Physical Therapy Commons^™

Comparisons Of The Four Square Step Test And The Four Square Step Test On Foam Surface In Their Accuracy To Discriminate Between Elderly With And Without Fall History, Phakkanut Mathurapongsakul

Chulalongkorn University Theses and Dissertations (Chula ETD)

The aims of this study were 1) to investigate the intra-rater reliability, inter-rater reliability and concurrent validity of the four square step test with foam (FSST+foam) and 2) to compare the four square step test (FSST) and the FSST+foam in their accuracy for discriminating among faller elderly, non-faller elderly, and adults. Twelve participants (4 each group) were assessed by the FSST, FSST+foam, timed up and go test (TUG) and five times sit to stand test (FTSST). The intraclass correlation coefficient and correlation coefficient were calculated to determine the reliability and validity, respectively. To investigate the accuracy for discriminating between groups, …

Primary Care Fall Risk Assessment For Elderly West Virginians, Vivian M. Minkemeyer, Matt Meriweather, Franklin D. Shuler, Saurabh P. Mehta, Zain N. Qazi

Orthopaedics

West Virginia is ranked second nationally for the percent of its population .65 years of age. The elderly are especially susceptible to falls with fall risk increasing as age increases. Because falls are the number one cause of injury-related morbidity and mortality in the West Virginia elderly, evaluation of fall risk is a critical component of the patient evaluation in the primary care setting. We therefore highlight fall risk assessments that require no specialized equipment or training and can easily be completed at an established office visit. High quality clinical practice guidelines supported by the American Geriatric Society recommend yearly …

Piecing The Puzzle Together With The Use Of Physical Therapy, Mikayla Pruitt

Honors Projects

For my Honors Project I decided to create a set of exercise cards for children with autism. The front of each card had a picture symbolizing the exercise/activity, and on the back included directions, supplies and tips to complete the activity. The following is a selection of a few exercise cards from each of the four exercise sections, as well as the title card, table of contents cards, information cards, and source cards.

Exploration Of Factors Associated With Patient Adherence In Upper Extremity Rehabilitation: A Mixed-Methods Embedded Design, Enrique V. Smith-Forbes

Theses and Dissertations--Rehabilitation Sciences

Adherence is considered a prerequisite for the success of exercise programs for musculoskeletal disorders. The negative effects of non-adherence to exercise recommendations impact the cost of care, and also treatment effectiveness, treatment duration, the therapeutic relationship, waiting times, the efficiency of personnel and use of equipment. Adherence to therapeutic exercise intervention is a multifaceted problem.

The World Health Organization (WHO) established the multidimensional adherence model (MAM). The MAM describes five interactive dimensions (socioeconomic, healthcare team and system, condition-related, therapy-related, and patient-related factors) that have an effect on patient adherence.

The first purpose of this dissertation was to explore the MAM …

Choice Of Human–Computer Interaction Mode In Stroke Rehabilitation, Hossein Mousavi Hondori, Maryam Khademi, Lucy Dodakian, Alison Mackenzie, Cristina V. Lopes, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Background and Objective. Advances in technology are providing new forms of human–computer interaction. The current study examined one form of human–computer interaction, augmented reality (AR), whereby subjects train in the real-world workspace with virtual objects projected by the computer. Motor performances were compared with those obtained while subjects used a traditional human–computer interaction, that is, a personal computer (PC) with a mouse. Methods. Patients used goal-directed arm movements to play AR and PC versions of the Fruit Ninja video game. The 2 versions required the same arm movements to control the game but had different cognitive demands. With …

Fall Risk Prediction Using Wearable Wireless Sensors, Thurmon Lockhart, Chris Frame, Rahul Soangra, John Lach

Physical Therapy Faculty Articles and Research

Wearable wireless sensors and nonlinear dynamics identify postural characteristics relevant to balance control and dynamic stability, revealing predictive risk of falls among older adults.

