Physical Therapy Commons^™

Inspiration For The Future: The Role Of Inspiratory Muscle Training In Cystic Fibrosis., Ren-Jay Shei, Robert L Dekerlegand, Kelly A Mackintosh, John D Lowman, Melitta A Mcnarry

Department of Physical Therapy Faculty Papers

Cystic fibrosis (CF) is an inherited, multi-system, life-limiting disease characterized by a progressive decline in lung function, which accounts for the majority of CF-related morbidity and mortality. Inspiratory muscle training (IMT) has been proposed as a rehabilitative strategy to treat respiratory impairments associated with CF. However, despite evidence of therapeutic benefits in healthy and other clinical populations, the routine application of IMT in CF can neither be supported nor refuted due to the paucity of methodologically rigorous research. Specifically, the interpretation of available studies regarding the efficacy of IMT in CF is hampered by methodological threats to internal and external …

Planning And Implementation Of Physical Therapy Services In An Athletic Training Pro-Bono Clinic: An Administrative Case Report, Tessa Wells, Scott Unruh

Posters and Presentations: Physical Therapy

Background & Purpose

Athletic Training and Physical Therapy students have overlapping, yet unique aspects of clinical competencies and scopes of practice, offering rich potential for interprofessional partnership. University of Nebraska Medical Center (UNMC) Doctor or Physical Therapy Education expanded its program to the University of Nebraska-Kearney (UNK) campus, which boasts a Division II athletic training (AT) program. To create meaningful IPE experiences for both programs (1,2), campus leaders from the UNMC College of Allied Health Professions and UNK sought to create an interprofessional clinic by adding PT care to an existing AT-led pro-bono clinic serving the University intramural recreation community. …

Brain Activity Associated With Dual-Task Performance Of Ankle Motor Control During Cognitive Challenge., Sue Peters, Janice J Eng, Teresa Liu-Ambrose, Michael R Borich, Elizabeth Dao, Ameen Amanian, Lara A Boyd

Physical Therapy Publications

INTRODUCTION: Skilled Ankle motor control is frequently required while performing secondary cognitively demanding tasks such as socializing and avoiding obstacles while walking, termed "Dual tasking." It is likely that Dual-task performance increases demand on the brain, as both motor and cognitive systems require neural resources. The purpose of this study was to use functional MRI to understand which brain regions are involved in resolving Dual-task interference created by requiring high levels of Ankle motor control during a cognitive task.

METHODS: Using functional MRI, brain activity was measured in sixteen young adults during performance of visually cued Ankle plantar flexion to …

Physical, Occupational, And Speech Therapy For Children With Cerebral Palsy., Sarah Westcott Mccoy, Robert Palisano, Lisa Avery, Lynn Jeffries, Alyssa Laforme Fiss, Lisa Chiarello, Steve Hanna

Physical Therapy Publications

AIM: To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).

METHOD: We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children's performance in self-care and participation in recreation. Therapists and parents collaboratively classified children's Gross Motor Function Classification System (GMFCS) levels. We created longitudinal …

Calculating Set-Volume For The Limb Muscles With The Performance Of Multi-Joint Exercises: Implications For Resistance Training Prescription, Brad J. Schoenfeld, Jozo Grgic, Cody Haun, Takahiro Itagaki, Eric R. Helms

Publications and Research

Resistance training volume, determined by the number of sets performed (set-volume) is considered one of the key variables in promoting muscle hypertrophy. To better guide resistance exercise prescription for weekly per-muscle training volume, the purpose of this paper is to provide evidence-based considerations for set-volume ratios between multi-joint (MJ) and single-joint (SJ) exercises so that practitioners can better manage prescription of training volume in program design. We analyzed this topic from three primary areas of focus: (1) biomechanical and physiological factors; (2) acute research; and (3) longitudinal research. From a biomechanical and physiological standpoint, when considering force production of different …

Self-Care Trajectories And Reference Percentiles For Children With Cerebral Palsy., Robert J Palisano, Lisa A Chiarello, Lisa Avery, Steven Hanna, On Track Study Team

Physical Therapy Publications

Aims: To create longitudinal trajectories and reference percentiles for performance in self-care of children with cerebral palsy (CP).

