Physical Therapy Commons^™

The Appropriateness Of Long-Term Opioids To Treat Chronic Back Pain, Thomas Watanabe, Michael Salino, Adam Schreiber

Department of Rehabilitation Medicine Faculty Papers

Point/Counterpoint Case Scenario: A 55-year old man presents to a pain clinic upon referral from his primary care physician. His symptom is axial low back pain. His pain started approximately 1 year earlier without a specific inciting event. He denies radiation of pain into the lower extremities. There is no bowel or bladder involvement. There is no directional preference. He reports pain "all the time," with minimal specific exacerbating or relieving factors. There is no medical-legal involvement. His medical history is significant for hypertension, hypercholesterolemia, obesity, and sleep apnea. He is a divorced father of 2 adult children. He is …

The Graded Redefined Assessment Of Strength Sensibility And Prehension: Reliability And Validity., Sukhvinder Kalsi-Ryan, Dorcas Beaton, Armin Curt, Susan Duff, Milos R Popovic, Claudia Rudhe, Michael G Fehlings, Mary C Verrier

Department of Physical Therapy Faculty Papers

Abstract With the advent of new interventions targeted at both acute and chronic spinal cord injury (SCI), it is critical that techniques and protocols are developed that reliably evaluate changes in upper limb impairment/function. The Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) protocol, which includes five subtests, is a quantitative clinical upper limb impairment measure designed for use in acute and chronic cervical SCI. The objectives of this study were to: (1) establish the inter-rater and test-retest reliability, and (2) establish the construct and concurrent validity with the International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI), …

Aging Contributes To Inflammation In Upper Extremity Tendons And Declines In Forelimb Agility In A Rat Model Of Upper Extremity Overuse., David M Kietrys, Ann E Barr-Gillespie, Mamta Amin, Christine K Wade, Steve N Popoff, Mary F Barbe

Department of Physical Therapy Faculty Papers

We sought to determine if tendon inflammatory and histopathological responses increase in aged rats compared to young rats performing a voluntary upper extremity repetitive task, and if these changes are associated with motor declines. Ninety-six female Sprague-Dawley rats were used in the rat model of upper extremity overuse: 67 aged and 29 young adult rats. After a training period of 4 weeks, task rats performed a voluntary high repetition low force (HRLF) handle-pulling task for 2 hrs/day, 3 days/wk for up to 12 weeks. Upper extremity motor function was assessed, as were inflammatory and histomorphological changes in flexor digitorum and …

Clinical Care Plan: Interdisciplinary Course (Ccpic), Marcia Levinson, Pt, Phd, Mft, Amy M Egras, Pharm.D, Bcps, E. Adel Herge, Otd, Otr/L, Kathryn Shaffer, Rn, Msn

Department of Physical Therapy Faculty Papers

Background/Rationale:

Interprofessional collaborative practice significantly improves patient outcomes, reduces mortality and enhances quality-of-life.

Person-focused care demands collaboration among professions in a team approach to address multiple issues including illness, prevention, and health promotion activities.

Key elements of successful implementation of interprofessional education supported by Clinical Care Plan, Interprofessional Course (CCPIC):

-Increasing knowledge of the roles, responsibilities, and competencies of multiple health professions.

-Collaborating in teams

-Recognizing the patient as the expert

-Communicating effectively

Course Statistics:

-176 students from various disciplines completed course (2008-2011).

Disciplines include:

-Medicine, Nursing, Occupational Therapy, Physical Therapy, Pharmacy

Aging Enhances Serum Cytokine Response But Not Task-Induced Grip Strength Declines In A Rat Model Of Work-Related Musculoskeletal Disorders., Dong L Xin, Michelle Y Harris, Christine K Wade, Mamta Amin, Ann E Barr, Mary F Barbe

Department of Physical Therapy Faculty Papers

BACKGROUND: We previously reported early tissue injury, increased serum and tissue inflammatory cytokines and decreased grip in young rats performing a moderate demand repetitive task. The tissue cytokine response was transient, the serum response and decreased grip were still evident by 8 weeks. Thus, here, we examined their levels at 12 weeks in young rats. Since aging is known to enhance serum cytokine levels, we also examined aged rats.

METHODS: Aged and young rats, 14 mo and 2.5 mo of age at onset, respectfully, were trained 15 min/day for 4 weeks, and then performed a high repetition, low force (HRLF) …

A Clincial Outcomes Commentary On "A Longitudinal Study Of Outcome Measures For Children Receiving Early Intervention Services", Marcia Levinson, Pt, Phd, Mft, Rosaleen Creedon Gnoffo, Pt, Ms, Dpt, Pcs

Department of Physical Therapy Faculty Papers

Pediatric physical therapy, especially in early intervention (EI), focuses on children’s function in natural environments and within daily routines. Valid and reliable tests measuring the ICF participation component are important to consider if we are to align our treatment focus and goals to our measures of progress. This article demonstrates that the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skill scaled scores are sensitive to change in children receiving EI with and without motor involvement.

