Physical Therapy Commons^™

Health And Appearance Reasons For Weight Loss As Predictors Of Long-Term Weight Change, Joseph E. Mroz, Carol H. Pullen, Patricia A. Hageman

Journal Articles: Physical Therapy

This study investigated whether women's initial reasons (health, appearance to others, or appearance to self) for wanting to lose weight influenced their weight change over a 30-month web-based intervention. Multilevel modeling with 1416 observations revealed that only appearance in relation to one's self was a significant (negative) predictor. Women highly motivated to lose weight to improve their appearance in relation to themselves gained weight at 30 months, whereas those not motivated for this reason achieved clinically significant weight loss. Results suggest examining participants' initial reasons for weight loss as an important component of intervention failure or success.

Transforming Physical Therapy Education Through The Use Of Social Network Analysis, Betsy J. Becker, Sara E. Bills

Posters and Presentations: Physical Therapy

PURPOSE

Social Network Analysis (SNA) is a quantitative method to study the patterning and effect of relationships and how individual connections form into social structures that influence outcomes of the group. The purpose of this study is to explain the underpinnings of SNA and its application to PT education for student success and faculty development. This study is innovative and will be beneficial to the profession because there is currently no published literature exploring how PT education is influenced by social structures.

METHODS/DESCRIPTION

The aims of this study are to describe SNA and outline its potential to transform PT education. …

Use Of A Team Building Activity To Teach Clinical Decision-Making Concepts To Physical Therapy Students, Robert Fuchs, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE : The purpose of this research was to find out if a team building exercise carried out by student groups will facilitate learning how to make clinical decision involving concepts from the International Classification of Function (ICF).

SIGNIFICANCE: Scant literature exists regarding the concept of integrating student and expert team case-based learning with the ICF to develop clinical decision-making skills.

SUBJECTS: Subjects were 213 first-year physical therapy students in the DPT program at UNMC in the first semester of the curriculum of years 2013-2016.

METHODS AND MATERIALS: A patient case was developed which included clinical decision-making steps using concepts …

Filling The Gap. Clinical Skill Acquisition With Interactive Online Modules To Supplement Traditional Instruction, Keriann Shaw, Betsy J. Becker, Nicole M. Sleddens, Robin High

Posters and Presentations: Physical Therapy

PURPOSE

The purpose of this study was to assess the effectiveness of interactive e-learning modules to supplement traditional instruction for range of motion (ROM) clinical skill acquisition in a doctor of physical therapy(DPT) curriculum.

BACKGROUNDS/SIGNIFICANCE

Online resources have become highly favored to augment learning especially by millennials for convenience, self-paced content, and versatility in learning styles. It has been reported that elearning platforms are as effective as traditional face-to-face instruction, but may be best utilized as an adjunctive resource for teaching psychomotor skills. Student confidence has also been analyzed with reports of increased self-efficacy with use of online learning materials. …

Evaluation Of A Student-Centered Digital Education Project In Health Science Education, Betsy J. Becker

Posters and Presentations: Physical Therapy

Student-centered learning is essential and evidence shows higher levels of achievement when students are engaged with educational activities that include critical thinking and effective communication in addition to creativity. The aim of this prospective cohort study was to evaluate a student-centered digital education project during a course about physical therapy (PT) management of chronic diseases. The objectives of this student project were to apply content through a well thought-out digital project and critically analyze information considering multiple points of view. Each project was evaluated by faculty using a rubric, and students completed a self- and peer-assessment. All projects were shared …

Web-Based Interventions Alone Or Supplemented With Peer-Led Support Or Professional Email Counseling For Weight Loss And Weight Maintenance In Women From Rural Communities: Results Of A Clinical Trial., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Bunny J. Pozehl, C Eisenhauer, Linda S. Boeckner

Journal Articles: Physical Therapy

Objective. This trial compared the effectiveness of a web-based only (WO) intervention with web-based supplemented by peer-led discussion (WD) or professional email counseling (WE) across 3 phases to achieve weight loss and weight maintenance in women from underserved rural communities. Methods. 301 women (BMI of 28-45 kg/m(2)) randomly assigned to groups participated in guided weight loss (baseline to 6 months), guided weight loss and maintenance (6 to 18 months), and self-managed weight maintenance (18 to 30 months). Results. Retention was 88.7%, 76.5%, and 71.8% at 6, 18, and 30 months, respectively. Intent-to-treat analyses demonstrated no group differences in change in …

