Physical Therapy Commons^™

Implementation Of Increased Physical Therapy Intensity For Improving Walking After Stroke: Walk 'N Watch Protocol For A Multisite Stepped-Wedge Cluster-Randomized Controlled Trial, Sue Peters, Shannon B Lim, Mark T Bayley, Krista Best, Louise A Connell, Hélène Corriveau, Sarah J Donkers, Sean P Dukelow, Tara D Klassen, Marie-Hélène Milot, Brodie M Sakakibara, Lisa Sheehy, Hubert Wong, Jennifer Yao, Janice J Eng

Physical Therapy Publications

RATIONALE: Clinical practice guidelines support structured, progressive protocols for improving walking after stroke. Yet, practice is slow to change, evidenced by the little amount of walking activity in stroke rehabilitation units. Our recent study (n = 75) found that a structured, progressive protocol integrated with typical daily physical therapy improved walking and quality-of-life measures over usual care. Research therapists progressed the intensity of exercise by using heart rate and step counters worn by the participants with stroke during therapy. To have the greatest impact, our next step is to undertake an implementation trial to change practice across stroke units where …

Reporting Of Harm In Randomized Controlled Trials Of Therapeutic Exercise For Knee Osteoarthritis: A Systematic Review, Johan Von Heideken, Sana Chowdhry, Joanna Borg, Khara James, Maura D. Iversen

Physical Therapy Faculty Publications

Objective: The Consolidated Standards of Reporting Trials (CONSORT) recommends reporting adverse events (AEs) and dropouts (DOs) with their definitions. The purpose of this study was to identify how AEs and DOs were reported in randomized controlled trials (RCTs) of therapeutic exercise for knee osteoarthritis (OA).

Methods: Data sources were the Cochrane Library, EMBASE, PUBMED, and CINAHL. Databases were searched to identify RCTs of therapeutic exercise for Knee OA published from January 1, 1980, through July 23, 2020. Researchers independently extracted participant and intervention characteristics and determined whether a clear statement of and reasons for AEs and DOs existed. The primary …

Perspectives Of Individuals With Chronic Spinal Cord Injury Following Novel Balance Training Involving Functional Electrical Stimulation With Visual Feedback: A Qualitative Exploratory Study, David J Houston, Janelle Unger, Jae W Lee, Kei Masani, Kristin E Musselman

Physical Therapy Publications

BACKGROUND: Individuals with an incomplete spinal cord injury (iSCI) are highly susceptible to falls during periods of walking or standing. We recently reported the findings of a novel intervention combining functional electrical stimulation with visual feedback balance training (FES + VFBT) on standing balance abilities among five individuals with motor iSCI. However, the previous publication did not report the perceived impact of the intervention on the participants' lives. In this report, the experiences of these five individuals with incomplete spinal cord injury (iSCI) who had recently completed the four-week balance training program are described.

METHODS: Five individuals with a motor …

Rehabilitation Modifications For A Patient With Parkinson’S Disease Following A Suspected Case Of Gilbert’S Syndrome: A Case Study, Jason Bandong, Hy Ia, Naureen Imam, Kayla Wilcox, Travis Dennis

San Marcos, Summer 2019

The purpose of this case study was to assess the effects of core stabilization exercises, balance training, agility ladder step drills, fine motor, and dual-task training in the treatment of a high-functioning, 55-year-old, male patient with a history of Parkinson’s Disease and suspected Gilbert’s Syndrome.

This treatment program delivered for 1 hour once per week over 4 weeks led to mild improvements in activity limitations with the most notable being able to button a shirt with decreased time and assistance. The patient also exhibited mild improvement in body structure/function impairments with decreased loss of balance as evident during tandem walking …

Intensive Balance Training For Adults With Incomplete Spinal Cord Injuries: Protocol For An Assessor-Blinded Randomized Clinical Trial., Janelle Unger, Katherine Chan, Carol Y Scovil, B Catharine Craven, Avril Mansfield, Kei Masani, Kristin E Musselman

Physical Therapy Publications

BACKGROUND: Impaired reactive balance control can lead to increased falls in people with neurological impairments. Perturbation-based balance training (PBT), which involves repetitive exposure to destabilizing external perturbations, improves the ability to take reactive steps in older adults and individuals who have had a stroke.

OBJECTIVE: The objective is to investigate whether PBT or conventional intensive balance training (CIBT) results in greater improvements in reactive stepping ability in individuals with chronic incomplete spinal cord injury (iSCI).

DESIGN: The design consists of an assessor-blind randomized clinical trial comparing the efficacy of 2 balance training programs (PBT and CIBT) matched for training duration …

Power Up With Parkinson's: A Case Report, Sean Ekekwe, Anne H. Boddy

St. Augustine, Fall 2018

The purpose of this study is to highlight the use of power training in a patient with low back pain and Parkinson’s disease.

