Physical Therapy Commons^™

Physiological, Cognitive, Behavioral, And Perceptual Contributors To Falls Risk Across Middle And Older Adulthood, Jacquelyn Moxey

Rehabilitation Sciences Theses & Dissertations

Falls are multifactorial events influenced by physiological, cognitive, behavioral, and perceptual factors. Although falls prevention research has traditionally focused on older adults and objectively measured physical impairments, less is known about how cognitive performance, physical activity, and perceptions of ability collectively contribute to falls risk vulnerability across middle and older adulthood. This dissertation examined these relationships through three complementary studies.

Study 1 examined associations between cognitive screening performance and physiological falls risk in 315 community-dwelling older adults. Lower global cognitive performance was associated with greater physiological falls risk. Performance on items reflecting attention and visuospatial/executive function demonstrated the strongest domain-level …

Building Bridges: Connecting Biomechanics And Lived Experience In Bertolotti's Syndrome, Andrea Morgan Muffly

Rehabilitation Sciences Theses & Dissertations

Bertolotti’s Syndrome (BSy), characterized by the presence of a lumbosacral transitional vertebra (LSTV), represents a complex clinical entity that affects not only the physical health of the individual, but the quality of their daily life. Prior research on BSy focused on epidemiology, not lived experience, revealing inconsistencies in diagnostic inconsistencies of LSTV morphology. A three-tiered diagnostic system is proposed to streamline the reporting of LSTV subtypes. We examined how BSy is diagnosed, its symptoms, presentation, and how this impacts individuals’ ability to participate in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). We conducted a multi …

Electromyography, Prosthetic Properties, And Running Biomechanics In Recreationally Active Persons With Lower Extremity Amputation, Paige M. Agnew

Rehabilitation Sciences Theses & Dissertations

Lower extremity loss affects nearly 150,000 individuals in the United States yearly yielding extreme health care costs annually. Typically, prosthetic devices are prescribed for 5-8 years despite known changes to an individual’s gait as time progresses. Patients can expect to undergo approximately 8-12 weeks of gait retraining to improve their comfort and efficiency. Biomechanical changes occur when running with a specific running prosthetic including considerable biomechanical and neuromuscular interlimb asymmetries and alterations in loading patterns. The purpose of this dissertation was to investigate the biomechanical demands for lower extremity prosthesis users during running. The first study synthesized peer reviewed evidence …

Learning In Motion: How Small Groups Can Promote Self-Regulated Learning In Physical Therapy Students, Sara Mclaren

STEMPS Theses & Dissertations

Self-regulated learning (SRL) is a critical skill for success in rigorous graduate health professions programs, where students must independently manage complex academic demands. Despite its importance, limited research has examined SRL processes among Doctor of Physical Therapy (DPT) students in the didactic phase of training. Guided by Zimmerman’s cyclical model of self-regulated learning, this study examined SRL behaviors among second-year DPT students and explored how small group learning contexts may influence engagement in SRL processes and academic performance.

This mixed-methods study included 39 DPT students enrolled in a physical therapy program at a public university in the southeastern United States. …

Accelerometer-Measured Physical Activity Among Children And Adolescents With And Without Neurodevelopmental Disorders: A Systematic Review And Meta-Analysis, Xiao Liang, Raffy C.F. Chan, Justin A. Haegele, Sean Healy, Richard H. Xu, Chang Liu, Ming Chen, Minghui Li, Hui Zhang, Cindy H.P. Sit, David H.K. Shum

Human Movement Studies & Special Education Faculty Publications

Purpose

Physical inactivity is a health concern for children and adolescents with neurodevelopmental disorders (NDDs) as it directly increases their risk of developing various health problems. Evidence on differences in accelerometer-assessed physical activity between children and adolescents with and without NDDs is inconclusive. And age- and body mass index (BMI)-related effects on physical activity remain unclear.