Identification And Intervention For Action Planning Deficits In Children With Hemiplegic Cerebral Palsy, Swati M. Surkar

Theses & Dissertations

The primary purpose of this investigation was to describe and quantify action-planning deficits during goal-directed movements in children with hemiplegic cerebral palsy (HCP). Three specific topics were addressed: brain activation, kinematics, and the use of visual input. First, we assessed prefrontal cortex (PFC) activation during complex goal-directed actions in children with HCP. The outcome suggested that children with HCP have higher PFC activation than age matched typically developing (TD) children during action planning, potentially due to the difficulty in allocating attentional resources for simultaneously processing the cognitive (i.e., attention, memory, information processing) and motor demands of the goal-directed task. Reduced …

Click Here! E-Learning Modules For Innovative Instruction And Learning, Nicole M. Sleddens, Betsy J. Becker, Sara E. Bills

Posters and Presentations: Physical Therapy

Purpose: Re-designing all or portions of a course with a fresh perspective can re-energize faculty and make the content more engaging for the learner. Teaching the millennial generation is also prompting faculty to revisit educational strategies. The use of electronic learning platforms, such as eLearning modules, is an innovative learning strategy with several reported benefits including flexibility and convenience for usage, ability for learners to study at their own pace and adaptability to different learning styles. Using technology that is free or already available to faculty, even the novice designer can begin development of these useful study tools. The key …

Use Of Distance Delivery Interventions (Web-Based, Mhealth, Telehealth) For Hard-To-Reach, Vulnerable Midlife And Older Individuals, Patricia A. Hageman

Posters and Presentations: Physical Therapy

As older adults may lack access to professional services and/or have limited transportation to seek care, the increasing availability of technologies for self-monitoring, safety, and/or preventive or therapeutic management may show promise for reaching vulnerable older adults. This presentation will describe several types of distance delivery platforms, such as web-based, mHealth, and/or telehealth, which may have applications to older adults in arenas of education, clinical practice or research. This session will highlight the benefits and limitations of these technologies, and will summarize current research about the effectiveness of using these technologies with midlife and older individuals.

Objectives:

1. Identify benefits and …

Measurement Of Daily Energy Expenditure In Individuals With Chronic Heart Failure, Yanlong Li

Theses & Dissertations

Being able to accurately monitor and quantify the amount of physical activity an individual with chronic heart failure (CHF) performs can be of assistance in developing appropriate interventions. This thesis attempted to evaluate the validity of the RT3 accelerometer (RT3) and 7-day Physical Activity Recall Questionnaire (7 day PAR) in measuring the daily activity levels of community dwelling individuals with CHF. Fifty-four individuals with CHF participated in a 7 day session to estimate their daily physical activity by using the RT3 accelerometer and 7-day PAR questionnaire. In addition, 15 of the 54 individuals participated in a second study in with …

Mobility Of Individuals With Multiple Sclerosis And The Influence Of Physical Therapy, Brenda L. Davies

Theses & Dissertations

One main purpose was to explore the compensatory gait strategies of individuals with multiple sclerosis (MS). To address this purpose, we quantified the mechanical work generated by the lower extremity joints during walking. The outcomes from this investi­gation suggested that individuals with MS redistribute positive mechanical work during walking to the hip in order to compensate for a reduced ability of the ankle to generate positive mechanical work. Additionally, we also explored the motor control of the ankle as a potential contributing factor to the mobility limitations of individuals with MS. The outcomes from this investigation indicated that individuals with …

Using Active Learning Strategies To Teach Dpt Students How To Assertively Address Inappropriate Patient Sexual Behavior (Ipsb), Betsy J. Becker, Kathleen G. Volkman, Robin R. High

Posters and Presentations: Physical Therapy

PURPOSE/HYPOTHESIS

Inappropriate sexual behavior is defined as a “verbal or physical act of an explicit, or perceived, sexual nature, which is unacceptable within the social context in which it is carried out.” In a survey of U.S. PTs, 86% of the respondents reported experiencing at least one type of IPSB. PT education programs are required to teach concepts of professional duty, communication skills, and cultural competency, however, management techniques of IPSB in the clinic are not uniformly taught in schools. The use of active learning methods such as role play simulation and small group discussion has been successful with other …

