Physical Therapy Commons^™

Exploring The Use Of Bimodal Transcranial Direct Current Stimulation To Enhance Movement In Individuals With Patellofemoral Pain—A Sham-Controlled Double Blinded Pilot Study, Kai-Yu Ho, Connan Wallace, Jeno Aquino, Bryce Broadwell, Makenzie Whimple, Jing Nong Liang

Physical Therapy Faculty Research

Introduction: In individuals with patellofemoral pain (PFP), addressing increased knee valgus during weight-bearing activities typically involves strengthening weak hip muscles. However, recent literature highlights the role of altered descending central control in abnormal movements associated with PFP. While transcranial direct current stimulation (tDCS) has demonstrated the capacity to enhance neuroplasticity, its application targeting the corticomotor function of gluteal muscles in PFP remains unexplored. This study aimed to investigate the effects of combining bimodal tDCS with exercise on frontal plane kinematics in individuals with PFP. The hypothesis was that bimodal tDCS, specifically targeting the corticomotor function of the gluteal muscles, would …

Direction Of Attentional Focus In Prosthetic Training: Current Practice And Potential For Improving Motor Learning In Individuals With Lower Limb Loss, Szu-Ping Lee, Alexander Bonczyk, Maria Katrina Dimapilis, Sarah Partridge, Samantha Ruiz, Lung-Chan Chien, Andrew Sawers

Physical Therapy Faculty Research

Objective:

Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting.

Methods:

Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age = 50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience = 10 …

Biomechanical Evaluation Over Level Ground Walking Of User-Specific Prosthetic Feet Designed Using The Lower Leg Trajectory Error Framework, Victor Prost, W. Brett Johnson, Jenny A. Kent, Matthew J. Major, Amos G. Winter V.

Physical Therapy Faculty Research

The walking pattern and comfort of a person with lower limb amputation are determined by the prosthetic foot’s diverse set of mechanical characteristics. However, most design methodologies are iterative and focus on individual parameters, preventing a holistic design of prosthetic feet for a user’s body size and walking preferences. Here we refined and evaluated the lower leg trajectory error (LLTE) framework, a novel quantitative and predictive design methodology that optimizes the mechanical function of a user’s prosthesis to encourage gait dynamics that match their body size and desired walking pattern. Five people with unilateral below-knee amputation walked over-ground at self-selected …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Brain And Spinal Cord Adaptations Associated With Patellofemoral Pain: A Systematic Review And Meta-Analysis, Kai-Yu Ho, Jing Nong Liang, Savanna Budge, Austin Madriaga, Kara Meske, Derrick Nguyenton

Physical Therapy Faculty Research

Objective: To evaluate the evidence for altered cortical and spinal cord functions in individuals with patellofemoral pain (PFP).

Methods: We conducted a comprehensive search of databases to appraise and analyze the studies published prior to December 10, 2021 that examined spinal reflex excitability measured using Hoffmann reflex (H-reflex) amplitudes, corticospinal excitability measured using transcranial magnetic stimulation (TMS)-elicited motor evoked potential (MEP) amplitudes, motor threshold (MT), or stimulus-response (SR) curves, cortical reorganization assessed using TMS cortical mapping or structural magnetic resonance imaging (MRI), or functional changes of the brain assessed using functional MRI (fMRI) in individuals with PFP.

Results: Eight studies …

Patient Engagement In Cosmetic Designing Of Prostheses: Current Practice And Potential Outcome Benefits, Szu-Ping Lee, Cailin Mitchell, Kenneth Repayo, Matthew Tillitt, Collin Weber, Lung-Chang Chien, Chris Doerger

Physical Therapy Faculty Research

Background: Making a prosthesis for an individual with limb loss is a highly personalized process. A currently unexplored area is whether there are tangible benefits in greater patient engagement during the cosmetic designing of their prostheses. We examined the current clinical practice of engaging patients in prosthetic cosmetic designing and identified factors associated with patient outcomes.

Methods: One hundred and four prosthetists and 28 prosthesis users were surveyed in this cross-sectional study. The question- naires covered aspects of prosthetic prescription and fabrication, users’ perceived level of engagement, and self-reported outcomes.

