Physical Therapy Commons^™

The Feasibility Of Virtual Reality To Provide Visual Feedback To Correct Lower Extremity Biomechanics: A Descriptive Retrospective Case Series, Margaret R. Klausing, Kylie Scott

Internet Journal of Allied Health Sciences and Practice

Purpose: This study explored the feasibility of using the Computer Assisted Rehabilitation Environment (CAREN) to enhance visual biofeedback for patients with lower quarter pain, aiming to improve awareness of faulty movement patterns. Methods: Six patients aged 19-66 (3 males, 3 females), with lower quarter pain involving the ankles, knees, or hips completed one session in an outpatient orthopedic setting using CAREN. The motion capture system projected an avatar onto a 180-degree screen, providing visual biofeedback from sagittal and frontal planes. Joint angles, Knee dominant squat (KDS), and Dynamic Q-Angle (DQA) were compared pre- and post-biofeedback during gait and squats. KDS …

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. …

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 …

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) …

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 …

Relative Muscular Effort In The Older Adults During The Sit-To-Stand Task: Monitoring Neuromuscular Reserve And Movement Limitations, Nayun Ahn, Michael H. Haischer, Cara L. Lewis, Kristof Kipp

Exercise Science Faculty Research and Publications

Background

Due to lower maximum strength, older adults purportedly need to exert greater muscular effort to stand up from a chair. This study investigated joint-specific muscular effort during a sit-to-stand by calculating relative-muscular-effort and investigating differences between healthy older and young adults.

Methods

Fifteen older (age: 69.9 ± 3.5 years) and 15 young (age: 22.2 ± 2.6 years) adults performed five self-paced sit-to-stand trials. Kinematic and kinetic data were collected and used to calculate inverse dynamics net joint moment. Peak isometric knee and hip extensor torques were measured and used as inputs to regression models that predicted angle- and velocity-dependent …

Exploring The Relationship Of Intact Limb Knee Joint Loading With Step Lengths And Step Length Symmetry In Individuals With Lower Limb Amputation, Edward D. Syrett

Theses and Dissertations

Individuals with unilateral lower limb amputation (LLA) frequently experience intact limb knee pain, dysfunction, and osteoarthritis. These problems can worsen pre-existing reductions in mobility and quality of life that this population regularly experiences. It is widely accepted that knee joint loading is implicated in the development of knee joint issues, and intact limb knee joint load alterations are thought to be widespread in individuals with LLA. Prior work suggests that gait deviations frequently present in this population may be a contributory cause of these altered forces. These deviations can take many forms, but individuals with LLA commonly demonstrate alterations in …

Biomechanics, Strength, And Physical Function After Surgical Repair Of Rotational Ankle Fractures, Benjamin Brightwell

Theses and Dissertations--Kinesiology and Health Promotion

Ankle Fractures account for approximately 9% of all lower extremity fractures and incidence continues to rise. Up to 53% of ankle fractures require surgical intervention. Impaired physical function is one of the most reported and observed lasting effects of surgically repaired ankle fractures. Additionally, limited physical capacity and function have been identified as the primary threats to health-related quality of life after surgical repair of ankle fractures. These impairments to physical capacity and functionality can last longer than 5 years after surgery. Since surgery typically successfully restores stability and congruency of the talocrural joint, these poor long-term outcomes are an …

Sex-Related Differences In Gait Characteristics And Their Associations With Symptoms In Individuals With Patellofemoral Osteoarthritis, Harvi Hart Dr.

Physical Therapy Publications

Background

Patellofemoral osteoarthritis (OA) is an important subgroup of knee OA. However, the influence of sex on gait characteristics in patients with patellofemoral OA is unknown.

Research question

Compare gait characteristics in females and males with patellofemoral OA and investigate their associations with patellofemoral joint-related symptoms and limitations.

Methods

Mixed effects polynomial regression models compared knee flexion-extension and adduction moments, knee flexion angles, and vertical ground reaction forces over 100% of stance between 26 females and 22 males with patellofemoral OA, with and without adjustment for walking speed and body mass. Multivariable linear regression models were then used to …

Muscle-Specific Contributions To Vertical Ground Reaction Force Profiles During Countermovement Jumps: Case Studies In College Basketball Players, Kristof Kipp, Hoon Kim

Exercise Science Faculty Research and Publications

The purpose of this study was to determine muscle-specific contributions to various types of vertical ground reaction force (vGRF) profiles in collegiate basketball players. Players from a men's (n = 5; height: 1.84 ± 0.14 m; mass: 92.8 ± 11.4 kg) and a women's (n = 5; 1.71 ± 0.09 m; mass: 80.1 ± 17.6 kg) basketball team completed 3–5 countermovement jumps (CMJ) while motion capture and force plate data were recorded. Muscle-specific contributions to vGRF were calculated through vGRF decomposition analysis. Profiles of vGRF were analyzed based on the presence of unimodal or bimodal peaks during the …

Running To The Beat: Does Listening To Music Affect Running Cadence And Lower Extremity Biomechanics?, Carolyn Meinerz, Jessica M. Fritz, Janelle A. Cross, Cody C. Dziuk, Kristof Kipp, Carole Vetter

Exercise Science Faculty Research and Publications

Background

Gait retraining can be effective in altering lower extremity biomechanics and reducing risk of injury. In attempts to alter running gait, previous studies used metronomes to manipulate cadence.

