Physical Therapy Commons^™

Polypharmacy And Physical Therapy In The Geriatric Population, Cathy A. Reuer

Physical Therapy Scholarly Projects

Physical therapists are seeing more and more elderly individuals with acute, chronic, or multiple disease conditions. Many of these conditions are treated with medications. It is common for the geriatric patient to be taking multiple medications. Polypharmacy is a relevant concern for physical therapists as adverse effects are often revealed in the musculoskeletal and central nervous systems. These manifestations can cause adverse effects in evaluation, treatment, and outcomes.

The purpose of this study is to discuss the common non-prescription and prescription medications consumed by the elderly, describe the biologic and physiologic changes that occur with age and how these changes …

An Overview Of The Prescription Of Orthotics For Abnormal Subtalar Joint Pronation, Kari Rafteseth

Physical Therapy Scholarly Projects

The foot and ankle are a complex set of joints that are susceptible to various types of dysfunction, including abnormal subtalar joint pronation. An option for treatment of this problem that may be used is the prescription of orthotics. An orthotic is used to assist the foot in functioning properly and to prevent damage due to malalignment.

In this literature review, the anatomy and biomechanical function of the subtalar joint are discussed. The structure of the other joints of the foot and ankle are also mentioned. Several etiologies of abnormal pronation are discussed. In addition, changes in structure and function …

Sacroiliac Joint: An Overview, Cheryl Walker

Physical Therapy Scholarly Projects

Low back pain is a common cause of limitation in daily activities. Sacroiliac joint (SIJ) dysfunction is often an overlooked cause of low back pain. The biomechanics of the SIJ is not well understood. There is controversy about how much movement is in the joint, but it is generally agreed that movement does occur. There are six ligaments in the SIJ that add to its stability and no muscles that act directly on the joint. SIJ dysfunction can be caused by direct trauma, indirect trauma, pregnancy, or muscle imbalances. Evaluation of the SIJ should include subjective and objective information. The …

Subtalar Joint Biomechanics, Tom L. Baumgartner

Physical Therapy Scholarly Projects

Subtalar joint movement is transmitted proximally to the lower extremity and distally to the forefoot during gait. Thus, the entire lower kinetic chain is influenced by abnormal subtalar joint biomechanics. If the subtalar joint is forced to compensate for structural deformities of the foot and leg, various lower extremity injuries are likely to develop. The purpose of this study is to examine the normal and abnormal biomechanics of the subtalar joint. In the process, the clinician will be able to identify various subtalar joint abnormalities and relate these to their respective lower kinetic chain pathologies. By correctly assessing the cause …

Physical Therapy Interventions For Falls In The Elderly, Melanie Benson

Physical Therapy Scholarly Projects

The elderly in America represent a population that is continually growing. As part of the aging process, various changes occur that contribute to falls. Therefore, as the number of elderly people in America increases, the possibility of falls in the elderly also increases.

The consequences of falls in the elderly are significant. Some of the more serious consequences include functional decline, increased medical cost, and death. Therefore, the scope of the problem is clear; strategies to prevent falls and treat those who have fallen are indicated.

The purpose of this independent study is to review the literature pertaining to falls …

Functional Electrical Stimulation As A Treatment For Spinal Cord Injuries, Gail Garrett

Physical Therapy Scholarly Projects

Injury of the spinal cord resulting in quadriplegia or paraplegia IS one of the most devastating conditions a person can experience. The majority of these individuals that suffer from a spinal cord injury are young males. The inability to ambulate is generally a major concern for these patients, but there are also degenerative and deconditioning effects of the spinal cord injury which may lead to devastating secondary complications that must be addressed.

