Physical Therapy Commons^™

Non-Invasive Brain Stimulation Techniques For Chronic Pain, Neil E. O'Connell, Louise Marston, Sally Spencer, Lorraine H. Desouza, Benedict M. Wand

Physiotherapy Papers and Journal Articles

Stimulating the brain without surgery in the management of chronic pain in adults

Bottom line: There is a lack of high-quality evidence to support or refute the effectiveness of non-invasive brain stimulation techniques for chronic pain.

Background: Electrical stimulation of the brain has been used to address a variety of painful conditions. Various devices are available that can electrically stimulate the brain without the need for surgery or any invasive treatment. There are five main treatment types: repetitive transcranial magnetic stimulation (rTMS) in which the brain is stimulated by a coil applied to the scalp, cranial electrotherapy stimulation (CES) in …

Is Heavy Eccentric Calf Training Superior To Wait-And-See, Sham Rehabilitation, Traditional Physiotherapy And Other Exercise Interventions For Pain And Function In Mid-Portion Achilles Tendinopathy?, Myles Murphy, Mervyn Travers, William Gibson

Physiotherapy Papers and Journal Articles

Background: Mid-portion Achilles tendinopathy (AT) is prevalent amongst athletic and non-athletic populations with pain, stiffness and impaired function typically reported. While different management options exist, loading protocols remain the best available intervention and have been shown to be effective in the management of AT. Trials investigating loading in AT have used a variety of different protocols, and recent narrative reviews suggest that no protocol is superior to another when comparing outcomes in pain and function. However, there has been no systematic review or meta-analysis completed to determine this. Furthermore, the narrative review did not consider wait-and-see or sham interventions, thus …

An Objective Measure For The Assessment And Management Of Fluid Shifts In Acute Major Burns, Pippa Kenworthy, Michael Phillips, Tiffany L. Grisbrook, William Gibson, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat™ on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns.

Methods: An observational longitudinal cohort study was conducted from December 2014 …

Critically Appraised Paper: Preoperative Physiotherapy Education Halved Postoperative Pulmonary Complications In Patients After Upper Abdominal Surgery [Commentary], Shane Patman

Physiotherapy Papers and Journal Articles

No abstract available for this paper.

Reducing Falls In Older Adults Recently Discharged From Hospital: A Systematic Review And Meta-Analysis, Chiara Naseri, Terry P. Haines, Christopher Etherton-Beer, Steven Mcphail, Meg E. Morris, Leon Flicker, Julie Netto, Jacqueline Francis-Coad, Den-Ching A. Lee, Ronald Shorr, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background: Older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital.

Methods: Literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager®

Results: Sixteen studies (total sample size N= 3,290, from …

Evaluation Of Older People's Knowledge, Awareness, Motivation And Perceptions About Falls And Falls Prevention In Residential Aged Care Homes: A Tale Of Two Cities, Jacqueline Francis-Coad, Tessa Watts, Christopher Etherton-Beer, Gerwyn Panes, Howard Griffiths, Michelle Anderson, Tracy Williams, Beth Griffiths, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Falls prevention strategies can only be effective in reducing falls amongst older people if they are adopted and enacted in their daily lives. There is limited evidence identifying what older people in residential aged care (RAC) homes understand about falls and falls prevention, or what may limit or enable their adoption of strategies. This study was conducted in two countries and explored older people’s knowledge and awareness of falls and their preferences, opportunities and motivation to undertake falls prevention strategies. A cross-sectional survey was administered to participants (N = 70) aged 65 years and over, living in six RAC homes …

Impact Of Tailored Falls Prevention Education For Older Adults At Hospital Discharge On Engagement In Falls Prevention Strategies Postdischarge: Protocol For A Process Evaluation, Chiara Naseri, Steven M. Mcphail, Julie Netto, Terrence P. Haines, Meg E. Morris, Christopher Etherton-Beer, Leon Flicker, Den-Ching A. Lee, Jacqueline Francis-Coad, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Introduction: Older adults recently discharged from hospital have greater incidence of adverse events, functional decline, falls and subsequent readmission. Providing education to hospitalised patients on how to prevent falls at home could reduce postdischarge falls. There has been limited research investigating how older adults respond to tailored falls prevention education provided at hospital discharge. The aim of this study is to evaluate how providing tailored falls prevention education to older patients at the point of, and immediately after hospital discharge in addition to usual care, affects engagement in falls prevention strategies in the 6-months postdischarge period, including their capability and …

The Translation, Validity And Reliability Of The German Version Of The Fremantle Back Awareness Questionnaire, Katja Ehrenbrusthoff, Cormac G. Ryan, Christian Gruneberg, Benedict Wand, Denis J. Martin

Physiotherapy Papers and Journal Articles

Background: The Fremantle Back Awareness Questionnaire (FreBAQ) claims to assess disrupted self-perception of the back. The aim of this study was to develop a German version of the Fre-BAQ (FreBAQ-G) and assess its test-retest reliability, its known-groups validity and its convergent validity with another purported measure of back perception.

