Physical Therapy Commons^™

Effects Of Blood Flow Restriction During Acute Multi-Joint Eccentric Exercise On Muscle Recovery, Cody Fisher

All Graduate Reports and Creative Projects, Fall 2023 to Present

Blood flow restriction (BFR) exercise has become an increasingly common modality due to evidence that it may yield positive muscle-related effects from low-intensity exercise. However, eccentric-only exercise in a multi-joint format has not yet been investigated in regard to the BFR influence on muscle recovery characteristics. The purpose of this study was to assess muscle recovery responses via isometric peak force (PF), soreness (i.e., VAS, PPT, PPD), and functional power (i.e., SLHD) following a 5-minute low-load multi-joint eccentric exercise bout with or without blood flow restriction. Thirty participants were randomly assigned into either an eccentric-only (CON) or an eccentric BFR …

Spatiotemporal Gait Parameter Consistency Across Two Days Of Treadmill Walking In Stroke Survivors, Alejandro Aguirre Ramirez, Samantha N. Jeffcoat, Natalia Sanchez, Andrian Kuch

Student Scholar Symposium Abstracts and Posters

Retraining impaired gait is essential in post-stroke recovery. This project aims to determine between day variability of spatiotemporal gait measures in treadmill walking post-stroke to differentiate between changes due to the intervention and measurement errors due to between day test-retest variability. Six individuals post-stroke performed a two-minute walk test at a self-selected speed (SSS) for two consecutive days. SSS was assessed through the six-minute walk test. Reflective markers were placed on anatomical landmarks (van den Bogert et al. 2013). The heel markers were used for step detection. We calculated spatiotemporal parameters: stride length, stride time, step length, stance time, and …

Implementation Of An Evidence-Based Program To Reduce Fall Risk Of Older Adults In Nevada, Hanna Brunty, Jordynn Cowan, Taylor Derose, Kanosha Gray, Kerry Margolin

UNLV Theses, Dissertations, Professional Papers, and Capstones

As Doctor of Physical Therapy (DPT) students from the University of Nevada, Las Vegas, we completed a service-learning project to deliver a free evidence-based fall prevention program to senior residents of Nevada. “Stepping On” is a 7-week fall prevention program from the Wisconsin Institute for Healthy Aging that is designed for older adults who are at risk or fearful of falling or for those who want to increase their awareness of fall prevention strategies. The program includes learning balance and strengthening exercises, discussing fall prevention strategies, and collaborating with community partners and healthcare professionals. The first objective of this service-learning …

A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: The hallmark gait deviation in individuals with post-stroke hemiparesis is slow walking speed. Reduction in gait speed after stroke is influenced by decreased propulsive forces, which may likely be related to impaired spinal circuit function and spasticity of the paretic plantarflexors. Chronic muscle tone maladaptations in paretic ankle plantarflexors can result in altered Achilles tendon (AT) morphology, therefore leading to altered mechanical properties, force transmission capabilities and subsequent insufficient propulsive forces during walking. The purpose of this study is to characterize the chronic maladaptations in both the spinal Ia afferent loop excitability and AT morphology after stroke lesions in …

The Impact Of Anatomy Academy In Underserved Las Vegas Elementary Schools, Jean Angeles, Edgar Armengual, Katrina Myers, Perceval Vollmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anatomy Academy is an interactive, service-learning experience that allows doctoral physical therapy students to pose as educators for elementary-aged adolescents. Through instructional and activity-based learning, mentors formulated the program to encase anatomical, physiological, nutritional, and general health and wellness topics that translate into overall healthy behaviors. The experiment enveloped 7 major sectors of anatomy, including the musculoskeletal system, cardiovascular system, pulmonary system, oral cavity/nutrition, gastrointestinal system, sensory system, and central nervous system. Throughout the length of the program, the doctoral candidates reviewed the quality of the content delivered, the engagement of the students and staff, and the effects this had …

Modulating Cortical Excitability To Improve Functional Movements In Individuals With Patellofemoral Pain: A Randomized Controlled Trial, Jeno Aquino, Bryce Broadwell, Connan Wallace, Makenzie Whimple

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Persons with patellofemoral pain (PFP) often exhibit increased knee valgus during functional tasks that is traditionally addressed by strengthening weak hip musculature. However, research related to this topic has revealed altered cortical reorganization in individuals with PFP contributes to dysfunctional movements and underscores the critical role of central neural control in this condition. Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that alters cortical excitability to enhance neuroplasticity. Research using tDCS priming supports its feasibility as a possible treatment for other musculoskeletal conditions. However, its application specifically targeting the corticomotor function of the gluteal musculature in individuals with …

