Physical Therapy Commons^™

Improving Interdisciplinary Communication To Improve Patient Satisfaction, Jennifer J. Barnes

Master's Projects and Capstones

The Clinical Nurse Leader project took place at a Magnet Hospital in Northern California. It involved the nursing staff on a 23-bed Post-Surgical Medical Surgical unit, as well as the therapists providing care to their diverse patient population. The goal was to improve interdisciplinary communication to decrease the frequency of missed or postponed therapy sessions. A review of literature revealed that this preventable issue could be the most significant factor resulting in an extended length of stay and affecting overall patient satisfaction. Project data was gathered from a variety of sources, including a unit assessment, shadowing therapists, interviews with key …

Reliability Of Two Alternative Methods For The Standard Mid-Thigh Isometric Pull, Duane A. Williams, Courtney D. Hall, Patsy Cantor, Jennifer Williams, N. Brown, Ryan Dulling, Ogechi Egbujor

ETSU Faculty Works

The purpose of this study was to determine the reliability of two new alternative portable methods for measuring maximal isometric force measures while performing the standard mid-thigh pull. One method, the bar grip method, required the use of the trunk and upper extremity muscles, while the second method, the pelvic belt method, did not. Both methods demonstrated good test-retest reliability via randomized repeated measures over 24-36 hours. Interestingly, the pelvic belt method generally demonstrated average maximal forces up to 65% higher than the bar method. There was a good relationship between both methods. These new alternative methods could provide strength …

Integrating Guided Motor Imagery And Cross Education Into Rehabilitation: Scientific Review And Clinical Application, Emily Bouchard

Mahurin Honors College Capstone Experience/Thesis Projects

BACKGROUND: Guided motor imagery and cross education are two concepts that build upon motor programs. Guided motor imagery consists of imagining a specific action, thereby activating the respective motor program without an actual movement. Cross education incorporates contralateral training to activate the motor program of an action to the resting limb. These techniques yield neurological actions that can lead to improved performance outcomes when integrated into physical therapy programs. PURPOSE: This literature review investigated guided motor imagery and cross education within the scientific literature, identified and summarized evident themes and provided suggestions for incorporating these methods into rehabilitation programs. METHODS: …

Evidence For The Validity Of A Tool For Improved Pressure Ulcer Staging By The Non-Expert In The Live Patient, Janelle Borg, Carrie Johnston, Megan Lucke, Jordan Sinclair

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses.

Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada.

Methods: Subjects assessed 11 wounds on the patients independently. They …

Blended Pedagogy Pathophysiology Course: Effectiveness And Student Satisfaction, Betsy Botsford, Samantha Corn, Alanna Keenan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Evidence supports the effectiveness of computer-assisted instruction (CAI) versus a traditional face-to-face teaching model, but little is known regarding the effectiveness of a blended pedagogy. The purpose of this study is to determine the effectiveness of a blended learning format in a pathophysiology course for entry-level Doctorate of Physical Therapy (DPT) students, to evaluate their level of satisfaction of a podcast formatted course, and to observe changes in cohort performance over time.

Subjects: Five University of Nevada, Las Vegas (UNLV) DPT cohorts (n = 139) participated in the study. Some cohorts were taught in a traditional classroom …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

The Effects Of A Progressive Exercise Program On Functional Activity And Quality Of Life For Older Overweight Women With Knee Osteoarthritis, Ty Carlson, Devin Edvalson, Tyler Peck, Brad Robison

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose Osteoarthritis (OA) is a common symptomatic condition experienced by older adults, especially in the overweight population, that affects the knees in particular. This study compares the effectiveness of two progressive exercise protocols (walking and stepping) on function and quality of life in older, overweight women with OA. This study includes self-management training and assesses participant selfperceived efficacy in managing OA.

Subjects This is a quasi-experimental design utilizing 16 women ≥ 50 years of age (60.44 ± 6.04) with a BMI > 25 (34.21 ± 7.28) and radiographic diagnosis of OA in at least one knee.

Methods and Measures …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …

Conceptual Framework Of A Novel Intervention To Improve Mobility In Children With Cerebral Palsy: The Successes And Challenges Of Implementing A Large Amplitude Movement Protocol, Tania Goodwill, Erin Jarrett, Beren Shah, Alanna Stockford

UNLV Theses, Dissertations, Professional Papers, and Capstones

While cerebral palsy remains one of the most common childhood disabilities, clinicians continue to face significant challenges developing effective treatment strategies for the widely variable presentation of motor function impairments associated with cerebral palsy. A large gap exists between current research based evidence and feasible clinical practice. The purpose of this paper is to introduce a novel intervention protocol, explore the theoretical framework behind the protocol and provide insight to clinicians about the successes and challenges faced while pilot testing the intervention. The novel intervention was adapted and implemented by researchers combining a large amplitude movement protocol with the well-researched …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …

The Fenzian Unit: Applications To Physical Therapy And Beyond, Jeshua Paul Spadino Mr.

