Physical Therapy Commons^™

Role Of Physical Therapists In The Management Of Individuals At Risk For Or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline 2022, Ellen Hillegass, Kathleen M. Lukaszewicz, Michael Puthoff

Physical Therapy Faculty Research and Publications

No matter the practice setting, physical therapists work with patients who are at risk for or who have a history of venous thromboembolism (VTE). In 2016, the first clinical practice guideline (CPG) addressing the physical therapist management of VTE was published with support by the American Physical Therapy Association’s Academy of Cardiovascular and Pulmonary Physical Therapy and Academy of Acute Care, with a primary focus on lower extremity deep vein thrombosis (DVT). This CPG is an update of the 2016 CPG and contains the most current evidence available for the management of patients with lower extremity DVT and new key …

Mediation Analysis Of The Effect Of Visuospatial Memory On Motor Skill Learning In Older Adults, Andrew Hooyman, Jennapher Lingo Vangilder, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

There is high inter-individual variability in motor skill learning among older adults. Identifying the nature of these individual differences remains challenging due to interactions between participant characteristics (e.g., age, cognition) and task-related factors (e.g., nature of task, level of skill pre-training), making it difficult to determine plausibly causal relationships. This study addresses these competing explanations by using mediation analysis to examine plausible causal inference between visuospatial memory and one-month retention of both gross and fine motor components of a functional upper-extremity task following training. Results suggest that better visuospatial memory results in more retention of fine but not gross motor …

Classifying Toe Walking Gait Patterns Among Children Diagnosed With Idiopathic Toe Walking Using Wearable Sensors And Machine Learning Algorithms, Rahul Soangra, Yuxin Wen, Hualin Yang, Marybeth Grant-Beuttler

Physical Therapy Faculty Articles and Research

Idiopathic toe walking (ITW) is a gait abnormality in which children’s toes touch at initial contact and demonstrate limited or no heel contact throughout the gait cycle. Toe walking results in poor balance, increased risk of falling, and developmental delays among children. Identifying toe walking steps during walking can facilitate targeted intervention among children diagnosed with ITW. With recent advances in wearable sensing, communication technologies, and machine learning, new avenues of managing toe walking behavior among children are feasible. In this study, we investigate the capabilities of Machine Learning (ML) algorithms in identifying initial foot contact (heel strike versus toe …

Projected Utility Of The Ready Set Return Application, Erin Hartigan, Cassidy Sirois, Jonathan Lindau, Taylor Lockwood, Valerie Nesom, Nan M. Solomons

Journal of Maine Medical Center

Introduction: An application (app) that summarizes best practices may promote standardized care among clinicians treating patients during anterior cruciate ligament (ACL) rehabilitation. The purpose of this study was to test the prototype of the Ready Set Return (RSR) app to determine receptiveness for use in clinical practice.

Methods: Two mock patient cases were used to familiarize 19 physical therapists and athletic trainers with the RSR app. Then these participants provided feedback about the user experience, features, and content using Likert ratings and free-text fields through an online survey.

Results: Most participants (89%-95%) would recommend the RSR app to others and …

Direction Of Attentional Focus In Prosthetic Training: Current Practice And Potential For Improving Motor Learning In Individuals With Lower Limb Loss, Szu-Ping Lee, Alexander Bonczyk, Maria Katrina Dimapilis, Sarah Partridge, Samantha Ruiz, Lung-Chan Chien, Andrew Sawers

Physical Therapy Faculty Research

Objective:

Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting.

Methods:

Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age = 50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience = 10 …

Advancing Academic Capacity In Physical And Rehabilitation Medicine To Strengthen Rehabilitation In Health Systems Worldwide: A Joint Effort By The European Academy Of Rehabilitation Medicine, The Association Of Academic Physiatrists, And The International Society Of Physical And Rehabilitation Medicine, Walter R Frontera, Gerold Stucki, Julia P Engkasan, Gerard E Francisco, Christoph Gutenbrunner, Nazirah Hasnan, Jorge Lains, Yusniza Mohd Yusof, Stefano Negrini, Zaliha Omar, Linamara Rizzo Battistella, Gwen Sowa, Henk Stam, Jerome Bickenbach, European Academy Of Rehabilitation Medicine, Association Of Academic Physiatrists, International Society Of Physical And Rehabilitation Medicine

Faculty, Staff and Student Publications

No abstract provided.