Functional electrical stimulation (FES) has been the subject of much research concerning the rehabilitation for patients with spinal cord injury. Functional electrical stimulation is a way to activate …

Shoulder Pain And Subsequent Loss Of Function In Hemiplegic Patients, Kari A. Goetz

Physical Therapy Scholarly Projects

Hemiplegia, caused by a stroke, is one of the most common disorders in which physical therapists are extensively involved in the rehabilitation process. When a stroke occurs, there is damage to the higher centers of the central nervous system resulting in neurologic, unilateral impairment or hemiplegia. The upper extremity is frequently involved and many patients complain of pain, particularly in the shoulder. Etiology and treatment of hemiplegic shoulder pain (HSP) is a challenging symptom that interferes with progressive rehabilitation and the overall quality of life of many patients.

The purpose of this study was to discuss HSP and the subsequent …

Fetal Alcohol Syndrome: Physical Therapy Implications And Treatment Strategies, Mary L. Emerson

Physical Therapy Scholarly Projects

Fetal Alcohol Syndrome (FAS) describes physical and neurological (motor, cognitive, and behavioral) deficits that result from maternal alcohol intake during pregnancy. FAS is the leading cause of mental retardation and birth defects in the U.S., ahead of spina bifida, fragile X syndrome, and down's syndrome. The incidence of FAS increased more than three-fold from 1979 to 1992; this increasing incidence rate, enhances the importance of the Physical Therapists' role in early recognition and intervention of FAS. A review of current F AS research studies, reveals a need for additional resource information on FAS, regarding implications for Physical Therapy and possible …

The Adverse Effects Of Long-Term Corticosteroid Use, Jennifer Ann. Johnston

Physical Therapy Scholarly Projects

Corticosteroids are an often prescribed anti-inflammatory medication. They are used to treat disease processes of every system of the body. Those disease processes or procedures for which corticosteroids are often prescribed are cancer, bone marrow transplants, collagenous diseases (systemic lupus erythematosus), rheumatoid arthritis, leukemia, and anemia.

However, despite the therapeutic benefits of corticosteroids, many adverse effects are possible. Gastrointestinal difficulties, steroid myopathy, hyperglycemia, osteoporosis, impaired cellular immunity, decreased neuropsychological functioning, and avascular necrosis are just a few of the possible adverse effects.

Patients receiving corticosteroids will often be seen by physical therapists for either their primary or secondary diagnoses. Physical …

The Lateral Scapular Slide Test: Is It Valid In Detecting Glenohumeral Impingement Syndrome?, Denise G. Litchfield

Physical Therapy Scholarly Projects

Recent literature has focused on instability of the scapulothoracic joint and on resulting scapular positions. Weakness of the scapular musculature can allow the scapula to slide laterally, leading to abnormal glenohumeral biomechanics and to subsequent shoulder pathology. Kibler1 has described the lateral scapular slide test (LSST) as a method of measuring lateral translation of the scapula. A significant difference between right and left scapular positions, as indicated by a discrepancy of greater than one centimeter side-to-side, may indicate functional scapulothoracic instability. The purpose of this study was to evaluate validity of the LSST, measured in two positions. Modified LSST measurements …

Musicians And Performance Related Injuries To The Hand, Leona Pang

Physical Therapy Scholarly Projects

Musicians spend a great amount of energy and time preparing for auditions, competitions, performances, and recitals. The process of developing techniques and learning musical pieces requires practice sessions filled with long hours of repeating musical passages and awkward upper extremity positions. Performance related injuries often result from these conditions. Injuries include joint disorders, musculotendinous disorders, muscle cramps and pain disorders, neurological disorders, and focal dystonia or occupational palsy disorders. Pain, numbness, tingling, muscle cramping, and motor dysfunctions are associated symptoms. If symptoms are ignored and intense performance is continued, the musician can experience tissue damage and permanent loss of function. …

The Use Of Ergogenic Aids In Athletes, Sheri L. Mounteer

Physical Therapy Scholarly Projects

Ergogenic aids are substances purported to enhance athletic performance or improve exercise capacity. The use of ergogenic aids in sports is very widespread. It is common for a physical therapist working in a sports clinic to have patients that are either considering using or using ergogenic aids. Use of these aids by patients being treated might affect the patients' response to treatment. Therapists should be able to recognize the signs of ergogenic aid abuse in individuals under their care, and they should be aware of the side effects of these aids. It is also important for therapists to be able …

