Physical Therapy Commons^™

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills

Doctoral Dissertations

Phantom limb pain is a chronic pain condition that negatively impacts the lives of over half of amputees, and results in considerable morbidity. Currently, there is no gold standard for treatment for phantom limb pain. However, a frequently used intervention is the use of mirror visual feedback, in which the amputee watches the reflection of the adjacent non-amputated limb move and exercise. In the last few decades, mindfulness-based interventions have been increasingly used with individuals living with different types of chronic pain. This study attempts to discover if the addition of a mindfulness-based intervention, such as guided meditation, will augment …

The Effects Of The Mckenzie Method And Strengthening/Stabilization Exercises In Patients With Chronic Nonspecific Low Back Pain., Lufei Harder

Honors College Theses

Background & objective: Low back pain is a frequent problem that the majority of people will face at some point in their lifetime. Exercise has been advocated as an effective treatment for chronic nonspecific low back pain; however, there is a lack of consensus on the best form of exercise treatment. This review was designed to compare the effectiveness of the McKenzie Method against stabilization/strengthening exercises in patients with chronic nonspecific low back pain.

Methods: A literature review examining McKenzie and stabilization exercises for chronic nonspecific low back pain were identified from three databases.

Results: A total of nine articles …

Icf Linking Of Patient-Reported Therapy Goals For Children With Acquired Upper Extremity Impairment, Jenny M. Dorich, Roger Cornwall, Timothy L. Uhl

Physical Therapy Faculty Publications

BACKGROUND: Patient reported outcome measures are used to evaluate hand therapy outcomes. Yet, limited evidence is available regarding the outcomes children desire from hand therapy.

PURPOSE: To determine the desired treatment outcomes of children with acquired upper extremity impairments.

STUDY DESIGN: Descriptive case series METHODS: Two raters independently applied International Classification of Function, Disability and Health (ICF) linking rules to the Canadian Occupational Performance goals of 151 children, age 6-18, receiving occupational therapy for acquired upper extremity impairments. Prevalence of the linked ICF codes was examined using frequency distributions. Kappa and the proportion of positive agreement assessed inter-rater agreement of …

Dancer Screening Clinic, Kristen Manaloto, John Lencioni, Laura Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dance students at the University of Nevada, Las Vegas (UNLV) do not have access to sports medicine specialists, thus a pro-bono dance clinic was created as a service-learning project by the UNLV Department of Physical Therapy (UNLVPT) in 2018. In the second year of the service-learning project, three graduate students from the UNLVPT program, under the supervision of a clinical faculty member, have continued to provide free dance specific injury prevention screenings and management to students within the UNLV Department of Dance. To improve clinic operation and services, the group emphasized communication and accessibility as areas of growth. Injury prevention …

Quality Assurance Of Service Learning Back School, Eric Bashaw, Vu Pham, Tyler Parvin, Ryan Pauly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Project Execution: Back School: During the 2019-20 academic year, two University of Nevada, Las Vegas Physical Therapy (UNLVPT) core faculty members, along with eight doctor of physical therapy students, provided three student-led, pro-bono back school classes at Volunteers in Medicine of Southern Nevada (VMSN). Each back school class consisted of two, 2-hour sessions where participants were screened for red flags, educated on pain management strategies and common causes of back pain, and given an individual home exercise program. Quality Assurance Surveys: Patient’s and VMSN staff were all given questions in the form of Likert-scale and open-ended questions via printed handouts …

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

Is Decreased Trunk Flexion Angle A Contributing Factor To Patellofemoral Joint Loading In Runners With Patellofemoral Pain?, Christine Duvall, Zachary Clark, Tavin Fox, Caitlin Howden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Reduced trunk flexion during running is theorized to be a contributing factor of elevated patellofemoral joint (PFJ) stress in runners with patellofemoral pain (PFP); thus, the primary purpose of this research study was to determine if runners with PFP would exhibit differences in PFJ stress and trunk flexion angle during running as compared to pain-free runners across three speeds. We hypothesized that runners with PFP would exhibit higher PFJ stress and decreased trunk flexion while running compared to the pain- free runners. Number of Subjects: 7 runners with PFP and 5 similar pain-free control runners. Materials/Methods: Kinematics and kinetics …

