Physical Therapy Commons^™

Blockade Of Neurokinin-1 Receptors In The Ventral Respiratory Column Does Not Affect Breathing But Alters Neurochemical Release, Clarissa Muere, Suzanne Neumueller, Samantha Olesiak, Justin Miller, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Substance P (SP) and its receptor, neurokinin-1 (NK1R), have been shown to be excitatory modulators of respiratory frequency and to stabilize breathing regularity. Studies in anesthetized mice suggest that tonic activation of NK1Rs is particularly important when other excitatory inputs to the pre-Bötzinger complex in the ventral respiratory column (VRC) are attenuated. Consistent with these findings, muscarinic receptor blockade in the VRC of intact goats elicits an increase in breathing frequency associated with increases in SP and serotonin concentrations, suggesting an involvement of these substances in neuromodulator compensation. To gain insight on the contribution to breathing of endogenous SP and …

A Teaching Tool To Visually Illustrate How Manipulating The Physiology Of The Ventilatory Muscle Pump Alters Functional Performance, Dennis Sobush

Physical Therapy Faculty Research and Publications

This clinical perspective article describes an inexpensive pedagogical tool intended for use in a laboratory setting as part of a cardiovascular and pulmonary physical therapy course. It uses a dual balance scale schematic/model. As a teaching resource, physical therapy students can use it to visually reinforce their understanding of the complex cause-and-effect interplay between physiological factors that affect ventilatory muscle pump (VMP) performance for sustained breathing or contribute to VMP fatigue/failure.

The Current State Of Physical Therapy Pain Curricula In The United States: A Faculty Survey, Marie K. Hoeger Bement, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Insufficient pain education is problematic across the health care spectrum. Recent educational advancements have been made to combat the deficits in pain education to ensure that health care professionals are proficient in assessing and managing pain. The purpose of this survey was to determine the extent of pain education in current Doctorate of Physical Therapy schools in the United States, including how pain is incorporated into the curriculum, the amount of time spent teaching about pain, and the resources used to teach about pain. The survey consisted of 10 questions in the following subject areas: basic science mechanisms and concepts …

A Novel Fmri Paradigm Suggests That Pedaling-Related Brain Activation Is Altered After Stroke, Nutta-On Promjunyakul, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

The purpose of this study was to examine the feasibility of using functional magnetic resonance imaging (fMRI) to measure pedaling-related brain activation in individuals with stroke and age-matched controls. We also sought to identify stroke-related changes in brain activation associated with pedaling. Fourteen stroke and 12 control subjects were asked to pedal a custom, MRI-compatible device during fMRI. Subjects also performed lower limb tapping to localize brain regions involved in lower limb movement. All stroke and control subjects were able to pedal while positioned for fMRI. Two control subjects were withdrawn due to claustrophobia, and one control data set was …

Evidence For Respiratory Neuromodulator Interdependence After Cholinergic Disruption In The Ventral Respiratory Column, Clarissa Muere, Suzanne Neumueller, Justin Robert Miller, Samantha Olesiak, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Reverse dialysis of the muscarinic receptor antagonist, atropine (ATR, 50 mM), into the pre-Bötzinger Complex region of the ventral respiratory column (VRC) of awake and sleeping goats increases breathing frequency and serotonin (5-HT), substance P (SP), glycine, and GABA concentrations in the effluent dialysate. Herein, we report data from goats in which we reverse dialyzed 5 mM ATR or specific antagonists of M2 or M3 muscarinic receptors into the VRC. The effects on frequency of all three antagonists were not significantly different from time control studies. 5 mM ATR and the M3 antagonist increased SP sevenfold less than 50 mM …

Changes In Glutamate Receptor Subunits Within The Medulla In Goats After Section Of The Carotid Sinus Nerves, Justin Robert Miller, Suzanne Neumueller, Clarissa Muere, Samantha Olesiak, Lawrence Pan, John D. Bukowy, Asem O. Daghistany, Matthew Hodges, Hubert Forster

