therapeutic Listening (TL), a novel intervention shown to increase personal and interpersonal skills including sensory processing skills, visual motor integration, and …

Knowledge And Behavioral Patterns Of Youth Ice Hockey Parents Regarding Sport Concussion: A Pilot Study, Jeff G. Konin, Delaney Horsley

Internet Journal of Allied Health Sciences and Practice

Purpose: There is an abundance of available concussion education programs for parents of youth ice hockey players. Parents play a vital role in recognizing signs and symptoms of a concussion sustained by a child, and therefore their knowledge and retention of such information is deemed to be very important. The purpose of the pilot survey is identify the general knowledge parents of youth ice hockey players possess regarding concussion. Methods: A survey of a sample of convenience was utilized. Forty-five parents (40 to 49 years of age) of youth ice hockey players were asked to complete a one-page survey to …

Effectiveness Of Hydrotherapy As An Adjunct Treatment For The Management Of Breast Cancer Related Lymphoedema In Women Following Breast Cancer Surgery: A Systematic Review, Eleanor Bills, Matthew Delsar, Steven O'Donnell, Alexandra Rice, Cory Stone, Saravana Kumar

Internet Journal of Allied Health Sciences and Practice

Cancer is a leading cause of death and disability around the world. Of all cancers, breast cancer commonly ranks amongst the top three. Surgical intervention for breast cancer is common and a possible side effect of this is breast cancer related lymphoedema (BCRL). Women with breast cancer related lymphoedema commonly have regional limb swelling and pain, which can negatively impact mental and social well-being as well as upper limb function. Hydrotherapy is therapeutic modality which may be used as an adjunct to self-management strategies after the intensive phase of lymphoedema management. Yet despite its popularity, recent research has questioned its …

Temporary Nerve Block At Selected Digits Revealed Hand Motor Deficits In Grasping Tasks, Aude Cateron, Kerry Mcpartlan, Christina Gioeli, Emily Reid, Matt Turturro, Barry Hahn, Cynthia Benson, Wei Zhang

Publications and Research

Peripheral sensory feedback plays a crucial role in ensuring correct motor execution throughout hand grasp control. Previous studies utilized local anesthesia to deprive somatosensory feedback in the digits or hand, observations included sensorimotor deficits at both corticospinal and peripheral levels. However, the questions of how the disturbed and intact sensory input integrate and interact with each other to assist the motor program execution, and whether the motor coordination based on motor output variability between affected and non-affected elements (e.g., digits) becomes interfered by the local sensory deficiency, have not been answered. The current study aims to investigate the effect of …

Standing Balance And Spatiotemporal Aspects Of Gait Are Impaired Upon Nocturnal Awakening In Healthy Late Middle-Aged And Older Adults, Amanda L. Mcbean, Raymond P. Najjar, Ronald A. Schuchard, Courtney D. Hall, Cheng-Ann Wang, Ban Ku, Joseph M. Furman

ETSU Faculty Works

Study Objectives: Nocturnal awakenings may constitute a unique risk for falls among older adults. We describe differences in gait and balance between presleep and midsleep testing, and whether changes in the lighting environment during the midsleep testing further affect gait and balance.

Methods: Twenty-one healthy, late middle-aged and older (64.7 ± 8.0 y) adults participated in this repeated-measures design consisting of four overnight laboratory stays. Each night, participants completed baseline visual acuity, gait, and balance testing. After a 2-h sleep opportunity, they were awakened for 13 min into one of four lighting conditions: very dim white light (< 0.5 lux); dim white light (∼28.0 lux); dim orange light (∼28.0 lux); and white room-level light (∼200 lux). During this awakening, participants completed the same sequence of testing as at baseline.

Results: Low-contrast …

Can Gait Signatures Provide Quantitative Measures For Aiding Clinical Decision-Making? A Systematic Meta-Analysis Of Gait Variability Behavior In Patients With Parkinson’S Disease, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

A disturbed, inconsistent walking pattern is a common feature of patients with Parkinson's disease (PwPD). Such extreme variability in both temporal and spatial parameters of gait has been associated with unstable walking and an elevated prevalence of falls. However, despite their ability to discretise healthy from pathological function, normative variability values for key gait parameters are still missing. Furthermore, an understanding of each parameter's response to pathology, as well as the inter-parameter relationships, has received little attention. The aim of this systematic literature review and meta-analysis was therefore to define threshold levels for pathological gait variability as well as to …

Paired Associative Transspinal And Transcortical Stimulation Produces Bidirectional Plasticity Of Human Cortical And Spinal Motor Pathways, Luke Dixon, Mohamed Ibrahim, Danielle Santora

