Physiotherapy Commons^™

The Relationship Of Plantar Sensation With Standing Balance And Gait Post-Stroke, Stephen Parsons

Electronic Thesis and Dissertation Repository

Gait and balance dysfunction after stroke limit independence and quality of life. Numerous contributing factors have been investigated but the role of sensation deficits has received little attention. This thesis investigated the relationship between plantar cutaneous sensation and 1) standing balance, 2) gait, and 3) use of vision to compensate for sensory loss with a secondary analysis of data from individuals with subacute stroke. Associations between standing balance, gait and sensation were investigated with Spearman correlations. Individuals classified as impaired or intact sensation were compared on gait and standing balance measures. This thesis found plantar sensation is related to standing …

Effect Of Dual Tasking On Walking Over Even And Uneven Surfaces In Functionally Independent Community Older Adults, Olajide L. Kolawole

Seton Hall University Dissertations and Theses (ETDs)

While several studies have reported a decrement in performance by older adults while walking and concurrently performing a dual task on even surfaces, to date the effects of dual tasking while walking on uneven surfaces commonly found in the community has received less attention. Thus, we sought to test the hypothesis that an incremental decrement in gait parameters will be observed, when walking on an uneven versus an even surface and furthermore, that this decrement would be dependent upon the concurrent performance of a secondary cognitive and/or motor task in functionally independent-living-community older adults.

Dynamic Gait Index assessed the subject’s …

Home-Based Multidisciplinary Rehabilitation Following Hip Fracture Surgery: What Is The Evidence?, Kathleen Donohue, Richelle Hoevenaars, Jocelyn Mceachern, Erica Zeman, Saurabh Mehta

Saurabh Mehta

Objective. To determine the effects of multidisciplinary home rehabilitation (MHR) on functional and quality of life (QOL) outcomes following hip fracture surgery. Methods. Systematic review methodology suggested by Cochrane Collaboration was adopted. Reviewers independently searched the literature, selected the studies, extracted data, and performed critical appraisal of studies. Summary of the results of included studies was provided. Results. Five studies were included. Over the short-term, functional status and lower extremity strength were better in the MHR group compared to the no treatment group (NT). Over the long-term, the MHR group showed greater improvements in balance confidence, functional status, and lower …

Physical Therapy Non-Treatment Of The Acute Hospital Inpatient, Daniel Lee Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detrimental effects of inactivity and mobility extend to the most ill and injured patients in the acute hospital setting. Facilitating the activity and exercise of these most critical patients often requires the skill and expertise of a physical therapist. When physical therapists are involved in the care of hospital inpatients they experience significant benefits; patients experience fewer secondary complications related to their primary illness or injury, they spend less time in critical care units and less time in the hospital overall, and when they leave they go to less restrictive environments and more comfortable care settings. These known benefits …

Interrater Reliability Of The Wolf Motor Function Test–Functional Ability Scale: Why It Matters, Susan V. Duff, Jiaxue He, Monica A. Nelsen, Christianne J. Lane, Veronica T. Rowe, Steve L. Wolf, Alexander W. Dromerick, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Background. One important objective for clinical trialists in rehabilitation is determining efficacy of interventions to enhance motor behavior. In part, limitation in the precision of measurement presents a challenge. The few valid, low-cost observational tools available to assess motor behavior cannot escape the variability inherent in test administration and scoring. This is especially true when there are multiple evaluators and raters, as in the case of multisite randomized controlled trials (RCTs). One way to enhance reliability and reduce variability is to implement rigorous quality control (QC) procedures. Objective. This article describes a systematic QC process used to refine …

Psychometric Evaluation Of Self-Report Pain And Disability Measures For Elbow Disorders, Joshua Vincent

Electronic Thesis and Dissertation Repository

Elbow disorders are one of the commonest musculoskeletal problems with a prevalence of 9% in men and 8.1% in women. Patient centered care is the goal of current healthcare delivery models; but optimizing treatment outcome and clinical research is hampered by a lack of outcome measures. Since pain and disability resulting from elbow disorders are experienced differently across individuals, they are best captured by patient reported outcome measures (PROM).

