Physical Therapy Commons^™

The Effects Of Haptic Feedback On Postural Sway, Andrew J. Meszaros, Brandon Crumpacker, Marc Gendelman, Peter Martin, Levi Vantol, Pierre Zook

Student-Faculty Research - College of Physical Therapy

Purpose: Effectiveness of haptic feedback on reducing postural sway

Hypothesis: Haptic input improves static standing stability. Individuals with increased variability in sway may have an increased risk for falls. Therefore, our haptic feedback device may have the ability to reduce risk of falling.

Postural control is a dynamic system involving vision, vestibular system, proprioception, and musculoskeletal system. Postural control enables people to maintain their balance, reduce their sway, and keep an upright posture.

Haptic feedback is tactile or vibratory cues that assist a subject in determining where they are in space.

Sit-To-Stand Symmetry, Andrew J. Meszaros, Nick Gammie, April Nichols, Warren Ocano, Mitchell Prunk, Montana Rhoden, Bill Walters

Student-Faculty Research - College of Physical Therapy

Asymmetric sit-to-stand (STS) and static standing mechanics may be related to fall risk and function after hip fracture. Even in those individuals who achieve an independent status in rising from STS, asymmetric movement strategies are frequently adopted. Previous research has revealed that the asymmetry is not fully explained by strength deficits alone. Stroke literature suggests that STS asymmetry is a function of perceptual deficits, such as sense of effort, however, this concept has not yet been explored following a hip fracture.

Validation Of The Paper Pull Test For 1st Metatarsophalangeal Strength In Patients With Hallux Valgus And Healthy Controls, Jeff Houck, Marcey Keefer Hutchison, Ian Hockett, Cody Cataldo-Gillman, Jamie Kahn, Geoffrey Kunita

Student-Faculty Research - College of Physical Therapy

Purpose: Explore the validity of the paper pull test (PPT) intrinsic muscle function.

Effect Of A One-Time Cognitive Functional Therapy Intervention In Patients With Moderate To High Risk Of Chronic Low Back Pain: Case Series Study, Tracy Broyles, Emily Stein, Talisa Swanson, Rusne Kuzmickas, Jeff Houck, Daniel Kang, Li-Zandre Philbrook

Student-Faculty Research - College of Physical Therapy

Can an early confrontation of patients’ fear and beliefs about low back pain lead to better outcomes?

Hypothesis: A one-time treatment geared toward confronting fear and negative pain beliefs will result in reduced pain interference and fatigue, and increased physical function and self-efficacy, as well as guide patients from fear avoidance behavior to active life participation.

Psychometric Evaluation Of The Patient-Reported Outcomes Measurement Information System (Promis) Physical Function And Pain Interference Computer Adaptive Test For Subacromial Impingement Syndrome, Benjamin Strong, Michael Maloney, Judith Baumhauer, Joseph Schaffer, Jeff Houck, Man Hung, Jerry Bounsanga, Maren W. Voss, Yushan Gu, Ilya Voloshin

Faculty Publications - College of Physical Therapy

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Computer Adaptive Test (CAT) was previously validated for rotator cuff disease and shoulder instability. This study evaluated the psychometric properties of the PROMIS Physical Function (PF) CAT, PROMIS Pain Interference (PI) CAT, and the American Shoulder and Elbow Surgeons (ASES) Shoulder Function Score for subacromial impingement syndrome.

Methods: PROMIS PF CAT, PI CAT, and ASES (Pain, Function, Total) were collected on all visits for 2 surgeons between January 2016 and August 2016. New patients, aged 18 years and older, were selected by International Classification of Diseases code for impingement syndrome …

What Are Typical Outcomes Associated With Physical Therapy For Foot & Ankle Patients?, Judith F. Baumhauer, Christopher Neville, Kostantinos Vasalos, Chad Condidorio, Kathleen Fear, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: It is unclear whether patients attending physical therapy, post-op or for conservative care, achieve clinically important differences (CID) on the patient reported outcome information system (PROMIS) scales. Key PROMIS outcomes physical function (PF) and pain interference (PI) match well with treatments provided in physical therapy. Physical therapy may also influence depression (Dep). Documentation of PROMIS outcomes associated with physical therapy are useful to help set patient expectations. The purpose of this analysis was to document expected PROMIS PF, PI, and Dep outcomes after physical therapy for foot and ankle diagnoses by 1) reporting average improvement and 2) examining whether …