Methods

The systematic literature searches were performed in 6 databases up to March 2025. Methodological quality was evaluated by the Newcastle-Ottawa Scales. Data were pooled using a random-effects model. Hedges' g was used to express the effect size index with 95 % confidence interval …

Graduate Physical Therapy Students Perceived Benefit Of Prior Anatomy Experiences Following Their First Semester Graduate Physical Therapy Anatomy Course, Austin Alexander

EVMS School of Health Professions Theses & Dissertations

Human anatomy stands as a cornerstone prerequisite for admission into graduate-level Physical Therapy Programs. As such, prior anatomy experiences need to prepare students for success in graduate-level coursework. However, studies have demonstrated that undergraduate anatomy courses vary in their ability to predict success in graduate Physical Therapy anatomy coursework. This research aimed to utilize students' perceptions of their undergraduate anatomy experiences to predict grades in graduate-level Physical Therapy anatomy coursework. The multinomial logistic regression in this study revealed that the absence of perceived preparedness was a significant predictor of membership in the C graduate anatomy grade group. Students who did …

Development Of A Personalized Conversational Health Agent To Enhance Physical Activity For Blind And Low-Vision Individuals, Soyoung Choi, Jooyoung Seo, Ashwath Krishnan, Sanchita Kamath, Justin Haegele

Human Movement Studies & Special Education Faculty Publications

Background: With the advancements in mobile health (mHealth) technologies, sighted individuals can benefit from mobile apps and wearable devices to more easily manage their physical activity (PA) and wellness data through intuitive touch gestures and effective data visualizations. However, for blind and low-vision (BLV) individuals, these conventional interaction methods are often challenging, not only limiting their ability to use these technologies but also potentially diminishing their motivation to adopt them to support health-promoting behaviors. We aimed to develop a health monitoring application called Personalized and Conversational Health Agent (PCHA) that supports BLV individuals with self-monitoring and management of their PA …

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

Case Report: Multifactorial Intervention For Safe Aging In Place, Ashwini Kulkarni

Rehabilitation Sciences Faculty Publications

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the …

The Landscape Of Virtual Reality Use In Mobility Rehabilitation From 2010-2023: A Scoping Review, Danielle T. Felsberg, Reza Pousti, Charlend K. Howard, Scott E. Ross, Louisa D. Raisbeck, Jared T. Mcguirt, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Significant advancements in virtual reality (VR) technology have occurred in the past decade, allowing clinical researchers to take advantage of these reduced barriers to explore the use of VR in patient populations. This scoping review on VR interventions to improve mobility in adults and children focuses on the literature from 2010-2023. A total of 2736 articles were screened and 126 articles met the inclusion criteria. Most of the studies were conducted in inpatient clinical settings (n = 41) and investigated VR interventions to improve balance (n = 118). Less immersive (n = 108) products such as Nintendo Wii or Xbox …

Comparing Immersive And Nonimmersive Clinical Experiences In Athletic Training Education: Effects On Student Engagement And Confidence, Julie M. Cavallario, Shana Pribesh, S. E. Walker

Rehabilitation Sciences Faculty Publications

Context

With the shift to a graduate-level professional degree in athletic training, it was hypothesized that immersive clinical experiences (ICEs) would be more effectively integrated into curricula than non-ICEs (N-ICEs) and better prepare students for practice.

Objective

To longitudinally compare clinical engagement opportunities in ICEs versus N-ICEs and assess if these opportunities are associated with changes in student confidence in performing related tasks.

Design

Prospective, longitudinal, time-diary study using a Web-based survey. Patients or Other Participants: Fifty-three first-year, master’s-level athletic training students from 21 programs.

Main Outcome Measure(s)

Participants reported their type of clinical experience (ICE, N-ICE, or none), the …

Athletic Trainers' Perspectives On Resources And Preparation Needed For Successful Salary Negotiation, Kimberly R. Detwiler, Cailee E. Welch Bacon, Indigo B. White, Leanne E. Jones, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context

Many athletic trainers (ATs) work under high stress, long hours, and low pay. These conditions often lead ATs and athletic training students to leave the profession. Previous studies show that over half of ATs do not negotiate salary, often because they feel the offer is fair or fear losing the job. Additional support is needed to help ATs prepare for negotiations, as current resources are limited.

Objective

This study explored ATs’ views on the resources need to prepare for salary negotiations during the hiring process.

Design

Consensual qualitative research.

Setting

Individual video interviews.

