Physical Therapy Commons^™

Patient Experiences When Preparing For Discharge Home After Total Knee Replacement, Renee Causey-Upton, Dana M. Howell

Internet Journal of Allied Health Sciences and Practice

Purpose: Following total knee replacement (TKR), patients must prepare quickly for discharge to home via education and rehabilitation. Patient needs may not fully be met prior to discharge after TKR surgery. The purpose of this descriptive study using transcendental phenomenology methods was to understand patients’ experiences when preparing to return home after TKR surgery. Method: Data was collected using semi-structured interviews that occurred 1 to 2 days prior to discharge in patients’ hospital rooms. Four participants were interviewed prior to discharge and interviews were transcribed verbatim for data analysis. Data analysis and data collection were concurrent, permitting subsequent interviews to …

Combining Online Education With International Service Learning To Increase Cultural Competence, Elaine Keane, Ingrid Provident

Internet Journal of Allied Health Sciences and Practice

PURPOSE: Although international service learning has the capacity to promote a variety of important professional behaviors, merely visiting another country does not automatically result in these benefits. METHODS: This article describes an evidenced-based course which used pre-trip preparation in combination with a nine day service learning trip to Ecuador to develop cultural competence among 6 occupational and 6 physical therapy students. Pre-trip preparation included online and in-person components to increase self-awareness, awareness of other cultures, knowledge about Ecuadorian culture and skill-building. On-site activities included exploration of the physical and social context in addition to providing occupational and physical therapy treatment …

Aquatic Therapy For A Patient With Postural Orthostatic Tachycardia Syndrome: A Case Report, Christine Tito, Judith Burton Hess

Internet Journal of Allied Health Sciences and Practice

Background and Purpose: Postural Orthostatic Tachycardia Syndrome (POTS) can have a debilitating effect on an individual’s quality of life. The purpose of this case report is to describe the use of interval training in an aquatic environment to decrease the symptoms of Postural Orthostatic Tachycardia Syndrome. Aquatic therapy provides benefits for individuals with cardiovascular issues, mainly through the principle of hydrostatic pressure. Hydrostatic pressure aids in shunting the blood from the extremities back to the heart, thus increasing cardiac output while reducing the individual’s heart rate. Description: An 18 year-old female high school student who had been experiencing …

What Does A Promis T-Score Mean For Physical Function?, Jeff Houck, Zane Wise, Amanda Tamanaha, Judith Baumhauer, Luke Skerjanec, Alexandra Wegner, Chris Dasilva, Michael Bass

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The use of patient-reported outcomes (PRO) continues to expand beyond research to involve standard of care assessments. Although the PROMIS physical function (PF) is normalized to a T-score it is unclear how to interpret and apply this information in the daily care of patients. The T-score is abstract and unanchored to patient abilities impairing its clinical utility when shared with the patient. Patient questions are concrete such as “when will I be able to run again after this procedure?” The purpose of this research was to link PROMIS PF T-scores with physical function activities and provide a visual map …

Reading The Future: Predicting Who Will Benefit From Bunion Surgery, Ashlee Macdonald, Jeff Houck, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Hallux valgus is a common condition of the foot with 4.4 million patients seeking care yearly for this condition. A previous study suggested specific pre-operative cut-off scores based on Patient Reported Outcomes Measurement Information System (PROMIS) physical function (PF), pain interference (PI), and depression (D) values could predict post-operative outcomes in foot and ankle surgery. Though hallux valgus correction, among other procedures, were identified as one of the most common surgeries in the previous study, specific conditions were not considered separately. The purpose of this study was to evaluate the validity of applying a published comprehensive pre-surgical PROMIS profile …

Comparison Of Patient Reported Outcomes Using Promis In Patients With Shoulder Pain, Benjamin Strong, Raymond James Kennedy, Joseph Christopher Schaffer, Jon Hedgecock, Jeff Houck, Michael D. Maloney, Ilya Voloshin

Faculty Publications - College of Physical Therapy

Objectives: Compare a disease specific questionnaire (American Shoulder and Elbow Surgeons [ASES]) and a multidimensional global health scale (Patient reported outcome measurement system [PROMIS]) across a variety of shoulder conditions

Generalizability And Validation Of Promis Scores To Predict Surgical Success In Foot And Ankle Patients: A Tale Of Two Academic Centers, Judith Baumhauer, Michael Anderson, Charles Saltzman, Man Hung, Florian Nickisch, Alexej Barg, Timothy Beals, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Patient-reported outcomes are advancing clinical care by improving patient satisfaction and engagement. A recent publication reported preoperative PROMIS scores to be highly predictive in selecting patients who would and would not benefit from foot and ankle (F/A) surgery. Although this publication used the data from 5 fellowship trained foot and ankle surgeons at one institution, the generalizability to other patient populations and geographic areas is unknown. This validation study assesses the pre-operative PROMIS physical function (PF) and pain interference (PI) t-scores as a predictor of post-operative success from a separate geographic area.

