Physical Therapy Commons^™

Low Back Pain And The Lumbar Multifidus Muscle, Richard E. Sroka

Graduate Research Theses & Dissertations

Low back pain (LBP) is common, debilitating, and costly to treat. In the United States alone, LBP treatment costs are estimated at 100-200 billion annually. Physical therapists often provide conventional core strengthening exercise (CCSE) to address the symptoms of LBP. On the other hand, however, a low rate of success is reported for individuals treated for their LBP. Despite numerous studies conducted on LBP treatments, patient outcomes are mixed and 60-86% of people have recurrent LBP episodes. This rating may be attributed to the complexity of the exercise that makes correct performance challenging and can potentially reduce patient compliance. An …

Health-Outcomes Related To Smartphone Use In The College Student Population: A Scoping Review, Gregory Deglomine

Honors Undergraduate Theses

Objective: A scoping review was employed to consolidate what is currently being studied and reported on concerning interactions with smartphone devices and correlated negative health-outcomes, specifically within the college student population. We are specifically concerned with this population due to the unique demands of technology use coupled with free time use of smartphone devices. Information such as study focus, study design, and summarized results are be provided within this compilation of available data. Results: The existing data findings are heavily skewed in favor of a positive correlation between smartphone use and negative health-outcomes. Sampling 17,069 total participants across 41 studies, …

Knowledge Translation Task Force For Core Measures Clinical Practice Guideline: A Short Report On The Process And Utilization, Marghuretta D. Bland, Jennifer Moore, Elizabeth Anderl, Megan Eikenberry, Arlene Mccarthy, Geneviève N. Olivier, Tracy Rice, Amelia Siles, Hallie Zeleznik, Wendy Romney

Physical Therapy Faculty Publications

Background

As part of the 2018 Clinical Practice Guideline (CPG): A Core Set of Outcome Measures for Adults with Neurologic Conditions Undergoing Rehabilitation, a Knowledge Translation (KT) Task Force was convened. The purpose of this short report was to (1) demonstrate the potential impact of a CPG KT Task Force through a practical example of efforts to implement a CPG into neurologic physical therapy practice and (2) describe the process to convene a KT Task Force and develop products (KT Toolkit) to facilitate implementation of the CPG.

Methods

To describe the process used by the KT Task Force to develop …

Exploring The Relationship Of Intact Limb Knee Joint Loading With Step Lengths And Step Length Symmetry In Individuals With Lower Limb Amputation, Edward D. Syrett

Theses and Dissertations

Individuals with unilateral lower limb amputation (LLA) frequently experience intact limb knee pain, dysfunction, and osteoarthritis. These problems can worsen pre-existing reductions in mobility and quality of life that this population regularly experiences. It is widely accepted that knee joint loading is implicated in the development of knee joint issues, and intact limb knee joint load alterations are thought to be widespread in individuals with LLA. Prior work suggests that gait deviations frequently present in this population may be a contributory cause of these altered forces. These deviations can take many forms, but individuals with LLA commonly demonstrate alterations in …

Clinical Reasoning Development: Exploring The Role Of Instructor Feedback During Health Professions Clinical Education Experiences, Ryan T. Orrison

Graduate Research Theses & Dissertations

The growing complexity of the healthcare environment and the need to equitably address the health and well-being of a diverse patient population has increased the requirement for practical instruction and assessment of clinical reasoning in the training of health professionals. Formative assessment, in the form of feedback, is recognized as an essential instructional component in teaching clinical reasoning. This study aimed to investigate the role of feedback in developing clinical reasoning during clinical education.

This investigation consisted of three unique studies completed in phases. The scoping review methodology in phase one revealed six themes from the included articles (n = …

Female Athletes With Better Psychological Readiness Are At Higher Risk For Second Acl Injury After Primary Acl Reconstruction, Ryan Zarzycki, Kathleen Cummer, Elanna Arhos, Matthew Failla, Jacob J. Capin, Angela H. Smith, Lynn Snyder-Mackler

Physical Therapy Faculty Research and Publications

Background: Approximately 1 in 4 athletes returning to sports will sustain a second anterior cruciate ligament (ACL) injury. Psychological factors related to kinesiophobia, confidence, and psychological readiness are associated with second ACL injury; however, the evidence is conflicting.

