Physiotherapy Commons^™

Clinat: In Service To Athletic Training Scholarship, Lindsey Eberman, Matthew J. Rivera

Clinical Practice in Athletic Training

To be of service to others means to help others without expecting anything in return. The ClinAT, or Clinical Practice in Athletic Training journal, is an online, open-access outlet for the dissemination of practice-based research in health care, and a donation of time, effort, and energy to the profession of athletic training. In 2018, when Indiana State University created its first issue of ClinAT, we were a faculty of 3 with 5 PhD students supporting the journal, one of whom was wholly dedicated to the effort. As the higher education landscape has changed, and the roles and responsibilities of our …

Prevalence, Perceptions, And Attitudes Of Accommodation For Students With Disabilities In Athletic Training Education Programs, T J. Babcock, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Disability accommodation has been widely researched in healthcare education programs, including medical doctor (MD), doctor of osteopathy (DO), and physical therapy (PT). However, little research has been conducted on classroom and clinical education accommodation in athletic training education. The purpose of this study was to explore these settings and gain an understanding of student experiences with accommodation in athletic training education programs. This project was deemed exempt by Indiana State University’s Institutional Review Board. Methods: A cross-sectional 24-question survey was developed and adapted from prior qualitative research on accommodation in physical therapy education. Emails containing a link to the …

Enhancing Clinic Efficiency: A Quality Improvement Initiative For Postoperative Patient Care In An Outpatient Orthopedic Physician Practice Setting, D Stepan, T Jp Greffly, R M. Williams

Clinical Practice in Athletic Training

Introduction: Following orthopedic surgery, patient post-operative (post-op) visits are deemed global surgical observations where day 00 to day 90 are appointments that cannot be billed. Patients are typically seen 3 times during this global period. Thus, the outpatient clinic needs to have non-billable time slots each day for these patients. The current scheduling model double books patients every 15 minutes, with the physician being the primary provider seeing patients for post-op visits. Therefore, the clinic has demonstrated inefficiencies with scheduling these patients while having sufficient appointments available for billable patients. This quality improvement initiative aimed to decrease post-op patient visits …

Characteristics Of Athletic Trainers That Are Satisfied And Dissatisfied With Their Compensation, K Ef Mair, J P. Young, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Job satisfaction among athletic trainers (ATs), particularly in relation to compensation, is a critical factor influencing retention and career fulfillment. Examining the factors linked to earnings satisfaction may offer insight into how workplace conditions can be improved to better support ATs. The purpose of our study was to investigate the attributes that distinguish ATs content with their compensation from those who are dissatisfied. Methods: We used a cross-sectional, web-based survey to gather AT compensation data, of which 1,887 participants responded to a question regarding their satisfaction with compensation. Respondents were divided into two groups based on their satisfaction with …

The Financial Stresses That Affect Athletic Training Students: A Qualitative Investigation, C Kuehner-Boyer, E León Zaragoza

Clinical Practice in Athletic Training

Introduction: A recent survey examining barriers that affect athletic training students found that financial-related barriers created significant stress for students in professional athletic training programs. The need to work while attending a professional athletic training program was the highest reported barrier with 54.82% of respondents indicating that this was a barrier for them during their program. Beyond the overall reporting rate, the need to work while completing a professional athletic training program was indicated by athletic training students to be the barrier that they encountered the most frequently with respondents reporting that this was a stress for them between monthly …

Musculoskeletal Tumors Disguised As Orthopedic Injuries: A Case Report, A Summers

Clinical Practice in Athletic Training

Background: Musculoskeletal tumors are relatively rare, accounting for only 0.2 to 0.5% of all malignancies across all age groups. More specifically, Pigmented Villonodular Synovitis, a type of musculoskeletal tumor, has an incidence rate of 1.8 cases per one million people in a population. This benign, proliferative disease is a type of tenosynovial giant cell tumor that can affect the soft tissue lining of joints, bursae, and tendon sheaths. These joint-related tumors often present with an insidious onset and non-specific physical exam findings. Therefore, they are often mistaken for other, more common orthopedic injuries, making them difficult to diagnose. Patient Information: …

Strength Assessment Protocol In Pre-Professional Ballet Dancers, Simona Di Nardo, Ivan Mascio

Clinical Practice in Athletic Training

Purpose: This research project aimed to investigate the effects, particularly regarding the ability to generate force, that could emerge following a ballet class. The purpose of the study was to support the thesis that low levels of fitness and performance in professional and amateur dancers, should be considered a significant gap that needs to be addressed. Larger will be the gap and bigger will be the demand of a dancer to be prepared athletically. While the shorter the gap and more efficient the artistic side of the dance performance will be. As a result, a stronger and healthier body will …

Exploring Leadership In Physical Therapy: How Clarity, Connection, And Communication Influence Team Engagement, Burnout, And Achieving Organizational Objectives, Jason Collin

Dissertations

Purpose: The purpose of this mixed methods study was to identify and describe how highly effective PT leaders use the three competencies of HPTs (clarity, connection, and communication) to increase engagement, prevent burnout, and achieve organizational objectives. The second purpose of this study was to determine the degree of importance that highly effective PT leaders perceive the three HPTE core competencies impact their leadership for creating HPTs.

