Physical Therapy Commons^™

Mechanisms Of Isometric Exercise-Induced Hypoalgesia In Young And Older Adults, Kathy J. Lemley

Dissertations (1934 -)

Pain reduction following exercise (exercise-induced hypoalgesia; EIH) is well-established in young adults. Specific to isometric exercise, the greatest EIH follows low intensity contractions held for long duration. The EIH response of older adults is not known; and the mechanisms for EIH are unclear at any age. This dissertation aimed to address these unknowns through a series of three studies. In study one, repeatability of pressure pain reports (pain threshold and pain ratings) was assessed in healthy older adults, including the impact of psychological factors. Pain reports, measured before and after quiet rest, did not change following quiet rest. Higher state …

Changes In Glutamate Receptor Subunits Within The Medulla In Goats After Section Of The Carotid Sinus Nerves, Justin Robert Miller, Suzanne Neumueller, Clarissa Muere, Samantha Olesiak, Lawrence Pan, John D. Bukowy, Asem O. Daghistany, Matthew Hodges, Hubert Forster

Physical Therapy Faculty Research and Publications

The mechanisms which contribute to the time-dependent recovery of resting ventilation and the ventilatory CO₂ chemoreflex after carotid body denervation (CBD) are poorly understood. Herein we tested the hypothesis that there are time-dependent changes in the expression of specific AMPA, NMDA, and/or neurokinin-1 (NK1R) receptors within respiratory-related brain stem nuclei acutely or chronically after CBD in adult goats. Brain stem tissues were collected acutely (5 days) or chronically (30 days) after sham or bilateral CBD, immunostained with antibodies targeting AMPA (GluA1 or GluA2), NMDA (GluN1), or NK-1 receptors, and optical density (OD) compared. Physiological measurement confirmed categorization of each …

Use Of Audio Biofeedback To Reduce Tibial Impact Accelerations During Running, Claire M. Wood, Kristof Kipp

Exercise Science Faculty Research and Publications

Visual biofeedback of tibial peak positive acceleration (PPA) during running has been used successfully as a method of gait retraining to reduce PPAs. Audio biofeedback generated from PPA may present a novel, portable alternative. The purpose of this study was to investigate the feasibility of using PPA-generated audio biofeedback to reduce PPAs while running. Nine runners were fitted with a wireless accelerometer on their left tibia. PPAs were recorded and a custom LabVIEW program was used to emit a single beep once the PPA reached a preset threshold. The numerical difference between this threshold and peak PPA during running was …

The Stroke-Related Effects Of Hip Flexion Fatigue On Over Ground Walking, Megan M. Rybar, Eric R. Walker, Henry Kuhnen, Daniel R. Ouellette, Reivian Berrios, Sandra K. Hunter, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Individuals post stroke often rely more on hip flexors for limb advancement during walking due to distal weakness but the effects of muscle fatigue in this group is not known. The purpose of this study was to quantify how stroke affects the influence of hip flexor fatigue on over ground walking kinematics and performance and muscle activation. Ten individuals with chronic stroke and 10 without stroke (controls) participated in the study. Maximal walking speed, walking distance, muscle electromyograms (EMG), and lower extremity joint kinematics were compared before and after dynamic, submaximal fatiguing contractions of the hip flexors (30% maximal load) …

Stressor-Induced Increase In Muscle Fatigability Of Young Men And Women Is Predicted By Strength But Not Voluntary Activation, Manda L. Keller-Ross, Hugo M. Pereira, Jaclyn Pruse, Tejin Yoon, Bonnie A. Schlinder-Delap, Kristy A. Nielson, Sandra K. Hunter

Psychology Faculty Research and Publications

This study investigated mechanisms for the stressor-induced changes in muscle fatigability in men and women. Participants performed an isometric-fatiguing contraction at 20% maximal voluntary contraction (MVC) until failure with the elbow flexor muscles. Study one (n = 55; 29 women) involved two experimental sessions: 1) a high-stressor session that required a difficult mental-math task before and during a fatiguing contraction and 2) a control session with no mental math. For some participants (n = 28; 14 women), cortical stimulation was used to examine mechanisms that contributed to muscle fatigability during the high-stressor and control sessions. Study two …

