Physical Therapy Commons^™

The Effectiveness Of Implementing A Collegiate Dance Clinic At The University Of Nevada, Las Vegas, Quinn Williams, Kristin Allman, Matthew Mcarthur, Ryan Yim

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screenings are commonly employed in athletics to identify deficits in performance with the goal of providing interventions to decrease injury risk; however, their utilization is uncommon in collegiate dance programs. Therefore, the purpose of this service learning project was to address the needs of the University of Nevada, Las Vegas (UNLV) dance program through implementation of an injury screening and prevention clinic for collegiate-level dancers. Four second year Doctor of Physical Therapy students (SPTs) supervised by a clinical faculty member with dance medicine expertise researched, developed, and provided screenings to identify increased risk for dance-specific injuries, and education to decrease …

The Effects Of Somatosensory Input On Gait In Individuals Post-Stroke, Victor Hung, Amanda Reilly, Rachel Wood, Nikita Yuskov

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is a leading cause of disability that results in various neurological deficits, one of which is hemiplegia. This deficit alters the gait cycle, resulting in decreased propulsion force by plantar flexor muscles, decreased activation of dorsiflexor (DF) muscles, and increased coactivation of antagonistic ankle muscles. Stroke also leads to altered somatosensory input which results in decreased balance and gait speed, ultimately increasing fall risk. Therapies targeting increased somatosensory input have been shown to be beneficial in stroke as well as other neurological populations. However, no known studies have investigated the acute effects of local vibration to …

Physical Therapy Nontreatment Events With Primary Physical Therapist, Stephen Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Physical therapy improves prognosis reduces stay and is generally helpful in aiding recovery from a wide range of ailments. Nontreatment rates occur for multiple reasons and are also related to the personalities of physical therapists.

Methods: We used data from a research project involving physical therapy at an acute care facility in our community. Our study focused on the retrospectively determined primary physical therapist for each patient. We used the chi-squared tests to compare nontreatment rates between days of the week and disease type and the reasons for nontreatment events. Repeated-measure models were used to evaluate the effect of …

Intra- And Inter-Rater Reliability Of A Ballet-Based Dance Technique Screening Instrument, Jessie Lesar, Zachary Shaver, Ivetta Lassey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: To execute the aesthetic demands of dance while utilizing proper biomechanical body position, a dancer needs the ability to maintain lumbopelvic stability, external rotation of the femur, and alignment of the knee, foot, and ankle. The ability to identify technique deficits can guide preventative programs that may reduce injury risk and frequency. Purpose: The purpose of this study was to investigate intra- and inter-rater reliability of the ballet-based Dance Technique Screening Instrument by physical therapists (PTs) and student PTs (SPTs) with prior dance medicine or dance experience. Subjects: Twenty-eight adult subjects served as raters which included licensed PTs and …

Rural Or Underserved Practice Interest Among Doctor Of Physical Therapy Students. Do Clinical Education Experiences Change Opinions?, Brandon Godin, Trenton Poulson, Mac Neil Moresca, Tyler Satoshige

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: People living in rural and underserved areas are poorly served by our country's healthcare system. The Federal Office of Rural Health Policy reports that approximately 18% of people in the United States live in rural areas. Within the physician and nursing literature the largest reported predictor of rural practice is having a rural background. Mandated rural medical rotations during training have been shown to positively alter interest in rural practice and employment. While nursing and medical students have been thus studied, limited evidence exists for physical therapists. The objective of this study was to determine how rural …

Neurodynamics Under Different Walking Speeds In Individuals With Chronic Post-Stroke Hemiparesis, Corey Ackley, Kiley Aki, Joshua Arias, Jassie Trinh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is the leading cause of long-term disability in adults worldwide. The ability to return to walking is often a main goal of rehabilitation in individuals with chronic post-stroke hemiparesis. To increase walking speed, non-neurologically impaired individuals produce greater ankle propulsion force at push-off with greater ankle dorsiflexion angles in swing phase with no change in ankle muscle co-contraction index in the swing phase. It remains unclear if individuals post-stroke would adopt similar neuromuscular strategies. Therefore, our aim was to examine the effect of altered walking speeds on propulsion force at push-off, ankle dorsiflexion angle during swing, …