Methods: The FreBaQ-G was translated following international guidelines for the transcultural adaptation of questionnaires. Thirty-five patients with non-specific CLBP and 48 healthy participants were recruited. Assessor one administered the FreBAQ-G to each patient with CLBP on two separate days to quantify intra-observer reliability. Assessor two administered the FreBaQ-G to each patient …

Mental Wellbeing In Non-Ambulant Youth With Neuromuscular Disorders: What Makes The Difference?, Vivienne Travlos, Jenny Downs, Andrew Wilson, Dana Hince, Shane Patman

Physiotherapy Papers and Journal Articles

The physical and social challenges associated with neuromuscular disorders may impact mental wellbeing in non-ambulant youth during the more vulnerable period of adolescence. This cross-sectional survey investigated non-ambulant youths’ mental wellbeing and relationships with physical health, participation and social factors. The conceptual model was the International Classification of Functioning, Disability and Health (ICF). Thirty-seven youth aged 13 – 22 years old (mean age 17.4 years; n = 30 male; n = 24 Duchenne Muscular Dystrophy) and their parents provided biopsychosocial data through a comprehensive self-report questionnaire. The primary outcome measure was the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). Relationships between …

8890: Athletic Training Student Application Of Patient-Centered Care During Clinical Education: A Report From The Athletic Training Clinical Education Network, J. M. Cavallario, C. E. Welch Bacon, S. E. Walker, R. C. Bay, B. L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Patient-centered care (PCC) is the most frequently implemented core competency by students in health care education programs, and is more likely to be included when students and preceptors are jointly treating patients during clinical education. However, past research has examined only self-identification of implementation, not the inclusion of components of the competency during patient encounters (PEs).

Objective: To assess whether athletic training students (ATSs) are integrating concepts of PCC during PEs as a part of their clinical education experiences.

Design: Multisite, panel design.

Setting: Three Commission on Accreditation of Athletic Training Education-accredited professional athletic training programs (2 baccalaureate, 1 …

Assessment Of Medical Screening And Clinical Reasoning Skills By Physical Therapy Students In A Simulated Patient Encounter, Therese E. Johnston

Internet Journal of Allied Health Sciences and Practice

Purpose: Physical therapists (PTs) screen their patients for medical issues that may present as musculoskeletal conditions. In physical therapy education, learning activities followed by assessment of skills and clinical reasoning is important. The purposes of this study are to 1) demonstrate the feasibility of the use of standardized patients (SPs) and standardized physicians (SPhs) during a practical examination focused on medical screening, and 2) report outcomes related to the students’ abilities to screen for medical issues and make clinical decisions about referral to a physician.

Methods: Students evaluated a standardized patient in an outpatient setting model. After receiving …

The Effect Of Yoga In Reducing Pain Related To Arthritis: An Integrative Review Of The Literature, Meredith Collins, Corinne Reed

Williams Honors College, Honors Research Projects

Research shows that arthritis is the most common cause of disability in the United States (Middleton et al., 2013). The PICOT question for this systematic review of literature is “In adults over the age of 40 years, how do yoga interventions, compared to pharmacological pain relief methods alone, affect arthritic pain intensity and frequency?” This systematic review will discuss the possible benefits of using yoga as treatment for both rheumatoid arthritis and osteoarthritis. The methods for this review included a comprehensive search yielding nineteen credible studies using the databases Search-A-Roo, Google Scholar, and CINAHL Plus for full-text academic journal articles …

The Effect Of Foot Strike In Female Runners, Courtney Dockry

Williams Honors College, Honors Research Projects

Abstract

PURPOSE: The purpose of this study is to determine if heel and forefoot striking influence on the amount and type of injuries in recreational female distance runners between the ages of 18 and 25. In addition, shoe type and training intensity were analyzed in relation to injury. METHODS: A quantitative, cross-sectional study was conducted anonymously utilizing The University of Akron’s Qualtrics survey tool. The survey was adopted based on Goss and Gross (2012). The survey was sent via email to members of the Zips Running Club, as well as other runners who fit the criteria to participate …

Clinical Reasoning In Physical Therapy: A Concept Analysis, Karen Huhn, Sarah J. Gilliland, Lisa L. Black, Susan F. Wainwright, Nicole Christensen

Physical Therapy Faculty Articles and Research

Background

Physical Therapy, along with most health professions, struggles to describe clinical reasoning, despite it being a vital skill in effective patient care. This lack of a unified conceptualization of clinical reasoning leads to variable and inconsistent teaching, assessment, and research.

