Physical Therapy Commons^™

Development And Validation Of A Home-Based Exercise Program Integrated With Patient Education Based On The Health Belief Model For Patients With Type 2 Diabetes Mellitus, Amirah Mustapa, Alia Alghwiri, Haidzir Manaf

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to develop and validate a comprehensive approach that integrates an exercise routine with patient education based on the health belief model (HBM) approach to promote effective exercise in this population. Method: A 3-phase study was conducted. In Phase I, two comprehensive scoping reviews were performed to develop the program. An initial draft of the program consisted of exercise protocols and HBM-based education. In Phase II, nine experts were chosen to further develop and refine the program’s content by providing feedback and validating it using the content validity index (CVI) and the Patient Education …

Modified Shuttle Walk Test In Chronic Health Conditions: A Literature Review, Manish Prannath Shukla, Gaurav Chhabra, Ashish Shankarrao Deshmukh Dr

Internet Journal of Allied Health Sciences and Practice

Background: The Modified Shuttle Walk Test (MSWT) is widely utilized to assess exercise capacity across various chronic health conditions. This literature review synthesizes evidence from studies evaluating the MSWT's reliability, validity, and clinical applicability in conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, sarcoidosis, obesity, hypertension, and asthma. Methods: A systematic search was conducted across electronic databases for studies published between 2006 and 2022. Eligible studies were assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Data extraction focused on study objectives, methods, participants, outcomes, and quality assessment. Results: Eleven studies met the inclusion criteria. The MSWT demonstrated …

The Effectiveness Of Verbal Instruction For Reducing Anterior Cruciate Ligament Injury Risk, Kazuna Ichikawa, Hironobu Kuruma, Sian Knott

Asian Journal of Physical Therapy

Background: Anterior cruciate ligament (ACL) injuries are serious for athletes because healing can take approximately 6–12 months. Some studies have suggested that verbal instruction can help reduce the incidence of ACL injuries. Verbal instruction is divided into two categories: internal focus (IF) verbal instruction and external focus (EF) verbal instruction; however, the optimal type of ACL instruction to prevent injury is unknown. No verbal instructions explicitly focus on the pelvis or trunk, even though proximal control or ACL injury prevention are considered significant. This study aimed to determine whether IF verbal instruction focused on proximal control of the trunk and …

Age-Related Balance Control Changes In Constrained-Speed Gait During A Concurrent Cognitive Task, Raymond Chong, Victoria Moore, Hope Brown Sampson, Heather Spears, Manh-Cuong Do

Asian Journal of Physical Therapy

Background: During walking, the center of mass (CoM) oscillates up and down in the sagittal plane. In the late-stance phase, as the CoM descends, its vertical velocity decreases before foot contact, indicating active neural balance control, which we refer to as CoM braking. Young adults tend to increase braking while maintaining step length and speed when performing a cognitive task, such as subtracting numbers. In contrast, older adults maintain consistent braking by reducing step length and speed. This study examined the effects of walking at constant self-selected, slower, or faster speeds on CoM braking and cognitive performance. Methods: Healthy young …

Optimizing Long Covid Outcomes: Insights From A Survey Of U.S. Occupational Therapists, Malachy J. Clancy, Phd, Otr/L, Bcpr, Robert Dekerlegand, Pt, Mpt, Phd, Ccs

Department of Occupational Therapy Posters and Presentations

Background & Purpose

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

Two-Year Follow-Up Of Gait And Postural Control Following Initiation Of Recombinant Human Tripeptidyl Intracerebroventricular Enzyme Replacement Therapy In Two Atypical Cln2 Patients, Rahul Soangra, Marybeth Grant-Beuttler, Harriet Chang, Raymond Y. Wang

Physical Therapy Faculty Articles and Research

Neuronal ceroid lipofuscinosis type 2 (CLN2) is a rapidly progressive neurodegenerative disorder leading to premature mortality. Ambulatory CLN2 patients typically receive standard of care treatment through biweekly intracerebroventricular (ICV) enzyme replacement therapy (ERT) involving recombinant human tripeptidyl peptidase 1, known as cerliponase alfa (Brineura^®, Biomarin Pharmaceuticals). This study longitudinally assessed the impact of ICV cerliponase alfa ERT on gait, and postural control across a two-year span in two siblings diagnosed with atypical CLN2 disease. Both participants, ID01 (18 years and 8 months old at enrollment) and ID02 (13 years and 3 months old at enrollment), exhibited symptomatic characteristics …

The Effects Of Vestibular Rehabilitation Interventions On Patients With Parkinson's Disease: A Systematic Review, Christopher Farrell, Eduard Turner

Student Research Poster Presentations 2025

Background: Vestibular rehabilitation is known to be effective in the treatment of vestibular dysfunction. While patients with Parkinson's disease have both central and peripheral vestibular dysfunction, there is little information regarding the efficacy of vestibular rehabilitation for the treatment of these individuals.

