Physical Therapy Commons^™

Can Foot Exercises And Going Barefoot Improve Function, Muscle Size, Foot Pressure During Walking And Qualitative Reports Of Function In People With Flat Foot?, Marcey Keefer Hutchison, Robin Dorociak, Alison Modafferi, Shanna Howland, Angela Foster, Jean Jarbath, Brenden Thompson, Tyler Whited, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Specific exercises to train foot muscles for barefoot running (i.e. doming seated[DS] and standing[DSt]) and post foot and ankle injury (i.e. seated plantar flexion and inversion[SPFI]) are common. Exercise programs specifically for the foot claim improvement in foot posture (foot posture index [FPI]) and foot strength. However, rigorous assessment of foot function as a result of exercise is lacking (i.e. foot posture, strength, and plantar pressure). Further, no studies specifically address patients with flat foot. The purpose of this case series study was to assess the immediate effects of an 8-week foot exercise and barefoot weight bearing program on …

Can Understanding Provider Expectations Improve Provider Adoption Of Patient Reported Outcomes?, Jeff Houck, Jillian Santer, Kostantinos Vasalos, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: New instruments like the Patient Reported Outcome Information System (PROMIS) minimize the burden to patients and providers addressing significant barriers to adoption. Despite these advances provider adoption remains lackluster. Models of technology adoption suggest adoption is more likely to occur when PRO’s directly improve patient care (performance expectancy) and it’s easy to implement (effort expectancy). Problems with effort expectancy are dealt with by training and improving logistics (i.e. eHR presentation, alerts), where performance expectancy is addressed through research (i.e. validation of thresholds). The purposes of this study were to: 1) evaluate the proportion of orthopedic rehabilitation providers who use …

Differences In Walking Mechanics Between A Traditional Walker And The Kb Balance Trainer, Silvia Zanini

Electronic Theses and Dissertations

INTRODUCTION: Millions of individuals with ambulatory difficulties rely on walking aids to maintain independence and mobility. However, users of traditional walkers typically exhibit increased forward lean of their trunk while using the assistive device. The KB Balance Trainer is a new posterior walker designed to facilitate a more erect position during gait. PURPOSE: To compare gait mechanics across three walking conditions: unassisted, using a traditional walker, and using the KB Balance Trainer. METHODS: Seven adults with experience using walkers due to ambulatory difficulties participated in the study. The study consisted of one training session and one gait analysis session. The …

The Combined Effects Of Physical Therapy And Music Therapy For An Older Adult With Chronic Left-Sided Hemiparesis: A Case Report, Nicholas Holkup, Scott Syverson

Physical Therapy Scholarly Projects

Background and Purpose: Stroke and other disorders that involve the neurological system can have adverse effects such as hemiparesis, spasticity, hypertonicity, and gait and balance deficits. Due to neurological disorders being so prevalent, proper rehabilitative treatments are necessary to return to a functional lifestyle. Multiple approaches across the therapy spectrum have been utilized, but rarely are these therapeutic approaches completed concurrently among different disciplines. The purpose of this case report is to address the interdisciplinary co-treatment by students of music therapy and physical therapy for a patient exhibiting chronic left-sided hemiparesis.

Case Description: This case report describes a …

Small Business Marketing Strategies For Physical Therapy Practice Owners, Matthew Lane Daugherty

Walden Dissertations and Doctoral Studies

The United States economy depends on small businesses, which represent 99% of all businesses in the United States, yet approximately 50% of small businesses cease operations in the first 5 years. The purpose of this multiple case study was to explore the marketing strategies used by owners of small businesses to develop and maintain their organization through the initial 5 years of business operation. The population included 5 physical therapy business owners in northeastern Florida who had sustained their business for a minimum of 5 years. The conceptual framework for this study was the brand equity model, and data were …

Mobility Boost: A Quality Improvement Project To Bridge A Gap In Care For Hospitalized Adults, Audrey M. Johnson