Preseason Y Balance Test Scores Are Not Associated With Noncontact Time-Loss Lower Quadrant Injury In Male Collegiate Basketball Players, Jason Brumitt, Kyle Nelson, Duane Duey, Matthew Jeppson, Luke Hammer

Faculty Publications - College of Physical Therapy

The Y-Balance Test-Lower Quarter has shown promise as a screening tool for identifying athletes at risk of injury. Subsequent studies, utilizing heterogeneous populations or different operational definitions of injury, have presented equivocal findings. Therefore, studies evaluating the efficacy of the Y-Balance Test to discriminate injury risk in a homogeneous population is warranted. One-hundred sixty-nine male (mean age 19.9 + 1.5 y) collegiate basketball players were recruited during 2 consecutive seasons (2016–2017/2017–2018). Athletes completed the Y-Balance testing protocol at the start of each preseason. Athletic trainers tracked noncontact time-loss lower quadrant injuries over the course of the season. Receiver operator characteristic …

Prior History Of Anterior Cruciate Ligament (Acl) Reconstruction Is Associated With A Greater Risk Of Subsequent Acl Injury In Female Collegiate Athletes, Jason Brumitt, Alma Mattocks, Amy Engilis, Dale Isaak, Jeremy Loew

Faculty Publications - College of Physical Therapy

Objectives: The risk of a subsequent anterior cruciate ligament (ACL) sprain is greater in high school aged female athletes with prior history of ACL reconstruction (ACLR) than in age-matched controls. The risk of a subsequent ACL injury in female collegiate athletes with prior ACLR is unknown. The primary purpose of this study was to determine the relative risk of a subsequent ACL injury in female collegiate athletes with prior ACLR when compared to age-matched controls. The secondary purpose of this study was to evaluate the ability of jump and hop tests to discriminate ACL injury risk.

Design: Prospective cohort.

Methods: …

Low Prevalence Of Patellar Tendon Abnormality And Low Incidence Of Patellar Tendinopathy In Female Collegiate Volleyball Players, Marcey Keefer Hutchison, Christopher Patterson, Tyler Cuddeford, Robert Dudley, Eric Sorenson, Jason Brumitt

Faculty Publications - College of Physical Therapy

The prevalence of patellar tendinopathy has been reported to be as high as 50% in elite male volleyball (VB) players; however, the rate of injury in female collegiate VB athletes is unknown. The purpose of this study was to 1) identify the prevalence of ultrasonographic evidence of patellar tendon abnormality at the start of the preseason in female collegiate VB players; 2) report the incidence of tendinopathy during the season; and 3) determine if the preseason presence of tendon abnormality is associated with onset of disease. One hundred and six female collegiate VB players had both patellar tendons imaged. Incidence …

Does Physical Therapy Produce Value For Post-Operative And/Or Non-Operative Foot And Ankle Patients?, Jeff Houck, Christopher Neville, Kostantinos Vasalos, Chad Condidorio, Kathleen Fear, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Healthcare is at a unique time in history where patient reported outcomes have become important in assessing value and subsequent reimbursement with pay-4-performance initiatives. It is unclear whether physical function, pain and depressive symptoms can assist providers determine if additional physical therapy may improve care for foot and ankle patients considering post-op and/or non-operative care. The purpose of this research was to examine symptom severity (PROMIS PF, PI, and Dep) after surgery or with non-operative care at the start of formal physical therapy to determine if this symptom severity presentation and/or change in symptoms over time are predictors of …

Preseason Y Balance Test Scores Are Not Associated With Noncontact Time-Loss Lower Quadrant Injury In Male Collegiate Basketball Players, Jason Brumitt, Kyle Nelson, Duane Duey, Matthew Jeppson, Luke Hammer

Faculty Publications - College of Physical Therapy

The Y-Balance Test-Lower Quarter has shown promise as a screening tool for identifying athletes at risk of injury. Subsequent studies, utilizing heterogeneous populations or different operational definitions of injury, have presented equivocal findings. Therefore, studies evaluating the efficacy of the Y-Balance Test to discriminate injury risk in a homogeneous population is warranted. One-hundred sixty-nine male (mean age 19.9 + 1.5 y) collegiate basketball players were recruited during 2 consecutive seasons (2016–2017/2017–2018). Athletes completed the Y-Balance testing protocol at the start of each preseason. Athletic trainers tracked noncontact time-loss lower quadrant injuries over the course of the season. Receiver operator characteristic …

Promis Pain Interference Is Superior Vs Numeric Pain Rating Scale For Pain Assessment In Foot And Ankle Patients, David N. Bernstein, Meghan Kelly, Jeff Houck, John P. Ketz, Samuel Flemister, Benedict F. Digiovanni, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Background: The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).

