Physical Therapy Commons^™

Fsm Restores Activity To Trapezius For 67 Y.O. Male, Marilyn Miller, Carolyn R. Mcmakin

San Marcos, Fall 2018

One session of frequency specific microcurrent (FSM) restored voluntary function and muscle definition for a 67 y. o. male DIY enthusiast after 18 mos of disuse.

Service Learning For Balance And Activity Promotion In The Older Adult, Christine Mary Childers

San Marcos, Summer 2018

Barr and Wong¹ challenged faculty to provide creative and innovative ways of teaching meaningful content related to care of the older adult population.¹ Service learning combines community service with learning objectives and reflection, meeting academic and community needs.² Service learning helps students manage the complex care of the older adult stroke population³ and intergenerational programs benefit both generations.⁴ The purpose of this study was to explore and compare student ideas and thoughts regarding balance and activity promotion in the older adult, both with and without a service learning opportunity Falls are a leading concern with …

A Different Instructional Model To Improve Student Learning Outcomes In Gross And Applied Anatomy For Physical Therapy Students, Cherie Peters-Brinkerhof, Christine Mary Childers

San Marcos, Fall 2018

Teaching and learning anatomy in a DPT program poses a challenge to students and faculty because of the volume of material needed as foundational information for a PT curriculum. The aim of this study was to determine if a round-robin model of instruction in anatomy and applied anatomy labs, is more effective to meet the course learning objectives compared to a more traditional, separate class instruction.

Guiding Questions:

1. What were the faculty and students’ perception of the teaching method used for anatomy and applied anatomy?

2. What were the faculty's perceptions of the students’ understanding of the material presented? …

Anti-Gravity Treadmill Training With 19-Year-Old Soccer Player Status Post-Leukemia, Britni Barber, Lisa Chase

St. Augustine, Fall 2018

The purpose of this case report was to describe the effects of anti-gravity treadmill training, in addition to standard treatment protocol, on endurance performance in a 19-year-old female collegiate soccer player following chemotherapy treatment for leukemia.

Physical therapy rehabilitation of patients who are experiencing chemotherapy-related fatigue may benefit from anti-gravity treadmill training. This case report not only identifies a successful outcoming using such intervention but also introduces a more aggressive approach to treatment for a patient whose goals included going back to play division one sports. The patient was not only able to reach her goals of being able to …

Inter-Institutional Collaboration To Benefit Student Learning: A Scenario In Graduate Education, Marilyn Miller, Linda Hill, Nicolas Van Den Heever

San Marcos, Fall 2018

Occupational and Physical Therapists are in a unique role, in which they can assist in the identification and rehabilitation of impairments. The collaboration between UCSD and USAHS is preparing students with the knowledge and skills to assess older persons for driving abilities.

The current content delivery allows the TREDS program to be available to the Gerontology course offering for other USAHS campus locations; and has the potential to be accessed by other institutions of higher education offering courses in Gerontology.

Conservative Therapy Of Patient With Dyspareunia In A Post-Menopausal State With Co-Morbidities Including Previous Breast Cancer And Valve Replacement: A Case Report, D. Ditoro, M. Mason-Cover, C. Hazelton, Annie Burke-Doe, Marilyn Miller

San Marcos, Fall 2018

Dyspareunia is defined as persistent pain in the vaginal area before, during, or after sexual intercourse.^1,2 The etiology is uncertain in the medical literature, but evidence proposes that pain and dysfunction of pelvic floor muscles (PFM) can contribute to dyspareunia and other forms of chronic pelvic pain.^1,2 The information contained in this case report is clinically relevant because it presents evidence that dyspareunia can be treated safely with physical therapy techniques on a patient with a complex medical history.

Soft Tissue Mobilization With Movement To Improve Cervical And Shoulder Range Of Motion Post-Thyroidectomy In A 36-Year-Old Male: A Case Report, Sarah Tomes, Megann Schooley

St. Augustine, Fall 2018

The purpose of this case report is to describe the effectiveness of soft tissue mobilization with movement (STMM) to improve cervical and shoulder range of motion status-post thyroidectomy in a 36-year-old male.