PROMs like the Patient-rated Elbow Evaluation (PREE); American Shoulder and Elbow surgeons – Elbow form (pASES-e) have been developed for use in elbow disorders, but important questions remain about their measurement …

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …

Stressor-Induced Increase In Muscle Fatigability Of Young Men And Women Is Predicted By Strength But Not Voluntary Activation, Manda Keller-Ross, Hugo Pereia, Jaclyn Pruse, Tejin Yoon, Bonnie Schlinder-Delap, Kristy Nielson, Sandra Hunter

Kristy Nielson

This study investigated mechanisms for the stressor-induced changes in muscle fatigability in men and women. Participants performed an isometric-fatiguing contraction at 20% maximal voluntary contraction (MVC) until failure with the elbow flexor muscles. Study one (n = 55; 29 women) involved two experimental sessions: 1) a high-stressor session that required a difficult mental-math task before and during a fatiguing contraction and 2) a control session with no mental math. For some participants (n = 28; 14 women), cortical stimulation was used to examine mechanisms that contributed to muscle fatigability during the high-stressor and control sessions. Study two (n = 23; …

Effect Of Monophasic Pulsed Current On The Treatment Of Plantar Fasciitis, Abdullah Alotaibi

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Plantar fasciitis (PF) is one of the most common soft tissue disorders that causes inferior heel and rear foot pain. Monophasic pulsed current (MPC) is a method of electrical stimulation (ES) clinically used to promote and accelerate wound healing processes. The aim of this prospective clinical trial was to investigate the effect of MPC and MPC coupled with plantar fascia specific stretching exercises (SE) in the treatment of PF. Methods: Forty four participants (twenty- two subjects were women; 22 were men with a mean age of 49 ± 10.6 years) diagnosed with PF were randomly allocated to receive MPC …

Integrating Guided Motor Imagery And Cross Education Into Rehabilitation: Scientific Review And Clinical Application, Emily Bouchard

Mahurin Honors College Capstone Experience/Thesis Projects

BACKGROUND: Guided motor imagery and cross education are two concepts that build upon motor programs. Guided motor imagery consists of imagining a specific action, thereby activating the respective motor program without an actual movement. Cross education incorporates contralateral training to activate the motor program of an action to the resting limb. These techniques yield neurological actions that can lead to improved performance outcomes when integrated into physical therapy programs. PURPOSE: This literature review investigated guided motor imagery and cross education within the scientific literature, identified and summarized evident themes and provided suggestions for incorporating these methods into rehabilitation programs. METHODS: …

The Effects Of A Single Bout Of Self-~Myofascial Release On Flexibility And Maximum Voluntary Contraction, Jonathan Robert Garcia

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to determine the effect of foam rolling on hamstrings flexibility, isometric and isokinetic torque. Participants: Thirteen female participants (N = 13; age: 28.5 + 6.8 years of age; height: 165.5 + 6.7 cm; mass: 64.2 + 8.4 kg) volunteered to participate in the study.

Methods: Hamstring flexibility was assessed using a sit and reach test; muscle strength was assessed by having participants complete a maximal voluntary isometric contraction (MVIC) of the hamstrings and maximal effort isokinetic knee flexion test using an isokinetic dynamometer. Participants completed these tests prior to any intervention (pre-rolling 1), …

Systematic Review Of Home Physiotherapy After Hip Fracture Surgery, Saurabh Mehta, Jean-Sébastien Roy

Saurabh Mehta

OBJECTIVE: To compare the benefits of home physiotherapy, institution-based physiotherapy and no physiotherapy following hip fracture surgery. DESIGN: Systematic review and meta-analysis of randomized controlled trials. METHODS: Two reviewers independently extracted data from 5 included studies. Standardized mean differences were pooled for health-related quality of life and performance-based outcomes. Review Manager Version 5 was used for data analysis. RESULTS: Analysis of the 5 included studies indicated that home physiotherapy was better than no physiotherapy and similar to outpatient physiotherapy in improving patient-reported health-related quality of life. Performance-based outcomes were marginally better following outpatient physiotherapy compared with home physiotherapy 3 and …

Establishing Normative Values For The Barnett Balance Assessment Tool: A Preliminary Study, Monica L. Cercone, Katherine M. Grulke-Kidd, Alora S. Haskin, Kyle M. Medearis, Clarissa J. Wegner, Ellen Herlache-Pretzer

The Open Journal of Occupational Therapy

The purpose of this study was to establish normative data for the Barnett Balance Assessment (BBA) for individuals ages 18-70+ years. The BBA is a newly developed assessment tool that may address limitations present in other assessments currently used to detect balance deficits. The BBA was administered to 141 participants who had no history of medical issues that could impact balance. A review of the normative data collected indicated little variation in total assessment scores in the age categories of 18-29, 30-39, and 40-49, due to the presence of a ceiling effect. Variations existed in scores among participants in the …

