Physical Therapy Commons^™

Peak Triceps Surae Muscle Activity Is Not Specific To Knee Flexion Angles During Mvic, Kim Hébert-Losier, Anthony G. Schneiders, José A. García, S John Sullivan, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

There is limited research on peak activity of the separate triceps surae muscles in select knee flexion (KF) positions during a maximum voluntary isometric contraction (MVIC) used to normalize EMG signals. The aim of this study was to determine how frequent peak activity occurred during an MVIC for soleus (SOL), gastrocnemius medialis (GM), and gastrocnemius lateralis (GL) in select KF positions, and if these peaks were recorded in similar KF positions. Forty-eight healthy individuals performed unilateral plantar-flexion MVIC in standing with 0°KF and 45°KF, and in sitting with 90°KF. Surface EMG of SOL, GM, and GL were collected and processed …

Bilateral Oscillatory Hip Movements Induce Windup Of Multijoint Lower Extremity Spastic Reflexes In Chronic Spinal Cord Injury, Tanya Onushko, Allison S. Hyngstrom, Brian D. Schmit

Physical Therapy Faculty Research and Publications

After spinal cord injury (SCI), alterations in intrinsic motoneuron properties have been shown to be partly responsible for spastic reflex behaviors in human SCI. In particular, a dysregulation of voltage-dependent depolarizing persistent inward currents (PICs) may permit sustained muscle contraction after the removal of a brief excitatory stimulus. Windup, in which the motor response increases with repeated activation, is an indicator of PICs. Although windup of homonymous stretch reflexes has been shown, multijoint muscle activity is often observed following imposed limb movements and may exhibit a similar windup phenomenon. The purpose of this study was to identify and quantify windup …

Pedaling Alters The Excitability And Modulation Of Vastus Medialis H-Reflexes After Stroke, Dana P. Fuchs, Namita Sanghvi, Jon A. Wieser, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

Objective

Individuals post-stroke display abnormal Group Ia reflex excitability. Pedaling has been shown to reduce Group Ia reflexes and to normalize the relationship between EMG and reflex amplitude in the paretic soleus (SO). The purpose of this study was to determine whether these changes extend to the paretic quadriceps.

Methods

H-reflexes were used to examine Group Ia reflex excitability of the vastus medialis (VM). H-reflexes were elicited in paretic (n = 13) and neurologically intact (n = 13) individuals at 11 positions in the pedaling cycle and during static knee extension at comparable limb positions and levels of …

Perspective Paper: Assessing Air Quality As Part Of A Physical Therapy Plan Of Care, Dennis Sobush, Monika Burrescia

Physical Therapy Faculty Research and Publications

Purpose: The purposes of this clinical perspective paper are (1) to expand physical therapists’ awareness to the topic of air quality as a health priority when providing professional services; and (2) to provide templates for screening the indoor clinical environments and patient profiles to avert respiratory exacerbations, especially in persons with asthma. Summary of Key Points: The location where a physical therapist practices determines the air quality indices to which a person is exposed. Poor indoor air quality can expose a person to even greater compromise of respiration (ie, Sick Building Syndrome) than outdoor air quality secondary to an array …

The Effects Of Lesions In The Dorsolateral Pons On The Coordination Of Swallowing And Breathing In Awake Goats, Joshua M. Bonis, S. E. Neumueller, B. D. Marshall, K. L. Krause, B. Qian, Lawrence Pan, M. R. Hodges, Hubert V. Forster

Physical Therapy Faculty Research and Publications

The purpose of this retrospective study was to gain insight into the contribution of the dorsolateral pons to the coordination of swallowing and breathing in awake goats. In 4 goats, cannulas were chronically implanted bilaterally through the lateral (LPBN) and medial (MPBN) parabrachial nuclei just dorsal to the Kölliker–Fuse nucleus (KFN). After >2 weeks recovery from this surgery, the goats were studied for 5½ h on a control day, and on separate days after receiving 1 and 10 μl injections of ibotenic acid (IA) separated by 1 week. The frequency of swallows did not change during the control and 1 …