Study Design: Systematic Review

Purpose: The purpose of this systematic review was to examine the effects of vestibular rehabilitation in patients with Parkinson’s disease.

Results: The interventions identified in this study resulted in improved Berg Balance Scale (BBS) and Dizziness Handicap Questionnaire (DHI) scores.

Conclusion: Vestibular rehabilitation improves balance and subjective dizziness in patients with Parkinson’s disease.

Incorporating Mindfulness Techniques In Therapeutic Practices To Impact A Patient’S Pain Perception, Abigail E. Masters

2025 Honors Symposium

Background: Chronic pain is a widespread condition that affects millions of individuals and leads to substantial healthcare costs, with estimates in the U.S. ranging from $560 billion to $635 billion annually. Traditional pain management heavily relies on opioid prescriptions, which, while effective in the short term, have contributed to the ongoing opioid crisis due to risks of addiction and dependency. As a result, there is a growing interest in alternative, non- pharmacological approaches to pain management, including mindfulness-based interventions (MBIs). MBIs have been increasingly recognized for their ability to help patients modulate pain perception and improve overall well-being. This study …

Physical And Perceived Effects Of The Menstrual Cycle On Female Athletes, Talia E. Casarella, Alyssa M. Quiteles, Emily E. Liddick, Madelyn R. Swarthout, Rebecca J. Turner

Student Research Poster Presentations 2025

Purpose: The purpose of this study was to understand the physical and perceived effects of the menstrual cycle on female athletes’ performance during training and competition.

Hypothesis: The researchers hypothesized that there would be a significant difference in performance based on the phase of the menstrual cycle.

Methods: This study used EBSCO Academic Search Complete and Science Direct, focusing on peer-reviewed articles from the last 10 years. Search terms included: (exercise or physical fitness or physical activity) AND (menstrual cycle or period or menstruation or menses or follicular phase or luteal phase) AND (female athletes or women athletes or athletic …

Gait During Community Ambulation And Laboratory-Based Walking In People With Mild Traumatic Brain Injury, Prokopios Antonellis, Jae W. Lee, Peter C. Fino, Margaret M. Weightman, Siting Chen, Margaret Stojak, Mark E. Lester, Carrie W. Hoppes, Leland E. Dibble, Laurie A. King

Physical Therapy Faculty Publications

Background: Gait impairments are common in individuals with mild traumatic brain injury (mTBI), presenting in the acute phase and often persisting in subtle ways over time. Despite the prominence of laboratory gait evaluations, a comprehensive understanding of gait deficits post-mTBI necessitates the examination of various gait domains in real-world environments. Assessing gait during a community ambulation task (CAT) may capture real-world challenges and influence focused interventions or rehabilitation in individuals with mTBI.

Research Question: The aim of the study was to compare gait performance across independent gait domains in individuals with and without mTBI using wearable sensors during both the …

Caregiver Perceptions Of Gobabygo Car Usage, Sierra L. Hays, Erin L. Hefner, Richelle Gray, Carrie Smith-Bell

Graduate Student Scholarship

This qualitative study aims to understand caregiver perceptions of their child’s play using a modified ride-on toy car (MROC). Caregivers of children with disabilities participated in a semi-structured interview and a photo-elicitation interview to better understand their beliefs, attitudes, values, and feelings about their children’s play with a MROC. A directed content analysis was used based on constructs of the model for the Process for Establishing Children’s Occupations (PECO; Wiseman et al., 2005). Most constructs of the PECO model, including stages of play and influences on play, were identified within the caregivers’ descriptions of children's play with the MROC. Additional …

Exploring Law Enforcement Officers' Experiences With Athletic Trainers And Work-Related Injury, Stephanie H. Clines, Rubie Gaudette, Amanda Wheeler, Jennifer Ostrowsk

