Physical Therapy Commons^™

Applying Principles Of Motor Learning And Control To Upper Extremity Rehabilitation, Lisa M. Muratori, Eric M. Lamberg, Lori Quinn, Susan V. Duff

Physical Therapy Faculty Articles and Research

The purpose of this article is to provide a brief review of the principles of motor control and learning. Different models of motor control from historical to contemporary are presented with emphasis on the Systems model. Concepts of motor learning including skill acquisition, measurement of learning, and methods to promote skill acquisition by examining the many facets of practice scheduling and use of feedback are provided. A fictional client case is introduced and threaded throughout the article to facilitate understanding of these concepts and how they can be applied to clinical practice.

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. …

Predictors Of Outcome Following Standardized Rehabilitation For Patients With Shoulder Pain, Stephanie D. Moore

Theses and Dissertations--Rehabilitation Sciences

Shoulder dysfunction is frequently treated and persistent symptoms are common. Differential diagnosis of shoulder injuries can be challenging and knowledge of a diagnosis alone does not appear to be enough information to predict outcomes. Determination of a set of factors that predict outcome would assist clinicians in making the most effective treatment decision for patients with shoulder pain. The purposes of this dissertation were to investigate patient-clinician agreement in an orthopedic population of patients with shoulder pain and to determine what combination of factors best predicts positive patient-reported outcome following standardized rehabilitation in patients with shoulder pain.

In the first …

Functional Rehabilitation Of Low Back Pain With Core Stabilization Exercises: Suggestions For Exercises And Progressions In Athletes, Joshua Johnson

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

Introduction: Low back pain is very common in the adult population and accounts for more time lost from work than other diagnoses. It also affects athlete's at all different levels of competition and results in missed practice and game time. Diagnosing and treating a specific pathology is often difficult because clinical evaluation and radiologic studies are often unable to find a root cause. A popular treatment approach with a high volume of anecdotal evidence is the use of core stabilization exercise in the treatment of low back pain.

Purpose: To evaluate exercise as a treatment for a low back pain …

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 …

A Systematic Review Of The Health-Related Quality Of Life Measures Following Total Knee Arthroplasty, Saurabh Mehta, Mary Law, Jean-Sebastian Roy

Physical Therapy Faculty Research

To perform systematic review and appraisal of common patient-reported outcomes (PROs) used in measuring aspects of health-related quality of life (HRQOL) following total knee arthroplasty (TKA). Especially, the study aimed to examine whether these common PROs assess the domains of HRQOL as described in the theoretical frameworks of the HRQOL.

Pedaling Alters The Excitability And Modulation Of Vastus Medialis H-Reflexes After Stroke, Dana P. Fuchs, Namita Sanghvi, Jon A. Wieser, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

Objective

Individuals post-stroke display abnormal Group Ia reflex excitability. Pedaling has been shown to reduce Group Ia reflexes and to normalize the relationship between EMG and reflex amplitude in the paretic soleus (SO). The purpose of this study was to determine whether these changes extend to the paretic quadriceps.

Methods

H-reflexes were used to examine Group Ia reflex excitability of the vastus medialis (VM). H-reflexes were elicited in paretic (n = 13) and neurologically intact (n = 13) individuals at 11 positions in the pedaling cycle and during static knee extension at comparable limb positions and levels of …

The Effect Of Joint Mobilization On Functional Outcomes Associated With Chronic Ankle Instability, Matthew C. Hoch

University of Kentucky Doctoral Dissertations

Ankle sprains are among the most common injuries sustained by physically active individuals. Although ankle sprains are often considered innocuous in nature, a large percentage of individuals experience repetitive sprains, residual symptoms, and recurrent ankle instability following a single acute sprain; otherwise known as chronic ankle instability (CAI). In addition to repetitive ankle trauma, those with CAI experience reductions in functional capacity over the life span. This indicates that current intervention strategies for CAI are inadequate and require further investigation.