Research question

The aim of this study was to determine if manipulating running cadence via music could alter lower extremity biomechanics.

Methods

Eighteen runners ran at a self-selected speed (SS) and ran to music where the beats per minute (bpm) of the songs was increased by 5% (+5%) and 10% (+10%). Kinematic and kinetic data were collected with a motion capture system and a triaxial accelerometer. A one-way repeated measures analysis …

Changes In Running Biomechanics In Master Runners Over Age 50: A Systematic Review, Matthew Klein, Chris Patterson

Faculty Publications - College of Physical Therapy

The number of individuals over 50 years of age participating in recreational and competitive running has increased over the past ten years. It has been established that older runners experience a reduction in strength and power. These changes may contribute to different running biomechanics from younger runners. The pur-pose of this study was to synthesise the current evidence on run-ning biomechanical differences in the lower extremity between masters runners over 50 years and younger runners under 40 years. The systematic data search included CINAHL, MEDLINE, and SPORTDiscus databases. Fourteen cross-sectional studies that com-pared lower extremity biomechanics of masters runners to …

The Immediate Effects Of The Nunee Patellar Support On Individuals With Patellofemoral Pain Syndrome, Nick Linn

Graduate Theses, Dissertations, and Problem Reports (ETD)

Patellofemoral pain syndrome (PFPS) is a common form of anterior knee pain caused by general overuse, muscular weakness or strength imbalances, and poor movement coordination leading to abnormal alignment or mal-tracking of the patella. Recent guidelines do not recommend the use of a knee orthosis due to a lack of evidence supporting their effectiveness. A new patellar support (NuNee, K-Neesio LLC.) which uses distraction force to relieve pressure placed on the patella, has been proposed. The purpose of this study was to examine the immediate effects of the NuNee patellar support on perceived pain, biomechanics, and function in individuals with …

Patellofemoral Contact Forces And Knee Gait Mechanics 3 Months After Acl Reconstruction Are Associated With Cartilage Degradation 24 Months After Surgery, J. R. Williams, Kelsey Neal, Abdulmajeed Alfayyadh, Jacob J. Capin, Ashutosh Khandha, Kurt Manal, Lynn Snyder-Mackler, Thomas S. Buchanan

Physical Therapy Faculty Research and Publications

Objective: Evaluate patellofemoral cartilage health, as assessed by quantitative magnetic resonance imaging (qMRI) T₂ relaxation times, 24-months after ACL reconstruction (ACLR) and determine if they were associated with patellofemoral contact forces and knee mechanics during gait 3 months after surgery.

Design: Thirty individuals completed motion analysis during overground walking at a self-selected speed 3 months after ACLR. An EMG-driven neuromusculoskeletal model was used to determine muscle forces, which were then used in a previously described model to estimate patellofemoral contact forces. Biomechanical variables of interest included peak patellofemoral contact force, peak knee flexion angle and moment, and walking speed. …

Assessment Of Postural, Locomotor, And Physical Fitness Status In Individuals With Intellectual And Developmental Disabilities, Alana J. Turner

Theses and Dissertations

Introduction: Postural control and locomotion deficits can be observed during the early years of childhood development and throughout life. For those with disabilities, these deficits can advance past the development years and into adolescence and adulthood while affecting the quality of life and daily activity. Finding interactive rehabilitative activities to delay or limit these deficits is essential for people with disabilities to improve their quality of life, inclusion, and overall movement. Adapted physical activity/sports like badminton and virtual reality could promote improvements in postural and locomotor status for young adults with intellectual and developmental disabilities like cerebral palsy (CP), intellectual …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Muscle-Specific Contributions To Lower Extremity Net Joint Moments While Squatting With Different External Loads, Kristof Kipp, Hoon Kim, William I. Wolf

Exercise Science Faculty Research and Publications

The purpose of this study was to determine muscle-specific contributions to lower extremity net joint moments (NJMs) during squats with different external loads. Nine healthy subjects performed sets of the back squat exercise with 0, 25, 50, and 75% of body mass as an added external load. Motion capture and force plate data were used to calculate NJMs and to estimate individual muscle forces via static optimization. Individual muscle forces were multiplied by their respective moment arms to calculate the resulting muscle-specific joint moment. Statistical parametric mapping (α = 0.05) was used to determine load-dependent changes in the time series …