The Effect Of Physical Therapy On Patient Self-Reported Outcomes And Perceptions Of Mobility After Lower Extremity Amputations, Gregory Amaya, Rosman Gante, Zachary Meinzer, Abbas Sadrossadat

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The number of people with limb loss is rapidly growing, partly due to an aging society and the prevalence of diabetes. Physical Therapy (PT) has been shown to improve perceived functional outcomes and quality of life in older adults and individuals with diabetes, but it is unclear why certain patients do not receive PT after amputation and whether the beneficial outcomes shown in other populations translate to individuals with limb loss. The purpose of this study was to determine whether receiving PT among patients with limb loss correlates with an improved quality of life, better mobility, and …

Lumbopelvic Muscle Performance And Morphology Differences: Implications For Low Back Pain In Individuals With Unilateral Above-The-Knee Amputation, Melissa Damele, Rachel Gross, Ronauldo Robina

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The number of people living with an amputation in the United States is rising at a rate of almost 200,000 cases a year [1]. The incidence of low back pain (LBP) in individuals with lower limb amputation (LLA) has been shown to be much greater than in the general population at 52%- 72% [2-4]. High amputation level, disuse, and abnormal movement patterns associated with prosthetic gait have been theorized to lead to decreased lower back muscle performance, contributing to the high prevalence of LBP in individuals with LLA [5-7]. However, lumbar muscle morphology and performance have not …

Modulation Of Corticospinal Excitability Using Cathodal Transcranial Direct Current Stimulation To Improve Walking In Individuals With Chronic Post Stroke Hemiparesis, Neil Drobitch, Kylie Henry, Sage Lyons, James Schomig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Individuals who have experienced a pyramidal cerebrovascular accident (pCVA) often exhibit impairments to volitional control of corresponding motor tasks. Promising effects in motor response, post-application of transcranial direct current stimulation (tDCS), have been reported in studies on individuals with the ability to achieve independent gait for 20 minutes. These studies mainly examined the effects of combined tDCS with locomotor training on lower extremity function among higher functioning individuals post-stroke. The purpose of this study was to determine the effect of tDCS among individuals post-stroke who may not have independent ambulatory capabilities, focusing on motor response and less …

Physiotherapy Is Associated With Improvements In Gait And Balance In Individuals With Cognitive Impairment: A Retrospective Analysis, Steven Jackson, Elbert Chen, Jason Phan

UNLV Theses, Dissertations, Professional Papers, and Capstones

BACKGROUND: Evidence suggests that individuals with cognitive impairment (CI) exhibit significant motor impairments; however, these motor impairments receive little treatment attention compared to more prominent CI. Moreover, there is a lack of evidence about physiotherapy (PT) in individuals with CI. OBJECTIVE: The purpose of this study was to determine if PT was effective at improving gait and balance in individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI). METHODS: Retrospective data of 173 individuals with CI conditions and an initial evaluation for PT were extracted from electronic records from January 2016 …

The Moderation Effect Of Bdnf Genotype And Self-Reported Lifetime Physical Activity Habits On Postural Instability In Parkinson’S Disease, Samantha Johnson, Tyler Ormsby

UNLV Theses, Dissertations, Professional Papers, and Capstones

Brain-derived neurotrophic factor (BDNF) levels play an important role in neuroplasticity in normal and neurologically compromised individuals. Studies suggest that BDNF levels increase in response to physical activity and are also affected by genotype. In individuals with Parkinson’s Disease (PD), it is not known if physical activity habits and BDNF genotype modulate this neuroprotective response. The purpose of this study was to determine if BDNF genotype interacts with lifetime self-reported physical activity levels to affect age of disease onset and severity of PD symptoms, specifically gait, balance, and motor dysfunction

Patellar Tendon Morphology In Trans-Tibial Amputees Utilizing A Prosthesis With A Patellar-Tendon-Bearing Feature, Jessica Kellogg, Kelly Teter, Michelle Evers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: A patellar-tendon-bearing (PTB) bar is a common prosthetic design feature used in individuals with trans-tibial amputations. As the patellar tendon in the knee of residual limb is subjected to the perpendicular compressive force not commonly seen in normal tendon loading, it is possible for tendon remodeling and degeneration to occur over time; however, there is limited data to support this idea. The primary purpose of this study was to use ultrasound imaging to compare the morphological differences between tendons of the residual and intact limb in unilateral trans-tibial amputees who utilize a prosthesis with a PTB feature. We hypothesized …

