Physical Therapy Commons^™

The Influence Of A Positive Empathetic Interaction On Conditioned Pain Modulation And Manipulation Induced Analgesia In People With Lateral Epicondylalgia, Ahmad Muhsen, Penny Moss, William Gibson, Bruce Walker, Angela Jacques, Stephan A. Schug, Anthony Wright

Physiotherapy Papers and Journal Articles

Objective: Conditioned pain modulation (CPM) and manipulation induced analgesia (MIA) are two forms of endogenous analgesia. Many forms of analgesia can be influenced by the nature of the patient clinician interaction. The aim of this study was to evaluate the influence of an empathetic and supportive interaction on CPM and MIA in people with Lateral Epicondylalgia (LE).

Methods: In a double-blind, randomised, controlled trial, 68 participants with LE were assigned to two groups: the empathetic and neutral interaction groups. The interactions were carried out by a trained, professional role play actor, playing the part of a research assistant (RA). The …

Blood Flow Restriction Training For The Rotator Cuff: A Randomized Controlled Trial, Jason Brumitt, Marcey Keefer Hutchison, Daniel Kang, Zach Klemmer, Mike Stroud, Edward Cheng, Neil Patrick Cayanan, Sheldon Shishido

Faculty Publications - College of Physical Therapy

Context: Blood flow restriction (BFR) training utilizes a tourniquet, applied to the proximal portion of one or more extremities, to occlude blood flow during exercise. Significant gains in strength and cross-sectional area can be achieved in muscles, both distal and proximal to BFR cuff application. Purpose: To compare strength gains of the rotator cuff and changes in tendon size in subjects who performed side-lying external-rotation exercise with or without BFR. Methods: Forty-six subjects (mean age 25.0 [2.2] y) were randomized to either a BFR + exercise group or to the exercise-only group. Subjects performed 4 sets of the exercise (30/15/15/15 …

Is There A Difference In Outcomes Between Patients Who Received A Double Or Triple Arthrodesis For Hindfoot Arthritis?, Amanda H. Holleran, Judith F. Baumhauer, Jeff Houck, Daniel Homeier, Adolph S. Flemister, John P. Ketz, Benedict F. Digiovanni, Irvin Oh

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Triple arthrodesis has historically been considered the standard of treatment for arthritis of the hindfoot with or without deformity. The complications of this surgery including non-union, malunion, nerve injury, infection and wound healing problems can occur at any of the three joints. Double arthrodesis is capable of producing a similar reduction in degrees of motion and correction of foot deformity but may also cause less patient morbidity in regard to these complications due to one less joint being incorporated into the fusion procedure. What is unknown is the patient reported outcomes, specifically physical function (PF) and pain interference (PI) …

Operative Intervention Does Not Change Pain Perception In Patients With Diabetic Foot Ulcers, Olivia V. Waldman, Stephanie P. Hao, Jeff R. Houck, Nicolette J. Lee, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Researchers investigated pain perception in patients with diabetic foot ulcers (DFUs) by analyzing pre- and postoperative physical function (PF), pain interference (PI), and depression domains of the Patient-Reported Outcome Measurement Information System (PROMIS). They hypothesized that 1) because of painful diabetic peripheral neuropathy (DPN), a majority of patients with DFUs would have high PROMIS PI scores unchanged by operative intervention, and 2) the initially assessed PI, PF, and depression levels would be correlated with final outcomes. Seventy-five percent of patients with DFUs reported pain, most likely because of painful DPN. Those who reported high PI and low PF were likely …

New Author Guidelines In Statistical Reporting: Embracing An Era Beyond P < .05, Samantha Johnson, Whitley J. Stone, Jennifer Bunn, Scott Lyons, James W. Navalta

Kinesiology and Nutrition Sciences Faculty Research

Statistical reporting of quantitative research data has been plagued by potential bias and reporting suppression due to a single numerical output: the p-value. While there is great importance in its merit, creating a pass-fail system (set at point of .05) has created a culture of researchers submitting their project’s data to a filing cabinet if it does not yield “statistical significance” based on this value. The editors of the International Journal of Exercise Science are following the American Statistical Association’s call for statistical reform by adjusting our reporting guidelines to the following requirements: [1.] make an intentional effort to move …

Comparison Of Home Therapy Vs Formal Outpatient Physical Therapy In Post-Operative Management Of Two-Incision Distal Bicep Tendon Repair, Joseph Botros, John Horneff Iii, Md, Thomas Harper, Brent Page