Athletic Training Faculty Publications

Law enforcement is an emerging clinical setting for athletic trainers (ATs), yet little is known regarding law enforcement officers (LEOs) perceptions of the profession. This qualitative study following a general inductive approach explored LEOs' experiences with musculoskeletal injury and their interactions with ATs. Seven officers (N = 7) participated in one-on-one semi-structured interviews. Three themes emerged: (1) roles and responsibilities of ATs, (2) education and training, and (3) impact of injury on LEOs. While participants viewed ATs positively, they demonstrated limited understanding of the profession's scope and expertise. Participants commonly described managing musculoskeletal injuries on their own due to …

Acute Influence Of Gum Chewing On Gait And Balance Measures In People With Parkinson's, Pamela Marie Durr

Graduate Research Theses & Dissertations

The overarching aim of this dissertation was to investigate the acute effects of gum chewing on functional measures of gait and balance and their associations to pupillometry in people with Parkinson’s Disease (PwP). A total of 27 PwP and 27 age-matched controls underwent three trials (baseline and then a randomized no gum and gum trial) to assess gait and balance and their relationship with pupillometry and, on a second day, ten of the PwP and ten controls returned within 7-14 days for repeat testing to investigate the test-retest reliability of pupillometry alongside gait and balance measures. Results: Significant improvements in …

Floor-To-Stand Transfers In Older Adults: Insights Into Strategies And Lower Extremity Demands, Lyndsay Stutzenberger, Tyler Whited

Faculty Publications - College of Physical Therapy

Background/Objectives: Getting up from the floor is an important functional skill for independence in older adults but is not often assessed clinically. The purpose of this study was to investigate how floor-to-stand transfer (FTS) ability is related to self-report measures and five-time sit-to-stand (5XSTS) performance, as well as compare peak joint angles during common FTS strategies and lower extremity demands between the 5XSTS and a commonly instructed FTS strategy. Methods: Thirty-four community-dwelling older adults completed self-report measures and performed the 5XSTS, a FTS in a self-selected manner, and an instructed FTS strategy. Biomechanical analysis of the lower extremities was used …

Predicting Student Success In Entry-Level Doctor Of Physical Therapy Courses, Lyndsay Stutzenberger, Tess Swake

Faculty Publications - College of Physical Therapy

Early identification of students at risk for academic challenges in a Doctor of Physical Therapy (DPT) program may allow for timely intervention and support. Little is known about the ability of the Motivated Strategies for Learning Questionnaire (MSLQ) to predict academic success in firstyear courses in a DPT program. Participants were 33 firstyear DPT students from a single cohort. Student demographics, previous academic performance, and responses to the MSLQ for Anatomy and Biomechanics courses were collected early in each semester. Spearman correlations determined associations between undergraduate grade point average (GPA) or MSLQ responses and grades for Fall and Spring semesters. …

Polycystic Ovary Syndrome And The Effects Of A Ketogenic Diet: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background/Objectives: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy experienced by females. Diagnosis of PCOS is established when at least two of the following are present: hyperandrogenism, oligo-anovulation, and/or polycystic ovaries. Conservative treatment for PCOS includes dietary modifications and physical activity. The purpose of this scoping review was to evaluate the efficacy of a ketogenic diet in improving biochemical measures and reducing the severity of PCOS symptoms. Methods: CINAHL, PubMed, and Google Scholar databases were searched to find research published in peer-reviewed journals between 2019 and 2025. An article was included in this scoping review if the study assessed …

Running Biomechanical And Isokinetic Strength Differences In Masters Runners With And Without Achilles Tendinopathy, Matthew Klein, Christopher Patterson, Annette Karim, Tyler Cuddeford

Faculty Publications - College of Physical Therapy

Masters runners are an increasing proportion of the running com-munity. The most significant musculoskeletal changes in runners occur after the age of 50 in addition to changes in injury rates and types, the most common being Achilles tendinopathy (AT). Previous evidence has suggested similarities between risk factors for AT and age-related changes that are focused at the hip and the ankle during the propulsive stage of running. The purpose of this study was to investigate biomechanical and peak torque association to AT in masters runners. Thirty-two masters runners over age 50 with AT(60.31 ± 8.37, n = 16) and without …

Mental Health And Belongingness Of Doctor Of Physical Therapy Students: A Mixed Methods Study Centering Black Student Voices, Robyn Redline

