Physical Therapy Commons^™

Physiological, Cognitive, Behavioral, And Perceptual Contributors To Falls Risk Across Middle And Older Adulthood, Jacquelyn Moxey

Rehabilitation Sciences Theses & Dissertations

Falls are multifactorial events influenced by physiological, cognitive, behavioral, and perceptual factors. Although falls prevention research has traditionally focused on older adults and objectively measured physical impairments, less is known about how cognitive performance, physical activity, and perceptions of ability collectively contribute to falls risk vulnerability across middle and older adulthood. This dissertation examined these relationships through three complementary studies.

Study 1 examined associations between cognitive screening performance and physiological falls risk in 315 community-dwelling older adults. Lower global cognitive performance was associated with greater physiological falls risk. Performance on items reflecting attention and visuospatial/executive function demonstrated the strongest domain-level …

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: …

Navigating Care In Cancer: Aligning Rehabilitation And Exercise To Support Patients, Christopher M. Wilson

Oncology Rehabilitation in Practice

The growing evidence base supporting both exercise oncology and cancer rehabilitation highlights their complementary roles across the cancer continuum. Research consistently demonstrates that physical activity improves physical function, fatigue, quality of life, and survival, while rehabilitation addresses impairments and restores participation in meaningful activities. Despite these advances, current care models often lack coordination, resulting in fragmented services, inappropriate referrals, and missed opportunities for optimal patient outcomes. Some individuals are directed to exercise programs without adequate screening for underlying impairments, while others may receive rehabilitation services when supervised, independent or community-based activity would suffice.

To address these gaps, there is a …

Accelerometer-Measured Physical Activity Among Children And Adolescents With And Without Neurodevelopmental Disorders: A Systematic Review And Meta-Analysis, Xiao Liang, Raffy C.F. Chan, Justin A. Haegele, Sean Healy, Richard H. Xu, Chang Liu, Ming Chen, Minghui Li, Hui Zhang, Cindy H.P. Sit, David H.K. Shum

Human Movement Studies & Special Education Faculty Publications

Purpose

Physical inactivity is a health concern for children and adolescents with neurodevelopmental disorders (NDDs) as it directly increases their risk of developing various health problems. Evidence on differences in accelerometer-assessed physical activity between children and adolescents with and without NDDs is inconclusive. And age- and body mass index (BMI)-related effects on physical activity remain unclear.

Methods

The systematic literature searches were performed in 6 databases up to March 2025. Methodological quality was evaluated by the Newcastle-Ottawa Scales. Data were pooled using a random-effects model. Hedges' g was used to express the effect size index with 95 % confidence interval …

The Effect Of Menopausal Symptoms On Physical Activity Participation, Morgan T. Walsh, Rebecca Franklin, Meghan E. Radnoff, Amy Tremback-Ball

Student Research Poster Presentations 2026

No abstract provided.

Covid-19 And The Impact Of Physical Activity On Persistent Symptoms, Lauren E. Opielinski, Toni D. Uhrich, Michael H. Haischer, Rachel N. Beilfuss, Lindsey M. Mirkes Clark, Kamryn M. Kroner, Rachel E. Bollaert, Michael J. Danduran, Linda B. Piacentine, Marie K. Hoeger Bement, Paula E. Papanek, Sandra K. Hunter, Sarah J. Hamilton

Physical Therapy Faculty Research and Publications

Introduction: Physical activity is protective against chronic disease but whether activity is associated with persistent symptoms in non-hospitalized coronavirus disease 2019 (COVID-19) survivors is unknown. The purpose of the study was to determine the impact of the COVID-19 pandemic on physical activity levels and the influence of physical activity on acute COVID-19 and long COVID symptoms in non-hospitalized COVID-19 survivors.

