Physical Therapy Commons^™

Type-2 Diabetes Mellitus Reduces Cortical Thickness And Decreases Oxidative Metabolism In Sensorimotor Regions After Stroke., Jennifer K Ferris, Sue Peters, Katlyn E Brown, Katherine Tourigny, Lara A Boyd

Physical Therapy Publications

Individuals with type-2 diabetes mellitus experience poor motor outcomes after ischemic stroke. Recent research suggests that type-2 diabetes adversely impacts neuronal integrity and function, yet little work has considered how these neuronal changes affect sensorimotor outcomes after stroke. Here, we considered how type-2 diabetes impacted the structural and metabolic function of the sensorimotor cortex after stroke using volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). We hypothesized that the combination of chronic stroke and type-2 diabetes would negatively impact the integrity of sensorimotor cortex as compared to individuals with chronic stroke alone. Compared to stroke alone, individuals with …

Trunk Motion Visual Feedback During Walking Improves Dynamic Balance In Older Adults: Assessor Blinded Randomized Controlled Trial., Eric Anson, Lei Ma, Tippawan Meetam, Elizabeth Thompson, Roshita Rathore, Victoria Dean, John Jeka

Department of Physical Therapy Faculty Papers

BACKGROUND: Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes.

RESEARCH QUESTION: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems.

METHODS: 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks …

Conservative Treatment Of A 58 Year-Old Male Referred To Physical Therapy With A Knee Sprain And Knee Osteoarthritis, Chase Pruitt

Physical Therapy Scholarly Projects

Background and Purpose: Knee osteoarthritis (OA) is a common condition in people over 50. Although there may be an association between acute knee injuries and knee OA later in life, the occurrence of acute knee injuries in patients with existing OA is less clear. The purpose of this case study is to evaluate the effectiveness of an impairment based therapy program in an individual with an acute knee injury and knee OA.

Case Description: This case follows a 57 year old male referred to physical therapy with an acute knee sprain and tri-compartmental knee OA. Treatment lasted 7 sessions …

The Attentional Demands Of Ambulating With An Assistive Device In Older Adults With Alzheimer's Disease, Susan W. Hunter, M Montero-Odasso

Physical Therapy Publications

Ambulation with a mobility aid is a unique real-life situation of multi-tasking. These simultaneous motor tasks place increased demands on executive function in healthy young and older adults, but the demands have not been evaluated in people with Alzheimer's disease (AD). Mobility problems are common among adults with AD, leading to provision of a mobility aid to optimize independent activity. The study objectives were: (i) to determine the dual-task cost (DTC) associated with the use of a mobility aid in straight and complex path walking, and (ii) to evaluate the association between executive function and ambulation with a mobility aid …

Visual, Verbal, And Tactile Cues On Improving Gait In A 71-Year Old Male With Dementia Of The Lewy Bodies, Symone Carter, Jackie Crossen-Sills

St. Augustine, Spring 2017

The purpose of the case report is to demonstrate how visual, verbal, and tactile cues can improve gait in a patient with DLB.

Training Of Anticipatory Postural Adjustments In An 83-Year-Old Female With Severe Anxiety Post-Femoral Fracture: A Case Report, Chandler Witt, Anne H. Boddy

St. Augustine, Spring 2017

The purpose of this case report is to present the outcomes of using APA training exercises in conjunction with conventional physical therapy to improve gait independence, and movement anxiety in older adult patients post femoral fracture secondary to a fall.

Don’T Let Me Fall: Implementing The Use Of Assistive Standing Device With Functional Task Specific Training Can Improve Safety Of Transfers In A 65 Y/O Woman With Primary Lateral Sclerosis: A Case Report, Megan Farr, Lindsay Perry

St. Augustine, Spring 2017

The purpose of this case report is to describe improvements of a novel functional training program in a patient diagnosed with PLS.