Effect Of Behavioural Practice Targeted At The Motor Action Selection Network After Stroke, Jill C. Stewart, Jessica F. Baird, Stacy L. Fritz, Julius Fridriksson Ph.D.

Faculty Publications

Motor action selection engages a network of frontal and parietal brain regions. After stroke, individuals activate a similar network, however, activation is higher, especially in the contralesional hemisphere. The current study examined the effect of practice on action selection performance and brain activation after stroke. Sixteen individuals with chronic stroke (Upper Extremity Fugl–Meyer motor score range: 18–61) moved a joystick with the more-impaired hand in two conditions: Select (externally cued choice; move right or left based on an abstract rule) and Execute (simple response; move same direction every trial). On Day 1, reaction time (RT) was longer in Select compared …

The Haunted House Experience: Developing A Home Health Assessment Training Utilizing An Interprofessional, Interinstitutional Virtual Simulation, Angel Holland Dpt, Edd, Pamela Degravelles Phd, Rn, Debbie Knight Pharmd, Karen Dickinson Md, Kathryn Neill Pharmd, Duston Morris Phd, Wendy Ward Phd

Faculty Research ​and Publications

To meet the interprofessional education needs of students during the COVID-19 pandemic, universities transitioned to virtual options. For many universities, this transition was challenging and time-consuming. The Arkansas Interprofessional Education Consortium (ARIPEC) combined resources to create a novel learning experience for students with a focus on the skill of home assessment. An interinstitutional, interprofessional faculty project team was developed to create a learning experience, with each institution responsible for a portion of the virtual simulation development. This paper describes the process for creation and implementation of an interprofessional, interinstitutional virtual learning experience to support the growth of healthcare students across …

Cost-Effectiveness Of High-Intensity Training Vs Conventional Therapy For Individuals With Subacute Stroke, T. George Hornby, Miriam Rafferty, Daniel Pinto, Dustin D. French, Neil Jordan

Physical Therapy Faculty Research and Publications

Objective

This investigation estimated the incremental cost-effectiveness of high-intensity training (HIT) compared with conventional physical therapy in individuals with subacute stroke, based on the additional personnel required to deliver the therapy.

Design

Secondary analysis from a pilot study and subsequent randomized controlled trial.

Setting

Outpatient laboratory setting.

Participants

Data were collected from individuals with locomotor impairments 1-6 months poststroke (N=44) who participated in HIT (n=27) or conventional physical therapy (n=17).

Interventions

Individuals performing HIT practiced walking tasks in variable contexts (stairs, overground, treadmill) while targeting up to 80% maximum heart rate reserve. Individuals performing conventional therapy practiced impairment-based and functional …

Comparative Effectiveness Of Jade Stone Mobilisation, Non-Abrasive Cupping, And Manual Drainage Technique In Subjects With Chronic Sinusitis: A Randomized Clinical Trial, Monali Gandhi, Peeyoosha Gurudut Dr.

Internet Journal of Allied Health Sciences and Practice

Purpose: Sinusitis in recent times has been known as one of the major causes for reduced quality of life and work absenteeism. Chronic sinusitis being one of the health hazards affecting QOL of subjects of any age and gender requires a specific therapeutic intervention. Clinical trials that can demonstrate the effectiveness of manual therapy intervention in sinusitis cases are lacking. Hence, this study aims to evaluate and compare the effectiveness of three manual therapy techniques in subjects with chronic sinusitis. Method: The current study is a prospective, parallel arm, randomised clinical trial performed at physiotherapy OPD, tertiary health …

Quality Delivered: How A Pandemic Fostered Innovation And Creative Solutions In Clinical Education, Alice M. Davis, Laura Laporta, Nancy F. Mulligan, Stacy Carmel, Shelene Thomas, Denise O'Dell

