Physical Therapy Commons^™

Adoption And Awareness Of Long-Covid Clinical Practice Guidelines Among Physical Therapists: A Nationwide Survey, Robert Dekerlegand, Pt, Mpt, Phd, Ccs, Malachy Clancy, Phd, Otr/L, Bcpr

Department of Physical Therapy Posters

Background and Purpose

• Approximately 15% of individuals infected with SARS-CoV-2 develop “Long-COVID” with persistent physical, cognitive, and/or mental symptoms potentially amendable to physical therapy.
• Variability exists in the rehabilitation approach for individuals receiving physical therapy for this novel condition.
• Clinical practice guidelines (CPGs) and other evidence-based resources exist to help standardized rehabilitation; however, it is unknown if physical therapists (PTs) are applying them in the management of individuals with Long-COVID.
• We surveyed PTs in the contiguous United States (U.S.) to explore their awareness and application of Long-COVID CPGs along with their general awareness of this condition.

The Efficacy Of Inspiratory Muscle Training Post Covid: A Systematic Review, Robert Dekerlegand, Sydney Brannen, Olivia Bunch, Amrit Deo, Erin Dopke, Kayleigh Moreland

Department of Physical Therapy Posters

Introduction

• Fatigue and dyspnea can persist post COVID infection and negatively impact both functional capacity and quality of life (QOL).^1,2
• Residual pulmonary impairments and/or inspiratory muscle dysfunction associated with COVID infection contribute to these symptoms.^2,3
• Ventilatory demands exceeding the capacity of the inspiratory muscles can exacerbate these symptoms accentuating activity limitations that restrict participation in life roles.
• As symptom-limited exercise and QOL are related to inspiratory muscle function post COVID,^4,5 inspiratory muscle training (IMT) may improve rehabilitation outcomes.³
• The purpose of this systematic review was to determine the potential efficacy of IMT in individuals post-COVID.

Effect Of Apathy On Exercise Adherence Among Community-Dwelling Older Adults With Chronic Health Conditions, Hiromichi Takeda, Katsuhiko Takatori

Asian Journal of Physical Therapy

Background: The association between apathy and physical activity levels in older adults is well established. It is essential for older adults with chronic health conditions not only to be more active but also to adhere to a personalized exercise prescription. However, the impact of apathy on exercise adherence remains unclear. This study aimed to investigate the effect of apathy on exercise adherence in older adults with chronic health conditions. Methods: This research was a secondary longitudinal data analysis of a behavior change intervention conducted through a randomized controlled trial. The participants included older adults aged 65 years and above (n …

Exploring Leadership In Physical Therapy: How Clarity, Connection, And Communication Influence Team Engagement, Burnout, And Achieving Organizational Objectives, Jason Collin

Dissertations

Purpose: The purpose of this mixed methods study was to identify and describe how highly effective PT leaders use the three competencies of HPTs (clarity, connection, and communication) to increase engagement, prevent burnout, and achieve organizational objectives. The second purpose of this study was to determine the degree of importance that highly effective PT leaders perceive the three HPTE core competencies impact their leadership for creating HPTs.

Methodology: The mixed methods study identified and described eight PT leaders’ perceptions of how they use clarity, connection, and communication to build and sustain HPTs. PT leaders were selected through purposive and snowball …

Influences Of Lower Limb Strength And Rate Of Torque Development On Recovery From A Backwards Balance Loss, Vadim Drake, Julie Gage, Madison Morris, Lyndsay Stutzenberger, Gabe Haberly

Student-Faculty Research - College of Physical Therapy

Falls account for the largest percentage of hip fractures and cause of unintentional death

Falls due to posterior losses of balance are the hardest to prevent and increase the risk of hip fractures

One way to prevent falls is to investigate how lower body strength impacts recovery stepping strategies

Research has not yet determined the extent to which lower body strength impacts stepping strategy during a posterior loss of balance

The purpose of this study is to determine the extent to which rate of peak torque and rate of torque development (RTD) impacts the recovery stepping response from a posterior …

Comparison Of Wingate Bike Test And 1-Min Sit-To-Stand Test Utilizing Blood Lactate And Patient Report, Tyler Whited, Mary Imboden, Jeff Houck, Hannah Quinn, Peter Weiss, Tony Huynh, Garrett Cassio

Student-Faculty Research - College of Physical Therapy

For older adults, performing activities of daily living (ADLs) requires generating short bursts of energy anaerobically.1 The current gold standard for measuring anaerobic threshold (AT) is the Wingate Anaerobic Test, which requires a specialized bicycle. While many tests exist to assess fall risk and submaximal endurance, there is an absence of accessible clinical tools for measuring anaerobic threshold. Measuring AT is an important predictor of an older adult’s ability to perform ADLs safely, allowing physical therapists to tailor interventions to improve function and quality of life.