Evaluation Of Fall Risk, Functional Mobility, And Quality Of Life Changes Of Community-Dwelling Older Adults With Parkinson's Disease Participating In A Community Exercise Program: Part Ii, Lauren Trudel, Courtney Mcdonald, Brittany Bleichner

Physical Therapy Scholarly Projects

Purpose/Hypothesis: As a person ages, the risk of a fall increases. Parkinson Disease (PD) is most commonly seen in the elderly population, which presents with symptoms such as bradykinesia, decreased balance, tremors, postural instability, and muscle weakness. These symptoms are associated with an increase in falls; therefore, a person with PD is more susceptible to falls than the average elderly individual. Exercise has been shown to combat those symptoms affecting people with PD. This study is an extension of a previous study, which examined the effect of a community based exercise program, for people with PD, on quality of …

Effectiveness Of The Timed Up And Go (Tug) Test In Assessing Fall Risk In Community-Dwelling Elders Participating In The Stepping On Program, Megan Shanahan

Physical Therapy Scholarly Projects

Background: The Timed Up and Go (TUG) is intended to predict fall risk through assessment of balance, functional mobility, and gait in community-dwelling adults age 65 and older. The Stepping On program aims toward fall prevention through education, exercise, and shared experiences among participants. Previous evidence has displayed positive, significant results for Stepping On and the TUG, indicating use of the assessment to track participants' progress in the program.

Objective: The purpose of this study was: 1) to determine if the Stepping On program decreases fall risk in community-dwelling elderly individuals as measured by the TUG test, 2) …

Total Knee Arthroplasty Rehabilitation: Case Report, Allen Kennedy

Physical Therapy Scholarly Projects

Background and Purpose: Osteoarthritis (OA) of the knee is a common problem in the world population and total knee replacement has become the gold standard for repair when the OA becomes severe enough. Total knee replacement, however, is not the complete answer to knee OA. Without rehabilitation these patients may struggle to be fully functional. The purpose of this case study was to describe the rehabilitation of a geriatric patient who underwent TKA and benefited from the use of hydrotherapy in his recovery.

Case Description: This report will look at the rehabilitation of one 73-year-old male patient and interventions …

The Effectiveness Of "Stepping On" In Reducing Fall Risk In The Elderly Using The 30-Second Chair Stand Test, Brianna Albrecht

Physical Therapy Scholarly Projects

Background: One-third of all adults over the age of 65 years of age falls each year. Falls cost patients financially, physically, and emotionally. Balance and strength deficits contribute to increasing an individual's fall risk. Studies have shown the efficiency of community-based exercise and education programs on reducing the risk of falling.

Objective: The purpose of this study was to determine whether participants in Stepping On experienced an improvement in balance and confidence following completion of the program. The study also evaluated the correlation between self-perceived risk of falling on the CDC Fall Risk Survey and their actual risk …

Evaluation Of Program Satisfaction, Quality Of Life, Strength, And Fall Risk Of Community-Dwelling Older Adults Participating In A Community Exercise Program: Part 2, Marissa Adolphson, Roy Nelson, Jenna Wyffels

Physical Therapy Scholarly Projects

Background and Purpose: Bone Builders is an exercise program that incorporates both lower and upper extremities and is specifically designed for the older adult population. It was originally created for those that wanted to reduce their risk of osteoporosis, but currently there is no evidence that demonstrates these effects. However, exercises that are completed in the class are those that target causes of fall risk such as strengthening of hip abductors and balance activities. Participants have also reported that benefits of the class include improved balance, increased energy and mobility, and social support. Our study consisted of testing the …

Evaluation Of Fall Risk, Functional Mobility And Quality Of Life Changes Of Community-Dwelling Older Adults With Parkinson's Disease Participating In A Community Exercise Program, Gabrielle Dahl, Elizabeth Hermanson, Laura Nelson, Kayla Selinger

Physical Therapy Scholarly Projects

Purpose/Hypothesis: Falls are evident in the older population and are a common and disabling feature of Parkinson Disease (PO). The benefits of activity are well known to decrease balance deficits and increase overall quality of life in the older adult population. In addition highly challenging exercises have been suggested to increase neuroplasticity in individuals with PD. The effect of challenging exercises on clinical outcomes in a structured Physical Therapy setting is documented in literature; however, the effect of a community based program is not well documented. Our pilot study examined the effect of a community exercise program on improving …

Physical Therapy Rehabilitation Following Arthroscopic Rotator Cuff Repair, Brittany E. Wirth

Physical Therapy Scholarly Projects

Background and Purpose: According to the American Academy of Orthopaedic Surgeons, previous studies have found the prevalence of rotator cuff tears may exceed 50% in individuals older than age 65. Since this age group is the fastest growing of the U.S. population, rotator cuff pathology is sure to become a more significant problem in the future. With this information, it is important to continue research on rotator cuff rehabilitation following arthroscopic surgery.