When addressing hypertrophic scarring and ROM restrictions after total thyroidectomy, a beneficial myofascial treatment may include STMM. A home program could incorporate STMM or self-myofascial release as well.

Power Up With Parkinson's: A Case Report, Sean Ekekwe, Anne H. Boddy

St. Augustine, Fall 2018

The purpose of this study is to highlight the use of power training in a patient with low back pain and Parkinson’s disease.

Power training demonstrated a more significant change in gait speed, mobility, and function compared to other phases in rehabilitation. After power training was implemented at visit 11, there was a dramatic increase gait speed with the 10-meter walk test, a reduction in Oswestry Disability Index score (ODI), and a decrease in Timed Up and Go (TUG) time. The increase in 10 MWT gait speed and reduction in ODI and TUG score were greater than their MDC values …

Are You Ready To Get High? High Repetition Exercise For Radial Nerve Palsy, Tayler Adams, Matthew L. Daugherty

St. Augustine, Fall 2018

Research suggests the need for early surgical nerve exploration for secondary radial nerve palsy based upon a 75% recovery rate with early exploration.⁵ In using typical conservative management plus high-repetition movement, the patient in this case report was able to avoid surgery for radial nerve exploration, attain complete recovery within 4 months of his initial injury, and fully return to work and daily function.

This case report offers the possibility of high-repetition movement being a beneficial treatment intervention. This is a simple, low-cost treatment and can be accomplished by the patient at home as part of a home exercise …

External Load On The Hemi-Paretic Lower Limb With Task-Oriented Training To Improve Gait Post Right Aca Stroke, Jacob France, Lindsey Perry

St. Augustine, Fall 2018

The purpose of this case report is to describe the treatment of a 77-year-old male post-stroke with the application of an external load to the paretic lower limb in conjunction with task-oriented training to improve gait.

Strength, balance, gait speed, and functional tasks all improved over the course of physical therapy. At the end of 2 weeks, the patient exceeded the minimal detectable change (MDC) for the TUG (2.9 sec) and achieved the minimal clinically important difference (MCID) for the FIM (22 points).^4-5 Although the MCID is not established for the Modified Ashworth Scale (MAS), the patient experienced improvements …

Incorporation Of Balance And Vestibular Exercises In A 45-Year-Old Female With Bell’S Palsy: A Case Report, Kelsey Andersson, Erica Kiernan

St. Augustine, Fall 2018

The purpose of this case report is to determine the effectiveness of balance and vestibular exercises in conjunction with facial strengthening exercises on a patient with Bell’s palsy.

By incorporating vestibular exercises into the patient’s therapy sessions, she was able to demonstrate improved single leg stance and self-reported decrease in onset of symptoms with a progression of vestibular exercises. Facial muscle strengthening exercises demonstrated significant improvements in eye closure and smiling but she exhibited little changes in facial symmetry, strength and self-perceived function. The patient reported she was starting to drive and participate in more social events by the 4th …

Sara Plus And Task Specific Training In A Patient With Anoxic Encephalopathy, Olivia Levi, Erica Kiernan

St. Augustine, Fall 2018

The purpose of this case report is to describe the benefits of using a task-specific approach and the SARA plus to improve balance and gait in a patient with anoxic encephalopathy.

This case demonstrated the positive results of incorporating repetitive, task-specific, and early use of the SARA plus for gait training. With these interventions, the patient was able to ambulate 25 ft and transfer from sit to stand with the use of a rolling walker and minimum assistance. He was also able to maintain static sitting balance for 32 seconds independently and reach 17 inches outside of his base of …

Proprioceptive Neuromuscular Facilitation In A Male Wrestler Post Type Ii Slap Lesion Surgical Repair, George Eskander, Matthew L. Daugherty

St. Augustine, Fall 2018

The primary purpose of this case report was to assess the effects of a specific progression of PNF and Rhythmic Stabilization Exercises (RSE) in conjunction with traditional physical therapy for a seventeen-year-old wrestler post Type II SLAP lesion surgical repair.