Patients or Other Participants

Twenty-eight participants …

How Many Trials Are Needed For Consistent Clinical Gait Assessment?, Charlend K. Howard, Christopher K. Rhea, Jacquelyn R. Moxey, Kyle Langerhans, Paphawee Prupetkaew, Brittany S. Samulski

Rehabilitation Sciences Faculty Publications

Background: Clinical assessment of gait typically consists of patients walking a few trials at various speeds while the clinician assesses performance. Unfortunately, there is no clear guidance on how gait changes across trials, leaving clinicians uncertain about the optimal number of trials needed to observe consistent (non-variable) performance. To address this issue, we examined gait performance from a large dataset of older adults who participated in a community-based comprehensive fall risk assessment. Methods: Community-dwelling, older adults (n = 340; 70.8 ± 7.4 years; 120 men, 220 women) performed gait trials under two conditions: preferred and maximum walking speed. …

Use Of Ultrasound For Identification Of Musculoskeletal Injury In Active Populations, Kathleen Karen Hogan

Rehabilitation Sciences Theses & Dissertations

Lower extremity tendinopathies and fasciopathy conditions are prevalent amongst sedentary individuals,^1,2 athletes,^3,4 elite runners,^5,6and military personnel⁷ and can lead to chronic disability and reduction in quality of life. ^8,9 Both tendinopathy and fasciopathy are thought to be mechanical in nature and caused by acute or chronic overloading leading to a disruption in the uniformity of the soft tissue structure. Ultrasound imaging has gained popularity in the last decade among many sports medicine clinicians to gain information regarding tissue structure for musculoskeletal injury (MKSI) management. Ultrasound imaging allows for the evaluation of in-vivo structures and at …

Perturbation-Based Gait Training, Julia Bohlman, Ashwini Kulkarni

Undergraduate Research Symposium

Background:

Falls during walking are common in older adults and individuals with Parkinson’s disease (PD) [1]. These falls are often caused by trips [2]. Injuries caused by falls can be severe, in all age groups and populations. Given the potential severity of injuries resulting from falls, it is crucial to implement interventions aimed at preventing falls. Such interventions focus on anticipatory and/or reactive mechanisms. Perturbation-based gait training (PBT) addresses both mechanisms by intentionally destabilizing participants to induce a loss of stability, triggering a motor response to regain postural stability. PBT works on the principle of specificity. While earlier studies on …

A Reflection Of Experiences Of Adults With Type 1 Diabetes In Integrated Physical Education Classes, Kalleigh West

Human Movement Studies & Special Education Theses & Dissertations

The purpose of this study was to gain an understanding of the experiences of type 1 diabetics in integrated physical education classes. In this study, we interviewed young type 1 diabetic adults and asked them to reflect on their school-based physical education experiences. An interpretative phenomenological analysis (IPA) approach was adopted to guide data collection, analysis, and interpretation for this retrospective study. Eight participants (ages 19 to 32) were enrolled in this study, and semi-structured interviews focused on their physical education experiences acted as the primary data. Transcribed interview data were analyzed using an IPA approach. Three interrelated themes emerged …

Evaluating The Effectiveness Of Recent Educational Foundations Requirements By The Commission On Accreditation In Physical Therapy Education For Program Directors Of Physical Therapist Assistant Programs, Sharan Dawn Zirges

Educational Leadership & Workforce Development Theses & Dissertations

On November 2015, the Commission on Accreditation of Physical Therapy Education (CAPTE) published position papers for the 2016 changes to the CAPTE standards. One of these position papers discussed the changes in the 2016 standards related to the qualifications for the position of a program director (PD) for a physical therapist assistant. A specific qualification requirement was added stating “experience in educational theory and methodology, instructional design, student evaluation and outcome assessment, including the equivalent of nine academic (semester) credits of coursework in educational foundations.” The effectiveness of this additional requirement has to date not been assessed. The purpose of …

Teaching Social Determinants Of Health In Physical Therapist Professional Education Programs: Exploring Curricular Approaches And Examining An Assessment Tool, Emily Jordan Hawkins

Rehabilitation Sciences Theses & Dissertations

There is a growing emphasis and need for physical therapists (PTs) to serve not only as clinicians but also as advocates to pursue health equity. Clinical practice for preventing and rehabilitating injuries and promoting physical activity will not eliminate health disparities resulting from the social determinants of health (SDH). Leaders in the field of physical therapy have charged physical therapist professional education programs to teach future PTs to address SDH, however, as of August 2023, the Standards and Required Elements for Accreditation of Physical Therapist Education Programs does not specifically require curricular content regarding SDH. The purposes of this dissertation …

