Physical Therapy Commons^™

The Links Between Motivational Techniques, Successful Physical Therapists, And Successful Rehab Clinics, Abigail Alyse Richmond

Senior Honors Theses

There is a strong positive correlation between a successful physical therapist (PT), their clinic, and the motivational techniques used during therapy. The PT should be prepared to sit down with each patient and set short- and long-term goals to help them accomplish what they desire through therapy. Effective communication skills, practical skills and technique, individualized care, and organizational and environmental factors are the four major aspects that define patient-therapist relationships. Patient adherence to their home exercise program (HEP) is vital to a successful rehabilitation, and therefore the PT’s goal should be to help the patient understand the importance of the …

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 …

The Effect Of Patterned Sensory Enhancement On Balance And Ambulation In Persons Diagnosed With Parkinson’S Disease, Brittany Barko

Masters Theses

One rehabilitation protocol effective in delaying the symptoms of Parkinson’s Disease (PD) is Lee Silverman Voice Training BIG (LSVT BIG), comprising pre-gait exercises and gait training. This study seeks to determine if combining Patterned Sensory Enhancement (PSE), a music therapy intervention, with LSVT BIG will improve quality of movement. During physical therapy sessions with three participants, a music therapist adapted the PSE stimuli to support each patient’s motor needs, which were then recorded on CD and sent with patients to exercise with at home. Results showed improved balance and ambulation comparing pre- and post- measures of the BERG balance scale …

The Use Of Neuromuscular Electrical Simulation In Glenohumeral Unidirectional Instability When An Exercise-Based Approach Has Failed: A Case Study, Kunal Bhanot, Navpreet Kaur, J Butler

Physical Therapy Collection

Purpose of this case study was to report the role of neuromuscular electrical stimulation (NMES) to restore strength and normal motion in a patient with unidirectional shoulder instability or glenohumeral internal rotation deficit (GIRD).

Home-Based, Square-Stepping Exercise Program Among Older Adults With Multiple Sclerosis: Results Of A Feasibility Randomized Controlled Study, Emerson Sebastião, Edward Mcauley, Ryosuke Shigematsu, Brynn C. Adamson, Rachel E. Bollaert, Robert W. Motl

Exercise Science Faculty Research and Publications

There is very little known about exercise rehabilitation approaches for older adults with multiple sclerosis (MS), yet this growing segment of the MS population experiences declines in cognition and mobility associated with disease progression and aging. We conducted a RCT examining the feasibility of a 12-week, home-based Square-Stepping Exercise (SSE) program in older adults with MS. Older adults with MS (N = 26) with mild-to-moderate levels of disability were recruited and randomized into the intervention (i.e., SSE) or a minimal activity, attention-control conditions. Participants in the SSE condition received a mat for home-based practice of the step patterns, an …

The High-Level Mobility Assessment Tool (Himat) In Myotonic Dystrophy Type 2: A Case Report, Kim B. Smith, Evan M. Pucillo

Physical Therapy Collection

Myotonic dystrophy type 2 (DM2) is a progressive muscular dystrophy with multi-system manifestations and can affect functional mobility, gait, and balance. Currently, there are few reports of functional outcome measures in this population. This case describes the change in function detected by the High-level Mobility Assessment Tool (HiMAT) and 30-second Chair Stand Test (CST) in a high-functioning adult female with DM2 after physical therapy treatment. The patient’s chief complaint was muscular pain and fatigue that affected activities of daily living (ADLs). Multimodal physical therapy focused on neuromuscular re-education, balance and strength training, patient education, and moderate cardiorespiratory training. Improvements were …

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.

Complicated Rehabilitation Status Post Total Knee Arthroplasty For A 26 Year Old Female Presenting With Psychosocial Dysfunction: A Case Report, Lindsey Atkins, David Kempfert

St. Augustine, Summer 2018

The purpose of this case report is to look at the post-TKA surgical outcomes of a 26-year-old patient who had multiple variables that increases the risk for poor outcomes.

Shock And Awe: Functional Strength Training To Improve Balance And Function In A Patient Post Electrocution, Amanda K. Boone, Anne H. Boddy

St. Augustine, Summer 2018

The purpose of this case study is to study the effects of functional strength training rehabilitation in a patient post electrocution suffering from a concurrent stroke.

Effects Of Dry Cupping Therapy On A 56-Year-Old Female Patient Post Haglund’S Deformity Surgery: A Case Report, Jordan Gaillard, David Kempfert

St. Augustine, Summer 2018

The purpose of this case report was to determine the effects of dry cupping therapy on a 56-year-old female patient who had Haglund’s deformity surgery.

Hip, Pop, Oa: Successful Treatment Of Hip Osteoarthritis With Sustained Stretches And Thrust Manipulation, Leah Fifelski, John Layne

St. Augustine, Summer 2018

The purpose of this poster is to show the effects of manual therapy, in the form of grade IV sustained stretches and thrust manipulations, on a patient with hip OA.