Stressor-Induced Increase In Muscle Fatigability Of Young Men And Women Is Predicted By Strength But Not Voluntary Activation, Manda L. Keller-Ross, Hugo M. Pereira, Jaclyn Pruse, Tejin Yoon, Bonnie A. Schlinder-Delap, Kristy A. Nielson, Sandra Hunter

Psychology Faculty Research and Publications

This study investigated mechanisms for the stressor-induced changes in muscle fatigability in men and women. Participants performed an isometric-fatiguing contraction at 20% maximal voluntary contraction (MVC) until failure with the elbow flexor muscles. Study one (n = 55; 29 women) involved two experimental sessions: 1) a high-stressor session that required a difficult mental-math task before and during a fatiguing contraction and 2) a control session with no mental math. For some participants (n = 28; 14 women), cortical stimulation was used to examine mechanisms that contributed to muscle fatigability during the high-stressor and control sessions. Study two …

Sex Differences In Human Fatigability: Mechanisms And Insight To Physiological Responses, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Sex-related differences in physiology and anatomy are responsible for profound differences in neuromuscular performance and fatigability between men and women. Women are usually less fatigable than men for similar intensity isometric fatiguing contractions. This sex difference in fatigability, however, is task specific because different neuromuscular sites will be stressed when the requirements of the task are altered, and the stress on these sites can differ for men and women. Task variables that can alter the sex difference in fatigability include the type, intensity and speed of contraction, the muscle group assessed and the environmental conditions. Physiological mechanisms that are responsible …

Physiotherapy To Enhance Active Ageing, Yee Hung, Priscilla Poon

International Conference: Overcoming Challenges in Active Ageing

No abstract provided.

In A 36-Year-Old Woman With Neck Pain, Will Manipulation And Mobilization Be Beneficial For Reducing Her Reports Of Neck Pain?, Holly Jonely, David A. Scalzitti

Physical Therapy and Health Care Sciences Faculty Publications

<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medications, surgery, education, nutrition, exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature.1 Each article in …

Cardiac Rehabilitation Programmes For Low-Risk Patients And Leisure Athletes: A Potential Paradox, Wendy Bjerke, Stu Steinman, Vincent Cotto

All PTHMS Faculty Publications

Background: Athletes are enrolled in cardiac rehabilitation (CR) programmes in small numbers and require unique diagnostic testing and training considerations. Additionally, many physiotherapists, exercise physiologists, athletic trainers and physicians lack experience treating athletes in CR due to their limited exposure to these types of patients. Content: This analysis distinguishes athletes from typical CR patients within the context of diagnostic testing, assessment, exercise prescription, and management. Several case studies present unique challenges and approaches to the rehabilitation of athletes in a CR setting. Conclusions: Athletes enrolled in CR should be treated and trained according to their abilities and goals. Combining traditional …

The Impact Of A Structured Reconditioning Program On The Physical Attributes And Attitudes Of Injured Police Officers: A Pilot Study, Rob Orr, Michael Stierli, Matteo L. Amabile, Benjamin Wilkes

Rob Marc Orr

Specific work tasks represent the most widely recognised risk for Workplace Musculoskeletal Disorders and injuries. Six injured police officers (m=38.8 years of age) volunteered to participate in a study to determine whether a structured and supervised reconditioning program may improve their return to work prospects. Three officers were allocated to the intervention group, receiving eight training sessions over four-weeks of a tailored reconditioning program, and three officers to a control group. Both groups continued to receive standard medical care. Mean total Functional Movement Screen scores increased in the intervention group (+4.3 points) to a greater extent than the control group …

The Impact Of A Structured Reconditioning Program On The Physical Attributes And Attitudes Of Injured Police Officers: A Pilot Study, Rob Orr, Michael Stierli, Matteo L. Amabile, Benjamin Wilkes

Rob Marc Orr

Specific work tasks represent the most widely recognised risk for Workplace Musculoskeletal Disorders and injuries. Six injured police officers (m=38.8 years of age) volunteered to participate in a study to determine whether a structured and supervised reconditioning program may improve their return to work prospects. Three officers were allocated to the intervention group, receiving eight training sessions over four-weeks of a tailored reconditioning program, and three officers to a control group. Both groups continued to receive standard medical care. Mean total Functional Movement Screen scores increased in the intervention group (+4.3 points) to a greater extent than the control group …

