Physical Therapy Commons^™

Multimodal Physical Therapy Management Of A 24 Year-Old Male With Chronic Retrocalcaneal Pain: A Case Report, Matthew Herring

All Capstone Projects

Background and Purpose: The multimodal approach reflects the type of individualized treatment commonly used in the clinical setting, in which many different interventions are available to the physical therapist. The purpose of this case report is to describe the physical therapy management process for a patient with chronic retrocalcaneal pain using a multimodal intervention approach.

Case Description: The patient was a 24 year-old male with chronic left retrocalcaneal pain. The patient’s impairments included decreased left ankle dorsiflexion, decreased left talocrural joint mobility, left ankle swelling, and gait deviations. The patient’s functional limitations included decreased ability to stand and walk for …

Outcomes Of Endurance Training For A 76 Year-Old Male With Hospital Acquired Pneumonia And Elevated Troponin Levels: A Case Report, Kathryn M. Limberopoulos

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Background/Purpose: The purpose of this case report is to describe the interventions that were implemented for a patient with hospital-acquired pneumonia with multiple co-morbidities.

Case Description: The patient was a 76 year old Caucasian male who was status-post 3.5 weeks in acute care and 11 days in the ICU secondary to hospital-acquired pneumonia and elevated troponin levels. The patient presented with decreased lower extremity strength, impaired balance, and difficulty with bed mobility, transfers and gait. The patient underwent endurance training and weaning of supplemental oxygen to return to prior level of function. Assessments were performed on a weekly basis. Outcome …

Outcomes Of Conservative Physical Therapy Treatment For Osteoarthritic Knee Pain In A 58 Year-Old Female: A Case Report, Sarah Wicklin

All Capstone Projects

Background/Purpose: Knee osteoarthritis (OA) is the most commonly diagnosed form of arthritis in older adults. The purpose of this case study is to describe a conservative physical approach towards alleviating symptomatic knee OA pain and achievement of functional outcomes.

Case Description: The patient was a 58-year-old Caucasian female with complaints of left shin and knee pain with a complex medical history. The patient’s goal for physical therapy was to return to functional activities such as walking greater than 60 minutes and climbing stairs pain free.

Outcomes: Upon completion of physical therapy, the patient demonstrated slight increases in left knee flexion …

Comparative Literature Analysis Of Peripheral Vestibular Function Assessment Tools, Riddhi Chinoy

All Capstone Projects

Objective Purpose: One main function of the peripheral vestibular system's semicircular canals is to stabilize images on a target during head movements through the important vestibula-ocular reflex (VOR) in order to maintain clear vision. Abnormal VOR response results in fast, compensatory, catch­ up saccadic eye movements suggesting dysfunction in the semicircular canals. Several functional assessment tools have been developed since the twentieth century to measure the VOR response and saccadic eye movement, and some are still widely used currently, such as the caloric test, rotary chair test, bedside head impulse test (bHIT), scleral search coil technique, and video head impulse …

Physical Therapy Management Of A 16 Year Old Female With Vestibular Symptoms Following Suspected Concussion: A Case Report, Gina Tassione

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Background: Post concussion syndrome has become more common in adolescents involved in school related sports. Management of dizziness and imbalance is challenging after concussion; vestibular rehabilitation has been shown to reduce symptoms and improve balance.

Purpose: The purpose of this study was to describe and implement appropriate interventions for a patient with suspected post concussion syndrome. A combined approach using targeted physical therapeutic exercise as well as functional tasks were evaluated and assessed.

Case description: The patient was a 16 year old Caucasian female who presented to the clinic with a physician order to evaluate and …

Treatment Of A 65 Year Old Deconditioned Female Admitted With Complications Resulting From Morbid Obesity: A Case Report, David Sarvin

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Background/Purpose: Obesity is a growing concern among the population of adults and children living in the United States. It costs the medical industry a great deal of money each year treating these patients, especially in those individuals classified as morbidly obese. The purpose of this study is to assess effectiveness of a cardiovascular based treatment plan on a deconditioned subject who suffers from complications resulting from morbid obesity.

Case Description: The patient described in this case study is a 65 year old Caucasian female admitted to the skilled nursing facility with complications resulting from morbid obesity, among other co-morbidities.

Interventions/Ouctomes …

Rehabilitative Management Of A 66-Year-Old Female With Chronic Low Back Pain: A Case Report, Rachael Matthews

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Background and Purpose: There is a lack of research demonstrating standardization of treatment protocols for patients with chronic low back pain and lumbar spinal stenosis. The purpose of this case report was to examine the effectiveness of a physical therapy rehabilitation program for a 66-year-old female referred for lumbar radiculopathy and lumbar spinal stenosis.

