Physical Therapy Commons^™

The Rehabilitation Of A 75-Year-Old Male Presenting With A Right Hip Flexor Strain Concomitant With Numerous Psychosocial Factors: A Case Report, Jillian Battista, Megan Chapski, Suma Varanasi, Jillian Witwicki

Case Report Papers

Background: Musculoskeletal disorders, often well understood, are a leading cause of disability worldwide. Concomitant psychosocial factors add a layer of complexity to the treatment of musculoskeletal disorders. The purpose of this case report is to highlight the potential impact psychological factors have in the rehabilitation of musculoskeletal disorders, specifically the rehabilitation of a right hip flexor strain.
Case Description: The patient was a 75-year-old male referred to outpatient physical therapy for the assessment of a right hip flexor strain, presenting with psychosocial factors including anxiety and kinesiophobia. Procedural interventions included patient education, neuromuscular re-education, therapeutic exercise, and manual therapy, but …

Phrenic Afferent Activation Modulates Cardiorespiratory Output In The Adult Rat, Kristi A. Streeter, Michael D. Sunshine, Paul W. Davenport, David D. Fuller

Physical Therapy Faculty Research and Publications

Phrenic afferents project to brainstem areas responsible for cardiorespiratory control and the mid-cervical spinal cord containing the phrenic motor nucleus. Our purpose was to quantify the impact of small- and large-diameter phrenic afferent activation on phrenic motor output. Anesthetized and ventilated rats received unilateral phrenic nerve stimulation while contralateral phrenic motor output and blood pressure were recorded. Twelve currents of 40-Hz inspiratory-triggered stimulation were delivered (20 s on, 5 min off) to establish current response curves. Stimulation pulse width was varied to preferentially activate large-diameter phrenic afferents (narrow pulse width) and recruit small-diameter fibers (wide pulse width). Contralateral phrenic amplitude …

Executive Functions And Student Success During Physical Therapist Education: An Exploratory Study, Jane Roitsch, Martha L. Walker, Anastasia M. Raymer

Communication Disorders & Special Education Faculty Publications

BACKGROUND: Clinical reasoning relies on executive functions (EFs) that manage attention, inhibition, organization, and decision-making. Assessment of EFs may help identify students who excel at clinical reasoning, yet data showing this relationship in physical therapy (PT) education programs are lacking. The primary purpose of this exploratory study was to examine EFs in relationship to success in PT educational programs. METHODS: Thirteen third-year PT graduate students completed two EF tests which were compared to culminating scores in the program and admissions scores. RESULTS: A relationship existed between National Physical Therapy Examination (NPTE) and comprehensive exam results and one EF test score; …

Lower Extremity Power And Movement Velocity In Competitive Older Athletes, Becca D. Jordre

Dissertations and Theses

Older adults are a rapidly growing population which house a subset of older athletes who regularly engage in sport competition. The physical health and risk factors of this competitive older athlete population have been largely overlooked by healthcare providers and researchers and are poorly understood. Older athletes exhibit distinctly different measures of physical performance which require unique thresholds to identify health-related risk factors. While lower extremity power and movement velocity have been identified as valuable measures of physical performance and fall risk in community-dwelling older adults this relationship has not been explored in competitive older athletes. One method for analyzing …

The Effect Of Dual-Task Testing On The Balance And Gait Of People With Lower Limb Amputations: A Systematic Review, Humberto Omana, Edward Madou, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

OBJECTIVE: To systematically review the literature on the effect of dual-task testing on the balance and gait of people with lower limb amputations (PLLA).

LITERATURE SURVEY: Databases MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and Scopus were searched in duplicate (inception to December 1, 2020).

METHODOLOGY: Inclusion criteria: participants were adults with transtibial, knee-disarticulation, transfemoral, or bilateral lower limb amputations; balance or gait was paired with a secondary task; and studies were peer-reviewed and published in English. Two authors independently reviewed articles and consensus was required. A standardized data extraction sheet was used to gather study relevant information in duplicate. …

Physical Therapy/Occupational Therapy And Applied Behavior Analysis Forming An Interdisciplinary Bridge For Positive Patient Outcomes, Rachel Ann Vaughn

Honors College Theses

Physical therapy, Occupational therapy, and Applied Behavior Analysis work within the pediatric population and are used to help children reach milestones throughout their development. This survey is meant to assess the amount of interdisciplinary collaboration that is occurring within these disciplines. The research team believes that this interdisciplinary collaboration could be beneficial to the pediatric population, but understands that this survey is a baseline and needs further research. Through a survey, there were 29 total participants, 22 PT/OT and 7 ABA therapists. The survey showed evidence of ABA techniques being used within PT and OT sessions for betterment of the …

