Physical Therapy Commons^™

Immediate Effect Of Local Vibration On Motor Unit Firing Behavior And Muscle Strength In Healthy Young Adult Males, Yuichi Nishikawa, Aleš Holobar, Kohei Watanabe, Toshihiko Komatsuzaki, Takanori Chihara, Jiro Sakamoto, Takashi Kawagoe, Hidetaka Nagayasu, Kyoko Mori, Kenji Kawano, Noriaki Maeda, Shinobu Tanaka, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

Purpose

The aim of this study was to examine the effect of vibration on motor unit (MU) firing behavior and physical performance of antagonist muscles in healthy young adult males.

Methods

Fourteen males (age = 24.3 ± 3.6 years) were included in this study. There were two conditions, one in which participants received 80 Hz vibration in the distal tendon of the hamstring for 30 s and the control condition (no vibration). High-density surface electromyography (HD-SEMG) signals and maximal voluntary contraction (MVC) of knee extensor muscles were evaluated before and after the respective conditions and recorded from the vastus lateralis …

The Dual Timescales Of Gait Adaptation: Initial Stability Adjustments Followed By Subsequent Energetic Cost Adjustments, Sasha A. Brinkerhoff, Natalia Sánchez, Meral N. Culver, William M. Murrah, Austin T. Robinson, J. Danielle Mccullough, Matthew W. Miller, Jaimie A. Roper

Physical Therapy Faculty Articles and Research

Gait adaptation during bipedal walking allows people to adjust their walking patterns to maintain balance, avoid obstacles and avoid injury. Adaptation involves complex processes that function to maintain stability and reduce energy expenditure. However, the processes that influence walking patterns during different points in the adaptation period remain to be investigated. We assessed split-belt adaptation in 17 young adults aged 19–35. We also assessed individual aerobic capacity to understand how aerobic capacity influences adaptation. We analyzed step lengths, step length asymmetry (SLA), mediolateral margins of stability, positive, negative and net mechanical work rates, as well as metabolic rate during adaptation. …

Discordance Between Balance Ability And Perception Is Associated With Falls In Parkinson’S Disease: A Coordinated Analysis, Jason K. Longhurst, Andrew Hooyman, Merrill R. Landers, Martina Mancini, Erika Franzén, Breiffni Leavy, Hanna Johansson, Daniel Peterson

Physical Therapy Faculty Articles and Research

Background: The congruence or discordance between actual and perceived balance ability has been proposed to be linked to functional outcomes such as falls. However, gaps remain in our ability to quantify discordance, and its relationship to relevant outcomes.

Objective: To investigate a novel quantification of concordance/discordance between balance performance and perception and determine the relationship to falls among people with Parkinson’s disease (PwPD).

Methods: Data from 244 PwPD were aggregated from 5 previously conducted studies. Variables extracted included age, sex, Activities-Specific Balance Confidence scale (ABC; perceived balance), Timed Up and Go (TUG; balance performance), Movement Disorder Society Unified Parkinson Disease …

Efficacy Of High-Definition Transcranial Alternating Current Stimulation (Hd-Tacs) At The M1 Hotspot Versus C3 Site In Modulating Corticospinal Tract Excitability, Hao Meng, Michael Houston, Nicholas Dias, Chen Guo, Gerard Francisco, Yingchun Zhang, Sheng Li

Faculty, Staff and Student Publications

Previous studies have shown that beta-band transcranial alternating current stimulation (tACS) applied at the M1 hotspot can modulate corticospinal excitability. However, it remains controversial whether tACS can influence motor unit activities at the spinal cord level. This study aims to compare the efficacy of applying tACS over the hotspot versus the conventional C3 site on motor unit activities and subsequent behavioral changes. This study used a randomized crossover trial design, where fifteen healthy participants performed a paced ball-squeezing exercise while receiving high-definition tACS (HD-tACS) at 21 Hz and 2 mA for 20 min. HD-tACS targeted either the flexor digitorum superficialis …

Toward Facilitating The Collection And Utilization Of Patient-Reported Outcomes In The Military Health System: Lessons Learned From A Pragmatic Clinical Trial On Physical Therapy Management For Low Back Pain, Emma H. Beisheim-Ryan, Brad D. Hendershot, Timothy C. Mauntel, Sara R. Gorczynski, Ryan W. Smith, Andrea Crunkhorn, Shawn Farrokhi, Christopher L. Dearth