Neuromuscular Adaptations Following Slope Walking In Individuals Post-Stroke, Eric Akoopie, Brooke Conway Kleven, Trisha Koch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The excitability of the H-reflex pathway in the non-impaired nervous system can be augmented by altering the different parameters of a walking task, specifically slope. We sought to examine the adaptations in soleus H-reflex excitability and foot force control following an acute bout of upslope or downslope treadmill walking in people post-stroke compared to those who are non- impaired. Methods: We recruited 12 individuals with chronic post-stroke hemiparesis and 9 age-similar non- neurologically impaired individuals. Each subject was tested over 2 sessions separated by at least 7 days. For each session, subjects walked at a self-selected walking speed on …

Treatment Interventions For Medial Tibial Stress Syndrome, Nathan Cook, Alexa Srolovitz

Thinking Matters Symposium Archive

Medial Tibial Stress Syndrome (MTSS) or more commonly referred to as “shin splints” is characterized as an overuse or repetitive stress injury that causes vague pain over and around the tibia. Researchers are yet to determine a definitive cause though numerous risk factors have been noted. They are as follows; over training,type of surface, poor footwear, muscular imbalances at the ankle, over tight or weak triceps surae muscles, imbalances at the thoracolumbar complex, other muscular imbalances and BMI above 30. Rehabilitation and treatment interventions often call for a pause in training entirely or at the very least an immediate scaling …

Trx® Suspension Training In Improving Single Leg Strength And Confidence In A Female Soccer Player Post Acl Reconstruction, Allison Evron, David Kempfert

St. Augustine, Spring 2018

The purpose of this case report is to describe the combination of TRX® suspension training with a functional lower extremity rehabilitation program in an ACLR patient whose lacking dynamic knee control and lower extremity strength and endurance.

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.

Can You Dig? Returning To Volleyball After Arthroscopic Medial Plica Excision, Kelsy Wheeler, Lisa Chase

St. Augustine, Spring 2018

The purpose of this case report is to describe the rehabilitation and return-to-sport process following arthroscopic medial plica excision for a patient who had previously undergone unsuccessful conservative management for anterior knee pain.

Ease Into It. Effects Of Mobilization With Movement Utilizing Patients Body Weight, Casey Brown, Matthew L. Daugherty

St. Augustine, Spring 2018

The purpose of this case report is to utilize mobilization with movement (MWM) to restore knee flexion in a patient with delayed quadriceps tendon repair.

When All Else Fails: Management Of An Irreparable Rotator Cuff With Capsular Reconstruction And Physical Therapy Targeting Accommodative Musculature, Savannah Faulk, Douglas Steele

St. Augustine, Spring 2018

The purpose of this case report is to describe the rehabilitative outcomes on a superior capsular reconstruction surgery following the re-injury of a surgically repaired rotator cuff (RTC) and glenoid labrum that was deemed irreparable.

Reforming Range Of Motion: The Use Of The Pilates Reformer In A Female With Postoperative Adhesive Capsulitis, Lanzi A. Young, Larry J. Mengelkoch

St. Augustine, Spring 2018

The purpose of this case report is to describe the rehabilitation outcomes of a 62-year-old female with post operative adhesive capsulitis using Pilates-based intervention in conjunction with standard Physical Therapy.

To Transplant Or Not To Transplant? The Successful Treatment Of A Lateral Meniscus Transplant, Jaime Rubin, Matthew L. Daugherty

St. Augustine, Spring 2018

The purpose of this case report was to demonstrate how physical therapists can successfully manage a young patient who received the rare lateral meniscal transplant procedure.

Six-Minute Walk Test Performance In Persons With Multiple Sclerosis While Using Passive Or Powered Ankle-Foot Orthoses, Morgan K. Boes, Rachel E. Bollaert, Richard M. Kesler, Yvonne C. Learmonth, Mazharul Islam, Matthew N. Petrucci, Robert W. Motl, Elizabeth T. Hsiao-Wecksler

Exercise Science Faculty Research and Publications

Objective

To determine whether a powered ankle-foot orthosis (AFO) that provides dorsiflexor and plantar flexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS).

Design

Short-term intervention.

Setting

University research laboratory.

Participants

Participants (N=16) with a neurologist-confirmed diagnosis of MS and daily use of a prescribed custom unilateral passive AFO.

Interventions

Three 6-minute walk tests (6MWTs), 1 per footwear condition: shoes (no AFO), prescribed passive AFO, and portable powered AFO (PPAFO). Assistive devices were worn on the impaired limb.