Analysis Of Continuous Gait Data Requires Temporal Alignment Of Gait Phases, Elham Alijanpour, Kathryn Riis, Daniel M. Russell

College of Health Sciences Posters

A statistical method for comparing time-continuous curves, such as the kinematics of gait cycles, is statistical parametric mapping analysis (SPM) (Pataky, 2010). According to a recent study, SPM results were sensitive to how each stride's beginning was defined (Honert & Pataky, 2021). Nonetheless, for meaningful comparisons between gait cycles, temporal alignment of phases within a stride may be required (Helwig et al., 2011). With both temporally aligned and unaligned gait data, the goal was to evaluate SPM results for different walking speeds using various gait cycle definitions. Participants in this study were 10 young, healthy adults. To figure out the …

Health Profession Students' Interprofessional Socialization And Values Toward A College-Based Virtual Interprofessional Education Activity, Denise Claiborne, Praveen Durgampudi, Anne C. Dumadag, Emily J. Hawkins, Patricia Laverdure, Amy Laurie Meeker, Barbara Kraj, Angela Wilson, Muge Akpinar-Elci

Dental Hygiene Faculty Publications

Purpose: The inclusion of interprofessional education (IPE) is essential for the health professions curricula and establishes the expectation of collaborative patient-centered care. The COVID-19 pandemic has required educators to develop innovative methods for IPE student engagement. The purpose of this study was to evaluate a college-based virtual IPE activity for first-year health profession students and measure their interprofessional socialization and values (ISVS) toward IPE teams. The validated interprofessional socialization and valuing scales (ISVS-9A/9B) were used.

Methods: A one-group pre-post-test design examined health profession students' ISVS from seven health programs before and after a virtual IPE activity. The IPE activity was …

Content Validation Of The Athletic Training Milestones: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Barton E. Anderson, Julie M. Cavallario, Bonnie Van Lunen, Lindsey E. Eberman

Rehabilitation Sciences Faculty Publications

The Athletic Training Milestones were developed as a comprehensive framework to assess athletic trainers' knowledge, skill, and behavior acquisition across the continuum of athletic training practice. However, without established content validity, it is unclear whether the Athletic Training Milestones can be used effectively as a clinical evaluation and research tool to evaluate competence and performance across multiple users and sites. We conducted a highly conservative content validity index (CVI) with data from 12 content experts. Our findings revealed an extremely high overall scale CVI of 0.99, and CVI scores of the 28 individual subcompetency items assessed ranged from 0.83 to …

Trust In Human-Robot Interaction Within Healthcare Services: A Review Study, Dedra Townsend, Amirhossein Majidirad

Mechanical & Aerospace Engineering Faculty Publications

There has always been a dilemma of the extent to which human can rely on machines in different activities of daily living. Ranging from riding on a self-driving car to having an iRobot vacuum clean the living room. However, when it comes to healthcare settings where robots are intended to work next to human, making decision gets difficult because repercussions may jeopardize people’s life. That has led scientists and engineers to take one step back and think out of the box. Having concept of trust under scrutiny, this study helps deciphering complex human-robot interaction (HRI) attributes. Screening essential constituents of …

Core Competency-Related Professional Behaviors During Patient Encounters: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, it is important that athletic trainers integrate the components of the core competencies (CCs; evidence-based practice [EBP], patient-centered care [PCC], health information technology [HIT], interprofessional education and collaborative practice [IPECP], quality improvement [QI], professionalism) as a part of routine clinical practice. In what ways, if any, athletic training students (ATSs) are currently integrating CCs into patient encounters (PEs) during clinical experiences is unclear.

Objective: To describe which professional behaviors associated with the CCs were implemented by ATSs during PEs that occurred during clinical experiences.

Design: Multisite panel design.

Setting: A total of …

Characteristics Of Patient Encounters For Athletic Training Students During Clinical Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, R.Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients that have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences.

Objective: To describe the characteristics of patient encounters (PEs) ATSs engage in during clinical experiences. Design: Multi-site, panel design.

Setting: 12 professional athletic training programs (ATPs; 5 Bachelor, 7 Master's).