A Vicious Cycle Of Fear Of Falling Avoidance Behavior In Parkinson’S Disease: A Path Analysis, Kameron Jacobson, Nicole Matsunami, Hannah Mccarl, Michelle Regis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Patient Engagement In Cosmetic Designing Of Prostheses: Current Practice And Potential Outcome Benefits, Kenneth Repayo, Cailin Mitchell, Matthew Tillitt, Collin Weber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Making a prosthesis for an individual with limb loss is a highly personalized process. A currently unexplored area is whether there are tangible benefits in greater patient engagement during the making of their prostheses. We examined the current practice of engaging patients in prosthetic cosmetic designing and identified factors associated with patient outcomes. Methods: This cross-sectional study surveyed 104 prosthetists and 25 prostheses users. The questionnaires covered aspects of prosthetic prescription, users’ perceived level of engagement, and self-reported outcomes. Regression analyses were used to examine the associations between perceived level of engagement, satisfaction, and other outcomes. Results: Among prosthesis …

Effects Of Altered Somatosensory Input On Lower Limb Mechanics Via Different Shoes And Barefoot Walking In Individuals With Chronic Post-Stroke Hemiparesis, Aaron Abraham Simon, Jynelle Marie Guerrero Arches, Megan Leigh Keohane, Wee Jin Jed Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

[Purpose/Hypothesis] Stroke is a leading cause of disability that results in various neurological deficits. Stroke can cause impaired somatosensory input, which results in decreased balance and gait speed, ultimately increasing fall risks. Therapies to increase somatosensory input have shown promise for people with stroke as well as other neurological populations. However, few studies have systematically investigated varying somatosensory input via different footwear to improve walking in people post-stroke. The purpose of this study was to investigate the effects of altering somatosensory input via different types of footwear (i.e., barefoot, self-selected shoes, and memory foam shoes) on gait kinetics and ankle …

Inter And Intra-Rater Reliability Of Dance Screening Tool, Kathleen Stone, Braden Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Previous literature has indicated that injury rates of ballet and modern dancers are among the highest of any physical activity. These injuries can be detrimental to the athlete and can also result in financial burden for dance companies due to time loss related to injuries. Preventative intervention aimed at those who are most at risk for injury can be effective at reducing the cost associated with lost time due to injury. An effective approach to identifying those most at risk for dance related injuries is to administer a functional movement screen. One such movement screen is the ballet-based Dance Technique …

Am-Pac Basic Mobility Inpatient Short Form (Low Function) Psychometrics/Clinimetrics, Meghan Wonderling, David Miller, Selena Soria

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine whether the Activity Measure for Post-Acute Care® Basic Mobility Inpatient Short Form (Low Function) (6-clicks LF) has increased responsiveness for patients with lower levels of physical function compared to the Activity Measure for Post-Acute Care Basic Mobility Inpatient Short Form (6-clicks). Design: Retrospective cohort study using original scores and simulated scores for assessment of internal responsiveness of the 6-clicks LF compared to the 6-clicks. Simulated 6-clicks and 6-clicks LF scores were created as a hypothetical future AM-PAC® score. Results: We found a statistically significant difference between the 6-clicks and simulated 6-clicks, t=24.8, p < 0.00 [two-tailed]. The effect size was large (d=1.2, r=0.51).There was a statistically significant difference between the 6-clicks LF and simulated 6-clicks LF, t=19.7, p < 0.00 [two-tailed]. The effect size was medium (d=0.91, r=0.41). Finally, for patients with a 6-clicks score in the bottom five-percentile (n=27), we found a statistically significant difference between the 6-clicks and 6-clicks LF, t=11.9, p < 0.00 [two-tailed]. Conclusion: Among patients scoring less than 15, the 6-clicks LF has greater internal responsiveness than the 6-clicks and thus demonstrates that the new low-level questions in the 6-clicks LF better quantify low-level patients’ functional level. Research using non-simulated data should be completed in the future to confirm these findings.