Case Description: This case report describes the physical therapy interventions and functional outcomes of a 58-year-old patient who underwent arthroscopic surgery to repair a partial tear …

Stepping On: Gait Velocity And Fall Risk Assessment, Brittney Herbst

Physical Therapy Scholarly Projects

Purpose: To identify fall risk and determine if the Stepping On program is effective at reducing the risk of falls in participants by increasing gait speed to greater than or equal to 1 m/s. Step and stride length were also compared to age related norms to determine if they correlated to fall risk. Gait speed of less than I m/s has been shown to increase the risk for falls in elderly.

Methods: Fourteen female participants over the age of 65 (mean age of 87) were recruited from a local Stepping On class conducted at an assisted living facility …

Primary Care Fall Risk Assessment For Elderly West Virginians, Vivian M. Minkemeyer, Matt Meriweather, Franklin D. Shuler, Saurabh P. Mehta, Zain N. Qazi

Orthopaedics

West Virginia is ranked second nationally for the percent of its population .65 years of age. The elderly are especially susceptible to falls with fall risk increasing as age increases. Because falls are the number one cause of injury-related morbidity and mortality in the West Virginia elderly, evaluation of fall risk is a critical component of the patient evaluation in the primary care setting. We therefore highlight fall risk assessments that require no specialized equipment or training and can easily be completed at an established office visit. High quality clinical practice guidelines supported by the American Geriatric Society recommend yearly …

Locomotor Adaptation Is Influenced By The Interaction Between Perturbation And Baseline Asymmetry After Stroke., Christine M. Tyrell, Erin Helm, Darcy S. Reisman

Department of Physical Therapy Faculty Papers

Stroke survivors without cerebellar involvement retain the ability to adapt to the split-belt treadmill; however it has been suggested that their rate of adaptation may be slowed compared to those who are neurologically intact. Depending on limb placement, the split-belt treadmill can be configured to either exaggerate baseline asymmetry, or reduce it, which may affect the behavior of adaptation or de-adaptation. The objectives of this study were to characterize the rate and magnitude of locomotor (de)adaptation in chronic stroke survivors compared to healthy matched subjects, and to evaluate whether exaggeration or reduction of baseline asymmetry impact the responses. Seventeen stroke …

Treatment Of A 92 Year Old Female Deconditioned After Hospitalization Secondary To A Hemorrhagic Stroke: A Case Report, Paul A. Naujokas

All Capstone Projects

Background and Purpose: Research suggests that older adults are more likely to be hospitalized and to be at risk for hospital-associated deconditioning after successful treatment of their medical condition.This case report demonstrates that a walking program with progressive resistive exercises (PREs) helped one 92 year old female patient, suffering from hospital associated deconditioning, improve her strength, cardiovascular endurance, and functional abilities, including sit-stand transfers, ambulation with the least resistive assistive device (LRAD) and stair climbing. These improvements allowed the patient to return to her prior level of functioning, living independently in her 2nd story apartment with assistance as needed from …

Evaluation Of Program Satisfaction, Quality Of Life, Strength, And Fall Risk Of Community-Dwelling Older Adults Participating In A Community Exercise Program, Rachel Bothun, Christine Gillespie, Zachariah Kvidt, Krista Moonnan

Physical Therapy Scholarly Projects

Background and Purpose: Exercise programs aimed at prevention of osteoporosis are effective in fall prevention and improving mobility in older adults. This trial examined whether the Bone Builder's community exercise program decreases fall risk and improves mobility in community dwelling females over the age of 60.

Methods: Fifty one females ages 60-90 who currently are participating in the Bone Builder's program volunteered to participate in four different assessments as well as two questionnaires. Tests included: the 4-stage balance, timed up and go, gait speed (measured with the GAITRite system), 30 second sit-to-stand, and grip strength. The Functional Efficacy …

Motoric Cognitive Risk Syndrome: Multicountry Prevalence And Dementia Risk, Joe Verghese, Cedric Annweiler, Emmeline Ayers, Nir Barzilai, Olivier Beauchet, David A Bennett, Stephanie A Bridenbaugh, Aron S Buchman, Michele L Callisaya, Richard Camicioli, Benjamin Capistrant, Somnath Chatterji, Anne-Marie De Cock, Luigi Ferrucci, Nir Giladi, Jack M Guralnik, Jeffrey M Hausdorff, Roee Holtzer, Ki Woong Kim, Paul Kowal, Reto W Kressig, Jae-Young Lim, Susan Lord, Kenichi Meguro, Manuel Montero-Odasso, Susan W. Hunter, Mohan L Noone, Lynn Rochester, Velandai Srikanth, Cuiling Wang

Physical Therapy Publications

OBJECTIVES: Our objective is to report prevalence of motoric cognitive risk syndrome (MCR), a newly described predementia syndrome characterized by slow gait and cognitive complaints, in multiple countries, and its association with dementia risk.