Physical Therapy Faculty Articles and Research

"In pursuit of delivering 'the right care to the right patient at the right time,' the Military Health System (MHS) advocates for collecting and using patient-reported outcomes (PROs) to help demonstrate value-based care.1 PROs identify patients’ perceptions of their health, function, and well-being, which can enhance patient-centered communication and guide data-driven healthcare. 2 The MHS recognizes the value of incorporating PRO data into clinical decision-making and has established a number of platforms for PRO collection across health conditions (eg, behavioral health, traumatic brain injury, musculoskeletal injuries). The Military Orthopedics Tracking Injuries and Outcomes Network (MOTION)3 was started as a research …

Enhancing Data Standards To Advance Translation In Spinal Cord Injury, Vanessa K. Noonan, Suzanne Humphreys, Fin Biering-Sørensen, Susan Charlifue, Yuying Chen, James D. Guest, Linda A. T. Jones, Jennifer French, Eva Widerström-Noga, Vance P. Lemmon, Allen W. Heinemann, Jan M. Schwab, Aaron A. Phillips, Marzieh M. Rizi, John L. K. Kramer, Catherine R. Jutzeler, Abel Torres-Espin

Department of Physical Therapy Faculty Papers

Data standards are available for spinal cord injury (SCI). The International SCI Data Sets were created in 2002 and there are currently 27 freely available. In 2014 the National Institute of Neurological Disorders and Stroke developed clinical common data elements to promote clinical data sharing in SCI. The objective of this paper is to provide an overview of SCI data standards, describe learnings from the traumatic brain injury (TBI) field using data to enhance research and care, and discuss future opportunities in SCI. Given the complexity of SCI, frameworks such as a systems medicine approach and Big Data perspective have …

Position- And Sex-Related Differences In Sagittal And Frontal Plane Concentric Isokinetic Hip Muscle Peak Torques And Agonist-Antagonist Ratios, Lisa T. Hoglund, Matthew C. Schiffino, James E. Freels, Isabella G. Romano

Department of Physical Therapy Faculty Papers

BACKGROUND: Hip muscle weakness is associated with many musculoskeletal conditions and athletic injuries. Isokinetic testing is often performed to measure a patient's strength or to assess treatment response. Patient sex and positioning during isokinetic strength testing may influence peak torque production and the agonist-antagonist peak torque ratios. However, different test positions are used clinically and in research to measure hip muscle strength. It is unknown how patient test position or sex impacts test results.

HYPOTHESIS/PURPOSE: The purpose of this study was to determine whether concentric isokinetic peak torques of sagittal and frontal plane hip muscles differ when tested in recumbent …

A Geriatric Interprofessional Education Workshop: A Mixed Method Study, Patricia Watford, Meghan Hall, Colleen Hergott, Wanda Jirau-Rosaly, Shilpa Brown, Elena Wood, Nicole Rockich-Winston

Journal of Applied Disciplines

Interprofessional healthcare teams are essential for meeting the needs of our older population. To prepare for interprofessional collaboration, educational programs should offer opportunities for interprofessional education. We created a four-hour geriatric interprofessional workshop addressing cognition, macular degeneration, dysphagia, home safety, fall risk, and pharmacotherapy to examine student perceptions of working in interprofessional teams and their attitudes toward geriatric patients. Participants included 189 second-year medical (MD) students, 41 first-year occupational therapy (OT) students, and 36 second-year physical therapy (PT) students. We utilized a sequential explanatory mixed-method approach. Data analysis comprised descriptive statistics, paired t-tests for the pre/post surveys, and inductive content …

Utility Of The Vestibular/Ocular Motor Screening In Military Medicine: A Systematic Review, Carrie W. Hoppes, Tomas Garcia De La Huerta, Stefanie Faull, Margaret Weightman, Margaret Stojak, Leland E. Dibble, Ryan Pelo, Peter C. Fino, Holly Richard, Mark E. Lester, Laurie A. King

Physical Therapy Faculty Publications

Introduction

The Vestibular/Ocular Motor Screening (VOMS) was created as a brief clinical screening tool for identifying vestibular and ocular motor symptoms and impairments post-concussion. It was found to have predictive validity in correctly identifying concussed athletes from healthy controls. In 2018, the Military Acute Concussion Evaluation 2 (MACE2) replaced the original Military Acute Concussion Evaluation (MACE); the most prominent change between the MACE and MACE2 was the addition of the VOMS. Despite its adoption into military medicine, it is not known if the addition of the VOMS to the MACE2 is acutely helpful, and if it provides additional information for …

The Lymphedema Treatment Act: Past, Present, And Future, Candace Alexander, Leigh Ann Foster, Susan Gordon, Runzun Shetye

Oncology Rehabilitation in Practice

No abstract provided.