This case report indicated that the utilization of PNF and RSE is a beneficial component to physical therapy treatment of a seventeen-year-old wrestling athlete with a Type II SLAP lesion surgical repair. Designing a treatment plan with emphasis on PNF and RSE is cost-efficient, as it does not require expensive equipment or additional certifications. Also, physical therapists utilizing PNF and …

Scapulothoracic Mobility And Strengthening After A Posterior Capsular Reconstruction Of The Glenohumeral Joint With An Allograft: A Case Report, Kris Saunders, David Kempfert

St. Augustine, Fall 2018

The purpose of this case report is to emphasize the importance of scapular mobility and strengthening exercises in rehabilitation protocols for patients after a posterior capsular reconstruction surgery of the glenohumeral joint.

The objective outcomes by week three are displayed in Table 1.0. The patient was discharged after nine visits over a period of three weeks. During the final session, the patient was able to perform standing shoulder abduction to 90 degrees with a one-pound dumbbell pain-free. The patient was able to reach into a shelf at 120 degrees of shoulder flexion with a pain scale rating of 2/10. He …

Shall We Dance: A Parkinson’S Dance-Based Program, Rebecca Zawodny, Anne H. Boddy

St. Augustine, Fall 2018

This poster presents the implementation of a community-based dance program for individuals diagnosed with Parkinson’s disease.

Dance interventions for individuals with PD are shown to be superior to exercise for improving balance and mobility^5,6,7 thus, effectively addressing both motor as well non-motor symptoms such as depression, fear, anxiety, and declined self-efficacy.^8,9,10 Further positive effects include improved flexibility and coordination7^,11 and forced-use of the senses of sight, sound, and touch to assist with movement and balance.¹² The use of choreography further allows for the rehearsal of movement sequences, new motor skill learning, and improved cognitive functions.^{13 …}

Effects Of Weight Shifting And Heel Lift On Gait, Posture, And Balance In An Elderly Female With Backward Disequilibrium: A Case Report, Gilissa T. Schjang, Evan M. Pucillo

St. Augustine, Fall 2018

The purpose of this case report is to investigate how weight shifts and a heel lift affects a patient's center of mass in respect to their base of support to improve posture, balance, and gait which will aid in decreasing falls.

The patient demonstrated functional improvements by reducing the amount of assistance required from a caregiver for transfers and gait. Improvements in balance will allow the patient to sit on the toilet and edge of bed for toileting and dressing more independently.

Older adults with BD or other similar balance disorders are at risk for increased falls.⁵ This case …

Effectiveness Of Stretching And Arch Strengthening In A 10-Year-Old Male With Calcaneal Apophysitis, Hannah Hardesty, Catherine M. Andrea

St. Augustine, Fall 2018

The aim of this case report is to create an independent exercise program to minimize pain while allowing continued participation in recreational activities.

Calcaneal apophysitis is a common condition in children that often results in the cessation of physical activity and participation in social activities, which can have a negative effect on both physical and mental well-being.^2-5 This case demonstrates positive outcomes with the use of static/dynamic stretching combined with arch strengthening in the rehabilitation of a patient with bilateral calcaneal apophysitis without reducing the child’s participation in daily and recreational activities.

Effects Of Trigger Point Dry Needling In Conjunction With Intramuscular Electrical Stimulation For A Patient With Lumbar Radiculopathy: A Case Report, Mayur Patel, Todd Bourgeois

St. Augustine, Fall 2018

The purpose of this case was to see the benefits of Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for the treatment of lumbar radiculopathy regarding the range of motion, strength, sensation, reduction of pain, improve functional ability, and quality of life.

Traditional interventions for this diagnosis include strengthening exercises, modalities such as transcutaneous electrical stimulation, and even surgery as a last resort. There is limited research available regarding Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for lumbar radiculopathy.⁴ This case report supports the idea that this physical therapy treatment intervention has positive outcomes …

Transitioning From The Level Surface To Stairs In Children With And Without Down Syndrome: Motor Strategy And Anticipatory Locomotor Adjustments, Huaqing Liang, Xiang Ke, Jianhua Wu

Physical Therapy Faculty Research

Background: Children with Down syndrome (DS) show underdeveloped motor strategy and anticipatory locomotor adjustments (ALA) before crossing an obstacle. Stairs presents another important setting to study environment navigation and motor adaptation. Inclusion of 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 motor strategy and ALA in 5-to-11-year-old children with typical development (TD) and with DS when approaching the stairs?

