Physical Therapy Commons^™

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 = …

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 …

Isokinetic Testing: Why It Is More Important Today Than Ever, Kevin E. Wilk, Christopher A. Arrigo, George J. Davies

Physical Therapy Faculty Publications

Isokinetics is a proven method to train and objectively assess the capability of muscle groups, particularly at the knee. The current re-injury rates and less than optimal return to sport percentages seen following anterior cruciate ligament surgery highlights the need for greater focus on what tests and methods are used to make these critical decisions. Isokinetics remains the best single method to objectively determine dynamic muscle strength, power, rate of force development and endurance. These factors make it well-suited to play a crucial role in influencing the appropriate patient progression through a rehabilitation program and assisting in determining return to …

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 …

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 …

Navigating The Layers Of Concern For Safe Dry Needling Of The Rectus Abdominis: A Cadaveric Study, Ryan C. Mcconnell, Christi L. Williams

Funded Scholarship

Objectives: To assess needle placement accuracy in the rectus abdominis (RA) muscle during dry needling (DN) without entering the peritoneum.

Methods: Two physical therapists performed DN on a cadaver, making 10 attempts each to needle the RA without entering the peritoneum. Techniques followed two common DN approaches. Ultrasound verified needle depth and safety.

Results: Seventy percent of attempts were recorded as safe needle placement, while 30% were unsafe. Accurate RA needle placement without peritoneal entry occurred in 55% of attempts.

Discussion/Conclusion: Inadvertent peritoneal needle placement during RA DN poses risks regardless of experience. Ultrasound guidance may enhance safety and precision …

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 …

Health Sciences Students’ Career Commitment, Mental Health, And Physical Activity During The Covid-19 Pandemic, David Wrucke, Marie K. Hoeger Bement, April L. Harkins, Sandra K. Hunter, Stacy Stolzman, Astrida S. Kaugars

Physical Therapy Faculty Research and Publications

Objective: To understand the biopsychosocial dimensions of university health sciences students’ experiences during the COVID-19 pandemic.

Participants: Health sciences students (n = 297) from two universities in July and August 2020.

Methods: Participants completed a Web-based survey asking about depression, anxiety, physical activity, coronavirus threat, and career commitment.

Results: Moderate or severe depression and anxiety were reported by 28.6% and 31.3% of respondents, respectively. Depression and anxiety were positively correlated with perceived coronavirus threat and negatively correlated with career commitment and strenuous physical activity. A change in career commitment interests during the COVID-19 pandemic was reported by 11% of …

Activity Levels Across The Intensity Spectrum In Athletes: A Systematic Review Protocol, Jacob J. Capin, Jena Heck Street, Alissa V. Fial, Nicola D. Ridgers, Grant R. Tomkinson

Physical Therapy Faculty Research and Publications

Physical activity (PA) promotes better cardiometabolic health, physical function, brain health and longevity. In contrast, prolonged sedentary behaviour (SB) is a risk factor for many chronic diseases and poor health. Limited research has evaluated or synthesised how competitive sports participation influences PA across the lifespan. Some evidence suggests, ironically, that former competitive athletes may be insufficiently active and current athletes may be highly sedentary away from sport. This study describes the protocol for a systematic review and meta-analysis on activity levels across the intensity spectrum in athletes, addressing the primary research question: is sports participation significantly associated with PA and/or …

Midlife Health Crisis Of Former Competitive Athletes: Dissecting Their Experiences Via Qualitative Study, Jacob J. Capin, Taylor Wolf, Jena Heck Street, Carolyn S. Smith, Shannon L. Lennon, William B. Farquhar, Sandra K. Hunter, Linda B. Piacentine

Physical Therapy Faculty Research and Publications

Sports participation confers many health benefits yet greatly increases injury risk. Long-term health outcomes in former athletes and transition to life after competitive sports are understudied. Ending a sport may pose physical and psychosocial challenges. The purpose was to determine the lived experiences of former competitive athletes and how their sports participation impacted their long-term health and well-being. Former college varsity athletes participated in semistructured interviews focusing on their experiences, including past and current health, the impact of injuries, activity, exercise, diet and transition to life after competitive sport. Thematic analysis was completed using a collaborative, iterative process. Thirty-one (16 …

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, …

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 …

Biomechanics, Strength, And Physical Function After Surgical Repair Of Rotational Ankle Fractures, Benjamin Brightwell

Theses and Dissertations--Kinesiology and Health Promotion

Ankle Fractures account for approximately 9% of all lower extremity fractures and incidence continues to rise. Up to 53% of ankle fractures require surgical intervention. Impaired physical function is one of the most reported and observed lasting effects of surgically repaired ankle fractures. Additionally, limited physical capacity and function have been identified as the primary threats to health-related quality of life after surgical repair of ankle fractures. These impairments to physical capacity and functionality can last longer than 5 years after surgery. Since surgery typically successfully restores stability and congruency of the talocrural joint, these poor long-term outcomes are an …

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 …

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 …