Theses and Dissertations--Rehabilitation Sciences

Early mobility quality improvement (QI) projects are leading the charge to shift the prevailing culture in acute care from a culture of immobility to a culture of mobility. Low mobility and hospital acquired functional decline is a persistent problem, especially for older adults, often leading to increased post acute care costs, increased risk of hospital readmission and increased mortality. Transition of care programs designed to improve care transitions and prevent hospital readmission exist but fail to include rehabilitation professionals or to adequately consider patient functional status during hospitalization. The goal of this research was to implement and evaluate an early …

The Assessment And Utilization Of Patients’ Self-Efficacy For Exercise During Rehabilitation, Kelsey J. Picha

Theses and Dissertations--Rehabilitation Sciences

Patient adherence to in-clinic rehabilitation is between 30-70% and even lower for home exercise programs (HEPs). Barriers to patient adherence have been identified and include but are not limited to anxiety, depression, lack of positive feedback, lack of social support, lack of time, low levels of physical activity at baseline, pain during exercise, and low self-efficacy. As clinicians prescribing rehabilitation may not be able to influence all of the identified barriers, they may positively influence others. Self-efficacy, or an individual’s belief in his/her ability to successfully complete a task, is a patient barrier that may be addressed by a clinician …

Tissues And Trauma: Pain Neuroscience Education For Veterans With Post-Traumatic Stress And Low Back Pain, Timothy Mark Benedict

Theses and Dissertations--Rehabilitation Sciences

Low back pain (LBP) is the top reason for Soldiers to seek medical care and one of the top reasons to be medically discharged. Mental health problems and psychosocial stressors have been increasing in Soldiers and are also top causes for medical discharge. Dysregulated stress has contributed to many Soldiers and Veterans to develop chronic LBP as well as mental health disorders like post-traumatic stress disorder (PTSD). Research suggests that psychosocial characteristics, as opposed to physical factors or tissue health, contribute to chronic pain the most. Focusing entirely on tissues for individuals seeking care for LBP can increase disability and …

Personality Oriented Job Analysis To Identify Non-Cognitive Factors For A Doctor Of Physical Therapy Program In The United States, Maureen A. Conard, Kristin Schweizer

Psychology Faculty Publications

It aimed to conduct a personality oriented job analysis to identify non-cognitive factors that may predict successful performance or performance difficulties in doctorate in physical therapy (DPT) students. The study employed focus groups and a survey with 9 DPT subject matter experts. Focus group participants including 3 DPT faculty members and 4 recent graduates of the DPT program identified 22 non-cognitive factors. Out of them, 15 factors were possibly associated with successful performance and 7 factors were possibly associated with performance difficulties. The questionnaire employing the Combination Job Analysis Method resulted in 12 factors which could be used in selection, …

Can Women Live With More Symptoms Than Men?: Defining Gender Differences In The Patient Acceptable Symptom State (Pass) In Orthopaedic Foot And Ankle Surgery, Judith Baumhauer, Adolph Flemister, Irvin Oh, Benedict Digiovanni, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Over the last few years an increasing focus has been directed to define cut-off points for important health improvement. Minimal clinically important difference (MCID) values have traditionally been used to determine if a statistical change translates to a clinical improvement to the patient. Although MCID is helpful, it may be even more important to identify if the current treatment is adequate or that the patient has achieved an acceptable symptom state (symptoms minimal enough to live with). The purpose of this study was to determine if gender influenced patient reported outcomes (patient acceptable symptom state (PASS) and PROMIS Physical …

Ability Of Patient-Reported Outcomes To Characterize Patient Acceptable Symptom State (Pass) After Attending A Primary Care Physical Therapist And Medical Doctor Collaborative Service: A Cross-Sectional Study, Jeff Houck, Daniel Kang, Tyler Cuddeford, Sarah Rahkola

Faculty Publications - College of Physical Therapy

Objectives: To determine if the Patient-Reported Outcome Measurement Information System (PROMIS) physical function, pain interference, self-efficacy, and global rating of normal function (GRNF) scales are able to accurately characterize a patient’s acceptable symptom state (PASS).