Methods: Fourteen children with DS and 14 age- and sex-matched children with TD participated in the study. They …

Swallow Strength Training Exercise For Elderly: A Health Maintenance Need, D. Agrawal, Mark Kern, F. Edeani, Gokulakrishnan Balasubramanian, Allison S. Hyngstrom, Patrick Sanvanson, Rita Shaker

Physical Therapy Faculty Research and Publications

Background: Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty‐ and age‐related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly. Methods: A total of 28 volunteers (75 + 7 years; 17 females) with no complaint of dysphagia were studied using video fluoroscopy …

Home-Based, Square-Stepping Exercise Program Among Older Adults With Multiple Sclerosis: Results Of A Feasibility Randomized Controlled Study, Emerson Sebastião, Edward Mcauley, Ryosuke Shigematsu, Brynn C. Adamson, Rachel E. Bollaert, Robert W. Motl

Exercise Science Faculty Research and Publications

There is very little known about exercise rehabilitation approaches for older adults with multiple sclerosis (MS), yet this growing segment of the MS population experiences declines in cognition and mobility associated with disease progression and aging. We conducted a RCT examining the feasibility of a 12-week, home-based Square-Stepping Exercise (SSE) program in older adults with MS. Older adults with MS (N = 26) with mild-to-moderate levels of disability were recruited and randomized into the intervention (i.e., SSE) or a minimal activity, attention-control conditions. Participants in the SSE condition received a mat for home-based practice of the step patterns, an …

Promis Pain Interference Is Superior Vs Numeric Pain Rating Scale For Pain Assessment In Foot And Ankle Patients, David N. Bernstein, Meghan Kelly, Jeff Houck, John P. Ketz, Samuel Flemister, Benedict F. Digiovanni, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Background: The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).

Methods: Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a …

Emotional Exhaustion, Depersonalization, And Feelings Of Decreased Personal Accomplishment Oh My: What Message Are We Sending To Our Students?, Nikki Sleddens, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE:

The purpose of this presentation is to address the issue of burnout amongst PTs through the lens that addressing this issue in our profession may very well be the first step in building resilience in the academic and clinical environments.

METHODS AND/OR DESCRIPTION:

Physical therapy student well-being is a priority for academic institutions. Yet, are we, as academic and clinical faculty, who are responsible for promoting student well-being, “well” ourselves? Could burnout of our academic and clinical faculty impact our student’s wellness? Burnout is a syndrome described as emotional exhaustion, depersonalization, and feelings of decreased personal accomplishment. All effects …

Experience Of Robotic Exoskeleton Use At Four Spinal Cord Injury Model Systems Centers, Allen W. Heinemann, Arun Jayaraman, Chaithanya K. Mummidisetty, Jamal Spraggins, Daniel Pinto, Susan Charlifue, Candy Tefertiller, Heather B. Taylor, Shuo-Hsiu Chang, Argyrios Stampas, Catherine L. Furbish, Edelle C. Field-Fote

Physical Therapy Faculty Research and Publications

Background and Purpose: Refinement of robotic exoskeletons for overground walking is progressing rapidly. We describe clinicians' experiences, evaluations, and training strategies using robotic exoskeletons in spinal cord injury rehabilitation and wellness settings and describe clinicians' perceptions of exoskeleton benefits and risks and developments that would enhance utility.

Methods: We convened focus groups at 4 spinal cord injury model system centers. A court reporter took verbatim notes and provided a transcript. Research staff used a thematic coding approach to summarize discussions.