Methods: Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a …

Preoperative Promis Scores Predict Postoperative Promis Score Improvement For Patients Undergoing Hand Surgery, David N. Bernstein, Jeff Houck, Ronald M. Gonzalez, Danielle M. Wilbur, Richard J. Miller, David J. Mitten, Warren C. Hammert

Faculty Publications - College of Physical Therapy

Background: Patient-Reported Outcomes Measurement Information System (PROMIS) can be used alongside preoperative patient characteristics to set postsurgery expectations. This study aimed to analyze whether preoperative scores can predict significant postoperative PROMIS score improvement. Methods: Patients undergoing hand and wrist surgery with initial and greater than 6-month follow-up PROMIS scores were assigned to derivation or validation cohorts, separating trauma and nontrauma conditions. Receiver operating characteristic curves were calculated for the derivation cohort to determine whether preoperative PROMIS scores could predict postoperative PROMIS score improvement utilizing minimal clinically important difference principles. Results: In the nontrauma sample, patients with baseline Physical Function (PF) …

Can Foot Exercises And Barefoot Weight Bearing Improve Foot Function In Participants With Flat Feet?, Marcey Keefer Hutchison, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Unexplored in individuals with flatfoot (FF) is the potential of foot specific exercise and barefoot weightbearing (BWB) to improve foot function. The purposes of this study were

A. To evaluate whether exercise and BWB alter foot muscle structure in participants with FF

B. To evaluate whether exercise and BWB alters foot and ankle function in participants with FF

C. To compare foot muscle structure and foot and ankle function between participants with FF to controls with neutral foot posture prior to exercise.

Methods: Twenty participants with FF and 12 participants with neutral foot posture participated. Participants with …

Preseason Lower Extremity Functional Test Scores Are Not Associated With Lower Quadrant Injury - A Validation Study With Normative Data On 395 Division Iii Athletes, Jason Brumitt, Victor Wilson, Natalie Ellis, Jordan Petersen, Christopher John Zita, Jordan Reyes

Faculty Publications - College of Physical Therapy

Background: Preseason performance on the lower extremity functional test (LEFT), a timed series of agility drills, has been previously reported to be associated with future risk of lower quadrant (LQ = low back and lower extremities) injury in Division III (D III) athletes.Validation studies are warranted to confirm or refute initial findings.

Hypothesis/Purpose: The primary purpose of this study was to examine the ability of the LEFT to discriminate injury occurrence in D III athletes, in order to validate or refute prior findings. It was hypothesized that female and male D III athletes slower at completion of the LEFT would …

Preseason Functional Test Scores Are Associated With Future Sports Injury In Female Collegiate Athletes, Jason Brumitt, Bryan C. Heiderscheit, Robert C. Manske, Paul E. Niemuth, Alma Mattocks, Mitchell J. Rauh

Faculty Publications - College of Physical Therapy

Brumitt, J, Heiderscheit, B, Manske, R, Niemuth, PE, Mattocks, A, and Rauh, MJ. Preseason functional test scores are associated with future sports injury in female collegiate athletes. J Strength Cond Res 32(6): 1692–1701, 2018—Recent prospective cohort studies have reported preseason functional performance test (FPT) measures and associations with future risk of injury; however, the findings associated with these studies have been equivocal. The purpose of this study was to determine the ability of a battery of FPTs as a preseason screening tool to identify female Division III (D III) collegiate athletes who may be at risk for a noncontact time-loss …

Determining Success Or Failure After Foot And Ankle Surgery Using Patient Acceptable Symptom State (Pass) And Patient Reported Outcome Information System (Promis), Michael R. Anderson, Judith F. Baumhauer, Benedict F. Digiovanni, Sam Flemister, John P. Ketz, Irvin Oh, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: As the role of generic patient-reported outcomes (PROs) expands, important questions remain about their interpretation. In particular, how the Patient Reported Outcome Measurement Instrumentation System (PROMIS) t score values correlate with the patients’ perception of success or failure (S/F) of their surgery is unknown. The purposes of this study were to characterize the association of PROMIS t scores, the patients’ perception of their symptoms (patient acceptable symptom state [PASS]), and determination of S/F after surgery.