First Of It's Kind: Primary Care Pt In Pediatrics! Implementing A Walk-In Pediatric Physical Therapy Service Co-Located With Primary Care Pediatrics: A Pilot Study For Possibility, Antonia Duerre, Kierstyn Ray, Taryn Conwell, Ryan Jacobson

Student-Faculty Research - College of Physical Therapy

Pediatric primary care physical therapy does not exist, but has many potential benefits. Primary care PT has been shown to be a successful model of care for meeting needs of adult patients. Purpose: to gather qualitative and quantitative data to better understand the potential of this novel practice model upstream in pediatric healthcare.

Size-Weight Illusion During Whole-Body Loading Via Squat, Aydan Parsons, Robin Dorociak, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

What is the size weight illusion? An item of smaller volume but equal weight is heavier than a larger volume item of the same weight.

Subjective Outcome Measures And Floor Transfer Ability In Communitydwelling Older Adults, Brianna Helton, Marisa Doveri, Shelby Peerboom, Emily Thomson, Lyndsay Stutzenberger, Tyler Whited

Student-Faculty Research - College of Physical Therapy

The ability to get up and down off the floor is associated with functional independence and is not often clinically assessed. Previous research has shown that floor transfers (FT) are closely linked with falls and associated injuries, age, and the physical function of older adults. There is association between individuals self reported ability and actual ability to complete a FT. No research has assessed the association between self-report measures and actual ability to get up from the floor. Purpose: Determine the relationship between self-report measures and FT ability while evaluating the differences in these measures and the strategies used by …

Accuracy Of Sagemotion Imu-Tactor With Knee Hyperextension During Gait, Peter Beach, Peter Jang, Maddy Wagar, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

Haptic feedback refers to the external vibratory cue that is activated by data picked up by an Inertial Measurement Unit (IMU) that senses joint position (Figure 1). ❏ Position-driven haptic touch input can give feedback on movement in real-time (Meszaros, 2019) ❏ Original goal: to reduce knee hyperextension during gait using haptic-feedback driven by an IMU-based angle sensor (Sagemotion) ❏ Concerns arose on the validity of IMU/tactor to accurately sense joint position and past research identified a delay between IMU and joint position.

Blood Flow Restriction To Expedite Acute Concussion Recovery: A Literature Review, Eddie Dudum, Madeleine O’Hare, Madeleine O’Hare, Caleb Rauch, Ashlee Rising, Scott Burkhart

Student-Faculty Research - College of Physical Therapy

Blood flow restriction (BFR) is increasing in popularity to help patients more efficiently recover from musculoskeletal injuries. The safety of BFR is well studied1 • There are no studies to date on the use of BFR in acute concussion recovery

Associations Between Physical Performance, Activity, And Reported Ability To Participate In Social Roles In Older Adults, Theresa Raudsepp, Christen Johnson, Isabella Mansley, Kaelynn Miller-Savoy, Karlie Stewart, Molly Shields, Jeff Houck

Student-Faculty Research - College of Physical Therapy

APTA recommends that all individuals visit a Physical Therapist annually to “optimize movement, and promote health, wellness, and fitness” Geriatrics SIG developed a template for these visits for older adults Template includes outcome measures for both body functions and structure, activity domains

Does Self-Soft Tissue Mobilization Of Obturator Internus Reduce Nonrelaxing Pelvic Floor Dysfunction?, Tess Swake, Katherine Briggs, Darschelle Desronvil, Caryn Jagla, Camille Jouzeau

Student-Faculty Research - College of Physical Therapy

The Obturator Internus (OI) is a muscle deep within the pelvis. This muscle is unique by being a muscle of the pelvic floor as well as a muscle of the hip. Currently, there’s limited research concerning the pelvic floor, especially regarding the rehabilitation of conditions related to Pelvic Floor Dysfunction (PFD), however, manual techniques addressing Obturator Internus tension are indicated as a treatment to reduce dysfunction with soft tissue mobilization. The goal of this research is to assess if self-soft tissue mobilization of the OI muscle is beneficial for active females with relaxing or nonrelaxing PFD or hip pain, and …

Changes In Rectus Femoris Strength And Size With Daily Single Leg Bfr Vs Daily Non-Bfr Training In Recreationally Active Individuals, Terrell Kopping, Dj Wilson, Kenzie Ward, Kaileigh Dietrich-Denton,, Bethany Nguyen, Jason Brumitt

Student-Faculty Research - College of Physical Therapy

Blood flow restriction (BFR) utilizes a controlled form of arterial and venous occlusion during resistance exercise.