Senior Honors Theses

The field of physical therapy includes many different treatment options in the form of exercises and modalities. The development of a low electrical stimulation signal through the Fenzian unit has provided a new outlook on healing. This device gives information to and receives information from the central nervous system (CNS) through electro-biofeedback and is separated into its own category of modalities. The device can be used to treat a wide range of ailments, all with no adverse effects. This makes it a promising tool in the medical field. It is currently being validated as an authentic medical device through clinical …

Pelvic Girdle Pain In The Antepartum Population: Physical Therapy Clinical Practice Guidelines Linked To The International Classification Of Functioning, Disability, And Health From The Section On Women’S Health And The Orthopaedic Section Of The American Physical Therapy Association, Susan C. Clinton, Alaina Newell, Patricia A. Downey, Kimberly Ferreira

Capstone Projects DScPT

The purposes of these clinical guidelines are to:

 Describe evidence-based physical therapy practice including diagnosis, prognosis, intervention, and assessment of outcome for musculoskeletal disorders commonly managed by women’s health and/or orthopedic physical therapists

 Classify and define common musculoskeletal conditions using the World Health Organization’s terminology related to impairments of body function and body structure, activity limitations, and participation restrictions

 Identify interventions supported by current best evidence to address impairments of body function and structure, activity limitations, and participation restrictions associated with common musculoskeletal conditions

 Identify appropriate outcome measures to assess changes resulting from physical therapy interventions …

Interdisciplinary Approach To Dizziness: Roles Of Audiology And Physical Therapy, Faith W. Akin, Courtney D. Hall, Kristal M. Riska

ETSU Faculty Works

Dizziness is one of the most common reasons patients seek medical care, and because there are many causes of dizziness, management of these patients requires an interdisciplinary approach. Peripheral vestibular dysfunction is the most common cause of dizziness/vertigo diagnosed in specialty clinics. The purpose of this article is to present an interdisciplinary approach to the management of patients with vestibular dysfunction with a focus on the unique and overlapping contributions of audiology and physical therapy to vestibular assessment and rehabilitation.

Intensive Goal-Directed Treatments In Enriched Environments Augments Patient Outcomes Post-Stroke, Blake A. Kandah, Michael A. Klonowski, Ryan M. Pelo, Nicole M. Williams, Raquel V. Santiago, Christopher K. Thompson, Kristan A. Leech, Carey L. Holleran, Abigail L. Leddy, T. George Hornby

GW Research Days 2013

Objective: Previous research indicates that patients post-stroke, average 400-800 steps within physical therapy sessions and demonstrate heart rate values of 24-35% of HR Max. This dosage and intensity is inadequate to promote neuroplastic changes and maximize recovery. The goal of this study was to quantify and examine the amount of high-intensity stepping practice that was delivered within an Acute Inpatient Rehabilitation (AIR) setting for individuals with sub-acute stroke.

Methods: 14 patients with a diagnosis of sub-acute stroke were admitted to AIR. Standardized outcomes included the 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), the Berg Balance Scale (BBS) and the …

Developing The Rehabilitation Education For Caregivers And Patients (Recap) Model: Application To Physical Therapy In Stroke Rehabilitation, Megan M. Danzl

Theses and Dissertations--Rehabilitation Sciences

Patient and caregiver education is recognized as a critical component of stroke rehabilitation and physical therapy practice yet the informational needs of stroke survivors and caregivers are largely unmet and optimal educational interventions need to be established. The objective of this dissertation was to develop a theory and model of “Rehabilitation Education for Caregivers and Patients” (RECAP) in the context of physical therapy and stroke rehabilitation, grounded in the experiences and perceptions of stroke survivors, their caregivers, and physical therapists.

Qualitative research methods with a novel grounded theory approach were used. Potential constructs of RECAP were identified from existing research. …

A Prototype Head-Motion Monitoring System For In-Home Vestibular Rehabilitation Therapy, Pamela T. Bhatti, Susan J. Herdman, Siddarth Datta Roy, Courtney D. Hall, Ronald J. Tusa

ETSU Faculty Works

This work reports the use of a head-motion monitoring system to record patient head movements while completing in-home exercises for vestibular rehabilitation therapy. Based upon a dual-axis gyroscope (yaw and pitch, ± 500-degrees/sec maximum), angular head rotations were measured and stored via an on-board memory card. The system enabled the clinician to document exercises at home. Several measurements were recorded in one patient with unilateral vestibular hypofunction: The total time of exercise for the week (118 minutes) was documented and compared with expected weekly exercise time (140 minutes). For gaze stabilization exercises, execution time of 60 sec was expected, and …

