Physical Therapy Commons^™

Biomechanical Evaluation Over Level Ground Walking Of User-Specific Prosthetic Feet Designed Using The Lower Leg Trajectory Error Framework, Victor Prost, W. Brett Johnson, Jenny A. Kent, Matthew J. Major, Amos G. Winter V.

Physical Therapy Faculty Research

The walking pattern and comfort of a person with lower limb amputation are determined by the prosthetic foot’s diverse set of mechanical characteristics. However, most design methodologies are iterative and focus on individual parameters, preventing a holistic design of prosthetic feet for a user’s body size and walking preferences. Here we refined and evaluated the lower leg trajectory error (LLTE) framework, a novel quantitative and predictive design methodology that optimizes the mechanical function of a user’s prosthesis to encourage gait dynamics that match their body size and desired walking pattern. Five people with unilateral below-knee amputation walked over-ground at self-selected …

Zoom In To Fitness: A Novel Way Of Bringing Fitness Experts To Seniors, Tessa Wells, Jenna Boyd, Gabriel Fisher, Victoria Kranz, Mckenzi Petricko

Posters and Presentations: Physical Therapy

Participants will discover a how a local educational institution was able to think creatively and bring much-needed programming to local seniors during the height of the COVID-19 pandemic restrictions. Participants will also experience first-hand how a virtual physical activity session can be delivered safely and effectively in the comfort of the senior’s own living environment or a group fitness room environment. Participants will be asked to think creatively of possible community partners, as well as possible barriers and facilitators to implementing this innovative wellness strategy. Information will be presented regarding additional activities that could be presented in this format such …

Therapists’ Perceptions Of The Carroll Upper Extremity Function Test To Measure Functional Outcomes Post-Hand Allotransplantation Based On Lived Experience, Jyoti Heiple

Graduate Theses, Dissertations, and Capstones

Hand allotransplantation is a treatment option available for individuals who have suffered a traumatic upper extremity injury. To date, there is not an industry-standard recognized measurement tool for assessing post-hand allotransplantation functional performance. A commonly used observational functional assessment tool is the Carroll Upper Extremity Function Test (UEFT). This dissertation explores therapists’ perceptions of the Carroll UEFT applicability to measure functional outcomes post-hand allotransplantation. The study employed a qualitative phenomenological approach with in-depth, semi-structured interviews with seven occupational and physical therapists representing five hand transplant centers in the United States. Braun and Clarke’s (2006) six-phase thematic analysis approach was utilized …

Task-Based Functional Connectivity And Blood-Oxygen-Level-Dependent Activation During Within-Scanner Performance Of Lumbopelvic Motor Tasks: A Functional Magnetic Resonance Imaging Study, Mark K. Jordon, Jill Campbell Stewart Pt,Phd, Sheri P. Silfies, Paul F. Beattie

Faculty Publications

There are a limited number of neuroimaging investigations into motor control of the lumbopelvic musculature. Most investigation examining motor control of the lumbopelvic musculature utilize transcranial magnetic stimulation (TMS) and focus primarily on the motor cortex. This has resulted in a dearth of knowledge as it relates to how other regions of the brain activate during lumbopelvic movement. Additionally, task-based functional connectivity during lumbopelvic movements has not been well elucidated. Therefore, we used functional magnetic resonance imaging (fMRI) to examine brain activation and ROI-to-ROI task-based functional connectivity in 19 healthy individuals (12 female, age 29.8 ± 4.5 years) during the …

Test-Retest Reliability Of Postural Control Assessment On Biodex Biosway™, Daniel Miner, Brent A. Harper, Stephen M. Glass, Brooke Martin, Molly Polizotto, S. Montana Hearl, Ellen Turner

Physical Therapy Faculty Articles and Research

Background. Recent protocols for posturographic assessment of postural control and balance have included head shake test conditions to challenge the vestibular contributions of postural control in an effort to increase the diagnostic accuracy of identifying individuals with impaired balance. However, evidence is limited regarding the test-retest reliability of such assessment protocols. Purpose. The purpose of this study was twofold: to determine the test-retest reliability of postural control assessment on the Biodex Biosway™, an accessible and field expedient tool for posturographic assessment, and to determine the test-retest reliability of the Head Shake Sensory Interaction and Balance Test (HS-SIB), an …

Perceptions Of Physical Therapy Clinicians Regarding The Impact Of Covid 19 On Patients’ Mental Health, Brandy Chase, Amy L. Barnett

Faculty Articles & Research

• Research shows that the COVID 19 outbreak can negatively affect a person’s mental health, especially those at a higher risk with debilitating conditions (Javed, Sarwer, & Soto, 2020).
• This alludes to the need to take a closer look at the impact of COVID 19 on physical therapy patients and the amount of mental health training needed by physical therapy clinicians.

