Physical Therapy Commons^™

Blended Pedagogy Pathophysiology Course: Effectiveness And Student Satisfaction, Betsy Botsford, Samantha Corn, Alanna Keenan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Evidence supports the effectiveness of computer-assisted instruction (CAI) versus a traditional face-to-face teaching model, but little is known regarding the effectiveness of a blended pedagogy. The purpose of this study is to determine the effectiveness of a blended learning format in a pathophysiology course for entry-level Doctorate of Physical Therapy (DPT) students, to evaluate their level of satisfaction of a podcast formatted course, and to observe changes in cohort performance over time.

Subjects: Five University of Nevada, Las Vegas (UNLV) DPT cohorts (n = 139) participated in the study. Some cohorts were taught in a traditional classroom …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …

Conceptual Framework Of A Novel Intervention To Improve Mobility In Children With Cerebral Palsy: The Successes And Challenges Of Implementing A Large Amplitude Movement Protocol, Tania Goodwill, Erin Jarrett, Beren Shah, Alanna Stockford

UNLV Theses, Dissertations, Professional Papers, and Capstones

While cerebral palsy remains one of the most common childhood disabilities, clinicians continue to face significant challenges developing effective treatment strategies for the widely variable presentation of motor function impairments associated with cerebral palsy. A large gap exists between current research based evidence and feasible clinical practice. The purpose of this paper is to introduce a novel intervention protocol, explore the theoretical framework behind the protocol and provide insight to clinicians about the successes and challenges faced while pilot testing the intervention. The novel intervention was adapted and implemented by researchers combining a large amplitude movement protocol with the well-researched …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …

The Effect Of Balance Training With An Innovative Approach Compared To Traditional Balance Exercises, Brian Curtis Waite

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the use of an X Box 360 KinectTM game as a modality for improving balance. Specifically, this study explores the use of the Target Kick mini game on Kinect SportsTM as a tool for VR rehabilitation. Subjects (N=18, age 23.3 ±2.87 yrs, mass 71.83 ±15.25 kg, height 168.4 ±7.79 cm) with no lower extremity injury were randomly placed into three groups (X Box n = 6, Traditional n = 6, and Control n = 6). The X Box (XBOX) group performed ten minutes of balance training by playing an X Box game …

Anterior Cervical Decompression And Fusion On Neck Range Of Motion, Pain And Function: A Prospective Analysis, Kate Addis, Jason Longhurst, Bree-Lyn Vom Steeg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Summary of background data: Intractable cervical radiculopathy secondary to stenosis or herniated nucleus pulposus is commonly treated with an anterior cervical decompression and fusion procedure (ACDF). However, there is little evidence in the literature that demonstrates the impact such surgery has on long term range of motion outcomes

Study Design: Prospective, non--‐experimental.

Objective: The objective of this study was to compare cervical range of motion and patient reported outcomes in patients before and after a 1, 2 or 3 level ACDF.

Patient Sample: 46 patients.

Methods: Patients undergoing an ACDF for cervical radiculopathy had their cervical range …

Land-Based Exercise And Its Effect On Quality Of Life Outcomes In Patients With Knee Osteoarthritis: A Systematic Review, Cody R. Buckner, Lindsay C. Martin, Michael L. Soukup

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The purpose of this systematic review was to examine effectiveness of land-based exercise interventions for improving quality of life (QOL) of individuals with symptomatic knee osteoarthritis.

Methods: A systematic search included PubMed, CINAHL, Scopus, Academic Search Premier, and the Cochrane Database of Systematic Reviews. Inclusion criteria included land-based exercise interventions aimed to improve lower extremity strength and QOL, published since 2000. Exclusion criteria included OA of joints other than the knee, and aquatic-based and surgical interventions. Studies were evaluated using a modified version of the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) methodology score.