The objective of this dissertation was to explore differences in walking and running gait parameters between individuals with and without …

Pain Perception After Isometric Exercise In Women With Fibromyalgia, Marie K. Hoeger Bement, Andy Weyer, Sarah Hartley, Breanna Drewek, April L. Harkins, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Objective: The purpose of this study was to identify exercise protocols incorporating isometric contractions that provide pain relief in women with fibromyalgia.

Design: A before-after trial.

Setting: A physical therapy department in an academic setting.

Participants: Fifteen women (mean ± SD, 52 ± 11y) with fibromyalgia.

Interventions: Subjects completed 4 sessions: 1 familiarization and 3 experimental. The following randomized experimental sessions involved the performance of isometric contractions with the elbow flexor muscles that varied in intensity and duration: (1) 3 maximal voluntary contractions (MVCs), (2) 25% MVC held to task failure, and (3) 25% MVC …

Digital Human Models Of People With Disabilities, Ron Hamameh

Wayne State University Theses

The current state-of-the-art in Digital Human Modeling (DHM) allows for full simulation and analysis of any task a person is required to perform at home, at work, in the military, in space, in sports, etc. The problem is that the software is missing a very important population: people with physical disabilities. What modifications and enhancements must be made to existing, commercially available DHM software to include this population?

Observation Of Amounts Of Movement Practice Provided During Stroke Rehabilitation, Catherine E. Lang, Jillian R. Macdonald, Darcy S. Reisman, Lara Boyd, Teresa Jacobson Kimberley, Sheila M. Schindler-Ivens, T. George Hornby, Sandy A. Ross, Patricia L. Scheets

Physical Therapy Faculty Research and Publications

Objective

To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

Design

Observational survey of stroke therapy sessions.

Setting

Seven inpatient and outpatient rehabilitation sites.

Participants

We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

Interventions

Not applicable.

Main Outcome Measures

We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were …

Shoulder Rehabilitation For The Injured Overhead-Throwing Athlete, Joshua M. Raskoff

Recreation, Parks, and Tourism Administration

Baseball incorporates the violent motion of throwing as a main act of physical exertion. The shoulder joint is vulnerable to injury during this movement. The overall purpose of this study was to produce a rehabilitation program for injured overhead-throwing athletes and have it evaluated by healthcare professionals. A paper and pen style questionnaire was sent through the mail to a network of professionals in California. Eighteen of the 20 questionnaires were returned. The quantitative feedback of the Likert scale questions indicated that the program was effective and usable while the qualitative feedback indicated the opposite. The additional comments allowed experts …

In-Season Rehabilitation Of A Division Iii Female Wrestler After A Glenohumeral Dislocation, Jason Brumitt, Alma Sproul, Philip Lentz, Linda Mcintosh, Richard Rutt

Faculty Publications - College of Physical Therapy

Objective: Wrestling is a popular sport in the United States at both the high school and collegiate levels. Traditionally a men’s sport, participation by female athletes in wrestling is increasing. There exists a paucity of literature regarding injury incidence in women’s wrestling. This lack of information challenges the ability of sports medicine and strength training professionals to design optimal injury prevention programs, training routines, and rehabilitation strategies. The objective of this report is to detail the successful conservative rehabilitation of a female wrestler after an initial glenohumeral dislocation.

Design: Case report

Case description: A 20-year-old female wrestling student–athlete presented to …

Trial And Error Versus Errorless Learning Of Functional Skills In Patients With Acute Stroke, Julie Mount, Samuel R. Pierce, Janet Parker, Rebecca Diegidio, Russell Woessner, Lenore Spiegel

Department of Physical Therapy Faculty Papers

Objective: To compare the effectiveness of errorless learning versus trial and error learning for teaching activities of daily living to patients with acute stroke with or without explicit memory impairments.

Design: Randomized crossover.

Setting: Rehabilitation hospital.