Analysis Of Knee Flexion Angles During 2 Clinical Versions Of The Heel Raise Test To Assess Soleus And Gastrocnemius Function, Kim Hébert-Losier, Anthony G. Schneiders, S John Sullivan, Richard J. Newsham-West, José A. García, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

STUDY DESIGN: Controlled laboratory study, using a repeated-measures, counterbalanced design. OBJECTIVES: To provide estimates on the average knee angle maintained, absolute knee angle error, and total repetitions performed during 2 versions of the heel raise test. BACKGROUND: The heel raise test is performed in knee extension (EHRT) to assess gastrocnemius and knee flexion (FHRT) for soleus. However, it has not yet been determined whether select knee angles are maintained or whether total repetitions differ between the clinical versions of the heel raise test. METHODS: Seventeen healthy males and females performed maximal heel raise repetitions in 0° (EHRT) and 30° (FHRT) …

Site-Specific Effects On Respiratory Rhythm And Pattern Of Ibotenic Acid Injections In The Pontine Respiratory Group Of Goats, Joshua M. Bonis, Suzanne Neumueller, Katie L. Krause, T. Kiner, A. Smith, B. D. Marshall, B. Qian, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

To probe further the contributions of the rostral pons to eupneic respiratory rhythm and pattern, we tested the hypothesis that ibotenic acid (IA) injections in the pontine respiratory group (PRG) would disrupt eupneic respiratory rhythm and pattern in a site- and state-specific manner. In 15 goats, cannulas were bilaterally implanted into the rostral pontine tegmental nuclei (RPTN; n = 3), the lateral (LPBN; n = 4) or medial parabrachial nuclei (MPBN; n = 4), or the Kölliker-Fuse nucleus (KFN; n = 4). After recovery from surgery, 1- and 10-μl injections (1 wk apart) of IA were made bilaterally through the …

Μ-Opioid Receptor Agonist Injections Into The Presumed Pre-Bötzinger Complex And The Surrounding Region Of Awake Goats Do Not Alter Eupneic Breathing, K. L. Krause, Suzanne E. Neumueller, B. D. Marshall, T. Kiner, Joshua M. Bonis, Lawrence Pan, B. Qian, Hubert V. Forster

Physical Therapy Faculty Research and Publications

Opioids are clinically important in the alleviation of pain. An undesirable side effect of opioids is depression of breathing. Data from isolated preparations suggest this effect is due to attenuation of discharge activity of neurons in the pre-Bötzinger complex (preBötzC), a medullary area with respiratory rhythmogenic properties. The purpose of this study was to examine how [d-Ala(2),N-Me-Phe(4),Gly(5)-ol]-enkephalin (DAMGO), a μ-opioid receptor agonist, affected breathing after injection into the presumed preBötzC of the adult awake goat. We hypothesized that DAMGO would cause breathing to decrease and become irregular when injected into the presumed preBötzC and the surrounding region of the conscious …

Observation Of Amounts Of Movement Practice Provided During Stroke Rehabilitation, Catherine E. Lang, Jillian R. Macdonald, Darcy S. Reisman, Lara Boyd, Teresa Jacobson Kimberley, Sheila M. Schindler-Ivens, T. George Hornby, Sandy A. Ross, Patricia L. Scheets

Physical Therapy Faculty Research and Publications

Objective

To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

Design

Observational survey of stroke therapy sessions.

Setting

Seven inpatient and outpatient rehabilitation sites.

Participants

We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

Interventions

Not applicable.

