Translational Medical Research Commons^™

Standardized Total Fitness Scores And Phase Angle In Cancer Survivors, Paulette Yamada, Trevor Short

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 4: Issue 1, Article 20, 2023. Cancer treatment can lead to decrement in all components of fitness. Exercise can attenuate these effects and build fitness. Exercise program design for this population continues to evolve with high-intensity interval training at the forefront. Phase angle (PhA) is an indirect measure of cellular health and function and is associated with fitness, health, and reduced disease severity. Continued exploration spurs an emerging question: What type of training should be used to maximize improvements in PhA? We provide a visualization of a cancer rehabilitation fitness profile and present …

Sex And Gender Differences In Arthritis Health Information, Tania Al-Jilawi

Electronic Thesis and Dissertation Repository

Arthritis is a common disorder that may result in pain and inflammation, making it challenging to move or continue being active. Arthritis comes in a variety of forms. The two studies of this thesis aimed to identify the influence of intersectionality, especially sex and gender, in arthritis. The first study, a structured review, evaluated the inclusion of sex/gender and intersectional identities in patient resources of three arthritis societies: the Canadian Arthritis Society, the American Arthritis Foundation, and the National Rheumatoid Arthritis Society. The appraisal tool, the Sex/Gender and Intersectional Considerations in Patient/Consumer Health Information Appraisal Tool was used to evaluate …

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

Apoe4, Age, And Sex Regulate Respiratory Plasticity Elicited By Acute Intermittent Hypercapnic-Hypoxia, Jayakrishnan Nair, Joseph F. Welch, Alexandria B. Marciante, Tingting Hou, Qing Lu, Emily J. Fox, Gordon S. Mitchell

Department of Physical Therapy Faculty Papers

Rational

Acute intermittent hypoxia (AIH) shows promise for enhancing motor recovery in chronic spinal cord injuries and neurodegenerative diseases. However, human trials of AIH have reported significant variability in individual responses.

Objectives

Identify individual factors (eg, genetics, age, and sex) that determine response magnitude of healthy adults to an optimized AIH protocol, acute intermittent hypercapnic-hypoxia (AIHH).

Methods

In 17 healthy individuals (age = 27 ± 5 yr), associations between individual factors and changes in the magnitude of AIHH (15, 1-min O2 = 9.5%, CO2 = 5% episodes) induced changes in diaphragm motor-evoked potential (MEP) amplitude and inspiratory mouth occlusion pressures …

Immobilization And Its Effects On Functional Recovery After Spinal Cord Injury., William H. Gregory

College of Arts & Sciences Senior Honors Theses

Recovery, or rather the failure to recover, is a perplexing issue of spinal cord injury that is currently being investigated. This issue becomes more puzzling when investigating models in which spinal cord injury (SCI) is studied. There appears to be greater functional recovery experienced by animals within these models after injury as compared to patients in the clinical setting. While many things could contribute to this disparity, one difference that stands out when comparing the basic research model and clinical experience of SCI is the inactivity and limb disuse after the injury. This same level of immobility is rarely accounted …

Effectiveness Of Vacuotherapy And Dry Needling As Adjunct Treatment For Musculoskeletal Cases: A Cohort In A Pt Clinic., Adnan N. Balisi, Vince Paul Lobaton, Dane Debulgado, Jhonas Jegira, Mae Adrinne Tumonong, Christian James Brillas, Ritchie Belle Gelito, Mychelle Rae Marasigan

Philippine Journal of Physical Therapy

Introduction: Usage of vacuum therapy and dry needling in physical therapy management of musculoskeletal cases have gained increasing usage but the literature regarding their effects is limited. This study determines the effect size of the interventions, which are vacuotherapy and dry needling as adjunct treatments to exercises, performed in a local PT clinic to musculoskeletal cases in three different treatment sessions with a week gap in between.

