Physical Therapy Commons^™

Personalized Versus Fixed Tactile Cueing In Parkinson’S Disease: Protocol For A Randomized Controlled Trial On Gait Automaticity, Pablo Burgos

Faculty Publications - College of Physical Therapy

Background

Gait automaticity, the ability of the brain to control locomotion with minimal use of executive-attentional resources, is altered in people with Parkinson’s disease (PD). Recently, we showed that step-synchronized tactile cueing improved gait regularity and freezing of gait in PD; however, it is not known if this cueing mode also improves gait automaticity. Thus, this study investigates the effects of step-synchronized tactile cueing (versus fixed cueing) on gait automaticity in the laboratory and during daily life.

Methods

This is a pilot, randomized, double-blinded study where sixty participants with PD will be randomized into one of two, cueing interventions: 1) …

Prevalence Of Stress Urinary Incontinence In Female Strength Athletes, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background: Stress urinary incontinence (SUI) is a symptom during pregnancy and in the postpartum period, but a high prevalence of SUI is experienced in sports involving running and jumping. Objectives: Identify the scope of the problem of SUI in women participating in strength sports, movement patterns that elicit SUI, and the impact on quality of life in female athletes with SUI. Study Design: Survey mixed methods with qualitative focus groups. Methods: The International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and a sport-specific and obstetric/gynecological history questionnaire were sent to women who are United States citizens, age 18-65, and members …

Weight Stigma In Physical And Occupational Therapy: A Scoping Review, Jason Brumitt

Faculty Publications - College of Physical Therapy

Background: Weight stigma describes the negative attitudes held toward people with obesity. Weight bias stereotypes have been previously reported in physicians, physician assistants, nurses, registered dieticians, psychologists, and students enrolled in healthcare professional education programs. Physical and occupational therapists (PTs and OTs) are healthcare providers who evaluate and treat individuals across their lifespan. A PT or an OT who harbors weight bias may create an environment where the patient may fail to optimize their rehabilitation recovery. The first purpose of this scoping review was to identify the prevalence of weight bias in PT and OT clinicians and students. The second …

Exploring The Role Of Bingocize® Workshops In Enhancing Health And Well-Being In Older Adults, Kaitlyn Gray

Mahurin Honors College Capstone Experience/Thesis Projects

As the population of older adults grows, the need for better health and well-being also grows, making it necessary to implement effective strategies for healthy aging to improve the length and quality of life of older adults (CDC, 2024). This study evaluates the effectiveness of a Bingocize^® Workshop in improving the physical health of older adults. Bingocize^®, a unique program combining bingo with exercise, is designed to increase physical activity. Eleven (11) participants aged 68.55 ± 6.235 attended a ten-week workshop, two times per week focusing on physical exercises tailored to their abilities. The primary objective was …

Whole Body Angular Momentum Characterizes Reactive Balance Adaptations And Perturbation Intensity, Mitchell D. Adam, Delaney Mcelvain, T. George Hornby, Allison S. Hyngstrom, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Identifying measures which accurately quantify reactive balance adaptation during walking is essential to understand how emerging perturbation-based gait paradigms impact stability over the course of an intervention. These perturbation paradigms have shown promise in reducing falls for numerous clinical populations, however tracking progress in objective terms throughout an intervention remains challenging. Whole body angular momentum (H) may be particularly suited to detect subtle adaptations in the reactive balance response and is applicable within numerous perturbation environments. We assessed the ability of young healthy adults to adapt to varying intensities of discrete, unexpected, treadmill-based perturbations directed mediolaterally, anteriorly, and posteriorly during …

Eccentric-Emphasis Exercise Program For Supraspinatus Partial Tear In Retired Police Officer An Intervention Case Report, German Eduardo Isea Fernandezx

Capstone Showcase

Abstract

Background and Purpose: Eccentric exercise has been shown to reduce pain in patients with multiple comorbidities, orthopedic surgeries, and neurologic conditions, while providing safety for greater loading during resistance training. The purpose of this case report is to describe changes in function and pain of a patient with a partial rotator cuff tear, following rehabilitation exercises focusing on eccentric action.