Knee Cartilage T2 Relaxation Times 3 Months After Acl Reconstruction Are Associated With Knee Gait Variables Linked To Knee Osteoarthritis, Jack R. Williams, Kelsey Neal, Abdulmajeed Alfayyadh, Kendra Lennon, Jacob J. Capin, Ashutosh Khandha, Kurt Manal, Hollis G. Potter, Lynn Snyder-Mackler, Thomas S. Buchanan

Physical Therapy Faculty Research and Publications

Osteoarthritis development after ACL reconstruction (ACLR) is not well understood. Investigators have examined associations between knee biomechanical alterations and quantitative MRI (qMRI) variables, reflective of cartilage health, 12–60 months following ACLR; however, none have done so early after surgery. As part of an exploratory study, 45 individuals (age, 23 ± 7 years) underwent motion analysis during walking and qMRI 3 months after ACLR. For each limb, peak knee adduction moment (pKAM) and peak knee flexion moment (pKFM) were determined using inverse dynamics and peak medial compartment force was calculated using a neuromusculoskeletal model. T₂ relaxation times in the medial …

Kinematic Analysis Of A Series Of Jumps In First Position In Professional Ballet Dancers, Jessica Smith, Kevin Robinson, Pat Sells

Internet Journal of Allied Health Sciences and Practice

Purpose: Few ballet-specific studies in the literature examine kinematics during dance activities. Sports studies have identified injury risk in athletes by observing kinematics during specific activity, but this has not yet been explored for ballet. Evaluating kinematics in dancers has the potential to identify injury risk and influence treatment for prevention and rehabilitation. Therefore, the purpose of this study was to examine the landing kinematics of professional ballet dancers during a series of 16 ballet-specific jumps. Methods: This study was a multi-factor repeated measures design. Participants (3 males, 16 females aged 19-33 years; first or second company members) performed 16 …

Asymmetries In Dynamic Valgus Index After Anterior Cruciate Ligament Reconstruction: A Proof-Of-Concept Study, Kai Yu Ho, Andrew Murata

Physical Therapy Faculty Research

Individuals with anterior cruciate ligament reconstruction (ACLR) are at a higher risk for subsequent anterior cruciate ligament (ACL) tears. Risk factors for ACL injuries likely involve a combination of anatomical, biomechanical, and neuromuscular factors. Dynamic knee valgus has been indicated as a possible biomechanical factor for future ACL injuries. Given that knee valgus is often accompanied by contralateral pelvic drop during single-leg activities, a dynamic valgus index (DVI) that quantifies combined kinematics of the knee and hip in the frontal plane has recently been developed. As the premise of asymmetrical DVI between limbs in the ACLR population has not been …

Muscle Force Contributions To Ankle Joint Contact Forces During An Unanticipated Cutting Task In People With Chronic Ankle Instability, Hoon Kim, Rianna M. Palmieri-Smith, Kristof Kipp

Exercise Science Faculty Research and Publications

The purpose of this study was to compare muscle force contributions to ankle joint compression and anteroposterior shear forces between people with chronic ankle instability (CAI) and healthy controls (CON) during an unanticipated cutting task. Eleven people with CAI and 11 CON performed an unanticipated cutting task as three-dimensional motion capture, ground reaction force (GRF), and muscle activation data were collected. A musculoskeletal modeling was used to calculate talocrural joint compression and anteroposterior shear forces and parse out the contributions to these forces from ankle-spanning muscles and from GRF. Independent t-tests were used for statistical analysis. People with CAI exhibited …

Biomechanically Inspired Assistive Technology To Restore Movement Of The Upper Limbs After Stroke, Ariel Thomas

Graduate Theses, Dissertations, and Problem Reports (ETD)

A stroke often damages the neural structures responsible for movement. Stroke is a heterogeneous disease, affecting each survivor differently. There are common motor features of a stroke, but even these features vary across time as an individual proceeds through different stages of recovery. The different ways in which stroke motor impairment can present itself are often overlooked, but these differences are fundamental to the understanding of the disease and its recovery. When motor assessments are capable of acquiring information necessary to parse out a detailed profile of each stroke case, this will lead to an improved neuromechanical understanding of the …

Validation Of An Inertial-Measurement-Unit System For Calculating Hip And Knee Flexion Angles During Gait, Joonsun Park

Master's Theses

Technological advances regarding Inertial Measurements Units (IMUs) have positioned this type of sensor as an alternative for camera-based motion capture. This study introduces a new IMU based system (IMU_sys) to measure hip and knee flexion angles. PURPOSE: To validate the use of a five-sensor IMU_sys for the measurement of knee and hip flexion angles during gait in adults and pediatrics at two different time points. METHODS: Bilateral hip and knee flexion patterns (LH, RH, LK, and RK) of twenty-two healthy participants (12 adults and 10 pediatric) between the ages of 8 – 35 years were investigated. Participants …