Health-Related Quality Of Life In Physically Active Individuals With A History Of Injury, Megan N. Houston

Human Movement Studies & Special Education Theses & Dissertations

Individuals around the globe engage in physical activity for personal interest or general health and fitness. Although participation in regular physical activity is important for general health it also brings with it the risk of injury. Ankle sprains, anterior cruciate ligament tears, and concussions are just a few of the injuries sustained by physically active individuals with long-term implications. With the number of physically active individuals on the rise, sports-related injuries are of growing concern.

Health-related quality of life (HRQOL) is a personal evaluation of everyday functioning and well-being. A variety of injuries and health conditions associated with physical activity …

Potential For Using Smartphone Accelerometers In Non-Laboratory Environments, Rahul Soangra, Thurmon Lockhart, Christopher W. Frames, Jian Zhang, Seong Hyun Moon, Jongsoon Park

Physical Therapy Faculty Articles and Research

In recent years, there has been rising interest in using accelerometers as an alternative instrument to measure the center of pressure. Accelerometers are inexpensive, small, sensitive, and can be readily used in non-laboratory environments. In addition to this, smartphones with built-in accelerometers add to their capability with real-time processing of data from sensors. Clinicians and researchers are currently in disagreement from whether these measurements provide the same physiological information about the participant’s balance. In this study, twelve participants were asked to wear smartphone on their right ASIS using a belt clip and stand still on the forceplate. The data was …

Health-Related Quality Of Life In Individuals With Chronic Ankle Instability, Megan N. Houston, Bonnie L. Van Lunen, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: Individuals with chronic ankle instability (CAI) have reported decreased global and regional function. Despite the identification of functional deficits in those with CAI, more research is required to determine the extent to which CAI influences the multidimensional profile of health-related quality of life.

Objective: To determine whether global, regional, and psychological health-related outcomes differ between individuals with and without CAI.

Design: Case-control study.

Setting: Laboratory.

Patients or Other Participants: Twenty-five participants with CAI (age = 21.9 ± 2.5 years, height = 170.8 ± 8.6 cm, mass = 69.8.0 ± 11.7 kg) were sex- and limb-matched to 25 healthy participants …

Comparison Of Shod Vs Nonshod On Balance And Postural Sway In Older Adults, Annika Vyakhk

EWU Masters Thesis Collection

Among older adults, falls are the leading cause of death due to injury and hospitalization. With age, cutaneous sensation in the foot sole diminishes, contributing to balance impairment. Discovering an effective method for retraining the mechanoreceptors of the feet will possibly increase balance control. Training the different physiological systems involved in balance maintenance is important for decreasing fall risks. The purpose of this study was to investigate whether a balance training intervention involving barefoot training (BT) yields better static and dynamic balance, and postural sway values than a group wearing shoes (WS). Twelve older adults (65-92 years) were randomly assigned …

Conceptualization And Design Of A Surface Translation Balance Training Device, Annie Djukic, Omri Tayyara, Deborah Espy, Majid Rashidi

Undergraduate Research Posters 2013

Research supports the idea that dynamic control of both a person's center of mass and base of support are necessary to prevent falls, and that older adults can learn this combined control through specific balance training. Effective balance training requires a large number of repetitions of task-specific practice. Externally induced movements have been employed in balance studies both to test and train balance responses, most often using mechanized surface perturbations. These systems however are quite expensive; therefore, we chose to investigate a more cost effective solution focusing on surface translation for balance training in our lab.

We performed a literature …

Examining Lower Extremity Range Of Motion And Movement Variability Chages Due To Focus Of Attention During Landing, Andrew Nordin, Janet Dufek

Interdisciplinary Research Scholarship Day

Attentional focus (AF) has been explored among a variety of motor skills providing evidence that external AF promotes automaticity and enhanced performance [6]. External focus of attention is distinguished from internal focus such that external focus is directed toward movement effect rather than body movements [6]. Movement variability provides a means of assessing functional characteristics of the neuromotor system, where normal functioning is suggested to occur within optimal limits, while excessively high or low movement variability is indicative of system dysfunction [2,4,5]. Additionally, the ability of the motor system to vary, or broadly distribute, internal loads is thought to reduce …

