Physical Therapy Commons^™

Inter And Intra-Rater Reliability Of Dance Screening Tool, Kathleen Stone, Braden Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Previous literature has indicated that injury rates of ballet and modern dancers are among the highest of any physical activity. These injuries can be detrimental to the athlete and can also result in financial burden for dance companies due to time loss related to injuries. Preventative intervention aimed at those who are most at risk for injury can be effective at reducing the cost associated with lost time due to injury. An effective approach to identifying those most at risk for dance related injuries is to administer a functional movement screen. One such movement screen is the ballet-based Dance Technique …

Am-Pac Basic Mobility Inpatient Short Form (Low Function) Psychometrics/Clinimetrics, Meghan Wonderling, David Miller, Selena Soria

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine whether the Activity Measure for Post-Acute Care® Basic Mobility Inpatient Short Form (Low Function) (6-clicks LF) has increased responsiveness for patients with lower levels of physical function compared to the Activity Measure for Post-Acute Care Basic Mobility Inpatient Short Form (6-clicks). Design: Retrospective cohort study using original scores and simulated scores for assessment of internal responsiveness of the 6-clicks LF compared to the 6-clicks. Simulated 6-clicks and 6-clicks LF scores were created as a hypothetical future AM-PAC® score. Results: We found a statistically significant difference between the 6-clicks and simulated 6-clicks, t=24.8, p < 0.00 [two-tailed]. The effect size was large (d=1.2, r=0.51).There was a statistically significant difference between the 6-clicks LF and simulated 6-clicks LF, t=19.7, p < 0.00 [two-tailed]. The effect size was medium (d=0.91, r=0.41). Finally, for patients with a 6-clicks score in the bottom five-percentile (n=27), we found a statistically significant difference between the 6-clicks and 6-clicks LF, t=11.9, p < 0.00 [two-tailed]. Conclusion: Among patients scoring less than 15, the 6-clicks LF has greater internal responsiveness than the 6-clicks and thus demonstrates that the new low-level questions in the 6-clicks LF better quantify low-level patients’ functional level. Research using non-simulated data should be completed in the future to confirm these findings.

Stepping On Fall Prevention Project, James P. Gaddi, Jordan T. Bowers, Lea M. K. Fung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Falls are a major problem in the United States among the older adult population and provide opportunity for community outreach via student-led physical therapy projects. Objective: The purpose of this project was to investigate the relationship between fall related outcome measures and questionnaires with the completion of the Stepping On Fall Prevention program along with evaluating the benefits of Physical Therapy student development with participation in service learning projects. Methods: The research quantified the fall risk of 13 participants with assessment of: gait speed (Timed Up and Go), lower extremity strength (30-Second Chair Stand), balance (4-Stage Balance Test), and …

Neurophysiological Assessments Of Brain And Spinal Cord Associated With Lower Limb Functions In Children With Cerebral Palsy: A Protocol For Systematic Review And Meta-Analysis, Leonard Ubalde, Jing Nong Liang

Physical Therapy Faculty Research

Background: Task-dependent neurophysiological adaptations in people with cerebral palsy have been examined using various techniques such as functional magnetic resonance imaging, peripheral nerve stimulation in order to assess H-reflexes, and transcranial magnetic stimulation. This activity-dependent plasticity is hypothesized to improve specific gross motor function in individuals with cerebral palsy. Although these adaptations have been examined extensively, most studies examined tasks utilizing the upper limbs. The aim of this review is to assess the neurophysiological adaptations of the central nervous system in individuals with cerebral palsy during lower limb functional tasks. Methods: A systematic review and meta-analysis will be conducted to …

Utilization Of Inertial Measurement Units For Determining The Sequential Chain Of Baseball Strike Posture, Yun-Ju Lee, Po-Chieh Lin, Ling-Ying Chen, Yu-Jung Cha, Jing Nong Liang

Physical Therapy Faculty Research

The purpose of this study was to employ inertial measurement units (IMU) with an eyetracking device to investigate different swing strategies between two levels of batters. The participants were 20 healthy males aged 20 to 30 years old, with ten professional and ten amateur batters. Eye gaze position, head, shoulder, trunk, and pelvis angular velocity, and ground reaction forces were recorded. The results showed that professional batters rotated segments more rhythmically and efficiently than the amateur group. Firstly, the professional group spent less time in the preparation stages. Secondly, the maximum angular velocity timing of each segment of the professional …