Phase 1

Background: Distal bicep tendon tears are a relatively uncommon injury, affecting 1.2/ 100,000 persons per year; they can also cause substantial loss in supination and flexion strength. The most common treatment is a double incision distal bicep tendon repair, which involves surgical reinsertion of the bicep tendon onto the radial tuberosity. Following surgery, physicians have traditionally recommended the patient undergo 5-12 weeks of formal outpatient physical therapy. This can be a significant cost and time burden to the patient. Therefore, some physicians have instead opted for home physical therapy, in which the patient is given instructions on exercises to complete …

The Effects Of Virtual Reality In The Treatment Of Stroke Patients, Melissa Schoettle

Capstone Showcase

The Effects of Virtual Reality in the Treatment of Stroke Patients

Stroke patients face many challenges on their road to recovery. Patients may lose motor function, speech abilities, and other important cognitive functions. They go through various forms of therapy to help rehabilitate them and improve their cognition, including physical, occupational, and speech therapy. Physical therapy helps improve motor function and muscle control, occupational therapy improves those skills needed for success in work and life, and speech therapy helps patients recover the ability to speak and the cognitive processes to think and form words and sentences. While these therapies are …

Clinical And Neurophysiological Effects Of Dry Needling On Individuals With Chronic Ankle Instability, Jennifer Mullins

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are generally considered innocuous injuries; however, as many as 74% of patients will develop chronic symptoms. 1-3 Chronic ankle instability (CAI) is defined by a history of ankle sprain accompanied by ongoing bouts of giving way, residual ankle sprain symptoms, and a decrease in patient-perceived function. As understanding of sensorimotor deficits in individuals with CAI have advanced, treatment strategies have evolved to include a robust focus on balance training to mitigate dynamic and static postural control impairments exhibited in individuals with CAI. A problem arises as these improvements have not been conclusively linked to a decrease in CAI. …

Effects Of Load Carriage On Shoulder Neuromuscular Functions And Recovery, Muataz R. Almaddah

Theses and Dissertations--Rehabilitation Sciences

Load carriage is a primary source for injury occurrence among military personnel and recreational hikers affecting all body areas. The shoulder ranks as the second or third most common site of injuries among military personnel. Many studies report that elevations in self-reported fatigue, soreness, and discomfort in the shoulders accompany the load carriage. Almost 50% of military personnel experienced a load carriage injury during the first episode of training, and 75% of those injured suffered a second injury during their career. The goal of this research project is to investigate the components associated with load carriage shoulder symptoms to determine …

Influences Of Functional And Psychological Factors On Biomechanics Following An Anterior Cruciate Ligament (Acl) Reconstruction, Chelsey Roe

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to return to sport (RTS) test batteries following primary anterior cruciate ligament reconstruction (ACLR) (Aim 1) and define recovery in athletes from 4-9 months after ACLR across three domains: 1) psychological recovery and biomechanics (Aim 2), 2) rehabilitation quantity and biomechanics (Aim 3), and 3) functional performance and biomechanics (Aim 4). Ultimately, the results of this research would quantify recovery following ACLR in athletes with a desire to RTS and identify objective criteria throughout rehabilitation prior to RTS.

Participants: Twenty-two post-ACLR athletes 17 females, 8 males, …

What Is The Responsiveness And Quality Of Life “Utility” For Promis Outcomes In Foot And Ankle Patients Following Physical Therapy?, Christopher G. Neville, Judith F. Baumhauer, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Patients with foot and ankle conditions have been shown to demonstrate improvement in their generic outcomes using the Patient Reported Outcome Measurement Information System (PROMIS). However, the responsiveness to change and the impact change may have on quality of life has not been explored following non-operative care with physical therapy. The effect size (ES) is an assessment of the magnitude of change while the impact of change in physical function can be assed with quality of life utility scores. Therefore, the purpose of this analysis was to investigate the responsiveness of the PROMIS physical function (PF) scale on changes …

Overall Health And The Influence Of Physical Therapy On Physical Function Following Total Ankle Arthroplasty, Frank E. Diliberto, Daniel H. Aslan, Jeff R. Houck, Bryant S. Ho, Anand M. Vora, Steven L. Haddad

Faculty Publications - College of Physical Therapy

Background: The overall health and the importance of physical therapy for people following total ankle arthroplasty (TAA) have been understudied. Our purpose was to characterize the overall health of patients following TAA, and explore the frequency, influence, and patient-perceived value of physical therapy.