Physical Therapy Faculty Research and Publications

The mechanisms which contribute to the time-dependent recovery of resting ventilation and the ventilatory CO₂ chemoreflex after carotid body denervation (CBD) are poorly understood. Herein we tested the hypothesis that there are time-dependent changes in the expression of specific AMPA, NMDA, and/or neurokinin-1 (NK1R) receptors within respiratory-related brain stem nuclei acutely or chronically after CBD in adult goats. Brain stem tissues were collected acutely (5 days) or chronically (30 days) after sham or bilateral CBD, immunostained with antibodies targeting AMPA (GluA1 or GluA2), NMDA (GluN1), or NK-1 receptors, and optical density (OD) compared. Physiological measurement confirmed categorization of each …

An Interprofessional Consensus Of Core Competencies For Prelicensure Education In Pain Management: Curriculum Application For Physical Therapy, Marie K. Hoeger Bement, Barbara J. St. Marie, Terry M. Nordstrom, Nicole Christensen, Jennifer M. Mongoven, Ian J. Koebner, Scott M. Fishman, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Core competencies in pain management for prelicensure health professional education were recently established. These competencies represent the expectation of minimal capabilities for graduating health care students for pain management and include 4 domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain (Appendix 1). The purpose of this article is to advocate for and identify how core competencies for pain can be applied to the professional (entry-level) physical therapist curriculum. By ensuring that core competencies in pain management are embedded within the foundation of physical therapist education, physical therapists will have the core knowledge …

Sensory Electrical Stimulation Improves Foot Placement During Targeted Stepping Post-Stroke, Eric R. Walker, Allison S. Hyngstrom, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Proper foot placement is vital for maintaining balance during walking, requiring the integration of multiple sensory signals with motor commands. Disruption of brain structures post-stroke likely alters the processing of sensory information by motor centers, interfering with precision control of foot placement and walking function for stroke survivors. In this study, we examined whether somatosensory stimulation, which improves functional movements of the paretic hand, could be used to improve foot placement of the paretic limb. Foot placement was evaluated before, during, and after application of somatosensory electrical stimulation to the paretic foot during a targeted stepping task. Starting from standing, …

Electrical Stimulation Technologies For Wound Healing, Luther C. Kloth

Physical Therapy Faculty Research and Publications

Objective: To discuss the physiological bases for using exogenously applied electric field (EF) energy to enhance wound healing with conductive electrical stimulation (ES) devices.

Approach: To describe the types of electrical currents that have been reported to enhance chronic wound-healing rate and closure.

Results: Commercial ES devices that generate direct current (DC), and mono and biphasic pulsed current waveforms represent the principal ES technologies which are reported to enhance wound healing.

Innovation: Wafer-thin, disposable ES technologies (wound dressings) that utilize mini or micro-batteries to deliver low-level DC for wound healing and antibacterial wound-treatment purposes are commercially available. Microfluidic wound-healing chips …

Physical Therapy In Wound Healing, Edema, And Urinary Incontinence, Jakub Taradaj, Tomasz Urbanek, Luther C. Kloth, Marco Romanelli

Physical Therapy Faculty Research and Publications

No abstract provided.

Contributions Of The Pre-Bötzinger Complex And The Kölliker-Fuse Nuclei To Respiratory Rhythm And Pattern Generation In Awake And Sleeping Goats, Hubert Forster, Joshua M. Bonis, Katie L. Krause, Julie Wenninger, Suzanne Neumueller, Matthew Hodges, Lawrence Pan

Physical Therapy Faculty Research and Publications

We investigated in three groups of awake and sleeping goats whether there are differences in ventilatory responses after injections of Ibotenic acid (IA, glutamate receptor agonist and neurotoxin) into the pre-Bötzinger complex (preBötC), lateral parabrachial (LPBN), medial (MPBN) parabrachial, or Kölliker-Fuse nuclei (KFN). In one group, within minutes after bilateral injection of 10 μl IA (50 mM) into the preBötC, there was a 10-fold increase in breathing frequency, but 1.5 h later, the goats succumbed to terminal apnea. These data are consistent with findings in reduced preparations that the preBötC is critical to sustaining normal breathing. In a second group, …

The Role Of Aerobic Physical Fitness In Overweight Adolescents, Stacy Stolzman, Jenna Speltz, Katherine Hoffmeister, Michael E. Danduran, Joseph Skelton, Paula E. Papanek, April L. Harkins, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

No abstract provided.