Development Of A Novel Cognitive-Motor Dual Task Assessment Battery In Neurodegenerative Disease, Jason Longhurst

UNLV Theses, Dissertations, Professional Papers, and Capstones

Automaticity --- the ability to perform a task with directing attentional resources to its completion --- is commonly reduced among individuals with neurodegenerative diseases. These automaticity deficits result in impaired functional and daily activities and are sensitive to subtle, subclinical impairments. However, current measurement of automaticity by dual task paradigms is methodologically limited. In order to gain insight into the current state of the literature regarding cognitive-motor interference in symptomatic and prodromal neurodegenerative disease, the author of this dissertation conducted a scoping review (Chapter 1). To address the methodological limitations of current measurement of automaticity, a new measurement tool was …

Examining The Experiences Of Lgbtq Dpt Students: A Critical Ethnography, Catherine Turner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the experiences of LGBTQ Doctor of Physical Therapy (DPT) students at a large public university in the south-western United States, as it relates to the culture and climate of the program and campus. The LGBTQ community faces its own unique health disparities. Research in medicine suggests improving the diversity of the healthcare profession is a vital component in improving access to care, and this requires the creation of inclusive and supportive educational environments for LGBTQ identifying healthcare students. However, minimal research exists examining the experiences of LGBTQ physical therapy students.

The study …

Slow Walking In Individuals With Chronic Post-Stroke Hemiparesis: Speed Mediated Effects Of Gait Kinetics And Ankle Kinematics, Jing Nong Liang, Kai-Yu Ho, Yun-Ju Lee, Corey Ackley, Kiley Aki, Joshua Arias, Jassie Trinh

Physical Therapy Faculty Research

Post-stroke rehabilitation often aims to increase walking speeds, as faster walking is associated with improved functional status and quality of life. However, for successful community ambulation, ability to modulate (increase and decrease) walking speeds is more important than walking continuously at constant speeds. Increasing paretic propulsive forces to increase walking speed has been extensively examined; however, little is known about the mechanics of slow walking post-stroke. The primary purpose of this study was to identify the effects of increased and decreased walking speeds on post-stroke kinetics and ankle kinematics. Fifteen individuals with chronic post-stroke hemiparesis and 15 non-neurologically impaired controls …

Participant Retention In Trauma Intensive Care Unit (Icu) Follow-Up Studies: A Post-Hoc Analysis Of A Previous Scoping Review, Himanshu Rawal, Daniel L. Young, Roozbeh Nikooie, Awsse H. Al Ani, Lisa Aronson Friedman, Sumana Vasishta, Elliott R. Haut, Elizabeth Colantuoni, Dale M. Needham, Victor D. Dinglas

Physical Therapy Faculty Research

Background The study aimed to synthesize participant retention-related data for longitudinal follow-up studies of survivors from trauma intensive care units (ICUs). Methods Within a published scoping review evaluating ICU patient outcomes after hospital discharge, two screeners independently searched for trauma ICU survivorship studies. Results There were 11 trauma ICU follow-up studies, all of which were cohort studies. Twelve months (range: 1-60 months) was the most frequent follow-up time point for assessment (63% of studies). Retention rates ranged from 54% to 94% across time points and could not be calculated for two studies (18%). Pooled retention rates at 3, 6, and …

The Association Between Medication Use And Gait In Adults With Intellectual Disabilities, S. Maas, D. A.M. Festen, Thessa I.M. Hilgenkamp, A. Oppewal

Physical Therapy Faculty Research

Background: Adults with intellectual disabilities (ID) often have polypharmacy and often use antipsychotics. Both polypharmacy and antipsychotics have a negative effect on gait in the general population, but this has not been studied in adults with ID. These negative effects may add to pre‐existing gait disturbances in adults with ID and increase the risk for adverse health outcomes in this population. Therefore, the aim of this study is to investigate the difference in gait parameters between adults with ID with and without polypharmacy and between adults with ID using and not using antipsychotics. Method: The gait parameters of 31 participants …

Sound Effects On Standing Postural Strategies In The Elderly Via Frequency Analysis Approach, Yun-Ju Lee, Chang-Hsu Chen, Chao-Che Wu, Yu-Jung Chen, Jing-Nong Liang