Regression analyses were used to examine the associations between patients’ …

Neurophysiological Changes Of Brain And Spinal Cord In Individuals With Patellofemoral Pain: A Systematic Review And Meta-Analysis Protocol, Jing Nong Liang, Savanna Budge, Austin Madriaga, Kara Meske, Derrick Nguyenton, Kai-Yu Ho

Physical Therapy Faculty Research

Introduction: Reduced neuromuscular control due to altered neurophysiological functions of the central nervous system has been suggested to cause movement deficits in individuals with patellofemoral pain (PFP). However, the underlying neurophysiological measures of brain and spinal cord in this population remain to be poorly understood. The purpose of this systematic review is to evaluate the evidence for altered cortical and spinal cord functions in individuals with PFP.

Methods and analysis: The protocol for conducting the review was prepared using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will systematically search the literature that examines cortical and …

Asymmetries In Dynamic Valgus Index After Anterior Cruciate Ligament Reconstruction: A Proof-Of-Concept Study, Kai Yu Ho, Andrew Murata

Physical Therapy Faculty Research

Individuals with anterior cruciate ligament reconstruction (ACLR) are at a higher risk for subsequent anterior cruciate ligament (ACL) tears. Risk factors for ACL injuries likely involve a combination of anatomical, biomechanical, and neuromuscular factors. Dynamic knee valgus has been indicated as a possible biomechanical factor for future ACL injuries. Given that knee valgus is often accompanied by contralateral pelvic drop during single-leg activities, a dynamic valgus index (DVI) that quantifies combined kinematics of the knee and hip in the frontal plane has recently been developed. As the premise of asymmetrical DVI between limbs in the ACLR population has not been …

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 …

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 …

Early Post-Immobilization Pain At Rest, Movement Evoked Pain, And Their Ratio As Potential Predictors Of Pain And Disability At Six- And 12-Months After Distal Radius Fracture, Maryam Farzad, Joy C. Mcdermid, Saurabh Mehta, Ruby Grewal, Erfan Shafiee

Physical Therapy Faculty Research

Background: Removal of immobilization is a critical phase of distal radius fracture (DRF) rehabilitation, typically occurring by 2 months post injury. This study examined the extent to which pain at rest (PAR), movement evoked pain (MEP), or the ratio between those (MEPR) assessed at 2-months after DRF predicts the occurrence of chronic pain or disability at 6- and 12-months after the injury.

Methods: This secondary analysis of a prospective cohort study was done at the Hand and Upper Limb Centre (HULC), London, Ontario, Canada. A total of 229 patients with DRF (159 (69.4%) women) were included. Scores for the pain …

A Systematic Review Of The Effects Of Blood Flow Restriction Training On Quadriceps Muscle Atrophy And Circumference Post Acl Reconstruction, Derek Charles, Ryan White, Caleb Reyes, Drew Palmer

Physical Therapy Faculty Research

Background:

ACL reconstruction often results in an extended period of muscle atrophy and weakness. Blood flow restriction (BFR) training is a technique that has been shown to decrease muscle atrophy in a variety of populations.

Purpose:

The purpose of this systematic review was to analyze the research presented on the effect of blood flow restriction training on quadriceps muscle atrophy and circumference post ACL reconstruction.

Study Design:

Systematic Review

Methods:

Articles were reviewed using the databases Google Scholar, PubMed, and EBSCO. Keywords included blood flow restriction training, ACL reconstruction, and quadriceps.

Inclusion criteria included:

English language, peer-reviewed journals; randomized control …

Neuromuscular Response To A Single Session Of Whole-Body Vibration In Children With Cerebral Palsy: A Pilot Study, Huaqing (Virginia) Liang, Gena Henderson, Jianhua Wu

Physical Therapy Faculty Research

Background Whole-body vibration (WBV) is a relative new intervention paradigm that could reduce spasticity and improve motor function in children with cerebral palsy (CP). We investigated neuromuscular response to a single session of side-alternating WBV with different amplitudes in children with CP.