Sensory Electrical Stimulation Improves Foot Placement During Targeted Stepping Post-Stroke, Eric R. Walker, Allison S. Hyngstrom, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Proper foot placement is vital for maintaining balance during walking, requiring the integration of multiple sensory signals with motor commands. Disruption of brain structures post-stroke likely alters the processing of sensory information by motor centers, interfering with precision control of foot placement and walking function for stroke survivors. In this study, we examined whether somatosensory stimulation, which improves functional movements of the paretic hand, could be used to improve foot placement of the paretic limb. Foot placement was evaluated before, during, and after application of somatosensory electrical stimulation to the paretic foot during a targeted stepping task. Starting from standing, …

An Interprofessional Consensus Of Core Competencies For Prelicensure Education In Pain Management: Curriculum Application For Physical Therapy, Marie K. Hoeger Bement, Barbara J. St. Marie, Terry M. Nordstrom, Nicole Christensen, Jennifer M. Mongoven, Ian J. Koebner, Scott M. Fishman, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Core competencies in pain management for prelicensure health professional education were recently established. These competencies represent the expectation of minimal capabilities for graduating health care students for pain management and include 4 domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain (Appendix 1). The purpose of this article is to advocate for and identify how core competencies for pain can be applied to the professional (entry-level) physical therapist curriculum. By ensuring that core competencies in pain management are embedded within the foundation of physical therapist education, physical therapists will have the core knowledge …

Electrical Stimulation Technologies For Wound Healing, Luther C. Kloth

Physical Therapy Faculty Research and Publications

Objective: To discuss the physiological bases for using exogenously applied electric field (EF) energy to enhance wound healing with conductive electrical stimulation (ES) devices.

Approach: To describe the types of electrical currents that have been reported to enhance chronic wound-healing rate and closure.

Results: Commercial ES devices that generate direct current (DC), and mono and biphasic pulsed current waveforms represent the principal ES technologies which are reported to enhance wound healing.

Innovation: Wafer-thin, disposable ES technologies (wound dressings) that utilize mini or micro-batteries to deliver low-level DC for wound healing and antibacterial wound-treatment purposes are commercially available. Microfluidic wound-healing chips …

Physical Therapy In Wound Healing, Edema, And Urinary Incontinence, Jakub Taradaj, Tomasz Urbanek, Luther C. Kloth, Marco Romanelli

Physical Therapy Faculty Research and Publications

No abstract provided.

Contributions Of The Pre-Bötzinger Complex And The Kölliker-Fuse Nuclei To Respiratory Rhythm And Pattern Generation In Awake And Sleeping Goats, Hubert Forster, Joshua M. Bonis, Katie L. Krause, Julie Wenninger, Suzanne Neumueller, Matthew Hodges, Lawrence Pan

Physical Therapy Faculty Research and Publications

We investigated in three groups of awake and sleeping goats whether there are differences in ventilatory responses after injections of Ibotenic acid (IA, glutamate receptor agonist and neurotoxin) into the pre-Bötzinger complex (preBötC), lateral parabrachial (LPBN), medial (MPBN) parabrachial, or Kölliker-Fuse nuclei (KFN). In one group, within minutes after bilateral injection of 10 μl IA (50 mM) into the preBötC, there was a 10-fold increase in breathing frequency, but 1.5 h later, the goats succumbed to terminal apnea. These data are consistent with findings in reduced preparations that the preBötC is critical to sustaining normal breathing. In a second group, …

The Role Of Aerobic Physical Fitness In Overweight Adolescents, Stacy Stolzman, Jenna Speltz, Katherine Hoffmeister, Michael E. Danduran, Joseph Skelton, Paula E. Papanek, April L. Harkins, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

No abstract provided.

Contributions Of The Kölliker-Fuse Nucleus To Coordination Of Breathing And Swallowing, Joshua M. Bonis, Suzanne E. Neumueller, K. L. Krause, Lawrence Pan, Matthew R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Herein we compare the effects of perturbations in the Kölliker–Fuse nucleus (KFN) and the lateral (LPBN) and medial (MPBN) parabrachial nuclei on the coordination of breathing and swallowing. Cannula was chronically implanted in goats through which ibotenic acid (IA) was injected while awake. Swallows in late expiration (E) always reset while swallows in early inspiration (I) never reset the respiratory rhythm. Before cannula implantation, all other E and I swallows did not reset the respiratory rhythm, and had small effects on E and I duration and tidal volume (V_T). However, after cannula implantation in the MPBN and …

