Physical Therapy Commons^™

Effectiveness Of Stretching And Arch Strengthening In A 10-Year-Old Male With Calcaneal Apophysitis, Hannah Hardesty, Catherine M. Andrea

St. Augustine, Fall 2018

The aim of this case report is to create an independent exercise program to minimize pain while allowing continued participation in recreational activities.

Calcaneal apophysitis is a common condition in children that often results in the cessation of physical activity and participation in social activities, which can have a negative effect on both physical and mental well-being.^2-5 This case demonstrates positive outcomes with the use of static/dynamic stretching combined with arch strengthening in the rehabilitation of a patient with bilateral calcaneal apophysitis without reducing the child’s participation in daily and recreational activities.

Effects Of Trigger Point Dry Needling In Conjunction With Intramuscular Electrical Stimulation For A Patient With Lumbar Radiculopathy: A Case Report, Mayur Patel, Todd Bourgeois

St. Augustine, Fall 2018

The purpose of this case was to see the benefits of Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for the treatment of lumbar radiculopathy regarding the range of motion, strength, sensation, reduction of pain, improve functional ability, and quality of life.

Traditional interventions for this diagnosis include strengthening exercises, modalities such as transcutaneous electrical stimulation, and even surgery as a last resort. There is limited research available regarding Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for lumbar radiculopathy.⁴ This case report supports the idea that this physical therapy treatment intervention has positive outcomes …

Transitioning From The Level Surface To Stairs In Children With And Without Down Syndrome: Motor Strategy And Anticipatory Locomotor Adjustments, Huaqing Liang, Xiang Ke, Jianhua Wu

Physical Therapy Faculty Research

Background: Children with Down syndrome (DS) show underdeveloped motor strategy and anticipatory locomotor adjustments (ALA) before crossing an obstacle. Stairs presents another important setting to study environment navigation and motor adaptation. Inclusion of external ankle load is often used to perturb the stability of a system and observe the emergence of new patterns.

Research question: How do stair height and external ankle load affect motor strategy and ALA in 5-to-11-year-old children with typical development (TD) and with DS when approaching the stairs?

Methods: Fourteen children with DS and 14 age- and sex-matched children with TD participated in the study. They …

Promis Pain Interference Is Superior Vs Numeric Pain Rating Scale For Pain Assessment In Foot And Ankle Patients, David N. Bernstein, Meghan Kelly, Jeff Houck, John P. Ketz, Samuel Flemister, Benedict F. Digiovanni, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Background: The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).

Methods: Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a …

Home-Based, Square-Stepping Exercise Program Among Older Adults With Multiple Sclerosis: Results Of A Feasibility Randomized Controlled Study, Emerson Sebastião, Edward Mcauley, Ryosuke Shigematsu, Brynn C. Adamson, Rachel E. Bollaert, Robert W. Motl

Exercise Science Faculty Research and Publications

There is very little known about exercise rehabilitation approaches for older adults with multiple sclerosis (MS), yet this growing segment of the MS population experiences declines in cognition and mobility associated with disease progression and aging. We conducted a RCT examining the feasibility of a 12-week, home-based Square-Stepping Exercise (SSE) program in older adults with MS. Older adults with MS (N = 26) with mild-to-moderate levels of disability were recruited and randomized into the intervention (i.e., SSE) or a minimal activity, attention-control conditions. Participants in the SSE condition received a mat for home-based practice of the step patterns, an …

Swallow Strength Training Exercise For Elderly: A Health Maintenance Need, D. Agrawal, Mark Kern, F. Edeani, Gokulakrishnan Balasubramanian, Allison S. Hyngstrom, Patrick Sanvanson, Rita Shaker

Physical Therapy Faculty Research and Publications

Background: Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty‐ and age‐related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly. Methods: A total of 28 volunteers (75 + 7 years; 17 females) with no complaint of dysphagia were studied using video fluoroscopy …

Experience Of Robotic Exoskeleton Use At Four Spinal Cord Injury Model Systems Centers, Allen W. Heinemann, Arun Jayaraman, Chaithanya K. Mummidisetty, Jamal Spraggins, Daniel Pinto, Susan Charlifue, Candy Tefertiller, Heather B. Taylor, Shuo-Hsiu Chang, Argyrios Stampas, Catherine L. Furbish, Edelle C. Field-Fote

Physical Therapy Faculty Research and Publications

Background and Purpose: Refinement of robotic exoskeletons for overground walking is progressing rapidly. We describe clinicians' experiences, evaluations, and training strategies using robotic exoskeletons in spinal cord injury rehabilitation and wellness settings and describe clinicians' perceptions of exoskeleton benefits and risks and developments that would enhance utility.

Methods: We convened focus groups at 4 spinal cord injury model system centers. A court reporter took verbatim notes and provided a transcript. Research staff used a thematic coding approach to summarize discussions.