Effects Of Chronic Diabetes And Attentional Focus On Performance And Learning Of A Novel Stabilometer Balance Task, Rebeca Carolina Armagnac Gonzalez, Yinny H. Lee, Alicia Marie Letkiewicz, Meiko Nagano Mamauag

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Chronic diabetes is a prevalent systemic disease that impairs physical functioning and often leads to increased risk of falls. Adopting an external focus of attention during motor skill practice has been shown to improve learning outcomes, however, it has not been examined in this population. We examined how attentional focus instructions (internal vs. external) affect balance performance and learning in older adults with and without diabetes.

Methods: Fifty-three older adults (27 with diabetes, 63.7±7.0 years) participated in the randomized, pre-post intervention study. The balance training involved 50 practice trials of a stabilometer task that was novel to …

Implementing Physical Therapy Services And Screenings For The Students Of The Unlv College Of Fine Arts For Health And Injury Prevention: A Service-Learning Approach, Selene Barajas, Justin Dietrich, Brenna Ganzon, Payton Mack, Katherine Metzger, Tanner Mueller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals who participate in Fine Arts such as orchestra, dance, and theater at high levels are predisposed to injury. Many of these injuries are preventable, and when not adequately managed, they can result in lost rehearsal time and prevent participation in performances required for degree completion. While collegiate athletes typically have access to healthcare resources such as a team physician, athletic trainer, and physical therapist, collegiate performing artists often must navigate the healthcare environment on their own. Furthermore, available healthcare providers may lack knowledge and experience working with performing artists and be less able to treat the unique healthcare needs …

Better Gait Quality And Speed In Adults With Down Syndrome When Wearing Supportive Shoes Compared To Unsupportive Shoes And Barefoot, Bailey Gosse, Kimberly Nguyen, Zoe Zelensky

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals with Down syndrome (DS), often experience a slower gait speed and decreased quality of gait. Different types of footwear have shown changes in gait in people without DS. The current study aimed to examine the differences between wearing commercially available supportive shoes, unsupportive shoes, and no footwear on gait quality and speed in people with DS.

Methods: In this repeated measures study, 20 adults with DS walked under three footwear conditions: supportive, unsupportive, and no footwear. Gait deviations were scored according to the Rancho Los Amigos Observational Gait Analysis (OGA) and gait speed was measured using the 10-Meter …

Implementation Of Evidence-Based Practices To Improve Treatment For Patients With Neck Pain: A Pilot Study, Kristine David, Sarah Kaderka, Christoffer-Judd Villarias

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: To determine physical therapists’ barriers to implementation and subsequent maintenance of evidence-based practices (EBPs) for treating neck pain from the American Physical Therapy Association (APTA) neck pain Clinical Practice Guideline (CPG) over the course of six months.

Materials and Methods: Participating physical therapists were trained on the EBPs of treating neck pain through a live 90-minute webinar followed by a hands-on, in-person 90-minute session. Clinics were supplied with all necessary equipment and reference guides. Assessment of participant maintenance to neck pain EBPs included data collection from a baseline Knowledge Check survey prior to educational sessions, an Implementation survey at …

Effects Of Exercise On Level Of Support, Mobility, And Quality Of Life In Adults With Down Syndrome, Jorge Lorza-Lopez, Jolena Sagaya, Simone Schroder, Paige Melvin Zink

UNLV Theses, Dissertations, Professional Papers, and Capstones

Down syndrome (Ds) is a genetic disorder characterized by the autosomal abnormality of a third copy of chromosome 21. Due to the physical and intellectual disabilities that many people with Ds experience, they often need support with (instrumental) activities of daily living. Since adults with Ds are living longer, it is important to determine how exercise can affect mobility and quality of life in the Ds community. The impact on more functional outcomes, such as level of support and quality of life has not been systematically investigated. Therefore, the aim was to investigate whether twelve weeks of a remote, structured …

Effect Of Asynchronous Virtual Interviews On Ethnic Minority Matriculation Into A Doctor Of Physical Therapy Program, Conner Clark, Nanea Lagasca, Gladys Miller, Jasmine Puspos

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: This study examines the impact of the use of asynchronous virtual interviews (AVIs) in the admissions process of the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). This research aims to examine racial and ethnic subgroup differences in AVI scores, evaluate the influence of AVIs on applicant scores in the admissions process, and assess the AVI inter-rater reliability among faculty evaluators using data from the 2019-2022 admissions cycles.