Methods: The study is a retrospective cohort where sampling was purposive in gathering historical patient charts. The numerical pain rating scales and relevant range of motion (ROM) in the musculoskeletal cases …

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …

Renal Replacement Therapy Could Be Initiated In Patients With Severe Aki, Regardless Of Age And Critical Condition, El Hussain Shamsa

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Meersch M, Küllmar M, Schmidt C, et al. Long-Term Clinical Outcomes after Early Initiation of RRT in Critically Ill Patients with AKI. J Am Soc Nephrol. Mar 2018;29(3):1011-1019. https://doi.org/10.1681/asn.2017060694

for a critically ill elderly patient with severe acute kidney injury.

Contributions Of Asymmetry And Instability To Transfer And Retention Following Locomotor Adaptation, Daniel L. Gregory

Doctoral Dissertations

Gait asymmetry resulting from neurological injury is more costly and less stable than healthy gait. Split-belt treadmills, which drive limbs at different speeds, lead to spatial and temporal gait asymmetries, and perturb walking balance, have been used to study locomotor adaptability and learning related to asymmetry and stability. This knowledge may be leveraged to design more effective rehabilitation protocols. In experiment 1, we asked how constraining stride-rates away from preferred during split-belt walking influences learning revealed in a retention test. We found that constraints to stride rate during asymmetric walking uncovered the capacity to leverage redundant degrees-of-freedom for walking control, …

Introducing A Physical Therapist-Led Acceptance And Commitment Therapy Training For Pain: A Clinical Perspective, Joseph Tatta

Internet Journal of Allied Health Sciences and Practice

Purpose: Mounting evidence supports the use of cognitive and behavioral techniques as part of physical therapist practice. These methods are used within a physical therapist’s multimodal treatment approach for the management of pain and to facilitate health behavior change. There is a multitude of evidence-based cognitive behavioral techniques to choose from including newer approaches based on Acceptance and Commitment Therapy. Yet few studies have examined physical therapists’ perceptions to learning and implementing ACT into clinical practice. The purpose of this manuscript is to present a clinical perspective of physical therapists learning about and incorporating Acceptance and Commitment Therapy in clinical …

Development And Application Of 3d Kinematic Methodologies For Biomechanical Modelling In Adaptive Sports And Rehabilitation, Anne Marie Severyn

All Dissertations

Biomechanical analysis is widely used to assess human movement sciences, specifically using three-dimensional motion capture modelling. There are unprecedented opportunities to increase quantitative knowledge of rehabilitation and recreation for disadvantaged population groups. Specifically, 3D models and movement profiles for human gait analysis were generated with emphasis on post-stroke patients, with direct model translation to analyze equivalent measurements while horseback riding in use of the alternative form of rehabilitation, equine assisted activities and therapies (EAAT) or hippotherapy (HPOT). Significant improvements in gait symmetry and velocity were found within an inpatient rehabilitation setting for patients following a stroke, and the developed movement …

Facilitating Aging In Place And Community By Empowering Participation In Society: A Mixed Methods Study On The Co-Development Of A Theory Of Change With Suburban-Dwelling Older Adults, Emily Balog

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Baby boomers are steadily aging in America and represent an increased population in nearly every sector. In suburban communities today, older adults make up 51% of the population. Ninety-five percent of all older adults live in community settings and have expressed a desire to avoid costly institutionalization and to remain in their homes and communities, also called aging in place. Older adults in moderate income suburban communities are increasingly at a higher risk for institutionalization should their health or finances decline as the access to their wealth is within the home in which they dwell. This process …

Neuroplasticity Of The Corticospinal System: Applications Of Neuromodulation-Based Therapies, Alzahraa M. Amer

Dissertations, Theses, and Capstone Projects

The motor cortex and corticospinal tract are necessary for producing skilled movements. I use intermittent theta burst stimulation (iTBS), a high-frequency stimulation protocol known to promote neural plasticity, as a tool to characterize short- and long-term plasticity of the CS system.

