Physical Therapy Commons^™

Optimizing Physical Therapy Sessions Among Patients Undergoing Elective Lumbar Surgery, Ellina Hattar, Md, Kelly Hufford, Dpt, Marie Wilson, Rn, James Harrop

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

Physical therapy is imperative in achieving early mobilization, thereby reducing morbidity of immobility such as venous thrombolic events, improving postoperative pain, and facilitating appropriate disposition among patients who have recently undergone spine surgery. At TJUH, patients undergoing elective spine surgery are planned to engage in physical therapy (PT) twice a day. There are however several impediments that may limit the ability of patients to adequately participate in PT.

Inertial Sensor-Based Variables Are Indicators Of Frailty And Adverse Post-Operative Outcomes In Cardiovascular Disease Patients, Rahul Soangra, Thurmon E. Lockhart

Physical Therapy Faculty Articles and Research

Cardiovascular disease (CVD) patients with intrinsic cardiac cause for falling have been found to be frail and submissive to morbidity and mortality as post-operative outcomes. In these older CVD patients, gait speed is conjectured by the Society of Thoracic Surgeons (STS) as an independent predictor of post-operative morbidity and mortality. However, this guideline by STS has not been studied adequately with a large sample size; rather it is based largely on expert opinions of cardiac surgeons and researchers. Although one’s gait speed is not completely associated with one’s risk of falls, gait speed is a quick robust measure to classify …

Locomotor Adjustments During Stair Ascent In Children With Down Syndrome: Comparison Between Walking And Crawling Strategies, Huaqing Liang, Jianhua Wu

Physical Therapy Faculty Research

Stair negotiation provides an important yet different paradigm to study environment navigation. As one has constantly move himself up while adjusting step length and foot placement due to the stair constraints, this paradigm is ideal to study motor strategy and adaptation in children with and without disabilities. Down syndrome (DS) is the most common genetic condition and causes significant delays in motor and cognitive development. Children with DS show poor postural control and less efficient gait patterns. When negotiating obstacles, they often select a more conservative strategy (i.e. crawling instead of walking). This study aimed to examine motor strategy and …

Characterizing The Recovery Trajectories Of Knee Range Of Motion For One Year After Total Knee Replacement, Saurabh Mehta, Andrew Rigney, Kyle Webb, Jacob Wesney, Paul W. Stratford, Franklin D. Shuler, Ali Oliashirazi

Physical Therapy Faculty Research

DESIGN: Retrospective analysis of routinely collected clinical data.

OBJECTIVE: This study modeled the recovery in knee flexion and extension range of motion (ROM) over 1 year after total knee replacement (TKR).

BACKGROUND: Recovery after TKR has been characterized for self-reported pain and functional status. Literature describing target knee ROM at different follow-up periods after TKR is scarce.

METHODS: Data were extracted for patients who had undergone TKR at a tertiary care hospital at 2, 8, 12, 26, and 52 weeks after TKR. A linear mixed-effects growth model was constructed that investigated the following covariates age, sex, pre-TKR range, body mass …

Transitioning From Level Surface To Stairs In Children With And Without Down Syndrome: Locomotor Adjustments During Stair Ascent, Huaqing Liang, Xiang Ke, Jianjia Wu

Physical Therapy Faculty Research

Background: Children with Down syndrome (DS) often show underdeveloped motor ability and adaptation. Stair ascent is a common task to examine locomotor function and external ankle load is often used to perturb the stability of a system and observe the emergence of new patterns.

Research question: How do stair height and external ankle load affect locomotor adjustments in 5-to-11-year-old children with typical development (TD) and with DS during stair ascent?

Methods: Fourteen children with DS and 14 age- and sex-matched children with TD participated in this study. They walked along a 5-m walkway and ascended 3-step staircases of different heights …

Preseason Functional Test Scores Are Associated With Future Sports Injury In Female Collegiate Athletes, Jason Brumitt, Bryan C. Heiderscheit, Robert C. Manske, Paul E. Niemuth, Alma Mattocks, Mitchell J. Rauh

Faculty Publications - College of Physical Therapy

Brumitt, J, Heiderscheit, B, Manske, R, Niemuth, PE, Mattocks, A, and Rauh, MJ. Preseason functional test scores are associated with future sports injury in female collegiate athletes. J Strength Cond Res 32(6): 1692–1701, 2018—Recent prospective cohort studies have reported preseason functional performance test (FPT) measures and associations with future risk of injury; however, the findings associated with these studies have been equivocal. The purpose of this study was to determine the ability of a battery of FPTs as a preseason screening tool to identify female Division III (D III) collegiate athletes who may be at risk for a noncontact time-loss …