Methodology: The mixed methods study identified and described eight PT leaders’ perceptions of how they use clarity, connection, and communication to build and sustain HPTs. PT leaders were selected through purposive and snowball …

Exploring Vestibular Rehabilitation Self-Efficacy In Entry-Level Physical Therapy, Colin Hulls

Graduate Theses, Dissertations, and Capstones

Vestibular rehabilitation, commonly performed by physical therapists, aims to improve the function and quality of life of individuals experiencing dizziness, vertigo, or disequilibrium. Vestibular curricular variation across physical therapy programs may lead to discrepancies in the self-efficacy of entry-level physical therapists to manage this population. The purpose of this study was to examine self-efficacy in vestibular rehabilitation in entry-level physical therapy and identify facilitators and barriers to its development. An online, cross-sectional survey design was utilized for quantitative and qualitative data collection, including a modified version of the Physiotherapist Self-Efficacy (PSE) Questionnaire, from new graduates and students preparing to graduate. …

Physiotherapists' Knowledge Of Ageing And Its Associated Factors, Unyime Jasper, Olayinka Akinrolie, Cornelius Mahdi Ishaku, Nnamdi Mgbemena

Internet Journal of Allied Health Sciences and Practice

Purpose: To evaluate knowledge of ageing and its associated factors among Nigerian physiotherapists (PTs).

Methods: We used a three-part questionnaire. Knowledge of ageing was evaluated with Palmore’s Facts on Aging Quiz (FAQ). Certain questions in the FAQ were modified to reflect the local setting. We conducted a validity and reliability check on the questionnaire using test-retest with 10 PTs. Data were analysed using descriptive statistics, t-test, ANOVA and multiple linear regression.

Resullts: Out of 204 PTs invited, 186 agreed to participate. Test-retest of the FAQ revealed a Cronbach alpha of 0.78. The age of participants ranged from …

A Quasi-Experimental Study Examining The Effects Of A Proprioceptive Rehabilitation Protocol For The Cervical Spine On Balance And Function Using A Laser Head Light In Older Community Dwelling Individuals, Vern M. Swanson Jr., M. Samuel Cheng, Leah Nof, Eric Shamus, Phd

Internet Journal of Allied Health Sciences and Practice

Purpose: Falls continue to be a major health issue when considering health risks for older individuals. The multi-factorial nature of falls in older adults leads to an overwhelming number of causal factors. Cervical joint position sense and joint position error could be additional factors that could influence the fall risk of older individuals. This research examined the effects of a proprioceptive rehabilitation protocol for the cervical spine using a laser head set in older community dwelling individuals. Methods: Sixty (60) subjects were purposively assigned into an experimental and a control group. Control group subjects were given a general lower extremity …

Prevalence Of Burnout Among Doctor Of Physical Therapy Faculty, Liana Wooten, Kim Dao, Melissa Burgemeister, Angela Spontelli Gisselman

Internet Journal of Allied Health Sciences and Practice

Objective: Growing numbers of physical therapy (PT) educational programs (PTEPs) creates a challenge in recruiting and retaining faculty, potentially having negative ramifications for PT education. Burnout may be contributory as it has known physiological, psychological, and behavioral consequences in numerous clinical and academic populations, creating widespread negative outcomes. This study aimed to investigate burnout prevalence among PT faculty. Methods: Eligible participants, including current full and part-time PTEP faculty members in the United States with emails listed on public-facing program websites, were emailed study information and a link to the consent and survey. Consenting participants completed a Qualtrics survey consisting of …

Development And Validation Of A Home-Based Exercise Program Integrated With Patient Education Based On The Health Belief Model For Patients With Type 2 Diabetes Mellitus, Amirah Mustapa, Alia Alghwiri, Haidzir Manaf