Results: Level of …

Therapeutic Neuroscience Education For Patients With Chronic Low Back Pain And Its Effect On Activity Level, Pain Perception, And Function, Stephen Burton, Amber Domingo, Ryan Spencer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Chronic low back pain (CLBP) is a significant cause of disability and inactivity in the United States. Patients with chronic pain are often symptomatic even in the absence of tissue damage. This is a major reason patients need to be educated about their pain. Cognitions such as fear, anxiety and faulty beliefs may impact the pain experiences and changing cognitions are important in changing pain behavior. If patients understand that the pain they are experiencing may not be a true indication of the health of their tissues, they may experience less fear of their pain, and may be able …

Reliability And Validity Of The Ne1 Wound Assessment Tool (Wat), Stephanie Coon, Faustina Tran, Melinda Vicencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current literature indicates a lack of reliability and validity of existing pressure ulcer (PrU) staging systems. This prompted the development of the N.E. One Can Stage (NEOCS). Recently this tool was modified and renamed, the NE1 Wound Assessment Tool (NE1 WAT). The purpose of this study is to test the reliability and validity of the NE1 WAT.

Subjects:

A sample of convenience of nine physical therapists (PTs) and 11 nurses (RNs) with PrU staging as part of their routine work duties were included in this study.

Methods:

A written exam was administered and consisted of assessment questions …

Effects Of Footstrike Pattern On Low Back Posture, Shock Attenuation, And Comfort During Running, Traci L. Delgado, Emilia Kubera-Shelton, Robert R. Robb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Barefoot running (BF) is popular in the running community. Biomechanical changes occur with BF, especially when initial contact changes from rearfoot strike (RFS) to forefoot strike (FFS). In addition, changes in lumbar spine range of motion (ROM), particularly involving lumbar lordosis, have been associated with increased low back pain (LBP). However it is not known how changing from RFS to FFS affects lumbar lordosis or LBP. Thus, the purpose of this study was to determine if a change from RFS to FFS would change lumbar lordosis, and/or decrease shock attenuation, and/or change comfort levels in healthy recreational/experienced runners.

Methods: …

The Acute Effects Of Upper Extremity Stretching On Throwing Velocity In Untrained Baseball Throwers, Ashley Delobel, Lanisa Harveson, Jason Melton, Michael Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to examine the effects of static and proprioceptive neuromuscular facilitation (PNF) stretching of shoulder internal rotators on throwing velocity as compared to a typical dynamic warm-up.

Subjects: 27 male untrained throwers (mean age = 25.1 years old, SD =2.4) with basic knowledge of throwing mechanics.

Methods:The study was conducted over a series of three sessions with at least one week between each session. During each session, subjects warmed-up, threw 10 pitches, were randomly assigned to one of three separate stretching protocols, and then threw 10 more pitches.The three protocols were static stretching, …

Effects Of Cervical Spine Manipulation On Balance And Joint Proprioception In Asymptomatic Individuals: Plausibility And Pilot Study, Kimberly Drayer, Michael Kauwe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Balance issues are prevalent in all ages of the population and can lead to many debilitating secondary impairments. There are various methods for treating balance problems, one of which is cervical spine manipulation (CSM). It seems to be biologically plausible that CSM would be an effective intervention, as it elicits effects in the same systems that are impaired in people with balance issues: vestibular, visual, and somatosensory.

Objective: The aim of this study is to investigate the immediate differences in balance and proprioception following a CSM in asymptomatic subjects.

Design: An experimental, cross-over study design was used

Methods: …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Russell Gourlie, Spencer Sorensen, Rithea Vong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study is to examine and identify key characteristics of and differences between people with Parkinson’s Disease (PD) who exhibit moderate/high fear of falling avoidance behaviors and those that exhibit low fear of falling avoidance behaviors.

Subjects: A total of 24 subjects (5 females, 19 males; mean age= 72.2, SD=9.1) participated in this study.