Main Outcome Measures

We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were …

Normal Breathing Pattern And Arterial Blood Gases In Awake And Sleeping Goats After Near Total Destruction Of The Presumed Pre-Bötzinger Complex And The Surrounding Region, Katie L. Krause, Hubert Forster, T. Kiner, S. E. Davis, Joshua M. Bonis, B. Qian, Lawrence Pan

Physical Therapy Faculty Research and Publications

Abrupt neurotoxic destruction of >70% of the pre-Bötzinger complex (preBötzC) in awake goats results in respiratory and cardiac failure (Wenninger JM, Pan LG, Klum L, Leekley T, Bastastic J, Hodges MR, Feroah TR, Davis S, Forster HV. J Appl Physiol 97: 1629–1636, 2004). However, in reduced preparations, rhythmic respiratory activity has been found in other areas of the brain stem (Huang Q, St. John WM. J Appl Physiol 64: 1405–1411, 1988; Janczewski WA, Feldman JL. J Physiol 570: 407–420, 2006; Lieske SP, Thoby-Brisson M, Telgkamo P, Ramierz JM. Nature Neurosci 3: 600–607, 2000; St. John WM, Bledsoe TA. J Appl …

Focal Acidosis In The Pre-Bötzinger Complex Area Of Awake Goats Induces A Mild Tachypnea, K. L. Krause, Hubert V. Forster, S. E. Davis, T. Kiner, Joshua M. Bonis, Lawrence Pan, B. Qian

Physical Therapy Faculty Research and Publications

There are widespread chemosensitive areas in the brain with varying effects on breathing. In the awake goat, microdialyzing (MD) 50% CO(2) at multiple sites within the medullary raphe increases pulmonary ventilation (Vi), blood pressure, heart rate, and metabolic rate (Vo(2)) (11), while MD in the rostral and caudal cerebellar fastigial nucleus has a stimulating and depressant effect, respectively, on these variables (17). In the anesthetized cat, the pre-Bötzinger complex (preBötzC), a hypothesized respiratory rhythm generator, increases phrenic nerve activity after an acetazolamide-induced acidosis (31, 32). To gain insight into the effects of focal acidosis (FA) within the preBötzC during physiological …

Bactericidal And Cytotoxic Effects Of Chloramine-T On Wound Pathogens And Human Fibroblasts In Vitro, Luther C. Kloth, Joseph E. Berman, Linda Jean Laatsch-Lybeck, Phyllis A. Kirchner

Physical Therapy Faculty Research and Publications

OBJECTIVES: To evaluate cytotoxicity and bactericidal effects of chloramine-T.

METHODS: In vitro study of various concentrations and exposure times to preparations containing human fibroblasts or 1.5 x 10⁸ colony forming units per milliliter (CFU/mL) of 3 gram-positive bacteria-Staphylococcus aureus, methicillin-resistant S aureus, and vancomycin-resistant Enterococcus faecalis-and 2 gram-negative bacteria-Escherichia coli and Pseudomonas aeruginosa-with and without fetal bovine serum present.

MAIN OUTCOME MEASURES: Percentage reduction of bacterial growth and percentage of viable fibroblasts 48 hours after exposure.

RESULTS: All gram-positive growth was reduced by 95% to 100%, regardless of dose, with or without serum. …

Co-Localization Of P-Creb And P-Nr1 In Spinothalamic Neurons In A Chronic Muscle Pain Model, Marie K. Hoeger Bement, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Activation of the cAMP pathway is an important mediator of chronic muscle pain. This study examined phosphorylation of the transcription factor cAMP-response-element-binding protein (p-CREB) and the NR1 subunit of the NMDA receptor (p-NR1) in the spinal cord. Bilateral mechanical hyperalgesia of the paw was induced by administering two injections of acidic saline, 5 days apart, into the gastrocnemius muscle of male Sprague–Dawley rats. The proportion of spinothalamic neurons that expressed p-NR1 or p-CREB did not change in the dorsal horn 24 h after the second intramuscular acid injection compared with animals that received pH 7.2 injections. This lack of change …