Effect Of Adding Stretching Techniques To Standardized Intervention On Nonspecific Mechanical Neck Pain, Saad S. Alfawaz

Loma Linda University Electronic Theses, Dissertations & Projects

Mechanical neck pain is becoming one of the leading causes of musculoskeletal disorders in the general adult population. Mobilization intervention is considered one of the most effective therapeutic techniques to treat non-specific neck pain. The purpose of this study was to investigate the benefit of adding stretching exercises as part of a rehabilitation program for patients with non-specific mechanical neck pain. Methods: Thirty-eight subjects with non-specific neck pain for at least 2 weeks with mean± SD age 30.9±8.1 years and body mass index (BMI) 26.8±6.7 kg/m2 participated in the study. Participants were randomly assigned to either the combined intervention (passive …

Preseason Lower Extremity Functional Test Scores Are Not Associated With Lower Quadrant Injury - A Validation Study With Normative Data On 395 Division Iii Athletes, Jason Brumitt, Victor Wilson, Natalie Ellis, Jordan Petersen, Christopher John Zita, Jordan Reyes

Faculty Publications - College of Physical Therapy

Background: Preseason performance on the lower extremity functional test (LEFT), a timed series of agility drills, has been previously reported to be associated with future risk of lower quadrant (LQ = low back and lower extremities) injury in Division III (D III) athletes.Validation studies are warranted to confirm or refute initial findings.

Hypothesis/Purpose: The primary purpose of this study was to examine the ability of the LEFT to discriminate injury occurrence in D III athletes, in order to validate or refute prior findings. It was hypothesized that female and male D III athletes slower at completion of the LEFT would …

Investigating The Effects Of Trans-Spinal Direct Current Stimulation On The Expression Of Nkcc1 In Mice, Pasindu Weliwaththage

Student Theses

Trans-spinal direct current stimulation (tsDCS) is a non-invasive powerful tool demonstrated to positively affect behavior and motor function. tsDCS is a neuromodulatory technique capable of altering spinal and cortical excitability and even regain motor function after complete motor paralysis (Cortes et at, 2017). tsDCS causes immediate and long-term effects in spinal excitability (Ahmed, 2011, 2013; Ahmed and Wieraszko, 2012; Cogiamanian et al., 2011, 2012). Studies have been conducted on both healthy and injured subjects. The ultimate goal is to ameliorate the devastating effects of Spinal Cord Injury. Though researchers have been successful in improving motor function, the molecular basis of …

Dynamical Properties Of Postural Control In Obese Community-Dwelling Older Adults, Christopher W. Frames, Rahul Soangra, Thurmon Lockhart, John Lach, Dong Sam Ha, Karen A. Roberto, Abraham Lieberman

Physical Therapy Faculty Articles and Research

Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m2, using a force plate and an inertial measurement unit affixed at the sternum. Participants’ fall history was recorded over 2 years and participants with at least …

Determining Success Or Failure After Foot And Ankle Surgery Using Patient Acceptable Symptom State (Pass) And Patient Reported Outcome Information System (Promis), Michael R. Anderson, Judith F. Baumhauer, Benedict F. Digiovanni, Sam Flemister, John P. Ketz, Irvin Oh, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: As the role of generic patient-reported outcomes (PROs) expands, important questions remain about their interpretation. In particular, how the Patient Reported Outcome Measurement Instrumentation System (PROMIS) t score values correlate with the patients’ perception of success or failure (S/F) of their surgery is unknown. The purposes of this study were to characterize the association of PROMIS t scores, the patients’ perception of their symptoms (patient acceptable symptom state [PASS]), and determination of S/F after surgery.

Methods: This retrospective cohort study contacted patients after the 4 most common foot and ankle surgeries at a tertiary academic medical center (n = …

Insertion And Presence Of Fine-Wire Intramuscular Electrodes To The Lumbar Paraspinal Muscles Do Not Affect Muscle Performance And Activation During Highexertion Spinal Extension Activities, Szu-Ping Lee, Jo Armour Smith, Matthew Kimber, Kelsey Houk

Physical Therapy Faculty Articles and Research

Background

Low back pain (LBP) is commonly associated with paraspinal muscle dysfunctions. A method to study deep lumbar paraspinal (i.e. multifidus) muscle function and neuromuscular activation pattern is intramuscular electromyography (EMG). Previous studies have shown that the procedure does not significantly impact muscle function during activities involving low-level muscle contractions. However, it is currently unknown how muscular function and activation are affected during high-exertion contractions.