Methods: A cross-sectional design was used to identify descriptive characteristics of subjects with PD associated with moderate/high levels of fear avoidance behavior (MHA) or low levels of fear avoidance (LA) as measured by the Fear of Falling Avoidance-Behavior …

Test-Retest Reliability And Responsiveness Of Gaze Stability And Dynamic Visual Acuity In High School And College Football Players, Denise Kaufman, Mallory Puckett, Mitchell Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: The purpose of this study was to establish reliability and responsiveness of the active dynamic visual acuity test (DVAT) at speeds of 150 to 200 degrees per second (deg/sec) and the gaze stabilization test (GST) in high school and college football players.

Design: Reliability design

Setting, Participants, Main Outcome Measures: A total of 50 high school and college football athletes completed vestibulo-ocular reflex testing using the DVAT and GST in the yaw (horizontal) and pitch (vertical) planes on two separate occasions within 14 days.

Results: Test-retest reliability for the DVAT was good in yaw, Intraclass Correlation Coefficient (ICC) (3,3) …

Using Over-The-Counter Ear Filters As A Treatment To Improve Dizziness And Balance In Patients Diagnosed With A Traumatic Brain, Brandy Sue Whitney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: People diagnosed with a Traumatic Brain Injury (TBI) usually have physical, cognitive, emotional, and sleep deficits. Sensory overload is a common symptom of TBI. One treatment prescribed for sensory overload is over the counter ear filters. Ear filters have shown to decrease sensory input. Could the ear filters have an effect on balance and dizziness without much cost to the patient or the clinic?

Subjects: Patients diagnosed with a mild or moderate brain injury, ages of 18-65 years old. They needed to be medically stable, potential to walk, and have complaints of dizziness and/or balance problems.

Methods: …

Supervised Lower Extremity Strengthening Program To Improve Function In Women Over Fifty With Knee Osteoarthritis: A Time Series Design, Janelle Brooke Lemons, Diane Christine Sheesley, Pamela Reagan Sutton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Develop a simple, self-paced lower extremity strengthening program incorporating functional activities for women over the age of fifty to reduce limitations associated with knee OA.

Study Design: This was a pilot study utilizing a time series design with 8 women aged 55-65 (M + SD = 60 + 3) meeting the American College of Rheumatology's criteria for clinical diagnosis of knee OA.

Background: Lower extremity weakness in women with knee osteoarthritis is associated with pain and functional limitations.

Methods and Measures: Subjects began the 14-week program with 2 weeks of baseline treadmill walking. The following 12 weeks were divided …

Therapist Characteristics Influencing Physical Therapy Non-Treatment In The Acute Care Setting, Daniel Mcgarvey, Colby Olsen, Aaron Van Wagoner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Research has found that participation in physical therapy (PT) services in the acute care setting increases functional outcomes and decreases patient length of stay. Certain physical therapist characteristics could be a potential source of influence on patient non-participation in physical therapy in the acute care setting. The purpose of this study was to determine whether specific characteristics of therapists and patients are predictive of physical therapy non-treatment.

Subjects: Subjects included 16 physical therapists or physical therapist assistants and 1225 patients at a community acute care hospital.

Methods: Characteristics of each therapist and their corresponding patient data were …

Attentional Focus During Balance Training In Idiopathic Parkinson’S Disease (Pd): A Randomized Clinical Trial, Alyssa Davis, Rebecca Hatlevig, Amanda Richards, Leslee Rosenlof

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare the effects of various attentional focus strategies on balance in people with PD. Forty-nine adults with idiopathic PD were randomized into one of four groups (internal focus, external focus, no focus, and control). The three intervention groups participated in a month-long balance program. The outcomes measured were the Sensory Organization Test, Berg Balance Scale, self selected gait velocity, Dynamic Gait Index, Activities-specific Balance Confidence Scale and obstacle course completion time. These outcomes were measured at baseline, post intervention, 2-weeks post intervention, and 8-weeks post intervention. Statistical analyses yielded no significant differences among …

Immediate Effects Of High Intensity Training In Children With Cerebral Palsy Gmfcs Levels I-Iii: A Pilot Study, Andrea Blahovec, Andrea Kuiken, Jillian Mears, Heather Riggins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cerebral Palsy is one of the most common causes of motor disability in the U.S., but there is still a lack of consensus for best intervention strategies to improve function and gait efficiency.