Internet Journal of Allied Health Sciences and Practice

Background: Clinical education placements for students enrolled in healthcare programs were abruptly upended in March 2020 due to COVID-19. Programs were faced with decisions of how to mitigate substantive challenges due to an unforeseen pandemic within timeframes that would align with curricular sequences and graduation dates. Schools quickly modified curriculum formats, implemented alternative teaching and learning instruction and developed safety protocols to protect students, clinical faculty, and patients. Purpose: The aim of this study explored the strategies employed by one physical therapy school’s clinical education team, which resulted in successful completion of clinical course requirements and on-time graduation. Method: Data …

Implementation Of Home Exercise Programs In A Pro-Bono Clinic: An Exploratory Study, Joseph M. Day

Internet Journal of Allied Health Sciences and Practice

Purpose: Because the number of return visits in a pro-bono setting is low and distributed over a longer timeframe, home exercise programs (HEP) adherence is crucial for patient success. The purpose of this study is to describe a process for HEP delivery and to collect measures of HEP adherence on patients at a pro- bono physical therapy clinic. Methods: Thirteen participants were instructed to perform at least four exercises at home. Exercises were chosen based on best available practice. Exercise images, instructions, and daily logs were populated using PHYSIOTEC® software. A follow up phone call was conducted approximately 4 days …

Pain Education Training In New York State Physical Therapy Programs: What We Do Well, Where The Gaps Are, And What Can Be Improved, Joseph Tatta, Marcia Spoto, Joseph Lorenzetti

Internet Journal of Allied Health Sciences and Practice

Purpose: Essential pain education produces graduates who are competent in contemporary pain management. Despite various educational resources, surveys demonstrate minimal pain content in entry-level physical therapist education programs. This paper examines 1) the learning content of pain education and faculty expertise teaching core pain content, 2) whether pain education content is sufficient to prepare physical therapists to meet the needs of contemporary pain management, and 3) whether standardization of pain education in entry level Doctor of Physical Therapy (DPT) programs is advantageous. Methods: A pain education survey was developed and sent to all accredited DPT program directors in New York …

Investigating Doctor Of Physical Therapy Student Stress During Pandemic Related Curricular Changes, Keithann Halle, Jennifer D. Hastings

Internet Journal of Allied Health Sciences and Practice

Introduction: Stress level in physical therapy students has been a focus of research due to multiple documented effects related to physical health, mental health, and ability to learn. Self-reflection has also been a focus of education research, relating it to personal learning, critical thinking, and demonstrable development of professional behaviors and skills. The aim of this study is to investigate student stress in response to programmatic changes wrought by the pandemic and whether stress impacted student self-reflection. Review of literature: Self-reflection is positively associated with growth of professional behavior and academic performance. Student level of self-reflection has been shown to …

Dérivation De Règles De Prédiction Clinique Pour Dépister Les Patients Ayant Une Lombalgie Non Aiguë Manifestant Un Succès Thérapeutique Lors D’Un Programme D’Exercice De Stabilisation Lombaire, Christian Larivière, Marie-France Coutu, Sharon M. Henry, Richard Preuss, Nicolas Roy, Khalil Rabhi

Rapports de recherche scientifique

Les exercices physiques permettent de réduire la douleur et les incapacités chez les gens souffrant d’une lombalgie non aiguë (> 3-4 semaines), mais ces effets sont limités. Pour rehausser l’efficacité de ce type d’intervention, il faut déterminer quels patients répondent le mieux à chaque modalité d’exercice (arrimage patient/intervention) et pour quelles raisons (mécanismes sous-jacents). Dans la présente recherche, l’intérêt est porté à un programme d’exercices de stabilisation lombaire (PESL), une modalité active d’exercice gagnant en crédibilité et en popularité. Deux objectifs ont été poursuivis : (1) finaliser l’étape de dérivation de règles de prédiction clinique (RPC) de succès^[1] pour …

Efektivitas Pemberian Lumbar Stabilization Exercise Terhadap Peningkatan Kemampuan Fungsional Pada Kasus Low Back Pain Myogenic: Literature Review, Sabilla Nur Hikhmah, Mita Noviana, Riza Pahlawi