Physical Therapy Faculty Research

Sound and sound frequency could improve postural sway in the elderly. The power spectrum intervals of the center of pressure (COP) displacement are associated with different postural regulations, which could be revealed by frequency analysis. The aim of the study was to investigate the effects of sound on dual-tasking postural control and conduct frequency analysis to distinguish postural regulations in the elderly. Fifteen young and 15 older healthy participants were instructed to stand on a force platform and performed the Purdue Pegboard test while hearing 50 dB sounds with sound frequencies of 250 Hz, 1000 Hz, 4000 Hz, or no …

Acute Systemic Inflammation Reduces Both Carotid And Aortic Wave Reflection In Healthy Adults, Thessa Hilgenkamp, Elizabeth C. Schroeder, Wesley L. Lefferts, Bo Fernhall

Physical Therapy Faculty Research

Acute inflammation increases the risk of cardiac and cerebrovascular events, possibly related to alterations in the hemodynamic load. Wave reflection at the aorta and carotid provides insight into downstream vascular changes and hemodynamic load at the heart and brain. Acute inflammation has been suggested to reduce wave reflection via downstream vasodilation; however, this is not firmly established and has only been investigated at the aorta. We sought to explore the effect of acute inflammation on aortic and carotid hemodynamics in healthy, young adults. Pressure waveforms were collected via radial and carotid applanation tonometry in 23 adults (26 ± 4 years) …

How Can Care Settings For People With Intellectual Disabilities Embed Health Promotion?, Kristel Vlot-Van Anrooij, Monique C. J. Kiks-Leensen, Anneke Van Der Cruijsen, Henk Jansen, Koos Van Der Velden, Geraline Leusink, Thessa I. M. Hilgenkamp, Jenneken Naaldenberg

Physical Therapy Faculty Research

Background:People with intellectual disabilities (ID) depend on their environment to live healthily. Asset‐based health promotion enhances a settings’ health‐promoting capacity starting with identifying protective or promotive factors that sustain health. Method: This inclusive mixed‐methods study used group sessions to generate and rank ideas on assets supporting healthy nutrition and physical activity in Dutch intellectual disability care settings. Participants included people with moderate intellectual disabilities and family and care professionals of people with severe/profound intellectual disabilities. Results: Fifty‐one participants identified 185 assets in group sessions. They include the following: (i) the social network and ways “people” can support, (ii) assets in/around …

Evaluation Of Repetitive Jumping Intensity On The Digi-Jump Machine, T. Scott Lyons, James W. Navalta, Whitley J. Stone, Scott W. Arnett, Mark A. Schafer, Laura Igaune

Kinesiology and Nutrition Sciences Faculty Research

Cardiorespiratory endurance is an important element of aerobic fitness, particularly in weight management and reducing risk for cardiovascular disease. While there are numerous options for aerobic exercise, rope jumping is often overlooked. In addition to regular exercise and a healthy diet, the American Heart Association strongly recommends rope jumping. The first purpose of this study was to determine the steady state metabolic cost of repetitive jumping on the Digi-Jump machine to evaluate whether exercise on this device is more or less strenuous than similar exercise with a jump rope, as demonstrated in previous literature. A second purpose was to determine …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Reliability Of The Lateral Reach Test In People With Unilateral Transfemoral Amputations, Stephen Hill, Samantha Leonard, Elizabeth Vianey Trujillo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lateral reach testing has been established as useful in quantifying stability and fall-risk for older populations without limb loss,1 and has potential for providing useful information about fall-risk, recovery, and rehabilitation of individuals after unilateral trans-femoral amputation. Investigators sought to determine the feasibility and reliability of the Lateral Reach Test (LRT) in people with unilateral trans-femoral amputations. Nine individuals, aged 20-68, with a unilateral trans-femoral amputation were recruited for this study. Two females and seven males participated, and the average height and weight for the group was 167cm and 76kg, respectively. Three participants had right trans-femoral amputations while six had …

Partnering With The Nevada Physical Therapy Association To Improve Pt/Pta Engagement, Rachel Cooklin, Joshua Cooper, Madison Luna