Effect Of Unilateral Lower-Limb Amputation On Intact Limb Biomechanics: A Systematic Review, Amanda Boyd

Master's Theses

The United States will perform 30,000-40,000 amputations this year (Ertl et al., 2019). As a common medical intervention, there is extensive research regarding rehabilitation strategies and post-operative care. Many studies have explored the effects of the affected limb and prosthetic intervention yet have neglected that of the contralateral limb (De Asha et al., 2014; Jones et al., 2006; Winter & Sienko, 1988). Studies have reported an increase in secondary musculoskeletal conditions among unilateral lower-limb amputees, particularly in the intact limb, indicating the need for additional research (Gailey et al., 2008). The purpose of this systematic review was to investigate the …

Lower Extremity Kinetics And Muscle Activation During Gait Are Significantly Different During And After Pregnancy Compared To Nulliparous Females, Jennifer J. Bagwell, Nicholas Reynolds, Michelle Walaszek, Hannah Runez, Kristina Lam, Jo Armour Smith, Dimitrios Katsavelis

Physical Therapy Faculty Articles and Research

Background

Low back, pelvic, and lower extremity pain are common during and after pregnancy. Understanding differences in mechanics between pregnant and non-pregnant females is a first step toward identifying potential pathological mechanisms. The primary purpose of this study was to compare joint kinetics and muscle activation during gait between females during and after pregnancy to nulliparous females.

Methods

Twenty pregnant females completed testing on three occasions (second trimester, third trimester, and post-partum), while 20 matched, nulliparous controls were tested once. Motion capture, force data, and surface electromyography were averaged across seven trials during gait. Lower extremity kinematics, lower extremity moments …

The Effects Of Somatosensory Input On Gait In Individuals Post-Stroke, Victor Hung, Amanda Reilly, Rachel Wood, Nikita Yuskov

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is a leading cause of disability that results in various neurological deficits, one of which is hemiplegia. This deficit alters the gait cycle, resulting in decreased propulsion force by plantar flexor muscles, decreased activation of dorsiflexor (DF) muscles, and increased coactivation of antagonistic ankle muscles. Stroke also leads to altered somatosensory input which results in decreased balance and gait speed, ultimately increasing fall risk. Therapies targeting increased somatosensory input have been shown to be beneficial in stroke as well as other neurological populations. However, no known studies have investigated the acute effects of local vibration to …

Improvement In Overground Walking After Treadmill-Based Gait Training In A Child With Agenesis Of The Corpus Callosum, Gena Henderson, Matthew Beerse, Huaqing Liang, Diego Ferreira, Jianhua Wu

Physical Therapy Faculty Research

Background: Agenesis of the corpus callosum (ACC) is a rare congenital brain defect that produces a wide variety of cognitive and motor impairments. Literature regarding the response of pediatric populations with ACC to physical rehabilitation is scarce. Treadmill-based gait training (TT) has been shown to improve walking ability in some pediatric populations but has not been investigated in children with ACC.

Objective: The purpose of this study was to investigate the effect of a novel treadmill intervention paradigm on the gait parameters of a child with ACC.

Design: A single-participant design with 2 phases was used.

Methods: The settings were …

Influences Of Functional And Psychological Factors On Biomechanics Following An Anterior Cruciate Ligament (Acl) Reconstruction, Chelsey Roe

Theses and Dissertations--Rehabilitation Sciences

Objective: The aims of this research were to identify gaps in the literature related to return to sport (RTS) test batteries following primary anterior cruciate ligament reconstruction (ACLR) (Aim 1) and define recovery in athletes from 4-9 months after ACLR across three domains: 1) psychological recovery and biomechanics (Aim 2), 2) rehabilitation quantity and biomechanics (Aim 3), and 3) functional performance and biomechanics (Aim 4). Ultimately, the results of this research would quantify recovery following ACLR in athletes with a desire to RTS and identify objective criteria throughout rehabilitation prior to RTS.

Participants: Twenty-two post-ACLR athletes 17 females, 8 males, …

An Evaluation Of Postural Control And Balance After Anterior Cruciate Ligament Reconstruction, Kathryn Lucas

Theses and Dissertations--Rehabilitation Sciences

Over 100,000 anterior cruciate ligament reconstructions (ACLR) occur annually in the United States, with one in four individuals sustaining a second injury within the first two years after reconstruction. Due to the proprioceptive nature of the anterior cruciate ligament, the lack of regaining postural control and balance are likely large contributors to the rate of secondary injuries after ACLR. Recent literature has identified cerebral changes after anterior cruciate ligament injury and surgery, likely due to altered sensation and feedback loops. However, no study thus far has investigated the neurological feedback loops that may place this group at higher risk of …