Jurnal Fisioterapi Terapan Indonesia

Low back pain is the most common symptom experienced by people of all ages. However, low back pain myogenic can cause pain, spasms, muscle weakness, limited range of motion (ROM), and muscle imbalances, resulting in decreased core and lower back muscles, and limited mobility of the lumbar spine, causing a decrease in ability functional. In Indonesia, the prevalence of people affected by myogenic LBP has increased, almost 75% of them are related to work. From the search results with various databases, 75 articles were found which were then filtered and 21 articles were selected. But of the 21 articles, there …

Analisis Interaksi Postur Dengan Peralatan Kerja Menggunakan Metode Rapid Office Strain Assessment (Rosa) Pada Pekerja Kantor X, Muhammad Luthfi

Jurnal Fisioterapi Terapan Indonesia

Workers in any industry are at risk for Work-related Musculoskeletal Disorders (WMSDs) including office administration workers. This study aims to analyze the interaction of posture with work equipment using the rapid office strain assessment (ROSA) method to assess the ergonomic risk factor. This study found typing is an area requiring ergonomic intervention with chair is more influential (52%) than monitors and other office equipment (48%). Meanwhile other equipment that affects worker posture is mouse and keyboard (62%) compared to telephone and monitor (38%). WMSDs in office administration workers are strongly affected by the chair, mouse and keyboard.

Studi Kasus Penatalaksanaan Terapi Okupasi Bersumberdayamasyarakat Dalam Aktivitas Memasak Pada Penderita Strokedi Desa Setisari, Hermito Gidion, Muhammad Luthfi, Dini Fajariani, Aditya Denny Pratama

Jurnal Fisioterapi Terapan Indonesia

Stroke is a health problem that affects a person's independence. Occupational therapists can carry out community-based occupational therapy (TOBM) in intervening in stroke patients. The aim of this intervention is to improve the patient's ability to cook from an occupational therapy perspective. In community service through TOBM, stroke patients in Siteari village were given an intervention for 1 month to assess an increase in independence in cooking. There are results that TOBM can increase patient independence in cooking.

Efektivitas Terapi Latihan Terhadap Kemampuan Fungsional Post Rekonstruksi Acl Grade 2, Faizah Abdullah Djawas, Prasasti Prasasti

Jurnal Fisioterapi Terapan Indonesia

Introduction: Anterior Cruciate Ligament rupture is a condition with a tear in the ACL ligament, caused by direct or indirect contact in the knee. Various problems in patients with post-ACL reconstructions include a limited range of motions (ROM), decreased muscle strength, and decreased functional ability. Exercise therapy in CKCE, OKCE, and core stability is believed to improve functional abilities by decreasing pain and improving ROM and muscle strength. The purpose of this study is to determine the effectiveness of exercise therapy on functional ability in post-reconstructionACL grade 2. Method: Single case study, physiotherapy intervention in a 19-year-old male. Exercise therapy …

Efektifitas Acbt Dalam Meningkatkan Ekspansi Dada Pada Kasus Bronchiectasis : Studi Kasus, Riza Pahlawi, Aditya Denny Pratama, Mita Noviana, Anastasia Viastuti Iskandar

Jurnal Fisioterapi Terapan Indonesia

Bronchiectasis is a major chronic disease characterized by infection, inflammation, and permanent dilation of the bronchial walls. Interaction of chronic infection, exacerbation, and inflammation resulting in lung injury. Patients with bronchiectasis have several clinical manifestations of primary bronchiectasis, which is the occurrence of recurrent, chronic infections. In patients with bronchiectasis, mechanical efficiency of breathing leads to decreased rib movement and increased abdominal movement leading to a paradoxical breathing pattern. Treatment goals include achieving symptom control, preventing or reducing exacerbations. Various alternative airway techniques have been used in the physiotherapeutic management of patients with bronchiectasis. Techniques are considered the way to …

Efektivitas Balance Dan Core Exercise Untuk Meningkatkankeseimbangan Statis Pada Kasus Stroke Hemiparese Sinistra, Aditya Denny Pratama, Fatimah Fatimah, Mita Noviana, Riza Pahlawi