Objective

To examine the effects of insertion and presence of fine-wire EMG electrodes in the lumbar multifidus on muscle strength, endurance, and activation profiles during high-exertion spinal extension muscle contractions.

Design

Single-blinded, repeated measures intervention …

Ua61/16 Pre-Commencement Hooding & Awards Ceremony, Wku Physical Therapy

WKU Administration Documents

Pre-commencement program for Physical Therapy students.

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 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: …

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 …

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 …

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 …

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 …

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 …

Effects Of Two High-Frequency Physical Therapy Programs On Balance, Gait, Fatigue, And Quality Of Life In People With Multiple Sclerosis, Min Liu

Theses & Dissertations

Multiple sclerosis (MS) is an inflammatory disease involving the inflammation and demyelination in both brain and spinal cord. MS typically affects people in early adulthood in the range of 20-40 years old, and most patients with MS experience symptoms on a daily basis, such as walking difficulties, balance impairment, and fatigue, which can be disabling and impact the Quality of Life (QOL).

The main purpose of this investigation is to determine if our novel, adaptive, high-frequency physical therapy protocol, compared with the conventional therapeutic exercise protocol, has the potential to improve participants’ dynamic balance, gait, fatigue, and overall QOL based …

Ua61/16 White Coat Ceremony Program, Wku Physical Therapy

WKU Administration Documents

White coat ceremony program for WKU Physical Therapy class of 2018.

Type-2 Diabetes Mellitus Reduces Cortical Thickness And Decreases Oxidative Metabolism In Sensorimotor Regions After Stroke., Jennifer K Ferris, Sue Peters, Katlyn E Brown, Katherine Tourigny, Lara A Boyd

Physical Therapy Publications

Individuals with type-2 diabetes mellitus experience poor motor outcomes after ischemic stroke. Recent research suggests that type-2 diabetes adversely impacts neuronal integrity and function, yet little work has considered how these neuronal changes affect sensorimotor outcomes after stroke. Here, we considered how type-2 diabetes impacted the structural and metabolic function of the sensorimotor cortex after stroke using volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). We hypothesized that the combination of chronic stroke and type-2 diabetes would negatively impact the integrity of sensorimotor cortex as compared to individuals with chronic stroke alone. Compared to stroke alone, individuals with …

Trunk Motion Visual Feedback During Walking Improves Dynamic Balance In Older Adults: Assessor Blinded Randomized Controlled Trial., Eric Anson, Lei Ma, Tippawan Meetam, Elizabeth Thompson, Roshita Rathore, Victoria Dean, John Jeka

Department of Physical Therapy Faculty Papers

BACKGROUND: Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes.

RESEARCH QUESTION: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems.

METHODS: 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks …

Normative Percent Differences Between Inter-Day And Inter-Limb Upper Extremity Volume In Healthy Adult Females, Lauren Canady, Emily Henry, Mollie Mccormick, Gabrielle Whisler

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Current diagnostic thresholds vary, but a 5% volume difference between limbs is generally accepted to diagnose lymphedema. Newer research among women with breast cancer-related lymphedema established a 3% threshold for diagnosis of preclinical lymphedema. Understanding normal limb volume fluctuations and side to side differences is important to determine whether this 3% cut point for diagnosis of subclinical lymphedema should be made compared to same or contralateral limbs.

The Effects Of An 8 Vs. 16 Week Yoga Practice On Balance, Strength, Flexibility, And Mindfulness In Children Ages 4-10 Years: A Pilot Study, Betsy Donahoe-Fillmore, Samantha Brown, Katherine Chu, Kelly Clancy, Jordan Mcmillan, Lesley Park, Kari Shank, Safiyeh Shalash

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Yoga has been shown to have positive benefits in: Improving cardiovascular, neuromuscular, musculoskeletal, and pulmonary function in ages 0-21 years and improving mindfulness to manage pain and anxiety in adults. There is limited evidence regarding the use of yoga to improve balance, strength, flexibility, and mindfulness in children ages 4-10 years.

Using The Classification And Regression Tree Analysis In Determining The Relationship Between Functional Movement Assessment, Clinical Measures, And Injury In Nba Players, Philip A. Anloague, Matt Gundlach, Andrew Hackney, Jacob Hoying, Meg Saunders

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Musculoskeletal pathology has been linked to games missed in the NBA due to player injury. Sports medicine professionals utilize functional assessments and clinical measures in order to minimize injury risk and maximize performance. The investigation of interactions among non-linear factors may help further the understanding of the interdependence of various measures and missed games due to injury.