The Impact Of E-Learning On Physical Therapy Students’ Clinical Skill Development, Taylor Majerus, Marissa Johnson, Betsy J. Becker

Posters and Presentations: Physical Therapy

Purpose: The purpose of this special interest report is to review the effectiveness of e-learning in comparison to traditional classroom learning by exploring different methods of implementation of e-learning into PT curriculum

Description: Education delivery via e-Learning is becoming a common teaching mode that appeals to students because it can be completed asynchronously at a self-directed pace and reviewed anytime, anywhere and as often as necessary for understanding. Translating knowledge from eLearning materials to skill performance is important to consider for PT students due to the requirements of psychomotor performance and demonstration of appropriate affective professional behaviors.

Literature review: A …

Feasibility Of Mhealth Technology Use Among A Sample Of Isolated Rural Men At High Risk For Cardiovascular Disease, Betsy J. Becker, Christine M. Eisenhauer, Carol H. Pullen, Paul J. Dizona, Patricia A. Hageman

Posters and Presentations: Physical Therapy

Purpose/Hypothesis: Isolated rural men are considered a health disparities group at high risk for cardiovascular disease. The increasing availability of technologies for self-monitoring for healthy eating, activity and weight loss (ie mHealth) may show promise for engaging rural men in lifestyle modification. This study investigated the feasibility of men from rural isolated areas to use a fitness monitor with text messaging support over a 3- week period. The study examined the men’s daily monitor use for tracking activity and eating, and assessed via written survey, their perspectives about mHealth.

Number of Subjects: Twelve men, ages 40 to 69, from …

The Feedforward And Feedback Controls On Gait In Adults With Diabetes, Chun-Kai Huang

Theses & Dissertations

There are nearly 26 million people with diabetes mellitus (DM) in the US, and half of chronic DMs develop somatosensory deficits due to diabetic polyneuropathy or diabetic peripheral neuropathy (DPN). The absence or impaired somatosensory feedback (e.g. touch sensation or joint proprioception) resulted from the damage of large nerve fiber, and motor deficits such as attenuated muscle strength and abnormal plantar pressure of lower extremity have been identified in DPN, and these sensorimotor impairments lead to an increased number of falls. To reduce the risk of falling, a well-coordinated and adapted limb movement driven by the feedforward (anticipatory) and feedback …

Postural Responses To Perturbations Of The Vestibular System During Walking In Healthy Young And Older Adults, Jung Hung Chien

Theses & Dissertations

It has been shown that approximate one-third of US adults aged 40 years and older (69 million US citizens) have some type of vestibular problems. These declining abilities of the vestibular system affect quality of life. Difficulties in performing daily activities (dressing, bathing, getting in and out of the bed and etc.) have been highly correlated to loss of balance due to vestibular disorders. The exact number of people affected by vestibular disorders is still difficult to quantify. This might be because symptoms are difficult to describe and differences exist in the qualifying criteria within and across studies. Thus, it …

Health Related Quality Of Life In Persons With Type 2 Diabetes In A Rural Community Served By A Critical Access Hospital, Betsy J. Becker, Terry F. Nelson, Robin High, Pat Hauer

Posters and Presentations: Physical Therapy

Purpose

Type 2 diabetes poses significant health concerns and severe complications can result. The prevalence of type 2 diabetes is greater in rural than urban areas with rural populations exhibiting higher blood glucose (A1C). The purpose of this study was to determine whether health related quality of life (QOL) varies by gender and diabetes control (A1C) in rural persons with type 2 diabetes.

Subjects

We surveyed 615 persons with type 2 diabetes who receive care at a critical access hospital that serves a seven county rural area in a Midwestern state.

Methods

This study was a cross-sectional mail survey including …

Effectiveness Of Tailored Lifestyle Interventions, Using Web-Based And Print-Mail, For Reducing Blood Pressure Among Rural Women With Prehypertension: Main Results Of The Wellness For Women: Dashing Towards Health Clinical Trial., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Linda Boeckner

Journal Articles: Physical Therapy

Background Lifestyle modification is recommended for management of prehypertension, yet finding effective interventions to reach rural women is a public health challenge. This community-based clinical trial compared the effectiveness of standard advice to two multi-component theory-based tailored interventions, using web-based or print-mailed delivery, in reducing blood pressure among rural women, ages 40–69, with prehypertension.