Antibacterial Activity Of Positive And Negative Polarity Low-Voltage Pulsed Current (Lvpc) On Six Typical Gram-Positive And Gram-Negative Bacterial Pathogens Of Chronic Wounds, Georg Daeschlein, Ojan Assadian, Luther C. Kloth, Christina Meinl, Frank Ney, Axel Kramer

Physical Therapy Faculty Research and Publications

The positive effect of electrical stimulation (ES) on wound healing has been shown in vitro and in vivo. On the basis of increased blood flow, protein denaturation, and stimulation of cellular defense, an antibacterial effect of ES is to be expected. Although the antibacterial effect of ES already has been demonstrated in vitro, little attention has been paid to the direct antibacterial effect of changing polarity of the applied current. The aim of this study was to investigate the antibacterial effect of positive and negative monophasic low-voltage pulsed current on typical Gram-positive and Gram-negative pathogens of chronic wounds. Using the …

Wound Debridement With 25 Khz Ultrasound, Margaret Mccarty Stanisic, Barbara Provo, David L. Larson, Luther C. Kloth

Physical Therapy Faculty Research and Publications

Several methods of wound debridement are described in the literature and are available to health care providers who specialize in wound management. Methods include the use of sharp surgical instruments; mechanical methods, such as whirlpool and pulsed lavage with suction; proteolytic and collagenolytic enzymes; autolysis; and sterile fly larvae (maggots). The use of surgical debridement is generally considered the most efficient method when performed by a skilled physician, who may in one session use his or her discretion to excise some viable tissue along with necrotic tissue in the wound. Sharp debridement performed in a clinical setting is a less …

Management Of Postsurgical Hyperhidrosis With Direct Current And Tap Water, Bernadette T. Gillick, Luther C. Kloth, Andrew John Starsky, Laura Cincinelli-Walker

Physical Therapy Faculty Research and Publications

Background and Purpose. Excessive sweating, known as hyperhidrosis, involves the eccrine sweat glands of the axillae, soles, palms, and/or forehead. The use of iontophoresis to reduce or eliminate excessive sweating has been described since 1952. The purpose of this case report is to describe the use of tap water galvanism (TWG) using direct current (DC) with a patient who had postsurgical hyperhidrosis. Case Description. The patient was a 36-year-old male electrician with traumatic phalangeal amputation and postsurgical development of hyperhidrosis. Tap water galvanism was administered using a DC generator, 2 to 3 times per week for 10 treatments. The patient's …

Effect Of Computer Keyboard Slope On Wrist Position And Forearm Electromyography Of Typists Without Musculoskeletal Disorders, Guy G. Simoneau, Richard W. Marklin, Joseph E. Berman

Physical Therapy Faculty Research and Publications

Positioning a computer keyboard with a downward slope reduces wrist extension needed to use the keyboard and has been shown to decrease pressure in the carpal tunnel. However, whether a downward slope of the keyboard reduces electromyographic (EMG) activity of the forearm muscles, in particular the wrist extensors, is not known. Subjects and Methods. Sixteen experienced typists participated in this study and typed on a conventional keyboard that was placed on slopes. Electromyographic activity of the extensor carpi ulnaris (ECU), flexor carpi ulnaris (FCU), and flexor carpi radialis (FCR) muscles was measured with surface electrodes, while the extension and ulnar …

A Randomized Controlled Clinical Trial To Evaluate The Effects Of Noncontact Normothermic Wound Therapy On Chronic Full-Thickness Pressure Ulcers, Luther C. Kloth, Joseph E. Berman, Marilyn Nett, Paula E. Papanek, Sonia Dumit-Minkel

Physical Therapy Faculty Research and Publications

OBJECTIVE: To determine the effect of noncontact normothermic wound therapy (NNWT) versus standard wound care on chronic full-thickness pressure ulcers.