Stepping On Fall Prevention Project, James P. Gaddi, Jordan T. Bowers, Lea M. K. Fung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Falls are a major problem in the United States among the older adult population and provide opportunity for community outreach via student-led physical therapy projects. Objective: The purpose of this project was to investigate the relationship between fall related outcome measures and questionnaires with the completion of the Stepping On Fall Prevention program along with evaluating the benefits of Physical Therapy student development with participation in service learning projects. Methods: The research quantified the fall risk of 13 participants with assessment of: gait speed (Timed Up and Go), lower extremity strength (30-Second Chair Stand), balance (4-Stage Balance Test), and …

Neurophysiological Assessments Of Brain And Spinal Cord Associated With Lower Limb Functions In Children With Cerebral Palsy: A Protocol For Systematic Review And Meta-Analysis, Leonard Ubalde, Jing Nong Liang

Physical Therapy Faculty Research

Background: Task-dependent neurophysiological adaptations in people with cerebral palsy have been examined using various techniques such as functional magnetic resonance imaging, peripheral nerve stimulation in order to assess H-reflexes, and transcranial magnetic stimulation. This activity-dependent plasticity is hypothesized to improve specific gross motor function in individuals with cerebral palsy. Although these adaptations have been examined extensively, most studies examined tasks utilizing the upper limbs. The aim of this review is to assess the neurophysiological adaptations of the central nervous system in individuals with cerebral palsy during lower limb functional tasks. Methods: A systematic review and meta-analysis will be conducted to …

Utilization Of Inertial Measurement Units For Determining The Sequential Chain Of Baseball Strike Posture, Yun-Ju Lee, Po-Chieh Lin, Ling-Ying Chen, Yu-Jung Cha, Jing Nong Liang

Physical Therapy Faculty Research

The purpose of this study was to employ inertial measurement units (IMU) with an eyetracking device to investigate different swing strategies between two levels of batters. The participants were 20 healthy males aged 20 to 30 years old, with ten professional and ten amateur batters. Eye gaze position, head, shoulder, trunk, and pelvis angular velocity, and ground reaction forces were recorded. The results showed that professional batters rotated segments more rhythmically and efficiently than the amateur group. Firstly, the professional group spent less time in the preparation stages. Secondly, the maximum angular velocity timing of each segment of the professional …

Quantifying Fear Of Falling By Utilizing Objective Body Sway And Muscle Contraction Measures, Chenfan Gui

Theses & Dissertations

Fear of falling (FOF) is a psychological condition that can lead to increased morbidity and mortality in the elder population. However, the subjective and multidimensional nature of FOF resulted in the limitations of existing FOF measurements, which could influence the quality of those studies. The present study aimed to quantify FOF by using objective center of pressure (COP) trajectories and muscle contraction of the lower extremity to compensate for those limitations. Nineteen young healthy adults (24 years ± 2.47) were recruited in the present study. Subjects were required to watch three 360-degree videos, one control video and two roller coaster …

The Effect Of Obstacle Intervals On Foot Integrated Pressure And Obstacle Negotiation Strategy, Zhuo Wang

Theses & Dissertations

When stepping over a single obstacle, despite of some spatiotemporal parameter changes, the impulse of the leading and trailing leg stays the same. This is considered an efficient obstacle avoidance strategy. However, research has shown that the strategy of multiple obstacles negotiation is different from a single obstacle crossing. Would this efficient strategy still exist during multiple obstacles negotiation? This study attempted to answer this question. Nineteen healthy young adults were recruited in this study. Each participant was required to complete 15 trials under 3 conditions: one-step, two-step, and three-step intervals. Data were collected for foot integrated pressure (FIP), walking …