Methods: People who received a TAA participated in this retrospective cohort online survey study. The survey included medical history questions and items from the Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms. Seven PROMIS domains, reflecting the biopsychosocial model of care (physical, mental, social), were included to examine participant overall health status in comparison to the general …

Do Patients Judge Success Of Treatment And Patient Acceptable Symptom State Based On Current Self-Reported Health Status?, Ryan Jacobson, Daniel Kang, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Value-based care models call for better interpretation of patient-reported outcomes. Patients may reference health status differently when appraising if an intervention was successful versus if their current state is acceptable. The purpose of this study was to determine the association between success of treatment (SOT), patient acceptable symptom state (PASS), and PROMIS measure T-scores, following a single primary care physical therapy encounter.

Methods: Cross-sectional study. Ninety-two patients with musculoskeletal complaints were administered standard SOT and PASS questions, and PROMIS Physical Function, Pain Interference, and Self-Efficacy for Managing Symptoms measures. Association of PASS and SOT was determined using rank biserial …

Can Patient-Reported Outcomes Measurement Information System® (Promis) Measures Accurately Enhance Understanding Of Acceptable Symptoms And Functioning In Primary Care?, Ryan Jacobson, Daniel Kang, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Value-based healthcare models will require prioritization of the patient’s voice in their own care toward better outcomes. The Patient-Reported Outcomes Measurement Information System® (PROMIS) gives patients a voice and leads providers to actionable treatments across a broad range of diagnoses. However, better interpretation of PROMIS measures is needed. The purpose of this study was to evaluate the accuracy of PROMIS Physical Function (PF), Self-Efficacy for Managing Symptoms (SE), Pain Interference (PI), Fatigue, and Depression measures to discriminate patient acceptable symptom state (PASS) in primary care, determining if that accuracy is stable over time and/or retained when PROMIS score thresholds …

Preseason Y Balance Test Scores Are Not Associated With A Lower Quadrant Sports Injury In A Heterogeneous Population Of Division Iii Collegiate Athletes, Jason Brumitt, Jill A. Sikkema, Saiko Mair, Cj Zita, Victor Wilson, Jordan Peterson

Faculty Publications - College of Physical Therapy

Functional performance tests, such as the Y Balance Test-Lower Quarter (YBT-LQ), hold promise as screening tools to identify athletes at risk for injury. The ability of the YBT-LQ to discriminate injury risk in Division III collegiate athletes is unknown. The purpose of this study was to determine if preseason YBT-LQ scores are associated with noncontact time-loss lower-quadrant (low back or lower extremities) injury in a heterogeneous population of Division III collegiate athletes. Two hundred and fourteen athletes (females = 104) performed the YBT-LQ test. Preseason YBT-LQ scores, analyzed by the total population, were not associated with noncontact time-loss lower-quadrant injury. …

An Evaluation Of Postural Control And Balance After Anterior Cruciate Ligament Reconstruction, Kathryn Lucas

Theses and Dissertations--Rehabilitation Sciences

Over 100,000 anterior cruciate ligament reconstructions (ACLR) occur annually in the United States, with one in four individuals sustaining a second injury within the first two years after reconstruction. Due to the proprioceptive nature of the anterior cruciate ligament, the lack of regaining postural control and balance are likely large contributors to the rate of secondary injuries after ACLR. Recent literature has identified cerebral changes after anterior cruciate ligament injury and surgery, likely due to altered sensation and feedback loops. However, no study thus far has investigated the neurological feedback loops that may place this group at higher risk of …

Can The Forward-Step-Down Test Be Used Reliably In The Clinical Setting To Assess Movement Changes Resulting From Maximal Exertion? A Pilot Study, Erin Mccallister, Daniel W. Flowers

Internet Journal of Allied Health Sciences and Practice

Introduction: Visual assessment of lower extremity mechanics is used frequently in clinical practice, and objective scoring of the visual assessment is beneficial to improve objectivity of patient evaluation. In addition, lower extremity mechanics change with fatigue and these changes may increase the risk of lower extremity injury. The Forward-Step-Down Test (FSDT) is one such objective tool, but its ability to detect changes in movement quality in response to exertion are not known. Methods: This study utilized a repeated-measures design, where the participants were scored on the FSDT before performing the Bruce protocol for an exertion stimulus. The participants were re-scored …

Physical Therapy Adherence: An Exploration Into Motivation, Keith Rader

Capstone Showcase

A major problem in the field of physical therapy is the lack of patient adherence to home exercise program prescriptions. Non-adherence to these exercise programs is as high as 70% according to the research. There must be an underlying mechanism because the type of non-adherent patients is not exclusively based on condition or injury. Past research has centered around two fields of thought for motivation, self-determination and self-efficacy, as well as practitioner intervention to increase these psychological principles in patients. Self-determination is present because while doing physical therapy exercises is not intrinsically enjoyable, patients can be extrinsically motivated by their …

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Clinical Validation Of Expert Consensus Statements For Respiratory Physiotherapy Management Of Invasively Ventilated Adults With Community-Acquired Pneumonia: A Qualitative Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Objectives: To conduct multidisciplinary peer-review of expert consensus statements for respiratory physiotherapy for invasively ventilated adults with community-acquired pneumonia, to determine clinical acceptability for development into a clinical practice guideline.