Can Foot Exercises Alter Foot Posture, Strength, And Walking Foot Pressure Patterns In People With Severe Flat Foot?, Jeff Houck, Lacey Seidl, Austin Montgomery, Joshua Keefer, Miranda Walker

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Muscle training muscle control 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. Although studies demonstrated improvement in foot posture (validated foot posture index [FPI]) immediately following a 4-week exercise program this was not assessed in people with flatfoot. Also, more rigorous assessment of foot function is lacking (i.e. foot posture, strength, and plantar pressure during walking). There is clearly a need for more rigorous clinical data on the effect of foot exercises. The purpose of this pilot study was to assess the immediate effect of …

Clinical Utilization Of Patient Reported Outcome (Promis) Scores For Surgical Reconstruction Of Posterior Tibialis Tendon Dysfunction, Michael Anderson, Jeff Houck, Adolph Flemister, Judith Baumhauer, John Ketz, Benedict Digiovanni, David Ciufo, Irvin Oh

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Previous studies have demonstrated that preoperative Patient Reported Outcome Instrumentation System (PROMIS) scores effectively predict improvement in foot and ankle surgery. Adult acquired flatfoot deformity (AAFD) and Posterior Tibialis Tendon Dysfunction (PTTD) are a common surgical problem, but it is unclear if the specific thresholds for the physical function (PF), pain interference (PI) and depression published previously for all foot and ankle surgeries apply to a specific diagnosis. Furthermore, the interplay of PROMIS scores and clinical variables has not been evaluated. The purpose of this study was: 1) to investigate the change in PROMIS scales and radiographic measurements from …

The Road To Recovery For Bunion Surgery: Data Analytic Plots To Target Patient Progress, Ashlee Macdonald, Jeff Houck, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Patient reported outcomes (PROs) can provide information on individual patient’s progress throughout a treatment course and additionally, with common surgeries, powerful numbers can be generated to provide data analytic curves to provide a recovery road map for patients and surgeons. Those who deviate negatively from the predicted path may have a complication and early intervention can be initiated. Those who deviate positively have the potential to need less physical therapy, early return to sports or work. Hallux valgus (HV) is a common condition of the foot with 4.4 million patients seeking care yearly and surgery is equally common. The …

Changes In Postural Sway Behavior Across The Life Span, Maria M B N R Santos

Graduate Student Theses, Dissertations, & Professional Papers

The present study aimed to investigate human balance control by assessing postural sway on three groups representing three stages of life (6-12, 19-40 and 65-74 years old). There were 14 individuals in each group and they were tested during upright bipedal stance with either eyes open or closed. Focus was given to multiple sway indices representing multi-dimensional features of postural sway in quiet stance and included: the center of pressure area, amplitude, root mean square (RMS), velocity, jerkiness, and sample entropy. Results confirmed that children and seniors swayed more (p<.004), faster (p<.001) and their body sway was shakier (p<.001) than young adults. Seniors also presented faster (p<.006) and shakier (p<.001) sway than children and a more unpredictable pattern of body sway in time (p<.002) than children and young adults. In addition, children presented a more random anterior-posterior sway (p<.034) and a more regular medio-lateral sway (p<.043) than young adults, and a higher synchronization between anterior-posterior and medio-lateral body sway (p<.012) than young adults and seniors. We also observed that postural control of children and young adults becomes relatively more challenged in experimental situations when eyes were closed for most postural indices. In conclusion, this study suggests that multi-dimension posturography is sensitive to detect subtle age-related changes in the postural behavior and each stage of life may have their own signature patterns of postural behavior. Therefore, we expect that quantifications of this nature may be used to assess not only postural instability and fall risk but also to aid the testing of the efficacy of balance interventional protocols.

In Patients Over Sixty Years Old With A Primary Hip Fracture, Is Home Based Therapy Effective For Restoring Functional Abilities?, Florence M. Fournier

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not homebased therapy is effective for restoring functional abilities in patients over sixty with a primary hip fracture.

STUDY DESIGN: This review consists of two RCTs and one randomized clinical trial published in the English language between the years 2014 and 20 15.

DATA SOURCES: Articles were published in peer reviewed journals and compared home-based therapy as an intervention following a primary hip fracture to individuals solely documentation of post-surgical care using Cochrane and PubMed databases.

OUTCOMES MEASURED: The specific outcomes measured varied …

Meniscectomy Of A College Athlete, Aaron Bakker

Physical Therapy Scholarly Projects

Background and Purpose: The purpose of this case study is to describe the case of an athlete who sustained a meniscus injury and his subsequent course of physical therapy.