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The American Physical Therapy Association (APTA) is the professional organization that represents Physical Therapy and exists to promote the needs of society by advocating access and availability of all Physical Therapy services. The Nevada Physical Therapy Association (NVPTA) is a chapter of the APTA that represents the Physical Therapy profession in Nevada. In 2017, only 38.9% of licensed Physical Therapists (PTs) and 7.9% of licensed Physical Therapy Assistants (PTAs) practicing in Nevada were members of the NVPTA. Objective: The purpose of this service-learning project was to explore membership trends in the NVPTA, explore why membership amongst PTAs is low, …

Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Patient, Student, And Faculty Perceptions Of A Student Led Pro-Bono Education And Treatment Based Back School For Uninsured Nevadans, James Tingey, Daniel Tiano, Rebecca Templeton, Meagan Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Importance: To determine feasibility and benefits of student led back school in an underserved population. Perceptions were positive support benefits for all participants. Objective: To evaluate perceived benefits for uninsured participants, students, and faculty with implementation of an evidence based, student led back school. Design: Eight DPT students created curriculum delivered over two days of two-hour classes, one week apart including screening and abbreviated evaluation of LBP, group education, specific exercise selection, and home exercise program assignment. Following first session, analysis performed to improve subsequent sessions. Setting: Cooperative effort between the pro bono clinic, Volunteers in Medicine of Southern Nevada, …

Effects Of Transcranial Direct Current Stimulation On Gait And Balance Post-Stroke, Leonard Ubalde, Jordon Jacklin, Peyton Hobson, Sara Wright-Avila

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Non-invasive brain stimulation is effective in combination with traditional physical therapy to facilitate motor performance in patients who recently survived a stroke. Current literature has focused on transcranial direct current stimulation and transcranial magnetic stimulation efficacy for improving the completion of fine motor tasks in the upper extremities. However, there is a lack of current evidence regarding the efficacy of this therapy in the lower extremities. Objective: To measure the effects of transcranial direct current stimulation on lower extremity clinical outcomes in patients who had a stroke including gait speed, functional reach, and balance. Methods: Randomized control trial in …

The Effectiveness Of Implementing A Collegiate Dance Clinic At The University Of Nevada, Las Vegas, Quinn Williams, Kristin Allman, Matthew Mcarthur, Ryan Yim

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screenings are commonly employed in athletics to identify deficits in performance with the goal of providing interventions to decrease injury risk; however, their utilization is uncommon in collegiate dance programs. Therefore, the purpose of this service learning project was to address the needs of the University of Nevada, Las Vegas (UNLV) dance program through implementation of an injury screening and prevention clinic for collegiate-level dancers. Four second year Doctor of Physical Therapy students (SPTs) supervised by a clinical faculty member with dance medicine expertise researched, developed, and provided screenings to identify increased risk for dance-specific injuries, and education to decrease …

Brain Volumes And Dual-Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jon Basterrechea, Daniel Krist, Caitlin Moreland, Morgan Wise

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. Objective: To examine associations between brain volumes, dual task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. Methods: We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual task performance, and measures of gait and balance. Results: Greater cognitive function and combined dual task effect (DTE) is associated with smaller brain volumes. In contrast, greater motor DTE is associated with larger …

Comparisons Of Patellar Bone Mineral Density Between Individuals With And Without Patellofemoral Pain, Chris Khuu, Allina Cummins, Steven Shepherd

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Although bone stress injuries have been reported in individuals with patellofemoral pain (PFP), especially within the lateral patella, it remains unclear whether persons with PFP exhibit altered patellar regional bone mineral density (BMD). The primary purpose of this study was to compare BMD of the patella (lateral, medial, and total regions) between individuals with and without PFP using quantitative computed tomography (QCT). The secondary aim was to examine the associations between patellar regional BMD and patellofemoral joint (PFJ) alignment. Methods: Ten individuals with retropatellar pain and 10 sex, age, weight, height, and activity matched pain-free controls underwent a QCT …

Patient And Facility Perceptions On The Feasibility Of A Student-Run Pro-Bono Back-School For Uninsured Patients With Low Back Pain, Javier Ascanio-Pellon, Sofia Cruz, Lauren Liebert, Trevor Pacuk