Case Description: This case report contained interventions focused on lumbar extension exercises, upper and lower extremity and postural control exercises, aerobic training, and modalities, in order to achieve the patient’s goals and to improve quality of life. To measure the outcomes the following tests and measures …

Physical Therapy Treatment For A 90-Year Old Male After Lacunar Stroke With Bppv: An Outpatient Case Report, Adam Nicholson

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Background and Purpose: The purpose of this case report was to delineate the differential diagnosis of vertigo symptoms in a patient after a stroke and describe interventions used in the outpatient physical therapy setting.

Case Description: The patient was a 90 year old male treated in an outpatient physical therapy clinic after a lacunar stroke 6 months prior. The patient presented with symptoms of vertigo that are common after a stroke, but also exhibited symptoms consistent with benign paroxysmal positional vertigo (BPPV).

Outcomes: Overall, the patient greatly improved his abilities for gait and balance after treatment. The patient appeared much …

Treatment Of A 92 Year Old Female Deconditioned After Hospitalization Secondary To A Hemorrhagic Stroke: A Case Report, Paul A. Naujokas

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Background and Purpose: Research suggests that older adults are more likely to be hospitalized and to be at risk for hospital-associated deconditioning after successful treatment of their medical condition.This case report demonstrates that a walking program with progressive resistive exercises (PREs) helped one 92 year old female patient, suffering from hospital associated deconditioning, improve her strength, cardiovascular endurance, and functional abilities, including sit-stand transfers, ambulation with the least resistive assistive device (LRAD) and stair climbing. These improvements allowed the patient to return to her prior level of functioning, living independently in her 2nd story apartment with assistance as needed from …

Task-Specific Resistance Training Bedside For An 80-Year-Old Deconditioned Female: A Case Report, Maura Ryan

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Background: The purpose of this case report was to describe the use of task-specific resistance training bedside on an 80-year-old deconditioned female.

Case Description: The patient was a retired 80-year-old African-American female seen in a skilled nursing facility who was hospitalized due to defibrillator firing with atrial fibrillation with abdominal pain and Clostridium Difficile. Three weeks prior the patient was hospitalized for a right inguinal hernia repair.

Outcomes: The patient was unable to return to her prior level of independence for all functional mobility, yet the patient increased her gait distance, improved her lower extremity strength evidenced by manual muscle …

A Study Examining Practice Style Traits Of Physical Therapists: Do They Explain Practice Behaviors And Knowledge Translation?, Kristen M. Johnson

Student Dissertations

Background: The advancement of evidence-based practice (EBP) has generated a flurry of outcome measures (OMs) and continuing education courses to assist in the creation and tailoring of this knowledge to the clinical environment. Despite the development of these resources, little is known about the attributes and behaviors of the physical therapist for knowledge translation (KT) into clinical practice.

Purpose: To determine the practice style traits of physical therapists who attended an evidence-based continuing education course on Oms and to determine their perceived barriers, facilitators, attitudes, knowledge, behaviors, and prerequisites for KT.

Methods: Seventy-nine physical therapists completed two standardized, validated surveys …

The Use Of Pbl In An Interprofessional Education Course For Health Care Professional Students, Kristine M. L'Ecuyer, David Pole, Sheila A. Leander

Interdisciplinary Journal of Problem-Based Learning

A problem-based learning (PBL) framework was utilized in a series of six interprofessional team seminars (IPTS) for postbaccalaureate students from seven health professions. The goal of IPTS was to develop a collaborative practice-ready workforce prepared to respond to patient care needs through use of concrete examples, skills development, critical thinking, and problem solving in safe, faculty-facilitated small groups. The collaborative nature of PBL closely correlates with teaching methodologies of the IPTS series. This study analyzed critical reflection assignments of nursing students in accelerated programs to determine the effectiveness of IPTS at preparing students for interprofessional collaborative practice. Findings indicated that …

Blockade Of Neurokinin-1 Receptors In The Ventral Respiratory Column Does Not Affect Breathing But Alters Neurochemical Release, Clarissa Muere, Suzanne Neumueller, Samantha Olesiak, Justin Miller, Matthew Hodges, Lawrence Pan, Hubert Forster

Physical Therapy Faculty Research and Publications

Substance P (SP) and its receptor, neurokinin-1 (NK1R), have been shown to be excitatory modulators of respiratory frequency and to stabilize breathing regularity. Studies in anesthetized mice suggest that tonic activation of NK1Rs is particularly important when other excitatory inputs to the pre-Bötzinger complex in the ventral respiratory column (VRC) are attenuated. Consistent with these findings, muscarinic receptor blockade in the VRC of intact goats elicits an increase in breathing frequency associated with increases in SP and serotonin concentrations, suggesting an involvement of these substances in neuromodulator compensation. To gain insight on the contribution to breathing of endogenous SP and …

Differential Effects Of Cardiovascular And Resistance Exercise On Functional Mobility In Individuals With Advanced Cancer: A Randomized Trial, Amy J. Litterini, Vickie Fieler, James T. Cavanaugh, Jeannette Lee