Graduate Research Theses & Dissertations

Background: Despite efforts to increase recruitment and enrollment, the physical therapy profession lacks Black students and clinicians. Racially marginalized students have higher rates of academic difficulty during physical therapy education (PTE) than White students. Mental health and belongingness have been proposed as prerequisites for reaching academic achievement and attaining one’s full potential. Conversely, poor mental health and lack of belongingness during PTE may contribute to the underrepresentation of Black Doctor of Physical Therapy (DPT) students and clinicians. Yet not enough is known about the relationships between mental health, belongingness, and the academic achievement of DPT students. Purpose: This study aimed …

Ankle Dorsiflexion Range Of Motion And Its Association With Semi-Professional Female Soccer Player's Overall Performance, Lily G. Nolan

Honors College Theses

Lower extremity injury screening is a common tool in soccer due to the changes of direction, jumping, landing, and cutting maneuvers players must exhibit. Talocrural dorsiflexion range of motion (DFROM), vertical jump (VJ) and unilateral hop tests are used to assess ankle and knee injury risk. Further, DFROM asymmetries may present a higher risk than reduced DFROM alone. It is unknown how DFROM asymmetries affect these tests. Thus, the purpose of this study was to examine the relationship between DFROM and hop and VJ performance, and to examine the differences between those with and without DFROM asymmetries. The current results …

Exploring Anterior Cruciate Ligament Tears: Causes, Reconstruction, And Outcomes, Holly L. Bollinger

Honors College Theses

The anterior cruciate ligament (ACL) is a critical structure in knee stability, and its injury can significantly impair athletic performance and daily functionality. The ACL plays a vital role in stabilizing the knee joint, preventing excessive forward movement of the tibia relative to the femur and aiding in rotational control. ACL tears are commonly associated with sports and physical activities that involve sudden stops, pivots, or changes in direction. These injuries can lead to knee instability, impaired function, and long-term complications. Despite the prevalence of ACL tears, there remains a lack of consensus on the multifactorial causes, optimal reconstruction techniques, …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Development And Clinical Validation Of The Sensor-E Exoskeleton For Objective Hand Function Assessment In Stroke Rehabilitation, Madison Bates

Theses and Dissertations--Biomedical Engineering

Hand function is often impaired following neurological trauma or in conditions such as stroke, limiting independence and the ability to perform activities of daily living (ADLs). Current clinical assessments rely heavily on subjective rating scales that lack the resolution to detect subtle changes in motor performance, which can limit access to rehabilitation. Recent advances in wearable technologies highlight the potential for hand-worn devices to provide objective, real-time measures of hand function. However, most systems focus solely on kinematics and rarely capture both movement and exerted force. Moreover, integration into rehabilitation frameworks and brain-computer interface (BCI) protocols remains limited. To address …

Commentary On “Predictors Of Length Of Physical Therapy Care For Infants With Congenital Torticollis”, Ryan Jacobson, Kathryn Knudsen, Katherine Binkerd

Faculty Publications - College of Physical Therapy

Most infants in this study were ≤3 months of age and 94% had severity grades I or II. Clinicians might prioritize accurately measuring active neck rotation using an arthrodial goniometer in younger, less severe infants, since active neck rotation deficit had the highest single-factor correlation with episode length and reflects degree of asymmetry in neck and torso strength. While the Alberta Infant Motor Scale and previous tummy/container time factors were not associated, we appreciate the efforts of the authors to address this gap in the literature.

Hopping Kinetic Differences In Masters Runners With And Without Achilles Tendinopathy, Matthew Klein, Chris Patterson, Annette Karim, Tyler Cuddeford

Faculty Publications - College of Physical Therapy

Achilles tendinopathy (AT) is the most common running-related pathology among masters runners. Previous evidence suggests there are no differences in submaximal running biomechanics between masters runners with and without AT. Evidence suggests lower extremity power deficits are common among ageing individuals and those with AT. The single-leg horizontal hop (SLHH) test isa valid and reliable lower extremity power test. The purpose of this study was to investigate differences in SLHH biomechanics between masters runners with and without AT. 32 masters runners age 50 and older with AT (60.31 ± 8.37, n = 16) and without (59.94 ±4.95 n = 16) …

Breaking Down Silos: Creating And Implementing A Longitudinal Interprofessional Education Curriculum For Graduate Health Science Professional Students, Robert Wellmon, Jill D. Black, Wendy Wachter-Schutz, Kathleen M. Youse, Adrienne N. Pinckney, Lori L. Felker

Health Professions Education

Background. Accreditation standards for graduate health professional programs require the inclusion of interprofessional learning and collaboration (IPL/C) activities in entry-level curricula. This implementation necessitates collaboration among educators from multiple disciplines and openness to innovation and to educate students in a manner that breaks down uni-professional curriculum silos that are known barriers to the creation of meaningful IPL experiences.