UNLV Theses, Dissertations, Professional Papers, and Capstones

A. Background of Knowledge: Nevada ranks 8th highest in uninsured population in the United States. People who are uninsured may be more affected by low back pain (LBP) than their insured counterparts. Volunteers in Medicine of Southern Nevada (VMSN), a non-profit organization, serves uninsured people in Nevada. VMSN partnered with UNLV Physical Therapy (UNLVPT) to provide a back-school for patients. UNLVPT proposed a service-learning model to provide both education and treatment for VMSN patients with LBP. B. Purpose: The purpose of this community-based research project is to create and implement a student-run pro-bono back-school for uninsured individuals with LBP in …

Fall Prevention Service-Learning Project, Alexis Mansoor, Kendra Morrison, Jeremy Nordfelt, Cheng Yang Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The purpose of this service-learning project was to: 1) reduce falls in the Las Vegas, Nevada community by implementing the Stepping On fall prevention program and 2) to investigate the effect of planning and implementing a service learning project (SLP) on physical therapy (PT) students’ education and professional development. Description: Under the supervision of our advisor, we planned and organized this SLP, became certified leaders of Stepping On, recruited and screened older adults using the STEADI fall risk screening tool, and facilitated the program at a local community hospital. We facilitated group discussion and instructed the exercises outlined in …

Dosage, Mode, And Timing Of Acute Care Physical Therapy: A Scoping Review, Brendan Acosta, Bradley Goins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Aims and Objectives: 1) To synthesize available evidence for mode, dosage, and timing of physical therapy in the acute care hospital setting. 2) To report the evidence about the effects of mode, dosage, and timing of physical therapy in the acute care hospital setting on LOS, associated costs, and PT-related outcomes. Background: Hospital based physical therapy quality depends on providing evidence-based interventions, however, the research regarding dosage, mode, and timing of physical therapy in the acute care hospital setting has not been synthesized for patient populations except for total joint arthroplasties or patients in the ICU. Design: A systematic search …

A Mobile App Specifically Designed To Facilitate Exercise In Parkinson Disease: Single-Cohort Pilot Study On Feasibility, Safety, And Signal Of Efficacy, Merrill R. Landers, Terry D. Ellis

Integrated Health Sciences Faculty Research

Background: Many people with Parkinson disease do not have access to exercise programs that are specifically tailored to their needs and capabilities. This mobile app allows people with Parkinson disease to access Parkinson disease–specific exercises that are individually tailored using in-app demographic questions and performance tests which are fed into an algorithm which in turn produces a video-guided exercise program. Objective: To test the feasibility, safety, and signal of efficacy of a mobile app that facilitates exercise for people with Parkinson disease. Methods: A prospective, single-cohort design of people with Parkinson disease who had downloaded the 9zest app for exercise …

The Effects Of Somatosensory Input On Gait In Individuals Post-Stroke, Victor Hung, Amanda Reilly, Rachel Wood, Nikita Yuskov

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is a leading cause of disability that results in various neurological deficits, one of which is hemiplegia. This deficit alters the gait cycle, resulting in decreased propulsion force by plantar flexor muscles, decreased activation of dorsiflexor (DF) muscles, and increased coactivation of antagonistic ankle muscles. Stroke also leads to altered somatosensory input which results in decreased balance and gait speed, ultimately increasing fall risk. Therapies targeting increased somatosensory input have been shown to be beneficial in stroke as well as other neurological populations. However, no known studies have investigated the acute effects of local vibration to …

Physical Therapy Nontreatment Events With Primary Physical Therapist, Stephen Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Physical therapy improves prognosis reduces stay and is generally helpful in aiding recovery from a wide range of ailments. Nontreatment rates occur for multiple reasons and are also related to the personalities of physical therapists.

Methods: We used data from a research project involving physical therapy at an acute care facility in our community. Our study focused on the retrospectively determined primary physical therapist for each patient. We used the chi-squared tests to compare nontreatment rates between days of the week and disease type and the reasons for nontreatment events. Repeated-measure models were used to evaluate the effect of …

Brain Volumes And Dual‑Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jason K. Longhurst, Morgan A. Wise, Daniel J. Krist, Caitlin A. Moreland, Jon A. Basterrechea, Merrill R. Landers

Integrated Health Sciences Faculty Research

Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. To examine associations between brain volumes, dual-task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual-task performance, and measures of gait and balance. Greater cognitive and combined dual-task efects (DTE) are associated with smaller brain volumes. In contrast, motor DTE is not associated with distinct pattern of brain volumes. As brain volumes decrease, …