Physical Therapy Commons^™

Perceived Exercise Habits Of Individuals With Parkinson’S Disease Living In The Community, Jordana Lockwich, Kate Schwartzkopf-Phifer, Camille L. Skubik-Peplaski, Richard D. Andreatta, Patrick H. Kitzman

Communication Sciences and Disorders Faculty Publications

Context

Exercise has been shown to improve gait in individuals with Parkinson’s disease (PD). Stepping practice at higher intensity levels has been suggested as a beneficial treatment option to improve gait in the neurological population. Unfortunately, this mode is poorly understood and underutilized within the PD population. Information on what individuals with PD are doing for exercise would be beneficial to help tailor exercise programs to improve gait and provide exercise options in the community for intensity-based exercise.

Objective

To investigate the current exercise habits of individuals living with PD in the community aimed at improving walking and to understand …

Hip Muscle Function In Individuals With Chronic Ankle Instability, Lindsay Carroll

Electronic Theses and Dissertations

Purpose: Hip muscle function has been reported to be altered in individuals with chronic ankle instability (CAI). The purpose of this study was (1) to determine whether the single leg squat test (SLST) could be used to detect differences in proximal muscle activation between individuals with and without CAI and (2) to determine if there was a difference in maximum isometric body weight normalized torque output of the hip lateral rotators, extensors, and abductors between individuals with and without CAI.

Subjects: Forty-eight subjects (14 males, 34 females; median age = 22.00 years, interquartile range (IQR) = 1.00; median height = …

Evidence Of Myomir Regulation Of The Pentose Phosphate Pathway During Mechanical Load-Induced Hypertrophy, Taylor Valentino, Vandre C. Figueiredo, C. Brooks Mobley, John J. Mccarthy, Ivan J. Vechetti Jr.

Physiology Faculty Publications

Many of the molecular and cellular mechanisms discovered to regulate skeletal muscle hypertrophy were first identified using the rodent synergist ablation model. This model reveals the intrinsic capability and necessary pathways of skeletal muscle growth in response to mechanical overload (MOV). Reminiscent of the rapid cellular growth observed with cancer, we hypothesized that in response to MOV, skeletal muscle would undergo metabolic programming to sustain increased demands to support hypertrophy. To test this hypothesis, we analyzed the gene expression of specific metabolic pathways taken from transcriptomic microarray data of a MOV time course. We found an upregulation of genes involved …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Safe Patient Handling, Aubrey Graves

Honors College Theses

Introduction: Nursing is a high-risk occupation for musculoskeletal injuries due to the strenuous activity of patient handling. These tasks include, assisting a patient in bed, moving a patient from the bed to a wheelchair, and assisting with walking. These work-related tasks can create a large amount of stress on the body, especially the back if proper technique is not utilized and/or if excessive loads are applied. The purpose of this study is to examine if teaching proper body mechanics and the dangers of not performing the tasks properly is an effective way of reducing musculoskeletal injuries.

Methods: The NUR 202 …

Effects On Adherence And Comprehension With Video Demonstration Support Versus Traditional Home Exercise Programs: Culminating Project, Emily E. Morales

Department of Occupational Therapy Entry-Level Capstone Projects

This culminating project examines the need for video-supported home exercise programs (HEP) in outpatient hand therapy clinics in South Jersey by developing a YouTube channel. This YouTube channel will consist of HEPs for common upper extremity diagnoses including proper demonstration of each exercise and clear concise written instructions within a playlist correlating to diagnosis. Advance clinical skill in hand therapy is the main goal for this capstone project. An analysis was completed evaluating adherence and comprehension when clients are prescribed traditional HEP to HEP supported by a video demonstration. The ultimate goal of this project was to establish an easily …

The Rehabilitation Of A 75-Year-Old Male Presenting With A Right Hip Flexor Strain Concomitant With Numerous Psychosocial Factors: A Case Report, Jillian Battista, Megan Chapski, Suma Varanasi, Jillian Witwicki, Tara Paradie

Case Report Posters

Musculoskeletal disorders, often well understood, are a leading cause of disability worldwide. Concomitant psychosocial factors add a layer of complexity to the physical therapy treatment of musculoskeletal disorders. The purpose of this case report is to highlight the potential impact psychological factors have in the rehabilitation of musculoskeletal disorders, specifically the rehabilitation of a right hip flexor strain.