Methods: This retrospective cohort study contacted patients after the 4 most common foot and ankle surgeries at a tertiary academic medical center (n = …

Combined Exercise/Weight Bearing Program Influences Of Foot Function In People With Asymptomatic Flat Feet, Alison Modafferi, Angela Foster, Brenden Thompson, Jean Jarbath, Shanna Howland, Tyler Whited, Jeff Houck, Marcey Keefer Hutchison

Student-Faculty Research - College of Physical Therapy

No abstract provided.

Sit-To-Stand Symmetry In Individuals With Hip Pathology, Andrew J. Meszaros, Allie Thomas, Alyssa Ware, Craig Hawkinson, Jaydee Romick, Michelle Thoreson

Student-Faculty Research - College of Physical Therapy

Post-hip fracture patients continue to exhibit asymmetries during sit-to-stand task following rehabilitation. While strength is thoroughly addressed, perceptual deficits may be a missing component to rehabilitation post-hip fracture.

Community-Based Exercise & Wellness Program For Chronic Stroke - A Pilot Study, Christen Johnson, Daniel Debates, Meggie Dallas, Morgan Johansen, Morgan Kilgore, Cindy Zablotny, Theresa Raudsepp

Student-Faculty Research - College of Physical Therapy

Purpose: The overall goal of this pilot study was to determine the feasibility and effectiveness of an 8 week university-based community exercise and wellness program designed to provide an opportunity for exercise, social interaction, and education on stroke-related health and wellness topics.

Effect Of Haptic Feedback On Static Standing Sway, Andrew J. Meszaros, Alyssa Carey, Jessica Hund, Morgan Mccann, Kindra Mcdougall

Student-Faculty Research - College of Physical Therapy

Study Goal: To explore the use of proprioceptive input as a means of attenuating postural sway through the development and implementation of a hands-free device, with the ultimate goal of providing sway-reference haptic input located at the upper trunk and shoulders to determine: Does sway-referenced haptic input improve static standing stability?

Changes In Achilles Tendon Thickness Following A 10-Week Heavy Load Eccentric Exercise Program, Tyler Cuddeford, Marcey Keefer Hutchison, Annika Piros, Jessica London, Andi Maleike, Tiffany Schoonover, Madison Eymann

Student-Faculty Research - College of Physical Therapy

Achilles tendinopathy often presents with increased tendon thickness, lower echogenicity, and decreased stiffness. Interestingly, tendons are also able to adapt their structural and mechanical characteristics in response to loading.

Eccentric exercise for Achilles tendinopathy continues to be the recommended treatment. The majority of individuals with midportion achilles tendinopathy have shown favorable response to eccentric exercise.

Predicting Patients Acceptable Symptom State At Short Term Follow Up Of A Collaborative Primary Care Pt/Md Service, Catherine Vandehaar, Kevin Morikawa, Andrea Mulligan, Amador Marcano, Ceci Gutierrez, Jeff Houck, Daniel Kang, Tyler Cuddeford, Sarah Rahkola

Student-Faculty Research - College of Physical Therapy

Hypothesis: Patient Reported Outcome Tools will predict a patient’s acceptable symptom state (PASS)

Kinetic And Kinematic Analysis Of Male Collegiate Basketball Players With Patella Tendinosis, Dacia Heckendorf, Luke Hammer, Matthew Jeppson, Nicole Jones, Katherine Porter

Student-Faculty Research - College of Physical Therapy

Patellar tendinopathy (PT) occurs in approximately 40% of elite jumping athletes. Players will typically play through the pain; however, if the condition is not successfully treated some are forced to retire from sport. Research has shown that there are no signs of chemical inflammation in the tendon, but rather the presence of a degenerative tendon with collagen disorientation and disorganization.