Research methodology: A qualitative study was undertaken using focus groups (n = 3) conducted with clinician representatives from five Australian states. Participants were senior intensive care physiotherapists, nurses and consultants. Thematic analysis was used, with a deductive approach to confirm clinical validity, and inductive analysis to identify new themes relevant to the application of the 38 statements into practice.

Setting: Adult intensive care.

Findings: Senior intensive care clinicians from physiotherapy …

Systematic Reviews That Include Only Published Data May Overestimate The Effectiveness Of Analgesic Medicines For Low Back Pain: A Systematic Review And Meta-Analysis, Matthew K. Bagg, Edel O'Hagan, Pauline Zahara, Benedict Wand, Markus Hubscher, G. Lorimer Moseley, James H. Mcauley

Physiotherapy Papers and Journal Articles

Objective: Systematic reviews of analgesics for low back pain generally include published data only. Obtaining data from unpublished trials is potentially important because they may impact effect sizes in meta-analyses. We determined whether including unpublished data from trial registries changes the effect sizes in meta-analyses of analgesics for low back pain.

Study Design and Setting: Trial registries were searched for unpublished data that conformed to the inclusion criteria of n = 5 individual source systematic reviews. We reproduced the meta-analyses using data available from the original reviews and then reran the same analyses with the addition of new unpublished data. …

Cross-Cultural Adaptation, Reliability, And Validity Study Of The Thai Version Of The Manchester-Oxford Foot Questionnaire In Individuals With Chronic Foot Pain, Poramat Kul-Eung

Chulalongkorn University Theses and Dissertations (Chula ETD)

There are 10-24% of the population who experience chronic foot pain. Patient-reported outcome measurement (PROM) is a standardized tool that is useful in measuring the outcomes of treatment. The Manchester-Oxford Foot Questionnaire (MOXFQ) is a foot-specific questionnaire that was developed for surgical outcomes and foot conditions assessment. There are 3 subscales of MOXFQ including walking/standing, pain, and social interaction. MOXFQ has been translated into several languages but there is no previous Thai version. This study aimed to cross-culturally adapt and test for reliability and validity of the Thai version of MOXFQ (Thai-MOXFQ) in participants with chronic foot problems. The original …

Effects Of A Strength Training Intervention And Quality Of Life: Case Study On A Sedentary Adult Female, Lucas Frazier

Williams Honors College, Honors Research Projects

The purpose of the project is to evaluate physiological and quality of life changes in a

sedentary, senior-aged (55 or older) female using a six-week strength training

intervention. This case study will instruct how to perform a push-pull-legs split

routine by going to the gym three times per week. Prior to the six week intervention,

both quantitative and qualitative variables will be collected to assess baseline data,

including the subject’s resting heart rate, resting blood pressure, grip strength, one-

repetition maximum on seven whole body exercises (dumbbell bicep curl, tricep

pushdown, barbell bench press, wide-grip lat pull-down, seated dumbbell press, …

Referral Patterns To Continence Physiotherapy Services For Patients With Chronic Respiratory Conditions, Hannah Brien, Cath Bunting, Shane Patman

Physiotherapy Papers and Journal Articles

Chronic respiratory conditions are a widely recognised risk factor for urinary incontinence and current chronic respiratory condition management guidelines state that patients should be screened for urinary incontinence and referred to continence physiotherapists for treatment. This study aimed to firstly confirm anecdotal sentiment that referrals of these patients to continence physiotherapists are low; and, secondly, to investigate barriers to the referral of these patients. Two online de novo surveys were disseminated across the metropolitan area of Perth, Western Australia: one to continence physiotherapists (Survey A) to investigate referral rates, and the other to respiratory physiotherapists, respiratory physicians and general practitioner …

The Association Of Working Alliance, Outcome Expectation, Adherence And Self-Efficacy With Clinical Outcomes For Achilles Tendinopathy: A Feasibility Cohort Study (The Map Study), Adrian Mallows, Jo Jackson, Chris Littlewood, James Debenham

Physiotherapy Papers and Journal Articles

Introduction: This study evaluated the feasibility of a large longitudinal cohort study utilizing an online platform to investigate the association and predictive relationship of working alliance, outcome expectations, adherence and self-efficacy with outcome in Achilles tendinopathy. The objectives were: (1) to determine the recruitment and retention rate and (2) to carry out preliminary data analysis of the selected variables and clinical outcomes.