Methods: Participants were 708 children with CP, 18 months through 11 years of age and their parents residing in 10 regions across Canada and the United States. Gross Motor Function Classification System (GMFCS) levels were determined by consensus between parents and therapists. Parents' completed the Performance in Self-Care domain of the Child Engagement in Daily Life Measure two to five times at 6-month intervals. Nonlinear mixed-effects models were used to create longitudinal trajectories. Quantile regression was used to construct cross-sectional reference percentiles. …

Longitudinal Changes In Physical Caregiving For Parents Of Children With Cerebral Palsy., Mohammed S Alghamdi, Lisa A Chiarello, Robert J Palisano, Sarah W Mccoy, Margo Orlin, Ehab M Abd-Elkafy

Physical Therapy Publications

Aims: To determine changes in physical caregiving for parents of children with cerebral palsy (CP) over a two-year period based on children’s gross motor function level and age.

Methods: 153 parents of children with CP rated their physical caregiving using the Ease of Caregiving for Children three times over two years. Parents and assessors classified children’s gross motor function using the Gross Motor Function Classification System (GMFCS). Physical caregiving was compared at three test times among parents of children grouped by GMFCS level (I, II–III, and IV–V) and age (1.7–5.9 and 6–11 years) using a three-way mixed ANOVA.

Results: Among …

Modulation Of The Hoffmann Reflex In The Tibialis Anterior With A Change In Posture., Janelle Unger, Justin W Andrushko, Alison R Oates, Doug W Renshaw, Trevor S Barss, E Paul Zehr, Jonathan P Farthing

Physical Therapy Publications

Hoffmann (H-) reflex amplitudes in plantar flexor soleus muscle are modulated by posture, yet dorsiflexor tibialis anterior (TA) H-reflex parameters have sparingly been studied. The purpose was to investigate modulation of the TA H-reflex when postural demands are increased from sitting to standing. In this study, data from 18 participants (Age: 25 ± 4 years, Height: 170.9 ± 9.5 cm, Weight: 75.9 ± 17.2 kg) allowed comparison of two experimental conditions involving different postures (i.e. sitting and standing). Maximal amplitude of the TA H-reflex (H_max) as a percent of the maximal M-wave amplitude (M_max) …

Case Study: Effects Of Psychosocial Factors On A Geriatric Patient With Guillain Barré Syndrome, Keane Evangelista, Mary Pent Hunter, Jessica Phung, Aum Tejani, Lee Anne H. Robotta

San Marcos, Summer 2019

The purpose of this case report is to determine how a change in intrinsic motivation and environmental factors help physical and functional improvements in a 77-year-old male patient with Guillain Barré Syndrome (GBS) in the geriatric population. Interventions to promote this change included patient education about lifestyle choices along with endurance and balance exercises.

Patient psychological state, community access, and general education about interventions/dosing had an effect on the patient's participation in his prescribed HEP. His comorbidities hindered his overall progress over the course of his treatment and should be addressed to improve patient outcomes. Activities that were more salient …

Differential Effects Of Aging And Physical Activity On Corticospinal Excitability Of Upper And Lower Limb Muscles, Vianney Rozand, Jonathon William Senefeld, Christopher W. Sundberg, Ashleigh E. Smith, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Corticospinal tract excitability can be altered by age, physical activity (PA), and possibly sex, but whether these effects differ between upper and lower limb muscles is unknown. We determined the influence of age, PA, and sex on corticospinal excitability of an upper limb and a lower limb muscle during submaximal contractions by comparing stimulus-response curves of motor evoked potentials (MEPs). Transcranial magnetic stimulation (TMS) was used to evoke stimulus-response curves in active muscles by incrementally increasing the stimulator intensity from below the active motor threshold (AMT) until a plateau in MEP amplitudes was achieved. Stimulus-response curves were analyzed from the …