Resistance training closer to an individual’s one repetition maximum (1RM) (e.g., 70% or higher) has been found to elicit increases in muscle strength and size.1-5

BFR training at lower loads (e.g., 20-30% 1RM) can lead to increases in muscle hypertrophy and strength without the muscle damage associated with training at heavier loads.

Finger Touch And Trunk Haptics Impact Com Control During Vr Perturbations, Ally Wong, Caitlyn Ward, Robin Dorociak, Andrew Meszaros

Student-Faculty Research - College of Physical Therapy

CDC reports that falls in the US cost $50 billion per year. Previous research has indicated that light touch is a strategy that humans rely on to maintain upright (Baldan, et al). Assistive devices are often used for increased proprioception, but requires use of both or one upper extremity. The use of a wearable haptic sway vest allows for participation in bimanual tasks while decreasing risk of falls. This is crucial for the older population to maintain functional independence.

Influences On Peak Effort During 1 Minute Sit To Stand Test, Claire Davidson, Maggie Smith, Destinee Thomas, Taylor Wright, Rebecca Dobler, Jeff Houck

Student-Faculty Research - College of Physical Therapy

The purpose of this study is to determine the influences of peak effort in participants with knee pain and/or knee osteoarthritis during a 1 minute sit to stand test, and new approaches in knee pain education. Many individuals with knee osteoarthritis (OA) may assume that engaging in physical activity could exacerbate their condition. As a result, they may refrain from participating in activities they enjoy due to concerns about worsening symptoms or the progression of OA in their knee. It has been shown in research that if we as clinicians, and other healthcare professionals shift the impairment based talk, individuals …

A Randomized, Double-Blind, Placebo-Controlled Trial Of Daxibotulinumtoxina For Injection For The Treatment Of Upper Limb Spasticity In Adults After Stroke Or Traumatic Brain Injury, Atul T Patel, Michael C Munin, Ziyad Ayyoub, Gerard E Francisco, Rashid Kazerooni, Todd M Gross

Faculty, Staff and Student Publications

Background: Intramuscular injection of botulinum toxin type A is a first-line pharmacotherapy for adults with upper limb spasticity (ULS). However, reemergence of symptoms within 12 weeks of treatment is common and longer-lasting treatments are needed.

Objective: To evaluate the efficacy and safety of three doses of DaxibotulinumtoxinA for Injection (DAXI) for treatment of ULS in adults with stroke or traumatic brain injury.

Intervention: Intramuscular injections of placebo (N = 24), DAXI 250 U (N = 22), DAXI 375 U (N = 19), or DAXI 500 U (N = 18) to the suprahypertonic muscle (SMG) and other muscle groups.

Design: Randomized, …

A Simple, Low-Cost Implant For Reliable Diaphragm Emg Recordings In Awake, Behaving Rats, Taylor C. Holmes, Jesus D. Penaloza-Aponte, Alyssa R. Mickle, Rachel L. Nosacka, Erica A. Dale, Kristi A. Streeter

Physical Therapy Faculty Research and Publications

Breathing is a complex neuromuscular process vital to sustain life. In preclinical animal models, the study of respiratory motor control is primarily accomplished through neurophysiologic recordings and functional measurements of respiratory output. Neurophysiologic recordings that target neural or muscular output via direct nerve recordings or respiratory muscle electromyography (EMG) are commonly collected during anesthetized conditions. While offering tight control of experimental preparations, the use of anesthesia results in respiratory depression, may impact cardiovascular control, eliminates the potential to record volitional nonventilatory behaviors, and can limit translation. Since the diaphragm is a unique muscle which is rhythmically active and difficult to …

Pain Is Modulated Differently Between Females With And Without Patellofemoral Pain: Factors Related To Sensitization, Kemery J. Sigmund, Marie K. Hoeger Bement, Wendy E. Huddleston, Kyle T. Ebersole, Jennifer E. Earl-Boehm

Physical Therapy Faculty Research and Publications

Context

Patellofemoral pain (PFP) has poor long-term recovery outcomes. Central sensitization describes central nervous system changes altering pain modulation, which can complicate recovery (poorer prognosis and worse function). Signs of central sensitization include amplified pain facilitation, pain hypersensitivity, and impaired pain inhibition, which can be measured with temporal summation of pain (TSP), pressure pain thresholds (PPTs), and conditioned pain modulation (CPM), respectively. Sex differences exist for these test responses, but female-only PFP investigations of sensitization are uncommon. Understanding pain modulation in females with PFP could improve treatment protocols.