Fatigue And Recovery From Dynamic Contractions In Men And Women Differ For Arm And Leg Muscles, Jonathon Senefeld, Tejin Yoon, Marie K. Hoeger Bement, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Introduction: Whether there is a gender difference in fatigue and recovery from maximal velocity fatiguing contractions and across muscles is not understood. Methods: Sixteen men and 19 women performed 90 isotonic contractions at maximal voluntary shortening velocity (maximal velocity concentric contractions, MVCC) with the elbow flexor and knee extensor muscles (separate days) at a load equivalent to 20% maximal voluntary isometric contraction (MVIC). Results: Power (from MVCCs) decreased similarly for men and women for both muscles (P > 0.05). Men and women had similar declines in MVIC of elbow flexors, but men had greater reductions in knee extensor MVIC force and …

Changes In Hemodynamic Responses In Chronic Stroke Survivors Do Not Affect Fmri Signal Detection In A Block Experimental Design, Nutta-On Promjunyakul, Brian D. Schmit, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

The use of canonical functions to model BOLD-fMRI data in people post-stroke may lead to inaccurate descriptions of task-related brain activity. The purpose of this study was to determine whether the spatiotemporal profile of hemodynamic responses (HDRs) obtained from stroke survivors during an event-related experiment could be used to develop individualized HDR functions that would enhance BOLD-fMRI signal detection in block experiments. Our long term goal was to use this information to develop individualized HDR functions for stroke survivors that could be used to analyze brain activity associated with locomotor-like movements. We also aimed to examine the reproducibility of HDRs …

Has The Foundation For Physical Therapy Advanced The Body Of Knowledge?, Sheila Schindler-Ivens, Jan Struhar, Martha G. Jermé

Physical Therapy Faculty Research and Publications

No abstract provided.

Atropine Microdialysis Within Or Near The Pre-Bötzinger Complex Increases Breathing Frequency More During Wakefulness Than During Nrem Sleep, Clarissa Muere, Suzanne E. Neumueller, Justin Robert Miller, Samantha Olesiak, Matthew R. Hodges, Lawrence Pan, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Normal activity of neurons within the medullary ventral respiratory column (VRC) in or near the pre-Bötzinger Complex (preBötC) is dependent on the balance of inhibitory and excitatory neuromodulators acting at their respective receptors. The role of cholinergic neuromodulation during awake and sleep states is unknown. Accordingly, our objective herein was to test the hypotheses that attenuation of cholinergic modulation of VRC/preBötC neurons in vivo with atropine would: 1) decrease breathing frequency more while awake than during non-rapid-eye-movement (NREM) sleep and 2) increase other excitatory neuromodulators. To test these hypotheses, we unilaterally dialyzed mock cerebrospinal fluid (mCSF) or 50 mM atropine …

Introgression Of Brown Norway Cyp4a Genes Onto The Dahl Salt-Sensitive Background Restores Vascular Function In Ss-5Bn Consomic Rats, Kathleen M. Lukaszewicz, John R. Falck, Vijaya L. Manthati, Julian H. Lombard

Physical Therapy Faculty Research and Publications

The present study tested the hypothesis that the Dahl SS (salt-sensitive) rat has vascular dysfunction due, in part, to the up-regulation of the CYP4A/20-HETE (cytochrome P450 ω-hydroxylase 4A)/20-hydroxyeicosatetraenoic acid) system. To assess the role of vascular 20-HETE, SS rats were compared with SS-5^BN consomic rats, carrying CYP4A alleles on chromosome 5 from the normotensive BN (Brown Norway) introgressed on to the SS genetic background. Cerebral arteries from SS-5^BN rats had less CYP4A protein than arteries from SS rats fed either NS (normal-salt, 0.4% NaCl) or HS (high-salt, 4.0% NaCl) diet. ACh (acetylcholine)-induced dilation of MCAs (middle cerebral …

A Pilot Study To Measure Upper Extremity H-Reflexes Following Neuromuscular Electrical Stimulation Therapy After Stroke, Ann M. Stowe, L. Hughes-Zahner, V. K. Barnes, L. L. Herbelin, Sheila M. Schindler-Ivens, B. M. Quaney