Methods: A multi-centred, longitudinal feasibility cohort study was used. Eligible participants were directed to a bespoke online platform hosting study information and the outcome measures in the form of an online questionnaire. Responses from the online questionnaire were …

The Resolve Trial For People With Chronic Low Back Pain: Statistical Analysis Plan, Matthew K. Bagg, Serigne Lo, Aidan G. Cashin, Robert D. Herbert, Neil E. O'Connell, Hopin Lee, Markus Hubscher, Benedict M. Wand, Edel O'Hagan, Rodrigo R.N Rizzoli, G Lorimer Moseley, Tasha R. Stanton, Christopher G. Maher, Stephen Goodall, Sopany Saing, James H. Mcauley

Physiotherapy Papers and Journal Articles

Background: Statistical analysis plans describe the planned data management and analysis for clinical trials. This supports transparent reporting and interpretation of clinical trial results. This paper reports the statistical analysis plan for the RESOLVE clinical trial. The RESOLVE trial assigned participants with chronic low back pain to graded sensory-motor precision training or sham-control.

Results: We report the planned data management and analysis for the primary and secondary outcomes. The primary outcome is pain intensity at 18-weeks post randomization. We will use mixed-effects models to analyze the primary and secondary outcomes by intention-to-treat. We will report adverse effects in full. We …

Comparing Moral Reasoning Across Graduate Occupational And Physical Therapy Students And Practitioners, Brenda S. Howard, Cheyenne Kern, Olivia Milliner, Lindsey Newhart, Sarah K. Burke

Journal of Occupational Therapy Education

Practicing clinicians must use moral reasoning to solve ethical problems and combat moral distress. Development of moral reasoning in occupational therapy (OT) and physical therapy (PT) students has been significantly under researched. The purpose of this study was to analyze the differences in moral reasoning between first year and second year OT and PT students and between students and OT and PT practitioners. Investigators utilized a cross-sectional study design with a convenience sample of University of Indianapolis OT and PT students and a combination of convenience and snowball sampling to recruit licensed OT and PT practitioners. One hundred and fifty-four …

The Positive Impact Of Occupational Therapy Involvement In Interprofessional Education, Wendie Leveille, James Brandes, Karene Boos, Amy Vega, Barbra Beck, Barbara Ruggeri, Thomas E. St. George, Jane Hopp

Journal of Occupational Therapy Education

It is essential that members of a successful interprofessional healthcare delivery team understand the crucial roles and responsibilities of each profession. Participation in interprofessional education and practice has been suggested to improve understanding of the roles of each discipline on an allied health team, however, often understanding of the occupational therapy scope of practice is confusing to other allied health professionals. This study presents the outcomes of a community-based interprofessional practice experience with occupational therapy, physical therapy, and physician assistant students on perceived understanding of each profession’s roles and responsibilities. In addition, this study introduces the Primary Care Training and …

Adherence To A Home Exercise Programme Following A Clinical Programme For Non-Acute Non-Specific Low Back Pain: An Exploratory Study, Judith L'Heureux, Marie-France Coutu, Djamal Berbiche, Christian Larivière

Études primaires

Purpose:Lack of adherence to home exercise programmes is hypothesised to partially explain the modest clinical effects seen in patients with low back pain. This study explored the association between the main biopsychosocial factors and adherence using a theory-driven approach including the fear-avoidance model, the common-sense model and the working alliance concept.

Methods: A repeated measures design was used. During and after an eight-week clinical exercise programme, 48 participants with non-acute and disabling low back pain followed a home exercise programme. Questionnaires assessed home exercise adherence and biopsychosocial factors at baseline, after the eight-week clinical programme and at the six-month follow-up. …

Three-Month Efficacy Of Three Knee Braces In The Treatment Of Medial Knee Osteoarthritis In A Randomized Crossover Trial, Xavier Robert-Lachaine, Yoann Dessery, Étienne L. Belzile, Sylvie Turmel, Philippe Corbeil

Études primaires

Immediate biomechanical and functional effects of knee braces are often reported, however, the duration and type of knee brace treatment for knee osteoarthritis (KOA) remain unclear. The objective was to evaluate usage, comfort, pain, and knee adduction moment (KAM) of three knee braces each worn 3 months by patients. Twenty-four patients with KOA were assigned in a randomized crossover trial a valgus three-point bending system brace (V3P-brace), an unloader brace with valgus and external rotation functions (VER-brace) and a stabilizing brace used after ligament injuries (ACL-brace). Functional questionnaires and gait assessment were carried out before and after each brace wear …