Design: A cross-sectional analysis, using receiver operator curves and chi-square analysis to explore criteria to determine thresholds (80% and 95% sensitivity/specificity) for PASS that are applicable to PROMIS and GRNF scales.

Setting: Phone survey after primary care. Participants: Patients (NZ94) attending primary care for musculoskeletal problems. Interventions: Not applicable. Main Outcomes Measures: Accuracy and proportion of patients classified as PASS Yes or No.

Results: Receiver …

Comparison Of Jump And Hop Test Measures Between Naia And Division Iii Male Collegiate Basketball Players, Jason Brumitt, Amy Engilis, Alma Mattocks, Natalie Ellis, Jordon Reyes

Faculty Publications - College of Physical Therapy

Purpose: To report normative data for two functional performance tests (FPTs) (the standing long jump [SLJ] and the single-leg hop [SLH]) in a population of male collegiate basketball players and to identify differences in measures between athletes based on level of competition, starter status, and position.

Methods: Eighty-six male collegiate basketball players from six teams were recruited for this study. Each athlete performed three SLJs and three SLHs (bilaterally).

Results: Mean (± SD) FPT measures (normalized to height) for all basketball players were: SLJ = 1.0 ± 0.1, right SLH = 0.84 ± 0.1, and left SLH = 0.85 ± …

Asymmetry After Hip Fracture: A Multi-Factorial Problem, Andrew J. Meszaros, Cindy Zablotny, Paul A. Shew, Bret Reordan

Faculty Publications - College of Physical Therapy

Background and Purpose: Sit-to-stand (STS) and static standing mechanics are related to fall risk and function after hip fracture. Often, these patients avoid weight bearing on the fracture side after rehabilitation. The purpose of this study was to use a novel clinically-relevant protocol to examine standing and STS vertical ground reaction force (vGRF) in light of perceptual measures of loading symmetry and muscle torque production in this population. Methods: A person post hip fracture performed 3 different STS conditions and 2 simple load-matching tasks. Motion, force plate, and perceptual data on weight distribution and load were collected. Findings: Standing and …

What Maximum Ankle Torque Is Appropriate For Training Patients With Non-Insertional Achilles Tendinopathy?, Tyler Cuddeford, Jeff Houck, Derek Palmer, Jason Beilstein, Jordan Visser

Faculty Publications - College of Physical Therapy

Background and Purpose: The capacity of the Achilles tendon during a 1-repetition eccentric maximum contraction is largely unknown. This study examined the maximum ankle torque during a concentric/ eccentric heel raise/lowering task and while running in healthy individuals and participants with chronic Achilles tendinopathy. These findings were applied to a 10-week training program for a patient with chronic Achilles tendinopathy.

Methods: A total of 13 subjects (9 healthy and 4 with Achilles tendinopathy) participated in this study. Subjects were asked to perform a maximum eccentric contraction wearing a weighted vest while collecting 3-dimensional biomechanical variables. Subjects also ran along an …

A Study Of Outcomes Following Collaborative Medical Doctor/Physical Therapist Primary Care Service For Musculoskeletal Problems, Daniel Kang, Sarah Rahkola, Catherine Vandehaar, Andrea Mulligan, Kevin Morikawa, Amador Marcano, Tyler Cuddeford, Jeff Houck

Faculty Publications - College of Physical Therapy

Background and Purpose: Collaborative medical doctor/physical therapist primary care services are not described in the literature. The 2 purposes of this observational study were to describe a collaborative medical doctor/physical therapist primary care service, and to describe simple, one question, outcomes including patient acceptable symptom state (PASS), global rating of normal function (GRNF), and success of treatment (SOT) at intake, 1 to 7 days, and 45 to 60 days follow-up. Methods: Patients were seen for 1 to 2 visits and typically received exercise, hands on treatment, ie, manual therapy, and education. Medical doctor/physical therapist collaborative encounters and provider training are …