Adaptation Of Human Locomotion And Unilateral Limb Loading During Different Inclination Treadmill Walking, Yuhang Zhang

Theses & Dissertations

Human locomotion is adaptive in any external environment or different terrains, which has been widely investigated. For example, people can walk at different walking speeds in each leg on a split-belt treadmill. However, human locomotor behaviors are passively adapted during the split-belt treadmill walking. Therefore, the knowledge of how humans actively adjust the flexibility of locomotion is limited by using the split-belt treadmill. To address this gap, this study investigated the flexibility of locomotion by using a 4-lb ankle weight on the dominant leg to induce the asymmetric walking pattern when walking on the inclined, declined, and level treadmill. Twenty …

Is The Walking Pattern Similar Between Slope Walking And Obstacle Negotiation?, Jiani Lu

Theses & Dissertations

Studying biomechanical characteristics of human motion sheds light on the motor control strategies in the central nervous system. Slope walking and obstacle negotiation appear to have some similarities in control strategies based on subjective observation, but these two motions have never been compared objectively in biomechanics literature. This study aimed to investigate the similarities between obstacle negotiation and slope walking in kinematics and muscle activity. The similarities were determined by the correlation of the maximum heel elevation and muscle co-activation index between obstacle negotiation and inclined treadmill walking. The strength of correlation was compared in four different pairs of conditions: …

Service-Learning And Case-Based Learning’S Impact On Student’S Clinical Reasoning : A Repeated Measures Design Study, Gordon B. Tsubira

Occupational Therapy Capstone Presentations

Clinical reasoning is crucial for the occupational therapy profession to thrive in an ever-changing healthcare environment but is seldom isolated for explicit instruction and outcome measurement in course curricula. A single-factor repeated measures design study was conducted to compare the impact of didactic case-based learning and experiential service-learning on the development of the clinical reasoning of students at a midwestern public university’s entry-level master of occupational therapy program. The participants were sixteen graduate occupational therapy students who had completed their foundation-level courses.

Participants explored modes of clinical reasoning in occupational therapy for eight weeks (the first half of the semester), …

The Relationship Of Rehabilitation Therapy Clients And Grit: A Pilot Study, Kamilla Kisch

Honors Theses

Client experience is an important consideration in physical and occupational therapy (known as rehabilitation therapy.) The personality trait of grit has been studied in many different settings and populations and could have an impact on rehabilitation therapy clients’ perceptions and experiences. The purpose of this study is to identify the relationship between scores on Dr. Angela Duckworth’s Grit Scale (that identifies the presence and strength of grit) and perceptions of experiences by rehabilitation therapy clients. Seven males and twelve females (age: 56.78 ± 15.83) participated in this study. The Grit Scale was used to assess participants’ grit. Multiple-choice questions were …

Functional Rehabilitation And Strength Training-Focused Interventions For An Achilles Tendon Rupture And Repair: A Case Report, Anna Murphy

Physical Therapy Scholarly Projects

Background and Purpose. Current literature identifies a lack of consensus regarding specific rehabilitation protocols following acute Achilles tendon ruptures. This case report highlights the rehabilitation of a patient following an Achilles rupture and surgical repair, who underwent a physical therapy treatment program, focusing on interventions to increase function, strength, and return to activity.

Description. The patient is a 64-year-old male, evaluated in the clinic four weeks following a status-post left Achilles tendon repair surgery, and presented with left ankle pain, decreased left ankle range of motion and decreased left ankle strength. The treatments and interventions used for this …

Outpatient Physical Therapy Management Of Lumbar Intervertebral Disc Disorder With Radiculopathy, Kaitlyn Mcclaflin

Physical Therapy Scholarly Projects

Background and Purpose. This article summarizes the 6-week outpatient physical therapy management of a patient that experienced a lumbar disc derangement with radiculopathy in the right lower extremity. She experienced a decrease in function, range of motion, and strength following onset of symptoms. The purpose of this article is to outline the interventions utilized in this patient's plan of care in an attempt to return her to caring for children, full-time work, and daily exercise at her prior level of function.