Contributions Of The Kölliker-Fuse Nucleus To Coordination Of Breathing And Swallowing, Joshua M. Bonis, Suzanne E. Neumueller, K. L. Krause, Lawrence Pan, Matthew R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Herein we compare the effects of perturbations in the Kölliker–Fuse nucleus (KFN) and the lateral (LPBN) and medial (MPBN) parabrachial nuclei on the coordination of breathing and swallowing. Cannula was chronically implanted in goats through which ibotenic acid (IA) was injected while awake. Swallows in late expiration (E) always reset while swallows in early inspiration (I) never reset the respiratory rhythm. Before cannula implantation, all other E and I swallows did not reset the respiratory rhythm, and had small effects on E and I duration and tidal volume (V_T). However, after cannula implantation in the MPBN and …

Changes In Hemodynamic Responses In Chronic Stroke Survivors Do Not Affect Fmri Signal Detection In A Block Experimental Design, Nutta-On Promjunyakul, Brian D. Schmit, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

The use of canonical functions to model BOLD-fMRI data in people post-stroke may lead to inaccurate descriptions of task-related brain activity. The purpose of this study was to determine whether the spatiotemporal profile of hemodynamic responses (HDRs) obtained from stroke survivors during an event-related experiment could be used to develop individualized HDR functions that would enhance BOLD-fMRI signal detection in block experiments. Our long term goal was to use this information to develop individualized HDR functions for stroke survivors that could be used to analyze brain activity associated with locomotor-like movements. We also aimed to examine the reproducibility of HDRs …

Has The Foundation For Physical Therapy Advanced The Body Of Knowledge?, Sheila Schindler-Ivens, Jan Struhar, Martha G. Jermé

Physical Therapy Faculty Research and Publications

No abstract provided.

Introgression Of Brown Norway Cyp4a Genes Onto The Dahl Salt-Sensitive Background Restores Vascular Function In Ss-5Bn Consomic Rats, Kathleen M. Lukaszewicz, John R. Falck, Vijaya L. Manthati, Julian H. Lombard

Physical Therapy Faculty Research and Publications

The present study tested the hypothesis that the Dahl SS (salt-sensitive) rat has vascular dysfunction due, in part, to the up-regulation of the CYP4A/20-HETE (cytochrome P450 ω-hydroxylase 4A)/20-hydroxyeicosatetraenoic acid) system. To assess the role of vascular 20-HETE, SS rats were compared with SS-5^BN consomic rats, carrying CYP4A alleles on chromosome 5 from the normotensive BN (Brown Norway) introgressed on to the SS genetic background. Cerebral arteries from SS-5^BN rats had less CYP4A protein than arteries from SS rats fed either NS (normal-salt, 0.4% NaCl) or HS (high-salt, 4.0% NaCl) diet. ACh (acetylcholine)-induced dilation of MCAs (middle cerebral …

Atropine Microdialysis Within Or Near The Pre-Bötzinger Complex Increases Breathing Frequency More During Wakefulness Than During Nrem Sleep, Clarissa Muere, Suzanne E. Neumueller, Justin Robert Miller, Samantha Olesiak, Matthew R. Hodges, Lawrence Pan, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Normal activity of neurons within the medullary ventral respiratory column (VRC) in or near the pre-Bötzinger Complex (preBötC) is dependent on the balance of inhibitory and excitatory neuromodulators acting at their respective receptors. The role of cholinergic neuromodulation during awake and sleep states is unknown. Accordingly, our objective herein was to test the hypotheses that attenuation of cholinergic modulation of VRC/preBötC neurons in vivo with atropine would: 1) decrease breathing frequency more while awake than during non-rapid-eye-movement (NREM) sleep and 2) increase other excitatory neuromodulators. To test these hypotheses, we unilaterally dialyzed mock cerebrospinal fluid (mCSF) or 50 mM atropine …

A Pilot Study To Measure Upper Extremity H-Reflexes Following Neuromuscular Electrical Stimulation Therapy After Stroke, Ann M. Stowe, L. Hughes-Zahner, V. K. Barnes, L. L. Herbelin, Sheila M. Schindler-Ivens, B. M. Quaney