Objective

The objective was to conceptualize a broad description of physical therapists’ clinical reasoning grounded in the published literature and to unify our understanding for future work related to teaching, assessment, and research.

Design/Methods

The design included a systematic concept analysis using Rodgers’ Evolutionary methodology. A concept analysis is a research methodology in which a concept's …

National Survey Of Lymphedema Therapists’ Dosing Of Complete Decongestive Therapy In Breast Cancer Survivors With Lymphedema, Katie M. Polo, Peter J. Rundquist, Nathaniel D. Krumdick, Gail L. Gamble

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to identify dosing levels of complete decongestive therapy (CDT) with survivors with Breast Cancer-Related Lymphedema (BCRL) and describe factors related to how occupational therapists, occupational therapy assistants, physical therapists, and physical therapists assistants with advanced lymphedema training determine dosing.

Methods: An electronic survey was sent to 598 occupational therapists, occupational therapy assistants, physical therapists, and physical therapists assistants with training in lymphedema. Respondents completed questions regarding demographics, dosing practices, and factors related to dose determination in complete decongestive therapy of survivors with Breast Cancer-Related Lymphedema.

Results: 107 surveys were returned (18% response rate). …

Differences In Walking Mechanics Between A Traditional Walker And The Kb Balance Trainer, Silvia Zanini

Electronic Theses and Dissertations

INTRODUCTION: Millions of individuals with ambulatory difficulties rely on walking aids to maintain independence and mobility. However, users of traditional walkers typically exhibit increased forward lean of their trunk while using the assistive device. The KB Balance Trainer is a new posterior walker designed to facilitate a more erect position during gait. PURPOSE: To compare gait mechanics across three walking conditions: unassisted, using a traditional walker, and using the KB Balance Trainer. METHODS: Seven adults with experience using walkers due to ambulatory difficulties participated in the study. The study consisted of one training session and one gait analysis session. The …

Trunk Postural Balance And Low Back Pain: Reliability And Relationship With Clinical Changes Following A Lumbar Stabilization Exercise Program, Ali Shahvarpour, Dany H. Gagnon, Richard Preuss, Sharon M. Henry, Christian Larivière

Études primaires

Lumbar stabilization programs reduce pain and disability, but the mechanisms of action underlying this treatment are unknown. Trunk postural control during unstable sitting represents a surrogate measure of motor control mechanisms involved to maintain the dynamic stability of the spine. This exploratory study aimed to determine the reliability of trunk postural control measures over an 8-week interval, their sensitivity to low back pain status and treatment and their relationship with clinical outcomes. Trunk postural control measures were determined in patients with low back pain before and after an 8-week lumbar stabilization exercise program. Healthy controls were assessed over the same …

Personality Oriented Job Analysis To Identify Non-Cognitive Factors For A Doctor Of Physical Therapy Program In The United States, Maureen A. Conard, Kristin Schweizer

Psychology Faculty Publications

It aimed to conduct a personality oriented job analysis to identify non-cognitive factors that may predict successful performance or performance difficulties in doctorate in physical therapy (DPT) students. The study employed focus groups and a survey with 9 DPT subject matter experts. Focus group participants including 3 DPT faculty members and 4 recent graduates of the DPT program identified 22 non-cognitive factors. Out of them, 15 factors were possibly associated with successful performance and 7 factors were possibly associated with performance difficulties. The questionnaire employing the Combination Job Analysis Method resulted in 12 factors which could be used in selection, …

Student And Faculty Perceptions Of Live Synchronous Distance Education For Allied Health Students Following Program Expansion To A Rural Campus, Betsy J. Becker, Kelsey Rutt, Allyson Huntley, Harlan Sayles, Kim Michael

Internet Journal of Allied Health Sciences and Practice

Background & Purpose: Distance education (DE) is a means to meet allied health workforce needs in rural locations where healthcare worker shortages are apparent. Five allied health programs were expanded to a rural campus teaching synchronously using distance education technology. The purpose of this convergent parallel mixed methods study was to explore perceptions of allied health students and faculty at two campus locations.