Practical Guidance For Engaging Patients In Health Research, Treatment Guidelines And Regulatory Processes: Results Of An Expert Group Meeting Organized By The World Health Organization (Who) And The European Society For Clinical And Economic Aspects Of Osteoporosis, Osteoarthritis And Musculoskeletal Diseases (Esceo), Maarten De Wit, Cyrus Cooper, Peter Tugwell, Nathalie Bere, John Kirwan, Philip G. Conaghan, Charlotte Roberts, Isabelle Aujoulat, Nasser Al-Daghri, Islene Arajujo De Carvalho, Mary Barker, Nicola Bedlington, Maria Luisa Brandi, Olivier Bruyère, Nansa Burlett, Philippe Halbout, Mickaël Hiligsmann, Famida Jiwa, John A. Kanis, Andrea Laslop, Wendy Lawrence, Daniel Pinto, Concepción Prieto Yerro, Véronique Rabenda, René Rizzoli, Marieke Scholte-Voshaar, Mila Vlaskovska, Jean-Yves Reginster

Physical Therapy Faculty Research and Publications

There is increasing emphasis on patient-centred research to support the development, approval and reimbursement of health interventions that best meet patients’ needs. However, there is currently little guidance on how meaningful patient engagement may be achieved. An expert working group, representing a wide range of stakeholders and disciplines, was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the World Health Organization (WHO). Through a structured, collaborative process the group generated practical guidance to facilitate optimal patient engagement in clinical development and regulatory decisions. Patient engagement is a relational process. The …

Bringing Upstairs Care Downstairs; Integration Of Rehabilitation Medicine, Care Management, And The Hospital Elder Life Program (Help) Into An Emergency Department., Robert Anderson, Molly Anderson, Rhonda Babine, Farid Feghali, Elizabeth Dunstan, Matthew Glazer, Susan Horton, Stephanie O'Brien, Elizabeth Pontius, David Smith, Megan Viens, Heather Williams

Journal of Maine Medical Center

Introduction: Services such as physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), social work (SW), care management, and elder life specialists have long been an established part of care for patients admitted to Maine Medical Center (MMC) but not for patients in the Emergency Department (ED). Methods and Results: Driven in part by changes in Medicare reimbursement models, care management established a presence in the Emergency Department (ED) in 2003 with a focus on care planning and cost avoidance. In recent years PT, OT, SLP, SW, and the Hospital Elder Life Program (HELP) have increased their ED involvement substantially. …

Developing Interactive Curricular Elements With Teams Of Faculty, Staff And Students, Betsy J. Becker, Sara Bills, Robert H. Fuchs, Kellie Gossman, Tessa Wells, Peggy Moore

Posters and Presentations: Physical Therapy

Students are continually searching for new resources to augment their learning. Online resources have become highly favored, especially by the millennial age group, for convenience, self-paced content, and versatility across learning styles. It has been reported that e-learning platforms are as effective as traditional face-to-face instruction, but may be best utilized when used as an adjunctive resource for teaching psychomotor skills.1,2 In a study about student confidence, results showed an increase in self-efficacy following the use of online learning materials.3 Blended learning, the next generation of web-based education, mixes advances in technology with creative faculty to fuse effective delivery methods …

Psychometric Properties Of Standardized Balance Confidence, Fear Of Falling, And Falls-Efficacy Measures In People With Lower Limb Amputations, Jack Y. Wang, Susan W. Hunter, Ricardo Viana, Jeffrey D. Holmes, Michael Payne

Western Research Forum

Background:

In Canada, >50% of community-dwelling lower limb amputees (LLA) fall at least once each year, a rate that is almost twice that of community-dwelling older adults. While the physical consequences of falls may be readily apparent, psychological sequelae that follow may be just as, if not more, detrimental than an actual fall itself. Current measures of balance confidence show no change in LLA following discharge from rehabilitation. The limited detectable change may be due to content validity challenges of the measures as they were not developed for the unique challenges faced by LLA.

Objectives:

1) Review items from standardized …

Depression Affects Recovery Following Distal Radius Fracture: A Latent Class Analysis, Shirin Modarresi, David M. Walton, Joy C. Macdermid

Western Research Forum

Background: Most people recover within six months following distal radius fractures (DRFs) but some experience pain and disability for one year or longer. Therefore, it is important to understand the factors that can help predict recovery. According to the biopsychosocial model of pain, psychological aspects of a condition can play important roles in explaining recovery.