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to develop and validate a comprehensive approach that integrates an exercise routine with patient education based on the health belief model (HBM) approach to promote effective exercise in this population. Method: A 3-phase study was conducted. In Phase I, two comprehensive scoping reviews were performed to develop the program. An initial draft of the program consisted of exercise protocols and HBM-based education. In Phase II, nine experts were chosen to further develop and refine the program’s content by providing feedback and validating it using the content validity index (CVI) and the Patient Education …

Modified Shuttle Walk Test In Chronic Health Conditions: A Literature Review, Manish Prannath Shukla, Gaurav Chhabra, Ashish Shankarrao Deshmukh Dr

Internet Journal of Allied Health Sciences and Practice

Background: The Modified Shuttle Walk Test (MSWT) is widely utilized to assess exercise capacity across various chronic health conditions. This literature review synthesizes evidence from studies evaluating the MSWT's reliability, validity, and clinical applicability in conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, sarcoidosis, obesity, hypertension, and asthma. Methods: A systematic search was conducted across electronic databases for studies published between 2006 and 2022. Eligible studies were assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Data extraction focused on study objectives, methods, participants, outcomes, and quality assessment. Results: Eleven studies met the inclusion criteria. The MSWT demonstrated …

Physical And Perceived Effects Of The Menstrual Cycle On Female Athletes, Talia E. Casarella, Alyssa M. Quiteles, Emily E. Liddick, Madelyn R. Swarthout, Rebecca J. Turner

Student Research Poster Presentations 2025

Purpose: The purpose of this study was to understand the physical and perceived effects of the menstrual cycle on female athletes’ performance during training and competition.

Hypothesis: The researchers hypothesized that there would be a significant difference in performance based on the phase of the menstrual cycle.

Methods: This study used EBSCO Academic Search Complete and Science Direct, focusing on peer-reviewed articles from the last 10 years. Search terms included: (exercise or physical fitness or physical activity) AND (menstrual cycle or period or menstruation or menses or follicular phase or luteal phase) AND (female athletes or women athletes or athletic …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Leveraging Deep Learning For The Automated Detection Of Hemophilic Arthropathy In Knee Radiographs, En-Wei Lin, Edzer Wu, Ming-Ching Shen, Shao-Li Han

Rehabilitation Practice and Science

Background/Purpose:

Hemophilic arthropathy (HA) is a progressive joint disease caused by recurrent hemarthroses in patients with hemophilia. Early radiographic identification of HA is critical for timely intervention and long-term joint preservation. This study aimed to develop and evaluate deep learning models for automated detection of HA in knee radiographs.

Methods:

A retrospective dataset of 849 knee radiographs (AP and lateral views) was used to train three convolutional neural networks: ResNet-34, DenseNet-121, and EfficientNet-B0. Model performance was assessed using standard classification metrics, including accuracy, precision, recall, F1-score, and AUC. Interpretability was evaluated using Grad-CAM heatmaps.

Results:

DenseNet-121 achieved balanced performance on …

Modified Constraint-Induced Movement Therapy After Stroke: A Process Evaluation Of Implementation In An Early-Supported Discharge Rehabilitation Service, Ashan Bimalka Weerakkody

Theses: Doctorates and Masters

Background

Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) function after stroke, but its routine delivery in rehabilitation settings remains limited.

Aims

The objectives were to determine the feasibility, acceptability, and sustainability of implementing mCIMT within an early-supported discharge (ESD) rehabilitation service, using existing resources and staffing.

Aims were to:

• Develop and deliver a multi-modal behaviour change intervention to clinicians to increase mCIMT delivery.
• Explore the acceptability of mCIMT among stroke survivors, carers, therapists, and allied health managers.
• Identify program adaptations to better suit stakeholder needs.
• Evaluate the process of implementing mCIMT in the ESD service.

Methods

This thesis …

Eccentric-Emphasis Exercise Program For Supraspinatus Partial Tear In Retired Police Officer An Intervention Case Report, German Eduardo Isea Fernandezx

Capstone Showcase

Abstract

Background and Purpose: Eccentric exercise has been shown to reduce pain in patients with multiple comorbidities, orthopedic surgeries, and neurologic conditions, while providing safety for greater loading during resistance training. The purpose of this case report is to describe changes in function and pain of a patient with a partial rotator cuff tear, following rehabilitation exercises focusing on eccentric action.