Impact Of Clinician Experience And Positive Language On Subject Expectation Of Cervical Spine Manipulation Effects, Joshua Wood, Jonah Mawae, Stephen Elmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Acute neck pain is a worldwide epidemic that physical therapists treat with cervical spine manipulation (CSM). While the mechanical and neurological effects of CSM are important, it is possible that the patient’s perception of the therapist’s skill level may also play a role in patient outcomes. Along with the patient’s perception of the practitioner, evidence suggests that patient expectation for intervention efficacy may also alter patient outcomes. The implication is that special consideration must be taken when practitioners choose their words when describing both themselves and their interventions. The purpose of this study is to examine if …

Successful Patient Participation In Acute Hospital Physical Therapy, Jesse Kim, Joseph Fertitta, Patrick Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Research has demonstrated that physical therapy plays a crucial role in patient recovery in the acute hospital setting. Despite known benefits, scheduled sessions do not always occur and are called nontreatment (NT) events. Reported NT ranges from 15% to 26% of scheduled sessions. Previous studies have found an association between NT and patient diagnosis as well as between NT and day of the week on which treatment was scheduled. Identifying additional factors that affect NT is important if therapists and administrators are to make improvements. The purpose of this study is to determine if an association exists between physical …

Investigation Of The Cardiovascular Endurance Of Dance Majors, Arnold Huang, Ali Ross, Kelsey Taelour, Geneva Winters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: College dancers have demonstrated low levels of cardiovascular endurance compared to other athletes, which could be one of the factors that leads to more fatigue and injuries during performance. The effects of an education session on cardiovascular endurance and on college dancers’ attitudes towards cardiovascular exercise outside of dance class have not been previously studied. Purpose: The purpose of this study was to use the accelerated three-minute step test to compare lower level and upper level college dancers’ cardiovascular endurance before and 2 months after an education session emphasizing fitness and exercise. Additionally, assessed were the dancers’ attitudes towards …

The Influence Of Socioeconomic Factors On Fear Of Falling And Mobility Outcomes After Lower Limb Loss: A Preliminary Study, Tyler Chin, Heather Fox, Juan Gutierrez Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with …

Immediate Effects Of Cervical Spine Thrust Joint Manipulation On Gait Parameters In Individuals With Neck Pain, Marc Anthony D. Albano, Emily Blok, Beau Gronert, Ryan Masuda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypotheses: 1. To investigate for any change in gait parameters in individuals with neck pain while walking with different functional neck conditions immediately following cervical thrust joint manipulation (TJM) versus a sham intervention. 2. To investigate any association between Global Rating of Change (GROC) scores and gait parameters immediately following cervical thrust joint manipulation versus a sham intervention. The hypotheses were that, a) cervical TJM would have an immediate effect on gait parameters during walking with the neck in at least one of three conditions (neutral, flexion/extension and rotation) among individuals with neck pain; and b) higher scores on the …

The Effect Of Standardized Photodocumentation On Coding Of Pressure Injuries, Brandon Bales, Alex Preciado, Angela Sandoval

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure injuries (PI) are prevalent and costly for hospitals. Hospitals implement different practices to accurately document PIs ranging from pen and paper to photodocumentation in electronic medical records (EMRs). In some instances, PIs that have been documented are not coded for billing and reporting. The purpose of this study is to determine if different documentation practices affect the number of coded PIs. Methods: Counts of coded PIs were collected from 2011- 2017 from two hospitals: a 500-bed acute care hospital (ACH) and a 42-bed acute rehabilitation hospital (ARH). A series of PI documentation practices were implemented over …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes Of Paraspinal Muscle Performance After Lumbar Multifidus Intramuscular Fine Wire Electrode Insertion, Anthony Duong, Vincent Dinglasan, Russell Totten