Methods 289 women with prehypertension enrolled in the Wellness for Women: DASHing towards Health trial, a 12-month intervention with 12-month follow-up. Women were randomly assigned to groups using a 1:2:2 ratio, comparing standard advice (30-minute counseling session) to two interventions (two 2-hour counseling sessions, 5 phone …

Multidisplinary Simulation In Physical Therapist Assistant Education, Betsy J. Becker, Nikki Sleddens, Ian Thompson

Posters and Presentations: Physical Therapy

Background and Purpose: Clinical simulation has been shown to be an effective method of teaching students in a controlled environment. Utilizing a realistic setting with built-in controls, allows students to practice skills, receive instructor feedback and complete self-assessments to refine performance prior to participation in terminal clinical education. Small group instructor-led debriefing is also an essential part of the process to facilitate reflection on performance. Currently there are very few published reports of multidisciplinary simulation including physical therapist assistant (PTA) students with high fidelity simulation mannequins and live standardized patients. Traditionally PTA students have very little, if any, actual …

Evidence For The Use Of Exercise In Patients With Breast Cancer To Reduce Cancer-Related Fatigue, Betsy J. Becker

Posters and Presentations: Physical Therapy

Background & Purpose:

Cancer-related fatigue is the most commonly reported side effect of cancer treatment and affects 70-100% of patients. According to the 2013 National Comprehensive Cancer Network Guidelines on Cancer-Related Fatigue, institutions should assess the quality of fatigue management in their continuous quality improvement projects. In addition, the Guidelines also state that Medicare contracts should reimburse for fatigue management and disability insurance should include coverage for the continuing effects of fatigue.

Exercise has been suggested for breast cancer survivors as an intervention to reduce cancer-related fatigue both during and after cancer treatment. However, it has been reported that only …

Obesity And Physical Function In Rural Women Who Enroll In A Lifestyle Modification Intervention For Reducing Blood Pressure, Patricia A. Hageman, Carol H. Pullen, Paul J. Dizona, Kristin Schmidt, Linda S. Boeckner

Journal Articles: Physical Therapy

Purpose: Rural women have high prevalence of obesity and prehypertension. Obesity, if associated with poor physical function, may have implications for applying activity guidelines for women volunteering for lifestyle modification. This study examined associations of body mass index (BMI) and percent body fat with measures of 1-mile walk time, post-walk perceived exertion, and 10-repetition chair stands in rural women ages 40-69.

Methods: Cross-sectional baseline data were collected using standardized methods from 289 rural women with prehypertension who volunteered for a lifestyle clinical trial for reducing blood pressure. ANOVAs and linear regression were used for analysis.

Results: With exception of the …

Integrating Best Evidence Into Practice: Outcomes Of A Community-Based 12-Week Exercise And Education Intervention In Women With Cancer, Betsy J. Becker, Katherine J. Jones, Patricia A. Hageman, Ruth Vangerpen

Posters and Presentations: Physical Therapy

Objective

Cancer-related fatigue is the most commonly reported side effect of cancer treatment, affecting 70-100% of patients and current literature suggests exercise is an important component of managing this side effect. The specific objective of this project was to evaluate the effectiveness of a 12-week evidence-based cancer exercise and education intervention on outcomes of fatigue, pain, depression, sleep disturbance and quality of life for women with cancer; the intervention was delivered by an interprofessional team in a medically-based wellness center.

Methods

The team was led by a physical therapist and included medical and radiation oncologists, general surgeons, nurses and cancer …

Associations Of Cardiorespiratory Fitness And Fatness With Metabolic Syndrome In Rural Women With Prehypertension., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Linda S. Boeckner, Susan Noble Walker

Journal Articles: Physical Therapy

BACKGROUND: This study investigated the associations of fitness and fatness with metabolic syndrome in rural women, part of a recognized US health disparities group.

METHODS: Fitness, percentage body fat, BMI, and metabolic syndrome criteria were assessed at baseline in 289 rural women with prehypertension, ages 40-69, enrolled in a healthy eating and activity community-based clinical trial for reducing blood pressure.

