Physical Therapy Commons^™

Influence Of A Post-­Graduate Physical Therapy Residency Program On Clinical Reasoning, Professional Development, And Career Advancement In Nairobi, Kenya, Shala Cunningham

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement

Residency programs that emphasize clinical reasoning and manual therapy can provide a means to optimize the outcomes of physical therapy without the need for or access to expensive equipment. The residency format of continuing education could allow physical therapists in developing countries access to specialty training and ongoing mentorship. However, there are limited studies that investigate the influence of residency training on the progression of clinical reasoning, professional development, and career advancement.

Purpose

The purpose of this study was threefold. The first objective was to describe the outcome of a post-graduate orthopaedic manual therapy residency program on development …

Predictors Of Shoulder Injuries In Female Collegiate Swimmers, Eric Lee Lippincott

Department of Physical Therapy Student Theses, Dissertations and Capstones

Competitive swimmers frequently injure their shoulders. The risk factors for shoulder injuries in competitive swimmers have not been clearly identified. The primary purposes of this study were to describe the characteristics of female collegiate swimmers at the onset of a swim season, identify the risk factors of shoulder injury in female collegiate swimmers, characterize the swim volume of female collegiate swimmers, and determine if swim volume is a predictor of shoulder injury.

A prospective longitudinal cohort multi-center design was utilized. Female collegiate swimmers [n=53, mean age=19.3+/– 1.2] from four NCAA Division II universities were recruited to participate in this study. …

Use Of A Telerehabilitation Delivery System For Fall Risk Screening, Robert W. Nithman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem: The Centers for Disease Control and Prevention indicates that falls are the “leading cause of injury death and the most common cause of nonfatal injuries and hospital admission for trauma among people ages 65 and older.”1 Falls can have significant economic consequences to the individual and payer sources. To address these consequences, telerehabilitation was hypothesized to be a suitable supplement for fall screening efforts. Several sources concluded that support for synchronous telerehab was underdeveloped in the literature. Purpose: The purpose of this study was to explore the acceptability, feasibility, reliability, and validity of telehealth-delivered fall screening among community-dwelling older …

Impact Of An Exercise Program On Stress, Fatigue, And Quality Of Life For Individuals Living With Primary Immunodeficiency Disease, Kerri Sowers

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: There are over 300 Primary Immunodeficiency diseases (PID) that are a result of a genetic or idiopathic dysfunction of any aspect of the immune system. These conditions result in a higher frequency of infections, autoimmune conditions, or malignancies. Moderate intensity exercise is thought to help the immune system, while high intensity exercise may have a negative impact on immune function. The impact of exercise on individuals with an impaired immune system due to PID is not yet understood. Purpose: The purpose of this study was to investigate whether a low to moderate intensity exercise program would have an effect …

Effects Of Functional Electrical Stimulation Cycling Versus Cycling Only On Walking Performance And Quality Of Life In Individuals With Multiple Sclerosis: A Randomized, Clinical Pilot Study, Lori Hochman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Functional Electrical Stimulation (FES) stimulates peripheral nerves via electrical current to evoke muscle contractions and when combined with lower extremity cycling (LE), creates patterned leg movements. Previous studies demonstrated FES cycling is safe and effective in the spinal cord injury and stroke populations with improvements seen in walking speed, muscle mass, and bone density. Few studies have applied FES cycling to a neurodegenerative disorder, such as multiple sclerosis (MS). The aim of this study is to assess the effect of an 8-week training program using FES cycling, compared to Cycling Only, in people with MS (PWMS). Methods: Using a …

Educational Program Attributes And Faculty Teaching Behaviors As Predictors Of National Physical Therapy Examination Success, Natonya Frazier-Early