Although it is well known that activity-dependent motor cortex (MCX) plasticity produces long-term potentiation (LTP) of local cortical circuits, leading to enhanced motor evoked potentials (MEPs), the effects produced by the corticospinal (CS) projection on spinal cord neurons have not yet been thoroughly studied. In Chapter 2, I determined if the CS tract (CST) is capable of producing LTP …

Intermittent Theta Burst Stimulation: Application To Spinal Cord Injury Rehabilitation And Computational Modeling, Neil Mittal

Theses and Dissertations

Loss of motor function from spinal cord injuries (SCI) results in loss of independence. Rehabilitation efforts are targeted to enhance the ability to perform activities of daily living (ADLs), but outcomes from physical therapy alone are often insufficient. Neuromodulation techniques that induce neuroplasticity may push the limits on recovery. Neuromodulation by intermittent theta burst transcranial magnetic stimulation (iTBS) induces neuroplasticity by increasing corticomotor excitability, though this has most frequently been studied with motor targets and on individuals not in need of rehabilitation. Increased corticomotor excitability is associated with motor learning. The response to iTBS, however, is highly variable and unpredictable, …

Validation Of An Inertial-Measurement-Unit System For Calculating Hip And Knee Flexion Angles During Gait, Joonsun Park

Master's Theses

Technological advances regarding Inertial Measurements Units (IMUs) have positioned this type of sensor as an alternative for camera-based motion capture. This study introduces a new IMU based system (IMU_sys) to measure hip and knee flexion angles. PURPOSE: To validate the use of a five-sensor IMU_sys for the measurement of knee and hip flexion angles during gait in adults and pediatrics at two different time points. METHODS: Bilateral hip and knee flexion patterns (LH, RH, LK, and RK) of twenty-two healthy participants (12 adults and 10 pediatric) between the ages of 8 – 35 years were investigated. Participants …

The Symbiome Project: An Exploratory Investigation Of The Biological, Psychological, And Social Mechanisms That Contribute To The Transition From Acute To Chronic Musculoskeletal Pain, Joshua Y. Lee

Electronic Thesis and Dissertation Repository

This dissertation presents the initial findings of the SYMBIOME project; which attempts to combine the objective and subjective aspects of musculoskeletal pain to develop a prognostic clinical phenotype. Chapter 2 presents a moderator analysis of functional outcomes (pain interference and pain severity). Psychosocial moderators can affect the relationship between biomarkers and pain. For pain severity, TNF-α, TGF-β1, and CRP were moderated by employment status, pre-existing psychopathology, and sex. For pain interference, IL-1β, cortisol, TGF-β1, CRP, and IL-6 were moderated by pre-existing pain, peri-traumatic fear, region of injury, and peri-traumatic stress. Chapter 3 presents a latent growth curve analysis in determining …

Effects Of Rocking On Attention And Arousal, Jonathan Lubeck, Roseann C. Schaaf, Phd, Otr/L, Faota, Rachel L. Dumont, Ms, Ots

Phase 1

Introduction: Difficulties regulating attention and arousal underlie common developmental conditions and impact performance in academic and work tasks. Sensory-based activities such as sitting in a rocker chair may help regulate attention and arousal by providing sensory stimulation. This pilot study assessed autonomic nervous system activity (ANS) while seated in a specially designed rocking chair providing vestibular sensation during a performance task.

Methods: Thirty-four adults (aged 20-35 years) were randomized to either a rocker chair (Virco Zuma, n = 17) or static chair (n =17) while performing cognitive tasks in a counterbalanced design. ANS measures of skin conductance level (SCL) …

Biomarkers Of Inflammation In Heart Failure Patients With Reduced And Preserved Ejection Fractions: Multi-Ethnic Study Of Atherosclerosis, Michelle Lynne Stone

UNF Graduate Theses and Dissertations

Purpose Examine the relationships between high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and soluble tumor necrosis factor-α receptor-1 (sTNF-R1) and the cumulative risk of heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fractions in a diverse, population-based sample. Methods Study sample included 6,814 adult (45-84 years of age) men and women who participated in the Multi-Ethnic Study of Atherosclerosis and were free of cardiovascular disease at baseline. Cox regression was used to calculate the hazard ratios (HR) associated with elevated baseline hs-CRP (> 3-10 mg/L), IL-6 (> 75^th percentile) and sTNF-R1 (> 75^th percentile) and risk of overall …