Physical Therapy Faculty Research and Publications

Upper extremity (UE) hemiparesis persists after stroke, limiting hand function. Neuromuscular electrical stimulation (NMES) is an effective intervention to improve UE recovery, although the underlying mechanisms are not fully understood. Our objective was to establish a reliable protocol to measure UE agonist–antagonist forearm monosynaptic reflexes in a pilot study to determine if NMES improves wrist function after stroke. We established the between-day reliability of the H-reflex in the extensor carpi radialis longus (ECRL) and flexor carpi radialis (FCR) musculature for individuals with prior stroke (n = 18). The same-day generation of ECRL/FCR H-reflex recruitment curves was well tolerated, regardless of …

Functional Implications Of Impaired Control Of Submaximal Hip Flexion Following Stroke, Allison S. Hyngstrom, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Introduction: We quantified sub-maximal torque regulation during low to moderate intensity isometric hip flexion contractions in individuals with stroke and the associations with leg function. Methods: 10 participants with chronic stroke and 10 controls performed isometric hip flexion contractions at 5%, 10%, 15%, 20%, and 40% of maximal voluntary contraction (MVC) in paretic, non-paretic, and control legs. Results: Participants with stroke had larger torque fluctuations (coefficient of variation, CV), for both the paretic and non-paretic legs, than controls (Pr² =0.45) and Berg Balance Score (r²=0.38). At 5% MVC, there were larger torque fluctuations in the …

Changes In Neurochemicals Within The Ventrolateral Medullary Respiratory Column In Awake Goats After Carotid Body Denervation, Justin Robert Miller, Suzanne E. Neumueller, Clarissa Muere, Samantha Olesiak, Lawrence Pan, Matthew R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

A current and major unanswered question is why the highly sensitive central CO₂/H⁺ chemoreceptors do not prevent hypoventilation-induced hypercapnia following carotid body denervation (CBD). Because perturbations involving the carotid bodies affect central neuromodulator and/or neurotransmitter levels within the respiratory network, we tested the hypothesis that after CBD there is an increase in inhibitory and/or a decrease in excitatory neurochemicals within the ventrolateral medullary column (VMC) in awake goats. Microtubules for chronic use were implanted bilaterally in the VMC within or near the pre-Bötzinger Complex (preBötC) through which mock cerebrospinal fluid (mCSF) was dialyzed. Effluent mCSF was collected …

Skin Cell Proliferation Stimulated By Microneedles, Horst Liebl, Luther C. Kloth

Physical Therapy Faculty Research and Publications

A classical wound may be defined as a disruption of tissue integrity. Wounds, caused by trauma from accidents or surgery, that close via secondary intention rely on the biological phases of healing, i.e., hemostasis, inflammation, proliferation, and remodeling (HIPR). Depending on the wound type and severity, the inflammation phase begins immediately after injury and may last for an average of 7–14 days. Concurrent with the inflammation phase or slightly delayed, cell proliferation is stimulated followed by the activation of the remodeling (maturation) phase. The latter phase can last as long as 1 year or more, and the final healed state …

Influence Of Knee Flexion Angle And Age On Triceps Surae Muscle Fatigue During Heel Raises, Kim Hébert-Losier, Anthony G. Schneiders, José A. García, S. John Sullivan, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

Hébert-Losier, K, Schneiders, AG, García, JA, Sullivan, SJ, and Simoneau, GG. Influence of knee flexion angle and age on triceps surae muscle fatigue during heel raises. J Strength Cond Res 26(11): 3134–3147, 2012—The triceps surae (TS) muscle-tendon unit is 1 of the most commonly injured in elite and recreational athletes, with a high prevalence in middle-aged adults. The performance of maximal numbers of unilateral heel raises is used to assess, train, and rehabilitate TS endurance and conventionally prescribed in 0° knee flexion (KF) for the gastrocnemius and 45° for the soleus (SOL). However, the extent of muscle selectivity conferred through …

Neuromagnetic Activity In The Cerebral Cortex Is Modulated By Locomotor-Like Movements Produced During Pedaling, Sheila M. Schindler-Ivens, Ruth M. Swedler, Brian D. Schmit, Sylvain Baillet

Physical Therapy Faculty Research and Publications

No abstract provided.

