Physical Therapy Commons^™

The Effect Of The Lee Silverman Voice Treatment (Lsvt) Big Method Based On Occupation On Older Adult Functional Mobility Balance, Muhammad Luthfi, Kharisma Nur Idalasari

Jurnal Fisioterapi Terapan Indonesia

Balance impairment is one of the major problems commonly experienced by older adults as a result of degenerative processes, leading to an increased risk of falls. Falls may cause fear of recurrent falling, reduced physical activity, loss of physical capability, and may eventually result in disability and psychological consequences such as depression. Structured, occupation-based physical activity has been shown to provide various benefits for older adults, including improving physical function, slowing functional decline associated with degenerative processes, reducing fall risk, and enhancing postural control. This study aimed to analyze the effect of the occupation-based Lee Silverman Voice Treatment (LSVT) BIG …

Fall Risk And Lower Extremity Strength In Diabetic And Non-Diabetic Older Adults: A Comparative Cross-Sectional Study, Maimoona Shahid, Yasha Sajjad, Shumail Fatima, Ayesha Tuba, Wajida Perveen, Asim Raza

Internet Journal of Allied Health Sciences and Practice

Purpose: Many studies have been conducted on falls in individuals older than 60 years of age with diabetes, so the current study focused on comparing and contrasting the fall risk and lower extremity strength in diabetic and non-diabetic people of 50 years of age and above and early identification of fall risk. Methods: This comparative cross-sectional study recruited 210 older adults 50 years of age and older from community dwelling areas. Thirty-one (31) participants were healthy and free of diabetes, while 179 of the same age range were diagnosed with diabetes mellitus. The study was conducted over a period of …

Personal And High-Intensity Gait Factors Associated With Balance And Walking Improvement With Outpatient Stroke Rehabilitation: A Retrospective Study, Heather Staal

Dissertations

Objective: The purpose of this study is to examine the relationships between personal factors and High-Intensity Gait variables and balance and walking improvement in an outpatient stroke population.

Background: Stroke is a leading cause of long-term disability, with persistent gait and balance impairments commonly limiting independence and participation. High-intensity gait training (HIGT) is an evidence-based rehabilitation approach that improves walking outcomes following stroke; however, guidance on how specific training variables are applied in outpatient physical therapy settings remains broad.

Methods: This retrospective observational study analyzes clinical data from outpatient physical therapy episodes in which HIGT is a …

Effect Of An Exercise Protocol On Balance In Adults With Down Syndrome, Juan Bernal, Natalie Sato

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Down syndrome (Ds) is a complex genetic condition that can impact multiple systems of the body, including functional balance. Ds-specific impairments such as muscle hypotonia, ligamentous laxity, and decreased muscle strength, coupled with a sedentary lifestyle can result in poor motor control, altered proprioceptive function, static and dynamic instability. Visual and vestibular impairments are also common in this population, increasing fall risk and fear of falling, and discouraging participation in physical activity. The aim of this study is to analyze the impact of a physical therapy-based exercise program on the functional balance of adults with Ds.

Number of Subjects: …

Feasibility Of A Functional Reach Tool For Individuals With Lower Extremity Amputations, Neil Bongolan, Dustin Hoy, Ashlyn Strange

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Patients with lower extremity amputations are at increased risk of falls due to decreased balance ability between amputated and sound side. The purpose of this study was to examine the usefulness of a reaching tool for practitioners to assess balance in an inpatient rehab facility. It was anticipated that clinicians will find the reaching device useful when administering the Functional Reach Test (FRT) in a clinical setting, given the frequent use of these assessments and the device’s demonstrated reliability.

