Physical Therapy Commons^™

Therapeutic Management Of A Patient With Necrotizing Fasciitis Resulting In Quadrilateral Amputation And Critical Illness Myopathy In The Intensive Care Setting: A Case Report., Mallory A. Kargela, Annette J. Siebens

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this case is to illustrate the best available evidence to provide early therapeutic intervention for a critically ill patient presenting with cardiovascular and pulmonary complications due to multi-system compromise. Case Description: A 19-year-old male was admitted to the hospital with the diagnosis of necrotizing fasciitis and necrotizing pneumonia. He experienced numerous additional medical complications ultimately leading to tracheostomy, delirium, critical illness myopathy, and quadrilateral amputation secondary to necrotizing fasciitis and critical limb ischemia following prolonged veno-venous extracorporeal membrane oxygenation (VV-ECMO). Outcomes: Patient was discharged to an outside rehabilitation hospital after 103 days in the acute setting …

An Introduction To Interprofessional Education For First Semester Doctoral Occupational Therapy And Physical Therapy Students, Suzanne Trojanowski, Jillian Woodworth, Anna Rose Wiencek, Amy Yorke

Internet Journal of Allied Health Sciences and Practice

Purpose: Interprofessional education (IPE) engages health care professional students in order to develop the knowledge, skills, and attitudes required of a health care practitioner. IPE can be challenging to execute; however, exposing students early in their professional education in IPE has positive results. Occupational therapy (OT) and physical therapy (PT) are health care professions who commonly work with each other. The purpose of this study is to describe the process and outcomes of implementing an IPE experience with first year doctoral OT (OTD) and PT (DPT) students completed within the first six weeks of the first semester of their respective …

Cost Outcomes Of Physical Therapist Providers Compared To Primary Care Providers In The Treatment Of Musculoskeletal Patients In A Military Treatment Facility: A Retrospective Chart Review”, Troy E. Mcgill, Debra F. Stern, Morey J. Kolber, John Mcgee

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to compare the cost of physical therapist (PT) management of patients with musculoskeletal (MSK) disorders to management by traditional primary care managers (PCMs); medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods: This is a retrospective study of electronic medical records using an exploratory, non-experimental, cross-sectional, and quantitative design method. The records of patients with MSK disorders were assessed at an Air Force military medical clinic for 18 months from January 2016 through June 2017. Results: PT management of MSK patients resulted in a …

The Teaching And Evaluation Of Professionalism For Dpt Students During The Clinical Education Experience, Bruce N. Elliott

Internet Journal of Allied Health Sciences and Practice

Abstract

Purpose: The purpose of this comparative study was to investigate the reports of clinical instructors (CIs) and Doctor of Physical Therapy (DPT) students from two different physical therapy programs in New England regarding their opinions on the teaching and evaluative techniques of professionalism during a clinical education rotation. One program emphasized professionalism prior to the students beginning their clinical rotations, while the other program did not have the same emphasis.

Methods: Three items from the professional practice section of the Clinical Performance Instrument (CPI) (accountability, communication, and professional behavior), were utilized to create the conceptual framework around which the …

Depression Screening In Outpatient Neurology, Lakicia Foster

Student Theses, Dissertations and Capstones

Depression is the preeminent cause of disability internationally. Support-based depression screening is a nationally recommended means of detecting and treating patients with this disabling illness. The purpose of the doctor of nursing practice (DNP) practice change project was to implement an outpatient neurology depression screening protocol so that depressed patients were identified and received intervention. The project answered whether implementation of an 8- to 12-week systematic depression screening protocol in a neurology practice increased the incidence of accurate depression identification and treatment in this patient population as compared to the 3-month prior baseline. The DNP depression screening project was based …

Are Finger Width Palpation, Tape Measure, And Caliper Reliable, Valid, And Accurate To Diagnose Diastasis Recti Abdominis (Dra)?, Tamara L. Roehling

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: Diastasis recti abdominis (DRA) is a condition where the medial rectus bellies separate at the linea alba. A DRA can negatively impact posture, trunk and pelvic stability, pelvic floor muscular control, respiration, trunk movement, and abdominal viscera support. The purpose of this research is to determine whether tools used in the clinic effectively screen for DRA. Specifically, this study compared the reliability, validity, and diagnostic accuracy of finger width, tape measure, and calipermeasurements to the clinical best standard, ultrasound imaging. Additionally, the study investigates whether there is a correlation between DRA and low back pain and pelvic floor dysfunction. …

