Investigative Techniques Commons^™

Exercise Induced Laryngeal Obstruction In A Collegiate Runner: A Case Report Of A Novel Therapy, Cody Inskeep, Todd Olin, Robert Arthur

Clinical Practice in Athletic Training

A 23-year-old male Division I distance runner presented with several years of exertional stridor (high-pitched inspiratory noise caused by airflow obstruction), previously diagnosed as exercised-induced laryngeal obstruction (EILO), a condition formerly known as vocal cord dysfunction and exercised-induced paradoxical vocal fold motion. Over the course of roughly 3 years, the patient had previously failed conventional and invasive respiratory therapies for EILO including respiratory retraining, inspiratory muscle training, reflux suppression, allergy suppression, amitriptyline, performance psychology, and injection of botulinum toxin to the larynx. At a referral center that specializes in the treatment of EILO, the patient's diagnosis was confirmed through the …

Graston Technique® As A Treatment For Patients With Chronic Plantar Heel Pain, Troy R. Garrett, Peter J. Neibert

Clinical Practice in Athletic Training

Use of Instrument-Assisted Soft Tissue Massage has increased in popularity, and the plantar fascia is a superficial tissue that may benefit from this treatment. The objective of this study was to determine the effectiveness of Graston Technique® (GT) for decreasing pain and increasing function in participants with chronic plantar heel pain over a six-week period. A single blind, pretest-posttest control/comparison group design, with a sample of 22 adults (5 males, 17 females) was utilized. Participants were assigned to three groups: GT/stretching, effleurage/stretching, and stretching only. After completion, effleurage/stretching and stretching only groups were later offered GT with posttest scores recorded. …

Treatment Of Scapular Dyskinesis With Reflexive Neuromuscular Stimulation: A Case Report, Alli Z. Powell, Russell T. Baker

Clinical Practice in Athletic Training

Scapular dyskinesis is an abnormal movement of the scapula due to poor motor control of the surrounding musculature and can lead to other glenohumeral pathologies. The pathology results in the lateral tilting of the scapula during many glenohumeral joint movements and weight-bearing activities of the upper extremity (i.e., plank). The typical conservative treatment protocol focuses on strengthening surrounding musculature and is often a lengthy protocol. A weakness of strengthening protocols is the failure to address the motor function of targeted muscles at the level of the central nervous system (CNS) to restore dynamic stability and motor control. Reactive Neuromuscular Stabilization …

The Mulligan Concept In The Treatment Of Anterior Knee Pain, Karla S. Judge, Alan Nasypany, Russell T. Baker, James May

Clinical Practice in Athletic Training

The purpose of the disablement model case study was to describe the case of a collegiate basketball player suffering from anterior knee pain (AKP). The patient had been experiencing AKP while participating in pre-season basketball related activities (playing, weight lifting, and conditioning) for approximately six weeks. As the intensity increased, the pain became intolerable. Previously, the patient had missed a significant amount of off-season workouts due to surgery for an upper extremity injury sustained during the competitive season. The patient reported tenderness at the inferior pole of the patella, and at the tibial tuberosity. There was no joint line tenderness, …

Multiple Regression Models To Analyze Length Of Hospitalization Due To Nosocomial Infections In U.S. Hospitals, Ernest M. Oleksy

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Nosocomial diseases are a serious concern and detriment to hospitals’ abilities to provide appropriate patient care. Bearing this in mind, an effort must be made to determine whether infection surveillance and control programs have reduced the rates of nosocomial infection at U.S. hospitals. The data that were studied were obtained as part of the Study on the Efficacy of Nosocomial Infection Control (SENIC) and used to develop a model of what variables most contribute to a patient’s length of stay at the Cleveland Clinic (Quade et al, 1980).

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Joint Coordination Variability In Anterior Cruciate Ligament Reconstructed Subjects During Stair Ambulation Using A Vector Coding Technique, Bryan R. Simrak

Theses and Dissertations (ETD)

Anterior cruciate ligament (ACL) rupture is a common injury, with an estimated incidence of 120,000 to 200,000 per year in the United States. ACL reconstruction surgery is the standard treatment for this injury to restore knee joint stability and function. While surgical reconstruction has been shown to restore laxity of the knee, current literature lacks consensus on return to normal knee joint kinematics following surgery. Additionally, re-injury is a major risk for those who return to sports activity after reconstruction surgery. Dynamical systems methods for quantifying joint coordination variability have been explored as a method for detecting differences between ACL …

Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry

Theses and Dissertations (ETD)

BACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.

DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.

SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.

MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray …

On The Verge Of Diagnosis: Detection, Reporting, And Investigation Of De Novo Variants In Novel Genes Identified By Clinical Sequencing., Isabelle Thiffault, Maxime Cadieux-Dion, Emily G. Farrow, Raymond Caylor, Neil A. Miller, Sarah E. Soden, Carol J. Saunders

Manuscripts, Articles, Book Chapters and Other Papers

The variable evidence supporting gene-disease associations contributes to the difficulty of accurate variant reporting in a clinical setting. An evidence-based scoring system for evaluating the clinical validity of gene-disease associations, proposed by ClinGen, considers experimental as well as genetic evidence. De novo variants are heavily weighted, given the overall rarity in the genome and their contribution to human disease, however they are reported as "genes of unknown significance" in our center when there is insufficient evidence for the gene-disease assertion. We report a collection of 21 de novo variants in genes of unknown clinical significance ascertained via clinical testing, of …

The Chapman Bone Algorithm: A Diagnostic Alternative For The Evaluation Of Osteoporosis, Elise Levesque, Anton Ketterer, Wajiha Memon, Cameron James, Noah Barrett, Cyril Rakovski, Frank Frisch

Mathematics, Physics, and Computer Science Faculty Articles and Research

Osteoporosis is the most common metabolic bone disease and goes largely undiagnosed throughout the world, due to the inaccessibility of DXA machines. Multivariate analyses of serum bone turnover markers were evaluated in 226 Orange County, California, residents with the intent to determine if serum osteocalcin and serum pyridinoline cross-links could be used to detect the onset of osteoporosis as effectively as a DXA scan. Descriptive analyses of the demographic and lab characteristics of the participants were performed through frequency, means and standard deviation estimations. We implemented logistic regression modeling to find the best classification algorithm for osteoporosis. All calculations and …

An Electromyography Study Of Muscular Endurance During The Posterior Shoulder Endurance Test, Neil A. Evans, Emily Dressler, Tim Uhl

Physical Therapy Faculty Research

The primary purpose was to determine if there is a difference between the median frequency slopes of 5 posterior shoulder muscles during the initial portion of the Posterior Shoulder Endurance Test (PSET) at the 90⁰ and 135⁰ shoulder abduction positions.

Fifty-five healthy volunteers (31 females) participated. The median frequency of the posterior deltoid (PD), upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and infraspinatus (INF) was measured during the PSET at 90⁰ and 135⁰ of shoulder abduction. External torque of 13±1 Nm was used for females and 21±1 Nm for males. A fixed effect multi-variable regression model was used …

Surgical And Medical Applications Of Drones: A Comprehensive Review, Brent Terwilliger, James C. Rosser Jr., Vudatha Vignesh, Brett C. Parker

Publications

Drones have the ability to gather real time data cost effectively, to deliver payloads and have initiated the rapid evolution of many industrial, commercial, and recreational applications. Unfortunately, there has been a slower expansion in the field of medicine. This article provides a comprehensive review of current and future drone applications in medicine, in hopes of empowering and inspiring more aggressive investigation.

Effects Of 8-Week Sensory Electrical Stimulation Combined With Motor Training On Eeg-Emg Coherence And Motor Function In Individuals With Stroke, Li-Ling Hope Pan, Wen-Wen Yang, Mei-Wun Tsai, Shun-Hwa Wei, Felipe Fregni, Vincent Chiun-Fan Chen, Li-Wei Chou

Engineering Science Faculty Publications

The peripheral sensory system is critical to regulating motor plasticity and motor recovery. Peripheral electrical stimulation (ES) can generate constant and adequate sensory input to influence the excitability of the motor cortex. The aim of this proof of concept study was to assess whether ES prior to each hand function training session for eight weeks can better improve neuromuscular control and hand function in chronic stroke individuals and change electroencephalography-electromyography (EEG-EMG) coherence, as compared to the control (sham ES). We recruited twelve subjects and randomly assigned them into ES and control groups. Both groups received 20-minute hand function training twice …

Agreement Between Clinician-Rated Versus Patient-Reported Outcomes In Huntington Disease, Noelle E Carlozzi, Nicholas R Boileau, Joel S Perlmutter, Kelvin L Chou, Julie C Stout, Jane S Paulsen, Michael K Mccormack, David Cella, Martha A Nance, Jin-Shei Lai, Praveen Dayalu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Clinician-rated measures of functioning are often used as primary endpoints in clinical trials and other behavioral research in Huntington disease. As study costs for clinician-rated assessments are not always feasible, there is a question of whether patient self-report of commonly used clinician-rated measures may serve as acceptable alternatives in low risk behavioral trials.