Participants: Physical Therapists and patients at an Inpatient Rehab Facility in Henderson, Nevada

Materials/Methods: A prototype reaching tool was provided …

Discordance Between Actual And Perceived Balance Ability Relates To Quality Of Life And Global Cognition In A Clinical Sample Of Parkinson Patients, Daniel S. Peterson, Jason K. Longhurst, Franziska Albrecht, Joanna Weller, Jennifer Vasquez, Myassar Zarif, Mark Gudesblatt, Andrew Hooyman

Physical Therapy Faculty Articles and Research

Background

Objective

Methods

The Impact Of An Aquatic Exercise Program On Self-Reported Balance And Confidence On Perceived Fall Risk: A Pilot Study, Antoney Labuschagne, Wesley Hopper, Bailey Watson, Alexis Ignatin, Ashtyn South, Whitney Dupree, Natalie Michaels

SPARK Symposium Presentations

Background: Each year, thousands of people experience one or more episodes of falling, that lead to a lasting impact in function and participation in daily life. Education regarding fall prevention is often focused mainly on the older adult population, but falls can happen at any age. Fear of falling and pain-related fear exists among adults at any age. The focus of this research study was to determine if participation in an aquatic exercise program that focused on balance, core body strength, and cardiopulmonary endurance could be utilized to alleviate the fear of falling and improve performance. Methods: Eight participants completed …

Clinical Effectiveness Of An Aquatic Exercise Program On Those With Visual Impairment, Mikayla Calitis, Haley Mcmenimen, Isabella Bernitsky, Amelia Gansz, Karol Bialek

Student Research Poster Presentations 2026

No abstract provided.

The Effects Of Virtual Reality Interventions On Gait And Balance In Patients With Chronic Stroke: A Systematic Review, Meghan Darrough, Stephanie Layland, Breena Kravchick

Student Research Poster Presentations 2026

Background: Chronic stroke survivors often experience long-term gait and balance impairments that impact their functional abilities and activities of daily living. Emerging interventions, such as virtual reality (VR), are being evaluated on their potential to enhance rehabilitation outcomes.

Objective: This systematic review aimed to evaluate the effects of virtual reality interventions on gait and balance in individuals with chronic stroke.

Methods: Two literature searches were performed in September 2025 and January 2026 using the CINAHL Complete, MEDLINE, and PubMed databases.

Results: Fourteen studies met the inclusion criteria and were categorized based on balance outcome measures (Berg Balance Scale, Tinetti Performance-Oriented …

Non-Instrumented Dva: Assessment Of Performance And Clinical Feasibility In Children Ages 2 Through 13 Years, Cathey P. Norton, Nancy S. Darr, Mary Katherine Beshears, Katherine Catalano, Tyra Dillard, Mahayla J.K. Gamble, Magdalene Olerich, Sadie Rodell Rupp

Funded Scholarship

Background/Objectives: Vestibular disorders can have functional consequences for children, including balance and gross motor delays, academic difficulties and behavioral manifestations; however, they are frequently undiagnosed in children. The purposes of this study were to evaluate the feasibility and clinical utility of performing a non-instrumented dynamic visual acuity (DVA) test as a primary screening tool for children and to examine typical performance on this non-instrumented DVA test in a large sample of children ages 2 through 13 years.

Methods: A clinical DVA test was administered to a convenience sample of 208 children aged 2–13 years. Static visual acuity was assessed using …

A Case Series: Effectiveness Of Nintendo Ring Fit In Improving Balance And Stability Deficits After Recovery From Acl Reconstruction, Emma C. Lord, Melissa A. Tolbert, Whitley J. Stone

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 6: Issue 1, Article 10, 2025. This study aimed to assess the effectiveness of a gaming system in improving balance, strength, and power after recovery from an anterior cruciate ligament reconstruction (ACLR). Existing bilateral deficits were also assessed among patients.

Four participants between the ages of 18-24 years were recruited for this case-control study. Participants must have had an ACLR in the last 2 years, been discharged from formal physical therapy, and have a continued history of participating in physical activity at least three times a week. Participants were assigned to either the …

The Association Of Acute Stress And Lower Quarter Emg During A Single Leg Balance Dexterity Task, Ted W. Gehrig Iii, Robert I. Dudley, Jo Armour Smith, Lida Gharibvand, Lee S. Berk, Everett B. Lohman Iii

Physical Therapy Faculty Articles and Research

Background

Research Question

Methods

Enhancing Motor Function In Individuals With Lower Limb Amputation Through Peerbased Learning Of Balance And Fall Recovery Skills, Zoe Castle, Jer Ja Chuang, Jewel Granados, Danna Shaw

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Lower limb amputation (LLA) is a devastating condition that is becoming more prevalent in the United States. We examined the effects of peer-based action observation learning on the brain activation and the eyetracking pattern in individuals with LLA.