Comparative Outcomes Assessment Of The C-Leg And X2 Knee Prosthesis, Michael Jason Highsmith

USF Tampa Graduate Theses and Dissertations

Background

There are more than 300,000 persons in the U.S. living with transfemoral amputation (TFA). Persons with TFA use a knee prosthesis for gait and mobility. Presently, the C-Leg microprocessor knee prosthesis is the standard of care. C-Leg has significantly improved safety and cost efficacy and has created modest gains in gait efficiency. Recently, a new prosthesis has introduced a new sensor array and processor that reportedly improves knee motion, stair function and standing stability. Early claims of the reported functional benefits of the new Genium knee (formerly X2) have not been validated in a rigorous clinical trial. Therefore, the …

Muscle Fatigue And Motor Output Variability With Acute Stress In Healthy Young Adults And Veterans With Posttraumatic Stress Disorder, Manda Linea Keller

Dissertations (1934 -)

Acute stress can alter motor performance differently for men and women. The first aim of this dissertation addresses possible causes for the sex difference in the motor response of a low-intensity fatiguing contraction of the elbow flexor muscles to an acute stressor (difficult mental math) in young, healthy adults. Muscle fatigue increased for men and women when exposed to the stressor, but impairment was more prominent for the women. This work showed that fatigue in the central nervous system, specifically in cortical motor and premotor areas, as well as relaxation rates of the muscle (quantified with cortical stimulation) were not …

A Clincial Outcomes Commentary On "A Longitudinal Study Of Outcome Measures For Children Receiving Early Intervention Services", Marcia Levinson, Pt, Phd, Mft, Rosaleen Creedon Gnoffo, Pt, Ms, Dpt, Pcs

Department of Physical Therapy Faculty Papers

Pediatric physical therapy, especially in early intervention (EI), focuses on children’s function in natural environments and within daily routines. Valid and reliable tests measuring the ICF participation component are important to consider if we are to align our treatment focus and goals to our measures of progress. This article demonstrates that the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skill scaled scores are sensitive to change in children receiving EI with and without motor involvement.

Can Student Reflection Predict Academic Success And Clinical Performance In A Physical Therapist Education Program?, Jeanne L. Cook

Department of Educational Administration: Dissertations, Theses, and Student Research

The purpose of this retrospective study was to determine if a predictive relationship existed between student reflection and student academic and clinical success as determined by student performance on the National Physical Therapy Examination (NPTE) and the Clinical Performance Instrument (CPI). Secondary questions included whether higher and lower reflection scores would correspond with higher and lower NPTE and CPI scores respectively, and whether students’ reflection scores would increase between the first and fourth clinical internships. Journal entries were submitted by students from a physical therapist education program at a large North Central Region university over the course of two clinical …

The Effect Of Direct Access With Direct Reimbursement On Physical Therapy Practice, Heather Lafreniere, Katie Sauvageau

Physical Therapy Scholarly Projects

In 2002, North Dakota passed legislation that allowed physical therapists to be directly reimbursed by Blue Cross Blue Shield of North Dakota for physical therapy services. The purpose of the study is to determine the effects of direct access with direct reimbursement on physical therapy practice. The survey was sent to 400 licensed physical therapists within Arizona, Maryland, and Minnesota. These states were chosen for their experience in utilizing direct access with direct reimbursement and the geographic location.

The survey consisted of 7 categories addressing demographics, clientele changes, marketing strategies, physical therapist/physician relationship, insurance changes, direct effects on patient care …

Conflict Of Interest And Physical Therapy, Mike W. Martin, Donald L. Gabard

Philosophy Faculty Books and Book Chapters

'In a chapter entitled “Conflict of Interest & Physical Therapy”, authors Martin & Gabard offer a cogent definition. They write simply, “conflicts of interest are situations in which individuals have interests that significantly threaten their role responsibilities, or would do so for a typical person having their role.” Likewise, Davis describes the standard view of conflict of interest as a situation in which a person P is in a relationship requiring P to exercise some judgment on another’s behalf and P has an interest “tending to interfere with the proper exercise of that judgment”. With regard to professional conflicts of …

A Practice Analysis Survey: Defining The Clinical Practice Of Primary Care Physical Therapy, Edsen Bermudez Donato

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Due to changes in the health care delivery systems, physical therapy services have moved toward a primary care model of practice. The purpose of this study was to identify the professional responsibilities, procedures, and knowledge areas of physical therapists practicing in primary care settings.

Subjects. A sample of 212 physical therapists practicing in primary care settings, and a control group of 250 physical therapists not practicing in primary care settings were surveyed.