Utilizing An Evidence-Based Practice Framework In Non-Operative Acl Rehabilitation - A Case Report, Eric Norman, Michael Madore, Kathryn Magee, Tyler Calimer, Parker Nally

Case Report Papers

Study Design: Case Report. Background: The patient was a 51-year-old female who tore her left anterior cruciate ligament (ACL) playing pickleball and opted for non-operative treatment. The clinicians involved treated the patient using the three pillars of practice: relevant scientific evidence, clinician experience, and patient perspective.
Treatment: The patient’s treatment consisted of therapeutic exercises, neuromuscular re-education, soft tissue massage, and motivational interviewing. Therapeutic exercises were designed to strengthen the muscles surrounding her hip and knee. Neuromuscular re-education helped to improve the patient’s knee stability and balance, while soft tissue massage was used to decrease swelling. Motivational interviewing helped her better …

The Rehabilitation Of A 75-Year-Old Male Presenting With A Right Hip Flexor Strain Concomitant With Numerous Psychosocial Factors: A Case Report, Jillian Battista, Megan Chapski, Suma Varanasi, Jillian Witwicki

Case Report Papers

Background: Musculoskeletal disorders, often well understood, are a leading cause of disability worldwide. Concomitant psychosocial factors add a layer of complexity to the treatment of musculoskeletal disorders. The purpose of this case report is to highlight the potential impact psychological factors have in the rehabilitation of musculoskeletal disorders, specifically the rehabilitation of a right hip flexor strain.
Case Description: The patient was a 75-year-old male referred to outpatient physical therapy for the assessment of a right hip flexor strain, presenting with psychosocial factors including anxiety and kinesiophobia. Procedural interventions included patient education, neuromuscular re-education, therapeutic exercise, and manual therapy, but …

Lower Extremity Power And Movement Velocity In Competitive Older Athletes, Becca D. Jordre

Dissertations and Theses

Older adults are a rapidly growing population which house a subset of older athletes who regularly engage in sport competition. The physical health and risk factors of this competitive older athlete population have been largely overlooked by healthcare providers and researchers and are poorly understood. Older athletes exhibit distinctly different measures of physical performance which require unique thresholds to identify health-related risk factors. While lower extremity power and movement velocity have been identified as valuable measures of physical performance and fall risk in community-dwelling older adults this relationship has not been explored in competitive older athletes. One method for analyzing …

Executive Functions And Student Success During Physical Therapist Education: An Exploratory Study, Jane Roitsch, Martha L. Walker, Anastasia M. Raymer

Communication Disorders & Special Education Faculty Publications

BACKGROUND: Clinical reasoning relies on executive functions (EFs) that manage attention, inhibition, organization, and decision-making. Assessment of EFs may help identify students who excel at clinical reasoning, yet data showing this relationship in physical therapy (PT) education programs are lacking. The primary purpose of this exploratory study was to examine EFs in relationship to success in PT educational programs. METHODS: Thirteen third-year PT graduate students completed two EF tests which were compared to culminating scores in the program and admissions scores. RESULTS: A relationship existed between National Physical Therapy Examination (NPTE) and comprehensive exam results and one EF test score; …

Phrenic Afferent Activation Modulates Cardiorespiratory Output In The Adult Rat, Kristi A. Streeter, Michael D. Sunshine, Paul W. Davenport, David D. Fuller