Methods: Fourteen individuals with LLA (51.9±12.6 years, 4 females, 9 with transfemoral amputations) were asked to learn a balance task through observing the movements demonstrated by individuals with LLA or persons with intact limbs. Electroencephalogram (EEG) signals, visual attention time, and peak saccade velocity were recorded when participants watched the demonstration videos. Power spectral density (PSD) was used to analyze the …

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 …

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 …

Assessment Of Gait, Balance, And Falls In Individuals With Neurodegenerative Diseases, Lauren Tueth

WUSM Theses and Dissertations – All Programs

Neurodegenerative diseases are a group of disorders that impact the brain and lead to neuronal degeneration. This degeneration causes many different symptoms, which are often grouped into motor, cognitive, and psychiatric domains. Individuals with these disorders can experience symptoms from multiple domains at the same time, but little is known about how these distinct symptoms may impact each other.

In Chapter 2, we explored the intersection of balance and cognitive impairment in individuals with Alzheimer disease (AD). AD is traditionally discussed in the context of the dementia symptoms, but people with AD also experience motor deficits. Falls are a huge …

Effects Of Chronic Diabetes And Attentional Focus On Performance And Learning Of A Novel Stabilometer Balance Task, Rebeca Carolina Armagnac Gonzalez, Yinny H. Lee, Alicia Marie Letkiewicz, Meiko Nagano Mamauag

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Chronic diabetes is a prevalent systemic disease that impairs physical functioning and often leads to increased risk of falls. Adopting an external focus of attention during motor skill practice has been shown to improve learning outcomes, however, it has not been examined in this population. We examined how attentional focus instructions (internal vs. external) affect balance performance and learning in older adults with and without diabetes.

Methods: Fifty-three older adults (27 with diabetes, 63.7±7.0 years) participated in the randomized, pre-post intervention study. The balance training involved 50 practice trials of a stabilometer task that was novel to …

Standing Posterior Trunk Rotation With Adaptive Proprioceptive Toss, Jennifer Elvir

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a remarkably individualized disease. Nearly every person’s trajectory is unique. One person may experience tremor at an early stage of the disease, while another may experience tremor at a later stage or even not at all. For all PD patients, for certain can expect increasing difficulty as the disease progresses. Parkinson’s disease is responsible for the loss of dopamine which displays itself most notably through motor and cognitive symptom disruption. Although Parkinson’s is a chronic and progressive condition that is irremediable, significant strides have been facilitated to help control and manage the trajectory of the disease. …

People With Degenerative Cervical Myelopathy Have Impaired Reactive Balance During Walking, Timothy F. Boerger, Learon Mcginn, Megan Bellman, Marjorie C. Wang, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

Background

People with degenerative cervical myelopathy are known to have impaired standing balance and walking abilities, but less is known about balance responses during walking.

Research question

The aim of this project was to assess reactive balance impairments during walking in people with degenerative cervical myelopothy (PwDCM). We hypothesized that center of mass motion following perturbations would be larger in PwDCM and gluteus medius electromyographic amplitude responses would be decreased in PwDCM.

Methods

Reactive balance responses were quantified during unanticipated lateral pulls to the waist while treadmill walking. Walking biomechanics data were collected from 10 PwDCM (F=6) and 10 non-myelopathic …

Clinical Effectiveness Of An Aquatic Exercise Program On Strength, Balance, Quality Of Life And Emotional Well-Being In Those With Visual Impairments, Michaela Fasolino, Samantha Lubin, Zoee Farr, Jillian Rogers, Maureen Rinehimer

Student Research Poster Presentations 2024

Background Information Numerous disabilities have been shown to benefit with aquatic exercise by research. There is a dearth of research on the health effects of aquatic exercise for individuals with visual impairments. Adults with visual impairments generally have a lower health-related quality of life (HRQoL) than their peers without visual impairments. Additionally, living a sedentary lifestyle increases the chance of developing diseases like diabetes, cardiovascular disease, hypertension, osteoporosis, and sarcopenic obesity. After reading about the positive and long-lasting effects of aquatic exercise in previous studies, these researchers investigated the effects of an aquatic fitness program for individuals with visual impairments. …