Can Patient Reported Outcomes Guide Therapy Needs In Foot And Ankle Patients?, Jeff Houck, Jillian Santer, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The patient acceptable symptom state (PASS) is a validated question establishing if patients activity and symptoms are at a satisfactory low level for pain and function. Surprisingly, ~20% of foot and ankle patients at their initial visit present for care with an acceptable symptom state (i.e. PASS yes). These patients are important to identify to prevent over treatment and avoid excessive cost. It is also unclear what health domains (Pain Interference (PI), Physical Function (PF), or Depression (Dep)) influence a patients judgement of their PASS state (i.e. why they are seeking treatment). The purpose of this analysis is to …

Comparison Of Four Fitbit And Jawbone Activity Monitors With A Research-Grade Actigraph Accelerometer For Estimating Physical Activity And Energy Expenditure, Mary T. Imboden, Michael B. Nelson, Leonard A. Kaminsky, Alexander Hk Montoye

Faculty Publications - Department of Kinesiology

Background/aim Consumer-based physical activity (PA) monitors have become popular tools to track PA behaviours. Currently, little is known about the validity of the measurements provided by consumer monitors. We aimed to compare measures of steps, energy expenditure (EE) and active minutes of four consumer monitors with one research-grade accelerometer within a semistructured protocol.

Methods Thirty men and women (18–80 years old) wore Fitbit One (worn at the waist), Fitbit Zip (waist), Fitbit Flex (wrist), Jawbone UP24 (wrist) and one waist-worn research-grade accelerometer (ActiGraph) while participating in an 80 min protocol. A validated EE prediction equation and active minute cut-points were …

Preseason Functional Performance Test Measures Are Associated With Injury In Female College Volleyball Players, Jason Brumitt, Alma Mattocks, Jeremy Loew, Phil Lentz

Faculty Publications - College of Physical Therapy

Context: Preseason functional performance test measures have been associated with noncontact time-loss injury in some athletic populations. However, findings have been equivocal with many studies consisting of heterogeneous populations. Objective: To determine if preseason standing long jump and/or single-leg hop test scores are associated with a noncontact time-loss injury to the lower quadrant (LQ = low back or lower-extremities) in female Division III college volleyball (VB) players. Design: Prospective cohort study. Setting: National Collegiate Athletic Association Division III female VB teams. Patients: A total of 82 female college VB players (age = 18.9 [1.0] y). Main Outcome Measures: Standing long …

Validation And Generalizability Of Preoperative Promis Scores To Predict Postoperative Success In Foot And Ankle Patients, Michael R. Anderson, Jeff Houck, Charles L. Saltzman, Man Hung, Florian Nickisch, Alexej Barg, Timothy Beals, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: A recent publication reported preoperative Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) scores to be highly predictive in identifying patients who would and would not benefit from foot and ankle surgery. Their applicability to other patient populations is unknown. The aim of this study was to assess the validation and generalizability of previously published preoperative PROMIS physical function (PF) and pain interference (PI) threshold t scores as predictors of postoperative clinically meaningful improvement in foot and ankle patients from a geographically unique patient population.

Methods: Prospective PROMIS PF and PI scores of consecutive patient visits to a tertiary foot and …

Subtle Cavus Deformities: Is Isolated Lateral Ankle Ligament Reconstruction Enough For Improved Patient-Reported Outcomes?, Ashlee Macdonald, Meghan Kelly, Jeff Houck, Judith Baumhauer, Irvin Oh, Adolph Flemister, John Ketz

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Lateral ankle ligament injuries are common conditions accounting for 25% of musculoskeletal injuries. Prior reports have found increased risk of failed lateral ankle reconstruction in those with a subtle cavus deformity, and therefore, correcting the deformity is often advocated. However, other studies have been unable to identify subtle cavus deformity as a clear risk factor for recurrent injury. The purpose of this study was to 1) compare PROMIS physical function (PF), pain interference (PI), and depression scores in patients with subtle cavus deformities to those without deformity who underwent lateral ankle ligament reconstruction, 2) compare PROMIS scores in allograft …

Midfoot Power During Walking And Stair Ascent In Healthy Adults, Frank Diliberto, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Intrinsic foot muscles have the capacity to attenuate and reverse arch deformation under loaded conditions. This function is proposed to be an important component in generating the midfoot power and stability requisite for gastroc-soleus muscle action at the ankle during forward propulsion. Synergistic activation of intrinsic foot muscles is proposed to function as a ‘foot core’ during weightbearing activity that is analogous to the function of the smaller muscles at the spine. If this theory were sound, midfoot power would be expected to increase, potentially in proportion to ankle power, as the muscular demand of a task increases. The …