Development And Validation Of The Self-Management Assessment For The Residuum And Prosthesis (S.M.A.R.T.), Daniel Joseph Lee

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Self-management is the process of preventing complications through meticulous self-care and vigilant self-inspection. Persons with long-term impairments or diseases must follow an effective self-management routine as part of their care regimen to reduce the risk of injury. Assessment of knowledge as it relates to self-management is standard care forpersons with chronic disease and long-term impairments. Identifying knowledge gaps allows for patient-centered educational interventions to be targeted to the person’s area of deficit. Despite the importance of self-management in persons with limb loss, there is currently no valid and reliable way to objectively assess knowledge specific to this population.

Purposes: …

Financial Impact Associated With Implementation Of The Low Back Pain Clinical Practice Guideline In Outpatient Physical Therapist Practice, Heidi Kosakowski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Dysfunction and disability arising from low back pain (LBP) affects more people than any other condition globally, and results in changes to the quality of life for many individuals. The financial burden of managing low back pain is among the highest both in the United States and globally. Clinical practice guidelines (CPGs) provide recommendations on patient management strategies and have the potential to simultaneously improve patient outcomes and lower health care costs. Limited evidence exists on the impact of CPG implementation on downstream medical costs that are incurred after physical therapist care. A retrospective observational study was conducted that examined …

Neurophysiological Effects Of Dry Needling To The Thoracolumbar Junction Multifidi In Subjects With Low Back Pain And Decreased Hamstring Length, Nicole Ginette Clark

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: Dry needling is becoming increasingly popular in the treatment of neuromusculoskeletal conditions. The neurophysiological effect of treatment, specifically those related to the sympathetic nervous system (SNS) is considered a relevant physiological mechanism contributing to a patient’s rehabilitation. The primary purpose of this study was toinvestigate the neurophysiological effects of dry needling, as measured by sympathetic outflow and muscular flexibility. A secondary purpose of this study was to determine if changes in SNS activity correlate with clinically meaningful improvements in pain and disability. Design: This was a prospective, double-blind randomized clinical trial. Subjects: The study sample consisted of …

Comprehensive Physical Function Measure For The Intensive Care Unit: The Use Of Rasch Analysis And Item Response Theory, Michelle Lynn Peterson

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction: This dissertation study provides an in-depth examination of current intensive care unit (ICU) physical function assessment measures and synthesizes these into one comprehensive measurement tool that addresses multiple areas of function.

Background: A recent systematic review identified 26 measures being used in ICU clinical research, although a subsequent systematic review revealed only 14 of those physical function assessment measures have psychometric properties evaluated specifically for the ICU setting. A robust physical function assessment measure for use in the ICU, allows for determination of efficacy of treatment, comparison of studies across settings, and broader interpretation of results.

Specific Aims: Aim …

Can A Prescribed Walking Program With Or Without Monitoring Impact Dizziness In The Older Adults? A Pilot Study, Amie Marie Jasper

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background. Dizziness, a common complaint among older adults, is associated with multiple falls, loss of function and independence, and reduced balance confidence. The Clinical Practice Guideline for Peripheral Vestibular Hypofunction recommends walking for endurance as a component of vestibular rehabilitation (VR). However, studies on VR in the olderadults do not include walking in the intervention.

Research Design: 1) A pragmatic, randomized, experimental design to evaluate the impact of walking on vestibular outcomes, length of stay, and number of visits, and to examine whether pedometers increase the adherence of older adults with vestibular issues to a walking program; 2) a descriptive …

The Effect Of Extraversion On Practical Examination Scores In Students Of Physical Therapy, Scott Richardson, Zachary Zemanek, Travis Downen, Chantsen Rich, Nate Weltzin

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to determine whether a physical therapy student’s level of extraversion positively correlates to practical exam scores. Methods: Participants were a convenience sample recruited from the classes of 2018 and 2019 in the Doctor of Physical Therapy program at Franklin Pierce University in Goodyear, Arizona. Subjects completed the Goldberg’s Big-Five Factor Marker questionnaire as a measure of introversion/extraversion. These scores were compared with participants’ practical exam scores using a Spearman Rho statistical test with data analysis completed using SPSS software. Results: 60 participants (31 males, 29 females) with mean extraversion score (32.97+/-7.90, p=.27) and …