Approximate Entropy And Velocity Of Center Of Pressure To Determine Postural Stability: A Pilot Study, Natalie Tipton, Gordon Alderink, Samhita Rhodes

Open Access Publishing Support Funded Articles

The body’s postural control system is responsible for responding to perturbations of balance and keeping the body upright. During quiet standing, the center of pressure oscillates about the center of mass, counteracting imbalances. These oscillations can be analyzed to determine the degree of stability, which could be helpful in quantifying the effects of brain injuries. In this research, the center of pressure was recorded for stances with feet together and feet tandem, with eyes opened and eyes closed, in neurotypical participants. These signals were analyzed using indices of approximate entropy and velocity to determine how sensitive the measures were in …

Effects Of A 12-Week Remote Exercise Program On Balance In Adults With Down Syndrome, Kayla Kotake, Sherwin Cadiao, Nicole Kaes, Jayston Prudencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis Individuals with Down syndrome (Ds) tend to have deficits in balance and postural control, which negatively affects their ability to perform physical activities safely and independently. Previous research has shown that exercise can improve balance in people with Ds, however, most studies looked at balance in children with Ds. As the average life expectancy for people with Ds has increased, there is a need for research investigating balance in adults with Ds. Also, there is a need to increase exercise opportunities (eg, remote exercise programs) for adults with Ds, as physical inactivity and sedentary behavior are prevalent among individuals …

Spatial Characteristics Of Reactive Stepping Among People Living With Chronic Incomplete Spinal Cord Injury, Matthew G Heffernan, Jae Woung Lee, Katherine Chan, Janelle Unger, Susan Marzolini, Timothy N Welsh, Kei Masani, Kristin E Musselman

Physical Therapy Publications

Objective: Compare the spatial characteristics of reactive stepping between individuals with chronic motor incomplete spinal cord injuries (iSCI) and able-bodied (AB) individuals.

Design: Cross sectional.

Setting: Lyndhurst Centre.

Participants: Twelve individuals with iSCI (3 males, 53.6 ± 15.2 years old) and 11 age- and sex-matched AB individuals (3 males, 54.8 ± 14.0 years old).

Interventions: The Lean-and-Release test was used to elicit reactive stepping. A horizontal cable, attached at waist height, was released when 8-12% body weight was supported in a forward lean position. Participants underwent up to 10 Lean-and-Release trials in a session. Kinematic and …

Using The Instrumented Sway System (Isway) To Identify And Compare Balance Domain Deficits In People With Multiple Sclerosis, Patrick G. Monaghan, Andrew S. Monaghan, Andrew Hooyman, Brett W. Fling, Jessie M. Huisinga, Daniel S. Peterson

Physical Therapy Faculty Articles and Research

Objective
To develop a multiple sclerosis (MS)-specific model of balance and examine differences between (1) MS and neurotypical controls and (2) people with MS (PwMS) with (MS-F) and without a fall history (MS-NF).

Design and Setting
A cross-sectional study was conducted at the Gait and Balance Laboratory at the University of Kansas Medical Center. Balance was measured from the instrumented sway system (ISway) assessment.

Participants
In total, 118 people with relapsing-remitting MS (MS-F=39; MS-NF=79) and 46 age-matched neurotypical controls.

Intervention
Not applicable.

Outcome Measures
A total of 22 sway measures obtained from the ISway were entered into an exploratory factor …

What’S All The Racket? Comparing Physical Health Outcomes Between Pickleball And Tennis In Older Athletes, Megan Doneen Wilson Spt, Ashley Nicole Meldrum Spt, Austin Jeffrey Buchholz Spt, Andrew David Taverna Spt, Michael John Olson Spt

Physical Therapy Student Research Projects

Background: Pickleball is rising in popularity, especially among older adults. Pickleball boasts psychological and physical benefits to aging athletes. Singles pickleball has been found to approximate brisk walking in metabolic equivalents (METs) at 4.1, while the METs level for singles tennis is 7.0-8.0. The physical health benefits of tennis are known to be positive while those of pickleball are still being explored. With objective differences in MET level it may be surmised that health outcomes might vary between the two sports.