Objective

To determine whether females with PFP exhibit signs of central sensitization …

Beliefs Regarding The Use Of Imaging Among Patients With Low Back Pain: A Cross-Sectional Study In The Context Of A Middle-Income Country, Leandro M. Diniz, Ítalo R. Lemes, Ana P. C. F. Freire, Ana F. Guimarães, Lucas A. C. Ferreira, Marcia R. Franco, Arianne P. Verhagen, Guy Simoneau, Rafael Z. Pinto

Physical Therapy Faculty Research and Publications

Introduction: Patients with low back pain may play an active role in the pre-scription of excessive spine imaging.

Objective: To determine the proportion of patients with low back pain who have beliefs not aligned with current evidence regarding the use of imaging and to identify factors associated with these beliefs.

Design: Secondary analysis of baseline data of a previously published randomized clinical trial.

Setting: Outpatient physical therapy clinic in a middle-income country.

Patients: Individuals with non-specific low back pain.

Methods: Outcome variables were two statements assessing the extent of patient agreement on the need for imaging in the management of …

Effects Of Ischemic Conditioning On Microvascular Reactivity To Single Passive Limb Movement In Young Adults: A Pilot Study, Alicen A. Whitaker-Hilbig, Jennifer N. Nguyen, Amanda E. Wietrzny, Gabriel R. Merkow, Sergey Tarima, Emilie A. Klevenow, Luke Nelson, Allison S. Hyngstrom, Matthew J. Durand

Physical Therapy Faculty Research and Publications

Purpose

Single passive limb movement (sPLM) of the lower extremity is a simple and clinically relevant measure of the microvascular vasodilatory response to movement. A promising stimulus to improve microvascular health is ischemic conditioning (IC). We examined whether a single session of IC could improve microvascular reactivity to sPLM in young adults.

Methods

This was a blinded, crossover, randomized clinical trial. Participants were seated in an isokinetic dynamometer that passively moved the knee 90° at a frequency of 1 Hz while superficial femoral artery leg blood flow (LBF) was measured. The absolute and the relative peak changes in LBF were …

A Model For Advocacy: Advancing Policy Change In Support For Patients With Medicaid, Betsy J. Becker, Jenae Pope

Posters and Presentations: Physical Therapy

There are differences in access and utilization of care for patients with Medicaid. When patients cannot access timely therapeutic care, the resulting outcomes are often poor. Because a major limiting factor in accessing services is insurance type, investigating optimal coverage practices is an important first step in advocating for change. This abstract reports on Phase One of a larger collaboration with state professional associations for physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) to present a model that describes Medicaid authorization services for PT, OT, and SLP, serving as a guide for policy change.

We collaborated with the …

Exploring Vestibular Rehabilitation Self-Efficacy In Entry-Level Physical Therapy, Colin Hulls

Graduate Theses, Dissertations, and Capstones

Vestibular rehabilitation, commonly performed by physical therapists, aims to improve the function and quality of life of individuals experiencing dizziness, vertigo, or disequilibrium. Vestibular curricular variation across physical therapy programs may lead to discrepancies in the self-efficacy of entry-level physical therapists to manage this population. The purpose of this study was to examine self-efficacy in vestibular rehabilitation in entry-level physical therapy and identify facilitators and barriers to its development. An online, cross-sectional survey design was utilized for quantitative and qualitative data collection, including a modified version of the Physiotherapist Self-Efficacy (PSE) Questionnaire, from new graduates and students preparing to graduate. …

Increasing Awareness Of Burnout And Developing An Action Plan To Reduce Stress For Graduate Health Profession Students Through An Interactive Workshop, Oaklee Rogers, Zachary Baker

Internet Journal of Allied Health Sciences and Practice

Purpose: Healthcare students can experience stress and burnout before becoming practicing clinicians. Increasing education about your level of stress and understanding what burnout is are important factors in preventing burnout. Method: A 90 minute interactive workshop was developed and implemented for graduate health profession students to meet three objectives: 1) increase foundational knowledge about burnout and its impact on different health professionals, 2) assess student’s level of burnout and apply strategies to mitigate their stress, and 3) create and share a plan on how they would incorporate stress reduction strategies and/or reduce their level of burnout. Results: In total, 349 …

Technical Note: What Exercises Are Appropriate For Managing Back Pain In Persons With Lower Limb Amputation?, M. Jason Highsmith, Shawn Farrokhi, John M. Mayer