Investigating The Influence That Service In A Pro Bono Clinic Has On A First Full-Time Clinical Education Experience From The Perspective Of Students And Their Clinical Instructors, Ellen Erdman, Jill D. Black, Sandra Campbell, Tim Golder, Stephen Grazioli, Kerstin M. Palombaro

Internet Journal of Allied Health Sciences and Practice

Purpose: Academic physical therapy programs strive to foster student readiness for full-time clinical education experiences in a variety of ways. This research looks at one program who has students participate in a student-run pro bono clinic for at least 60 hours prior to the first full-time clinic experience. The purpose of the study is to explore the influence that participation in this pro bono clinic has on a first full-time clinical education experience from the perspective of both the student and the clinical instructor (CI). Methods: Qualitative methodology was employed to gain the perspectives of 29 students and their respective …

Grit And Academic Performance In Doctor Of Physical Therapy Students, Scott Richardson, Michael Scotto, Mayanne Belcina, Richa Patel, Kevin Wiener

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to determine whether a physical therapy student’s level of grit positively correlates to graduate school grade point average. Methods: Participants were a convenience sample recruited from the class of 2021 in the Doctor of Physical Therapy program at Franklin Pierce University in Goodyear, Arizona. Subjects completed the Short Grit Scale (Grit-S) as a measure of grit. These scores were compared with participants’ graduate school grade point average using a Spearman Rho statistical test with data analysis completed using SPSS software. Results: 27 participants (15 males, 12 females) with mean grit score of 3.76 …

Make Changes Early! High Stress Levels Predict Lower Academic Performance In First-Year Physical Therapy Students: A Pilot Study, Daniel W. Flowers, Amanda Bernard

Internet Journal of Allied Health Sciences and Practice

Purpose: Evidence exists in the literature that allows admissions committees to predict which students will be most successful in entry-level physical therapy educational programs. Evidence linking modifiable predictors of academic performance to currently enrolled students allowing enhancement of their performance during enrollment is lacking. Previous healthcare education literature indicates that stress has a negative predictive relationship with academic performance, and that stress is the highest in the beginning of an academic program. Research studies with medical students report exercise assists in minimizing stress and improving academic performance, while the role of leisure time has also been investigated. No study has …

Can The Forward-Step-Down Test Be Used Reliably In The Clinical Setting To Assess Movement Changes Resulting From Maximal Exertion? A Pilot Study, Erin Mccallister, Daniel W. Flowers

Internet Journal of Allied Health Sciences and Practice

Introduction: Visual assessment of lower extremity mechanics is used frequently in clinical practice, and objective scoring of the visual assessment is beneficial to improve objectivity of patient evaluation. In addition, lower extremity mechanics change with fatigue and these changes may increase the risk of lower extremity injury. The Forward-Step-Down Test (FSDT) is one such objective tool, but its ability to detect changes in movement quality in response to exertion are not known. Methods: This study utilized a repeated-measures design, where the participants were scored on the FSDT before performing the Bruce protocol for an exertion stimulus. The participants were re-scored …

Student Experiences With Engagement In A Nursing And Physical Therapy Interprofessional Education Simulation, Sarah Koplow, Melissa Morris, Shari Rone-Adams, Heather Hettrick, Bini Litwin, Lisa B. Soontupe, Archana Vatwani

Internet Journal of Allied Health Sciences and Practice

Purpose: Interprofessional Education (IPE) incorporated into healthcare discipline instruction has been shown to be successful in improving the understanding perceptions of complimentary professions. The purpose of this mixed method study was to measure differences in perceptions of early Baccalaureate of Science in Nursing (BSN) students and Doctor of Physical Therapy (DPT) with participation in a immersive interprofessional education experience. Method: Students completed a pre and posttest survey consisting of the Readiness for Interprofessional Learning Scale and several short answer qualitative questions. Cohorts of BSN and DPT students participated in a computerized mannequin simulation experience or a hybrid simulation. Results: Students …

Impact Of Psychological Factors On Adolescents With Anterior Knee Pain, Mitchell Selhorst

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem and purpose: Psychological factors impact self-report measures of pain and function among adults with anteriorknee pain (AKP), but we do not know (1) if psychological factors also impact pain, self-reported function, and objective measures of function among adolescents with AKP and (2) if a psychological intervention would affect function. The purpose of this dissertation is to determine the impact of psychological factors on pain, self-reported function, and objective measures of function in adolescents with AKP.