Purpose: The purpose of this study was to use the Senior Athlete Fitness Exam (SAFE) to quantify and compare …

Advancing The Assessment And Treatment Of Signs And Symptoms Of Parkinson Disease, David Scott May

WUSM Theses and Dissertations – All Programs

People with PD often report signs and symptoms that negatively impact quality of life. Among these are balance difficulties, impaired gait, and FOG. New treatment and assessment strategies for these signs and symptoms are needed, as current techniques are limited. While new treatment and assessment strategies continue to emerge, gaps in knowledge persist. Deep brain stimulation (DBS) has been utilized in many people with PD throughout the 21st century, but it is unknown specifically how subthalamic nucleus deep brain stimulation (STN-DBS) affects balance. Alternative treatment strategies, such as a dental mouthpiece, have also been proposed. While dental mouthpieces have shown …

Effects Of Neuromuscular Interventions Utilizing External Biofeedback Apparatuses On The Risk And Incidence Of Second Anterior Cruciate Ligament Injuries: A Systematic Review., Marisa Olmo, Rebecca Sharp

DPT Capstones

STUDY DESIGN: Systematic review.

BACKGROUND: Anterior cruciate ligament (ACL) injury is a common orthopedic condition with an estimated rate of 20,000 to 600,000 injuries in the US per year, with higher incidences in athletic and female populations. The rate of re-injury following surgical ACL repair (ACLR)ranges between 13.8-33.3%. Current clinical practice guidelines for ACLR rehabilitation cite inconclusive evidence for definitive outcome measures that accurately determine successful return to sport (RTS). There is a need to establish more effective avenues of rehabilitation interventions to decrease the rate of reinjury, particularly in female athletes. Recent evidence suggests interventions utilizing external biofeedback apparatuses …

Degenerative Cervical Myelopathy Delays Responses To Lateral Balance Perturbations Regardless Of Predictability, T. F. Boerger, L. Mcginn, M. C. Wang, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The aim of this study was to quantify balance impairments in standing in people with degenerative cervical myelopathy (PwDCM) in response to external perturbations. PwDCM have damage to their spinal cord due to degeneration of the cervical vertebral column, but little is known about balance. Balance was quantified by capturing kinetics, kinematic, and electromyographic data during standing in response to lateral waist pulls. Participants received pulls during predictable and unpredictable contexts in three stance widths at two magnitudes. In response to lateral waist pulls, PwDCM had larger center of mass excursion (P < 0.001) and delayed gluteus medius electromyography onset (P < 0.001) and peak (P < 0.001) timing. These main effects of history of myelopathy were consistent across predictability, stance width, and magnitude. A multilinear regression determined that gluteus medius peak timing + tibialis anterior peak timing most strongly predicted center of mass excursion (R2 = 0.50, P < 0.001). These data suggest that PwDCM have delays in generating voluntary and reactive motor commands, contributing to balance impairments. Future rehabilitation strategies should focus on generating rapid muscular contractions. Additionally, frontal plane postural control is regulated by the gluteus medius and the tibialis anterior, whereas other muscles (e.g. gluteus minimus, ankle invertors/evertors) not studied here may also contribute.

Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla

Journal of Transformative Touch

Does Zero Balancing positively impact occupational performance? This is a question many Occupational Therapists (OTs) ask when discerning if Zero Balancing (ZB) is an evidence-based treatment modality. Case studies from the book Experiencing the Power of Zero Balancing: Case Studies of Journeys to Health and Wholeness (Quarry & King, 2016) were reviewed and compared to the Occupational Therapy domain of practice to show clear evidence that each case study had a positive impact on occupational performance. A comparison chart shows a direct link between the occupational categories and documented evidence of improved occupational performance through practitioner observation and client feedback …

Using Biofeedback To Reduce Spatiotemporal Asymmetry Impairs Dynamic Balance In People Post-Stroke, Sungwoo Park, Chang Liu, Natalia Sánchez, Julie K. Tilson, Sara J. Mulroy, James M. Finley

Physical Therapy Faculty Articles and Research

Background. People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined. Objective. We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum. Methods. We performed clinical balance assessments and measured wholebody angular momentum during walking using a full-body marker set in a sample of 36 people with …