Physical Therapy Commons^™

Development Of A Statement On Autonomous Practice: Practice Committee, Section On Geriatrics, Jason Hardage, Stacey Zeigler, Jennifer Blackwood, Tamara Gravano, Greg Hartley, Jill Heitzman, Joe Libera, Ken Miller

Physical Therapy Faculty Research

Vision 2020 is the official vision statement of the American Physical Therapy Association (APTA). Drafted by the APTA House of Delegates in 2000, this statement contains 6 elements: autonomous physical therapist practice, direct access, Doctor of Physical Therapy and lifelong education, evidence-based practice, practitioner of choice, and professionalism. Autonomous practice has been operationally defined by the APTA primarily through its characteristics: “Physical therapists accept the responsibility to practice autonomously and collaboratively in all practice environments to provide best practice to the patient/client. Autonomous physical therapist practice is characterized by independent, self-determined, professional judgment and action.” The Section on Geriatrics has …

The Appropriateness Of Long-Term Opioids To Treat Chronic Back Pain, Thomas Watanabe, Michael Salino, Adam Schreiber

Department of Rehabilitation Medicine Faculty Papers

Point/Counterpoint Case Scenario: A 55-year old man presents to a pain clinic upon referral from his primary care physician. His symptom is axial low back pain. His pain started approximately 1 year earlier without a specific inciting event. He denies radiation of pain into the lower extremities. There is no bowel or bladder involvement. There is no directional preference. He reports pain "all the time," with minimal specific exacerbating or relieving factors. There is no medical-legal involvement. His medical history is significant for hypertension, hypercholesterolemia, obesity, and sleep apnea. He is a divorced father of 2 adult children. He is …

The Effect Of Movement Rate And Complexity On Functional Magnetic Resonance Signal Change During Pedaling, Jay P. Mehta, Matthew D. Verber, Jon A. Wieser, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

We used functional magnetic resonance imaging (fMRI) to record human brain activity during slow (30 RPM), fast (60 RPM), passive (30 RPM), and variable rate pedaling. Ten healthy adults participated. After identifying regions of interest, the intensity and volume of brain activation in each region was calculated and compared across conditions (p < .05). Results showed that the primary sensory and motor cortices (S1, M1), supplementary motor area (SMA), and cerebellum (Cb) were active during pedaling. The intensity of activity in these areas increased with increasing pedaling rate and complexity. The Cb was the only brain region that showed significantly lower activity during passive as compared with active pedaling. We conclude that M1, S1, SMA, and Cb have a role in modifying continuous, bilateral, multijoint lower extremity movements. Much of this brain activity may be driven by sensory signals from the moving limbs.

The Influence Of Interlimb Differences On Anterior Cruciate Ligament Injury Risk Factors In Female Collegiate Soccer Athletes, Eric Kevin Greska

Human Movement Studies & Special Education Theses & Dissertations

Female collegiate soccer athletes suffer anterior cruciate ligament (ACL) injuries at a rate of 0.31 per 1000 athlete-exposures, with 67% of injuries expected to be from a non-contact mechanism. As well, previous studies have demonstrated dissimilarity in non-contact ACL injuries relative to dominant and non-dominant legs; with the non-dominant leg being the involved side in 48-67% of reported incidents. The aim of this study was to examine lower extremity neuromechanics relative to leg dominance during an unanticipated sidestep cutting task, with differing states of fatigue and training.

Twenty female collegiate soccer players performed three valid trials for both the dominant …

Corticomotor Excitability During A Noxious Stimulus And Following Exercise In Women With Fibromyalgia, Marie K. Hoeger Bement, Andy Weyer, Tejin Yoon, Sandra K. Hunter

Physical Therapy Faculty Research and Publications

No abstract provided.