Gait Analysis For The Enhancement Of Aka Gait Patterns, Krista Lausen

Physical Therapy Scholarly Projects

The amputation of a body part is both a physically and psychologically traumatic event for an individual. There are a number of gait deviations that often occur when a person has had a lower extremity amputation, especially when that amputation is above the knee. The entire locomotor mechanism of the body is altered by this change. The person must then adjust ahd relearn how to accommodate for the loss.

This literature review will discuss specific causes of certain gait deviations to determine whether the deviation is due to a musculoskeletal deficit or habit pattern on the part of the patient …

Balance Exercise For Fall Prevention In The Elderly, Lorrina Mcclellan

Physical Therapy Scholarly Projects

Falls are a very common and serious problem in the elderly population. Individuals who fall may suffer from physical trauma, psychological problems, and possible death. In the past, falls were thought to be an unavoidable occurrence that accompanied aging. Research has .recently identified risk factors that may predict those who are at risk for falling. By recognizing and then modifying these risk factors, potential falls may be prevented. Examples of risk factors that occur with aging include visual impairments, vestibular decline, deterioration of muscle strength, decrease in joint flexibility, and the loss of sensation. Natural biological declines may have profound …

The Effects Of Botulinum Toxin Injections On Function In Patients With Spasticity, Leann Pippen

Physical Therapy Scholarly Projects

Spasticity can be one of the most challenging problems for patients with neurologic conditions such as cerebral palsy, spinal cord injuries, cerebrovascular accidents, multiple sclerosis, traumatic brain injuries, etc. It can lead to a wide variety of problems including decreased mobility, decreased quality of movement, interference with normal postural reactions, interference with functional activities, and pressure sores. Therefore, the medical community has focused on effective treatments for spasticity which do not produce overwhelming weakness, spasticity, paralysis, fatigue, and/or muscle atrophy. Since the late 1970's, the use of botulinum toxin (BTX-A) injections to decrease spasticity has been investigated.

The purpose of …

A Review Of Bell's Palsy, Jodi Spicer

Physical Therapy Scholarly Projects

Bell's Palsy is an acute unilateral weakness or paralysis of the facial muscles resulting from peripheral facial nerve dysfunction. Bell's Palsy is the most common cause of unilateral facial weakness. Since idiopathic facial paralysis was first diagnosed, several treatment options have been tried in an effort to influence early and full recovery. The role of physical therapy in the treatment of Bell's Palsy is to exercise the muscle in an attempt to keep the denervated muscle healthy while the injured axons regenerate and reinnervate the muscle. The natural course of Bell's Palsy is a spontaneous return of function in 71 …

A Review Of The Causes And Treatment Of Low Back Pain During Pregnancy, Dana Krenzel

Physical Therapy Scholarly Projects

Pregnancy is a time of great musculoskeletal change for a woman. Complaints of low back pain are a very common occurrence at this time. Many women regard this type of pain as a normal adjunct to pregnancy. However, most types of low back pain related to pregnancy are either treatable or avoidable. Mechanical, hormonal, and vascular factors may all contribute to low back pain. Differentiation of these different causes of low back pain is crucial to providing the patient with effective intervention plans. Physical therapists can provide evaluation, treatment, and low back pain management techniques to the expectant mother. Exercise, …

Meniscal Substitution: A Literature Review, Kerry L. Muir

Physical Therapy Scholarly Projects

With the increased awareness that meniscectomy results in degenerative changes in the knee joint, research is now aimed at substituting the meniscus that had been previously removed. Surgical attempts at replacing the meniscus include the use of autografts, allografts, and artificial synthetic prosthesis.

This paper will review the available literature regarding each type of meniscal substitute. Surgical procedures, results, and considerations relating to the different substitutes will be examined.