Results: Thirty clinicians participated in focus groups. They reported using exoskeletons primarily in outpatient and wellness settings; 1 center used …

Locomotor Adaptations To Prolonged Step-By-Step Frontal Plane Trunk Perturbations In Young Adults, Eric R. Walker, Allison S. Hyngstrom, Tanya Onushko, Brian D. Schmit

Physical Therapy Faculty Research and Publications

The purpose of this study was to quantify the magnitude and time course of dynamic balance control adaptations to prolonged step-by-step frontal plane forces applied to the trunk during walking. Healthy young participants (n = 10, 5 female) walked on an instrumented split-belt treadmill while an external cable-driven device applied frontal plane forces to the trunk. Two types of forces were applied: 1) forces which accentuated COM movement in the frontal plane (destabilizing) and 2) forces which resisted COM movement in the frontal plane (stabilizing). We quantified dynamic balance control using frontal plane measures of (1) the extent of center …

Lean Mass Mediates The Relation Between Temporal Summation Of Pain And Sex In Young Healthy Adults, Abdulaziz Awali, Ali Alsouhibani, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Background

Previous studies have shown that women experience greater temporal summation (TS) of pain than men using a repetitive thermal stimulus. These studies, however, did not individualize the thermal stimulus to each subject’s thermal pain sensitivity. The aim of this study was to investigate sex differences in TS using an individualized protocol and potential mediators that have been shown to influence TS including physical activity and body composition.

Methods

Fifty young healthy men and women (21 men) participated in the study. Subjects completed TS testing on the right forearm using a repetitive thermal stimulus at a temperature that the subject …

Relationships Between Variance In Electroencephalography Relative Power And Developmental Status In Infants With Typical Development And At Risk For Developmental Disability: An Observational Study, Andrew Hooyman, David Kayekjian, Ran Xiao, Crystal Jiang, Douglas L. Vanderbilt, Beth A. Smith

Physical Therapy Faculty Articles and Research

Background: Electroencephalography (EEG) is a non-invasive tool that has the potential to identify and quantify atypical brain development. We introduce a new measure here, variance of relative power of resting-state EEG. We sought to assess whether variance of relative power of resting-state EEG could predict i) classification of infants as typical development (TD) or at risk (AR) for developmental disability, and ii) Bayley developmental scores at the same visit or future visits.

Methods: A total of 22 infants with TD participated, aged between 38 and 203 days. In addition, 11 infants broadly at risk participated (6 high-risk pre-term, …

A Framework For Secondary Cognitive And Motor Tasks In Dual-Task Gait Testing In People With Mild Cognitive Impairment., Susan W Hunter, Alison Divine, Courtney Frengopoulos, Manuel Montero Odasso

Physical Therapy Publications

BACKGROUND: Cognition is a key factor in the regulation of normal walking and dual-task gait assessment is an accepted method to evaluate the relationship. The objective of this study was to create a framework for task complexity of concurrent motor and cognitive tasks with gait in people with mild cognitive impairment (MCI).

METHODS: Community-dwelling people with MCI (n = 41, mean age = 76.20 ± 7.65 years) and cognitively normal controls (n = 41, mean age = 72.10 ± 3.80 years) participated in this study. Gait velocity was collected using an instrumented walkway under one single task and six combined …

Gait Variability And Energy Cost Of Overground Walking In Persons With Multiple Sclerosis: A Cross-Sectional Study, Emerson Sebastião, Rachel E. Bollaert, Elizabeth A. Hubbard, Robert W. Motl

Exercise Science Faculty Research and Publications

Objective: This study examined the associations between gait variability based on common spatiotemporal parameters and energetic cost of walking in persons with multiple sclerosis.

Design: Eighty-six persons with multiple sclerosis underwent the 6-min walk while wearing a portable metabolic unit. The cost of walking was generated by dividing the net steady-state VO₂ (milliliter per kilogram per minute) by walking speed during the 6-min walk. Participants further completed two trials of walking on the GAITRite mat at a self-selected pace for measuring spatiotemporal parameters. Variability of step length, step time, stride length, swing time, stance time, stride velocity, and single- …

Exercise-Induced Pain And Analgesia? Underlying Mechanisms And Clinical Translation, Kathleen A. Sluka, Laura Frey-Law, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

No abstract provided.