Applying Principles Of Motor Learning And Control To Upper Extremity Rehabilitation, Lisa M. Muratori, Eric M. Lamberg, Lori Quinn, Susan V. Duff

Physical Therapy Faculty Articles and Research

The purpose of this article is to provide a brief review of the principles of motor control and learning. Different models of motor control from historical to contemporary are presented with emphasis on the Systems model. Concepts of motor learning including skill acquisition, measurement of learning, and methods to promote skill acquisition by examining the many facets of practice scheduling and use of feedback are provided. A fictional client case is introduced and threaded throughout the article to facilitate understanding of these concepts and how they can be applied to clinical practice.

Instruction And Jump-Landing Kinematics In College-Aged Female Athletes Over Time, Jena Etnoyer, Nelson Cortes, Stacie I. Ringleb, Bonnie L. Van Lunen, James A. Onate

Rehabilitation Sciences Faculty Publications

Context: Instruction can be used to alter the biomechanical movement patterns associated with anterior cruciate ligament (ACL) injuries.

Objective: To determine the effects of instruction through combination (self and expert) feedback or self-feedback on lower extremity kinematics during the box–drop-jump task, running–stop-jump task, and sidestep-cutting maneuver over time in college-aged female athletes.

Design: Randomized controlled clinical trial.

Setting: Laboratory.

Patients or Other Participants: Forty-three physically active women (age = 21.47 ± 1.55 years, height = 1.65 ± 0.08 m, mass = 63.78 ± 12.00 kg) with no history of ACL or lower extremity injuries or surgery in the 2 months …

Investigation Into The Functional Mobility Difference Between Obese And Non-Obese Elderly, Xuefang Wu, Han T. Yeoh, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Obese aging population is increasing in the United States, and obese elderly experience fall twice as frequent as their lean counterparts. However, the mechanisms of older obese adults fall are still not clear. It is not known whether the obese elderly has more functional mobility impairments than their lean counterparts, and consequently have increased risks of falls. It was hypothesized that obese elderly have more functional mobility impairments compared with their healthy weight counterparts. Six lean and six obese community-dwelling elderly participated in the study. “Timed up & go” test was used to quantify the functional mobility for both lean …

Mobility, Balance, And Falls In Persons With Multiple Sclerosis, Jacob J. Sosnoff, Michael J. Socie, Morgan K. Boes, Brian M. Sandroff, John H. Pula, Yoojin Suh, Madeline Weikert, Steven Morrison, Robert W. Motl

Rehabilitation Sciences Faculty Publications

Background: There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS).

Methods: 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery.

Results: Over 51% of the participants …

An Approach For Identifying Gait Events Using Wavelet Denoising Technique And Single Wireless Imu, Rahul Soangra, Thurmon Lockhart, Nathalie Van De Berge

Physical Therapy Faculty Articles and Research

A new approach is proposed to identify gait events in non-laboratory environments with a single inertial measurement unit (IMU) embedded inside shoe. The aim of our work is to develop a useful clinical tool for monitoring individuals walking disability and detect specific pathological gait patterns. Temporal parameters of gait are determined by classification of accelerations and angular velocities. Wavelets denoising of IMU signals allows for an important amount of information that is exploited in different manners for event identification. It was found that wavelet denoising enhanced specific turning points which could effectively identify gait events. The method is verified by …

Portable, Non-Invasive Fall Risk Assessment In End Stage Renal Disease Patients On Hemodialysis, Thurmon Lockhart, Adam T. Barth, Xiaoyue Zhang, Rahul Soangra, Emaad Abdel-Rahman, John Lach