Case Description: A 65 y/o retired police male officer who presented right shoulder pain secondary to a partial tear of the supraspinatus tendon. The case reported mild to severe pain under the visual analog scale (VAS) of 75mm that …

Functional Recovery Of A Patient In Her Home Environment Following A Stroke Using Proprioceptive Neuromuscular Facilitation And Task-Specific Training: A Case Report, Andrea L. Crawford-Perry

Capstone Showcase

Abstract Background and Purpose: Stroke is a growingly common disability that affects an individual’s bodily function, activity and participation levels and thus impacts the whole livelihood of that individual. Proprioceptive Neuromuscular Facilitation (PNF) and Task-specific Training have been shown to improve the overall functional recovery of a patient and affect neuroplasticity. Most studies tend to compare the individual effect of these techniques; hence the purpose of this case report is to describe how both PNF and task-specific training are used to improve the functional recovery of a patient in her home environment following an acute stroke. Case Description: The patient …

Unveiling The Role Of The Suprascapular Nerve In Painful Shoulder: A Narrative Review With A Focus On Ultrasound-Guided Diagnosis And Intervention, Hong Hong, Wei-Ting Wu, Ke-Vin Chang

Rehabilitation Practice and Science

Suprascapular nerve disorders are a significant yet often underdiagnosed cause of shoulder pain and dysfunction, stemming from the nerve's critical role in shoulder stability and mobility through its innervation of the supraspinatus and infraspinatus muscles. This review explores the anatomy and clinical relevance of the suprascapular nerve, highlighting the need for accurate diagnosis in cases of pain, weakness, or functional impairment that mimic other shoulder conditions. Among diagnostic modalities, ultrasound has become a vital tool, providing real-time imaging to precisely assess nerve compression or damage. Its utility extends to therapy, with recent advancements in ultrasound-guided interventions—such as nerve blocks, corticosteroid …

Hemiplegic Shoulder Pain: A Narrative Review, Yeh-Kai Liao, Chueh-Hung Wu, Levent Özçakar

Rehabilitation Practice and Science

Hemiplegic shoulder pain is a common post-stroke complication that negatively affects functional recovery. It is caused by both mechanical and neurological factors. Prevention focuses on proper positioning, patient education, and maintenance of motion. Treatment remains largely conservative; with increasing research surrounding injection therapies, including intra-articular corticosteroid injection, subacromial hyaluronic acid injection, suprascapular nerve blocks, and botulinum toxin injection, all of which have demonstrated improved pain control. Functional electrical stimulation appears to be beneficial, and adjunct therapies such as supportive devices and robotic training may further enhance conventional treatment. Herewith, evidence regarding medications and acupuncture remains limited. Emerging treatments including high-intensity …

Current Injection Treatment For Adhesive Capsulitis, A Narrative Review, Laurence Roy-Bélanger, Tian Yue Ding, Édouard Marcoux, Mathieu Boudier-Revéret

Rehabilitation Practice and Science

This narrative review outlines the current practices related to ultrasound-guided (USG) injection treatments for adhesive capsulitis (AC), including injection sites, approaches, medications, and doses.

USG procedures are increasingly accessible for AC, offering diverse injection approaches and medication dosing. Given the methodological variations in existing studies, a summary of current practices is essential. We conducted a narrative review of recent literature retrieved from computerized databases.

Glenohumeral (GH) and coracohumeral ligament (CHL) injections may improve outcomes for AC, with some evidence suggesting potential benefits of targeting the CHL. Subacromial bursa injections alone appear to be less effective. Multi-site injection techniques show promising …

Axillary Web Syndrome Following Breast Cancer Surgery: A Review Of Current Literature, Christina Soong, Tyng-Guey Wang, Shaw-Gang Shyu

Rehabilitation Practice and Science

Axillary web syndrome (AWS), a complication primarily following breast cancer surgeries involving axillary lymph node dissection (ALND), presents as painful cords extending from the axilla, impairing shoulder mobility and potentially delaying cancer treatment. This review consolidates existing knowledge on AWS, covering its clinical presentation, risk factors, pathophysiology, and management strategies. AWS typically arises within weeks post-surgery but may develop later, manifesting as fibrous cords that hinder arm movement. Diagnosis relies primarily on clinical examination, and the reported incidence varies significantly across different populations and study designs. Risk factors include ALND, younger age, low body mass index, and adjuvant therapies. The …

Multidisciplinary Approach To Managing Hypotonia And Developmental Delays Due To A Novel Gtpbp3 Mutation, Fan Mei, Ru-Lan Hsieh

Rehabilitation Practice and Science

Introduction: Hypotonia in early life is often challenging to diagnose due to its diverse etiologies, with genetic disorders accounting for about one-third of cases. A precise diagnosis using a comprehensive, multidisciplinary approach is crucial for determining prognosis, guiding treatment, and providing genetic counseling.