Case Description: A 65 y/o retired police male officer who presented right shoulder pain secondary to a partial tear of the supraspinatus tendon. The case reported mild to severe pain under the visual analog scale (VAS) of 75mm that …

Functional Recovery Of A Patient In Her Home Environment Following A Stroke Using Proprioceptive Neuromuscular Facilitation And Task-Specific Training: A Case Report, Andrea L. Crawford-Perry

Capstone Showcase

Abstract Background and Purpose: Stroke is a growingly common disability that affects an individual’s bodily function, activity and participation levels and thus impacts the whole livelihood of that individual. Proprioceptive Neuromuscular Facilitation (PNF) and Task-specific Training have been shown to improve the overall functional recovery of a patient and affect neuroplasticity. Most studies tend to compare the individual effect of these techniques; hence the purpose of this case report is to describe how both PNF and task-specific training are used to improve the functional recovery of a patient in her home environment following an acute stroke. Case Description: The patient …

Effects Of Tecar Therapy With Conventional Physical Therapy In Patient With Knee Osteoarthritis (Oa): A Case Report, Mitzi Joy O. Fernandez

Capstone Showcase

Background and Purpose: Transfer energy capacitive and resistive (TECAR) therapy is a relatively new form of technology used as an adjunct for the rehabilitation of musculoskeletal conditions. Several studies have found its beneficial effects in reducing pain and improving quality of life in numerous orthopedic conditions. Knee osteoarthritis (OA) is one of the most common causes of global disability and pain, with accompanying complaints of morning stiffness, limitation of motion, knee buckling, swelling and inflammation, muscle weakness, functional limitations, and bony enlargement that affects the activities of daily living, occupation, and leisure activities. The purpose of this case report is …

Evaluation And Treatment Of Baseball Pitchers: There’S More To Assess Than The Arm, Matthew L. Gauthier, Casey A. Unverzagt, George J. Davies

Physical Therapy Faculty Publications

Injuries are commonplace in the overhead athlete, with many occurring to the shoulder and elbow. The increasing prevalence of injuries to the shoulder and elbow has been discussed at length in recent years, with increased research focus being placed on arm care for rehabilitation and prevention strategies. Even though the pitching motion is well-established as a whole-body kinetic chain movement, most attention in rehabilitation and prevention efforts is often placed on the upper extremity. The purpose of this clinical commentary is to highlight the impact the lower extremity and trunk have on the upper extremity during the throwing motion, better …

The Association Between Pain Sensitivity And Low Energy Availability, Sleep, Mental Health, And Stress In Female Endurance Athletes, Taylor R. Moler

Honors Undergraduate Theses

The disruption of certain physiological functions due to low energy availability (LEA) in female endurance athletes is a prominent concern. This condition resulting from LEA has been described as Relative Energy Deficiency in Sport (RED-S), which can include alterations in metabolism, menstrual function, bone deposition and resorption, mental well-being, and more. The goal of this study was to determine whether pain sensitivity was associated with LEA, sleep, mental health, and stress in female endurance athletes. Participants completed a demographic survey, the Low Energy Availability in Females Questionnaire (LEAF-Q), the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-4), and …

Benefits Of Early Intervention With A Certified Lymphedema Therapist For Management Of Radiation Fibrosis Syndrome (Rfs) And Axillary Web Syndrome (Aws) In Breast Cancer Patients, June Leary, June Leary

Capstone Showcase

All breast cancer treatment leads to soft tissue changes in the treated quadrant. While these changes are chronic, they are also identifiable and manageable with care from an appropriate provider. Scarring, lymphedema, radiation fibrosis syndrome (RFS), and axillary web syndrome (AWS) may all be part of the post-treatment soft tissue changes for a breast cancer survivor.

Familiarity with the likely presentation and lifelong management of a patient’s specific symptom burden is crucial. While any physical therapist can rehabilitate the neuropathies, shoulder pain, postural dysfunction, or other numerous orthopedic issues that may occur, there is an acknowledged deficit in the treatment …

Development Of A Personalized Conversational Health Agent To Enhance Physical Activity For Blind And Low-Vision Individuals, Soyoung Choi, Jooyoung Seo, Ashwath Krishnan, Sanchita Kamath, Justin Haegele