Degenerative Cervical Myelopathy Delays Responses To Lateral Balance Perturbations Regardless Of Predictability, T. F. Boerger, L. Mcginn, M. C. Wang, Brian D. Schmit, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

The aim of this study was to quantify balance impairments in standing in people with degenerative cervical myelopathy (PwDCM) in response to external perturbations. PwDCM have damage to their spinal cord due to degeneration of the cervical vertebral column, but little is known about balance. Balance was quantified by capturing kinetics, kinematic, and electromyographic data during standing in response to lateral waist pulls. Participants received pulls during predictable and unpredictable contexts in three stance widths at two magnitudes. In response to lateral waist pulls, PwDCM had larger center of mass excursion (P < 0.001) and delayed gluteus medius electromyography onset (P < 0.001) and peak (P < 0.001) timing. These main effects of history of myelopathy were consistent across predictability, stance width, and magnitude. A multilinear regression determined that gluteus medius peak timing + tibialis anterior peak timing most strongly predicted center of mass excursion (R2 = 0.50, P < 0.001). These data suggest that PwDCM have delays in generating voluntary and reactive motor commands, contributing to balance impairments. Future rehabilitation strategies should focus on generating rapid muscular contractions. Additionally, frontal plane postural control is regulated by the gluteus medius and the tibialis anterior, whereas other muscles (e.g. gluteus minimus, ankle invertors/evertors) not studied here may also contribute.

Prospective Telehealth Analysis Of Functional Performance, Frailty, Quality Of Life, And Mental Health After Covid-19 Hospitalization, Jacob J. Capin, Melissa P. Wilson, Kristine Hare, Swati Vempati, Carley E. Little, Donna Mcgregor, Jose Castillo-Mancilla, Jennifer E. Stevens-Lapsley, Sarah Jolley, Kristine M. Erlandson

Physical Therapy Faculty Research and Publications

Background

COVID-19 is a global pandemic with poorly understood long-term consequences. Determining the trajectory of recovery following COVID-19 hospitalization is critical for prioritizing care, allocating resources, facilitating prognosis, and informing rehabilitation. The purpose of this study was to prospectively evaluate recovery following COVID-19 hospitalization.

Methods

Participants age 18 years or older who were hospitalized for ≥24 h due to COVID-19 completed phone/video call virtual assessments (including the 10-time chair rise test) and survey forms at three time points (2–6, 12, and 18 weeks) after hospital discharge. Univariate logistic and linear regression models assessed the associations of the outcomes with primary …

Improving Prediction Of Amyloid Deposition In Mild Cognitive Impairment With A Timed Motor Task, Sydney Y. Schaefer, Kevin Duff, Andrew Hooyman, John M. Hoffman

Physical Therapy Faculty Articles and Research

Cortical amyloid deposition is one of the hallmark biomarkers of Alzheimer’s disease (AD). However, given how cost- and time-intensive amyloid imaging can be, there is a continued need for a low-cost, non-invasive, and accessible enrichment strategy to pre-screen individuals for their likelihood of amyloid prior to imaging. Previous work supports the use of coordinated limb movement as a potential screening tool, even after controlling for cognitive and daily function. Thirty-six patients diagnosed with amnestic mild cognitive impairment over the age of 65 underwent 18F-Flutemetamol amyloid-positron emission tomography Cortical amyloid deposition is one of the hallmark biomarkers of Alzheimer’s disease (AD). …

Editor's Note, Rolando Lazaro

Philippine Journal of Physical Therapy

The Editor-in-Chief of the Philippine Journal of Physical Therapy introduces its inaugural issue.

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Brain And Spinal Cord Adaptations Associated With Patellofemoral Pain: A Systematic Review And Meta-Analysis, Kai-Yu Ho, Jing Nong Liang, Savanna Budge, Austin Madriaga, Kara Meske, Derrick Nguyenton

Physical Therapy Faculty Research

Objective: To evaluate the evidence for altered cortical and spinal cord functions in individuals with patellofemoral pain (PFP).

Methods: We conducted a comprehensive search of databases to appraise and analyze the studies published prior to December 10, 2021 that examined spinal reflex excitability measured using Hoffmann reflex (H-reflex) amplitudes, corticospinal excitability measured using transcranial magnetic stimulation (TMS)-elicited motor evoked potential (MEP) amplitudes, motor threshold (MT), or stimulus-response (SR) curves, cortical reorganization assessed using TMS cortical mapping or structural magnetic resonance imaging (MRI), or functional changes of the brain assessed using functional MRI (fMRI) in individuals with PFP.

Results: Eight studies …

Comparative Analysis Of Gait Interventions For Pediatric Cerebral Palsy, Sydney Ross

Student Scholarship & Creative Works

Spastic cerebral palsy (CP) is the most common motor disability in childhood, affecting 1 in 345 children in the U.S. Functional gait training (FGT) has been used with and without electrical stimulation (ES) to improve gait.The purpose of this study is to evaluate existing research on the effectiveness of FGT with and without ES to improve gait speed and endurance, step length, and gross motor function in young children with spastic CP. The investigators evaluated 6 studies aimed at analyzing the effects of FGT with and without ES on gait function in children with spastic CP. Three of the studies …

Clinical Reasoning Readiness And Confidence Of Dpt Students With Pt Interventions Using Telehealth, Derrick F. Campbell, Jean-Michel Brismee, Brad Allen, Troy L. Hooper, Tony A. Domenech, Kathleen Manella

Physical Therapy Collection

Telehealth service-delivery content has an emerging footprint on entry-level physical therapy programs. This study evaluated clinical reasoning readiness and confidence in third-year DPT students during clinical experiences with and without telehealth.