Physical Therapy Faculty Research and Publications

Upper extremity (UE) hemiparesis persists after stroke, limiting hand function. Neuromuscular electrical stimulation (NMES) is an effective intervention to improve UE recovery, although the underlying mechanisms are not fully understood. Our objective was to establish a reliable protocol to measure UE agonist–antagonist forearm monosynaptic reflexes in a pilot study to determine if NMES improves wrist function after stroke. We established the between-day reliability of the H-reflex in the extensor carpi radialis longus (ECRL) and flexor carpi radialis (FCR) musculature for individuals with prior stroke (n = 18). The same-day generation of ECRL/FCR H-reflex recruitment curves was well tolerated, regardless of …

Changes In Neurochemicals Within The Ventrolateral Medullary Respiratory Column In Awake Goats After Carotid Body Denervation, Justin Robert Miller, Suzanne E. Neumueller, Clarissa Muere, Samantha Olesiak, Lawrence Pan, Matthew R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

A current and major unanswered question is why the highly sensitive central CO₂/H⁺ chemoreceptors do not prevent hypoventilation-induced hypercapnia following carotid body denervation (CBD). Because perturbations involving the carotid bodies affect central neuromodulator and/or neurotransmitter levels within the respiratory network, we tested the hypothesis that after CBD there is an increase in inhibitory and/or a decrease in excitatory neurochemicals within the ventrolateral medullary column (VMC) in awake goats. Microtubules for chronic use were implanted bilaterally in the VMC within or near the pre-Bötzinger Complex (preBötC) through which mock cerebrospinal fluid (mCSF) was dialyzed. Effluent mCSF was collected …

Skin Cell Proliferation Stimulated By Microneedles, Horst Liebl, Luther C. Kloth

Physical Therapy Faculty Research and Publications

A classical wound may be defined as a disruption of tissue integrity. Wounds, caused by trauma from accidents or surgery, that close via secondary intention rely on the biological phases of healing, i.e., hemostasis, inflammation, proliferation, and remodeling (HIPR). Depending on the wound type and severity, the inflammation phase begins immediately after injury and may last for an average of 7–14 days. Concurrent with the inflammation phase or slightly delayed, cell proliferation is stimulated followed by the activation of the remodeling (maturation) phase. The latter phase can last as long as 1 year or more, and the final healed state …

Influence Of Knee Flexion Angle And Age On Triceps Surae Muscle Fatigue During Heel Raises, Kim Hébert-Losier, Anthony G. Schneiders, José A. García, S. John Sullivan, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

Hébert-Losier, K, Schneiders, AG, García, JA, Sullivan, SJ, and Simoneau, GG. Influence of knee flexion angle and age on triceps surae muscle fatigue during heel raises. J Strength Cond Res 26(11): 3134–3147, 2012—The triceps surae (TS) muscle-tendon unit is 1 of the most commonly injured in elite and recreational athletes, with a high prevalence in middle-aged adults. The performance of maximal numbers of unilateral heel raises is used to assess, train, and rehabilitate TS endurance and conventionally prescribed in 0° knee flexion (KF) for the gastrocnemius and 45° for the soleus (SOL). However, the extent of muscle selectivity conferred through …

Neuromagnetic Activity In The Cerebral Cortex Is Modulated By Locomotor-Like Movements Produced During Pedaling, Sheila M. Schindler-Ivens, Ruth M. Swedler, Brian D. Schmit, Sylvain Baillet

Physical Therapy Faculty Research and Publications

No abstract provided.

Restoring Functional Status: A Long-Term Case Report Of Severe Lung And Ventilatory Muscle Pump Dysfunction Involving Recurrent Bacterial Pneumonias, Dennis Sobush, Linda Jean Laatsch-Lybeck, Randolph J. Lipchik

Physical Therapy Faculty Research and Publications

Background and Purpose: Prolonged mechanical ventilation contributes to immobility and deconditioning making efforts to safely discontinue ventilator support desirable. This case report documents how implementing physical therapy treatment interventions, based on the Guide to Physical Therapist Practice, can help to restore a person’s functional status even after multiple years of mechanical ventilation dependency. Case Description: A patient (female; aged 63 years) with severe restrictive and obstructive ventilatory impairment has survived 34 recurrent pneumonias involving 6 bacterial pathogens while being mechanically ventilated at home. A 3-year study was approved and informed consent obtained for a home exercise program of resistive extremity …

E-Stimulation: An Effective Modality To Facilitate Wound Healing, Pamela Scarborough, Luther C. Kloth

Physical Therapy Faculty Research and Publications

No abstract provided.