Physical Therapy Faculty Research and Publications

Phrenic afferents project to brainstem areas responsible for cardiorespiratory control and the mid-cervical spinal cord containing the phrenic motor nucleus. Our purpose was to quantify the impact of small- and large-diameter phrenic afferent activation on phrenic motor output. Anesthetized and ventilated rats received unilateral phrenic nerve stimulation while contralateral phrenic motor output and blood pressure were recorded. Twelve currents of 40-Hz inspiratory-triggered stimulation were delivered (20 s on, 5 min off) to establish current response curves. Stimulation pulse width was varied to preferentially activate large-diameter phrenic afferents (narrow pulse width) and recruit small-diameter fibers (wide pulse width). Contralateral phrenic amplitude …

The Effect Of Dual-Task Testing On The Balance And Gait Of People With Lower Limb Amputations: A Systematic Review, Humberto Omana, Edward Madou, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

OBJECTIVE: To systematically review the literature on the effect of dual-task testing on the balance and gait of people with lower limb amputations (PLLA).

LITERATURE SURVEY: Databases MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and Scopus were searched in duplicate (inception to December 1, 2020).

METHODOLOGY: Inclusion criteria: participants were adults with transtibial, knee-disarticulation, transfemoral, or bilateral lower limb amputations; balance or gait was paired with a secondary task; and studies were peer-reviewed and published in English. Two authors independently reviewed articles and consensus was required. A standardized data extraction sheet was used to gather study relevant information in duplicate. …

Physical Therapy/Occupational Therapy And Applied Behavior Analysis Forming An Interdisciplinary Bridge For Positive Patient Outcomes, Rachel Ann Vaughn

Honors College Theses

Physical therapy, Occupational therapy, and Applied Behavior Analysis work within the pediatric population and are used to help children reach milestones throughout their development. This survey is meant to assess the amount of interdisciplinary collaboration that is occurring within these disciplines. The research team believes that this interdisciplinary collaboration could be beneficial to the pediatric population, but understands that this survey is a baseline and needs further research. Through a survey, there were 29 total participants, 22 PT/OT and 7 ABA therapists. The survey showed evidence of ABA techniques being used within PT and OT sessions for betterment of the …

The Role Of Eye Movements, Attention, And Hand Movements On Age-Related Differences In Pegboard Tests, Brittany Heintz Walters, Wendy E. Huddleston, Kristian M. O'Connor, Jinsung Wang, Marie K. Hoeger Bement, Kevin G. Keenan

Physical Therapy Faculty Research and Publications

Well-documented manual dexterity impairments in older adults may critically depend on the processing of visual information. The purpose of this study was to determine age-related changes in eye and hand movements during commonly used pegboard tests and the association with manual dexterity impairments in older adults. The relationship between attentional deficits and manual dexterity was also assessed. Eye movements and hand kinematics of 20 young (20–38 yr) and 20 older (65–85 yr) adults were recorded during 9-Hole Pegboard, Grooved Pegboard, and a visuospatial dual test. Results were compared with standardized tests of attention (The Test of Everyday Attention and Trail …

Kinematic Assessment Of Turning And Walking Tasks Among Stroke Survivors By Employing Wearable Sensors And Pressure Platform, Masoud Abdollahi, Pranav Madhav Kuber, Christopher Hoang, Michael Shiraishi, Rahul Soangra, Ehsan Rashedi

Physical Therapy Faculty Articles and Research

Stroke survivors often experience reduced movement capabilities due to alterations in their neuromusculoskeletal systems. Modern sensor technologies and motion analyses can facilitate the determination of these changes. Our work aims to assess the potential of using wearable motion sensors to analyze the movement of stroke survivors and identifying the affected functions. We recruited 10 participants (5 stroke survivors, 5 healthy individuals) and conducted a controlled laboratory evaluation for two of the most common daily activities: turning and walking. Among the extracted kinematic parameters, range of trunk and sacrum lateral bending in turning were significantly larger in stroke survivors (p-value<0.02). However, no statistical difference in mean angular velocity and range of motion for trunk/sacrum/shank flexion-extension were obtained in the turning task. Our results also indicated that during walking, while there was no difference in swing time, double support portion of gait among the stroke group was significantly larger (p-value = 0.001). Outcomes of this investigation may help in designing new rehabilitation programs for stroke and other neurological disorders and/or in improving the efficacy of such programs.Clinical Relevance— This study may provide a better insight on the detailed functional differences between stroke survivors and healthy individuals which in turn could be used to develop a more efficient rehabilitation program for stroke community.