METHODS: Pooled MCR prevalence analysis of individual data from 26,802 adults without dementia and disability aged 60 years and older from 22 cohorts from 17 countries. We also examined risk of incident cognitive impairment (Mini-Mental State Examination decline ≥4 points) and dementia associated with MCR in 4,812 individuals without dementia with baseline Mini-Mental State Examination scores ≥25 from 4 prospective cohort studies using Cox models adjusted …

Pilot Comparative Effectiveness Study Of Surface Perturbation Treadmill Training To Prevent Falls In Older Adults, Jon D. Lurie, Alexandra B. Zagaria, Dawna M. Pidgeon, Judith L. Forman, Kevin Spratt

Dartmouth Scholarship

Falls are the leading cause of fatal and non-fatal injuries among older adults. Exercise programs appear to reduce fall risk, but the optimal type, frequency, and duration of exercise is unknown. External perturbations such as tripping and slipping are a major contributor to falls, and task-specific perturbation training to enhance dynamic stability has emerged as a promising approach to modifying fall risk. The purpose of this pilot study was 1) to determine the feasibility of conducting a large pragmatic randomized trial comparing a multidimensional exercise program inclusive of the surface perturbation treadmill training (SPTT) to multidimensional exercise alone (Standard PT); …

"Any Movement At All Is Exercise": A Focused Ethnography Of Rural Community-Dwelling Older Adults' Perceptions And Experiences Of Exercise As Self-Care, Laura J. Graham, Denise M Connelly

Physical Therapy Publications

PURPOSE: To understand rural community-dwelling older adult participants' shared values, beliefs, and behaviours related to exercise as self-care.

METHODS: We conducted a constructivist-focused ethnography involving semi-structured interviews and participant observation with 17 individuals 65 years and older. Interviews were transcribed and inductively coded to develop themes related to exercise, self-care, and exercise as self-care. Field notes were triangulated with follow-up interviews and dialogue between authors to enhance interpretation.

RESULTS: Participants described exercise broadly as movement and not as a central self-care behaviour. However, awareness of the importance and health-related benefits of exercise increased after a significant personal health-related event. Participants …

Neither Heavy Nor Light Load Resistance Exercise Acutely Exacerbates Lymphedema In Breast Cancer Survivor, Prue Cormie, Daniel A. Galvao, Nigel A. Spry, Robert Newton

Research outputs 2013

Resistance exercise has great potential to aid in the management of breast cancer-related lymphedema (BCRL), but little is known regarding the acute response of performing resistance exercises with the affected limb. Purpose. To examine the acute impact of upper body resistance exercise on the amount of swelling and severity of symptoms in women with BCRL and to compare these effects between resistance exercise involving high and low loads (heavier vs lighter weights). Methods. Seventeen women aged 61 ± 9 years with mild to severe BCRL participated in this study. Participants completed a high load (6-8 repetition maximum) and low load …

Associations Of Cardiorespiratory Fitness And Fatness With Metabolic Syndrome In Rural Women With Prehypertension., Patricia A. Hageman, Carol H. Pullen, Melody A. Hertzog, Linda S. Boeckner, Susan Noble Walker

Journal Articles: Physical Therapy

BACKGROUND: This study investigated the associations of fitness and fatness with metabolic syndrome in rural women, part of a recognized US health disparities group.

METHODS: Fitness, percentage body fat, BMI, and metabolic syndrome criteria were assessed at baseline in 289 rural women with prehypertension, ages 40-69, enrolled in a healthy eating and activity community-based clinical trial for reducing blood pressure.