Methods: Quantitative and qualitative information were collected through a survey of students and faculty (physical therapy, physician assistant, and medical imaging [diagnostic medical sonography, radiography, magnetic resonance imaging] programs). Both campuses served as live and distance sites …

Effects Of Motion Segment Simulation And Joint Positioning On Spinal Loads In Trunk Musculoskeletal Models, F. Ghezelbash, A. H. Eskandari, A. Shirazi-Adl, N. Arjmand, Z. El Ouaaid, A. Plamondon

Études primaires

Musculoskeletal models represent spinal motion segments by spherical joints/beams with linear/nonlinear properties placed at various locations. We investigated the fidelity of these simplified models (i.e., spherical joints with/without rotational springs and beams considering nonlinear/linear properties) in predicting kinematics of the ligamentous spine in comparison with a detailed finite element (FE) model while considering various anterior-posterior joint placements. Using the simplified models with different joint offsets in a subject-specific musculoskeletal model, we computed local spinal forces during forward flexion and compared results with intradiscal pressure measurements. In comparison to the detailed FE model, linearized beam and spherical joint models failed to …

The Effect Of Wearing A Lumbar Belt On Biomechanical And Psychological Outcomes Related To Maximal Flexion-Extension Motion And Manual Material Handling, Ali Shahvarpour, Richard Preuss, Michael J.L. Sullivan, Alessia Negrini, Christian Larivière

Études primaires

Workers with low back pain (LBP) may benefit from wearing a lumbar belt (LB), but the biomechanical and psychological mechanisms involved are not fully understood. Two types of flexible LB (extensible and non-extensible) were compared to a control condition (no LB) regarding pain-related (pain, fear of pain and catastrophizing) and biomechanical (range of motion – ROM) outcomes related to two tasks: maximal trunk flexion-extension and manual material handling. Healthy controls and participants with LBP were tested. During both tasks, the two LBs reduced the lumbar ROM in participants with LBP in the same way as healthy controls. This was observed …

The Effects Of An 8-Week Stabilization Exercise Program On Lumbar Multifidus Muscle Thickness And Activation As Measured With Ultrasound Imaging In Patients With Low Back Pain: An Exploratory Study, Christian Larivière, Dany H. Gagnon, Sharon M. Henry, Richard Preuss, Jean-Pierre Dumas

Études primaires

Background

Lumbar stabilization exercise programs (LSEP) produce positive effects on clinical outcomes, but the underlying mechanisms remain relatively unexplored. Psychological and neuromuscular mechanisms can be involved, such as a better activation of the lumbar multifidus, which represents one possibility.

Objectives

To determine the following: (1) the effect of an LSEP on lumbar multifidus muscle thickness and activation, as measured with rehabilitative ultrasound imaging (RUSI), in patients with low back pain (LBP); (2) the correlation between RUSI measures and any change in clinical outcomes following the LSEP; and (3) the reliability of RUSI measures in control subjects over 8 weeks.

Design …

Trunk Musculoskeletal Response In Maximum Voluntary Exertions: A Combined Measurement-Modeling Investigation, F. Ghezelbash, Z. El Ouaaid, A. Shirazi-Adl, A. Plamondon, N. Arjmand

Études primaires

Maximum voluntary exertion (MVE) tasks quantify trunk strength and maximal muscle electromyography (EMG) activities with both clinical and biomechanical implications. The aims here are to evaluate the performance of an existing trunk musculoskeletal model, estimate maximum muscle stresses and spinal forces, and explore likely differences between males and females in maximum voluntary exertions. We, therefore, measured trunk strength and EMG activities of 19 healthy right-handed subjects (9 females and 10 males) in flexion, extension, lateral and axial directions. MVEs for all subjects were then simulated in a subject-specific trunk musculoskeletal model, and estimated muscle activities were compared with EMGs. Analysis …

Trunk Postural Adjustments: Medium-Term Reliability And Correlation With Changes Of Clinical Outcomes Following An 8-Week Lumbar Stabilization Exercise Program, Jean-Alexandre Boucher, Richard Preuss, Sharon M. Henry, Marilee Nugent, Christian Larivière

Études primaires

Background

Low back pain (LBP) has been previously associated with delayed anticipatory postural adjustments (APAs) determined by trunk muscle activation. Lumbar stabilization exercise programs (LSEP) for patients with LBP may restore the trunk neuromuscular control of the lumbar spine, and normalize APAs. This exploratory study aimed at testing the reliability of EMG and kinematics-based postural adjustment measures over an 8-week interval, assessing their sensitivity to LBP status and treatment and examining their relationship with clinical outcomes.