Conservative Management Of Low Back Pain, Se Won Lee, Dan Nguyen, Denny Mack, Eric Aguila, Mary Thomas, Karyn Doddy

HCA Healthcare Journal of Medicine

Low back pain (LBP) is frequently encountered in outpatient clinics and affects individual patients and society in general with decreased physical function, quality of life, disability, and/or economic burden. Although most acute LBP resolves on its own, recurrent and chronic LBP is a common reason for outpatient clinic visits. This review explores pragmatic approaches to LBP in the clinical setting, focusing on recognizing prognostic factors, initial approaches to evaluation, including selective imaging, and conservative management including patient education, therapeutic exercises and bracing.

Prediction Of Fall Risk Among Community-Dwelling Older Adults Using A Wearable System, Thurmon Lockhart, Rahul Soangra, Hyunsoo Yoon, Teresa Wu, Christopher W. Frames, Raven Weaver, Karen A. Roberto

Physical Therapy Faculty Articles and Research

Falls are among the most common cause of decreased mobility and independence in older adults and rank as one of the most severe public health problems with frequent fatal consequences. In the present study, gait characteristics from 171 community-dwelling older adults were evaluated to determine their predictive ability for future falls using a wearable system. Participants wore a wearable sensor (inertial measurement unit, IMU) affixed to the sternum and performed a 10-m walking test. Measures of gait variability, complexity, and smoothness were extracted from each participant, and prospective fall incidence was evaluated over the following 6-months. Gait parameters were refined …

Enhancing The Patient Experience Through Innovative Quality Improvement Education, Tami Struessel, Betsy J. Becker, Nicole M. Sleddens

Posters and Presentations: Physical Therapy

The “Patient Experience” arm of the Institute for Healthcare Improvement’s Quadruple Aim is defined by the Institute of Medicine (IOM) as quality care that is safe, effective, patient-centered, timely efficient, and equitable. The IOM called for a uniform approach to health professions education utilizing five core competencies to achieve high-quality care. “All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.” Physical Therapy educators have expanded curricula to teach three of these five competencies. We routinely teach that physical therapists practice in interprofessional teams to provide …

Ease-Ing Dpt Students Into The Acute Care Environment, Nicole M. Sleddens, Tessa Wells, Stacie Mae Larreau Christensen, Kellie Clapper, Lora Pieper

Posters and Presentations: Physical Therapy

Purpose: The Early Acute Service Experience program (EASE) is a dual-purpose program that prepares physical therapy students to transition from the academic setting to the acute clinical environment while providing a helpful service to key clinical partners. Methods/Description: This program requirement begins as students are assigned a weekend in the second semester of the DPT curriculum to work with a physical therapist in the hospital. As the first step in their orientation, students complete an e-learning module which focuses on the knowledge, skills, and abilities required in the acute care clinical environment. Once a student has completed the module and …

Criterion Validation And Interpretability Of The Single Assessment Numerical Evaluation (Sane) Of Self-Reported Recovery In Patients With Neck Pain, Elizabeth Oakley, Chad E. Cook, Bryan O'Halloran

Faculty Publications

Background

The SANE is a PROM of recovery, which may assist clinicians in clinical decision-making and discharge planning. The psychometric measurement properties of the SANE have yet to be determined for neck pain.

Objectives

Threefold objectives included: 1)determine the numerical threshold for the SANE at which patients with neck pain determine their symptoms are acceptable; 2)determine the association between scores for the NDI and VAS, with the SANE; 3)determine the average number of visits, costs and value associated with the management of neck pain.

Design

Longitudinal repeated measures cohort design.