Results: Significant differences were found in AVI scores among racial and ethnic groups, with Black applicants scoring highest and Asian applicants scoring lowest. Additionally, inclusion …

Standing Posterior Trunk Rotation With Adaptive Proprioceptive Toss, Jennifer Elvir

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a remarkably individualized disease. Nearly every person’s trajectory is unique. One person may experience tremor at an early stage of the disease, while another may experience tremor at a later stage or even not at all. For all PD patients, for certain can expect increasing difficulty as the disease progresses. Parkinson’s disease is responsible for the loss of dopamine which displays itself most notably through motor and cognitive symptom disruption. Although Parkinson’s is a chronic and progressive condition that is irremediable, significant strides have been facilitated to help control and manage the trajectory of the disease. …

Increasing Social Inclusion And Engagement Of Exercise For Individuals With Spinal Cord Injuries: A Universal Resource Development For Wellness Facilities, Alexa Hall

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Individuals with spinal cord injuries (SCIs) are 1.5 times more likely to disengage in exercise one-year post-injury despite 80% of these individuals agreeing that exercise is critical to their overall health and quality of life (Baehr. Et al., 2022). A needs assessment was conducted on why the lack of engagement in exercise exists for individuals with SCIs within fitness facilities to identify barriers preventing participation. A quality improvement program called the Spinal Cord Injury Wellness Toolkit was created based off these findings and implemented at the MUSC Wellness Center. 14 individuals with SCIs participated at wellness center; REDCap surveys were …

Evidence And Sources Of Placebo Effects In Transcranial Direct Current Stimulation During Visuospatial Working Memory Training, Andrew Hooyman, Nicole K. Haikalis, Peiyuan Wang, Heidi M. Schambra, Keith R. Lohse, Sidney Y. Schaefer

Physical Therapy Faculty Articles and Research

Transcranial direct current stimulation (tDCS) can be used to non-invasively augment cognitive training. However, the benefits of tDCS may be due in part to placebo effects, which have not been well-characterized. The purpose of this study was to determine whether tDCS can have a measurable placebo effect on cognitive training and to identify potential sources of this effect. Eighty-three right-handed adults were randomly assigned to one of three groups: control (no exposure to tDCS), sham tDCS, or active tDCS. The sham and active tDCS groups were double-blinded. Each group performed 20 min of an adapted Corsi Block Tapping Task (CBTT), …

Cracking A Back Is Not Rehabilitation: A Comparative Analysis Of Chiropractic Vs. Physical Therapy, Lauren M. Radack

Student Scholar Showcase

There is an increasingly common belief among the general public that chiropractic care is more successful in treating injuries than physical therapy. Research shows that chiropractic care cannot be compared to physical therapy due to their different skill sets, knowledge of treatment, and applications; therefore, one modality cannot be determined better than the other. While the two domains are incomparable, individuals continue to feel pressured to select between chiropractic care and physical Therapy. Analyzing the influence of the false claims and misinformation that surrounds rehabilitation services, the belief that physical therapy treatment is able to be replaced by chiropractic treatment …

Quantitative Pilot Study: Impact Of Social Responsibility And Altruism Values On Rehabilitation Employee Satisfaction, Debra Beazley, Agnes Kim, Lori Bolgla

Asian Journal of Physical Therapy

Background: This study explores the association between physical therapist satisfaction in a rehabilitation private practice and perceptions of altruism and social responsibility in the workplace. Small private, for-profit businesses like therapy practices often embrace altruistic values and socially responsible cultures driven by close stakeholder relationships. Alignment between business culture and personal values is a stronger predictor of workplace and career satisfaction. Employees who perceive value alignment report higher job satisfaction and relatedness. Prosocial cultures, rich in altruism and social responsibility, foster job fit and reduce dissatisfaction and turnover. Physical therapy's core values, including altruism and social responsibility, are integral to …

Childhood Cancer Survivorship: Navigating A New Normal In Middle Tennessee, Karli M. Beaumont

OTD Capstone Projects

Monroe Carell Jr. Children’s Hospital at Vanderbilt in partnership with Vanderbilt-Ingram Cancer Center offers REACH for Cancer Survivorship, a pediatric cancer survivorship clinic. REACH provides a full range of follow-up care designed to meet the physical, emotional, and practical needs of survivors and continuous surveillance of deleterious effects of cancer and its treatments. The purpose of this project was to meet population and agency needs through research of long- and late-term sequela while advocating for occupational therapy’s role in the oncology population through the proactive therapy and prospective surveillance models. The process of creating this project included synthesizing the literature, …