Methods. The survey instrument was developed with the assistance of a National Advisory Committee (NAC) consisting of 12 subject matter experts. A modified Delphi …

An Outcome Comparison On The Use Of Mckenzie Technique With And Without Mulligan Mobilizations On The Treatment Of Low Back Derangement, Jason J. Vila

Physical Therapy Scholarly Projects

Effective research and outcome studies are currently lacking evidence to support the use and reimbursement of manual therapy interventions such as McKenzie techniques and Mulligan mobilizations. The purpose of this study was to compare the cost-effectiveness, efficiency, and outcomes of McKenzie techniques and McKenzie techniques with Mulligan mobilization on the treatment of patients with low back derangement through performing a chart review. Twenty-two subjects with a diagnosis of low back derangement were included in this study with sixteen subjects in the McKenzie group and six subjects in the McKenzie with Mulligan mobilizations group. An independent sample T -test showed no …

Maximixing Clinical Education Options In Cardiopulmonary Physical Therapy, Beverly D. Fein

Physical Therapy Faculty Publications

The purpose of this article is to present a series of suggestions for increasing cardiopulmonary content in clinical education experiences. This article offers strategies for maximizing cardiopulmonary clinical education experiences of physical therapy students in order to better prepare them to function in the changing clinical environment. Specific strategies addressed include: 1) enhancing student selfdirectedness; 2) integrating cardiopulmonary content into management of patients with a variety of diagnoses; and 3) use of resources for student and staff development. A series of guiding questions to facilitate student learning in the area of cardiopulmonary physical therapy is provided. Alternative models for full …

Polypharmacy And Physical Therapy In The Geriatric Population, Cathy A. Reuer

Physical Therapy Scholarly Projects

Physical therapists are seeing more and more elderly individuals with acute, chronic, or multiple disease conditions. Many of these conditions are treated with medications. It is common for the geriatric patient to be taking multiple medications. Polypharmacy is a relevant concern for physical therapists as adverse effects are often revealed in the musculoskeletal and central nervous systems. These manifestations can cause adverse effects in evaluation, treatment, and outcomes.

The purpose of this study is to discuss the common non-prescription and prescription medications consumed by the elderly, describe the biologic and physiologic changes that occur with age and how these changes …

Total Quality Management In Physical Therapy: A Primer For Physical Therapists In Search Of Quality, Brian C. Kittelson

Physical Therapy Scholarly Projects

Total quality management (TQM), a management system first successfully utilized in the manufacturing industry, has gained much popularity in the healthcare industry over the past few years. Books, articles, conferences, workshops, and video tapes that teach health care executives how to utilize TQM in their organizations abound. Unfortunately, resources which specifically apply the TQM philosophy and tools to the practice of physical therapy are few. The purpose of this project is to provide a resource that introduces the philosophy, methods, and tools of TQM with applications to the physical therapy setting.

Chapter one briefly discusses the general history of TQM …

Nonoperative Treatment Of Shoulder Instability In The Throwing Athlete, Whitney A. Meier

Physical Therapy Scholarly Projects

An increase interest of the shoulder complex has led to additional knowledge through research and enhancement of rehabilitation for various shoulder disorders. Shoulder injuries are common for overhead sporting activities, such as pitching. The pitching mechanism combines a high level of neuromuscular coordination between the glenohumeral and scapulothoracic muscles. The intricate balance and timing of these muscles is necessary to allow full mobility and to maintain the dynamic stability throughout the entire throwing motion. Any deficiency in muscular strength or timing can affect shoulder function and potentially cause shoulder instability.

Rehabilitation and nonoperative management of shoulder pain due to instability …

Providing Physical Therapy Services In The Least Restrictive Educational Environment, Judy E. Bahe

Physical Therapy Scholarly Projects

Federal legislation has mandated free appropriate public education for all children with disabilities. Physical therapy is included as one of the related services which must be provided, if needed, to assist students with disabilities to benefit from the educational programs. This creates unique challenges for the physical therapist, who traditionally has provided services in a medical model rather than an educational model. The American Physical Therapy Association has published policies and guidelines for providing physical therapy services in the educational environment; however, each state is encouraged to adapt the guidelines to meet individual needs.

This paper provides a general review …

Determination Of Eligibility For Physical Therapy In The Public School Setting, Margaret Ann Borkowski

Physical Therapy Scholarly Projects

The Individuals with Disabilities Education Act of 1991 (IDEA) includes physical therapy as one of the related services which may be necessary for a student with disabilities to benefit from special education. The determination of eligibility is therefore an important part of the provision of physical therapy in a public school setting. This study investigates how this determination is made across the United States and makes recommendations for physical therapists in the state of North Dakota.

This study consists of a literature review (including medical and educational journals) and two surveys. The requirements for special education and related services under …