Knee Joint Loading Following Anterior Cruciate Ligament Reconstruction: Link To Patient Reported Outcomes And A Novel Method To Monitor With Wearable Sensors, Alex Spencer

Theses and Dissertations--Kinesiology and Health Promotion

Recovery from anterior cruciate ligament reconstruction (ACLR) commonly results in undesirable physical and patient-reported outcomes (PROs). Identification of modifiable factors such as knee contact force (KCF) early in rehabilitation that can improve these outcomes is important due to the rapid decrease in function, quality of life, and joint health in this population. Additionally, if noninvasive measurement of KCFs outside of a traditional laboratory were possible, clinicians could optimize patient treatment with personalized care. Therefore, there are two primary aims to this thesis: 1) quantify the link between KCF and PROs which measure pain, ability to perform activities of daily living, …

Outcomes Of Formalized Physical Therapy Vs. Self-Directed Home Exercise, Thomas Lee, Daniel Bowles

Phase 1

Introduction: After a formal microdiscectomy or 1-2 level anterior cervical discectomy and fusion (ACDF) there exists a lack of consensus on effectiveness of postoperative formal physical therapy (PT) rehabilitation efficacy. We seek to determine whether home PT is equivalent to standard PT using patient reported outcomes measures (PROMs) after the aforementioned operations.

Methods: This study is a prospective single center cohort study. The inclusion criteria is patients undergoing a microdiscectomy or ACDF operation excluding patients under 18, infection, trauma, tumor, or revision. Outcomes are measured using PROMs specific for each operation.

Results: Preliminary data suggests that post-operative …

Comparison Of Home Therapy Vs Formal Outpatient Physical Therapy In Post-Operative Management Of Two-Incision Distal Bicep Tendon Repair, Joseph Botros, John Horneff Iii, Md, Thomas Harper, Brent Page

Phase 1

Background: Distal bicep tendon tears are a relatively uncommon injury, affecting 1.2/ 100,000 persons per year; they can also cause substantial loss in supination and flexion strength. The most common treatment is a double incision distal bicep tendon repair, which involves surgical reinsertion of the bicep tendon onto the radial tuberosity. Following surgery, physicians have traditionally recommended the patient undergo 5-12 weeks of formal outpatient physical therapy. This can be a significant cost and time burden to the patient. Therefore, some physicians have instead opted for home physical therapy, in which the patient is given instructions on exercises to complete …

An Intervention With Dance And Yoga For Girls With Functional Abdominal Pain Disorders (Just In Time): Protocol For A Randomized Controlled Trial, Anna Philipson, Stefan Särnblad, Lars Ekstav, Mats Eriksson, Ulrika L. Fagerberg, Margareta Möller, Evalotte Mörelius, Anna Duberg

Research outputs 2014 to 2021

©Anna Philipson, Stefan Särnblad, Lars Ekstav, Mats Eriksson, Ulrika L Fagerberg, Margareta Möller, Evalotte Mörelius, Anna Duberg. Background: Functional abdominal pain disorders (FAPDs) affect many children worldwide, predominantly girls, and cause considerable long-term negative consequences for individuals and society. Evidence-based and cost-effective treatments are therefore strongly needed. Physical activity has shown promising effects in the practical management of FAPDs. Dance and yoga are both popular activities that have been shown to provide significant psychological and pain-related benefits with minimal risk. The activities complement each other, in that dance involves dynamic, rhythmic physical activity, while yoga enhances relaxation and focus. Objective: …

Amantadine Minimally Improves Arousal In Patients With Severe Traumatic Brain Injury, Michelle Eventov

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Giacino JT, Whyte J, Bagiella E, et al. Placebo-Controlled Trial of Amantadine for Severe Traumatic Brain Injury. New England Journal of Medicine. 2012;366(9):819-826. doi: 10.1056/nejmoa1102609.