Participants: 33 adult subjects following an acute stroke.

Intervention: Subjects were taught to prepare a wheelchair for a transfer and to put on a sock with a sock-donner. Tasks were taught using errorless learning or trial and error learning. Explicit memory was assessed using the Neurobehavioral Cognitive Status Exam.

Main Outcome Measures: Days until subject was able to …

Does Motor Lateralization Have Implications For Stroke Rehabilitation?, Robert L. Sainburg, Susan V. Duff

Physical Therapy Faculty Articles and Research

Recent findings on motor lateralization have revealed consistent differences in the control strategies of the dominant and nondominant hemisphere/limb systems that could have implications for hemiplegic stroke patients. Studies in stroke patients have demonstrated deficiencies in the ipsilesional arm that reflect these distinctions; patients with right-hemisphere damage tend to show deficits in positional accuracy, and patients with left-hemisphere damage show deficits in trajectory control. Such deficits have been shown to impede functional performance; yet patients with severe dominant-side hemiplegia must often use the nondominant arm as the primary manipulator for activities of daily living. Nevertheless, the nondominant arm may not …

Preliminary Validation Of A Mobility Obstacle Course For Persons With Mobility Impairment, Stephen F. Figoni, Christian Thompson, A. Katherine Froehlich, Dot E. Nary, Janet Marquis, Glen W. White

Kinesiology (Formerly Exercise and Sport Science)

The purpose of this study was to assess the reliability and validity of a mobility obstacle course for women with mobility impairments. Participants included 72 adult women with permanent physical disabilities including arthritis, orthopedic conditions, paraplegia, and others. The 60-m course consisted of carpeted runways and turns, ramps, a doorway, a transfer, and object manipulation. Participants completed two trials, walking or wheeling through the course as quickly as possible, safely and without running. Total course time and peak heart rate data were correlated with SF-36 health survey subscales. Overall, peak heart rate was significantly (p < .05) correlated with physical functioning (r = -.328), limitations due to physical functioning (r = .261), and pain (r = .296). Total course time was significantly correlated with physical functioning. These findings indicate very high reliability and preliminary evidence of validity.

Comparison Between Successful And Failed Sit-To-Stand Trials Of A Patient After Traumatic Brain Injury, Cynthia M. Zablotny, Deborah A. Nawoczenski, Bing Yu

Faculty Publications - College of Physical Therapy

Comparison between successful and failed sit-to-stand trials of a patient after traumatic brain injury.

Objective: To compare the peak whole-body center of mass (COM) velocities and joint angular contributions in successful and unsuccessful sit-to-stand (STS) trials in a subject with traumatic brain injury (TBI).

Design: Single-case study.

Setting: Motion research laboratory.

Participant: A 24-year-old man who was 3.5 years post-TBI.

Interventions: Not applicable.

Main Outcome Measures: Peak horizontal and vertical velocities of the whole-body COM and peak angular velocities of the ankle, knee, hip, and shoulder joints.

Results: The peak whole-body COM vertical velocity was significantly lower in the unsuccessful …

The Effect Of Jogging On Anterior Knee Laxity After Anterior Cruciate Ligament Reconstruction, Fawzi F. Bouzubar

Rehabilitation Sciences Theses & Dissertations

Jogging is commonly performed in the latter stages of the rehabilitation program (2½-3 months) following ACL reconstruction. However, its cyclic loading effect on the ACL graft, 4-6 months after surgery has not been examined. Therefore, the purpose of this study was to examine changes in anterior knee laxity before and after 15 minutes of jogging on the treadmill. Subjects (N=l 1) were 8 males and 3 females (X age= 30.27 ± 4.76 years; heights= 175.7 ± 10.7 cm; weights= 81.1 ± 15.9 kg) with unilateral ACL reconstruction (central 1/3 patellar tendon graft, postoperation range = 4-6 months). Measurements were made …