Human Movement Studies & Special Education Faculty Publications

Background: With the advancements in mobile health (mHealth) technologies, sighted individuals can benefit from mobile apps and wearable devices to more easily manage their physical activity (PA) and wellness data through intuitive touch gestures and effective data visualizations. However, for blind and low-vision (BLV) individuals, these conventional interaction methods are often challenging, not only limiting their ability to use these technologies but also potentially diminishing their motivation to adopt them to support health-promoting behaviors. We aimed to develop a health monitoring application called Personalized and Conversational Health Agent (PCHA) that supports BLV individuals with self-monitoring and management of their PA …

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

Effects Of Exercise On Cognitive Performance, Autumn Bailey

Williams Honors College, Honors Research Projects

This research project “Effects of Exercise on Cognitive Performance” will be conducted with the purpose of determining the relationship between exercise and cognitive performance. The relationship between injury and cognitive performance will also be investigated. In order to investigate these relationships 60 participants who are current students at the University of Akron will be asked to complete three cognitive assessments, one while at rest, one while riding an exercise bike, and one following the completion of exercise. The results of these three assessments will be compared to determine the relationship between cognitive performance in all three states. Participants will include …

Correlations Of Gait Kinematics And Cognitive Skills In Parkinson Disease, Joshua J. Lander, Matthew F. Moran, Hannah Alexanian

Physical Therapy Faculty Publications

Cognitive impairments and gait disturbances are often concurrent in Parkinson disease (PD), but the extent to which specific cognitive deficits relate to gait abnormalities remains unclear, especially in early-stage PD. To address this gap, we conducted an observational correlational study to determine if cognitive performance in distinct domains is associated with gait kinematics in PD. This study included a cohort of 19 individuals with early-stage PD who underwent gait analysis with a three-dimensional marker-less motion capture system (Theia Markerless Inc., Kingston, ON, CA) during three conditions: single-task walking, cognitive dual-task walking, and the Timed Up and Go (TUG) test. Cognitive …

Computational Approaches For Diagnosing Neurological Impairments And Restoring Functional Movement, Serhii Bahdasariants

Graduate Theses, Dissertations, and Problem Reports (ETD)

Movement is the primary means by which the nervous system converts intention into interaction with the environment. Voluntary limb motion enables standing, walking, reaching, and grasping—actions that underpin self‑care, communication, and economic participation. When diseases or injuries disrupt the pathways that couple neural commands to muscle forces—whether through cortical stroke, spinal cord injury, or peripheral nerve damage—mechanical outcomes such as weakness, loss of coordination, and ultimately reduced mobility emerge. These impairments cascade into secondary complications, increased dependence on caregivers, and diminished quality of life. Quantifying how the lesion alters the mechanics of movement is therefore essential for designing targeted interventions …

Isapa 2025: Program Guide, Catherine Carty, Gerard Masdeu Yelamos

Publications

ISAPA 2025 is a landmark international event that brings together global leaders, researchers, practitioners, and advocates in Adapted Physical Activity to ignite systemic change under the unifying theme “Shifting the Dial: From Awareness to Transformation.” Hosted in Kerry, Ireland, under the patronage of UNESCO, the symposium integrates five major events into one dynamic platform.

The program reflects IFAPA’s mission to advance inclusion, research, professional excellence, and international cooperation, while also contributing meaningfully to the implementation of global frameworks such as the UN Convention on the Rights of Persons with Disabilities (CRPD), the Sustainable Development Goals (SDGs), the Paris 2024 Call …

Evaluating The Efficacy Of A Progressive Mobility Protocol Among Adult Icu Patients, Clayton Chroust

DNP Projects

Background: Many intensive care unit (ICU) patients are critically ill and require ventilator support, and they often do not receive any progressive mobility interventions until after they are liberated from the ventilator or receive transfer orders out of the ICU. Current literature suggests that patients in the ICU face deconditioning, increased ventilator days, development of deep vein thrombosis, pressure ulcers, pulmonary embolism, muscular atrophy, and increased days in the ICU which can be attributed to a lack of mobility. Current evidence-based research identifies that utilization of a progressive mobility protocol is one way to improve patient outcomes and reduce …

The Impact Of Professionalism Education And Formative Feedback In Doctor Of Physical Therapy Students Utilizing The Abbreviated Cpi Feedback Form In The On-Campus Clinic Environment, William L. Scott