Methods: In total, 64 non-hospitalized COVID-19 survivors (45 female participants, 40 ± 18 years) were assessed for activity levels, body composition, and symptoms of COVID-19 8.5 ± 4.7 months post-infection and categorized into two groups: (1) persistent symptoms and (2) …

Effect Of Apathy On Exercise Adherence Among Community-Dwelling Older Adults With Chronic Health Conditions, Hiromichi Takeda, Katsuhiko Takatori

Asian Journal of Physical Therapy

Background: The association between apathy and physical activity levels in older adults is well established. It is essential for older adults with chronic health conditions not only to be more active but also to adhere to a personalized exercise prescription. However, the impact of apathy on exercise adherence remains unclear. This study aimed to investigate the effect of apathy on exercise adherence in older adults with chronic health conditions. Methods: This research was a secondary longitudinal data analysis of a behavior change intervention conducted through a randomized controlled trial. The participants included older adults aged 65 years and above (n …

Perspectives Of Midwives And Nurse Practitioners In Kentucky On Exercise Counseling During Pregnancy: A Qualitative Study, Madhawa Perera, Taniya S. Nagpal, Maire M. Blankenship, Dano Tolusso, Jordyn Cox, Dilini Prashadika, Mark Schafer, Rachel A. Tinius

Physical Therapy Faculty Research and Publications

Introduction

Healthcare professionals are in an optimal position to deliver exercise information to pregnant women, yet previous research suggests this seldom happens. Midwives and nurse practitioners, who may have more time with pregnant women, are particularly well suited for this role.

Objectives

This qualitative study examined the exercise advice and counseling provided by midwives and nurse practitioners in Kentucky, focusing on the barriers they face.

Methods

Twenty-one midwives and nurse practitioners were recruited until the sample size reached saturation. A survey with open-ended questions was distributed to potential participants in regional hospitals, universities, and professional associations. The framework method was …

The Role Of The Physical Therapist In Managing Type 2 Diabetes: Systematic And Qualitative Perspectives, Garrett Matthew Hainline

Theses and Dissertations

Introduction: Physical activity (PA) is an effective tool in the management of Type 2 Diabetes (T2D). PA recommendations for people with T2D are to achieve at least 150 minutes per week of moderate intensity PA. This assists to maintain blood glucose control and reduce cardiovascular disease risk factors. Unfortunately, people with T2D are less likely than their normoglycemic peers to meet PA recommendations.

Veterans of the armed forces experience T2D at even greater levels than the general population, with prevalence at about 20%. In addition, T2D and pre-diabetes are elevated among younger veterans, including those of recent conflicts. Reducing rates …

The Role Of Social Determinants Of Health On Patient Recovery After Critical Illness, Lindsey E. Fresenko

Theses and Dissertations--Rehabilitation Sciences

Patients who survive critical illness have a prolonged recovery which impacts their quality of life and outcomes. The sudden life changes from being critically ill may create or exacerbate social factors or needs also known as social determinants of health. Patients’ SDOH are defined as the environments in which we live, work and play that impact health outcomes. Patients’ SDOH impact their life in early recovery from changes in previous roles to their need for increased financial, physical and emotional support. During this early recovery, patients are often recommended to participate in rehabilitation to improve their physical function. Although, accessing …

Heart Rate Variability Is Reduced In Covid-19 Survivors And Associated With Physical Activity And Fatigue, Michael H. Haischer, Lauren E. Opielinski, Lindsey M. Mirkes, Toni D. Uhrich, Rachel E. Bollaert, Michael E. Danduran, Marie K. Hoeger Bement, Linda B. Piacentine, Paula E. Papanek, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Reduced heart rate variability (HRV) and fatigue are common after COVID-19 infection and both are potentially influenced by physical activity (PA). We compared resting HRV, PA from accelerometers and questionnaires, and self-reported fatigue in 41 COVID-19 survivors (~8 months postinfection, 38 ± 17 years) with 41 matched controls. Differences in HRV were observed on acceleration capacity (p = 0.041), deceleration capacity (p = 0.032), high-frequency peak frequency (p = 0.019), absolute low-frequency power (p = 0.042), relative very low-frequency power (p = 0.012), SD2 (from Poincare plot; p = 0.047), and DFA2 (slope of long-term …