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: To determine the differences between PT program NPTE 3-year ultimate pass rates (3YUPR) based on program length and faculty scholarship. To explore relationships between 3YUPR and quality faculty behaviors. Subjects: A total of 112 CAPTE accredited PT educational programs in the United States and Puerto Rico during 2013. Method: A quantitative design method was used to retrospectively test differences between program and faculty traits and student NPTE 3YUPR using data from the Commission on Accreditation in Physical Therapy Education (CAPTE), PT Annual Accreditation Reports (AAR) and Federation of State Boards of Physical Therapy (FSBPT) score reports. A self-generated faculty …

Dry Needling Of Myofascial Trigger Points: Quantification Of The Biomechanical Response Using A Myotonometer., Joseph P. Kelly

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Biomechanical stiffness has been linked to risk of injury and found to be a measureable characteristic in musculoskeletal disorders. Specific identification of stiffness may clarify who is most likely to benefit from the trigger point dry needling (TDN). The purpose of this study is to investigate the reliability and concurrent validity of the MyotonPRO® to the criterion of shear wave ultrasound elastography for the measurement of biomechanical stiffness in the infraspinatus, erector spinae, and gastrocnemius of healthy subjects over increasing muscle contraction. Second purpose is to investigate the biomechanical effects of TDN to latent myofascial trigger points (MTrPs) in …

Gait Analysis Following Total Knee Arthroplasty During Inpatient Rehabilitation: Can Findings Predict Los, Ambulation Device, And Discharge Disposition?, Janet Anne Herbold

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Total knee arthroplasty (TKA) is the treatment of choice for end-stage knee osteoarthritis. Growth in the number of procedures performed annually in the United States is expected to increase steadily. Post-operative rehabilitation settings vary and include both institutional and community based physical therapy (PT) services. Despite access to PT, deficits in gait often persist for months and even years after surgery. Slow gait speed, asymmetrical walking patterns, and prolonged time in double-limb support following the TKA often lead to the need for an assistive device for walking and prolong the rehabilitation phase. Purpose: The purpose of this study is …

Risk Factors For Low Back Pain In Recreational Distance Runners, Jonathan Gallas

Department of Physical Therapy Student Theses, Dissertations and Capstones

Risk Factors for Low Back Pain in Recreational Distance Runners By Jonathan E. Gallas Purpose. The purpose of this study was to examine differences between runners with and without low back pain and a control group of non-runners in demographic, physical/running, and LBP variables. Subjects. This study included 102 subjects in three groups. Subjects, 18 to 55 years old, were from a running store, sports club, and physical therapy clinics in Rockford, IL. Methods. A pilot study of ten runners with LBP was conducted prior to data collection to assess testers’ reliability. One hundred and twelve runners, with or without …

Immediate Effects Of A Seated Versus Supine Upper Thoracic Spine Thrust Manipulation Compared To Sham Manipulation In Individuals With Subacromial Pain Syndrome – A Randomized Clinical Trial, Jason Keith Grimes

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Individuals with Subacromial Pain Syndrome (SPS) often present with a variety of contributing factors. It is possible that a subgroup exists within SPS that has primary impairments of scapular mobility and/or muscle strength. In an attempt to better identify scapular contributions in SPS, the Scapular Assistance Test (SAT) and Scapula Reposition Test (SRT) have been described. Additionally, thoracic spine thrust manipulation has been shown to be effective for shoulder pain. Problem Statement: It is currently unknown whether or not there are impairments in scapulothoracic muscle force generation or scapular mobility in individuals with SPS who have positive results on …

Iliotibial Band Length And Patellofemoral Pain Syndrome: Relationship Between Two Measurement Techniques, Duane Michael Scotti

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: To determine the relationship between iliotibial band (ITB) length and the presence of patellofemoral pain syndrome (PFPS), compare the difference in ITB length between the painful knee and the non-painful knee in subjects with unilateral PFPS, determine the test-retest reliability, standard error of measurement, and minimal detectable change (MDC) of the Ober test and modified Thomas test, and explore the relationship between the Ober test and the modified Thomas test in measuring ITB length. Subjects: Forty-eight subjects were recruited (PFPS group n=24, control group n=24) from three different outpatient physical therapy clinics. Methods: The Ober test and modified Thomas …