Patients or Other Participants: 363 ATSs from the ATPs that used E*Value software to document PEs during clinical …

Cross-Education Balance Effects After Unilateral Rehabilitation In Individuals With Chronic Ankle Instability: A Systematic Review, Briana Lawry-Popelka, Sunghoon Chung, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Objective: To conduct a systematic review of existing literature on cross-education balance effects after unilateral training in the population with chronic ankle instability (CAI).

Data Sources: PubMed, SPORTDiscus, CINAHL Plus.

Study Selection: To be included in the systematic review, studies were required to have been published in English, included participants with CAI, had participants undergo a unilateral therapeutic exercise for the lower extremity, and measured balance performance of the untrained lower extremity before and after the intervention.

Data Extraction: The certainty of evidence in each included study was assessed via the Downs and Black checklist. A score of 24 to …

Executive Functions And Student Success During Physical Therapist Education: An Exploratory Study, Jane Roitsch, Martha L. Walker, Anastasia M. Raymer

Communication Disorders & Special Education Faculty Publications

BACKGROUND: Clinical reasoning relies on executive functions (EFs) that manage attention, inhibition, organization, and decision-making. Assessment of EFs may help identify students who excel at clinical reasoning, yet data showing this relationship in physical therapy (PT) education programs are lacking. The primary purpose of this exploratory study was to examine EFs in relationship to success in PT educational programs. METHODS: Thirteen third-year PT graduate students completed two EF tests which were compared to culminating scores in the program and admissions scores. RESULTS: A relationship existed between National Physical Therapy Examination (NPTE) and comprehensive exam results and one EF test score; …

The Influence Of Lumbopelvic Function On Perceived Ankle Function In Individuals With Chronic Ankle Instability, Sunghoon Chung, A. M. B. Suttmiller, K. R. Johnson, R. S. Mccann

College of Health Sciences Posters

Perceived functional impairments measured via patient-reported outcomes (PROs) are associated with reduced postural control ability in CAI patients. Furthermore, hip and trunk neuromuscular impairments are critical factors that can cause decreased postural stability in those with CAI. Identifying the relevance between reduced lumbopelvic function and impaired sensory-perceptual outcomes might direct clinicians to novel methods for CAI patients to improve postural control ability and perceived ankle function. Therefore, the aim of this study was to examine the relationship between tests of lumbopelvic function and PROs in individuals with CAI. Thirty-three individuals with CAI underwent assessment of transversus abdominis and lumbar multifidus …

Footwear Affects Conventional And Sumo Deadlift Performance, Kevin A. Valenzuela, Kellie A. Walters, Elizabeth L. Avila, Alexis S. Camacho, Fany Alvarado, Hunter J. Bennett

Human Movement Studies & Special Education Faculty Publications

Barefoot weightlifting has become a popular training modality in recent years due to anecdotal suggestions of improved performance. However, research to support these anecdotal claims is limited. Therefore, the purpose of this study was to assess the differences between the conventional deadlift (CD) and the sumo deadlift (SD) in barefoot and shod conditions. On day one, one-repetition maximums (1 RM) were assessed for thirty subjects in both the CD and SD styles. At least 72 h later, subjects returned to perform five repetitions in four different conditions (barefoot and shod for both CD and SD) at 70% 1 RM. A …

The Role Mentoring Plays In The Transition To Practice Of Newly Credentialed Athletic Trainers, Stacy E. Walker, Stephanie Mazerolle Singe, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Mentoring has been identified as an important method of supporting newly credentialed athletic trainers (ATs) during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs in developing a plan to better facilitate the transition.

Objective: To examine which aspects of the mentoring relationship provided the most benefit during the transition to practice of newly certified ATs.

Design: Qualitative study.

Setting: Individual phone interviews.

Patients or Other Participants: A total of 13 ATs who graduated from a professional master's program, were certified from February through July 2016, …

Upper Limb Rehabilitation For Amputees, Michaela Ramandanes

Virginias Collegiate Honors Council Conference

It is estimated that 75% of the 30 million people that need prosthetic devices lack access to the technologies they need. This suggests a need for solutions outside of standard healthcare models. In this work we present a solution by development of a simple, safe and accessible at-home exercise program for individuals with upper limb loss. It is intended to help amputees strengthen the muscles needed to operate body-powered prostheses when muscles have atrophied from lack of use. Extensive research identified the most effective exercises to hinder overuse injuries. The exercises were compiled and published on a website with a …