Health Sciences Students’ Career Commitment, Mental Health, And Physical Activity During The Covid-19 Pandemic, David Wrucke, Marie K. Hoeger Bement, April L. Harkins, Sandra K. Hunter, Stacy Stolzman, Astrida S. Kaugars

Physical Therapy Faculty Research and Publications

Objective: To understand the biopsychosocial dimensions of university health sciences students’ experiences during the COVID-19 pandemic.

Participants: Health sciences students (n = 297) from two universities in July and August 2020.

Methods: Participants completed a Web-based survey asking about depression, anxiety, physical activity, coronavirus threat, and career commitment.

Results: Moderate or severe depression and anxiety were reported by 28.6% and 31.3% of respondents, respectively. Depression and anxiety were positively correlated with perceived coronavirus threat and negatively correlated with career commitment and strenuous physical activity. A change in career commitment interests during the COVID-19 pandemic was reported by 11% of …

A Mixed Methods Study Of Physical Activity In The Intensive Care Unit And Post-Intensive Care Unit Hospital Stay: Patient Characteristics, Symptom Burden, And Experiences Of Postoperative Adults, Christina Bach

Theses & Dissertations

Background: Physical activity (PA) beginning early in the intensive care unit (ICU) can reduce adverse outcomes commonly experienced by individuals after ICU discharge. Patient-centered approaches to PA in the ICU and reliable activity evaluations are essential for understanding PA's impact on patient outcomes.

Objective: This dissertation sought to evaluate patient-related factors associated with PA in the ICU and post-ICU hospital stay.

Methods: The purpose of the dissertation was to conduct: 1) a concept analysis to define ICU survivorship and identify critical care aspects important for patient recovery; 2) an integrative literature review to assess early mobility (EM) interventions with physical, …

Greater Number Of Weekly Stairs Climbed Is Associated With Lower Low Back Pain Prevalence Among Female But Not Male Physical Therapists, Amy H. Amabile, Sharon L. Larson, Lisa T. Hoglund, John P. Guarnieri, Maureen Mcdonald, Madeline R. Reich

Department of Physical Therapy Faculty Papers

INTRODUCTION: Certain cardiovascular health benefits of stair climbing are now widely accepted, but no prior studies have as yet been found linking the quantity of stairs climbed to low back pain (LBP) morbidity. Low back pain is a common musculoskeletal impairment, and research has begun to show an association between LBP and gluteus maximus (GM) weakness. With stair climbing being the activity which most activates GM, the aim of the present research was to assess the relationship between stair ambulation and LBP prevalence. The hypothesis of this cross-sectional study was that individuals with LBP would report a significantly lower numbers …

A Reflection Of Experiences Of Adults With Type 1 Diabetes In Integrated Physical Education Classes, Kalleigh West

Human Movement Studies & Special Education Theses & Dissertations

The purpose of this study was to gain an understanding of the experiences of type 1 diabetics in integrated physical education classes. In this study, we interviewed young type 1 diabetic adults and asked them to reflect on their school-based physical education experiences. An interpretative phenomenological analysis (IPA) approach was adopted to guide data collection, analysis, and interpretation for this retrospective study. Eight participants (ages 19 to 32) were enrolled in this study, and semi-structured interviews focused on their physical education experiences acted as the primary data. Transcribed interview data were analyzed using an IPA approach. Three interrelated themes emerged …

Resistance Training In Patients After Metabolic And Bariatric Surgery: Protocol For A Systematic Review, Whitney Elks, Adam Rooks, Spencer Schulte, Kavita Batra, Jocelyn Burke, Varun Jain