Dissertations, Theses, and Capstone Projects

Anatomical, physiological, and functional connectivity exists between primary motor cortex (M1) and spinal cord neurons. Paired associative stimulation (PAS) produces enduring changes in M1 based on the Hebbian principle of associative plasticity. The present study aims to discover immediate neurophysiological changes on human corticomotor pathways by pairing noninvasive transspinal and transcortical stimulation via transcranial magnetic stimulation (TMS). We delivered paired transspinal and transcortical stimulation for 40-min at precise interstimulus intervals with TMS being delivered after (transspinal-transcortical PAS) or before (transcortical-transspinal PAS) transspinal stimulation. Transspinal-transcortical PAS markedly decreased intracortical inhibition, increased intracortical facilitation and M1 excitability with concomitant decreases of motor …

Revealing The Quality Of Movement: A Meta-Analysis Review To Quantify The Thresholds To Pathological Variability During Standing And Walking, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Neuromotor processes are inherently noisy, which results in variability during movement and fluctu-ations in motor control. Although controversial, low levels of variability are traditionally considered healthy, while increased levels are thought to be pathological. This systematic review and meta-analysisof the literature investigates the thresholds between healthy and pathological task variability.

After examining 13,195 publications, 109 studies were included. Results from over 3000 healthy sub-jects and 2775 patients revealed an overall positive effect size of pathology on variability of 0.59 forwalking and 0.80 for sway. For the coefficient of variation of stride time (ST) and sway area (SA), upperthresholds of 2.6% …

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 …

Rapid Step Test Based On Leg Length As A Novel Dynamic Standing Balance Test In The Geriatric Population: A Pilot Study, Harold L. Merriman, Kurt Jackson, E. Conkel, D Mcintyre, Q Rizvi, P Sharkey

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Each year, 1 out of 3 adults over age 65 experience a fall resulting in a traumatic injury or even mortality. Falls are the leading cause of death in the elderly population and cause the greatest number of hospital admissions from trauma. The Balance Evaluation Systems Test (BEST), Berg Balance Scale, and Tinetti are frequently used tests to determine fall risk. However, they can be complicated, time consuming, and exhibit a ceiling effect. This study employed the Rapid Step Test (RST) to examine the use and practicality of a new, portable and easy to administer test that may differentiate between …

Scapular Performance In Women With Breast Cancer Compared To Healthy Controls, Carlie S. Henzler, Mary I. Fisher, Lucinda A. Pfalzer, Ellen Levy, Shana E. Harrington, Naomi L. Gerber, Nicole L. Stout

University of Dayton Doctor of Physical Therapy Annual Research Symposium

The Scapular Flip Test is designed to recognize abnormal scapular position defined by winging/tipping of the scapula on resisted external rotation. Originally created to detect scapular dysfunction with spinal accessory nerve damage, the Scapular Flip Test may be a simple screening tool for any scapular dysfunction that results from breast cancer surgery and treatment to the shoulder and axillary region.

Knowledge Of A1c Predicts Diabetes Self- Management And A1c Level Among Chinese Patients With Type 2 Diabetes, Shengnan Yang, Weimin Kong, Cunyi Hsue, Anne Fish, Yufeng Chen, Xiaohui Guo, Qingqing Lou, Robert Anderson

Nursing Faculty Works

This study was to identify current A1c understanding status among Chinese patients with type 2 diabetes, assess if knowledge of A1c affects their diabetes self-management and their glycemic control and recognize the factors influencing knowledge of A1c among patients with type 2 diabetes. A multi-center, cross-sectional survey was conducted between April and July 2010 in 50 medical centers in the Mainland China. Participants were recruited from inpatients and outpatients who were admitted to or visited those medical centers. The survey included core questions about their demographic characteristics, diabetes self-management behavior, and A1c knowledge. Overall, of 5957 patients, the percentage of …

Pelvic Floor Muscle Training In Management Of Postpartum Pelvic Floor Dysfunctions: A Literature Review, Rebecca S. Tanner

Honors Undergraduate Theses

Women can face a wide range of pelvic floor dysfunctions following pregnancy, ranging from urinary incontinence to pelvic pain. Unfortunately, these problems are not routinely checked for in postpartum check-ups and women do not always bring it to the physician’s attention. Strengthening of the pelvic floor muscles may be able to help women prevent these disorders and improve these women’s lifestyles.

The purpose of this thesis was to review and analyze different trials to determine if different pelvic floor dysfunctions (urinary incontinence, sexual dysfunction, and pelvic girdle pain) can be treated using pelvic floor muscle training in the postpartum. After …

Health-Related Fitness For Children And Adults With Cerebral Palsy, Yvette Blanchard, Mary E. Gannotti, Wendy Romney

All PTHMS Faculty Publications

Position Statement of ACSM Sports Medicine Basics 2016: Health-related physical fitness for persons with Cerebral Palsy should be developed in the same model as fitness for all of us: start early, be easily available and continue throughout the life span.