Methods

Muscle activation of 10 trunk muscles, using surface electromyography (EMG), and lumbar angular kinematics were recorded during a rapid arm-raising/lowering task. Patients with …

Power Mobility Sensor Data Collection Verified Through Standardized Pediatric Assessments, Ayshka Elise Rodriguez-Velez

UNF Graduate Theses and Dissertations

The collaboration between the School of Engineering and the Department of Physical Therapy at the University of North Florida has introduced the possibility of creating a new environment for pediatric physical therapy assessments. There are currently no methods for remotely monitoring children with impairments. However, with embedded sensor technology in the form of power mobility and accepted therapy assessment tools, remote monitoring can become a possibility. As a part of this work, a ride-on toy car was developed as a remote monitoring device and a case study with a child with a mobility impairment was used as a proof of …

Preseason Functional Performance Test Measures Are Associated With Injury In Female College Volleyball Players, Jason Brumitt, Alma Mattocks, Jeremy Loew, Phil Lentz

Faculty Publications - College of Physical Therapy

Context: Preseason functional performance test measures have been associated with noncontact time-loss injury in some athletic populations. However, findings have been equivocal with many studies consisting of heterogeneous populations. Objective: To determine if preseason standing long jump and/or single-leg hop test scores are associated with a noncontact time-loss injury to the lower quadrant (LQ = low back or lower-extremities) in female Division III college volleyball (VB) players. Design: Prospective cohort study. Setting: National Collegiate Athletic Association Division III female VB teams. Patients: A total of 82 female college VB players (age = 18.9 [1.0] y). Main Outcome Measures: Standing long …

Validation And Generalizability Of Preoperative Promis Scores To Predict Postoperative Success In Foot And Ankle Patients, Michael R. Anderson, Jeff Houck, Charles L. Saltzman, Man Hung, Florian Nickisch, Alexej Barg, Timothy Beals, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: A recent publication reported preoperative Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) scores to be highly predictive in identifying patients who would and would not benefit from foot and ankle surgery. Their applicability to other patient populations is unknown. The aim of this study was to assess the validation and generalizability of previously published preoperative PROMIS physical function (PF) and pain interference (PI) threshold t scores as predictors of postoperative clinically meaningful improvement in foot and ankle patients from a geographically unique patient population.

Methods: Prospective PROMIS PF and PI scores of consecutive patient visits to a tertiary foot and …

Subtle Cavus Deformities: Is Isolated Lateral Ankle Ligament Reconstruction Enough For Improved Patient-Reported Outcomes?, Ashlee Macdonald, Meghan Kelly, Jeff Houck, Judith Baumhauer, Irvin Oh, Adolph Flemister, John Ketz

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Lateral ankle ligament injuries are common conditions accounting for 25% of musculoskeletal injuries. Prior reports have found increased risk of failed lateral ankle reconstruction in those with a subtle cavus deformity, and therefore, correcting the deformity is often advocated. However, other studies have been unable to identify subtle cavus deformity as a clear risk factor for recurrent injury. The purpose of this study was to 1) compare PROMIS physical function (PF), pain interference (PI), and depression scores in patients with subtle cavus deformities to those without deformity who underwent lateral ankle ligament reconstruction, 2) compare PROMIS scores in allograft …

Midfoot Power During Walking And Stair Ascent In Healthy Adults, Frank Diliberto, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Intrinsic foot muscles have the capacity to attenuate and reverse arch deformation under loaded conditions. This function is proposed to be an important component in generating the midfoot power and stability requisite for gastroc-soleus muscle action at the ankle during forward propulsion. Synergistic activation of intrinsic foot muscles is proposed to function as a ‘foot core’ during weightbearing activity that is analogous to the function of the smaller muscles at the spine. If this theory were sound, midfoot power would be expected to increase, potentially in proportion to ankle power, as the muscular demand of a task increases. The …

Does Identifying Provider Expectations Improve Adoption Of Patient Reported Outcomes?, Jeff Houck, Jillian Santer, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: New instruments like the Patient Reported Outcome Information System (PROMIS) minimize the burden to patients and providers addressing significant barriers to adoption. Despite these advances provider adoption remains lackluster. Models of technology adoption suggest adoption is more likely to occur when PRO’s directly improve patient care (performance expectancy) and it’s easy to implement (effort expectancy). Problems with effort expectancy are dealt with by training and improving logistics (i.e. eHR presentation, alerts), where performance expectancy is addressed through research (i.e. validation of thresholds). The purposes of this study were to: 1) evaluate the proportion of orthopedic rehabilitation providers who use …