Department of Medical Education Faculty Research

Background: Resistance training has been consistently shown to have multiple health benefits, especially for patients who have undergone bariatric surgery. Patients who have undergone bariatric surgery are recommended to participate in resistance exercise; however, protocols and guidelines for resistance training remain poorly implemented. Objective: This is a protocol for a systematic review and possibly a meta-analysis that will synthesize evidence of the effects of resistance exercise on changes in body composition, muscular strength, overall weight loss or maintenance of weight loss, and quality of life in patients after metabolic and bariatric surgery (MBS). The findings of this study may provide …

Physical Activity And Exercise With Blood Flow Restriction As Medicine During The Covid-19 Pandemic And Beyond, Isaac J. Wedig

Dissertations, Master's Theses and Master's Reports

During the COVID-19 pandemic, physical activity levels have decreased and sitting time has increased. This is a major concern as physical inactivity increases the risk for severe COVID-19 outcomes. Evidence also indicates that COVID-19 survivors can experience reduced physical function (i.e., ability to complete daily living activities) long after acute illness. Currently, there are no evidence-based guidelines for recovering physical function following COVID-19 infection. Exercise with blood flow restriction (BFR) presents a promising rehabilitation strategy as the benefits of traditional exercise can be achieved using lower intensities. However, several barriers such as cost, access to equipment, and lack of standardized …

Using Wearable Technology To Quantify Physical Activity Recovery: Secondary Report From The After (App-Facilitated Tele-Rehabilitation) Program For Covid-19 Survivors Randomized Study, Laura Churchill, Mary Morrow, Jacob J. Capin, Sarah Jolley, Kristine Hare, Samantha Mawhinney, Jennifer E. Stevens-Lapsley, Kristine M. Erlandson

Physical Therapy Faculty Research and Publications

Background: Knowledge on physical activity recovery after COVID-19 survival is limited. The AFTER (App-Facilitated Tele-Rehabilitation) program for COVID-19 survivors randomized participants, following hospital discharge, to either education and unstructured physical activity or a telerehabilitation program. Step count data were collected as a secondary outcome, and we found no significant differences in total step count trajectories between groups at 6 weeks. Further step count data were not analyzed.

Objective: The purpose of this analysis was to examine step count trajectories and correlates among all participants (combined into a single group) across the 12-week study period.

Methods: Linear mixed …

Physical Activity Interventions In Children With Juvenile Idiopathic Arthritis: A Systematic Review Of Randomized Controlled Trials, Maura D. Iversen, Marie Andre, Johan Von Heideken

Physical Therapy Faculty Publications

Introduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.

Materials and methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and …

Evaluating The Effects Of Physical Activity On The Cognitive Functions And Motor Skills Of The Special Needs Population And Testing A Different Teaching Style To Maximize The Efficiency Of Special Needs Programs, Oren Nedjar

BIO4960: Practicum in Biology I

This study aimed to analyze the effects of physical activities on the motor and cognitive functions of participants with special needs and compare these results with a similar program but organized online because of the health precautions that have been applied due to the COVID-19 pandemic. An intervention consisting of sending an educational brochure aiming to increase high school volunteers' health literacy was then tested and results showed that it improved participants' health outcomes and also could increase the program's effectiveness in the long term.

Increasing Physical Activity In Older Australians To Reduce Falls: A Program Evaluation, Kristy Robson, Nazmul Ahasan, Carly Barnes, Kylie Murphy, Rodney Pope

Internet Journal of Allied Health Sciences and Practice

Purpose: As people age, they are at greater risk of injurious falls. Falling has a significant impact not only on the individual but also the wider community. Undertaking physical activity is effective in reducing the rate of falls in this population. Therefore, providing targeted education during group-based falls prevention programs may increase the awareness and amount of physical activity older people undertake to assist in reducing their risk of falling. Methods: A longitudinal cohort design involving a pre-post intervention survey was conducted over an eight-month period with community-dwelling older adults who participated in a fall-prevention program. Participants were N = …