AIM: The purpose of this paper was to determine the level of agreement between self-report and clinician-ratings of commonly used functional assessment measures in Huntington disease.

DESIGN: 486 participants with premanifest or manifest Huntington disease were examined. Total Functional Capacity, Functional Assessment, and Independence Scale assessments …

A Study Of Acoustically Activated Nanodroplets, Songita Choudhury

Theses & Dissertations

Current treatment of acute myocardial infarction (AMI), which is the main pathophysiological event leading to death in the United States, has advanced considerably with the introduction of emergent percutaneous interventions, but there remains an urgent need for novel techniques to rapidly and accurately detect infarcted or ischemic tissue that results from AMI. Ultrasound contrast agents, also known as microbubbles (MB), have become commonplace in echocardiography. However, MBs are purely intravascular tracers and unable to cross endothelial barriers due to size. The limitations of MBs, namely size and short circulation times within the human body, led to the development of phase-change …

Design Of A Homeopathic Solution For Chronic Cough, Jacob Ziemke

Senior Honors Projects, 2010-2019

Chronic cough is most commonly defined as a cough that persists for more than eight weeks and is estimated to affect more than 30 million people in the United States at any given time. Diseases contributing to the onset of chronic cough include asthma, pulmonary fibrosis, lung cancer, postnasal drip, gastroesophageal reflux disease (GERD), and bronchitis, and may include lifestyle choices such as smoking. For those who seek medical advice, pharmaceuticals and speech therapy are two common methods of combating chronic cough but serve to mask the symptoms rather than treat the problem; frequently, chronic cough is misdiagnosed or cannot …

Modeling And Analyzing An Optogenetic System For Photoactivatable Protein Dissociation, Anvin Thomas, James Schaff

Honors Scholar Theses

Computational modeling of cell-cell interactions can grant clues and can answer questions about an experiment, especially for observations about binding interactions and kinetics. This approach was used to investigate an interaction between a light-oxygen-voltage (LOV) domain and an engineered protein called Zdark (Zdk). The LOV domain is membrane-bound while Zdk is cytosolic. The LOV domain and Zdk bind strongly in dark (K_d 26.2 nM), and weakly upon exposure to blue light (K_d > 4 μM). Total internal reflection fluorescence (TIRF) images are acquired of Zdk, the fluorescent species bound to a mCherry tag, and the loss of fluorescence is …

Failure Of Primary Total Knee Arthroplasty: Establishing A Baseline For Retrieval Analysis Using Well-Functioning Necropsy Specimens, Meredith Perkins

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is an effective treatment for end-stage osteoarthritis of the knee. While many patients have positive functional and pain outcomes following primary TKA, a subset of patients have suboptimal outcomes, such as unexplained pain or aseptic loosening of the implant components necessitating revision of the index procedure. The understanding of the exact etiology of these suboptimal outcomes of primary TKA is in its infancy. In order to elucidate the etiology of failure in primary TKAs, a baseline for the factors contributing to arthroplasty failure and dissatisfaction must first be established. The purpose of this study …

Longitudinal Measures Of Deformation Are Associated With A Composite Measure Of Contractility Derived From Pressure-Volume Loop Analysis In Children., Shahryar M. Chowdhury, Ryan J. Butts, Carolyn L. Taylor, Varsha M. Bandisode, Karen S. Chessa, Anthony M. Hlavacek, Arni Nutting, Girish S. Shirali, G Hamilton Baker

Manuscripts, Articles, Book Chapters and Other Papers

Aims: The relationship between echocardiographic measures of left ventricular (LV) systolic function and reference-standard measures have not been assessed in children. The objective of this study was to assess the validity of echocardiographic indices of LV systolic function via direct comparison to a novel composite measure of contractility derived from pressure-volume loop (PVL) analysis.

Methods and results: Children with normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. A composite invasive composite contractility index (ICCI) was developed using data reduction strategies to combine four measures of contractility derived from PVL analysis. Echocardiograms …

Open Cycle: Forecasting Ovulation For Family Planning, Karen Clark, Mridul Jain, Araya Messa, Vinh Le, Eric C. Larson

SMU Data Science Review

Abstract: Forecasting the length and different phases of a woman’s menstrual cycle, especially ovulation, is an important aspect of family planning. Predicting fertility has many uses in family planning including avoiding pregnancy and assisting couples in becoming pregnant. Past methods have focused on monitoring basal body temperature (BBT), cervical mucus changes, and hormonal levels to determine fertility. While these methods can provide an accurate prediction of ovulation these tests can become expensive, time-consuming, and do not provide prediction until after ovulation has occurred. In this paper, we compare conventional fertility assessment that is based on a rule known as “three-over-six” …