Rewiring Our Psychologically Informed Physical Therapy Interventions: Triple Network Model, Immunology, Sex, And Pain Perception, Roberto Sandoval, Mary Lou A. Galantino

Oncology Rehabilitation in Practice

No abstract provided.

Vestibular Rehabilitation Considerations For Chemotherapy-Induced Vestibulotoxicity: A Clinical Perspective, Tabitha Galindo

Oncology Rehabilitation in Practice

No abstract provided.

The Role Of Cancer Rehabilitation In Chemotherapy-Induced Sarcopenia, Tracy L. Moore, Jessica Bertram

Oncology Rehabilitation in Practice

No abstract provided.

Perceptions And Outcomes Of Older Adults Following A Cancer Prevention Educational Seminar, Lori Boright, Sara Arena, Christopher M. Wilson, Andrew Boardman, Kevin Chen, Marcel Soleimani, Hannah Wickersham

Oncology Rehabilitation in Practice

Introduction: 19.9 million new cancer cases and 9.7 million cancer deaths occurred globally in 2023. 90-95% of cancers originate from environment and lifestyle choices. Age is a prominent non-modifiable risk factor for cancer development, so it is essential that older adults are informed on lifestyle factors affecting their cancer risk. Physical therapists (PTs) play a major role in educating and advocating for healthy cancer preventive behaviors. The purpose of this study was to describe outcomes of an educational intervention relating to cancer prevention in community-dwelling older adults.

Methods: Investigators developed and delivered a cancer prevention educational seminar relevant to exercise, …

Cover, Table Of Contents, President's Message, Editorial Board's Message, Academy Of Oncologic Physical Therapy

Oncology Rehabilitation in Practice

No abstract provided.

Duration, Cost, And Escalation Of Care Events For Physical Therapy Management Of Low Back Pain In Service Members With Limb Loss, Brittney M. Gunterstockman, Brad D. Hendershot, Joseph Kakyomya, Charity G. Patterson, Christopher L. Dearth, Shawn Farrokhi

Physical Therapy Faculty Articles and Research

Introduction Physical therapy (PT) is recommended as a primary treatment for low back pain (LBP), a common and impactful musculoskeletal condition after limb loss. The purpose of this brief report is to report the duration and cost of PT care, and subsequent escalation of care events, for LBP in service members with and without limb loss. Materials and Methods This was a retrospective cohort, descriptive study. Service members with and without limb loss (matched) who received PT for LBP at a military treatment facility from 2015 to 2017 were included. Duration of PT care, number of PT visits, and escalation …

Sleep Disturbances Effect On The Development Of Disability Following A Motor Vehicle Collision: A Cohort Study, Bradford Callan, Morey J. Kolber, Joshua Cleland, James M. Elliott

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to evaluate sleep disturbance and calculate its effect on long-term outcomes for people with whiplash associated disorder (WAD) following a motor vehicle collision (MVC). Methods: A secondary analysis of data for 97 people (females = 72) diagnosed with WAD was collected at 10%. Logistic regression was used to calculate significance and odds ratios (OR) for the variables of age, body mass index (BMI), sex, and sleep disturbance. Results: With logistic regression age and BMI were non-significant factors, however, sex (ꭕ² = 9.37, p = 0.025; OR = 4.3) and …

Professional Identity Formation Through A Peer Learning, Integrated Clinical Experience, T.R. Goins, Michelle Green, Bridget Eubanks

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to explore the experiences and perceptions of first-year DPT students related to professional behaviors and professional identity formation after an integrated clinical experience facilitated by peers. Methods: Forty-one first-year DPT students from an accredited Doctor of Physical Therapy program participated in a class assignment designed to collect qualitative data regarding their experiences with professional behaviors and professional identity formation after completing an integrated clinical experience. Incident coding processes analyzed responses to open-ended assignment prompts. Results: The most frequent professional behaviors students felt they could demonstrate during the integrated clinical experience were “communication” and …

How Allied Health Programs Can Integrate Pharmacists Into Didactic Education Medication Curriculum: Benefits, Challenges, And Implementation, Dawn M. Battise, Susan M. Smith

Internet Journal of Allied Health Sciences and Practice

Many allied health professionals are required to receive medication-related education. As the “medication experts,” pharmacists are uniquely qualified to provide such training. Although pharmacy involvement in interprofessional education is frequently described, there is limited data about the pharmacist's role in the allied health didactic setting. This paper describes how two allied health programs leveraged the medication knowledge of pharmacy educators to enhance delivery of medication related content. Strategies are provided for pharmacy and allied health educators who are considering implementing a similar interprofessional model.

