Physical Therapy Commons^™

The Effects On Gait Of 4-Wheeled Walker Use In People With Alzheimer's Disease Dementia And Gait Impairment: A Pilot Study, Humberto Omaña, Edward Madou, Susan W. Hunter

Physical Therapy Publications

In people with dementia, provision of mobility aids is standard treatment for those with impaired gait. However, mobility aid use is independently associated with increased falls risk. In this short communication, gait velocity and stride time variability were recorded in eleven adults with Alzheimer's disease dementia. Three conditions were tested: single-task (no aid), walking with a walker, and dual-task (walker use and counting backwards) under both a straight path and Figure-of-8 walking configuration. Gait velocity increased when using a walker compared to no aid in the Figure-of-8 walking configuration. Walker use improved gait in simple walking, but benefits diminished upon …

Physical Therapists Clinical Instructors Perceptions, Practices And Experience When Supervising An Underperforming Student In Clinical Education, Ruth Lyons Hansen

Seton Hall University Dissertations and Theses (ETDs)

Physical Therapist (PT) clinical instructors’ (CIs) perceptions, practices, and experiences when supervising an underperforming student.

Background: The experience of supervising an underperforming student (UPS) in clinical education and failure to fail (FTF) are described in health professions such as nursing and medicine but there is little description of it in Physical Therapist (PT) clinical education.

Purpose: To explore the PT clinical instructors’ (CIs) perceptions, practices and experience when supervising an under-performing student, and to determine if failure to fail exists in PT clinical education and if so, what organizational, personal, and demographic factors may be related to it.

Methods: …

Assessing Ground Reaction Forces And Degenerative Changes Of Sound Limb In Unilateral Lower Extremity Amputees: A Systematic Review, Kira Donnelly, Colin Davis, Nicole Liotta, Angela Perkins, Vibhor Agrawal, Michael Jason Highsmith, Scott Michael Love

Physical Therapy Collection

Abstract Background: There is a rising number of individuals undergoing lower extremity amputation (LEA) and is associated with increased risk of comorbidities. Osteoarthritis (OA) and Degenerative Joint Disease (DJD) are conditions that cause reduction in an individual’s function, independence, and quality of life.

Research Design: A search of multiple databases using terms associated with possible functional declines as evidenced by the International Classification of Functioning, Disability and Health (ICF), followed by assessment of evidence using the PEDro scoring method will be conducted. Multiple reviewers will screen, sort, rate and extract data from articles.

Methods: A computer-aided literature search of PubMed, …

A Proposed Value Metric To Quantify Value In Outpatient Therapy, Bryan Bourcier Dpt, Scs, Thomas Ruediger Dpt, Ocs, Scs, Alexandra Bond Dpt

Other Specialties

ABSTRACT

Study Design: Case report

Objectives: The purpose of this study is to report the steps towards developing a single number Value Metric that represents both the quality and cost of clinical care for outpatient therapy that can be used in real time.

Background: As healthcare continues to move towards value-based and risk-based reimbursement, it is imperative that leaders in outpatient therapy settings understand and can quantify the value of the services that therapists provide.

Methods and Measures: This study proposes a Value Metric to quantify value in outpatient therapy using existing quality and cost data. The Value Metric was …

Knee Joint Biomechanics During Gait Improve From 3 To 6 Months After Anterior Cruciate Ligament Reconstruction, Kelsey Neal, Jack R. Williams, Abdulmajeed Alfayyadh, Jacob J. Capin, Ashutosh Khandha, Kurt Manal, Lynn Snyder-Mackler, Thomas S. Buchanan

Physical Therapy Faculty Research and Publications

Gait alterations after anterior cruciate ligament reconstruction (ACLR) are commonly reported and have been linked to posttraumatic osteoarthritis development. While knee gait alterations have been studied at several time points after ACLR, little is known about how these biomechanical variables change earlier than 6 months after surgery, nor is much known about how they differ over the entire stance phase of gait. The purpose of this study was to examine knee gait biomechanical variables over their entire movement pattern through stance at both 3 and 6 months after ACLR and to study the progression of interlimb asymmetry between the two …