Case Description: The patient in the study is a 20 year old college football player seen by physical therapy following a left knee arthroscopic lateral meniscectomy. He injured his knee while cutting to change direction during football practice.

Intervention: Initial treatment for the patient started off as basic body weight resistance along with modalities and ice to reduce inflammation. Each week he progressed from bodyweight to weighted resistance activities and …

Physical Therapy Interventions Following Acute Traumatic Brain Injury: Early Mobility In The Acute Care Setting, Ashley Hickox

Physical Therapy Scholarly Projects

Background: Approximately 2.5 million individuals suffered from a TBI in the year of 2010. Many individuals who suffer a TBI are hospitalized for extended periods of time. Studies have shown that extended intensive care can result in deleterious and long-lasting side effects. Early mobility has been utilized to combat effects and has been shown to be safe and effective.

Purpose: To examine early mobility use as applied with respect to this case, a patient with a severe, acute TBI.

Case Description: The patient was a 26 year old male who sustained a TBI following a boat accident. …

Physical Therapist Professional Appearance: From The Patients' Perspective, Brock Clements, Kelsey Decamp

Physical Therapy Scholarly Projects

No abstract provided.

The Activities-Specific Balance Confidence Scale And Its Use In The Stepping On Program To Determine The Relationship Between Balance Confidence And Fall Risk, Erin Yankovec

Physical Therapy Scholarly Projects

Introduction: Due to the high incidence of falls in the elderly population, there is a continued need to develop intervention strategies and prevention programs to help reduce the risk of fall related injuries. Stepping On is a 7 week program designed to reduce falls and build confidence in older adults. Participants are educated on balance and strengthening exercises along with information on home hazards, community mobility, safe footwear and equipment, coping, and many other topics to help reduce falls.

Purpose: To determine if group education and exercise classes, like Stepping On, improve balance confidence levels, if balance confidence …

Effectiveness Of The Stepping On Program In Fall Prevention Measured By The Four Stage Balance Test (Fsbt), Jenna Goecke

Physical Therapy Scholarly Projects

Introduction: Falls are a leading cause of injury for older adults. Stepping On is one of many fall prevention programs in which individuals who have a fear of falling can participate. Stepping On is a 7 week multifactorial fall prevention program for community-dwelling adults age 65 and older. The program implements an exercise program and addresses education on mobility safety in the community and home. The program addresses how different fall risk factors impact function including diet, medication, vision, balance, and strength.

Purpose: The purpose of this study is to measure pre- and post-program fall risk with the …

A Case Study: Adhesive Capsulitis After Breast Cancer Surgery, Kelsey Kratzke

Physical Therapy Scholarly Projects

Purpose: The purpose of this case report was to outline the physical therapy interventions and factors affecting rehabilitation of a patient with adhesive capsulitis following breast cancer surgery.

Case Description: A 65 year-old female, with limited range of motion in the right shoulder and right anterior chest pain, was seen at an outpatient physical therapy clinic. Past medical history included unilateral right mastectomy, right lymph node dissection, and chemotherapy. The physical therapy examination and patient history led to the diagnosis of adhesive capsulitis of the right shoulder and fibrosis of the anterior chest wall musculature.

Plan of Care …

Physical Therapy Treatment Of Upper Back, Neck, And Shoulder Pain: A Case Report, Lauren A. Graham

Physical Therapy Scholarly Projects

Background and Purpose. Neck, shoulder, and upper back pain may be caused by a number of different pathologies and can decrease a patient's functional ability and participation in their daily life. The purpose of this case study is to describe the use of strengthening, stretching, manual therapy, and neuroscience of pain education for decreasing pain in a patient with chronic neck, thoracic, and shoulder pain.

Case Description. The patient was a 69 year old female who had been experiencing neck, shoulder, and upper back pain for 8 months with an insidious onset. She was functionally limited and experienced …

Evaluation Of Fall Risk, Functional Mobility, And Quality Of Life Changes Of Community-Dwelling Older Adults With Parkinson's Disease Participating In A Community Exercise Program: Part Ii, Lauren Trudel, Courtney Mcdonald, Brittany Bleichner

Physical Therapy Scholarly Projects

Purpose/Hypothesis: As a person ages, the risk of a fall increases. Parkinson Disease (PD) is most commonly seen in the elderly population, which presents with symptoms such as bradykinesia, decreased balance, tremors, postural instability, and muscle weakness. These symptoms are associated with an increase in falls; therefore, a person with PD is more susceptible to falls than the average elderly individual. Exercise has been shown to combat those symptoms affecting people with PD. This study is an extension of a previous study, which examined the effect of a community based exercise program, for people with PD, on quality of …