While studies indicate that meniscal transplantation is technically feasible, the long-term results are unknown. More research is necessary to determine if meniscal substitutes can survive for a prolonged time and function …

1996 Touro College School Of Health Sciences Yearbook, Touro College School Of Health Sciences

Yearbooks and Newsletters

1996 Touro College School of Health Sciences Yearbook

A Review Of Shoulder Impingement Syndrome, Jodee Backhaus

Physical Therapy Scholarly Projects

Shoulder impingement syndrome (IS) is one of the most common shoulder problems seen today in the orthopaedic clinical setting. Patients exhibit symptoms of pain and discomfort due to pathomechanics of increasing pressure under the acromion. Factors related to IS include degeneration of the rotator cuff, vascular insufficiency of the supraspinatus, glenohumeral instability, muscle imbalances, bursitis, and bony impingement.

Impingement syndrome is most often classified as an overuse syndrome, although it can occur from a traumatic episode such as a blow to the shoulder or a fall. The population most affected are those in occupations that require a high number of …

Rehabilitation Treatment Following Total Shoulder Arthroplasty, Debbie Aarhus

Physical Therapy Scholarly Projects

The shoulder is a very complex joint in the human body and, therefore, is easily injured and/or damaged. When conservative methods (pain reducing modalities, exercise, or medication) to treat the injury fail, an alternative method of treatment could be a total shoulder arthroplasty. Corrective surgery alone, however, is not enough. A rehabilitation program involving range of motion and strengthening exercises is fundamental in the successful return of function at the shoulder.

The purpose of this literature review is to provide an overview of shoulder anatomy, surgical procedures of total shoulder arthroplasty, rehabilitation protocols, and outcomes. The information gained from this …

Isokinetic Ratios Of Concentric And Eccentric Work Production Of Internal And External Rotators In A Simulated Throwing Pattern, Deane M. Chinen

Physical Therapy Scholarly Projects

Shoulder internal and external rotators have been the focus of several isokinetic studies. However, an examination of muscular work in a functional pattern has not been investigated. Therefore, the purpose of this study was twofold: 1) to establish normative ratios of concentric to eccentric work of internal and external shoulder rotators respectively, and 2) to provide information on the balance of strength in shoulder rotators during a simulated throwing pattern.

Twenty-seven subjects without shoulder pathology were tested on the KINCOM isokinetic dynamometer. The statistics for the whole group revealed 55% more concentric internal rotation work in relation to eccentric external …

The Role Of Fascia In The Musculoskeletal System, Lori Folkers

Physical Therapy Scholarly Projects

The function of fascia in the human body is poorly understood. This anatomical structure has not been given the clinical significance it may deserve. The purpose of this literature review is to provide a physiological explanation for physical therapy techniques that manipulate fascia. The review is designed to facilitate an understanding of the role of fascia in the' musculoskeletal system.

Physical therapists may deal with musculoskeletal system pathologies on a daily basis. In order for the therapist to utilize soft-tissue techniques, it is necessary to have a working knowledge of the involved structures. Anatomical material is presented to define the …

An Electromyographic And Goniometric Analysis Of The Lower Extremity During Stair Climbing With And Without The Use Of Ez-Steps® In An Elderly Population, Staci L. Fethkenher

Physical Therapy Scholarly Projects

Purpose: EZ-StepsTM is a device that fits into an existing stairwell which decreases the height, or rise, of each step by half. The purpose of this study was to determine if there is a difference in lower extremity muscle activity and knee joint range of motion (ROM) during stair climbing with and without the use of EZ-StepsTM in an elderly population.

Methods: Eight healthy, elderly (aged 65-89 years) male and female subjects volunteered for the study. Surface electromyography (sEMG) was used to assess muscle activity in four lower extremity muscles during stair climbing standard steps and steps installed with EZ-StepsTM. …

Crossing The Language Barrier In Physical Therapy Practice, Nancy Ann Feist

Physical Therapy Scholarly Projects

Physical therapists provide health care services to a diverse range of patient populations. Members of these populations may differ in language or culture from the therapists who treat them. If a language barrier is present, vital communication is lost, and there is interference with the implementation of effective physical therapy.