Results: Thirty clinicians participated in focus groups. They reported using exoskeletons primarily in outpatient and wellness settings; 1 center used …

Emotional Exhaustion, Depersonalization, And Feelings Of Decreased Personal Accomplishment Oh My: What Message Are We Sending To Our Students?, Nikki Sleddens, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE:

The purpose of this presentation is to address the issue of burnout amongst PTs through the lens that addressing this issue in our profession may very well be the first step in building resilience in the academic and clinical environments.

METHODS AND/OR DESCRIPTION:

Physical therapy student well-being is a priority for academic institutions. Yet, are we, as academic and clinical faculty, who are responsible for promoting student well-being, “well” ourselves? Could burnout of our academic and clinical faculty impact our student’s wellness? Burnout is a syndrome described as emotional exhaustion, depersonalization, and feelings of decreased personal accomplishment. All effects …

Locomotor Adaptations To Prolonged Step-By-Step Frontal Plane Trunk Perturbations In Young Adults, Eric R. Walker, Allison S. Hyngstrom, Tanya Onushko, Brian D. Schmit

Physical Therapy Faculty Research and Publications

The purpose of this study was to quantify the magnitude and time course of dynamic balance control adaptations to prolonged step-by-step frontal plane forces applied to the trunk during walking. Healthy young participants (n = 10, 5 female) walked on an instrumented split-belt treadmill while an external cable-driven device applied frontal plane forces to the trunk. Two types of forces were applied: 1) forces which accentuated COM movement in the frontal plane (destabilizing) and 2) forces which resisted COM movement in the frontal plane (stabilizing). We quantified dynamic balance control using frontal plane measures of (1) the extent of center …

Lean Mass Mediates The Relation Between Temporal Summation Of Pain And Sex In Young Healthy Adults, Abdulaziz Awali, Ali Alsouhibani, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Background

Previous studies have shown that women experience greater temporal summation (TS) of pain than men using a repetitive thermal stimulus. These studies, however, did not individualize the thermal stimulus to each subject’s thermal pain sensitivity. The aim of this study was to investigate sex differences in TS using an individualized protocol and potential mediators that have been shown to influence TS including physical activity and body composition.

Methods

Fifty young healthy men and women (21 men) participated in the study. Subjects completed TS testing on the right forearm using a repetitive thermal stimulus at a temperature that the subject …

Relationships Between Variance In Electroencephalography Relative Power And Developmental Status In Infants With Typical Development And At Risk For Developmental Disability: An Observational Study, Andrew Hooyman, David Kayekjian, Ran Xiao, Crystal Jiang, Douglas L. Vanderbilt, Beth A. Smith

Physical Therapy Faculty Articles and Research

Background: Electroencephalography (EEG) is a non-invasive tool that has the potential to identify and quantify atypical brain development. We introduce a new measure here, variance of relative power of resting-state EEG. We sought to assess whether variance of relative power of resting-state EEG could predict i) classification of infants as typical development (TD) or at risk (AR) for developmental disability, and ii) Bayley developmental scores at the same visit or future visits.

Methods: A total of 22 infants with TD participated, aged between 38 and 203 days. In addition, 11 infants broadly at risk participated (6 high-risk pre-term, …

A Framework For Secondary Cognitive And Motor Tasks In Dual-Task Gait Testing In People With Mild Cognitive Impairment., Susan W Hunter, Alison Divine, Courtney Frengopoulos, Manuel Montero Odasso

Physical Therapy Publications

BACKGROUND: Cognition is a key factor in the regulation of normal walking and dual-task gait assessment is an accepted method to evaluate the relationship. The objective of this study was to create a framework for task complexity of concurrent motor and cognitive tasks with gait in people with mild cognitive impairment (MCI).

METHODS: Community-dwelling people with MCI (n = 41, mean age = 76.20 ± 7.65 years) and cognitively normal controls (n = 41, mean age = 72.10 ± 3.80 years) participated in this study. Gait velocity was collected using an instrumented walkway under one single task and six combined …

Gait Variability And Energy Cost Of Overground Walking In Persons With Multiple Sclerosis: A Cross-Sectional Study, Emerson Sebastião, Rachel E. Bollaert, Elizabeth A. Hubbard, Robert W. Motl

Exercise Science Faculty Research and Publications

Objective: This study examined the associations between gait variability based on common spatiotemporal parameters and energetic cost of walking in persons with multiple sclerosis.

Design: Eighty-six persons with multiple sclerosis underwent the 6-min walk while wearing a portable metabolic unit. The cost of walking was generated by dividing the net steady-state VO₂ (milliliter per kilogram per minute) by walking speed during the 6-min walk. Participants further completed two trials of walking on the GAITRite mat at a self-selected pace for measuring spatiotemporal parameters. Variability of step length, step time, stride length, swing time, stance time, stride velocity, and single- …

Exercise-Induced Pain And Analgesia? Underlying Mechanisms And Clinical Translation, Kathleen A. Sluka, Laura Frey-Law, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

No abstract provided.