Physical Therapy Faculty Articles and Research

Individuals with lower extremity amputation (LLA) have high rates of low back pain (LBP) and related disability. The purpose of this technical note is to discuss considerations and provide initial recommendations about what exercises may be appropriate for management of LBP in persons with LLA. Five commonly prescribed motor control and strengthening exercises (cat-camel, curl-up, bird dog, side bridge, and Roman chair extensor exercise) were examined for use in the LLA population. Each exercise seemed to be safe and appropriate for use in persons with LLA yet required additional considerations for use in this population. For example, some of the …

Reliability And Validity Of Trunk Flexion-Extension Angular Velocity Measurement In Healthy Young Adults Using Ai-Enhanced Motion Capture, Joga Katayama, Kai Tennan, Sakino Harada, Aoi Hirata, Hayato Shigetoh, Junya Miyazaki

Asian Journal of Physical Therapy

Background: Openpose is a motion capture system that uses artificial intelligence. This study aimed to verify the reliability and validity of motion angular velocity using Openpose in trunk flexion-extension movements (TFEM) and compare Openpose with methods that use accelerometers and marker measurements. Methods: Fifty healthy young participants were included in the study. The TFEM tasks were performed. Motion analyses were performed using accelerometers, markers, and the Openpose software. To examine the reliability and validity of the angular velocity of motion, we calculated intraclass correlation coefficients (ICC) (1,1) and ICC (1,3) for each maximum flexion and extension angular velocity. …

Fostering Future Professional Contemporary Collaboration, Rene'e M. Huth, Jordan M. Tucker

Internet Journal of Allied Health Sciences and Practice

Collaborative teamwork needs to be fostered early and often to meet contemporary practice ideals. This qualitative phenomenological designed study’s purpose was to investigate student physical therapists (SPTs) and student physical therapist assistants' (SPTAs) perceptions of an intraprofessional online activity reflective of contemporary home health and telehealth settings. A convenience sample of 25 SPTs from one program and 24 SPTAs from another program met synchronously online to view a video case of an ambulatory patient with dementia, develop a plan of care, and discuss appropriate interventions reflective of practice in Virginia. Following interactions, students wrote reflections on their experiences that were …

A Quasi-Experimental Study Examining The Effects Of A Proprioceptive Rehabilitation Protocol For The Cervical Spine On Balance And Function Using A Laser Head Light In Older Community Dwelling Individuals, Vern M. Swanson Jr., M. Samuel Cheng, Leah Nof, Eric Shamus, Phd

Internet Journal of Allied Health Sciences and Practice

Purpose: Falls continue to be a major health issue when considering health risks for older individuals. The multi-factorial nature of falls in older adults leads to an overwhelming number of causal factors. Cervical joint position sense and joint position error could be additional factors that could influence the fall risk of older individuals. This research examined the effects of a proprioceptive rehabilitation protocol for the cervical spine using a laser head set in older community dwelling individuals. Methods: Sixty (60) subjects were purposively assigned into an experimental and a control group. Control group subjects were given a general lower extremity …

Assessment Of Physical Therapy Students’ Self-Efficacy And Accuracy Measuring Blood Pressure Using A Low-Fidelity Task Trainer, Daniel C. Dale, Deborah M. Wendland, Tiffany Haney

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to determine if use of a task trainer in physical therapy education improves the self-efficacy and accuracy of students when assessing blood pressure measurements. Methods: Participants from consecutive cohorts of Doctor of Physical Therapy (DPT) students (38 students per cohort) participated in the first semester of their first year of study in a DPT program. The study was conducted concurrently with the course in which the measurement of blood pressure and pulse rate are typically taught. In addition to traditional classroom instruction and lab practice for both groups, the experimental group also had …

Prevalence Of Burnout Among Doctor Of Physical Therapy Faculty, Liana Wooten, Kim Dao, Melissa Burgemeister, Angela Spontelli Gisselman

Internet Journal of Allied Health Sciences and Practice

Objective: Growing numbers of physical therapy (PT) educational programs (PTEPs) creates a challenge in recruiting and retaining faculty, potentially having negative ramifications for PT education. Burnout may be contributory as it has known physiological, psychological, and behavioral consequences in numerous clinical and academic populations, creating widespread negative outcomes. This study aimed to investigate burnout prevalence among PT faculty. Methods: Eligible participants, including current full and part-time PTEP faculty members in the United States with emails listed on public-facing program websites, were emailed study information and a link to the consent and survey. Consenting participants completed a Qualtrics survey consisting of …