Description. Patient was a 3 1 -year-old female with 3 children. She worked as a nurse full-time and …

Bankart Labral Repair Rehabilitation Using Fascial Counterstrain, Proprioceptive Neuromuscular Facilitation, And Range Of Motion: A Case Report, Lauren Mcintosh

Physical Therapy Scholarly Projects

Background and Purpose: This case study will address the use of fascial counterstrain, proprioceptive neuromuscular facilitation (PNF), and range of motion (ROM) to rehabilitate an arthroscopic anterior Bankart labrum repair in a pediatric patient. Bankart labral tears are defined as an anteroinferior tear of the labrum, frequently caused by multiple anterior shoulder dislocations. Fascial counterstrain can be used in post-surgical patients to reduce swelling, decrease healing time, and reduce pain. PNF and ROM allow the patient to return to a functional lifestyle and are included in most protocols provided by the surgeon. The purpose of this study is to demonstrate …

Outpatient Physical Therapy Rehabilitation Of A Patient With Ehlers-Danlos Syndrome And Received A Total Knee Arthroplasty, Jacob Todd

Physical Therapy Scholarly Projects

Background and Purpose. Total knee arthroplasties (TKA) remain the gold standard of surgical interventions to the knee and are often used to treat the knee joint for arthritic changes along with therapeutic exercise.

Case Description. This case report describes the physical therapy rehabilitation of a 48-year-old female post left T KA due to increased instability, afthritic changes, and pain caused by her EDS combined with her high BMI. The patient previously had her right knee replaced with a TKA and was acquainted with the rehabilitation process and familiar with all of the therapeutic exercises and proper progression of …

Outpatient Physical Therapy Rehabilitation For A Patient With Wrist Pathology, Amy Svir

Physical Therapy Scholarly Projects

Case Description. This case report describes the physical therapy evaluation and intervention for a 14-year-old female with right wrist pathology. The patient presented with increased pain as well as decreased function, decreased active range-of-motion (AROM), decreased passive range-of-motion (PROM), and decreased wrist strength.

Plan of Care and Intervention. The treatment for this patient was a combination of iontophoresis administration of dexamethasone, manual therapy in the form of instrument-assisted soft tissue mobilization (IASTM) and joint mobilization, and therapeutic exercise. Iontophoresis was used to transfer dexamethasone, an anti-inflammatory medicine, into the affected area.

Outcomes. After 8 treatment sessions, the patient had decreased …

Outpatient Physical Therapy Management For A Full Thickness Sutraspinatus Tendon Tear: A Case Study, Samantha Miller

Physical Therapy Scholarly Projects

Background and Purpose. This article describes the 14-week physical therapy treatment of a pre- and postoperational full thickness supraspinatus tendon tear of a 45-year-old female. The four muscles of the rotator cuff provide stabilization to the glenohumeral joint of the shoulder. These muscles are the supraspinatus, infraspinatus, teres minor, and the subscapularis. ^l In the United States, roughly 460 000 rotator cuff repair surgeries occur each year and they are the second most common orthopedic procedure. ² Past research studies have shown that a full recovery from this surgery takes 3 to 6 months, with factors such as integrity …

Acute Effects Of Static Stretching/Foam Rolling On Muscle And Tendon Stiffness, Michaela Lawlor

Honors Theses

There are various ways to decrease muscle and tendon stiffness, including but not limited to: static stretching, ballistic stretching, cycle stretching, passive and active stretching, and foam rolling. The purpose of this paper is to review different studies that focus on the acute effects of static stretching and foam rolling on muscles of the leg including the gastrocnemius, rectus femoris, hamstrings, soleus, etc. Results showed that static stretching and foam rolling decrease muscle and tendon stiffness in the leg while simultaneously increasing their range of motion, flexibility, and muscle fascicle length immediately after exercise.