Methods Ten children with spastic CP aged 7–17 years at GMFCS level I-III participated in this pilot study. Participants received two sessions of side-alternating WBV with the same frequency (20 Hz) but different amplitudes (low-amplitude: 1 mm and high-amplitude: 2 mm). Each session included six sets of 90 s of WBV and 90 s of rest. Before and …

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 …

Effect Of Predictability Of The Magnitude Of A Perturbation On Anticipatory And Compensatory Postural Adjustments, Tippawan Kaewmanee, Huaqing (Virginia) Liang, Alexander S. Aruin

Physical Therapy Faculty Research

Balance maintenance in response to a perturbation could be affected by the predictability of the magnitude of the body disturbance. We investigated anticipatory (APAs) and compensatory (CPAs) postural adjustments in response to perturbations of predictable and unpredictable magnitudes. Twenty young adults received series of perturbations of small or large magnitudes the order of which was varied. Electromyographic activity of six leg and trunk muscles and displacements of the center-of-pressure (COP) were recorded. The muscle onset time, integrals of muscle activity, and COP displacements in the anterior–posterior direction were analyzed during the APA and CPA phases. The results indicated that when …

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) …

Young Adults Can Learn To Predict Unexpected Posterior Perturbations Using An Auditory Cue, Huaqing Liang, Tippawan Kaewmanee, Alexander S. Aruin

Physical Therapy Faculty Research

To reduce the effect of an expected postural perturbation, central nervous system uses anticipatory postural adjustments (APAs), which include the activation and inhibition of the postural muscles and a slight shift of the center-of-pressure (COP) position. The generation of APAs majorly relies on the availability of visual information, and is learned through past experience. Hence, such protective mechanism to maintain balance is not implemented when perturbation comes from one’s back unexpectedly. Our previous work showed that young adults could rely on an auditory cue only to generate APAs for a front perturbation similar to that when vision was available. So …

Older Adults Retain The Ability To Predict External Perturbations Using Auditory Cues Only, Huaqing Liang, Tippawan Kaewmanee, Alexander S. Aruin

Physical Therapy Faculty Research

To maintain balance and prevent destabilization, humans utilize anticipatory postural adjustments (APAs) prior to the postural perturbations based on predictions and past experience. APAs involve the activation and inhibition of the trunk and leg muscles and a shift of the center-of-pressure (COP) position. The generation of APAs majorly relies on the availability and accuracy of visual information. However, our previous work showed that young adults could rely on an auditory cue only to generate APAs for an external perturbation similar to that when the visual information was available. Older adults generally have diminished APAs and consequently diminished postural control when …

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 …

A Literature Review And Clinical Commentary On The Development Of Iliotibial Band Syndrome In Runners, Derek Charles, Clay Rodgers

Physical Therapy Faculty Research

Background and Purpose:

Iliotibial Band Syndrome (ITBS) is the second leading cause of pain in runners and there are a number of theories related to its etiology. Multiple theories exist for the etiology of ITBS related symptoms including anterior-posterior friction of the IT band on the lateral femoral condyle during knee flexion and extension activities, compression of a layer of fat near the IT band distal attachment, and inflammation of the IT band bursa. The purpose of this literature review and clinical commentary was to explore the potential factors that contribute to ITBS development in runners.

Description of Topic with …

Altered Achilles Tendon Morphology In Individuals With Chronic Post-Stroke Hemiparesis: A Case Report, Jing Nong Liang, Kai-Yu Ho

Physical Therapy Faculty Research

Background: Individuals post-stroke walk slowly and with more effort, which puts them at higher risks for falls. The slow walking speed results from insufficient propulsive forces generated by the paretic leg. Current rehabilitative efforts to improve walking function target increasing propulsive forces, but overlook the muscle-tendon unit. Case presentations: Two individuals with chronic post-stroke hemiparesis are presented. In both individuals post-stroke, paretic ankle plantarflexors presented with increased muscle tone. Gait kinetics revealed asymmetric propulsive forces, specifically, insufficient propulsive forces by the paretic legs, consistent with previous literature. Sonography revealed increased thickness of paretic Achilles tendon at the calcaneal insertion, in …