Kinematic Assessment Of Turning And Walking Tasks Among Stroke Survivors By Employing Wearable Sensors And Pressure Platform, Masoud Abdollahi, Pranav Madhav Kuber, Christopher Hoang, Michael Shiraishi, Rahul Soangra, Ehsan Rashedi

Physical Therapy Faculty Articles and Research

Stroke survivors often experience reduced movement capabilities due to alterations in their neuromusculoskeletal systems. Modern sensor technologies and motion analyses can facilitate the determination of these changes. Our work aims to assess the potential of using wearable motion sensors to analyze the movement of stroke survivors and identifying the affected functions. We recruited 10 participants (5 stroke survivors, 5 healthy individuals) and conducted a controlled laboratory evaluation for two of the most common daily activities: turning and walking. Among the extracted kinematic parameters, range of trunk and sacrum lateral bending in turning were significantly larger in stroke survivors (p-value<0.02). However, no statistical difference in mean angular velocity and range of motion for trunk/sacrum/shank flexion-extension were obtained in the turning task. Our results also indicated that during walking, while there was no difference in swing time, double support portion of gait among the stroke group was significantly larger (p-value = 0.001). Outcomes of this investigation may help in designing new rehabilitation programs for stroke and other neurological disorders and/or in improving the efficacy of such programs.Clinical Relevance— This study may provide a better insight on the detailed functional differences between stroke survivors and healthy individuals which in turn could be used to develop a more efficient rehabilitation program for stroke community.

The Role Of Eye Movements, Attention, And Hand Movements On Age-Related Differences In Pegboard Tests, Brittany Heintz Walters, Wendy E. Huddleston, Kristian M. O'Connor, Jinsung Wang, Marie K. Hoeger Bement, Kevin G. Keenan

Physical Therapy Faculty Research and Publications

Well-documented manual dexterity impairments in older adults may critically depend on the processing of visual information. The purpose of this study was to determine age-related changes in eye and hand movements during commonly used pegboard tests and the association with manual dexterity impairments in older adults. The relationship between attentional deficits and manual dexterity was also assessed. Eye movements and hand kinematics of 20 young (20–38 yr) and 20 older (65–85 yr) adults were recorded during 9-Hole Pegboard, Grooved Pegboard, and a visuospatial dual test. Results were compared with standardized tests of attention (The Test of Everyday Attention and Trail …

Conservative Management Of Low Back Pain, Se Won Lee, Dan Nguyen, Denny Mack, Eric Aguila, Mary Thomas, Karyn Doddy

HCA Healthcare Journal of Medicine

Low back pain (LBP) is frequently encountered in outpatient clinics and affects individual patients and society in general with decreased physical function, quality of life, disability, and/or economic burden. Although most acute LBP resolves on its own, recurrent and chronic LBP is a common reason for outpatient clinic visits. This review explores pragmatic approaches to LBP in the clinical setting, focusing on recognizing prognostic factors, initial approaches to evaluation, including selective imaging, and conservative management including patient education, therapeutic exercises and bracing.

Prediction Of Fall Risk Among Community-Dwelling Older Adults Using A Wearable System, Thurmon Lockhart, Rahul Soangra, Hyunsoo Yoon, Teresa Wu, Christopher W. Frames, Raven Weaver, Karen A. Roberto

Physical Therapy Faculty Articles and Research

Falls are among the most common cause of decreased mobility and independence in older adults and rank as one of the most severe public health problems with frequent fatal consequences. In the present study, gait characteristics from 171 community-dwelling older adults were evaluated to determine their predictive ability for future falls using a wearable system. Participants wore a wearable sensor (inertial measurement unit, IMU) affixed to the sternum and performed a 10-m walking test. Measures of gait variability, complexity, and smoothness were extracted from each participant, and prospective fall incidence was evaluated over the following 6-months. Gait parameters were refined …

Enhancing The Patient Experience Through Innovative Quality Improvement Education, Tami Struessel, Betsy J. Becker, Nicole M. Sleddens

Posters and Presentations: Physical Therapy

The “Patient Experience” arm of the Institute for Healthcare Improvement’s Quadruple Aim is defined by the Institute of Medicine (IOM) as quality care that is safe, effective, patient-centered, timely efficient, and equitable. The IOM called for a uniform approach to health professions education utilizing five core competencies to achieve high-quality care. “All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.” Physical Therapy educators have expanded curricula to teach three of these five competencies. We routinely teach that physical therapists practice in interprofessional teams to provide …

Ease-Ing Dpt Students Into The Acute Care Environment, Nicole M. Sleddens, Tessa Wells, Stacie Mae Larreau Christensen, Kellie Clapper, Lora Pieper