Efficacy Of Kinesio Taping As An Adjunct Intervention To Traditional Physical Therapy In The Treatment Of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial, Hossameldien Elkholy

Department of Physical Therapy Student Theses, Dissertations and Capstones

The Efficacy of Kinesio Taping as an Adjunct Intervention to Traditional Physical Therapy in the Treatment of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial Background: Acute low back pain (LBP) is a significant health problem worldwide and is one of the leading causes of disability. Objective: The purpose of this study was to examine the effect of Kinesio Taping (KT) on disability, fear-avoidance beliefs, and pain intensity in patients with acute, nonspecific LBP. Research Design and Methods: A prospective, randomized controlled study of consecutive patients referred to physical therapy with a primary complaint of LBP. Seventy-eight patients …

Cost Of Physical Therapists Serving As A Musculoskeletal Providers Compared To Family Practice Providers In A Military Treatment Facility, Troy Edward Mcgill

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background. Physical therapists (PTs) in the U.S. military practice direct access and can order limited prescription medications, imaging studies. Military PTs function as autonomous primary care managers (PCMs) for patients with musculoskeletal (MSK) disorders. Objective. The study compared cost of PT management of patients with MSK disorders to management by traditional PCMs; medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods. The researcher used a retrospective study of electronic medical records, using an exploratory, non-experimental, cross-sectional, and quantitative design method. Results. At an Air Force military medical clinic during an 18-month …

Sub-Clinical Neck Symptoms, Disability, Posture, And Muscle Function In Computer Users, And The Effect Of Education Versus Education And Deep Cervical Flexor Exercise, Donna Lynne Skelly

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: 1, to determine effect of education and exercise on neck pain, disability, cervical posture and muscle function in office workers with sub-clinical neck symptoms; 2, to determine differences in forward head posture in preferred and standardized posture, and 3, to explore the influence of time on work posture in a sub-group of office workers. Subjects: Sixty-six office workers with sub-clinical neck symptoms who utilize computers at least 4 hours per day participated. A sub-group of 27 were videotaped to assess posture over a workday. Methods: Videotaping was performed 15 minutes of the first and last hour of the workday …

Validation Of A Pressure Pain Threshold Scale In Patients Diagnosed With Myofascial Pain Syndrome And Fibromyalgia, Scott William Cheatham

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Palpation is an examination technique used to diagnose and treat myofascial pain syndrome (MPS) and fibromyalgia (FM). Currently, there is no validated technique for classifying the results. A valid and reliable pressure pain threshold scale (PPTS) may provide a means for clinicians to grade, document, and report findings. The purpose of this dissertation was to validate a PPTS in patients diagnosed with MPS and FM. Design and Methods: An observational study. Participants who met the inclusion criteria were placed into three equal groups: MPS, FM, and control. All participants underwent one, two-part testing sessions using the American College of …

Effect Of Stance Symmetry On Perturbation-Induced Protective Stepping In Persons Poststroke And Controls, Katherine M. Martinez

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Stepping is a common strategy after a perturbation. Stroke survivors display a predilection for stepping with non-paretic leg. Insight into induced stepping between stroke survivors and age-matched control may guide our understanding for reactive postural control training post stroke. Purpose: To investigate the difference in perturbation-induced stepping between chronic stroke survivors and age-matched controls at three phases of the stepping response: preparation, execution, and landing and association with clinical outcome measures. Procedure: Twenty-one community-dwelling chronic stroke survivors (mean age 59y/o ±13yrs) and 17 age- and gender-matched controls (mean age 54.4y/o ±17yrs) completed this study. Clinical measures of gait, …

Humeral Retrotorsion In Developing Children And Its Relationship To Throwing Sports, Elliot M. Greenberg