Altered Achilles Tendon Morphology In An Individual With Chronic Post-Stroke Hemiparesis: A Case Report, Jing Nong Liang, Kai-Yu Ho

Physical Therapy Faculty Research

Background: Individuals post-stroke walk slowly and with more effort, which puts them at higher risks for falls. The slow walking speed results from insufficient propulsive forces generated by the paretic leg. Current rehabilitative efforts to improve walking function target increasing propulsive forces, but overlook the muscle-tendon unit. Case presentations: Two individuals with chronic post-stroke hemiparesis are presented. In both individuals poststroke, paretic ankle plantarflexors presented with increased muscle tone. Gait kinetics revealed asymmetric propulsive forces, specifically, insufficient propulsive forces by the paretic legs, consistent with previous literature. Sonography revealed increased thickness of paretic Achilles tendon at the calcaneal insertion, in …

Hypertension In Adults With Intellectual Disability: Prevalence And Risk Factors, Elizabeth C. Schroeder, Lindsay Dubois, Molly Sadowsky, Thessa I.M. Hilgenkamp

Physical Therapy Faculty Research

No abstract provided.

Knee Joint Kinematics Of The Pendulum Test In Children With And Without Down Syndrome, Diego M. Ferreira, Huaqing Liang, Jianhan Wua

Physical Therapy Faculty Research

Background: The Wartenberg pendulum test is a common clinical test that is used to measure stiffness about the knee in persons with and without disabilities such as cerebral palsy and Down syndrome (DS). Adults and adolescents with DS show fewer number of swing cycles and a lower relaxation index than healthy controls. However, it is not clear if children with DS show a similar trend compared to typically developing (TD) children.

Research question: Was the knee joint kinematics different between children with and without DS during the pendulum test?

Methods: Thirteen children with DS and 13 TD children participated in …

The Role Of An Auditory Cue In Generating Anticipatory Postural Adjustments In Response To An External Perturbation, Huaqing Liang, Tippawan Kaewmanee, Alexander S. Aruin

Physical Therapy Faculty Research

Anticipatory postural adjustments (APAs) are usually generated to minimize the potential postural disturbance induced by predictable external perturbations. Visual information about a perturbation is important for the generation of APAs, but whether people can rely on auditory information to generate APAs is unknown. The aim of this study was to investigate the role of an auditory cue in generating APAs when visual information is not available. Fifteen young adults participated in the study. They received external perturbations a) with visual information but no auditory information available, b) without neither visual nor auditory information, c) with both visual and auditory information …

Improving Environmental Capacities For Health Promotion In Support Settings For People With Intellectual Disabilities: Inclusive Design Of The Dihasid Tool, Kristel Vlot-Van Anrooij, Thessa I. M. Hilgenkamp, Geraline L. Leusink, Anneke Van Der Cruijsen, Henk Jansen, Jenneken Naaldenberg, Koos Van Der Velden

Physical Therapy Faculty Research

People with intellectual disabilities (ID) have unhealthier lifestyles than the general population. To sustainably improve their lifestyle and health status, a whole-system approach to creating healthy environments is crucial. To gain insight into how support for physical activity and healthy nutrition can be embedded in a setting, asset mapping can be helpful. Asset mapping involves creating a bottom–up overview of promoting and protective factors for health. However, there is no asset mapping tool available for ID support settings. This study aims to develop an asset mapping tool in collaboration with people with ID to gain insight into assets for healthy …

Effects Of Ankle Angular Position And Standing Surface On Postural Control Of Upright Stance, Fawaz A. Alwadani, Huaqing Liang, Alexander S. Aruin

Physical Therapy Faculty Research

The purpose of the study was to investigate the effects of ankle angular position and standing surface type on static upright balance. Ten young adults stood on a force platform or on a firm wedge that induced 15° of either dorsiflexion or plantarflexion. In addition, a piece of foam was placed on top of the force platform and on the wedge. The center of pressure distance and velocity in the anteroposterior and mediolateral directions were calculated. Significantly larger magnitudes in most of the investigated variables were seen while standing with ankles in the dorsiflexion when compared with standing with the …