Dissertations

Problem

The American Physical Therapy Association (APTA) developed the Clinical Performance Instrument (CPI) to assess the professional behaviors required for a Doctor of Physical Therapy (DPT) student to be considered "entry level" in their clinical training. Feedback from our clinical partners has indicated that, historically, students from the Andrews University DPT program have scored lower than students from other programs in several areas of the CPI during their clinical experiences. According to subjective reports from our clinical partners, these areas included safety, professional behavior, accountability, communication, and critical thinking. These five areas have been the focus of our efforts in …

Case Report: Multifactorial Intervention For Safe Aging In Place, Ashwini Kulkarni

Rehabilitation Sciences Faculty Publications

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the …

The Landscape Of Virtual Reality Use In Mobility Rehabilitation From 2010-2023: A Scoping Review, Danielle T. Felsberg, Reza Pousti, Charlend K. Howard, Scott E. Ross, Louisa D. Raisbeck, Jared T. Mcguirt, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Significant advancements in virtual reality (VR) technology have occurred in the past decade, allowing clinical researchers to take advantage of these reduced barriers to explore the use of VR in patient populations. This scoping review on VR interventions to improve mobility in adults and children focuses on the literature from 2010-2023. A total of 2736 articles were screened and 126 articles met the inclusion criteria. Most of the studies were conducted in inpatient clinical settings (n = 41) and investigated VR interventions to improve balance (n = 118). Less immersive (n = 108) products such as Nintendo Wii or Xbox …

Comparing Immersive And Nonimmersive Clinical Experiences In Athletic Training Education: Effects On Student Engagement And Confidence, Julie M. Cavallario, Shana Pribesh, S. E. Walker

Rehabilitation Sciences Faculty Publications

Context

With the shift to a graduate-level professional degree in athletic training, it was hypothesized that immersive clinical experiences (ICEs) would be more effectively integrated into curricula than non-ICEs (N-ICEs) and better prepare students for practice.

Objective

To longitudinally compare clinical engagement opportunities in ICEs versus N-ICEs and assess if these opportunities are associated with changes in student confidence in performing related tasks.

Design

Prospective, longitudinal, time-diary study using a Web-based survey. Patients or Other Participants: Fifty-three first-year, master’s-level athletic training students from 21 programs.

Main Outcome Measure(s)

Participants reported their type of clinical experience (ICE, N-ICE, or none), the …

Athletic Trainers' Perspectives On Resources And Preparation Needed For Successful Salary Negotiation, Kimberly R. Detwiler, Cailee E. Welch Bacon, Indigo B. White, Leanne E. Jones, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context

Many athletic trainers (ATs) work under high stress, long hours, and low pay. These conditions often lead ATs and athletic training students to leave the profession. Previous studies show that over half of ATs do not negotiate salary, often because they feel the offer is fair or fear losing the job. Additional support is needed to help ATs prepare for negotiations, as current resources are limited.

Objective

This study explored ATs’ views on the resources need to prepare for salary negotiations during the hiring process.

Design

Consensual qualitative research.

Setting

Individual video interviews.

Patients or Other Participants

Twenty-eight participants …

How Many Trials Are Needed For Consistent Clinical Gait Assessment?, Charlend K. Howard, Christopher K. Rhea, Jacquelyn R. Moxey, Kyle Langerhans, Paphawee Prupetkaew, Brittany S. Samulski

Rehabilitation Sciences Faculty Publications

Background: Clinical assessment of gait typically consists of patients walking a few trials at various speeds while the clinician assesses performance. Unfortunately, there is no clear guidance on how gait changes across trials, leaving clinicians uncertain about the optimal number of trials needed to observe consistent (non-variable) performance. To address this issue, we examined gait performance from a large dataset of older adults who participated in a community-based comprehensive fall risk assessment. Methods: Community-dwelling, older adults (n = 340; 70.8 ± 7.4 years; 120 men, 220 women) performed gait trials under two conditions: preferred and maximum walking speed. …

Effect Of Trauma Type And Trauma Burden On Self-Efficacy For Physical Exercise In Military Veterans, Kaley E. Davis, Meghan M. Bennett, Cecilia J. Hillard, Jeffrey Whittle, Zeno Franco, Rachel E. Bollaert, Jacklynn M. Fitzgerald

Exercise Science Faculty Research and Publications

Introduction

United States (U.S.) military veterans experience significant physical health problems. Lifestyle modifications, such as increasing daily physical activity, are often considered the first course of action in treatment for the general public. However, veterans report low levels of physical activity, often due to perceived barriers to engaging in exercise. Trauma exposure type and cumulative trauma burden may be differentially associated with exercise attitudes and behaviors.