Power training demonstrated a more significant change in gait speed, mobility, and function compared to other phases in rehabilitation. After power training was implemented at visit 11, there was a dramatic increase gait speed with the 10-meter walk test, a reduction in Oswestry Disability Index score (ODI), and a decrease in Timed Up and Go (TUG) time. The increase in 10 MWT gait speed and reduction in ODI and TUG score were greater than their MDC values …

Core Stabilization And Pelvic Motility Training For A 28-Week Pregnant Female With Low Back Pain And Sciatic Nerve Pain, Jenna Belser, Anne H. Boddy

St. Augustine, Fall 2018

The purpose of this case study is to determine the effects of core stabilization and pelvis mobility training for a 28-week pregnant female to improve function and decrease pain.

Low back pain during pregnancy is a common occurrence that affects a majority of the population.¹ Over the five treatment sessions, the patient was able to tolerate a full ten-hour work shift and sleep through the night. She also showed improvements in muscle strength and flexibility. As seen in non-pregnant females, the patient was able to have a decrease in pain and improvement in function with these techniques.⁴

Are You Ready To Get High? High Repetition Exercise For Radial Nerve Palsy, Tayler Adams, Matthew L. Daugherty

St. Augustine, Fall 2018

Research suggests the need for early surgical nerve exploration for secondary radial nerve palsy based upon a 75% recovery rate with early exploration.⁵ In using typical conservative management plus high-repetition movement, the patient in this case report was able to avoid surgery for radial nerve exploration, attain complete recovery within 4 months of his initial injury, and fully return to work and daily function.

This case report offers the possibility of high-repetition movement being a beneficial treatment intervention. This is a simple, low-cost treatment and can be accomplished by the patient at home as part of a home exercise …

Incorporation Of Balance And Vestibular Exercises In A 45-Year-Old Female With Bell’S Palsy: A Case Report, Kelsey Andersson, Erica Kiernan

St. Augustine, Fall 2018

The purpose of this case report is to determine the effectiveness of balance and vestibular exercises in conjunction with facial strengthening exercises on a patient with Bell’s palsy.

By incorporating vestibular exercises into the patient’s therapy sessions, she was able to demonstrate improved single leg stance and self-reported decrease in onset of symptoms with a progression of vestibular exercises. Facial muscle strengthening exercises demonstrated significant improvements in eye closure and smiling but she exhibited little changes in facial symmetry, strength and self-perceived function. The patient reported she was starting to drive and participate in more social events by the 4th …

Sara Plus And Task Specific Training In A Patient With Anoxic Encephalopathy, Olivia Levi, Erica Kiernan

St. Augustine, Fall 2018

The purpose of this case report is to describe the benefits of using a task-specific approach and the SARA plus to improve balance and gait in a patient with anoxic encephalopathy.

This case demonstrated the positive results of incorporating repetitive, task-specific, and early use of the SARA plus for gait training. With these interventions, the patient was able to ambulate 25 ft and transfer from sit to stand with the use of a rolling walker and minimum assistance. He was also able to maintain static sitting balance for 32 seconds independently and reach 17 inches outside of his base of …

Scapulothoracic Mobility And Strengthening After A Posterior Capsular Reconstruction Of The Glenohumeral Joint With An Allograft: A Case Report, Kris Saunders, David Kempfert

St. Augustine, Fall 2018

The purpose of this case report is to emphasize the importance of scapular mobility and strengthening exercises in rehabilitation protocols for patients after a posterior capsular reconstruction surgery of the glenohumeral joint.

The objective outcomes by week three are displayed in Table 1.0. The patient was discharged after nine visits over a period of three weeks. During the final session, the patient was able to perform standing shoulder abduction to 90 degrees with a one-pound dumbbell pain-free. The patient was able to reach into a shelf at 120 degrees of shoulder flexion with a pain scale rating of 2/10. He …

Anti-Gravity Treadmill Training With 19-Year-Old Soccer Player Status Post-Leukemia, Britni Barber, Lisa Chase

St. Augustine, Fall 2018

The purpose of this case report was to describe the effects of anti-gravity treadmill training, in addition to standard treatment protocol, on endurance performance in a 19-year-old female collegiate soccer player following chemotherapy treatment for leukemia.

Physical therapy rehabilitation of patients who are experiencing chemotherapy-related fatigue may benefit from anti-gravity treadmill training. This case report not only identifies a successful outcoming using such intervention but also introduces a more aggressive approach to treatment for a patient whose goals included going back to play division one sports. The patient was not only able to reach her goals of being able to …

Conservative Therapy Of Patient With Dyspareunia In A Post-Menopausal State With Co-Morbidities Including Previous Breast Cancer And Valve Replacement: A Case Report, D. Ditoro, M. Mason-Cover, C. Hazelton, Annie Burke-Doe, Marilyn Miller

San Marcos, Fall 2018

Dyspareunia is defined as persistent pain in the vaginal area before, during, or after sexual intercourse.^1,2 The etiology is uncertain in the medical literature, but evidence proposes that pain and dysfunction of pelvic floor muscles (PFM) can contribute to dyspareunia and other forms of chronic pelvic pain.^1,2 The information contained in this case report is clinically relevant because it presents evidence that dyspareunia can be treated safely with physical therapy techniques on a patient with a complex medical history.