UNLV Theses, Dissertations, Professional Papers, and Capstones

STUDY DESIGN: Case control study. BACKGROUND: Recurrent low back pain (RLBP) is associated with paraspinal muscle dysfunction. Intramuscular electromyography (EMG) is a common tool for studying activation of the deep lumbar paraspinal muscles such as multifidi muscles, but it is currently currently unclear how muscle performance and activation are affected by the pain and micro-injury associated with intramuscular fine-wire electrode (IFWE) insertion and how it interacts with the presence of RLBP. OBJECTIVES: The purpose of this study was to examine how IFWE insertion into the lumbar multifidus affects paraspinal muscle strength and endurance in subjects with and without RLBP. METHODS: …

Patellofemoral Joint Stress During Uphill And Downhill Running In Healthy, Theresa French, Brooks Klein, Young Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Subjects: Twenty recreational runners participated (mean age of 24.9 years). Methods: Kinematics and kinetics of the trunk and lower extremity were obtained at 3 conditions: level, 6° uphill, and 6° downhill, at a speed of 2.3 m/s. PFJ stress was determined using a biomechanical model that incorporates knee flexion angle and knee extensor moment as subject-specific input variables. The model output consisted of PFJ reaction force, PFJ stress, and PFJ contact area. One-way ANOVAs with repeated measures and post-hoc t-tests with a Bonferroni adjustment were used to compare outcome variables across the 3 conditions. Results: Peak PFJ stress during downhill …

The Moderation Effect Of Bdnf Genotype And Self-Reported Habitual Physical Activity Levels On Age Of Onset, Disease Progression, And Postural Instability In Parkinson's, Kyle Johnson, Danielle Salgo, Jessica Zorn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Brain-derived neurotrophic factor (BDNF) levels have been reported to play an important role in driving neuroprotection in people with neurologic disorders, and levels of BDNF are known to increase in response to physical activity. Moreover, the level of BDNF produced is also affected by BDNF genotype. It is not known, however, whether one’s BDNF genotype interacts with physical activity throughout life to affect a neuroprotective response in people with Parkinson’s disease (PD). Therefore, the purpose of this study was to determine if BDNF genotype interacts with lifetime self-reported physical activity levels to affect disease severity and progression …

Neuromuscular Adaptations Following Slope Walking In Individuals Post-Stroke, Eric Akoopie, Brooke Conway Kleven, Trisha Koch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The excitability of the H-reflex pathway in the non-impaired nervous system can be augmented by altering the different parameters of a walking task, specifically slope. We sought to examine the adaptations in soleus H-reflex excitability and foot force control following an acute bout of upslope or downslope treadmill walking in people post-stroke compared to those who are non- impaired. Methods: We recruited 12 individuals with chronic post-stroke hemiparesis and 9 age-similar non- neurologically impaired individuals. Each subject was tested over 2 sessions separated by at least 7 days. For each session, subjects walked at a self-selected walking speed on …

Reliability And Validity Of Using A Mobile Application To Asses Knee Valgus In Healthy And Post-Anterior Cruciate Ligament Reconstruction Participants, Brenda Benson Deaver, Tyrel Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To examine the reliability and validity of using a movement analysis application (MAA) to measure knee valgus angle during three functional activities used to assess return-to-sport after ACL reconstruction (ACLR). Design: Reliability and validity study Setting: University laboratory Participants: Twelve ACLR participants with a non-contact mechanism of injury and 20 healthy individuals. Independent Variables: Each subject performed single-leg drop landing, single-leg hop, and 90º cut with simultaneous 3-dimensional (3D) motion capture and video recording in the frontal plane on an iPad. Main Outcome Measures: Peak knee valgus angle during the landing phase of each task was measured using a …

The Effects Of Fatigue On Balance In Individuals With Parkinson's Disease: Influence Of Medication And Brain-Derived Neurotrophic Factor Genotype, Michael Baer, Bradley Klemetson, Diana Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose was to investigate the effects of fatigue on balance in individuals with Parkinson’s disease (PD). Because falls in this population can have deleterious consequences, it is important to understand the influence of fatigue and PD medications on balance. Additionally, since brain-derived neurotrophic factor (BDNF) has been shown to be related to motor performance, we explored its role in balance fatigue. Participants: 27 individuals (age= 65.4±8.1; males= 14, females= 13) with neurologist-diagnosed PD. Of the 27, 13 were genotyped for BDNF as Val/Val, 11 as Val/Met, 2 as Met/Met, and one refused genotyping. Methods: Participants were …