Methods

We surveyed U.S. military veterans on perceived self-efficacy to overcome barriers to engaging in exercise and physical activity levels. Additionally, we explored the relationship between the type of traumatic event exposure and cumulative …

Contemporary Normative Values For Five Common Static Standing Tasks On Firm And Compliant Floor Surfaces In Children Two To Thirteen Years, Nancy Darr

Funded Scholarship

Background/Objectives: Static upright tasks, including standing unsupported (SU), eyes closed (SEC), feet together (SFT), tandem (TS), and single limb (SLS), are routinely examined in children and are included in many norm-referenced measures. Existing normative values for these standing tasks may not apply to contemporary children and have not been established across wide age ranges. The primary purpose of this study was to investigate developmental trajectories of and relationships between four static standing positions (SPs [SU, SFT, TS, SLS]) in children aged 2 through 13 years who are developing typically. The effects of altered sensory input, including floor surface (firm and …

Influence Of Virtual Reality On Lower Extremity Joint Kinematics During Overground Walking, Hunter Derby, Nathan Conner, Adam C. Knight, Harish Chander

Funded Scholarship

The inability to regain balance following a trip-induced event is one of the leading causes of falls and fall-related injuries in older adults. Virtual reality (VR) has the potential to expose individuals to realistic environments with minimal injury risk compared to real-world exposures. The purpose of this study was to compare lower extremity joint kinematics during overground walking when exposed to real and virtually generated trip obstacles. A total of 14 healthy participants [7 male, 7 female; age: 23.46 ± 3.31 years; height: 173.85 ± 8.46 cm; mass: 82.19 ± 11.41 kg; shoe size (men’s): 9.03 ± 2.71 s] were …

Rebuttal: Reduced Oxidative Capacity Of Skeletal Muscle Is Not An Inevitable Consequence Of Adult Ageing, Ian R. Lanza, Christopher W. Sundberg, Jane A. Kent

Physical Therapy Faculty Research and Publications

We thank Drs Marcinek and Ferrucci for their perspective on the inevitability of age-related declines in skeletal muscle oxidative capacity (Marcinek & Ferrucci, 2025). We agree that mitochondria have numerous roles in the cell beyond provision of chemical energy, many of which may be altered by ageing, but our focus in this debate is entirely on its role in energy production.

Perspectives Of Midwives And Nurse Practitioners In Kentucky On Exercise Counseling During Pregnancy: A Qualitative Study, Madhawa Perera, Taniya S. Nagpal, Maire M. Blankenship, Dano Tolusso, Jordyn Cox, Dilini Prashadika, Mark Schafer, Rachel A. Tinius

Physical Therapy Faculty Research and Publications

Introduction

Healthcare professionals are in an optimal position to deliver exercise information to pregnant women, yet previous research suggests this seldom happens. Midwives and nurse practitioners, who may have more time with pregnant women, are particularly well suited for this role.

Objectives

This qualitative study examined the exercise advice and counseling provided by midwives and nurse practitioners in Kentucky, focusing on the barriers they face.

Methods

Twenty-one midwives and nurse practitioners were recruited until the sample size reached saturation. A survey with open-ended questions was distributed to potential participants in regional hospitals, universities, and professional associations. The framework method was …

Age-Related Differences In Eye Movements And The Association With Archimedes Spiral Tracing Performance In Young And Older Adults, Brittany Heintz Walters, Wendy E. Huddleston, Kristian M. O'Connor, Jinsung Wang, Marie K. Hoeger Bement, Kevin G. Keenan

Physical Therapy Faculty Research and Publications

Age-related hand motor impairments may critically depend on visual information though few studies have examined eye movements during tasks of hand function in older adults. The purpose of this study was to assess eye movements and their association with performance while tracing on a touchscreen in young and older adults. Eye movements of 21 young (age 20–38 years; 12 females, 9 males) and 20 older (65–85 years; 10 females, 10 males) adults were recorded while performing an Archimedes spiral tracing task, a common clinical assessment sensitive to age-associated impairments in hand function. Participants traced an Archimedes spiral template on a …