Push-Pull Control Of Motor Output, Michael D. Johnson, Allison S. Hyngstrom, Marin Manuel, C J. Heckman

Physical Therapy Faculty Research and Publications

Inhibition usually decreases input–output excitability of neurons. If, however, inhibition is coupled to excitation in a push–pull fashion, where inhibition decreases as excitation increases, neuron excitability can be increased. Although the presence of push–pull organization has been demonstrated in single cells, its functional impact on neural processing depends on its effect on the system level. We studied push–pull in the motor output stage of the feline spinal cord, a system that allows independent control of inhibitory and excitatory components. Push–pull organization was clearly present in ankle extensor motoneurons, producing increased peak-to-peak modulation of synaptic currents. The effect at the system …

The Graded Redefined Assessment Of Strength Sensibility And Prehension: Reliability And Validity., Sukhvinder Kalsi-Ryan, Dorcas Beaton, Armin Curt, Susan Duff, Milos R Popovic, Claudia Rudhe, Michael G Fehlings, Mary C Verrier

Department of Physical Therapy Faculty Papers

Abstract With the advent of new interventions targeted at both acute and chronic spinal cord injury (SCI), it is critical that techniques and protocols are developed that reliably evaluate changes in upper limb impairment/function. The Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) protocol, which includes five subtests, is a quantitative clinical upper limb impairment measure designed for use in acute and chronic cervical SCI. The objectives of this study were to: (1) establish the inter-rater and test-retest reliability, and (2) establish the construct and concurrent validity with the International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI), …

Effect Of A Single High-Fat Meal And Vitamins On The Circulatory Response To Local Heat In Koreans And Caucasians, Jongeun Yim

Loma Linda University Electronic Theses, Dissertations & Projects

Blood flow mediated by the vascular endothelium plays an important role in removing heat from the skin. Asians who have thrifty genes have impaired endothelial function (EF) due to the westernized high fat (HF) dietary lifestyle. Hypertriglyceridemia (HTG) can produce free radicals which reduces the bioavailability of the endothelium derived relaxing factor, nitric oxide (NO). EF, as measured by the blood flow response (BFR) to heat, occlusion and the free radical concentration after a single HF meal has not been studied in Korean-Asians compared to Caucasians. The purpose of this study was to evaluate baseline and postprandial EF as related …

Supraspinal Fatigue Impedes Recovery From A Low-Intensity Sustained Contraction In Old Adults, Tejin Yoon, Bonnie Schlinder-Delap, Manda L. Keller, Sandra K. Hunter

Exercise Science Faculty Research and Publications

This study determined the contribution of supraspinal fatigue and contractile properties to the age difference in neuromuscular fatigue during and recovery from a low-intensity sustained contraction. Cortical stimulation was used to evoke measures of voluntary activation and muscle relaxation during and after a contraction sustained at 20% of maximal voluntary contraction (MVC) until task failure with elbow flexor muscles in 14 young adults (20.9 ± 3.6 yr, 7 men) and 14 old adults (71.6 ± 5.4 yr, 7 men). Old adults exhibited a longer time to task failure than the young adults (23.8 ± 9.0 vs. 11.5 ± 3.9 min, …

Vitamin D And Brain Imaging In The Elderly: Should We Expect Some Lesions Specifically Related To Hypovitaminosis D?, Cédric Annweiler, Manuel Montero-Odasso, Susan W Muir, Olivier Beauchet

Physical Therapy Publications

Hypovitaminosis D is associated with cognitive decline in the elderly, but the issue of causality remains unresolved. Definitive evidence would include the visualization of brain lesions resulting from hypovitaminosis D. The aim of the present article is to determine, through a literature review, the location and nature of possible brain disorders in hypovitaminosis D. We found limited brain-imaging data, which reported ischemic infarcts and white matter hyperintensities in hypovitaminosis D, though did not provide their specific location or report any focal atrophy. Based on the finding of executive dysfunctions (i.e., mental shifting and information updating impairments) in the presence of …

A Prototype Head-Motion Monitoring System For In-Home Vestibular Rehabilitation Therapy, Pamela T. Bhatti, Susan J. Herdman, Siddarth Datta Roy, Courtney D. Hall, Ronald J. Tusa

ETSU Faculty Works

This work reports the use of a head-motion monitoring system to record patient head movements while completing in-home exercises for vestibular rehabilitation therapy. Based upon a dual-axis gyroscope (yaw and pitch, ± 500-degrees/sec maximum), angular head rotations were measured and stored via an on-board memory card. The system enabled the clinician to document exercises at home. Several measurements were recorded in one patient with unilateral vestibular hypofunction: The total time of exercise for the week (118 minutes) was documented and compared with expected weekly exercise time (140 minutes). For gaze stabilization exercises, execution time of 60 sec was expected, and …

Aging And The Motor Unit, J. Bunn

Physical Therapy

No abstract provided.