Identifying Foot And Ankle Patients At Risk To Fall Based On Patient Reported Outcomes Assessments, Judith Baumhauer, Jack Teitel, Allison Mciyntyre, David Mitten, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Each year approximately 30-40% of people over the age of 65 fall. Approximately one half of these falls result in an injury with the estimated annual direct medical costs of $30 billion. Pain, mobility issues, neuropathy and post- operative weight bearing limitations make foot and ankle patients particularly vulnerable to falls. Current approaches to determine at risk patients are cumbersome and time consuming requiring performance testing and “hands on” clinical assessment. The efficiency of obtaining PRO, such as PROMIS, in the clinical arena has been well documented. The purpose of this study is determine if patient reported outcomes (PROMIS) …

Using Foot Pressure Analysis To Predict Reoccurrence Of Deformity For Children With Unilateral Clubfoot, Juanita Jean Wallace

Theses and Dissertations--Kinesiology and Health Promotion

Reoccurrence of deformity can affect upwards of 64% of children with clubfoot. The ability to use foot function as a measure of reoccurrence has not been previously assessed. The purpose of this investigation was to utilize foot pressure analysis to predict the probability of reoccurrence in children with unilateral clubfoot. Retrospective foot pressure data revealed predictive algorithms detecting the probability of experiencing any type of reoccurrence (overall reoccurrence) and for experiencing a tibialis anterior tendon transfer (TATT). The equation for overall reoccurrence reported sensitivity and specificity of 0.82 and 0.81 and the equation for TATT reported values of 0.81 and …

Treatment Post Total Knee Arthroplasty With Common Peroneal Nerve Palsy, Megan Berndt

Physical Therapy Scholarly Projects

Introduction. With more than 600,000 knee replacements performed each year in the United States, functional exercise is necessary post-surgery. Patients who undergo knee replacements often attend physical therapy after surgery, which has been found to have significant effects on functional outcomes. In rare cases, patients experience a post-surgical complication of common peroneal nerve palsy (CPNP), and interventions must be adjusted based on the patient's specific needs.

Purpose. This is a case report describing the interventions for a patient with a right total knee arthroplasty ([R] TKA), multiple co-morbidities, and a post-surgical complication of CPNP.

Methods. A 78-year-old …

The Effect Of Barefoot Running On Navicular Drop: A Randomized Controlled Trial, Corrie Fredericks, Alison Cygan, Robert Plemel

Physical Therapy Scholarly Projects

Background and Purpose: Gaining knowledge of the change in navicular drop/over-pronation of the foot in response to barefoot running training may allow sports medicine professionals, coaches, athletes, and others in the healthcare field to decrease the amount of injuries that may be caused by these motions. Effects of a running retraining program with conversion from a rearfoot strike pattern (RFSP) to forefoot strike pattern (FFSP) to determine impact on navicular drop is lacking in literature. Due to the increased correlation of over-pronation and lower extremity injuries, the purpose of this study was to determine if barefoot running training, with …

Treatment Of Subacromial Impingement Syndrome In A 53-Year-Old Female: A Case Study, Jarad Syrstad

Physical Therapy Scholarly Projects

Background and Purpose. Subacromial impingement syndrome (SAIS) is a common shoulder pathology. The purpose of this case report is to discuss the outcomes of subsequent physical therapy after operative treatment for SAIS and the clinical decision making involved in seeking surgical intervention.

Case Description. This case report describes a 54 y/o female who participated in eight weeks of physical therapy after undergoing shoulder decompression surgery while failing conservative physical therapy prior to surgical intervention.

Intervention. Physical therapy interventions were designed to strengthen the rotator cuff and shoulder, increase range of motion, decrease pain, and improve functional activity. …