Objective: Determine if ambulatory children with CP, exposed to a brief, high intensity training session, will: 1) experience changes in temporal-spatial gait characteristics 2) demonstrate increased gait speed and 3) demonstrate improved gait kinematics.

Design: Five participants walked at preferred and fast speeds over an instrumented walkway followed by a 15-minute intervention. After a short rest, post-intervention walking was completed.

Results: Ten dependent variables were extracted …

Foot Volume Change During Long Distance Running In Healthy Adults, Meghan Boni, Istvan Takacs, Rebecca Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: Healthy adults frequently engage in running as a means of cardiovascular exercise. Larger running shoes are often chosen based on common beliefs that feet swell during running, yet many continue to encounter foot injuries, such as blisters, as a result of this activity. Previous research has analyzed the changes in foot volume during short bouts of activity. However, there has been limited research on the effect of long distance running on foot volume, which is where many of these injuries are seen. The purpose of this study was to examine the effects of long distance running, defined …

Duration Of The Effects Of Three Static Stretching Conditions With Or Without A Dynamic Warm-Up In College Age Adults, Spencer Blackwell, Andrew Blomberg, Jonathan Griffith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose. The purpose of this study was to determine the stretching duration (15, 30, 60 seconds) with or without a dynamic warm-up that resulted in the longest lasting acute effects in hamstring flexibility.

Subjects. Forty subjects (17 male, 23 female) (age: 20-35 years) were selected to participate in this study using a sample of convenience from university graduate students.

Methods. This study contained 7 treatment conditions in which each subject completed in random order. Three groups consisted of a 5-minute treadmill warm-up at a self-selected velocity (SSV) followed by one of three stretching durations (15, 30, or 60 sec). …

Kinesio Taping On Short-Term Changes In Shoulder Strength In Healthy Adults: A Randomized Clinical Trial, Dario A. Callegari, Cristobal E. Cordova, Julia R. Dunievitz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Type: A Randomized Clinical Trial

Introduction:

Kinesio tape is an elastic tape used in various settings and it is purported to assist in strengthening weakened muscles. The mechanism behind this claim is neuromuscular facilitation. The purpose of this study was to determine if the claims of Kinesio tape would be supported in its role in strength enhancing properties.

Methods:

Twenty-nine healthy, untrained male and female college-aged individuals participated in this study. Two baseline measurements assessing shoulder external rotation (ER) strength were collected using isokinetic dynamometry. Subjects were then randomized into two groups, Kinesio tape with ER strengthening (KT-Ex) and …

Determining The Validity Of The Nintendo Wii Balance Board As An Assessment Tool For Balance, Sabrina Mae Deans

UNLV Theses, Dissertations, Professional Papers, and Capstones

Context. Application of the Nintendo Wii-fit balance board and its games have been used in Physical Therapy clinics, showing success in individuals with neurological disorders, and has been recommended as a minimum baseline assessment of a symptoms checklist and standardized cognitive and balance assessments for concussion management by the NCAA. However, it still faces challenges of being considered a reliable and consistent tool for producing normative data in the allied healthcare. Because there is little to no evidence for the Wii-fit balance board as a valid balance assessment tool for clinical and/or research usage, the significance of this study is …

Effect Of Aquastretch On Range Of Motion At Knee Joint In Total Knee Arthroplasty Patients, Raja Devinder Kochar

UNLV Theses, Dissertations, Professional Papers, and Capstones

The success of the Total Knee Arthroplasty (TKA) depends upon its functional outcomes of increase in reduction in pain, and gait ambulation and performing functional activities of daily living. Compromised range of motion, pain and weakness can reduce their ability to perform activities of daily living. Aquatic Physical Therapy may offer an alternative intervention to traditional Physical Therapy Rehabilitation and many studies have shown improvements in range of motion, swelling, pain reduction, stiffness and quality of life after TKA. AquaStretch, a relatively new form of aquatic therapy, claims to restore the functional mobility which is lost restrictions caused due to …