Energy Drink Usage By Students Attending An Online University, Jodi Lynn Hutak, Ali Boolani, Lauri O. Byerley

School of Medicine Faculty Publications

Objective: This study determined the frequency, reasons for, and side effects of energy drinks (ED) consumption among online students. Participants: Students attending an online university. Methods: Participants were recruited by email and completed a 59-question survey about their prior months ED practices using a combination of validated surveys previously published examining similar constructs in on-campus students. Results: 307 students (age = 32.4 ± 6.5yrs) completed the survey, and 88% reported consuming EDs. Students’ reasons for consuming ED included school (p < .001), work (p < .001), an event/competition (p < .001), pick me up (p < .001), lack of rest (p < .001), more energy (p < .001), and staying awake while driving (p < .001). Only individuals who consumed > 10 ED/month reported side effects of headaches (p = .01) and speeding (p=.01). Conclusions: In our sample, a majority of …

Advancing The Assessment And Treatment Of Signs And Symptoms Of Parkinson Disease, David Scott May

WUSM Theses and Dissertations – All Programs

People with PD often report signs and symptoms that negatively impact quality of life. Among these are balance difficulties, impaired gait, and FOG. New treatment and assessment strategies for these signs and symptoms are needed, as current techniques are limited. While new treatment and assessment strategies continue to emerge, gaps in knowledge persist. Deep brain stimulation (DBS) has been utilized in many people with PD throughout the 21st century, but it is unknown specifically how subthalamic nucleus deep brain stimulation (STN-DBS) affects balance. Alternative treatment strategies, such as a dental mouthpiece, have also been proposed. While dental mouthpieces have shown …

Assessment Of Postural, Locomotor, And Physical Fitness Status In Individuals With Intellectual And Developmental Disabilities, Alana J. Turner

Theses and Dissertations

Introduction: Postural control and locomotion deficits can be observed during the early years of childhood development and throughout life. For those with disabilities, these deficits can advance past the development years and into adolescence and adulthood while affecting the quality of life and daily activity. Finding interactive rehabilitative activities to delay or limit these deficits is essential for people with disabilities to improve their quality of life, inclusion, and overall movement. Adapted physical activity/sports like badminton and virtual reality could promote improvements in postural and locomotor status for young adults with intellectual and developmental disabilities like cerebral palsy (CP), intellectual …

Community Based Rehabilitation Programs For Resettled Muslim Women Refugees, Lori Maria Walton Phd, Dpt, Mscpt, Mph(S), Renee Hakim, Phd, Pt, Ncs, Veena Raigangar, Phd(C), Mscpt, M.Ed., Jennifer Schwartz, Dpt, Ncs, Sjm Ummul Ambia, Mscpt, Najah Zaaeed, Drph, Lmsw, Bassima Schbley

Journal of Health Ethics

According to the 2021 report from the United Nations High Commissioner for Refugees, 82.4 million people were forcibly displaced because of violence, wars, or persecution and over 26.4 million are currently living with refugee status. Displacement and resettlement trauma are associated with chronic disease onset and poor cognitive, physical, and mental health outcomes for refugee populations. To mitigate some of the deleterious effects of resettlement trauma, we propose a community-based rehabilitation program (CBRP) framework that is culturally sensitive, trauma-informed and focused on the vulnerabilities of women. The purpose of this novel CBRP framework is to address health inequities among a …

Role Of Physical Therapists In The Management Of Individuals At Risk For Or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline 2022, Ellen Hillegass, Kathleen M. Lukaszewicz, Michael Puthoff

Physical Therapy Faculty Research and Publications

No matter the practice setting, physical therapists work with patients who are at risk for or who have a history of venous thromboembolism (VTE). In 2016, the first clinical practice guideline (CPG) addressing the physical therapist management of VTE was published with support by the American Physical Therapy Association’s Academy of Cardiovascular and Pulmonary Physical Therapy and Academy of Acute Care, with a primary focus on lower extremity deep vein thrombosis (DVT). This CPG is an update of the 2016 CPG and contains the most current evidence available for the management of patients with lower extremity DVT and new key …