Effect Of Segmental Expansion Exercises On Pulmonary Function In Patients With Upper Abdominal Surgery- A Randomized Controlled Trial, Pranali R. Gaikwad, Manish P. Shukla

Internet Journal of Allied Health Sciences and Practice

Background: Following upper abdominal surgeries, restricted pulmonary function and limited chest expansion often occur due to incisions near the diaphragm. This study aimed to assess the influence of segmental expansion exercises on pulmonary function among individuals recovering from upper abdominal surgery. Method: The study involved 88 patients who underwent elective upper abdominal surgery, randomized into two groups. Over a five-day postoperative period, Group A received standard physiotherapy, including diaphragmatic exercises, splinted huffing/coughing, and ambulation. In contrast, Group B received routine physiotherapy along with segmental expansion exercises. The study evaluated pulmonary function through measurements of forced vital capacity, Forced Expiratory Volume …

Making Reflection Assignments Meaningful And Enjoyable For Health Professions Students And Faculty, Karen A. Gibbs, Megan L. Trad, Shannon R. Herrin

Internet Journal of Allied Health Sciences and Practice

Purpose: Recognizing the professional and personal benefits of self-reflection, health professions programs routinely incorporate reflection activities into their curricula. However, designing, administering, and grading engaging, meaningful reflection activities that can be utilized for in-person or online teaching can be challenging for faculty and less than enjoyable for students. This study explored student perceptions of a shared activity using photovoice to stimulate individual and group reflection and discussion of learning during clinical experiences. Methods: Second year, doctor of physical therapy students were asked to reflect on their clinical experiences. During the semester-long assignment, each student completed a photovoice slide …

Gynecological Cancers And Quality Of Life, Shaina E. Ettinger

Internet Journal of Allied Health Sciences and Practice

ABSTRACT

Background: Every five minutes a woman in the United States receives a gynecological cancer diagnosis. On average, 88,128 women in the United States are diagnosed with gynecological cancer yearly and 12,158 of those women, or 7% require hospital readmission. Although patient readmission rate is relatively low for this population, a better understanding of how patients frame quality of life (QoL) may decrease readmission stemming from QoL complications. Objective: The aim of this study was to identify the QoL issues that contributed to hospital readmission following surgical intervention in women newly diagnosed with gynecological cancer. Method: The study used a …

Obstacles To Physical Therapy Clinical Instruction: A Qualitative Study Of Clinical Instructors, Alicia K. Rabena-Amen, Bhavana Raja, Todd E. Davenport

Internet Journal of Allied Health Sciences and Practice

Purpose: Clinical instructors (CIs) are essential contributors to clinical education. Limited literature exists describing CI perceptions of supervising students. The purpose of this research was to identify CI challenges and possible solutions when supervising student physical therapists and student physical therapist assistants. Methods: A convenience sample of 99 CIs in the Northern California Clinical Education Consortium participated in this study. A phenomenological approach obtained CI perceptions of the barriers to supervising students. Researchers employed a web-based survey to obtain demographic information and pose two open-ended questions that allowed for up to three responses. Thematic analysis using a coding framework was …

Scoping Out Leadership Opportunities And Motivational Factors Of Doctor Of Physical Therapy Students, Laura Stephens, Ronald Childress

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to open investigation into the scope of leadership opportunities available to students at a physical therapy educational program and to identify factors that motivated students to pursue leadership development opportunities during their pre-professional education. Methods: This qualitative study utilized semi-structured interviews to investigate the experiences and perspectives of current and former student leaders. Participants were queried regarding what leadership opportunities were available to them and what motivated them to pursue those specific roles. Results: Findings revealed the scope of leadership development opportunities included experiences within and external to the Doctor of Physical Therapy …