Options in overcoming language barriers include a language assistance department, a bilingual staff directory, a telephone interpreter service, and an outside interpreter. Limitations of these options exist that can lead to ineffective treatment.

This project makes one further option available. This option is translated written material and audiotapes. This project …

Nutrition In Rehabilitation, John D. Jr. Haywood

Physical Therapy Scholarly Projects

Diet has been implicated as a risk factor in atherosclerotic cardiovascular diseases, cancer, diabetes, osteoporosis, obesity, high blood pressure and chronic liver and kidney diseases. These diseases include almost all of the most common non-traumatic causes of death in the United States. It has been suggested that many physicians do not have the opportunity for specific training in nutrition while in medical school. Many studies have shown that patients admitted to a hospital are at risk of malnutrition and that this risk will increase as length of hospital stay increases. Other studies suggested nutritional deficiencies may result in delayed wound …

Nurses' Perceptions Of The Profession Of Physical Therapy In The Inpatient Setting, Sharon Vanmullekom, Joanne Childs

Masters Theses

The purpose of this study was to investigate the interprofessional relationship that exists between nurses (RNs) and physical therapists (PTs) as perceived by RNs in the inpatient setting. A questionnaire, the Interprofessional Perception Scale, (Ducanis & Golin 1978) was modified and sent to 230 day shift nurses who have contact with PTs at four West Michigan hospitals. Forty-five percent of the surveys were returned. RNs responded to the following questions regarding the nursing and physical therapy professions: how would you answer; how would PTs answer, and how would PTs say that you answered, for 15 interprofessional issues. Differences between how …

Knowledge, Utilization, And Favorability Of Commonly Referring Michigan Physicians Regarding Physical Therapy, Jill M. Cabanilla, Sandra J. Frantz

Masters Theses

The purpose of this study was to assess commonly referring Michigan physicians' knowledge of physical therapy, and its impact on favorability toward, and utilization of, its services. Three hundred questionnaires were sent to physicians of orthopedics, neurology, pediatrics, physical medicine & rehabilitation, and general practice. The usable return rate was 22 percent. Technical, professional, and overall knowledge scores, as well as utilization patterns were compared across medical specialty, practice location, and years of experience. The mean overall knowledge score was 63% with orthopedic physicians scoring the highest at 77 percent. Physicians demonstrated higher knowledge of "professional" PT procedures over "technical" …

The Effects Of Exercise Training On Functional Balance In A Community-Dwelling Elderly Population, Kathryn E. Smith

Masters Theses

The objective of this study was to determine the effectiveness of aerobic exercise training to improve balance in healthy adults over age 65. Twenty-five habitual exercisers (mean age 75.3 yrs.) and 25 control subjects (mean age 72.8 yrs.) were recruited from a senior day center. Balance was measured by the functional reach test. A two-sample t-test revealed no significantly higher difference in the mean balance score of the exercise group compared to the control group. Regression analysis indicated that none of the other variables collected (age, group, or level of fitness) were significant predictors of the functional reach scores. There …

Use Of Alternative Approaches By Physical Therapists In Michigan, Karen E. Huber, Brian W. Scherff

Masters Theses

The purpose of this research was to determine the prevalence of use of alternative treatments by physical therapists in Michigan, what approaches are used most often and if use of alternative techniques is associated with practice characteristics. A questionnaire listing 20 treatment techniques which met the operational definition of alternative was mailed to a random sample of 300 licensed physical therapists in Michigan. Number of modalities used, frequency of use for each alternative treatment, average caseload treated, and relationships between modality use and characteristic of practitioners were determined. Results showed 83% of respondents use one or more alternative modalities; 39% …