Bone Stress Injury Of The Ankle In Professional Ballet Dancers Seen On Mri., Ilan Elias, Adam C Zoga, Steven M Raikin, Judith R Peterson, Marcus P Besser, William B Morrison, Mark E Schweitzer

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Ballet dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME) in the ankles of high performance professional ballet dancers, to evaluate clinical relevance. METHODS: MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32). Individuals were imaged on a 0.2 T or 1.5 T MRI units. Images were evaluated by two musculoskeletal radiologists and one orthopaedic surgeon in consensus for location …

Trial And Error Versus Errorless Learning Of Functional Skills In Patients With Acute Stroke, Julie Mount, Samuel R. Pierce, Janet Parker, Rebecca Diegidio, Russell Woessner, Lenore Spiegel

Department of Physical Therapy Faculty Papers

Objective: To compare the effectiveness of errorless learning versus trial and error learning for teaching activities of daily living to patients with acute stroke with or without explicit memory impairments.

Design: Randomized crossover.

Setting: Rehabilitation hospital.

Participants: 33 adult subjects following an acute stroke.

Intervention: Subjects were taught to prepare a wheelchair for a transfer and to put on a sock with a sock-donner. Tasks were taught using errorless learning or trial and error learning. Explicit memory was assessed using the Neurobehavioral Cognitive Status Exam.

Main Outcome Measures: Days until subject was able to …

Movement Patterns Used By The Elderly When Getting Out Of Bed, Julie Mount, Leslie Kresge, Gabrielle Klaus, Lynn Mann, Caitlin Palomba

Department of Physical Therapy Faculty Papers

Background and Purpose. Getting out of bed is difficult for 27.6% of people over 65. The purpose of this study is to describe movement patterns used by older adults for rising from bed.

Subjects. 42 healthy subjects between the ages of 65 and 90.

Methods. Subjects were videotaped performing 5 trials of getting out of bed. Movement patterns were categorized for each body part.

Results. A number of movement patterns occurred that were not reported in younger people. The most frequent movement patterns used were: “roll off” (38.3%) for the trunk, “double push” (34.7%) for the far arm, “multi-push” (36.0%) …

Effects Of Dorsiflexor Endurance Exercises On Foot Drop Secondary To Multiple Sclerosis: A Pilot Study, Julie Mount, Stan Dacko

Department of Physical Therapy Faculty Papers

PURPOSE: This is a pilot study to determine if endurance exercises for dorsiflexors will improve walking for people with foot drop secondary to MS, and if improvement in muscle endurance for persons with MS can be predicted based on the amount of central fatigue (CF) in the muscle.

SUBJECTS: Five individuals with foot drop secondary to MS and five age-matched controls.

METHODS: The intervention was 4 sets of 10 isometric contractions, at 60% of MVC, 3X/week, 8 weeks. Pretests-posttests included a dorsiflexor endurance test with superimposed electrical stimulation to measure CF, and a gait assessment including measurement of dorsiflexion at …

Test-Retest Reliability Of Temporal And Spatial Gait Characteristics Measured With An Instrumented Walkway System (Gaitrite®), Cornelius J.T. Van Uden, Marcus P. Besser

Department of Physical Therapy Faculty Papers

Background
The purpose of this study was to determine the test-retest reliability of temporal and spatial gait measurements over a one-week period as measured using an instrumented walkway system (GAITRite®).

Methods
Subjects were tested on two occasions one week apart. Measurements were made at preferred and fast walking speeds using the GAITRite® system. Measurements tested included walking speed, step length, stride length, base of support, step time, stride time, swing time, stance time, single and double support times, and toe in-toe out angle.

Results
Twenty-one healthy subjects participated in this study. The group consisted of 12 men and 9 women, …

Test-Retest Reliability Of Temporal And Spatial Gait Characteristics Measured With An Instrumented Walkway System (Gaitrite)., Cornelis J T Van Uden, Marcus P Besser

Department of Physical Therapy Faculty Papers

BACKGROUND: The purpose of this study was to determine the test-retest reliability of temporal and spatial gait measurements over a one-week period as measured using an instrumented walkway system (GAITRite). METHODS: Subjects were tested on two occasions one week apart. Measurements were made at preferred and fast walking speeds using the GAITRite system. Measurements tested included walking speed, step length, stride length, base of support, step time, stride time, swing time, stance time, single and double support times, and toe in-toe out angle. RESULTS: Twenty-one healthy subjects participated in this study. The group consisted of 12 men and 9 women, …

Investigation Of The Optimal Load-Bearing Characteristics Of Patellar Tendon Bearing (Ptb) Prostheses, Rahamim Seliktar, Theerasakdi Vachranukunkiet, Marcus P. Besser, Denise Kuenzig, A. Esquenazi

Department of Physical Therapy Faculty Papers

The long-term goal of the research team is to automate the construction of lower limb prostheses using computer integrated manufacturing (CIM) techniques.

Investigation Of The Optimal Load-Bearing Characteristics Of Patellar Tendon Bearing (Ptb) Prostheses, Rahamim Seliktar, Theerasakdi Vachranukunkiet, Marcus P. Besser, Denise Kuenzig, A. Esquenazi

Department of Physical Therapy Faculty Papers

The long term goal of the research team is to automate the construction of the lower limb prostheses using Computer Integrated Manufacturing (CIM) techniques.