Greater Fatigue Resistance Of Dorsiflexor Muscles In People With Prediabetes Than Type 2 Diabetes, Jonathon Senefeld, Lynette A. Singh-Peters, Kenji A. Kenno, Sandra K. Hunter, Jennifer M. Jakobi

Exercise Science Faculty Research and Publications

Although exercise can prevent progression to T2D among people with prediabetes, little is known about fatigue during exercise in people with prediabetes compared to T2D. The purpose of the study was to compare the magnitude and mechanisms of fatigability of the ankle dorsiflexor muscles between people with prediabetes and T2D. Ten people with prediabetes (6 females, 51.7 ± 6.9 years) and fourteen with T2D (6 females, 52.6 ± 6.2 years) who were matched for age, body mass index and physical activity performed an intermittent (6 s contraction: 4 s relaxation) fatiguing task at 75% maximal voluntary contraction (MVC) with the …

Exercise And Lifestyle Physical Activity Recommendations For People With Multiple Sclerosis Throughout The Disease Course, Rosalind Kalb, Theodore R. Brown, Susan Coote, Kathleen Costello, Ulrik Dalgas, Eric Garmon, Barbara Geisser, June Halper, Herb Karpatkin, Jennifer Keller, Alexander V. Ng, Lara A. Pilutti, Amanda Rohring, Paul Van Asch, Kathleen Zachowski, Robert W. Motl

Exercise Science Faculty Research and Publications

Objectives:

To provide clinicians who treat multiple sclerosis (MS) patients with evidence-based or expert opinion–based recommendations for promoting exercise and lifestyle physical activity across disability levels.

Methods:

The National MS Society (“Society”) convened clinical and research experts in the fields of MS, exercise, rehabilitation, and physical activity to (1) reach consensus on optimal exercise and lifestyle physical activity recommendations for individuals with MS at disability levels 0–9.0 on the Expanded Disability Status Scale (EDSS) and (2) identify and address barriers/facilitators for participation.

Recommendations:

Based on current evidence and expert opinion, the Society makes the following recommendations, endorsed by the Consortium …

Determinants Of Low Bone Mineral Density In People With Multiple Sclerosis: Role Of Physical Activity, Brice T. Cleland, Paula E. Papanek, Benjamin A. Ingraham, April L. Harkins, Mauricio Garnier-Villarreal, Douglas Woo, Mary Ellen Csuka, Alexander V. Ng

Exercise Science Faculty Research and Publications

Background

People with multiple sclerosis (PwMS) have reduced bone mineral density (BMD), but the causes are unclear. Some factors that may cause reduced BMD in PwMS have been understudied, including physical activity, inflammation, cortisol, symptomatic fatigue, and depression. The aim of this study was to investigate factors that may uniquely contribute to reduced BMD in PwMS as compared to people without MS. We hypothesized that physical activity would be the primary determinant of low BMD in PwMS, with additional contributions from inflammation and sympathetic nervous system activation.

Methods

We tested 23 PwMS (16 women; median EDSS: 2) and 22 control …

Differential Effects Of Aging And Physical Activity On Corticospinal Excitability Of Upper And Lower Limb Muscles, Vianney Rozand, Jonathon William Senefeld, Christopher W. Sundberg, Ashleigh E. Smith, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Corticospinal tract excitability can be altered by age, physical activity (PA), and possibly sex, but whether these effects differ between upper and lower limb muscles is unknown. We determined the influence of age, PA, and sex on corticospinal excitability of an upper limb and a lower limb muscle during submaximal contractions by comparing stimulus-response curves of motor evoked potentials (MEPs). Transcranial magnetic stimulation (TMS) was used to evoke stimulus-response curves in active muscles by incrementally increasing the stimulator intensity from below the active motor threshold (AMT) until a plateau in MEP amplitudes was achieved. Stimulus-response curves were analyzed from the …

Self-Report Participation Of Physical Activity Outside Of School On Rate Of Motor Skills Development In Elementary Students, Maritza Cuevas, Kara Lynn Boynewicz Dr., Brandi Eveland-Sayers Dr.