DESIGN: Prospective, randomized, controlled trial

SETTING: Veterans administration medical center and 7 long-term-care facilities

PATIENTS: 40 inpatients with 43 Stage III and IV pressure ulcers

INTERVENTIONS: A sterile noncontact wound dressing was applied to 21 wounds for 24 hours per day, 7 days per week. Each day after the wound was irrigated and the noncontact dressing was changed, a heating element in the dressing was activated for 3 1-hour periods for 12 weeks or until wound closure. Twenty-two control wounds …

5 Questions–And Answers–About Negative Pressure Wound Therapy, Luther C. Kloth

Physical Therapy Faculty Research and Publications

No abstract provided.

5 Questions–And Answers–About Electrical Stimulation, Luther C. Kloth

Physical Therapy Faculty Research and Publications

No abstract provided.

Effect Of Setup Configurations Of Split Computer Keyboards On Wrist Angle, Richard W. Marklin, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

Alternative computer keyboards whose halves can be slanted toward each other can reduce a risk factor (ulnar deviation) for work-related musculoskeletal disorders (WMSDs) affecting the upper limbs. Two questions that computer keyboard operators face when using keyboards that can be separated into halves (split keyboards) are: (1) At what angle should the keyboard halves be opened? and (2) At what distance apart should the keyboard halves be placed? The objective of this study was to investigate the effects of the opening angle and separation distance between halves of a split keyboard on wrist ulnar deviation and typing efficiency. Methods. Eleven …

Walker-Assisted Gait In Rehabilitation: A Study Of Biomechanics And Instrumentation, Rebecca Ann Bachschmidt, Gerald F. Harris, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

While walkers are commonly prescribed to improve patient stability and ambulatory ability, quantitative study of the biomechanical and functional requirements for effective walker use is limited. To date no one has addressed the changes in upper extremity kinetics that occur with the use of a standard walker, which was the objective of this study. A strain gauge-based walker instrumentation system was developed for the six degree-of-freedom measurement of resultant subject hand loads. The walker dynamometer was integrated with an upper extremity biomechanical model. Preliminary system data were collected for seven healthy, right-handed young adults following informed consent. Bilateral upper extremity …

Effects Of Electrical Stimulation On Wound Closure In Mice With Experimental Diabetes Mellitus, Habiba A. Thawer, Pamela E. Houghton, Luther Kloth, Anna Butryn

Physical Therapy Faculty Research and Publications

The purpose of the present study was to examine the effect of electrical stimulation (ES) on the closure of full-thickness excisional wounds in mice with type-1 experimental diabetes mellitus (DM). Alloxon monohydrate (100mg/kg) was used to induce experimental DM in mole CD-1 mice (n = 88). Full-thickness skin excisions (1cm²) in diabetic (urine glucose > 0) and non-diabetic (urine glucose = 0) mice were administered 1, 3, or 5 treatments of ES (200μs, 200 Hz) for 15 minutes, at 0 (sham), 5, 10, or 12.5 volts. Alloxon injection resulted in a positive urine glucose test in 48 mice yielding …

Whole Body Momentum During Gait: A Preliminary Study Of Non-Fallers And Frequent Fallers, Guy G. Simoneau, David E. Krebs

Physical Therapy Faculty Research and Publications

The importance of momentum in compensating for elderly individua ls ' strength deficits to achieve activities of daily living. such as rising from a chair ha.!o been demonstrated in earlier studies. Here we present a case control study of three healthy "non-fallers" and two "frequent fallers," All 5 elders were community-living and were tested in the gai l laboratory. A four-camera Selspot system was used to obtain whole-body momentum from an 11-segment kinematic model. Ground reaction forces and kinematics were used 10 calculate lower extremity join! moments. With the exception of the whole-body's angular momentum about the vertical axis, linear …

Changes In Ankle Joint Proprioception Resulting From Strips Of Athletic Tape Applied Over The Skin, Guy G. Simoneau, Rebecca M. Degner, Cindi A. Kramper, Kent H. Kittleson

Physical Therapy Faculty Research and Publications

Athletic trainers, physical therapists, and other rehabilitation professionals stress the importance of proprioceptive reeducation during the rehabilitation process following an injury." 2 It is believed that an injury such as an inversion ankle sprain, for example, results in a reduction of proprioceptive function that may lead to future reinjuries. 3 One suggested palliative method to supplement a deficit in proprioceptive function at the ankle is the use of external support such as taping and braces.47 The tape or brace is believed to provide increased mechanical support as well as increased proprioception.