Physical Therapy Management Of Myasthenia Gravis: A Case Study, Erin Hung, Gwendolyn Juha, Todd E. Davenport, Joy Williams

Internet Journal of Allied Health Sciences and Practice

Purpose: Myasthenia gravis (MG) is an autoimmune disease that involves dysfunction of the neuromuscular junction, and commonly involves fluctuating muscle weakness and central fatigue. Current literature lacks consensus on the benefit of exercise in addressing central fatigue in this population. This case report explores the role of physical therapy in an individual with MG for whom fatigue is a primary concern. Methods: This case study describes the physical therapy management of a 62-year-old Caucasian male recently diagnosed with myasthenia gravis. Physical therapy intervention focused on strength and balance training as well as patient education on energy conservation and activity pacing. …

Physical Therapy Management For An Individual With Stiff Person Syndrome In The Acute Care Setting: A Case Report, Paul Kim, Christina Berdoulay, Todd E. Davenport, Joy Williams

Internet Journal of Allied Health Sciences and Practice

Purpose: Stiff Person Syndrome (SPS) is a rare neurological disease which is characterized by progressive rigidity and painful spasms of axial and limb muscles. We report here on the physical therapy management as well as medical complications which impacted the physical therapy plan of care for a patient with paraneoplastic SPS in the acute care setting. Method: This case report describes rehabilitation management of a 71-year-old woman who presented in the acute care setting for complaints of progressively worsening stiffness in the bilateral lower extremities leading to multiple falls as well as dysphagia. Primary interventions for this patient included passive …

Clinical Instructor And Student Reports Of Affective Behavior Issues During A Clinical Experience, Bruce N. Elliott, Jon J. Rizzo

Internet Journal of Allied Health Sciences and Practice

Purpose: Clinical Instructors (CIs) have optimal opportunity to support non-cognitive attributes while observing and assessing student interactions with staff and patients because of the time spent with their students. There is a dearth of literature related to how items in the professional practice section of the Clinical Performance Instrument (CPI) are truly addressed during a clinical affiliation. Therefore, the purpose of this study was to record the occasions when lapses occur with respect to a student’s accountability, communication, or professional behavior, as well as assessing student and CI interpretations of how these instances were addressed, and subsequently corrected within …

Proceedings Of The 2022 “Lifestyle Intervention For Epilepsy (Life)” Symposium Hosted By Cleveland Clinic, Martha Sajatovic

Faculty Scholarship

Lifestyle interventions are strategies used to self-manage medical conditions, such as epilepsy, and often complement traditional pharmacologic and surgical therapies. The need for integrating evidence-based lifestyle interventions into mainstream medicine for the treatment of epilepsy is evident given that despite the availability of a multitude of treatments with medications and surgical techniques, a significant proportion of patients have refractory seizures, and even those who are seizure-free report significant adverse effects with current treatments. Although the evidence base for complementary medicine is less robust than it is for traditional forms of medicine, the evidence to date suggests that several forms of …

Investigating Dual Task Balance Exercises: Quantifying Practice Patterns And Understanding Decision-Making Among Physical Therapists, Amelia Sabin, Wes Spagnuolo, Narissa Libby, Kylie Berry

Research Report Posters

Dual-task exercise has been shown to be an effective intervention to improve patient functional outcomes and decrease falls. However, little is known about whether physical therapists are prescribing dual task exercises during their sessions, or at what intensity. The objective of this research was to analyze differences and similarities of observed balance exercise practice patterns and reported practice and decision-making among physical therapists. We analyzed both quantitative and qualitative data from two separate studies and extracted data regarding dual-task balance exercises. Our analysis found that therapists rarely perform, describe, or report thinking about dual-task balance exercises in their physical therapy …

Pelvic Floor Physical Therapy In Pregnant And Postpartum Women, Madison G. Kaup

Senior Theses

This project had three main goals: 1) Explore how pregnancy and childbirth affect the female pelvic floor anatomy and physiology, 2) Examine current practices through a literature review and interviews conducted with pelvic floor physical therapists currently practicing in various clinical settings across the United States, and 3) Develop suggestions to mitigate the challenges currently faced in the field by patients and therapists.

The female pelvic floor undergoes extensive changes throughout pregnancy as its structures are targeted by laxity-inducing hormones and mechanical stress from the growing fetus. During childbirth, the system is stretched beyond its physiological limit, causing damage to …