Objectives: To identify the recovery trajectories of patients with DRFs and to determine the degree to which depression affects these trajectories.

Methods: Recovery was assessed in 318 patients using the Patient-Rated Wrist Evaluation scale at baseline, three, six, and 12 months. Demographic information was collected …

Do Patient Sociodemographic Factors Impact The Promis Scores Meeting The Patient-Acceptable Symptom State At The Initial Point Of Care In Orthopaedic Foot And Ankle Patients?, David N. Bernstein, Kiah Mayo, Judith F. Baumhauer, Chris Dasilva, Kathleen Fear, Jeff Houck

Faculty Publications - College of Physical Therapy

Background

Patient-reported outcome measures such as the Patient-Reported Outcomes Measurement Information System (PROMIS) allow surgeons to evaluate the most important outcomes to patients, including function, pain, and mental well-being. However, PROMIS does not provide surgeons with insight into whether patients are able to successfully cope with their level of physical and/or mental health limitations in day-to-day life; such understanding can be garnered using the Patient-acceptable Symptom State (PASS). It remains unclear whether or not the PASS status for a given patient and his or her health, as evaluated by PROMIS scores, differs based on sociodemographic factors; if it does, that …

A Method To Concatenate Multiple Short Time Series For Evaluating Dynamic Behaviour During Walking, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Gait variability is a sensitive metric for assessing functional deficits in individuals with mobility impairments. To correctly represent the temporal evolution of gait kinematics, nonlinear measures require extended and uninterrupted time series. In this study, we present and validate a novel algorithm for concatenating multiple time-series in order to allow the nonlinear analysis of gait data from standard and unrestricted overground walking protocols. The fullbody gait patterns of twenty healthy subjects were captured during five walking trials (at least 5 minutes) on a treadmill under different weight perturbation conditions. The collected time series were cut into multiple shorter time series …

Risk Factors For The Elevation Of Psychosocial Barriers In The Recovery Of Lumbar Pathology, Christopher Keating, Cameron Hui, Gerard Smith, Tingting Zhan

Department of Physical Therapy Faculty Papers

Background/Purpose: The prevalence of low back pain (LBP) continues to rise and an appreciation for a biopsychosocial approach, which takes in multiple facets of a patient presentation, may significantly impact this increase. To the best our knowledge, there are no studies evaluating the relationship between the STarTBack Screening Tool (SBT) and the access point the patient enters the health system. Our hypothesis is that patients that access care through the medical model will exhibit greater psychosocial risk.

Methods: A retrospective analysis of 1404 cases of LBP utilizing past medical history, demographic information, and SBT data. A linear regression model to …

Taking Advantage Of External Mechanical Work To Reduce Metabolic Cost: The Mechanics And Energetics Of Split-Belt Treadmill Walking, Natalia Sánchez, Surabhi N. Simha, J. Maxwell Donelan, James M. Finley

Physical Therapy Faculty Articles and Research

No abstract provided.

The Validity, Reliability, Measurement Error, And Minimum Detectable Change Of The 30‐Second Fast‐Paced Walk Test In Persons With Knee Osteoarthritis: A Novel Test Of Short‐Distance Walking Ability, Lisa T. Hoglund, Phd, Erik Folkins, Dpt, Laura Pontiggia, Phd, Michael W. Knapp, Dpt

Department of Physical Therapy Faculty Papers

Objective

To develop and establish the reliability, validity, measurement error, and minimum detectable change of a novel 30‐second fast‐paced walk test (30SFW) in persons with knee osteoarthritis (OA) that is easy to administer and can quantify walking performance in persons of all abilities.

Methods

Twenty females with symptomatic knee OA (mean age [SD] 58.30 [8.05] years) and 20 age‐ and sex‐matched asymptomatic controls (57.25 [8.71] years) participated in the study. Participants completed questionnaires of demographic and clinical data, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the 36‐item Short Form Health Survey (SF‐36) followed by 30SFW performance. Participants returned …