Physical Therapy Faculty Posters

Objective: To compare the effects of resistance and cardiovascular exercise on functional mobility in individuals with advanced cancer.
Design: Prospective, 2-group pretest-posttest pilot study with randomization to either resistance or cardiovascular exercise mode.
Setting: Comprehensive community cancer center and a hospital-based fitness facility.
Demographics: Volunteer sample of individuals with advanced cancer recruited through the cancer center, palliative care service, rehabilitation department, and a local hospice.
Outcome Measures: Functional mobility was assessed using the Short Physical Performance Battery (SPPB); self-reported pain and fatigue were assessed secondarily using visual analog scales. Data were analyzed using a split plot 2x2 analysis of variance …

Effect Of Tai Chi Exercise Combined With Mental Imagery In Improving Balance, Abdulrahman Alsubiheen

Loma Linda University Electronic Theses, Dissertations & Projects

Background: One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects feet sensation and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Methods: Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 50-80 years of age were recruited. All subjects in both groups attended a Yang style of TC class, two sessions per week for 8 weeks. Each session was one hour long. Measures …

A Teaching Tool To Visually Illustrate How Manipulating The Physiology Of The Ventilatory Muscle Pump Alters Functional Performance, Dennis Sobush

Physical Therapy Faculty Research and Publications

This clinical perspective article describes an inexpensive pedagogical tool intended for use in a laboratory setting as part of a cardiovascular and pulmonary physical therapy course. It uses a dual balance scale schematic/model. As a teaching resource, physical therapy students can use it to visually reinforce their understanding of the complex cause-and-effect interplay between physiological factors that affect ventilatory muscle pump (VMP) performance for sustained breathing or contribute to VMP fatigue/failure.

Muscle Dynamics As The Result Of Whole Body Vibration And Plyometrics, Richard Jeremy Hubbard

Loma Linda University Electronic Theses, Dissertations & Projects

BACKGROUND: Whole body (WBV) vibration and plyometrics are common training techniques which increase strength, blood flow, force and power. The effects these techniques have on sedentary population is unknown. It is our aim to assess the effectiveness of WBV and plyometrics on sedentary population. SUBJECTS: Three groups of nine sedentary subjects were assigned to either the control group (C), jumping only group (J), or jumping with vibration group (JV). METHODS AND PROCEDURES: Measurements included: jump height (Myotest or Vertec), velocity, force, blood lactates, gastrocnemius and quadriceps strength, and exertion (RPE). Subjects were measured at the first, seventh, and eighteenth visits. …

Stroke-Related Effects On Maximal Dynamic Hip Flexor Fatigability And Functional Implications, Henry Kuhnen, Megan M. Rybar, Tanya Onushko, Ryan E. Doyel, Sandra K. Hunter, Brian D. Schmit, Allison S. Hyngstrom

Exercise Science Faculty Research and Publications

Introduction: Stroke-related changes in maximal dynamic hip flexor muscle fatigability may be more relevant functionally than isometric hip flexor fatigability. Methods: Ten chronic stroke survivors performed 5 sets of 30 hip flexion maximal dynamic voluntary contractions (MDVC). A maximal isometric voluntary contraction (MIVC) was performed before and after completion of the dynamic contractions. Both the paretic and nonparetic legs were tested. Results: Reduction in hip flexion MDVC torque in the paretic leg (44.7%) was larger than the nonparetic leg (31.7%). The paretic leg had a larger reduction in rectus femoris EMG (28.9%) between the first and last …

The Effect Of Muscle Energy Technique On Forward Shoulder Posture, Pectoralis Minor Length, And Upper Extremity Blood Flow In Collegiate Female Swimmers, Elizabeth Gross

Theses and Dissertations

Context: Overhead sports are at an increased risk of shoulder injury, particularly when scapular posture is restricted. Pectoralis minor length has been linked to scapular malpositioning and forward shoulder posture. Upper extremity blood flow has also been linked to shortened pectoralis minor length, which could lead to thoracic neurovascular occlusion. Swimmers specifically may be at an increased risk for shoulder injury if the pectoralis minor is shortened. Stretching of the pectoralis minor has been suggested as a treatment to correct shortening of the muscle, however research examining muscle energy technique (MET) applied to the pectoralis minor is limited. Objective: To …

Health Related Quality Of Life In Persons With Type 2 Diabetes In A Rural Community Served By A Critical Access Hospital, Betsy J. Becker, Terry F. Nelson, Robin High, Pat Hauer

Posters and Presentations: Physical Therapy

Purpose

Type 2 diabetes poses significant health concerns and severe complications can result. The prevalence of type 2 diabetes is greater in rural than urban areas with rural populations exhibiting higher blood glucose (A1C). The purpose of this study was to determine whether health related quality of life (QOL) varies by gender and diabetes control (A1C) in rural persons with type 2 diabetes.

Subjects

We surveyed 615 persons with type 2 diabetes who receive care at a critical access hospital that serves a seven county rural area in a Midwestern state.

Methods

This study was a cross-sectional mail survey including …