Jurnal Fisioterapi Terapan Indonesia

Stroke is a rapidly developing loss of brain function due to interruption of the blood supply to the brain. This can be caused by a blockage or bleeding in the blood vessels in the brain. The purpose of this study is to find out and understand how the effectiveness of balance and core exercise is to improve static balance in cases of left hemiparese stroke at Karmel Stroke Services. Of the various physiotherapy methods that can be done to overcome problems that can arise such as muscle weakness, balance disorders, posture disorders, and Activity Daily Living (ADL) disturbances in cases …

Paired Associative Stimulation Applied To The Cortex Can Increase Resting-State Functional Connectivity: A Proof Of Principle Study, Andrew Hooyman, Alexander Garbin, Beth E. Fisher, Jason J. Kutch, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Introduction
There is emerging evidence that high Beta coherence (hBc) between prefrontal and motor corticies, measured with resting-state electroencephalography (rs-EEG), can be an accurate predictor of motor skill learning and stroke recovery. However, it remains unknown whether and how intracortical connectivity may be influenced using neuromodulation. Therefore, a cortico–cortico PAS (ccPAS) paradigm may be used to increase resting-state intracortical connectivity (rs-IC) within a targeted neural circuit.

Purpose
Our purpose is to demonstrate proof of principle that ccPAS can be used to increase rs-IC between a prefrontal and motor cortical region.

Methods
Eleven non-disabled adults were recruited (mean age 26.4, sd …

“Assessment Of Student Readiness For Clinical Education In Mixed-Mode Curriculum Delivery: A Case Study”, Laura W. White, Kelly E. Jordan, Heidi Mcdermott

Physical Therapy Faculty and Staff publications

Purpose – The purpose of this case study is to describe a simulation-based assessment designed to assure student readiness for a first full-time clinical experience in an entry-level Doctor of Physical Therapy program that transitioned to mixed-mode instruction during the COVID-19 pandemic.

Design/methodology/approach – A cohort of 40 second-year physical therapy students whose content delivery mode, assessment methods and curricular sequence deviated from the curricular plan participated in a new assessment using standardized patients. The assessment was developed to preferentially address the knowledge, skills, abilities and professional behaviors (KSAs) that were typically assessed with other methods before the pandemic.

Findings …

Doctor Of Physical Therapy Students’ Clinical Reasoning Readiness And Confidence Treating With Telehealth: A United States Survey, Derrick F. Campbell, Jean-Michel Brismée, Brad Allen, Troy L. Hooper, Manuel A. Domenech, Kathleen Manella

Education Collection

Purpose: Telehealth has an emerging footprint on entry-level physical therapy programs. Students’ readiness for clinical reasoning with virtual versus traditional face-to-face treatment remains unknown. The purpose of this study was to evaluate Doctor of Physical Therapy (DPT) students’ preparedness for clinical experiences with and without telehealth.

Methods: A descriptive and exploratory cross-sectional survey was employed, with a voluntary convenience sample of 211 second- and third-year university DPT students during Fall 2020 clinical experiences. Descriptive and inferential statistics evaluated differences in DPT students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, …

Assessing The Efficacy Of Physical Prehabilitation On A Total Knee Arthroplasty, Zen S. Miyashiro

University Honors Theses

Prehabilitation is a rather new method of approach to the physical therapy setting in which patients attend therapy sessions to prepare for their upcoming surgery. Researchers hypothesize that if patients enter a procedure with higher levels of strength and function, they will be able to recover from their surgery quicker and more successfully. This literature review assesses different approaches that numerous studies have taken with regards to prehabilitation for patients about to undergo a Total Knee Arthroplasty. Majority of the studies conclude that there needs to be further research done to yield consistent results. Based on what has been done, …

Identifying Gait Pathology After Acl Reconstruction Using Temporal Characteristics Of Kinetics And Electromyography, Naoaki Ito, Jacob J. Capin, Ashutosh Khandha, Thomas S. Buchanan, Lynn Snyder-Mackler

Physical Therapy Faculty Research and Publications

Purpose

Asymmetrical gait mechanics after anterior cruciate ligament reconstruction (ACLR) are associated with the development of posttraumatic knee osteoarthritis. Current measures of gait mechanics have focused heavily on peak magnitudes of knee kinematics, kinetics, and joint contact forces but have seldom considered the rate of knee loading, cumulative knee load, or the timing of motor input surrounding peaks. The purpose of this study was to introduce and describe novel metrics of gait using temporal characteristics of kinetics and EMG to identify neuromuscular deficits of the quadriceps in patients after ACLR.