Hypothesis: Athletes who sustain a second ACL injury (ie, graft rupture or contralateral ACL rupture) within 2 years of ACL reconstruction (ACLR) would have greater kinesiophobia, less confidence, and lower psychological readiness prior to return to sport (RTS) compared with athletes who do not sustain a second ACL injury.

Study Design: Secondary analysis of a prospective randomized trial.

Level …

Age-Related Development Of Bilateral Coordination Of The Upper Limbs In Children And Adolescents, Samuel Nemanich, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

Bilateral coordination of the upper limbs (UL) is important for activities of daily living and physical activities. Motor coordination improves from childhood through adolescence. However, age-coordination trajectories for bilateral UL movements are not well-established, and it is unclear if bimanual coordination develops slower than unilateral coordination. In this study we examined age-related changes in UL coordination from childhood to late adolescence. Typically-developing children (N = 29, aged 7–17 years) performed unilateral and bilateral, antiphase cycling tasks with their ULs. Variations in cycling velocity and interlimb phase errors were computed as measures of coordination. Linear regression was used to examine …

The Effects Of Attentional Focus Instructions On Approach Jump Performance, Hanwen Liu, Scott Arnett, Dano Tolusso, Kaylee Woodard

Physical Therapy Faculty Research and Publications

Introduction

Attentional focus has been shown to significantly influence motor learning and performance, with external focus instructions enhancing performance compared to internal focus instructions. Research has also demonstrated that novice performance is improved when instructed to focus on skill execution processes rather than outcomes. However, this effect remains untested in complex jumping skills crucial to numerous sports.

Purpose

This study aimed to investigate the effect of internally and externally directed process and outcome focus instructions on approach jump height and approach speed in novice participants.

Methods

Twelve individuals aged 18 to 22 participated across three sessions: Familiarization, Test Session 1, …

Heart Rate Variability Is Reduced In Covid-19 Survivors And Associated With Physical Activity And Fatigue, Michael H. Haischer, Lauren E. Opielinski, Lindsey M. Mirkes, Toni D. Uhrich, Rachel E. Bollaert, Michael E. Danduran, Marie K. Hoeger Bement, Linda B. Piacentine, Paula E. Papanek, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Reduced heart rate variability (HRV) and fatigue are common after COVID-19 infection and both are potentially influenced by physical activity (PA). We compared resting HRV, PA from accelerometers and questionnaires, and self-reported fatigue in 41 COVID-19 survivors (~8 months postinfection, 38 ± 17 years) with 41 matched controls. Differences in HRV were observed on acceleration capacity (p = 0.041), deceleration capacity (p = 0.032), high-frequency peak frequency (p = 0.019), absolute low-frequency power (p = 0.042), relative very low-frequency power (p = 0.012), SD2 (from Poincare plot; p = 0.047), and DFA2 (slope of long-term …

Middle-Range Scores From The Patient Determined Disease Steps Scale Reflect Varying Levels Of Walking Dysfunction In Multiple Sclerosis, Robert W. Motl, Whitney Neal, Deborah Backus, Jeffrey Hebert, Kevin K. Mccully, Francois Bethoux, Prudence Plummer, Alexander V. Ng, John Lowman, Hollie Schmidt, Robert Mcburney, Gary R. Cutter

Exercise Science Faculty Research and Publications

Background

Multiple sclerosis (MS) is a leading cause of neurological disability among young and middle-aged adults worldwide, and disability is measured using a variety of approaches, including patient reported outcome measures (PROMs) such as the Patient Determined Disease Steps (PDDS) scale. There is limited evidence for the validity of inferences from the middle-range of scores on the PDDS (i.e., 3 “gait disability” – 6 “bilateral support”), but that range of scores seemingly represents moderate disability characterized by varying levels of walking dysfunction.