Students’ clinical reasoning readiness and confidence were determined using the Physical Therapist Self-Efficacy (PTSE) score, self-confidence rating treating patients, and final APTA Clinical Performance Instrument (CPI) clinical reasoning and summative ratings.

DPT students providing PT interventions using telehealth reported lower clinical reasoning self-efficacy (PTSE) when compared to traditional service-delivery. Confidence treating using telehealth was greater at the initial visit compared to subsequent visits, suggesting a lack of student readiness …

Gender-Specific Effects On Muscle Activation During Incline Treadmill Walking: A Virtual Perturbation Study For Future Astronauts, Jie Hao, Robin High, Ka-Chun Siu

Posters and Presentations: Physical Therapy

Introduction Microgravity-induced muscle atrophy is a critical issue for astronauts in spaceflight [1]. To overcome neuromuscular deconditioning, combining virtual reality (VR) with treadmill training protocol could be a promising countermeasure for astronauts to enhance muscle activities and maximize the training effect [2]. Our previous study [3] found the presence of visual perturbation significantly increased muscle activation while walking on incline treadmill, compared with no visual perturbation; surprisingly, we found females had more pronounced muscle responses than males. Based upon these findings, this study aimed to investigate the effects of different visual rotation speeds and different types of visual perturbation on …

Muscle-Specific Contributions To Lower Extremity Net Joint Moments While Squatting With Different External Loads, Kristof Kipp, Hoon Kim, William I. Wolf

Exercise Science Faculty Research and Publications

The purpose of this study was to determine muscle-specific contributions to lower extremity net joint moments (NJMs) during squats with different external loads. Nine healthy subjects performed sets of the back squat exercise with 0, 25, 50, and 75% of body mass as an added external load. Motion capture and force plate data were used to calculate NJMs and to estimate individual muscle forces via static optimization. Individual muscle forces were multiplied by their respective moment arms to calculate the resulting muscle-specific joint moment. Statistical parametric mapping (α = 0.05) was used to determine load-dependent changes in the time series …

Disparities In The Allocation Of Inpatient Physical And Occupational Therapy Services For Patients With Covid-19, Sarah Jolley, Amy Nordon-Craft, Melissa P. Wilson, Kyle Ridgeway, Michelle R. Rauzi, Jacob J. Capin, Lauren M. Heery, Jennifer Stevens-Lapsley, Kristine M. Erlandson

Physical Therapy Faculty Research and Publications

Background

Survivors of the novel coronavirus (COVID-19) experience significant morbidity with reduced physical function and impairments in activities of daily living. The use of in-hospital rehabilitation therapy may reduce long-term impairments.

Objective

To determine the frequency of therapy referral and treatment amongst hospitalized COVID-19 patients, assess for disparities in referral and receipt of therapy, and identify potentially modifiable factors contributing to disparities in therapy allocation.

Design, Setting and Participants

Retrospective cohort study using data collected from the University of Colorado Health Data Compass data warehouse assessing therapy referral rates and estimated delivery based on available administrative billing.

Measurements

Multivariable logistic …

Task Effects On Functional Connectivity Measures After Stroke, Kaleb Vinehout, Sheila M. Schindler-Ivens, Jeffrey R. Binder, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Understanding the effect of task compared to rest on detecting stroke-related network abnormalities will inform efforts to optimize detection of such abnormalities. The goal of this work was to determine whether connectivity measures obtained during an overt task are more effective than connectivity obtained during a “resting” state for detecting stroke-related changes in network function of the brain. This study examined working memory, discrete pedaling, continuous pedaling and language tasks. Functional magnetic resonance imaging was used to examine regional and inter-regional brain network function in 14 stroke and 16 control participants. Independent component analysis was used to identify 149 regions …

Developing Peri-Operative Rehabilitation In Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 6]: An Unexplored Opportunity?, Timothy F. Boerger, Allison S. Hyngstrom, Julio C. Furlan, Sukhvinder Klasi-Ryan, Armin Curt, Brian K. Kwon, Shekar N. Kurpad, Michael G. Fehlings, James S. Harrop, Bizhan Aarabi, Vafa Rahimi-Movaghar, James D. Guest, Jefferson R. Wilson, Benjamin M. Davies, Mark R. N. Kotter, Paul A. Koljonen

Physical Therapy Faculty Research and Publications

Study Design

Narrative review.

Objective

Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies.

Methods

Literature search.

Results

In other neurological disorders such as …