Main Outcome Measures

Distance walked and metabolic cost of transport were recorded during each 6MWT and …

Effect Of Stable And Unstable Surfaces On The Serratus Anterior Muscle Activation In A Kinetic-Chain Exercise Among Healthy Adults, Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

PURPOSE/HYPOTHESIS: The stabilizing action of the serratus anterior (SA) muscle is vital in maintaining proper scapulothoracic rhythm.^1,2 Poor activation of SA muscle could lead to many shoulder dysfunctions.^1,3 This warrants for exercises that are best to activate the SA muscle. Kinetic-chain recruitment during exercises has demonstrated increased SA activation due to the myofascial connections between various segments of the body.^4–6 Variation of surfaces during an exercise has been shown to alter the muscle recruitment patterns.^7–9 The primary purpose of this study was to determine if the unstable surface can influence SA muscle activity during the kinetic …

Global Health And Disability: A Review And Call To Action For All Rehabilitation Professions, Evan M. Pucillo, Matthew B. Huish, Quinn Tate, Edward C. O'Bryan, Ty T. Dickerson

Physical Therapy Collection

The World Health Organization estimates 15% of the world’s population is living with disability and anticipates an increase as the population ages. Disability is a growing healthcare concern and presents a tremendous burden to all nations. The world will soon need to provide health and rehabilitative care for an enormous number of persons with disability. The purpose of this article is to provide a brief narrative review pertaining to global health and rehabilitation, and to motivate the rehabilitation professions in taking immediate action through further investment in global health initiatives to manage both the current and projected burden of disability. …

Can Patient Reported Outcomes Guide Therapy Needs In Foot And Ankle Patients?, Jeff Houck, Jillian Santer, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The patient acceptable symptom state (PASS) is a validated question establishing if patients activity and symptoms are at a satisfactory low level for pain and function. Surprisingly, ~20% of foot and ankle patients at their initial visit present for care with an acceptable symptom state (i.e. PASS yes). These patients are important to identify to prevent over treatment and avoid excessive cost. It is also unclear what health domains (Pain Interference (PI), Physical Function (PF), or Depression (Dep)) influence a patients judgement of their PASS state (i.e. why they are seeking treatment). The purpose of this analysis is to …

Ability Of Patient-Reported Outcomes To Characterize Patient Acceptable Symptom State (Pass) After Attending A Primary Care Physical Therapist And Medical Doctor Collaborative Service: A Cross-Sectional Study, Jeff Houck, Daniel Kang, Tyler Cuddeford, Sarah Rahkola

Faculty Publications - College of Physical Therapy

Objectives: To determine if the Patient-Reported Outcome Measurement Information System (PROMIS) physical function, pain interference, self-efficacy, and global rating of normal function (GRNF) scales are able to accurately characterize a patient’s acceptable symptom state (PASS).

Design: A cross-sectional analysis, using receiver operator curves and chi-square analysis to explore criteria to determine thresholds (80% and 95% sensitivity/specificity) for PASS that are applicable to PROMIS and GRNF scales.

Setting: Phone survey after primary care. Participants: Patients (NZ94) attending primary care for musculoskeletal problems. Interventions: Not applicable. Main Outcomes Measures: Accuracy and proportion of patients classified as PASS Yes or No.

Results: Receiver …

Expert Consensus For Respiratory Physiotherapy Management Of Mechanically Ventilated Adults With Community-Acquired Pneumonia: A Delphi Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Rationale and aims: Patients with community‐acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability in clinical practice and limited research directing best practice for this cohort. This study aimed to determine expert consensus for best physiotherapy practice for invasively ventilated adults with CAP.

Method: A modified Delphi technique involved an international expert panel completing three rounds of an online questionnaire. The initial 35‐statement questionnaire, based on a systematic literature review and survey of current clinical practice, covered physiotherapy assessment and treatment of intubated patients with …

Grip And Muscle Strength Dynamometry In Acute Burn Injury: Evaluation Of An Updated Assessment Protocol, Paul M. Gittings, Dana A. Hince, Benedict M. Wand, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry.

Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum …

Association Between Sedentary Time And Quality Of Life From The Osteoarthritis Initiative: Who Might Benefit Most From Treatment?, Daniel Pinto, Jing Song, Jungwha Lee, Rowland W. Chang, Pamela A. Semanik, Linda S. Ehrlich-Jones, Christine A. Pellegrini, Dorothy D. Dunlop

Physical Therapy Faculty Research and Publications

Objective

To investigate the relationship between sedentary behavior and quality-adjusted life years (QALYs) among participants in the Osteoarthritis Initiative.

Design

Longitudinal, observational design.

Setting

Osteoarthritis Initiative cohort.

Participants

Individuals (N=1794) from a prospective, multicenter longitudinal cohort were classified into quantile groups based on average daily sedentary time (most sedentary, quartile 1 [Q1] ≥11.6h; 10.7h≤ Q2

Interventions

Not applicable.

Main Outcome Measures

Individual QALYs were estimated over 2 years from the area under the curve of health-related utility scores derived from the Medical Outcomes Study 12-Item Short-Form Health Survey versus time. The relationship between baseline sedentary behavior and median 2-year QALYs …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Implementing The Weefim System In Outpatient Pediatric Rehabilitation, Chelsea Ratilainen

Master's Projects and Capstones

Abstract

This project was designed to achieve an unmet criteria in the accreditation process for the outpatient pediatric rehabilitation program at a local, community hospital in the greater Bay Area. The clients range from 6 months old to 20 years old with functional disabilities. The Commission of Accreditation of Rehabilitation Facilities (CARF) requires that applicants demonstrate outcome measure data over a 6 month time period. During the self-evaluation process this was noted to be a deficiency in the department’s efforts. The WeeFIM system was chosen as the first tool to implement in the department. This is a functional improvement measurement …