Methods: This dissertation was prospective, with three separate studies. Two were cross-sectional observational studies, and the third was a randomized-controlled trial. Patient questionnaires were …

Neck Muscle Composition In Persistent Whiplash Associated Disorder: A Relationship With Disability, Bradford G. Callan

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose/hypothesis: Neck pain and related symptoms following a motor vehicle collision (MVC) can significantly influence the quality of life for some people. While the MVC related mechanics of the head and neck gives rise to the term whiplash, the signs and symptoms of neck related disability are often complex and are clinically referred to as whiplash associated disorder(WAD). Muscle fatty infiltrate (MFI) has been associated with persistent WAD, but its influence on the generation and maintenance of WAD is largely unknown. The purpose of this study was to evaluate the relationship between MFI and baseline demographic variables related to persistent …

Does One Session Of Pre-Operative Pelvic Floor Muscle Training Aid In Improving Urinary Incontinence Immediately Following Robotic Assisted Radical Prostatectomy? A Retrospective And Pilot Study, Francine Noel-Ford

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Despite advancements in surgical techniques through the use of robotic assisted radical prostatectomy, urinary incontinence remains the most common side effect following surgery affecting men’s quality of life.

Objective: To explore the role of a single pre-operative pelvic floor muscle training session. To determine if men who receive the training session have a decrease incidence of incontinence post-op, whether pelvic floor muscle strength pre-operatively is an independent predictor of urinary incontinence, and the impact of incontinence on quality of life in men following a robotic-assisted radical prostatectomy in the early stages post-operatively.

Design: A two part study with a …

Impact Of Physical Therapist Attitudes And Beliefs On The Outcomes Of Patients With Low Back Pain, Adam P. Rufa

Department of Physical Therapy Student Theses, Dissertations and Capstones

Introduction: Physical therapist attitudes and beliefs about low back pain (LBP) have been shown to influence patientbeliefs and affect clinician behavior. The purpose of this project was to investigate physical therapist attitudes and beliefsabout LBP, identify factors that influence those beliefs, and determine if attitudes and beliefs have an impact on patientoutcomes. Methods: This study was a retrospective cohort design that included a survey of physical therapists and thecollection of patient outcomes from Focus on Therapeutic Outcomes, Inc. (FOTO). Attitudes and beliefs were measured using the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain Attitudes and …

Does The Type Of Dual Cognitive Task Impact Gait Variability Using The Quantitative Timed Up And Go (Qtug) In Community-Dwelling Adults?, Laurie G. Hiatt

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: The purpose of this study was to determine how different cognitive dual-tasks impact gaitvariability in community-dwelling adults using the Quantitative Timed Up and Go (QTUG).

Methods: Participants aged 65 and older were recruited from two communities in Iowa and Wisconsin. Inclusion criteria: theability to stand and ambulate without an assistive device, having no orthopedic surgical procedures in the previous six weeks, living independently in the community, demonstrating corrected vision and ability to read, sufficient auditory function to carry on a conversation and ability to follow directions. Participants needed to follow three step commands and have no history …

Impact Of Strength And Range Of Motion On Loss Of Ambulation And Functional Change Measures In Boys With Dmd, Tina Duong

Department of Physical Therapy Student Theses, Dissertations and Capstones

Duchenne muscular dystrophy (DMD) is an x-linked lethal progressive disorder affecting boys who are typically diagnosed due to motor delays or weakness. Key features include loss of motor function throughout the lifetime resulting in early mortality from cardiopulmonary complications in the late 2nd and 3rd decades of life. Rates of progression are variable yet sequential due to a typical pattern of motor weakness that occurs from proximal to distal muscle groups. Current standards of care include contracture management and Glucocorticosteroids (GC). Timed function tests have been used to understand and predict loss offunctional milestones such as walking, getting off the …

Does The Range Of Walking Speeds Produced By Community-Dwelling Older Adults Relate To Or Predict Function, Disability, And Community Mobility?, Michelle Germaine Criss

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Self-selected (SSWS) and maximum walking speeds (MWS) are frequently studied and related to multiple body systems, function, falls, and mortality. Walking at a slow speed voluntarily or measuring a range of walking speeds (WS), however, has rarely been investigated. Purpose: The aims ofthis project were to explore a proposed measure of WS adaptability called total walking speed range(TWSR), to assess the reliability and validity of slow walking speed (slowWS) as a component of TWSR, to assess if TWSR could predict function, disability or community mobility, and finally, to compare thepredictive ability of TWSR to single walking speeds. Methods: This …