Risk Factors Associated With Low Back Pain In Golfers: A Systematic Review And Meta-Analysis, Jo Armour Smith, Andrew Hawkins, Marybeth Grant-Beuttler, Richard Beuttler, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Context:

Low back pain is common in golfers. The risk factors for golf-related low back pain are unclear but may include individual demographic, anthropometric, and practice factors as well as movement characteristics of the golf swing.

Objective:

The aims of this systematic review were to summarize and synthesize evidence for factors associated with low back pain in recreational and professional golfers.

Data Sources:

A systematic literature search was conducted using the PubMed, CINAHL, and SPORTDiscus electronic databases through September 2017.

Study Selection:

Studies were included if they quantified demographic, anthropometric, biomechanical, or practice variables in individuals with and without golf-related …

The High-Level Mobility Assessment Tool (Himat) In Myotonic Dystrophy Type 2: A Case Report, Kim B. Smith, Evan M. Pucillo

Physical Therapy Collection

Myotonic dystrophy type 2 (DM2) is a progressive muscular dystrophy with multi-system manifestations and can affect functional mobility, gait, and balance. Currently, there are few reports of functional outcome measures in this population. This case describes the change in function detected by the High-level Mobility Assessment Tool (HiMAT) and 30-second Chair Stand Test (CST) in a high-functioning adult female with DM2 after physical therapy treatment. The patient’s chief complaint was muscular pain and fatigue that affected activities of daily living (ADLs). Multimodal physical therapy focused on neuromuscular re-education, balance and strength training, patient education, and moderate cardiorespiratory training. Improvements were …

The Modified Dynamic Gait Index And Limits Of Stability In Myotonic Dystrophy Type 1, Evan M. Pucillo, Melissa M. Mcintyre, Mary Pautler, Man Hung, Jerry Bounsanga, Maren W. Voss, Heather Hayes, Deanna Dibella, Caren Trujillo, Melissa Dixon, Russell Butterfield, Nicholas E. Johnson

Physical Therapy Collection

INTRODUCTION:

The purpose of this study was to describe and compare the performance of balance and walking tests in relation to self-reported fall history in adults with myotonic dystrophy type 1 (DM1).

METHODS:

Twenty-two (13 male) participants with DM1 completed, a 6-month fall history questionnaire, the modified Dynamic Gait Index (mDGI), limits of stability (LoS) testing, and 10-m walking tests.

RESULTS:

Mean (SD) falls in 6 months was 3.7 (3.1), and 19 (86%) participants reported at least 1 fall. Significant differences in mDGI scores (P = 0.006) and 10-m fast walking gait velocity (P = 0.02) were found between those …

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 …

Associations Of Functional Connectivity And Walking Performance In Multiple Sclerosis, Rachel E. Bollaert, Kyle Poe, Elizabeth A. Hubbard, Robert W. Motl, Lara A. Pilutti, Curtis L. Johnson, Bradley P. Sutton

Exercise Science Faculty Research and Publications

Background

Persons with multiple sclerosis (MS) often demonstrate impaired walking performance, and neuroimaging methods such as resting state functional connectivity. (RSFC) may support a link between central nervous system damage and disruptions in walking.

Objectives

This study examined associations between RSFC in cortical networks and walking performance in persons with MS.

Methods

29 persons with MS underwent 3-T brain magnetic resonance imaging (MRI) and we computed RSFC among 68 Gy matter regions of interest in the brain. Participants completed the Timed 25-foot Walk as a measure of walking performance. We examined associations using partial Pearson product-moment correlation analyses (r …

Preoperative Promis Scores Predict Postoperative Promis Score Improvement For Patients Undergoing Hand Surgery, David N. Bernstein, Jeff Houck, Ronald M. Gonzalez, Danielle M. Wilbur, Richard J. Miller, David J. Mitten, Warren C. Hammert

Faculty Publications - College of Physical Therapy

Background: Patient-Reported Outcomes Measurement Information System (PROMIS) can be used alongside preoperative patient characteristics to set postsurgery expectations. This study aimed to analyze whether preoperative scores can predict significant postoperative PROMIS score improvement. Methods: Patients undergoing hand and wrist surgery with initial and greater than 6-month follow-up PROMIS scores were assigned to derivation or validation cohorts, separating trauma and nontrauma conditions. Receiver operating characteristic curves were calculated for the derivation cohort to determine whether preoperative PROMIS scores could predict postoperative PROMIS score improvement utilizing minimal clinically important difference principles. Results: In the nontrauma sample, patients with baseline Physical Function (PF) …