Scapulothoracic Stabilization To Reduce Cervical Pain And Headaches: A Case Report, Bethany June Law, Shannon Logan

St. Augustine, Summer 2018

The purpose of this case report was to describe the outcomes of a scapular stabilization program in an adult female with cervical neck pain and headaches.

Combined Dry Needling And Ccft Biofeedback Training For A Fireman With A Two-Month History Of Cervicogenic Headaches: A Case Report, Jared Commander, Jim Viti

St. Augustine, Summer 2018

The purpose of this case report is to show that by combining the use of the CCFT as an exercise and trigger point dry needling, clinicians can effect significant improvement in their patients.

Marfan Syndrome, It Doesn’T Have To Be A Pain In The Back, Carolyn Sims, Jim Viti

St. Augustine, Summer 2018

The purpose of this study is to describe a rehabilitation program for low back pain in an individual with Marfan syndrome and surgical history of aortic root repair with mechanical aortic valve replacement (AVR) and Harrington rod placement to correct spinal scoliosis.

Elbow Joint Manipulation And Exercise For Post-Operative Medial Epicondylectomy: A Case Report, Kelsey Newman, Eric Chaconas

St. Augustine, Summer 2018

The purpose of this case report is to describe joint manipulation and exercise progressions post-medial epicondylectomy.

Application Of Forced Use In A Traditional Acute Hospital Setting With A 77-Year-Old Female Post Left Cva, Jimmie Parten, Anne H. Boddy

St. Augustine, Summer 2018

The purpose of this case report is to look at the positive outcomes following the application of forced use physical therapy techniques in the traditional acute hospital setting with a 77-year-old female post left CVA.

Therapeutic Exercise And Vibration Training For A Military Veteran Mimicking Relapse-Remitting Multiple Sclerosis, Lauren Elizabeth Miller, Laurie Shimko

St. Augustine, Summer 2018

The purpose of this case report is to describe the combination of therapeutic exercise and vibration training to improve stair navigation for a patient with mimicking RRMS.

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 …

Scapular Mobilization Combined With Thoracic Manipulation For Treating Subacromial Impingement Syndrome In An Elderly Female: A Case Report, Tyler Alford, David Kempfert

St. Augustine, Spring 2018

Purpose: To describe the treatment of a patient with Subacromial Impingement Syndrome (SAIS) pathology utilizing a combination of manual therapy techniques at the scapulothoracic joint and the upper thoracic spine along with more traditional scapular stabilization exercises.

Myofascial Manipulation To Alleviate Forearm And Hand Weakness And Numbness In A Female Competitive Rock Climber, Ben Kern, Evan M. Pucillo

St. Augustine, Spring 2018

The purpose of this case report is to describe the effectiveness of myofascial manipulation along with therapeutic exercise on a patient with weakness, numbness, and tingling in the distal upper extremities in order to return to competitive rock climbing.

Non-Organic Motor Disorder: Combatting The Effects Of Stress On Functional Mobility, Kelsi Taylor, Lindsay Perry

St. Augustine, Spring 2018

The purpose of the case report was to show how neurological symptoms can be effectively treated with task-specific interventions and the role of stress in symptom presentation in patients with somatoform disorders.

Walkin’ On Air: Alter-G Gait Training In A Male With Hereditary Spastic Paraplegia, Kimberly Richardson, Evan M. Pucillo

St. Augustine, Spring 2018

The purpose of this case report is to determine the effectiveness of LBPPS treadmill training, using the Alter-G, to improve the spatiotemporal parameters of gait for a patient with HSP.

A Case Report: Outpatient Physical Therapy Treatment Of A Patient With Unilateral Medial And Posterior Knee Pain And Osteoarthritis, Joseph T. Griffin

Physical Therapy Scholarly Projects

Background & purpose: Meniscus tears are commonly considered to be associated with a traumatic event, but the degenerative nature of osteoarthritis can also damage the cartilage. As meniscal tears are a common orthopedic pathology, choosing the correct treatment can be difficult and involve several factors. Current treatment options include partial or total meniscectomy, meniscal repair, or conservative management. There is growing research supporting the effectiveness in non-operative management of degenerative meniscal tears (DMT). The purpose of this case report was to investigate the non-operative management of a 47-year-old male with a unilateral DMT combined with osteoarthritis.

Case description: …

The Effects Of Spinal Mobilizations, Manual Stretching, And Exercises In The Treatment Of Testicular Pain: A Case Report, Kunal Bhanot, Navpreet Kaur, R Chambers

Physical Therapy Collection

The purpose of this case report was to describe the PT management in relieving testicular pain related to genitofemoral nerve entrapment.

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.

Chain Reaction: Functional Strengthening For The Treatment Of Posterior Tibialis Tendinopathy In An Adolescent Athlete, Emily Terrell, John Layne

St. Augustine, Spring 2017

The purpose of this case report was to describe the successful addition of lower extremity kinetic chain functional strengthening to the standard of care for chronic PPT treatment.

You Down With Alter-G? Yeah, You Better Be!, Tom Phan, Anne H. Boddy

St. Augustine, Spring 2017

The purpose of this study was to investigate the effectiveness of free rehabilitation protocol utilizing an Alter-G treadmill system.

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 …