Physical Therapy Faculty Articles and Research

Patients with end stage renal diseases (ESRD) on hemodialysis (HD) have high morbidity and mortality due to multiple causes, one of which is dramatically higher fall rates than the general population. The mobility mechanisms that contribute to falls in this population must be understood if adequate interventions for fall prevention are to be achieved. This study utilizes emerging noninvasive, portable gait, posture, strength, and stability assessment technologies to extract various mobility parameters that research has shown to be predictive of fall risk in the general population. As part of an ongoing human subjects study, mobility measures such as postural and …

The Impact Of Left Hemisphere Stroke On Force Control With Familiar And Novel Objects: Neuroanatomic Substrates And Relationship To Apraxia, Amanda M. Dawson, Laura J. Buxbaum, Susan V. Duff

Physical Therapy Faculty Articles and Research

Fingertip force scaling for lifting objects frequently occurs in anticipation of finger contact. An ongoing question concerns the types of memories that are used to inform predictive control. Object-specific information such as weight may be stored and retrieved when previously encountered objects are lifted again. Alternatively, visual size and shape cues may provide estimates of object density each time objects are encountered. We reasoned that differences in performance with familiar versus novel objects would provide support for the former possibility. Anticipatory force production with both familiar and novel objects was assessed in six left hemisphere stroke patients, two of whom …

Characteristics And Outcomes Of Individuals Self-Selecting Yoga Versus Physical Therapy For The Treatment Of Chronic Low Back Pain, Dian Dowling Evans

Theses and Dissertations (ETD)

Chronic low back pain (cLBP) is a significant public health problem that is difficult and costly to treat. Determining whether a patient with cLBP will benefit from a particular treatment approach is challenging, since little is understood about the patient characteristics that predict improved treatment outcomes. Understanding these characteristics could reduce treatment failures and costs of care.

This study was designed to explore the demographic, clinical and treatment- related characteristics of individuals self-selecting yoga versus physical therapy (PT) for treatment of cLBP. A growing body of research demonstrates that yoga reduces pain and improves function in persons with cLBP. However, …

The Physiological Consequences Of Bed Rest, Kristin J. Stuempfle, Daniel G. Drury

Health Sciences Faculty Publications

Bed rest often is used to treat a wide variety of medical conditions. However, bed rest results in profound deconditioning of the body. Bed rest reduces the hydrostatic pressure gradient within the cardiovascular system, reduces muscle force production, virtually eliminates compression on the bones, and lowers total energy expenditure. This review focuses on the deconditioning that occurs in the cardiovascular, muscular, and skeletal systems following bed rest. Reduction in plasma volume reduces cardiac preload, stroke volume, cardiac output, and ultimately, maximal oxygen consumption. Skeletal muscle volume, muscle cross sectional area, and fiber cross sectional area decrease, which results in diminished …

Visual-Vestibular Habituation And Balance Training For Motion Sickness, Rose Marie Rine, Michael C. Schubert, Thomas J. Balkany

Physical Therapy Faculty Research

Background and Purpose. This case report describes physical therapy for motion sickness in a 34-year-old woman. The purpose of the report is twofold: (1) to provide an overview of the literature regarding motion sickness syndrome, causal factors, and rationale for treatment and (2) to describe the evaluation and treatment of a patient with motion sickness.

Case Description and Outcomes. The patient initially had moderate to severe visually induced motion sickness, which affected her functional abilities and prevented her from working. Following 10 weeks of a primarily home-based program of visualvestibular habituation and balance training, her symptoms were alleviated and she …

Head And Trunk Movement Responses In Healthy Children To Induced Versus Self-Induced Lateral Tilt, Donnalee Milette, Rose Marie Rine

Physical Therapy Faculty Research

The purpose of our study was to determine head and trunk movement responses that occur in healthy 7-year-old children during induced and self-induced lateral tilt. Twenty subjects, while tailor sitting on a tiltboard, participated in three trials of both induced and self-induced left and right lateral displacements. Measurements of neck and trunk lateral flexion; trunk counterrotation; and neck, trunk, and body anterior-posterior movement were obtained from slide transparencies made at three stages of tilt (original position, initial tilt, and full tilt). For each subject in the two test conditions, changes in these measurements between the stages of tilt were determined …