Case Presentation: We report the first case in Taiwan involving compound heterozygous mutations in the GTPBP3 gene. A 13-month-old girl presented with developmental delays and hypotonia despite normal prenatal screenings and a year of rehabilitation therapy. Next-generation sequencing revealed two novel mutations: c.785A>C (p.Gln262Pro), a missense mutation in Exon 5, and c.1175_1181dup (p.Ser395GlufsTer4) …

Principles And Practices Of Selecting Screening Tools For Oropharyngeal Dysphagia: A Narrative Review, Yu-Hsuan Lai, Tyng-Guey Wang, Nai-Hsin Meng

Rehabilitation Practice and Science

Oropharyngeal dysphagia is a potentially life-threatening condition, particularly affecting individuals with neurological diseases, head and neck cancers, and age-related issues. Its prevalence in the general population ranges from 2.3% to 16%, with much higher rates among patients with stroke, Parkinson’s disease, and traumatic brain injury. Dysphagia is prevalent in geriatric and long-term care settings, where over 50% of elderly residents may experience swallowing difficulties. Given its high prevalence and serious consequences, early detection through dysphagia screening in at-risk populations is essential. Since the 1990s, numerous screening tools for dysphagia have been developed, with over 160 non-instrumental tools identified in review …

Ambulation Challenges Post High-Voltage Electrical Burn Involving Three Extremities, Complicated With Osteomyelitis: A Case Report, Chiang-Hui Huang, Katie Pei-Hsuan Wu

Rehabilitation Practice and Science

High-voltage electrical burns in occupational settings can leave detrimental injuries with immediate impact and long-term sequel. Despite extensive literature on the injury mechanism, comprehensive long-term rehabilitation descriptions for such devastating cases remain scarce. This report presents a significant traumatized high-voltage electrical injury involved three out of four extremities. A late complication with extensive tibial osteomyelitis affecting two-thirds of the bone severely compromised the patient’s ambulation potential, emphasizing the importance of segmental rehabilitation with progressive tolerance in ambulatory weight-bearing. We evaluated the patient’s physical, mental, and social component using Barthel Index, Veterans RAND 12-Item Health Survey (VR-12), and Patient-Reported Outcomes Measurement …

Clinical Application Of Intraoperative Neurophysiological Monitoring During Detethering Surgery Of A Newborn: A Case Report, Mu-Yun Lin, Hsin-Hung Chen, Tsui-Fen Yang

Rehabilitation Practice and Science

Background:

Tethered cord syndrome (TCS) is a rare congenital condition that causes abnormal tension on the spinal cord and often requires early surgical intervention to prevent progressive neurological and orthopedic deficits. However, performing detethering surgery in neonates presents unique challenges due to their immature neural pathways, which complicate intraoperative neuromonitoring (IONM).

Case Description:

We report the case of a 13-day-old neonate with TCS who underwent successful detethering surgery under advanced IONM. Double-train stimulation with a linked quadripolar montage was employed to elicit motor evoked potentials (MEPs), overcoming the challenge of monitoring immature corticospinal tracts. Additionally, subdural strip electrodes were used …

Late-Onset Sciatic Nerve Compression Due To Distal Femoral Osteochondroma, I-Fan Hsieh, Tian-Shin Yeh

Rehabilitation Practice and Science

Osteochondroma is one of the most common benign bone tumors, typically asymptomatic, and rarely causes nerve compression. Previous case reports documented nerve compression by osteochondroma arising from the proximal fibula, pelvic bone, and spine. We report a rare case of osteochondroma at the distal femur causing sciatic nerve compression with symptom onset at 42 years old. This case highlights that osteochondroma can develop at any skeletal location, and even though these lesions typically cease to grow after skeletal maturity. Individuals with a history of osteochondroma should consider it as a differential diagnosis for new symptoms even in older age to …

Dysphagia In Becker Muscular Dystrophy: A Case Report And Literature Review, Chien-Ping Chen, Hung-Jui Chuang, Yi-Chi Li, Ming-Yen Hsiao, Tyng-Guey Wang

Rehabilitation Practice and Science

Dysphagia is a recognized complication in patients with muscular dystrophies, but its characteristics in Becker muscular dystrophy (BMD) remain underexplored. This case report describes a man with BMD who developed dysphagia, initially presenting with mild symptoms but later experiencing aspiration pneumonia with respiratory failure. He regained safe oral intake after swallowing training. Three years later, he suffered worsening dysphagia following a severe coronavirus disease-2019 (COVID-19) infection, ultimately losing the ability to resume oral feeding despite months of rehabilitation. Literature on swallowing disorder in BMD reported poor mastication, reduced laryngeal elevation, and increased pharyngeal residue; however, silent aspiration, as observed in …