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Baseball players exhibit a more posteriorly oriented humeral head or humeral retrotorsion (HRT) in the dominant arm, likely representing an adaptive response to the stress of throwing. This adaptation is thought to occur while skeletally immature, however there is limited research detailing how throwing while young influences the development HRT. In addition, it is currently unclear how this changing osseous orientation influences shoulder motion within young athletes. Purpose: To determine the influence of throwing and age on the development of asymmetry in HRT and shoulder range of motion (ROM); and analyze the relationship between HRT and ROM. Study Design: …

Investigation Of Relationships Between Physical Characteristics Of Recreational Runners And Lower Extremity Injuries, Steven Marc Jackson

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: The purpose of this study was to investigate the relationship between anthropometric measurements, proximal and distal lower extremity muscle performance, core muscle endurance, lower extremity flexibility, and neuromuscular control with the incidence of injury in recreational runners over one season. Also, when a relationship was established, we sought to evaluate the predictive validity for any of the variables being investigated for risk of injury in this population. Study Design: Prospective cohort Methods: Anthropometric measurements, proximal and distal isometric lower extremity muscle performance, isometric core muscle endurance, lower extremity flexibility and neuromuscular control were measured in 75 recreational runners prior …

Achieving Competence: Clinical Instructors' Perspective, Kimberly W. Coleman-Ferreira

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: The profession of physical therapy uses physical therapist clinical instructors to educate students in the clinical education portion of the curriculum. The requirements to become a clinical instructor are minimal and non- specific regarding formal training and development. A variety of educational opportunities is available to clinical instructors, but the evidence in the physical therapy literature is conflicting regarding the effectiveness of these programs. Additionally, no previous research regarding the meaning of competence, nor the pathway to achieving competence as a clinical instructor was found. Therefore, the purpose of this study was to describe the experience of achieving competence …

Promoting Professional Behavior In Physical Therapist Students : Use Of Standardized Patient Feedback, Mary Anne Riopel

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Entry-level physical therapist (PT) students receive feedback on professional behavior performance from academic and clinical faculty members. Literature is lacking on the impact that verbal feedback from standardized patients (SPs) may have on student learning of professional behavior in PT students. Purpose: The primary aim of this study was to examine the use of SP feedback as a strategy for professional behavior development. A secondary purpose was to describe the perspectives of PT students on the influence of SP feedback on clinical interactions and professional behavior during a full-time clinical experience. Participants: A sample of convenience identified 13 PT …

Effective Mentoring In Physical Therapy : Approaches For Residency Training, Anne E. O'Donnell

Department of Physical Therapy Student Theses, Dissertations and Capstones

PURPOSE: This study aimed to investigate how physical therapy mentors instill clinical judgment and competence during residency training. The researcher investigated effective mentoring behaviors and techniques in physical therapy residency training. SUBJECTS: Participants included physical therapy residency faculty, physical therapy residents currently enrolled in U.S. residency programs credentialed by the American Physical Therapy Association (APTA), and resident graduates (ie, within the past 2 years) from APTA programs. METHOD: A quantitative survey design was used to gain information about effective mentoring behaviors and techniques of physical therapy residency faculty who foster clinical expertise in physical therapy residents. Two online surveys were …

Effects Of Managed Care On The Professional Autonomy Of Board Certified Physical Therapy Specialist's Practice, Cami Diezel

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: Identify perceptions of professional autonomy of Board Certified Physical Therapy Specialists (BCPTS) who practiced in managed care environments.

Guiding questions: Do BCPTS perceive an increase in professional autonomy as a specialist than as a generalist? How do the perceptions of professional autonomy vary among each specialization? What variables affect perceptions of professional autonomy among BCPTS?

Method: Two-hundred BCPTS throughout the country were randomly chosen as participants. One-hundred-eight respondents were used as subjects.

Data analysis: Frequency distributions and Pearson's correlation coefficient statistic were utilized.

Results: Majority of respondents reported no increase in professional autonomy as a specialist. Greater than three-quarters …