RESULTS: Ninety (31%) women had metabolic syndrome, of which 70% were obese by BMI (≥30 kg/m²), 100% by percentage body fat (≥30%), and 100% by revised BMI standards (≥25 kg/m²) cited in current literature. Hierarchical logistic regression models, adjusted for …

Maintenance Of Activity And Eating Change After A Clinical Trial Of Tailored Newsletters With Older Rural Women., Susan Noble Walker, Carol H. Pullen, Patricia A. Hageman, Linda S. Boeckner, Melody A. Hertzog, Maureen K. Oberdorfer, Matthew J. Rutledge

Journal Articles: College of Nursing

BACKGROUND: In the Wellness for Women Project, a randomized-by-site 1-year controlled clinical trial, the efficacy of generic newsletters and newsletters tailored on Health Promotion Model behavior-specific cognitions, eating behavior, and activity behavior were compared among 225 women aged 50 to 69 years.

OBJECTIVES: The purpose of this study was to compare the maintenance of change in healthy eating and physical activity over the 12 months following the tailored versus generic mailed newsletter intervention.

METHODS: Outcomes at 18 and 24 months included behavioral markers and biomarkers of physical activity and eating. Data were analyzed using the multivariate approach to repeated measures …

Clinical Trial Of Tailored Activity And Eating Newsletters With Older Rural Women., Susan Noble Walker, Carol H. Pullen, Linda Boeckner, Patricia A. Hageman, Melody Hertzog, Maureen K. Oberdorfer, Matthew J. Rutledge

Journal Articles: College of Nursing

BACKGROUND: Unhealthy diet and lack of physical activity increase rural midlife and older women's risk of chronic diseases and premature death, and they are behind urban residents in meeting Healthy People 2010 objectives.

OBJECTIVES: The objective of this study was to compare a tailored intervention based on the Health Promotion Model with a generic intervention to increase physical activity and healthy eating among rural women.

METHODS: In a randomized-by-site, community-based, controlled, clinical trial, Wellness for Women, 225 women aged 50 to 69 years were recruited in two similar rural areas. Over 12 months, women received by mail either 18 generic …

A Preliminary Study On The Reliability Of Physical Performance Measures In Older Day-Care Center Clients With Dementia., Vince Salazar Thomas, Patricia A. Hageman

Journal Articles: Physical Therapy

BACKGROUND: Decline in physical functional ability is an intrinsic component of the dementia syndrome. Reductions in muscle mass and strength represent a major factor in the loss of functional ability Although resistance exercise has been studied as a method for maintaining/recovering function in populations of frail older adults, people with dementia have been systematically excluded because of uncertainty about the reliability of outcome measurements.

OBJECTIVE: The purpose of this study was to determine the test-retest reliability of a battery of established performance-based measures of strength and function among subjects with dementia.

SETTING: A hospital-affiliated adult day-care facility.

SUBJECTS: Twelve of …

The Effects Of Line Dancing On Balance And Coordination In The Elderly, Sara Welder

Physical Therapy Scholarly Projects

The purpose of this study was to determine if a six-week line dancing program has a significant effect on balance and coordination in a geriatric population. If proven effective, line dancing can be added to the options available to physical therapists for balance and coordination training.

A total of 12 volunteer subjects participated in this study. They were separated into two groups, a control group (n = 6, 4 females and 2 males), and a dance group (n = 6, all female) according to participant's preference. Subjects were in good health, were high functioning , and were found to be …

The Effects Of Line Dancing On Balance And Coordination In The Elderly, Christa M. Stelmachuk

Physical Therapy Scholarly Projects

The purpose of this study was to determine if a six-week line dancing program has a significant effect on balance and coordination in a geriatric population. A total of 12 volunteer subjects participated in this study. They were separated into two groups, a control group (n = 6, 4 females and 2 males) and a dance group (n = 6, all female) according to participants' preference. Subjects were in good health, were high functioning, and were found to be at low risk for falls. Age of subjects ranged from 72 to 94 years, with a mean age of 85.67.

The …

The Effect Of TʻAi Chi Chih On Balance In The Elderly, Justin Berry

Physical Therapy Scholarly Projects

Loss of balance and falls among the elderly is a large health care problem, annually causing thousands of injuries and millions of dollars in health care costs. This study investigates whether T'ai Chi Chih can influence balance in the elderly. T' ai Chi Chih is a gentle form of exercise that originated as a martial art.

Fifteen subjects (T'ai Chi Chih, n = 9; control, n = 6) initially underwent two standard functional balance measures (Berg and Tinetti measures), were tested for eyes open single leg stance, and had their blood pressure taken. Subjects were randomly assigned to either a …