Effects Of Cueing On Sit To Stand Transfers In Parkinson Disease, Rebecca Ann Martin

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Individuals with Parkinson Disease (PD) often experience difficulty transferring from sit to stand (STS). Current evidence suggests cues which promote an external attentional focus improve gait and transfers for individuals with PD. However, this research utilizes cues which are difficult to replicate in clinical or natural environments making the findings difficult to generalize or implement. Purpose: The primary purpose of this study is to determine the effect of 3 different explicit cues on STS for individuals with PD. Additionally we sought to determine if, in this population, a relationship exists between latency of movement initiation and postural sway …

Correlation Of Trust And Outcomes Following Physical Therapy For Chronic Low Back Pain, Kory J. Zimney

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Trust is a key component for developing therapeutic alliance. Improvements in trust have been found to improve outcomes forpatients receiving psychiatric and medical physician care. Current trust measurement scales have not been utilized in a physical therapy setting and no studies have explored the relation of trust in provider to physical therapy outcomes.

Purpose: The primary goal was to explore the correlation of patient trust measured at various points within the therapeutic encounter to the change in outcome measurements after receiving physical therapy care.

Research Design and Methods: Non-experimental correlational quantitative analysis of patient trust in their physical therapist …

Educational Impact On Therapists’ Knowledge, Beliefs, And Actions: A Pilot Study, Elena Wong Espiritu, Natalie N. Michaels, Steven Busby

Internet Journal of Allied Health Sciences and Practice

ABSTRACT

Purpose: Collaborative goal setting has been shown to be an effective way to promote client engagement leading to improved outcomes; however, healthcare professionals face challenges when implementing collaborative goal setting into their clinical practice. The purpose of this study was to evaluate the effectiveness of educational workshops to 1) increase a therapist’s knowledge of motivational interviewing and action planning, 2) promote collaboration between therapists and their patients/clients, 3) promote collaboration between therapists and their interdisciplinary team and 4) increase the ease of implementation of motivational interviewing and action planning skills into a therapist’s clinical practice. Method: A mixed-methods design …

Athletic Training And Physical Therapy Junior Faculty Member Preparation: Perceptions Of Doctoral Programs And Clinical Practice, Jessica L. Barrett, Stephanie M. Singe, Aynsley Diamond

Internet Journal of Allied Health Sciences and Practice

Background: Institutions of higher education suffer from a shortage of appropriately prepared faculty members in athletic training and physical therapy programs. Both professional programs have recently undergone curricular reform and degree change. We sought gain an understanding of the preparation mechanisms experienced by athletic training and physical therapy practitioners for their junior faculty positions. Method: Twenty-six athletic trainers and physical therapists participated in this phenomenological study. Data from one-on-one phone interviews were analyzed following the inductive process of interpretive phenomenological analysis. Content experts, pilot interviews, multiple analysts and member checking ensured trustworthiness. Results: Findings indicate two primary mechanisms prepared the …

Plyometric Training For Young Male Field Hockey Players, Vijaya Krishnan, Twincy Rajawadha

Internet Journal of Allied Health Sciences and Practice

Background: Field hockey is a team sport requiring a combination of skill set to enhance a player’s performance. Power, Fitness and Agility are few such basic parameters. Newer training protocols are constantly explored to achieve the desired effect and plyometrics is one such method. It is also important to know how long lasting the effects of training are. Methodology: Fifty (50) male field hockey players at interschool and zonal level participated in the study. These sports specific parameters - lower limb power, fitness level and agility - were tested using the vertical jump test, 40-metre sprint test, and shuttle cross …

The Prevalence And Characteristics Of Physical Therapy Pro Bono Services Involving Doctor Of Physical Therapy Students, Catherine E. Crandell, Jill D. Black, Robin L. Dole, Kerstin M. Palombaro

Internet Journal of Allied Health Sciences and Practice

Purpose: The offering of pro bono services has been a historical practice in a number of professions including law and medicine. Medical literature suggests pro bono services provide a vital safety net for individuals who are underinsured or uninsured. Medical students commonly participate in pro bono services, however, little is known about doctor of physical therapy (DPT) student involvement. The purpose of this study was to conduct a survey of physical therapy (PT) programs accredited or in candidacy in the United States to determine the prevalence and characteristics of pro bono services involving DPT students. Method: A 30-item electronic survey …