In Vitro Effects Of Two Silver Electrodes On Select Wound Pathogens, Linda Jean Laatsch-Lybeck, Poh Chye Ong, Luther C. Kloth

Physical Therapy Faculty Research and Publications

The use of electrical current to promote wound healing is well documented. However, little is understood about the effects of micro-amperage direct current (μADC) on growth of wound pathogens. The purpose of this project was to investigate the antibacterial effects of a silver wire/silver nylon electrode carrying μADC in vitro on several Gram positive and Gram negative bacteria. The current was delivered via silver wire and silver nylon electrodes at an amplitude of 100 μA for a 30-minute duration in an in vitro system. Results demonstrated that only silver wire carrying current inhibited bacterial growth around …

Antibacterial Effects Of A Silver Electrode Carrying Microamperage Direct Current In Vitro, Poh Chye Young, Luther C. Kloth, Linda Jean Laatsch-Lybeck

Physical Therapy Faculty Research and Publications

Currently, electrical stimulation is an accepted method used clinically to promote chronic wound healing. A literature review revealed that similar therapeutic current has been shown to suppress growth of common wound pathogens in vitro and in vivo. To date, little has been reported on the factors contributing to the antibacterial effects of microamperage direct current (μADC) stimulation. The purpose of this project was to investigate the role of electric field strength, current density, pH, and type of electrode used in vitro, to gain a better understanding of how these factors contribute to inhibiting growth of select wound pathogens. …

Posture And Gait In Patients With Diabetic Distal Symmetrical Polyneuropathy, Guy G. Simoneau, Peter R. Cavanagh, Jan S. Ulbrecht

Physical Therapy Faculty Research and Publications

No abstract provided.

Chronic Dermal Ulcer Healing Enhanced With Monophasic Pulsed Electrical Stimulation, Jeffery A. Feedar, Luther C. Kloth, Gary D. Gentzkow

Physical Therapy Faculty Research and Publications

The purposes of this randomized, double-blind, multicenter study were to compare healing of chronic dermal ulcers treated with pulsed electrical stimulation with healing of similar wounds treated with sham electrical stimulation and to evaluate patient tolerance to the therapeutic protocol. Forty-seven patients, aged 29 to 91 years, with 50 stage II, III, and IV ulcers were randomly assigned to either a treatment group (n=26) or a control (sham treatment) group (n=24). Treated wounds received 30 minutes of pulsed cathodal electrical stimulation twice daily at a pulse frequency of 128 pulses per second (pps) and a peak amplitude of 29.2 mA …

Improved Healing Of Pressure Ulcers Using Dermapulse, A New Electrical Stimulation Device, Gary D. Gentzkow, Sheldon V. Pollack, Luther C. Kloth, Harrison A. Stubbs

Physical Therapy Faculty Research and Publications

A double-blind, clinical study of pulsed electrical stimulation using the Dermapulse® device was carried out on 40 pressure ulcers, randomized to receive either active (stim) or sham treatment.

Electrodes were placed over saline-moistened gauze on the ulcers. An electrical current of 35mA was delivered to the wound tissues at a frequency of 128 pulses per second. Polarity was negative until the wound debrided, then alternated from .positive to negative every three days. Ulcers were treated for 30 minutes twice daily for four weeks, after which sham patients could cross over to active treatment, and stim patients could continue active treatment. …