Exploring The Interplay Between Physical Activity Wellness, Social Networks, And Academic Performance In Pt Students, Grace C. Johnson, Kellie Gossman, Tessa Wells, Betsy J. Becker

Posters and Presentations: Physical Therapy

Purpose

Recognizing the intersection of peer influence, physical activity, student wellness, and academic performance, this study aims to provide insights that can inform educational practices and promote success among future physical therapist (PT) students. The study's purpose is to investigate the associations between students' physical activity wellness scores, their social networks, and academic performance within the school environment. The research questions are (1) Do students tend to form friendships with classmates who exhibit similar physical activity wellness scores and student achievement? and (2) How do the Exercise Factor scores of PT students align with published normative values?

Subjects: 124 students …

From Textbooks To Clinical Practice: Selecting And Implementing Outcomes Measures In Stroke Rehabilitation, Stacie Mae Larreau Christensen, Monica Dial

Posters and Presentations: Physical Therapy

No abstract provided.

Participation And Outcomes Of A Community-Based Fall Prevention Program Before, During And After Covid-19 Pandemic., Bhavana Raja, Preeti Oza

Pacific Journal of Health

Introduction: Several community education programs aim to minimize risk of falling in community-dwelling older adults. However, due to the covid-19 pandemic most of these programs stopped or were delivered virtually. A matter of balance (MOB) is one such program that was delivered virtually during pandemic. The purpose of this study is to assess the differences in outcomes between in-person and virtual MOB program in San Joaquin County of California.

Methods: Participants were recruited from the community. Each MOB course ran for 8 sessions in-person or 9 sessions in the virtual format. A retrospective analysis was conducted on deidentified pre-post survey …

How Has Body Image Been Evaluated Among People With Lower Limb Loss? A Scoping Review, Kristin Nugent, Atharv Joshi, Ricardo Viana, Michael W Payne, Janelle Unger, Susan W Hunter

Physical Therapy Publications

PURPOSE: Lower limb loss can result in an altered body image, leading to changes in self-esteem, mental health and quality of life. This scoping review explored how body image has been evaluated among people with lower limb loss.

MATERIALS AND METHODS: Five databases (Embase, Medline, PsychINFO, CINHAL, and Nursing and Allied Health Database) were searched from inception until March 19, 2023. Inclusion criteria: 1) people with lower limb loss; 2) evaluated a body image outcome or theme; and 3) a qualitative, quantitative or mixed methods design.

RESULTS: Twenty-four quantitative (n = 19 cross-sectional, n = 3 intervention cohort and …

Increased Perceived Confidence In Professional Role Skills Among Undergraduate Dietetic Students Following Simulation-Based Learning Experiences, Makenzie Barr-Porter, Elizabeth Combs, Lauren Batey, Dawn Brewer, Aaron Kyle Schwartz, Tammy Stephenson

UK CARES Faculty Publications

Simulation-based learning experiences (SBLEs) are effective for teaching healthcare students clinical and communication skills. The current study assessed self-perceived clinical and communication confidence among dietetics students completing a series of four SBLEs (3 group, 1 individual) across nine months. Dietetics students were recruited in February 2023 prior to their first SBLE. Simultaneously through the academic year, students completed clinical and communication courses. Students were invited to complete an online, anonymous self-reported survey regarding confidence with nutrition care and communication prior to their first SBLE (Time 1), prior to their third SBLE (Time 2), and following their final SBLE (Time 3). …

Finger Contracture Relief Sensorized Splint, Katia Campos, Alfonso Gonzalez, Olivia Rojas

Posters - 2024

Hand traumas may result from an accident, a burn, or even something far more common like a jammed finger. Due to the pain, the hand is immobilized and this lack of movement, in addition to the healing processes, can lead to a deformity. The specific deformity addressed in this project is a Proximal Interphalangeal Joint Flexion Contracture, which is when the middle knuckles of the fingers are stuck in a flexed position. Contractions can occur after trauma or certain illnesses. It is the shortening of muscles, tendons, skin, and nearby soft tissues that causes the joints to become very stiff. …

Prevalence Of Depression In Physical Therapy Environments For Young Adult Populations In The U.S.: A Systematic Literature Review, Audrey N. Baucom