Methods

Threshold measures for self-reported recovery with the …

Physical Therapy And Occupational Therapy Well-Being, Jenna Pilkington, Dara Musher-Eizenman, Cindi Baum, Elizabeth Emley

Honors Projects

There is a lack of research in the professions of physical therapy and occupational therapy. To be more specific, the areas of stress and burnout have been topics of research within the healthcare field for medical physicians and nurses, but currently there is little research looking at stress and burnout for physical therapists and occupational therapists. (Anderson 2015; Berry 2019). The current study aims to look at the emotional connections between patients and professions, along with the related emotional stress experienced by these professionals. A survey was administered to 59 physical therapists and occupational therapists for the purpose to give …

Self-Paced Treadmills Do Not Allow For Valid Observation Of Linear And Nonlinear Gait Variability Outcomes In Patients With Parkinson’S Disease, Maryam Rohafza, Rahul Soangra, Jo Armour Smith, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Background

Due to the imposed constant belt speed, motorized treadmills are known to affect linear and nonlinear gait variability outcomes. This is particularly true of patients with Parkinson’s Disease where the treadmill can act as an external pacemaker. Self-paced treadmills update the belt speed in response to the subject's walking speed and might, therefore, be a useful tool for measurement of gait variability in this patient population. This study aimed to compare gait variability during walking at self-paced and constant treadmill speeds with overground walking in individuals with PD and individuals with unimpaired gait.

Methods

Thirteen patients with Parkinson’s Disease …

Remote, Unsupervised Functional Motor Task Evaluation In Older Adults Across The United States Using The Mindcrowd Electronic Cohort, Andrew Hooyman, Joshua S. Talboom, Matthew D. De Both, Lee Ryan, Matthew J. Huentelman, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

COVID-19 has impacted the ability to evaluate motor function in older adults, as motor assessments typically require face-to-face interaction. One hundred seventy-seven older adults nationwide completed an unsupervised functional upper-extremity assessment at home. Data were compared to data from an independent sample of community-dwelling older adults (N = 250) assessed in lab. The effect of age on performance was similar between the in-lab and at-home groups. Practice effects were also similar. Assessing upper-extremity motor function remotely is feasible and reliable in community-dwelling older adults. This test offers a practical solution for telehealth practice and other research involving remote or geographically …

Impact Of Pro Bono Clinic On Attitudes, Beliefs, And Confidence Towards Cultural Competence In First-Year Doctoral Physical Therapy Students, Scarlett Morris, Ruiping Xia, Troy Klaassen, Trey Johnson

Internet Journal of Allied Health Sciences and Practice

Purpose: Cultural competence is an essential skill for healthcare providers in our increasingly ethnically diversified society. There is an unmet need for educating future culturally competent physical therapists. The purpose of this study was to investigate the impact of pro bono clinic on cultural competence in first-year doctoral physical therapy students. Method: Forty-two participants completed a survey before and after attending three individual sessions of mentored pro bono clinical experiences during their first semester. The survey assessed participants’ attitudes and beliefs (Part I), and self-perceived level of confidence (Part II) towards cultural competence. Wilcoxon signed-rank tests were performed. Results: The …

A Student Physical Therapist’S Perspective On Her Efficacy Providing Culturally Competent Care: A Reflective Case Study, Anna S. Kelly, Deborah M. Wendland

Internet Journal of Allied Health Sciences and Practice

Purpose: Cultural differences and personal biases can affect the way a clinician provides care and the way in which patients receive it. The Commission on Accreditation in Physical Therapy Education (CAPTE) designates cultural competence as one of the professional practice expectations for physical therapy students, although no standardized blueprint exists for Doctor of Physical Therapy (DPT) programs. This case report will illustrate how reflection can be used to facilitate a student’s growth into becoming more prepared to practice in a culturally aware and effective way. In addition, this report seeks to provide a student’s perspective on her efficacy providing culturally …

Clinician Productivity During Student Full Time Clinical Experiences, Jamie Dehan, Michele Avery, Trevor Elmer, Yvonne Colgrove