Examination Of Two Hydration Protocols During Simulated Forced Marching Under Acute Heat Stress, David Alan Cottrill

Theses, Dissertations and Capstones

The purpose of this study was to identify and compare the effects of ingesting either water or 6% solution of carbohydrates, electrolytes, and water on hydration status during simulated military road marching in hot environmental conditions. Five volunteer male subjects completed two 60 minute experimental trials exercising at a high intensity (RER .90-.95) in an improvised environmental chamber (29.7 ^{_{+ or -}} .18^oC, 11.3 + or - 2.13% relative humidity) in full army combat uniform carrying 18.18kg of equipment. Random assignment of either water or solution was completed prior to trial 1, and consumption of the unselected protocol …

A Stepped-Wedge Cluster Randomised Controlled Trial For Evaluating Rates Of Falls Among Inpatients In Aged Care Rehabilitation Units Receiving Tailored Multimedia Education In Addition To Usual Care: A Trial Protocol, Anne-Marie Hill, Nicholas Waldron, Christopher Etherton-Beer, Steven Mcphail, Katharine Ingram, Leon Flicker, Terry P. Haines

Physiotherapy Papers and Journal Articles

INTRODUCTION:

Falls are the most frequent adverse event reported in hospitals. Approximately 30% of in-hospital falls lead to an injury and up to 2% result in a fracture. A large randomised trial found that a trained health professional providing individualised falls prevention education to older inpatients reduced falls in a cognitively intact subgroup. This study aims to investigate whether this efficacious intervention can reduce falls and be clinically useful and cost-effective when delivered in the real-life clinical environment.

METHODS:

A stepped-wedge cluster randomised trial will be used across eight subacute units (clusters) which will be randomised to one of four …

Psychometric Properties Of The Compulsive Exercise Test In An Adolescent Eating Disorder Population, Pam Formby, Hunna J. Watson, Anna Hilyard, Kate Martin, Sarah J. Egan

Physiotherapy Papers and Journal Articles

The objective of this study was to evaluate the factor structure, validity, and reliability of the Compulsive Exercise Test (CET) in an adolescent clinical eating disorder population. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project, a prospective ongoing registry study comprising consecutive paediatric tertiary eating disorder referrals. Adolescents (N = 104; 12-17 years) with eating disorders completed the CET and other measures. Factor structure, convergent validity, and internal consistency were evaluated. Despite failing to identify a factor structure, the study provided clear evidence of the multidimensionality of the measure. The total score correlated significantly …

Expert Consensus And Recommendations On Safety Criteria For Active Mobilization Of Mechanically Ventilated Critically Ill Adults, Carol L. Hodgson, Kathy Stiller, Dale M. Needham, Claire J. Tipping, Megan Harrold, Claire E. Baldwin, Scott Bradley, Sue Berney, Lawrence R. Caruana, Doug Elliott, Margot Green, Kimberley Haines, Alisa Higgins, Kirsi-Maija Kaukonen, Isabel A. Leditschke, Marc R. Nicols, Jennifer Paratz, Shane Patman, Elizabeth Skinner, Paul J. Young, Jennifer M. Zanni, Linda Denehy, Steven A. Webb

Physiotherapy Papers and Journal Articles

Introduction:

The aim of this study was to develop consensus recommendations on safety parameters for mobilizing adult, mechanically ventilated, intensive care unit (ICU) patients.

Methods:

A systematic literature review was followed by a meeting of 23 multidisciplinary ICU experts to seek consensus regarding the safe mobilization of mechanically ventilated patients.

Results:

Safety considerations were summarized in four categories: respiratory, cardiovascular, neurological and other. Consensus was achieved on all criteria for safe mobilization, with the exception being levels of vasoactive agents. Intubation via an endotracheal tube was not a contraindication to early mobilization and a fraction of inspired oxygen less than …

An Audit Of Antenatal Education Facilitated By Physiotherapists In Western Australian Public Hospitals, Judy Wilson, Richard G. Berlach, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

This paper reports on the delivery of antenatal education by physiotherapists in Western Australia in 2012, including the location of antenatal education providers, number of mothers attending, qualifications of physiotherapists involved, allocation of physiotherapy hours, the content of the education, and strategies used to enhance learning in the classes. A survey was emailed to the physiotherapists in 31 hospitals with maternity services that were funded by the Department of Health Western Australia. Antenatal education facilitated by a physiotherapist was provided at 25/30 (83.3%) hospitals. Four physiotherapists had postgraduate women’s health qualifications and all the antenatal education classes provided information about …

Achilles Tendinopathy Alters Stretch Shortening Cycle Behaviour During A Sub-Maximal Hopping Task, James R. Debenham, Mervyn J. Travers, William Gibson, Amity Campbell, Garry T. Allison

Physiotherapy Papers and Journal Articles

Objectives

To describe stretch shortening cycle behaviour of the ankle and lower limb in patients with Achilles tendinopathy (AT) and establish differences with healthy volunteers.