Purpose

The current study examined whether the middle-range of scores from the PDDS reflect varying levels of walking …

Disability Reduction Following A Lumbar Stabilization Exercise Program For Low Back Pain: Large Vs. Small Improvement Subgroup Analyses Of Physical And Psychological Variables, Christian Larivière, Richard Preuss, Marie-France Coutu, Michael J. Sullivan, Nicolas Roy, Sharon M. Henry

Études primaires

Background: Little is known about why patients with low back pain (LBP) respond differently to treatment, and more specifically, to a lumbar stabilization exercise program. As a first step toward answering this question, the present study evaluates how subgroups of patients who demonstrate large and small clinical improvements differ in terms of physical and psychological changes during treatment. Methods: Participants (n = 110) performed the exercise program (clinical sessions and home exercises) over eight weeks, with 100 retained at six-month follow-up. Physical measures (lumbar segmental instability, motor control impairments, range of motion, trunk muscle endurance and physical performance tests) were …

What Are The Perceptions And Lived Experiences Of Canadian Injured Workers About The Provision Of Physiotherapy Services Using Telerehabilitation?, Anne Hudon, Maxi Miciak, Teri Slade, Stacey Lovo, Jackie L. Whittaker, Daniel Côté, Debbie E. Feldman, Dahlia Kairy, Marie Laberge, Beverley Mckeen, Lynn Cooper, Douglas P. Gross

Études primaires

Purpose

Despite evidence of efficacy, the effectiveness of telerehabilitation in real-world clinical settings is still largely unknown. Telerehabilitation requires a substantial transformation of the organization and delivery of traditional services. Considering that a virtual setting can create unique challenges for providing physiotherapy services and given the physical and potential hands-on nature of evidence-based assessments and interventions, it is important to investigate what injured workers think of receiving physiotherapy care via telerehabilitation and to examine if rehabilitation needs are adequately met.

Methods

A qualitative interpretive description study was conducted to explore the perspectives and experiences of 17 injured workers receiving physiotherapy …

Qualitative Evaluation Of Interprofessional Education Experiential Learning (Ipeel) For Health Professional Students, Kelle Deboth Foust, Madalynn Wendland, John Schaefer, Suzanne Giuffre, Donald Allensworth-Davies

Journal of Occupational Therapy Education

Interprofessional education (IPE) is critical for health professional students to form professional identities and develop collaborative skills. Although accrediting bodies mandate incorporating IPE, the effects of IPE programming on health professional students and the best pedagogical approach for achieving desirable outcomes are still unclear. In addition, specific effects of IPE within the context of experiential learning are not fully understood. That is, the literature has not presented a clear framework for structuring IPE programs, nor have outcome measures for IPE utilizing experiential learning (IPEEL) been established. The purpose of this study was to complete a grounded theory qualitative analysis of …

Embedding Physical Therapy In The Pediatric Primary Care Setting: Qualitative Analysis Of Pediatricians’ Insights On Potential Collaborative Roles And Benefits, Ryan P. Jacobson, Rebecca R. Dobler

Faculty Publications - College of Physical Therapy

The growing need for collaborative healthcare teams to meet complex health challenges has led to physical therapists (PTs) being embedded in adult primary care settings for many years now. However, this model of care has not been found in pediatrics. This qualitative study sought to gain insights from pediatricians on the potential of embedding pediatric PTs in primary care. Participants were nine pediatricians practicing in both urban and rural, hospital-based and private settings. Semi-structured interviews were recorded, transcribed, and analyzed via thematic analysis per published methods, assuring trustworthiness. Three overarching themes emerged: pediatricians’ priorities aligned with the Quadruple Aim of …

How Hormonal Contraceptives Influence Injury In Female Athletes: A Systematic Review, Ashley V. Malvita

Honors Undergraduate Theses

Research indicates that female athletes have a higher risk of musculoskeletal injuries. Hormone fluctuations throughout the different periods of the menstruation cycle impacts the risk of injuries for women. Contraceptive use, most used in the form of an oral contraceptive pill, directly effects hormones and menstrual cycle related symptoms, with evidence of ameliorating some symptoms. Oral contraceptive use is suggested to influence musculoskeletal injuries in female athletes. However, there is little research and data that explores the direct relationship between oral contraceptive use and the injury rates of female athletes. Within this systematic review, five articles investigating this relationship fulfilled …

How Can We Treat If We Do Not Measure: A Systematic Review Of Neurogenic Bowel Objective Measures, Argy Stampas, Amisha Patel, Komal Luthra, Madeline Dicks, Radha Korupolu, Leila Neshatian, George Triadafilopoulos

Faculty, Staff and Student Publications

Background: Guidelines fail to recommend objective measures to assist with treatment of neurogenic bowel dysfunction (NBD) in spinal cord injury (SCI).