The Acute Effects Of Various Types Of Stretching (Static, Dynamic, Ballistic, And No Stretch) Of The Iliopsoas On 40-Yard Sprint Times In Non-Athletes, Scott David Christensen, Craig Perry, Ryan Richard Resnik

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine the effect of static, ballistic, dynamic, and no stretching immediately prior to a 40-yard sprint in college students. There were 35 healthy subjects (22 male and 13 female) between the ages of 24 and 37 (Mean = 26.46 yrs, SD = 2.99 yrs) who participated. The experiment consisted of running 4, 40-yard sprint trials immediately following 1 of 4 different stretching protocols. Prior to each 40- yard sprint trial, a 5-minute warm up was performed at 3.5 mph on a treadmill. Each subject received each of the four techniques in a randomized …

Patient Factors And Day Of The Week Influencing Physical Therapy Non-Treatment Events In The Acute Care Setting, Daniel Goodrich, Curtis Doug Jensen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background. In acute care hospitals, scheduled physical therapy visits not resulting in treatment may increase patient length of stay and the financial burden to the hospital. Previous literature has not fully evaluated the occurrence of these events, nor have any associated factors been identified.

Objective. Measure the rate of non-treatment and determine which patient characteristics were most likely to predict a non-treatment event.

Design. Retrospective review of documentation at a suburban hospital.

Methods. Data were collected from records of 1,096 patients, totaling 6,097 scheduled sessions. The rate of non-treatment was calculated and logistic regression used to …

Development Of A Scale To Assess Avoidance Behavior Due To A Fear Of Falling: The Fear Of Falling Avoidance Behavior Questionnaire (Ffabq), Cortney Durand, D. Shalom Powell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: A history of falls or imbalance may lead to a fear of falling which may lead to self-imposed avoidance of activity; this avoidance may stimulate a vicious cycle of deconditioning and subsequent falls.

Objective: The purpose of this study was to develop a questionnaire that would quantify avoidance behavior due to a fear of falling.

Design: This study consisted of two parts, questionnaire development and psychometric testing. Questionnaire development included an expert panel and 39 assisted living residents. Psychometric testing included 63 community dwelling subjects with various health conditions.

Methods: Questionnaire development included the evaluation …

Effects Of Environment On Children's Motor Scores, Eligibility Status, And Administration Times, Derrick Mittelstadt, Abigail Parker, Kirsten Pickett, Heather Temkin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Best practices for assessing developmental skills in young children focus on naturalistic observation in everyday settings, but the effects of environment on test scores, eligibility status and administration time have not been explored. The Peabody Developmental Motor Scales-Second Edition (PDMS-2) was administered to 34 children aged 18 to 59 months in natural and pull-out settings. PDMS-2 total, gross, and fine motor quotient (TMQ, GMQ, and FMQ) scores were significantly lower in the natural environment (p’s≤.014). Based on our results, more children would qualify for services when tested in natural environments using TMQ and GMQ scores. It also took significantly longer …

Safety Of Cervical Manipulation: Are Adverse Events Preventable And Are Manipulations Being Performed Appropriately?, Joseph Anders, Jessica March, Amber Perez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: Documented case reports found in medical literature describing adverse events associated with cervical spine manipulation (CSM) were reviewed to determine if the CSM was used appropriately and if the events could have been prevented. Our hypothesis was that CSM had been used inappropriately and that adverse events could have been prevented. This study also looked to identify potential characteristics that may put the patient at risk for injury, or even death as a result of a CSM.

Methods: One hundred and thirty four cases, reported in 93 articles, published between 1950 and 2010, were reviewed. CSMs were categorized as …