Honors College Theses

Objective: This systematic review aimed to examine interactions of depression symptoms and diagnoses and its prevalence in physical therapy settings among the young adult population ages 18-24 in the United States through current literature and to identify existing literature. Methods: This review followed the PRISMA guidelines to form a systematic review. Ten databases were extensively searched. Results were screened by one researcher and those that met the criteria were verified as inclusive by a second researcher. Results: The search yielded 3,017 results and included two studies. In each study, age was not identified as a prevalent variable in mental health …

Neuromuscular Electrical Stimulation In Comparison To Heat Therapy As A Modality After Exercise-Induced Muscle Fatigue, Diana Dzasezeva

All NMU Master's Theses

Increasing blood flow to exercised areas expedites metabolite removal, aiding quicker recovery and preventing injury during return to exercise. However, the effectiveness of different recovery modalities remains unclear. The purpose of the study is to evaluate the efficacy of neuromuscular electrical stimulation (NMES) and heat therapy (HT) as recovery modalities after inducing fatigue with maximal exercise in active individuals. The study involved 56 participants who performed a fatiguing exercise before the intervention. They then either rested (control group) or received one of three treatments: HT, NMES, or NMES+HT for 15 minutes. Afterward, they performed another bout of fatiguing exercise. Outcomes …

Blood Flow Restriction Therapy: A Review Of Physiology, Clinical Application, And Guidelines For Implementation, Nathan Schuliger

Senior Honors Theses

Blood flow restriction (BFR) therapy is an emerging clinical modality utilizing the metabolic stress of a hypoxic state to induce hypertrophic and strength adaptations in a manner allowing for reduced external loading. BFR has a variety of applications in rehabilitation settings, showing great potential for patients seeking the benefits of high intensity training without the associated degrees of mechanical stress. This literature review details the proposed mechanisms of BFR, along with various clinical applications of BFR including active and aerobic BFR. Concerns and contraindications for BFR usage are discussed regarding certain clinical populations, with risk stratification recommendations provided. Current BFR …

Mechanisms Of Neuromuscular Fatigability In Individuals With Multiple Sclerosis, Mitra Rouhani

Dissertations (1934 -)

Subjective fatigue and pain are commonly reported in people with MS (pwMS), as is neuromuscular fatigability. The dynamometry protocols used to measure neuromuscular fatigability in pwMS varied substantially in terms of components, leading to inconsistent findings regarding the extent of neuromuscular fatigability and its central and peripheral mechanisms in pwMS compared to non-MS controls. This dissertation aimed to compare neuromuscular fatigability and its underlying mechanisms following a sustained maximal to intermittent submaximal ankle dorsiflexion in pwMS, grouped by disease severity, and non-MS controls. Additionally, we aimed to determine the impact of physical activity, muscle oxidative capacity, and exercise-induced pain on …

Perturbation-Based Gait Training, Julia Bohlman, Ashwini Kulkarni

Undergraduate Research Symposium

Background:

Falls during walking are common in older adults and individuals with Parkinson’s disease (PD) [1]. These falls are often caused by trips [2]. Injuries caused by falls can be severe, in all age groups and populations. Given the potential severity of injuries resulting from falls, it is crucial to implement interventions aimed at preventing falls. Such interventions focus on anticipatory and/or reactive mechanisms. Perturbation-based gait training (PBT) addresses both mechanisms by intentionally destabilizing participants to induce a loss of stability, triggering a motor response to regain postural stability. PBT works on the principle of specificity. While earlier studies on …

Exploring The Prospects Of Transcranial Electrical Stimulation (Tes) As A Therapeutic Intervention For Post-Stroke Motor Recovery: A Narrative Review, Hao Meng, Michael Houston, Yingchun Zhang, Sheng Li

Faculty, Staff and Student Publications

Introduction: Stroke survivors often have motor impairments and related functional deficits. Transcranial Electrical Stimulation (tES) is a rapidly evolving field that offers a wide range of capabilities for modulating brain function, and it is safe and inexpensive. It has the potential for widespread use for post-stroke motor recovery. Transcranial Direct Current Stimulation (tDCS), Transcranial Alternating Current Stimulation (tACS), and Transcranial Random Noise Stimulation (tRNS) are three recognized tES techniques that have gained substantial attention in recent years but have different mechanisms of action. tDCS has been widely used in stroke motor rehabilitation, while applications of tACS and tRNS are very …