The Effect Of Arm Swing On Countermovement Vertical Jump Performance, Arash Mohammadzadeh Gonabadi

UNO Student Research and Creative Activity Fair

Vertical jumping is one of the popular ways to evaluate ankle-knee efficiency in athletic population. Arm swing can play a crucial role in enhancing vertical jump performance. This study aimed to address the differences in kinetic and kinematic parameters during countermovement jump motion with arm swing (AS) and no arm swing (NAS). We used OpenSim to examine the efficacy of AS in reducing the impulse applied to the body and changes in range of lower limb joint angles at landing instant. We calculated the maximum vertical peak of the ground reaction force and impulse generated at landing in two different …

The Development And Evaluation Of Resources To Improve The Quality Of Care For Patients With Knee Osteoarthritis, Laura K. Churchill

Electronic Thesis and Dissertation Repository

Purpose: The non-operative management of patients with knee osteoarthritis (OA) is often considered suboptimal. Sub-optimal management includes inadequate use of non-surgical treatments, misuse of diagnostic imaging, and non-operative referrals to surgeons in consideration of total knee replacement (TKR). These inefficiencies result from an interplay of factors involving primary care physicians, patients, and the systems in which they function. The overall purpose of this thesis is to develop a means to optimize the management of patients with knee OA, and the timing and quality of referrals to TKR.

Methods: This thesis includes three studies. In study 1, we identified and cross-validated …

A Brain-Computer Interface For Closed-Loop Sensory Stimulation During Motor Training In Patients With Tetraplegia, Sarah Helen Thomas

Theses and Dissertations--Biomedical Engineering

Normal movement execution requires proper coupling of motor and sensory activation. An increasing body of literature supports the idea that incorporation of sensory stimulation into motor rehabilitation practices increases its effectiveness. Paired associative stimulation (PAS) studies, in which afferent and efferent pathways are activated in tandem, have brought attention to the importance of well-timed stimulation rather than non-associative (i.e., open-loop) activation. In patients with tetraplegia resulting from spinal cord injury (SCI), varying degrees of upper limb function may remain and could be harnessed for rehabilitation. Incorporating associative sensory stimulation coupled with self-paced motor training would be a means for supplementing …

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Selective Generation Of Dopaminergic Precursors From Human Fibroblasts By Direct Lineage Conversion, Miao He

Theses & Dissertations

Transplantation of dopaminergic precursors (DPs) is a promising therapeutic strategy of Parkinson’s disease (PD). However, limited cell source for dopaminergic precursors has become a major obstacle for transplantation therapy. In the first part of the study, we demonstrated that Foxa2 is superior to Lmx1a in inducing dopaminergic neuronal differentiation from induced neural progenitor cells (iNPCs). Based on the results above and some other published results, our group demonstrated that mouse fibroblasts can be reprogrammed into induced dopaminergic precursors (iDPs) through ectopic expression of transcription factors Brn2, Sox2 and Foxa2(1). In the current study, we hypothesized that similar strategy …

Development Of Health Rehabilitation In Mainland China: From Traditional Chinese Medicine To Modern Western Rehabilitation Methods, Michelle Moy

Independent Study Project (ISP) Collection

The aim of this study is to understand the changes occurring in China, leading to the development of health rehabilitation. This study will portray the shift of traditional Chinese medicine to modern influences of Western rehabilitation, and will also introduce the idea of an integrated model of TCM and Western Rehabilitation.

Observations were held at a TCM hospital, a rehabilitation hospital, as well as a TCM hospital that provided modern rehabilitation services. Two online questionnaire surveys were sent out to rehabilitation health professionals working in mainland China, one of which collected quantitative data while the other collected both qualitative and …

Design And Analysis Of A 3d-Printed, Thermoplastic Elastomer (Tpe) Spring Element For Use In Corrective Hand Orthotics, Kevin Thomas Richardson

Theses and Dissertations--Mechanical Engineering

This thesis proposes an algorithm that determine the geometry of 3D-printed, custom-designed spring element bands made of thermoplastic elastomer (TPE) for use in a wearable orthotic device to aid in the physical therapy of a human hand exhibiting spasticity after stroke. Each finger of the hand is modeled as a mechanical system consisting of a triple-rod pendulum with nonlinear stiffness at each joint and forces applied at the attachment point of each flexor muscle. The system is assumed quasi-static, which leads to a torque balance between the flexor tendons in the hand, joint stiffness and the design force applied to …