Internet Journal of Allied Health Sciences and Practice

Purpose: Clinical education is an essential part of physical therapy education. Clinicians who provide student clinical training have the primary responsibility of patient care and meeting their job demands including meeting productivity standards. Adding a student to the mix is often perceived as negatively impacting productivity. The purpose of this study is to examine the impact on clinician productivity in direct patient care while hosting a student for a clinical experience. This study (a) investigates differences seen when hosting a DPT student or a PTA student; (b) compares differences seen influenced by which curricular stage the student is in for …

Kinematic Analysis Of A Series Of Jumps In First Position In Professional Ballet Dancers, Jessica Smith, Kevin Robinson, Pat Sells

Internet Journal of Allied Health Sciences and Practice

Purpose: Few ballet-specific studies in the literature examine kinematics during dance activities. Sports studies have identified injury risk in athletes by observing kinematics during specific activity, but this has not yet been explored for ballet. Evaluating kinematics in dancers has the potential to identify injury risk and influence treatment for prevention and rehabilitation. Therefore, the purpose of this study was to examine the landing kinematics of professional ballet dancers during a series of 16 ballet-specific jumps. Methods: This study was a multi-factor repeated measures design. Participants (3 males, 16 females aged 19-33 years; first or second company members) performed 16 …

Intensive Robot-Assisted Gait Training In Individuals With Chronic Spinal Cord Injury: Case Series From Saudi Arabia, Naif Alraddadi, Sanaa Madi

Internet Journal of Allied Health Sciences and Practice

Purpose: The aim of this study was to report whether intensive body weight-supported treadmill training with a robotic exoskeleton could improve over-ground functional mobility in individuals with chronic spinal cord injury and to investigate its feasibility and safety. Methods: This was a case series design. Two male individuals with chronic (> 1 year since injury) spinal cord injury (SCI) were included in this study. All subjects underwent intensive gait training sessions 5 times per week using exoskeleton for 12 weeks with a total of 60 sessions. The duration of the session was 60 minutes, including the installment of the HAL, …

Functional Reach Test, Single-Leg Stance Test, And Tinetti Performance-Oriented Mobility Assessment For The Prediction Of Falls In Older Adults: A Systematic Review, Humberto Omaña, Kari Bezaire, Kyla Brady, Jayme Davies, Nancy Louwagie, Sean Power, Sydney Santin, Susan W. Hunter

Physical Therapy Publications

OBJECTIVE: The authors sought to systematically review the existing literature on the falls-related diagnostic test properties of the Functional Reach Test (FRT), single-leg stance test (SLST), and Tinetti Performance-Oriented Mobility Assessment (POMA) in older adults across settings and patient populations.

METHODS: The PubMed, EMBASE, and CINAHL databases were searched (inception-July 2020). Inclusion criteria were participants aged 60 years or more, prospectively recorded falls, and the reporting of falls-related predictive validity. Manuscripts not published in English were excluded. Methodological quality of reporting was assessed using the Tooth Scale.

RESULTS: Of 1071 studies reviewed, 21 met the inclusion criteria (12 POMA, 8 …

Co-Contraction Of Ankle Muscle Activity During Quiet Standing In Individuals With Incomplete Spinal Cord Injury Is Associated With Postural Instability, Kai Lon Fok, Jae W Lee, Janelle Unger, Katherine Chan, Kristin E Musselman, Kei Masani

Physical Therapy Publications

Previous findings indicate that co-contractions of plantarflexors and dorsiflexors during quiet standing increase the ankle mechanical joint stiffness, resulting in increased postural sway. Balance impairments in individuals with incomplete spinal cord injury (iSCI) may be due to co-contractions like in other individuals with reduced balance ability. Here we investigated the effect of co-contraction between plantar- and dorsiflexors on postural balance in individuals with iSCI (iSCI-group) and able-bodied individuals (AB-group). Thirteen able-bodied individuals and 13 individuals with iSCI were asked to perform quiet standing with their eyes open (EO) and eyes closed (EC). Kinetics and electromyograms from the tibialis anterior (TA), …