Design

Between-subjects case-controlled.

Methods

Fifteen patients with AT (mean age 41.2 ± 12.7 years) and 11 healthy volunteers (CON) (mean age 23.2 ± 6.7 years) performed sub-maximal single-limb hopping on a custom built sledge-jump system. Using 3D motion analysis and surface EMG, temporal kinematic (lower limb stiffness, ankle angle at 80 ms pre-contact, ankle angle at contact, peak ankle angle, ankle stretch amplitude) and EMG measures (onset, offset and peak times relative to contact) were …

Illusory Touch Temporarily Improves Sensation In Areas Of Chronic Numbness: A Brief Communication, Benedict Martin Wand, Samantha Eve Stephens, Effie Ida Marquita Mangharam, Pamela Jane George, Max Bulsara, Neil Edward O'Connell, G Lorimer Moseley

Physiotherapy Papers and Journal Articles

Background. Creating the visual illusion of touch can improve tactile perception in healthy subjects. Objective. We were interested in seeing if creating the illusion of touch in an insensate area could improve sensation in that area. Methods. Fourteen people with chronic numbness participated in a randomized crossover experiment. The 4 conditions were the following: (a) stimulation over the unaffected limb with mirror visual feedback (experimental condition), (b) stimulation over the affected limb with mirror visual feedback, (c) stimulation over the unaffected limb without mirror visual feedback, and (d) stimulation …

Moving In An Environment Of Induced Sensorimotor Incongruence Does Not Influence Pain Sensitivity In Healthy Volunteers: A Randomised Within-Subject Experiment, Benedict Wand, Lareina Szpak, Pamela J. George, Max Bulsara, Neil Edward O'Connell, G. Lorimer Moseley

Physiotherapy Papers and Journal Articles

Objectives: It has been proposed that in the same way that conflict between vestibular and visual inputs leads to motion sickness, conflict between motor commands and sensory information associated with these commands may contribute to some chronic pain states. Attempts to test this hypothesis by artificially inducing a state of sensorimotor incongruence and assessing self-reported pain have yielded equivocal results. To help clarify the effect sensorimotor incongruence has on pain we investigated the effect of moving in an environment of induced incongruence on pressure pain thresholds (PPT) and the pain experienced immediately on completion of PPT testing.

Methods: Thirty-five healthy …

Exploring The Role And Skill Set Of Physiotherapy Clinical Educators In Work Integrated Learning, Susan Edgar, Joanne Connaughton

Physiotherapy Papers and Journal Articles

Clinical educators are under increasing pressures in the workplace to provide quality education of healthcare students within varying supervision frameworks. Along with facilitating the teaching of clinical skills, clinical educators play a support role for students and so require more than expert clinical abilities in their vital position linking institutions and the healthcare environment. Twelve physiotherapy clinical educators attended one of two focus groups exploring their opinions on the role and skill set of clinical educators in work-integrated learning (WIL).Clinical educators described their role, their skills, challenges they faced supporting the needs of students, as well as future training requirements. …

Movement Restriction Does Not Modulate Sensory And Perceptual Effects Of Exercise-Induced Arm Pain, Markus Hubscher, Simon Tu, Tasha Stanton, G Lorimer Moseley, Benedict M. Wand, John Booth, James H. Mcauley

Physiotherapy Papers and Journal Articles

BACKGROUND:

Movement restriction has been proposed as an important modulator of changes in sensory and perceptual function and motor imagery performance that are observed in musculoskeletal pain syndromes. There are no empirical data to support this view.

PURPOSE:

The primary objective of this experiment was to determine the effects of movement restriction on local and widespread sensory, perceptual and motor imagery changes after exercise-induced muscular pain. Further objectives were to investigate whether changes in sensory perception are correlated with pain intensity and tactile acuity or motor imagery performance.

METHODS:

In forty healthy volunteers, delayed onset muscle soreness (DOMS) of the …