Objectives: The main objective was to review the literature to identify the objective measures used in all NBD populations and to present their results and any correlations performed to validated subjective measures.

Methods: A systematic review of the literature was performed in accordance with PRISMA (2020) guidelines, including all records from January 2012 to May 2023 with MeSH terms like "neurogenic bowel" indexed in the following databases: PubMed, EMBASE, CINAHL, Cochrane Central Trials Register, and ClinicalTrials.gov. Abstracts were excluded …

Multimodal Therapy And Use Of Adjunctive Therapies To Bont-A In Spasticity Management: Defining Terminology To Help Enhance Spasticity Treatment, Rajiv Reebye, Luis Jorge Jacinto, Alexander Balbert, Bo Biering-Sørensen, Stefano Carda, Nathalie Draulans, Franco Molteni, Michael W O'Dell, Alessandro Picelli, Andrea Santamato, Monica Verduzco-Gutierrez, Heather Walker, Joerg Wissel, Gerard E Francisco

Faculty, Staff and Student Publications

Spasticity management should be provided within the context of a comprehensive person-centered rehabilitation program. Furthermore, active goal setting for specific spasticity interventions is also important, with a well-established "more is better" approach. It is critical to consider adjunctive therapy and multimodal approaches if patients are not attaining their treatment goals. Often used interchangeably, there may be confusion between the terms adjunctive and multimodal therapy. Yet it is imperative to understand the differences between these approaches to achieve treatment goals in spasticity management. Addition of a secondary pharmacologic or non-pharmacologic treatment to optimize the efficacy of the initial modality, such as …

Safety And Feasibility Of Paired Vagus Nerve Stimulation With Rehabilitation For Improving Upper Extremity Function In People With Cervical Spinal Cord Injury: Study Protocol For A Pilot Randomized Controlled Trial, Nuray Yozbatiran, Gerard E Francisco, Radha Korupolu

Faculty, Staff and Student Publications

Introduction: Pairing vagus nerve stimulation with traditional rehabilitation therapies results in improved motor recovery in people with stroke. However, this approach has not yet been studied in people with spinal cord injury (SCI). Motor recovery continues to be challenging after SCI, and there is a need for innovative research strategies to enhance motor recovery after SCI. Hence, this pilot randomized controlled trial aims to evaluate the safety, feasibility, and potential efficacy of pairing vagus nerve stimulation (VNS) with rehabilitation therapy to restore the motor function of the paretic upper limbs in people with cervical SCI.

Methods and analysis: In this …

An Overview Of Systematic Reviews Investigating Clinical Features For Diagnosing Neck Pain And Its Associated Disorders, Ryan C. Mcconnell

Funded Scholarship

Background: Neck pain is a common condition that is often difficult to diagnose. Previous literature has investigated diagnostic accuracy of examination measures, but the strength and clinical applicability are limited. This overview of systematic reviews aimed to investigate clinical features for diagnosing neck pain and its associated disorders.

Methods: An overview of systematic reviews was conducted searching four electronic databases for systematic reviews evaluating diagnostic criteria for neck pain. Quality and risk of bias were assessed using the AMSTAR 2 and ROBIS. Clinical features for neck pain were investigated for diagnostic utility.

Results: Twenty-seven systematic reviews were included. Hand radiculopathy …

Completeness Of Dry Needling Intervention Reporting In Musculoskeletal Conditions Using The Standards For Reporting Interventions In Clinical Trials Of Acupuncture And Template For Intervention Description And Replication Checklists: A Systematic Review, Ryan C. Mcconnell

Funded Scholarship

OBJECTIVE: The purpose of this study was to determine the completeness of reporting of dry needling (DN) as a primary intervention, using the Template for Intervention Description and Replication (TIDieR) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklists.

DESIGN: This study is a systematic review of methodological reporting.

LITERATURE SEARCH: Electronic databases (Ovid MEDLINE ALL, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register for Controlled Trials, Embase, and SPORTDiscus) were searched from inception to April 2024.

STUDY SELECTION CRITERIA: Clinical trials addressing the effects of DN on pain, function, and/or musculoskeletal impairments in …