RESULTS: Ninety (31%) women had metabolic syndrome, of which 70% were obese by BMI (≥30 kg/m²), 100% by percentage body fat (≥30%), and 100% by revised BMI standards (≥25 kg/m²) cited in current literature. Hierarchical logistic regression models, adjusted for …

Web-Based Interventions For Weight Loss And Weight Maintenance Among Rural Midlife And Older Women: Protocol For A Randomized Controlled Trial., Patricia A. Hageman, Carol H. Pullen, Melody Hertzog, Linda S, Boeckner, Susan Noble Walker

Journal Articles: Physical Therapy

BACKGROUND: Weight loss is challenging and maintenance of weight loss is problematic among midlife and older rural women. Finding effective interventions using innovative delivery methods that can reach underserved and vulnerable populations of overweight and obese rural women is a public health challenge.

METHODS/DESIGN: This Women Weigh-In for Wellness (The WWW study) randomized-controlled trial is designed to compare the effectiveness of theory-based behavior-change interventions using (1) website only, (2) website with peer-led support, or (3) website with professional email-counseling to facilitate initial weight loss (baseline to 6 months), guided continuing weight loss and maintenance (7-18 months) and self-directed weight maintenance …

Maintenance Of Activity And Eating Change After A Clinical Trial Of Tailored Newsletters With Older Rural Women., Susan Noble Walker, Carol H. Pullen, Patricia A. Hageman, Linda S. Boeckner, Melody A. Hertzog, Maureen K. Oberdorfer, Matthew J. Rutledge

Journal Articles: College of Nursing

BACKGROUND: In the Wellness for Women Project, a randomized-by-site 1-year controlled clinical trial, the efficacy of generic newsletters and newsletters tailored on Health Promotion Model behavior-specific cognitions, eating behavior, and activity behavior were compared among 225 women aged 50 to 69 years.

OBJECTIVES: The purpose of this study was to compare the maintenance of change in healthy eating and physical activity over the 12 months following the tailored versus generic mailed newsletter intervention.

METHODS: Outcomes at 18 and 24 months included behavioral markers and biomarkers of physical activity and eating. Data were analyzed using the multivariate approach to repeated measures …

The Effects Of Shoe Traction And Obstacle Height On Lower Extremity Coordination Dynamics During Walking., Leslie Decker, Jeremy J. Houser, John M. Noble, Gregory M. Karst, Nicholas Stergiou

Journal Articles: Physical Therapy

This study aims to investigate the effects of shoe traction and obstacle height on lower extremity relative phase dynamics (analysis of intralimb coordination) during walking to better understand the mechanisms employed to avoid slippage following obstacle clearance. Ten participants walked at a self-selected pace during eight conditions: four obstacle heights (0%, 10%, 20%, and 40% of limb length) while wearing two pairs of shoes (low and high traction). A coordination analysis was used and phasing relationships between lower extremity segments were examined. The results demonstrated that significant behavioral changes were elicited under varied obstacle heights and frictional conditions. Both decreasing …

Clinical Trial Of Tailored Activity And Eating Newsletters With Older Rural Women., Susan Noble Walker, Carol H. Pullen, Linda Boeckner, Patricia A. Hageman, Melody Hertzog, Maureen K. Oberdorfer, Matthew J. Rutledge

Journal Articles: College of Nursing

BACKGROUND: Unhealthy diet and lack of physical activity increase rural midlife and older women's risk of chronic diseases and premature death, and they are behind urban residents in meeting Healthy People 2010 objectives.

OBJECTIVES: The objective of this study was to compare a tailored intervention based on the Health Promotion Model with a generic intervention to increase physical activity and healthy eating among rural women.

METHODS: In a randomized-by-site, community-based, controlled, clinical trial, Wellness for Women, 225 women aged 50 to 69 years were recruited in two similar rural areas. Over 12 months, women received by mail either 18 generic …

A Preliminary Study On The Reliability Of Physical Performance Measures In Older Day-Care Center Clients With Dementia., Vince Salazar Thomas, Patricia A. Hageman

Journal Articles: Physical Therapy

BACKGROUND: Decline in physical functional ability is an intrinsic component of the dementia syndrome. Reductions in muscle mass and strength represent a major factor in the loss of functional ability Although resistance exercise has been studied as a method for maintaining/recovering function in populations of frail older adults, people with dementia have been systematically excluded because of uncertainty about the reliability of outcome measurements.

OBJECTIVE: The purpose of this study was to determine the test-retest reliability of a battery of established performance-based measures of strength and function among subjects with dementia.

SETTING: A hospital-affiliated adult day-care facility.

SUBJECTS: Twelve of …