Near Infrared Spectroscopic Monitoring During Cardiopulmonary Exercise Testing Detects Anaerobic Threshold, Rohit P. Rao, Michael J. Danduran, J. E. Dixon, Rohit S. Loomba, George M. Hoffman

Exercise Science Faculty Research and Publications

Cardiopulmonary exercise testing (CPET) provides assessment of the integrative responses involving the pulmonary, cardiovascular, and skeletal muscle systems. Application of exercise testing remains limited to children who are able to understand and cooperate with the exercise protocol. Near-infrared spectroscopy (NIRS) provides a noninvasive, continuous method to monitor regional tissue oxygenation (rSO2). Our specific aim was to predict anaerobic threshold (AT) during CPET noninvasively using two-site NIRS monitoring. Achievement of a practical noninvasive technology for estimating AT will increase the compatibility of CPET. Patients without structural or acquired heart disease were eligible for inclusion if they were ordered to undergo CPET …

Restoring Functional Status: A Long-Term Case Report Of Severe Lung And Ventilatory Muscle Pump Dysfunction Involving Recurrent Bacterial Pneumonias, Dennis Sobush, Linda Jean Laatsch-Lybeck, Randolph J. Lipchik

Physical Therapy Faculty Research and Publications

Background and Purpose: Prolonged mechanical ventilation contributes to immobility and deconditioning making efforts to safely discontinue ventilator support desirable. This case report documents how implementing physical therapy treatment interventions, based on the Guide to Physical Therapist Practice, can help to restore a person’s functional status even after multiple years of mechanical ventilation dependency. Case Description: A patient (female; aged 63 years) with severe restrictive and obstructive ventilatory impairment has survived 34 recurrent pneumonias involving 6 bacterial pathogens while being mechanically ventilated at home. A 3-year study was approved and informed consent obtained for a home exercise program of resistive extremity …

E-Stimulation: An Effective Modality To Facilitate Wound Healing, Pamela Scarborough, Luther C. Kloth

Physical Therapy Faculty Research and Publications

No abstract provided.

A Standardized Evidence-Based Model Of Orthopaedic Physical Therapy Practice: A Quest For The Holy Grail?, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

The growth of knowledge in orthopaedic physical therapy practice is on an exponential trajectory. This growth is occurring simultaneously for many aspects of evidence-based practice: diagnosis, prognosis, treatment, and harm – with increasingly more sophisticated basic science and mechanistic studies guiding and supporting the clinical research endeavors. Just how close are we to the day when we can clearly establish the accuracy of our diagnoses, regardless of the model used, and then can confidently inform our patients of the most effective treatment approach and the expected outcomes, as well as any potential harm? This knowledge is being created now, and …

The Effect Of Movement Rate And Complexity On Functional Magnetic Resonance Signal Change During Pedaling, Jay P. Mehta, Matthew D. Verber, Jon A. Wieser, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

We used functional magnetic resonance imaging (fMRI) to record human brain activity during slow (30 RPM), fast (60 RPM), passive (30 RPM), and variable rate pedaling. Ten healthy adults participated. After identifying regions of interest, the intensity and volume of brain activation in each region was calculated and compared across conditions (p < .05). Results showed that the primary sensory and motor cortices (S1, M1), supplementary motor area (SMA), and cerebellum (Cb) were active during pedaling. The intensity of activity in these areas increased with increasing pedaling rate and complexity. The Cb was the only brain region that showed significantly lower activity during passive as compared with active pedaling. We conclude that M1, S1, SMA, and Cb have a role in modifying continuous, bilateral, multijoint lower extremity movements. Much of this brain activity may be driven by sensory signals from the moving limbs.

Corticomotor Excitability During A Noxious Stimulus And Following Exercise In Women With Fibromyalgia, Marie K. Hoeger Bement, Andy Weyer, Tejin Yoon, Sandra K. Hunter

Physical Therapy Faculty Research and Publications

No abstract provided.

Push-Pull Control Of Motor Output, Michael D. Johnson, Allison S. Hyngstrom, Marin Manuel, C J. Heckman

Physical Therapy Faculty Research and Publications

Inhibition usually decreases input–output excitability of neurons. If, however, inhibition is coupled to excitation in a push–pull fashion, where inhibition decreases as excitation increases, neuron excitability can be increased. Although the presence of push–pull organization has been demonstrated in single cells, its functional impact on neural processing depends on its effect on the system level. We studied push–pull in the motor output stage of the feline spinal cord, a system that allows independent control of inhibitory and excitatory components. Push–pull organization was clearly present in ankle extensor motoneurons, producing increased peak-to-peak modulation of synaptic currents. The effect at the system …