Objective. The purpose of this paper is to describe one institution’s process for creating a longitudinal interprofessional education (IPE) curriculum that aligns with accreditation mandates and meets the call to foster IPC competency skills.

Methods. Widener University established an interprofessional thread of …

Blood Flow Restriction, Tendon Hypertrophy, And Strength Gain In The Biceps Brachii, Tonya M. Parker, Samuel Corbin, Matthew R. Feeback, Bailey Wilks, Andrew Lowe, Noelle Kaminski

Open Access Publishing Support Funded Articles

Introduction: Blood flow restriction (BFR) can improve muscular strength under lower loads versus traditional resistance training. Little research has been completed on the upper extremity and almost no targeted research on BFR and the tendon. Therefore, we aim to investigate the effects of BFR on the biceps brachii muscle and tendon compared to traditional resistance training.

Methods: Randomized controlled trial of healthy participants over seven weeks of completing bicep curls. Participants were randomly allocated to the BFR or control group (C). Ultrasound measurement of the tendon occurred at baseline, midpoint, and completion of study, while adjusted one repetition maximum (Adj1RM) …

The Importance Of Trunk Motion In Wearable Based Infant Spontaneous Movement Analysis, Pablo Burgos

Faculty Publications - College of Physical Therapy

The characteristics of spontaneous movements in infants are essential for the early detection of neurological pathologies, with the Prechtl method being a widely recognized approach. While the Prechtl method is effective in predicting motor risks, its reliance on the evaluator’s expertise limits its scalability, particularly in low-income areas. In such contexts, the use of inertial sensors combined with automated analysis presents a promising accessible alternative; however, more research is necessary to get results comparable to those of the Precht method. This research aims to determine the more important metrics of trunk and limbs to assess spontaneous movement in healthy infants …

Cognition Is Associated With Daily-Life Mobility In People With Parkinson’S Disease, Pablo Burgos

Faculty Publications - College of Physical Therapy

Introduction: Cognitive impairment is common in people with Parkinson’s disease (PD). Mobility is also impaired in people with PD and functional mobility often requires cognitive dual-tasking to navigate complex environments in daily life. We hypothesized that visuospatial and executive cognitive dysfunction in people with PD will be associated with digital measures of mobility in daily life. Since freezing of gait (FoG) is associated with both cognitive dysfunction and mobility impairments, we also examined the influence of FoG on the cognitionmobility relationship. Here, we investigated, for the first time, the association between cognition and dailylife mobility in PD and the influence …

Responsiveness Of Promis Measures For Hip, Knee, And Shoulder Arthroplasty, Ryan Jacobson

Faculty Publications - College of Physical Therapy

Objectives: In hip, knee, and shoulder arthroplasty, there is evidence that using a broader set of Patient-Reported Outcomes Measurement Information System (PROMIS) measures beyond Physical Function and Pain Interference might improve assessment of patient outcomes. However, the utility and responsiveness of PROMIS domains measuring anxiety, fatigue, sleep, and social participation have been minimally investigated in arthroplasty. This retrospective study aimed to determine the 1) responsiveness of seven PROMIS domains and 2) association between change scores for all seven domains and MCID improvement in Physical Function and/or Pain Interference.

Methods: PROMIS domains of Physical Function, Pain Interference, Depression, Anxiety, Fatigue, Sleep …

The Use Of Virtual Reality To Improve Gait And Balance In Patients With Parkinson’S Disease: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

(1) Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that impairs balance and postural control, gait, overall motor function, and mood, and involves the gradual degradation of several physiologic systems. With limited treatments available, physical therapy (PT)-based exercise is the nonpharmacologic measure of choice. There is a growing interest in using virtual reality (VR) gaming when rehabilitating patients with various acute brain injuries and neurological disorders. The purpose of this scoping review was to examine randomized controlled trials comparing VR-based rehabilitation programs versus traditional PT at improving gait and balance. (2) Methods: PubMed, CINAHL, and the Cochrane Central Register …