A Standardized Evidence-Based Model Of Orthopaedic Physical Therapy Practice: A Quest For The Holy Grail?, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

The growth of knowledge in orthopaedic physical therapy practice is on an exponential trajectory. This growth is occurring simultaneously for many aspects of evidence-based practice: diagnosis, prognosis, treatment, and harm – with increasingly more sophisticated basic science and mechanistic studies guiding and supporting the clinical research endeavors. Just how close are we to the day when we can clearly establish the accuracy of our diagnoses, regardless of the model used, and then can confidently inform our patients of the most effective treatment approach and the expected outcomes, as well as any potential harm? This knowledge is being created now, and …

The Effect Of Movement Rate And Complexity On Functional Magnetic Resonance Signal Change During Pedaling, Jay P. Mehta, Matthew D. Verber, Jon A. Wieser, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

We used functional magnetic resonance imaging (fMRI) to record human brain activity during slow (30 RPM), fast (60 RPM), passive (30 RPM), and variable rate pedaling. Ten healthy adults participated. After identifying regions of interest, the intensity and volume of brain activation in each region was calculated and compared across conditions (p < .05). Results showed that the primary sensory and motor cortices (S1, M1), supplementary motor area (SMA), and cerebellum (Cb) were active during pedaling. The intensity of activity in these areas increased with increasing pedaling rate and complexity. The Cb was the only brain region that showed significantly lower activity during passive as compared with active pedaling. We conclude that M1, S1, SMA, and Cb have a role in modifying continuous, bilateral, multijoint lower extremity movements. Much of this brain activity may be driven by sensory signals from the moving limbs.

Corticomotor Excitability During A Noxious Stimulus And Following Exercise In Women With Fibromyalgia, Marie K. Hoeger Bement, Andy Weyer, Tejin Yoon, Sandra K. Hunter

Physical Therapy Faculty Research and Publications

No abstract provided.

Push-Pull Control Of Motor Output, Michael D. Johnson, Allison S. Hyngstrom, Marin Manuel, C J. Heckman

Physical Therapy Faculty Research and Publications

Inhibition usually decreases input–output excitability of neurons. If, however, inhibition is coupled to excitation in a push–pull fashion, where inhibition decreases as excitation increases, neuron excitability can be increased. Although the presence of push–pull organization has been demonstrated in single cells, its functional impact on neural processing depends on its effect on the system level. We studied push–pull in the motor output stage of the feline spinal cord, a system that allows independent control of inhibitory and excitatory components. Push–pull organization was clearly present in ankle extensor motoneurons, producing increased peak-to-peak modulation of synaptic currents. The effect at the system …

Pain Relief In Older Adults Following Static Contractions Is Not Task-Dependent, Kathy J. Lemley, Breanna Drewek, Lauren Miller, Sandra K. Hunter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Pain complaints increase with age. Exercise is frequently utilized for pain relief but the optimal exercise prescription to relieve pain is not clear. Following static contractions, young adults experience the greatest pain relief with low intensity, long duration contractions. The pain response to static contractions in older adults however is unknown.

PURPOSE : To compare pain reports in healthy older adults before and after static contractions of varying intensity and duration.

METHODS: Pain perception was assessed in 23 healthy older adults (11 men, 12 women; 72.0 ± 6.3 yrs) using a pressure pain device consisting of a 10 N force …

Biomechanical Effects Of Mobile Computer Location In A Vehicle Cab, Kyle Saginus, Richard W. Marklin, Patricia Seeley, Guy G. Simoneau, Stephen H. Freier

Physical Therapy Faculty Research and Publications

Objective: The objective of this research is to determine the best location to place a conventional mobile computer supported by a commercially available mount in a light truck cab.

Background: U.S. and Canadian electric utility companies are in the process of integrating mobile computers into their fleet vehicle cabs. There are no publications on the effect of mobile computer location in a vehicle cab on biomechanical loading, performance, and subjective assessment.

Method: The authors tested four locations of mobile computers in a light truck cab in a laboratory study to determine how location affected muscle activity of the lower back …