Methods

Gait mechanics were assessed 6 months (n = …

Total Knee Arthroplasty Assessments Should Include Strength And Performance-Based Functional Tests To Complement Range-Of-Motion And Patient-Reported Outcome Measures, Jacob J. Capin, Michael J. Bade, Jason M. Jennings, Lynn Snyder-Mackler, Jennifer E. Stevens-Lapsley

Physical Therapy Faculty Research and Publications

Range of motion (ROM) and pain often define successful recovery after total knee arthroplasty (TKA), but these routine clinical outcomes correlate poorly or not at all to functional capacity after TKA. The purpose of this Perspective is to underscore the importance of muscle strength and performance-based functional tests in addition to knee ROM and patient-reported outcome (PRO) measures to evaluate outcomes after TKA. Specifically: (1) muscle strength is the rate-limiting step for recovery of function after TKA; (2) progressive rehabilitation targeting early quadriceps muscle strengthening improves outcomes and does not compromise ROM after TKA; (3) ROM and PROs fail to …

Walking Improvement In Chronic Incomplete Spinal Cord Injury With Exoskeleton Robotic Training (Wise): A Randomized Controlled Trial, Dylan J Edwards, Gail Forrest, Mar Cortes, Margaret M Weightman, Cristina Sadowsky, Shuo-Hsiu Chang, Kimberly Furman, Amy Bialek, Sara Prokup, John Carlow, Leslie Vanhiel, Laura Kemp, Darrell Musick, Marc Campo, Arun Jayaraman

Faculty, Staff and Student Publications

Study design: Clinical trial.

Objective: To demonstrate that a 12-week exoskeleton-based robotic gait training regimen can lead to a clinically meaningful improvement in independent gait speed, in community-dwelling participants with chronic incomplete spinal cord injury (iSCI).

Setting: Outpatient rehabilitation or research institute.

Methods: Multi-site (United States), randomized, controlled trial, comparing exoskeleton gait training (12 weeks, 36 sessions) with standard gait training or no gait training (2:2:1 randomization) in chronic iSCI (>1 year post injury, AIS-C, and D), with residual stepping ability. The primary outcome measure was change in robot-independent gait speed (10-meter walk test, 10MWT) post 12-week intervention. Secondary …

Interprofessional Collaboration With Occupational Therapy Assistant And Physical Therapist Assistant Students Through A Simulated Academic Setting, Brooke Gentry, Samantha Harris, Cindy Hayden, Allen Keener

International Journal of Health Sciences Education

Background: There is a direct emphasis on interprofessional learning and interprofessional education (IPE) at the accreditation and national level (IPE, 2016). There are, however, no studies on the effectiveness in the delivery of interprofessional collaboration in the academic setting, specific to occupational therapy assistant students. Therefore, the following research has been developed to address this area of need in occupational therapy assistant education.

Methods: This research was conducted in the academic setting, through a simulated lab-based case with occupational therapy assistant and physical therapist assistant students as the participants. The perceived confidence and communication were measured through a pre …

A Novel Approach Toward Concussion Testing, Jorge K. Mercado, Ari Schacter, Danielle Euzent

Student Theses

A concussion is a violent jarring or shaking of the head caused by whiplash or direct impact that results in a disturbance of brain function. Concussions can be mild and brief, as a person may be dazed momentarily or can be more serious, resulting in a loss of consciousness. Underreporting of concussions is prevalent because they are a symptom-based diagnosis, lacking a clinical test. In this study, we investigated the use of VNG testing as a clinical diagnosis of concussions. Looking at the VNG test battery, the previous research cohort found that saccades, gaze, and positional testing are the most …