Predictors Of Physical Therapy Non-Treatment Among Patients Scheduled For Treatment Two Times A Day In The Acute Hospital, Sara Bookout, Kyle Ozaki

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Consistent participation in physical therapy treatment is the key to the success of any physical therapy treatment program. Scheduled therapy sessions that do not result in treatment (non-treatment) may cause longer hospital stays and/or poor outcomes. A better understanding of the factors affecting non-treatment could allow proper adjustments to prevent non-treatment by hospital administration, improve patient-therapist interaction, and may result in improved care, greater patient satisfaction, and lower healthcare costs. The purpose of this study was to investigate characteristics of patients that affect physical therapy non-treatment events for patients scheduled for therapy twice a day (BID) in …

The Impact Of Visual Impairments On Mobility Performance In Community-Dwelling Older Adults, Lauren Andrew, Talia Davis, Christian Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Falls are a major concern for elderly adults and can have a significant impact on overall health and well-being. Declines in vision with aging may be related to the development of fear of falling (FOF) and impaired mobility. It is possible that impaired vision due to common eye diseases can increase the FOF avoidance behavior and affect mobility function in this population. The purpose of this study was to investigate the relation among visual impairment, mobility performance, and FOF avoidance behavior in older adults. Methods: Inclusion criteria for eligible participants were: 50 years of age and older, …

Gait And Balance In Alzheimer's Disease: A Retrospective Analysis Across Varying Levels Of Cognitive Impairment, Diana Contreras, Jessica Heim, Jun Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: It was once thought that Alzheimer’s disease (AD) affected mostly cognition with minor motor impairment; however, it is becoming apparent that motor impairment may also be a prominent feature. Determining the extent of motor impairments throughout the continuum of cognitive impairment is critical in developing timely interventions for this population. Purpose/Hypothesis: The aim of this study was to gain a greater understanding of motor impairment in AD by exploring the relationships among gait, balance, and falls. Specifically, we explored the association of fall history to measures of cognition and performance-based balance measures in individuals with AD. We hypothesized that …

Disposition And Success Of Patients Following Discharge In The Acute Setting, Ciera Cortney, Kathryn Lutjens, Kristopher Raines

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract: Background & Purpose: Many patients are seen in the hospital by physical therapists who also help decide where the patient will go after discharge (e.g., home, rehab hospital, skilled nursing facility) with the goal being the safest and best quality of life. Therapists may use different tests and measures along with their own professional judgment to help make a recommendation for a discharge location. The purpose of this study was to examine how PT’s recommendation for discharge location, POMA score, “6-clicks” score, age, diagnosis, and gender determine patient’s fall/readmission status after being discharged by hospital. Subjects: There were 113 …

Fine-Wire Intramuscular Insertion To The Lumbar Paraspinal Muscles Does Not Affect Muscle Activation And Performance During High Exertion Spinal Extension Muscle Contractions, James Dimascio, Rebeka Hicks, Matthew Kimber, Kelsey Synder

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Low back pain (LBP) is associated with paraspinal muscle dysfunctions. A method to study the deep lumbar paraspinal muscle activation is with intramuscular electromyography (EMG). However, it is currently unknown how paraspinal muscle performance is affected by the invasive intramuscular insertion and the presence of the fine-wire electrode in the muscle. The purpose of this study was to analyze how insertion of fine-wire EMG into lumbar paraspinal muscle affects the lumbar paraspinal muscle fatigue, endurance, activation, and peak extension torque during high exertion spinal extension exercises. Participants: 20 individuals between the ages of 18-40 participated. The participants …

The Reliability Of The Thoracic Percussion Test, Casey Donaldson, Rey Veloz, Kaylee Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To investigate the reliability of the Thoracic Percussion Test (TPT), which is a quick screening tool used by manual therapists to assess hypomobility in the thoracic spine. Participants: 36 healthy subjects (18-60 years old), with or without back pain, and 10 therapists participated in the study. Six of the therapists with less than 5 years clinical experience were considered “novice” and 4 with at least 20 years experience were considered “expert” therapists. Methods: All participants were divided into a morning and an afternoon group. Both groups consisted of 18 subjects and a mix of novice and expert therapists. All …