Undergraduate Honors Theses

In this research project, the question of why some younger children appear to have better motor skills than older children is investigated. The hypothesis proposed is that children involved in physical activities after school or in the evenings have better motor skills at younger ages than children who are not involved in physical activities outside of school. Young children have very varied levels of motor skills competency that have developed due to living in different environments and having varied opportunity to be physically active. These differences are a result of factors like socioeconomic status, parental influence, climate, culture, etc.1 Sports …

Preferences For Physical Activity: A Conjoint Analysis Involving People With Chronic Knee Pain, Daniel Pinto, Ulf Bockenholt, Jungwha Lee, Rowland W. Chang, Leena Sharma, Daniel J. Finn, Allen W. Heinemann, Jane Louise Holl, Paul D. Hansen

Physical Therapy Faculty Research and Publications

Objective

To investigate individual preferences for physical activity (PA) attributes in adults with chronic knee pain, to identify clusters of individuals with similar preferences, and to identify whether individuals in these clusters differ by their demographic and health characteristics.

Design

An adaptive conjoint analysis (ACA) was conducted using the Potentially All Pairwise RanKings of all possible Alternatives (PAPRIKA) method to determine preference weights representing the relative importance of six PA attributes. Cluster analysis was performed to identify clusters of participants with similar weights. Chi-square and ANOVA were used to assess differences in individual characteristics by cluster. Multinomial logistic regression was …

Ballroom Dance For Persons With Multiple Sclerosis: A Pilot Feasibility Study, Alexander V. Ng, Sheri Bunyan, Jimin Suh, Pamela Huenink, Tyler Gregory, Shannon Gambon, Deborah Miller

Exercise Science Faculty Research and Publications

Purpose: The purpose of this study was to evaluate the exercise intensity and feasibility of recreational ballroom dance for persons with multiple sclerosis (MS).

Methods: Seven persons with MS participated in 2 one-hour dance sessions per week for 6 weeks. Dance types included rumba, foxtrot, waltz, and push-pull. Six other persons with MS comprised a control group that did not dance. Heart rate and ratings of perceived exertion (RPE) were monitored during the sessions. Outcomes included: quality of life, fatigue, depression, self-efficacy, timed up and go, Berg Balance Scale, Dynamic Gait Index and the Multiple Sclerosis Functional Composite comprising 9-hole …

Response Shift After A 4-Week Multimodal Intervention For Chronic Ankle Instability, Cameron J. Powden, Matthew C. Hoch, Beth E. Jamali, Johanna M. Hoch

Rehabilitation Sciences Faculty Publications

Context The accurate evaluation of self-reported changes in function throughout the rehabilitation process is important for determining patient progression. Currently, how a response shift (RS) may affect the accuracy of self-reported functional assessment in a population with chronic ankle instability (CAI) is unknown.

Objective To examine the RS in individuals with CAI after a 4-week multimodal rehabilitation program.

Design Controlled laboratory study.

Setting Laboratory.

Patients or Other Participants Twenty adults (5 men, 15 women; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at …

Lean Mass Mediates The Relation Between Temporal Summation Of Pain And Sex In Young Healthy Adults, Abdulaziz Awali, Ali Alsouhibani, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Background

Previous studies have shown that women experience greater temporal summation (TS) of pain than men using a repetitive thermal stimulus. These studies, however, did not individualize the thermal stimulus to each subject’s thermal pain sensitivity. The aim of this study was to investigate sex differences in TS using an individualized protocol and potential mediators that have been shown to influence TS including physical activity and body composition.

Methods

Fifty young healthy men and women (21 men) participated in the study. Subjects completed TS testing on the right forearm using a repetitive thermal stimulus at a temperature that the subject …