Association Between Visuomotor Skills And The Effects Of Stroboscopic Vision On Depth Jump Performance, Riley Welch

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

The reactive strength index (RSI) is a popularized method of evaluating depth jump performance. Performance in anticipation of ground impact is influenced by the proprioceptive, vestibular, and visuomotor systems through multisensory integration. The contribution of vision to depth jump performance has been studied through use of stroboscopic goggles, but no study has evaluated which visuomotor skills may be a predictor for DJ performance. The purpose of this investigation was to evaluate the association between visuomotor skills and the effects of stroboscopic vision on DJ performance. Participants consisted of 9 female and 13 male college aged adults. DJ performance was evaluated …

Association Of Disease Outcomes With Physical Activity In Multiple Sclerosis: A Cross-Sectional Study, Trinh L T Huynh, Stephanie L Silveira, Brenda Jeng, Robert W Motl

Faculty, Staff and Student Publications

Purpose/Objective Research: This study examined combinations of disease outcomes (i.e., walking, cognition, and symptoms) as correlates of physical activity subgroups (insufficiently active vs. sufficiently active) in persons with multiple sclerosis (MS).

RESEARCH METHOD/DESIGN: This study included 213 participants who completed walking and cognitive function tests and self-report measures of symptoms and physical activity. Multivariate analysis of variance and discriminant function analysis identified combinations of MS outcomes associated with physical activity.

RESULTS: The sample had a mean age of 49.6 years (

CONCLUSION/IMPLICATIONS: The findings identified walking endurance and limitations, processing speed, depression, and fatigue as primary correlates of physical activity …

Mediation Analysis Of The Effect Of Visuospatial Memory On Motor Skill Learning In Older Adults, Andrew Hooyman, Jennapher Lingo Vangilder, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

There is high inter-individual variability in motor skill learning among older adults. Identifying the nature of these individual differences remains challenging due to interactions between participant characteristics (e.g., age, cognition) and task-related factors (e.g., nature of task, level of skill pre-training), making it difficult to determine plausibly causal relationships. This study addresses these competing explanations by using mediation analysis to examine plausible causal inference between visuospatial memory and one-month retention of both gross and fine motor components of a functional upper-extremity task following training. Results suggest that better visuospatial memory results in more retention of fine but not gross motor …

Classifying Toe Walking Gait Patterns Among Children Diagnosed With Idiopathic Toe Walking Using Wearable Sensors And Machine Learning Algorithms, Rahul Soangra, Yuxin Wen, Hualin Yang, Marybeth Grant-Beuttler

Physical Therapy Faculty Articles and Research

Idiopathic toe walking (ITW) is a gait abnormality in which children’s toes touch at initial contact and demonstrate limited or no heel contact throughout the gait cycle. Toe walking results in poor balance, increased risk of falling, and developmental delays among children. Identifying toe walking steps during walking can facilitate targeted intervention among children diagnosed with ITW. With recent advances in wearable sensing, communication technologies, and machine learning, new avenues of managing toe walking behavior among children are feasible. In this study, we investigate the capabilities of Machine Learning (ML) algorithms in identifying initial foot contact (heel strike versus toe …

Projected Utility Of The Ready Set Return Application, Erin Hartigan, Cassidy Sirois, Jonathan Lindau, Taylor Lockwood, Valerie Nesom, Nan M. Solomons

Journal of Maine Medical Center

Introduction: An application (app) that summarizes best practices may promote standardized care among clinicians treating patients during anterior cruciate ligament (ACL) rehabilitation. The purpose of this study was to test the prototype of the Ready Set Return (RSR) app to determine receptiveness for use in clinical practice.

Methods: Two mock patient cases were used to familiarize 19 physical therapists and athletic trainers with the RSR app. Then these participants provided feedback about the user experience, features, and content using Likert ratings and free-text fields through an online survey.