Preventing Muscle Atrophy With Protein And Amino Acid Supplementation, J. Bunn

Physical Therapy

No abstract provided.

Reliability Of A Seated Three-Dimensional Passive Intervertebral Motion Test For Mobility, End-Feel, And Pain Provocation In Patients With Cervicalgia, D. M. Manning, G. S. Dedrick, P. S. Sizer, J. M. Brismée

Physical Therapy

No abstract provided.

Chronic Female Pelvic Pain; Part Ii: Differential Diagnosis And Management, P. Nelson, G. Apte, R. Justiz, J. M. Brismée, G. S. Dedrick, P. S. Sizer

Physical Therapy

No abstract provided.

Chronic Female Pelvic Pain; Part I: Clinical Pathoanatomy And Examination Of The Pelvic Region, G. Apte, P. Nelson, J. M. Brismée, G. S. Dedrick, R. Justiz, P. S. Sizer Jr.

Physical Therapy

No abstract provided.

The Effect Of Isometric Shoulder Internal And External Rotation On The Acromiohumeral Distance, C. White, G. S. Dedrick, P. S. Sizer, G. G. Apte, J. M. Brismée

Physical Therapy

No abstract provided.

Chronic Lower Back Pain: A Maladaptive Perceptions Model, Benedict M. Wand

Physiotherapy Conference Papers

High quality evidence suggests that current approaches to the management of CLBP show only limited effectiveness; one explanation of this finding is that current models of management are misdirected or incomplete. This talk proposes a model of CLBP underpinned by data on the psychological contributors to the LBP experience and recent evidence of neuroplastic changes in the brains of people with CLBP (see below). The model suggests that maladaptive cognitive perception about the nature of the back problem and future consequences drive behaviours that might bring about maladaptive neuroplastic changes. These central nervous system changes may enhance sensitivity, influence normal …

Moving In An Environment Of Induced Sensory-Motor Incongruence Does Not Influence Pain Sensitivity In Healthy Volunteers: A Randomised Within-Subject Cross-Over Experiment, Benedict M. Wand, Lareina Szpak, Pamela George, Max Bulsara, Neil E. O'Connell, G Lorimer Moseley

Physiotherapy Conference Papers

A mismatch between the brain's motor control and sensory systems has been suggested as one mechanism whereby maladaptive neuroplastic changes contribute to the experience of chronic pain. Several studies have investigated this hypothesis by artificially inducing a state of sensory-motor incongruence using mirrors. The data to date appear to suggest that creating an environment of sensori-motor incongruence induces various sensory changes and feeling of peculiarity, however the effect on pain is less clear. The aim of this study was to test the hypothesis that healthy participants would demonstrate reduced pain thresholds and report greater intensity of pain in a condition …

Treatment-Based Classification Of Low Back Pain – Who Are The Unclear Classifications?, T R. Stanton, J M. Fritz, A T. Apeldoorn, Benedict M. Wand, M J. Hancock

Physiotherapy Conference Papers

A recent focus in low back pain research has been to identify patient subgroups that respond best to certain treatments. To integrate these subgroup findings into a useable form, a treatment-based classification algorithm for LBP was created.^1,2 To allow the algorithm to be comprehensive – eg, provide a classification for all patients – additional criteria are provided to assist therapists’ decisions for patients who do not clearly meet a treatment subgroup (unclear classifications).

Recent research found that approximately 34% of patients will receive unclear classifications using the algorithm.³ It has also been shown that the reliability of the …