Results: Most participants (89%-95%) would recommend the RSR app to others and …

Direction Of Attentional Focus In Prosthetic Training: Current Practice And Potential For Improving Motor Learning In Individuals With Lower Limb Loss, Szu-Ping Lee, Alexander Bonczyk, Maria Katrina Dimapilis, Sarah Partridge, Samantha Ruiz, Lung-Chan Chien, Andrew Sawers

Physical Therapy Faculty Research

Objective:

Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting.

Methods:

Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age = 50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience = 10 …

Advancing Academic Capacity In Physical And Rehabilitation Medicine To Strengthen Rehabilitation In Health Systems Worldwide: A Joint Effort By The European Academy Of Rehabilitation Medicine, The Association Of Academic Physiatrists, And The International Society Of Physical And Rehabilitation Medicine, Walter R Frontera, Gerold Stucki, Julia P Engkasan, Gerard E Francisco, Christoph Gutenbrunner, Nazirah Hasnan, Jorge Lains, Yusniza Mohd Yusof, Stefano Negrini, Zaliha Omar, Linamara Rizzo Battistella, Gwen Sowa, Henk Stam, Jerome Bickenbach, European Academy Of Rehabilitation Medicine, Association Of Academic Physiatrists, International Society Of Physical And Rehabilitation Medicine

Faculty, Staff and Student Publications

No abstract provided.

Effect Of Behavioural Practice Targeted At The Motor Action Selection Network After Stroke, Jill C. Stewart, Jessica F. Baird, Stacy L. Fritz, Julius Fridriksson Ph.D.

Faculty Publications

Motor action selection engages a network of frontal and parietal brain regions. After stroke, individuals activate a similar network, however, activation is higher, especially in the contralesional hemisphere. The current study examined the effect of practice on action selection performance and brain activation after stroke. Sixteen individuals with chronic stroke (Upper Extremity Fugl–Meyer motor score range: 18–61) moved a joystick with the more-impaired hand in two conditions: Select (externally cued choice; move right or left based on an abstract rule) and Execute (simple response; move same direction every trial). On Day 1, reaction time (RT) was longer in Select compared …

The Haunted House Experience: Developing A Home Health Assessment Training Utilizing An Interprofessional, Interinstitutional Virtual Simulation, Angel Holland Dpt, Edd, Pamela Degravelles Phd, Rn, Debbie Knight Pharmd, Karen Dickinson Md, Kathryn Neill Pharmd, Duston Morris Phd, Wendy Ward Phd

Faculty Research ​and Publications

To meet the interprofessional education needs of students during the COVID-19 pandemic, universities transitioned to virtual options. For many universities, this transition was challenging and time-consuming. The Arkansas Interprofessional Education Consortium (ARIPEC) combined resources to create a novel learning experience for students with a focus on the skill of home assessment. An interinstitutional, interprofessional faculty project team was developed to create a learning experience, with each institution responsible for a portion of the virtual simulation development. This paper describes the process for creation and implementation of an interprofessional, interinstitutional virtual learning experience to support the growth of healthcare students across …

Cost-Effectiveness Of High-Intensity Training Vs Conventional Therapy For Individuals With Subacute Stroke, T. George Hornby, Miriam Rafferty, Daniel Pinto, Dustin D. French, Neil Jordan

Physical Therapy Faculty Research and Publications

Objective

This investigation estimated the incremental cost-effectiveness of high-intensity training (HIT) compared with conventional physical therapy in individuals with subacute stroke, based on the additional personnel required to deliver the therapy.

Design

Secondary analysis from a pilot study and subsequent randomized controlled trial.

Setting

Outpatient laboratory setting.

Participants

Data were collected from individuals with locomotor impairments 1-6 months poststroke (N=44) who participated in HIT (n=27) or conventional physical therapy (n=17).

Interventions

Individuals performing HIT practiced walking tasks in variable contexts (stairs, overground, treadmill) while targeting up to 80% maximum heart rate reserve. Individuals performing conventional therapy practiced impairment-based and functional …