Posters and Presentations: Physical Therapy

Purpose: The Early Acute Service Experience program (EASE) is a dual-purpose program that prepares physical therapy students to transition from the academic setting to the acute clinical environment while providing a helpful service to key clinical partners. Methods/Description: This program requirement begins as students are assigned a weekend in the second semester of the DPT curriculum to work with a physical therapist in the hospital. As the first step in their orientation, students complete an e-learning module which focuses on the knowledge, skills, and abilities required in the acute care clinical environment. Once a student has completed the module and …

Criterion Validation And Interpretability Of The Single Assessment Numerical Evaluation (Sane) Of Self-Reported Recovery In Patients With Neck Pain, Elizabeth Oakley, Chad E. Cook, Bryan O'Halloran

Faculty Publications

Background

The SANE is a PROM of recovery, which may assist clinicians in clinical decision-making and discharge planning. The psychometric measurement properties of the SANE have yet to be determined for neck pain.

Objectives

Threefold objectives included: 1)determine the numerical threshold for the SANE at which patients with neck pain determine their symptoms are acceptable; 2)determine the association between scores for the NDI and VAS, with the SANE; 3)determine the average number of visits, costs and value associated with the management of neck pain.

Design

Longitudinal repeated measures cohort design.

Methods

Threshold measures for self-reported recovery with the …

Physical Therapy And Occupational Therapy Well-Being, Jenna Pilkington, Dara Musher-Eizenman, Cindi Baum, Elizabeth Emley

Honors Projects

There is a lack of research in the professions of physical therapy and occupational therapy. To be more specific, the areas of stress and burnout have been topics of research within the healthcare field for medical physicians and nurses, but currently there is little research looking at stress and burnout for physical therapists and occupational therapists. (Anderson 2015; Berry 2019). The current study aims to look at the emotional connections between patients and professions, along with the related emotional stress experienced by these professionals. A survey was administered to 59 physical therapists and occupational therapists for the purpose to give …

Self-Paced Treadmills Do Not Allow For Valid Observation Of Linear And Nonlinear Gait Variability Outcomes In Patients With Parkinson’S Disease, Maryam Rohafza, Rahul Soangra, Jo Armour Smith, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Background

Due to the imposed constant belt speed, motorized treadmills are known to affect linear and nonlinear gait variability outcomes. This is particularly true of patients with Parkinson’s Disease where the treadmill can act as an external pacemaker. Self-paced treadmills update the belt speed in response to the subject's walking speed and might, therefore, be a useful tool for measurement of gait variability in this patient population. This study aimed to compare gait variability during walking at self-paced and constant treadmill speeds with overground walking in individuals with PD and individuals with unimpaired gait.

Methods

Thirteen patients with Parkinson’s Disease …

Remote, Unsupervised Functional Motor Task Evaluation In Older Adults Across The United States Using The Mindcrowd Electronic Cohort, Andrew Hooyman, Joshua S. Talboom, Matthew D. De Both, Lee Ryan, Matthew J. Huentelman, Sydney Y. Schaefer

Physical Therapy Faculty Articles and Research

COVID-19 has impacted the ability to evaluate motor function in older adults, as motor assessments typically require face-to-face interaction. One hundred seventy-seven older adults nationwide completed an unsupervised functional upper-extremity assessment at home. Data were compared to data from an independent sample of community-dwelling older adults (N = 250) assessed in lab. The effect of age on performance was similar between the in-lab and at-home groups. Practice effects were also similar. Assessing upper-extremity motor function remotely is feasible and reliable in community-dwelling older adults. This test offers a practical solution for telehealth practice and other research involving remote or geographically …

Impact Of Pro Bono Clinic On Attitudes, Beliefs, And Confidence Towards Cultural Competence In First-Year Doctoral Physical Therapy Students, Scarlett Morris, Ruiping Xia, Troy Klaassen, Trey Johnson

Internet Journal of Allied Health Sciences and Practice

Purpose: Cultural competence is an essential skill for healthcare providers in our increasingly ethnically diversified society. There is an unmet need for educating future culturally competent physical therapists. The purpose of this study was to investigate the impact of pro bono clinic on cultural competence in first-year doctoral physical therapy students. Method: Forty-two participants completed a survey before and after attending three individual sessions of mentored pro bono clinical experiences during their first semester. The survey assessed participants’ attitudes and beliefs (Part I), and self-perceived level of confidence (Part II) towards cultural competence. Wilcoxon signed-rank tests were performed. Results: The …

A Student Physical Therapist’S Perspective On Her Efficacy Providing Culturally Competent Care: A Reflective Case Study, Anna S. Kelly, Deborah M. Wendland

Internet Journal of Allied Health Sciences and Practice

Purpose: Cultural differences and personal biases can affect the way a clinician provides care and the way in which patients receive it. The Commission on Accreditation in Physical Therapy Education (CAPTE) designates cultural competence as one of the professional practice expectations for physical therapy students, although no standardized blueprint exists for Doctor of Physical Therapy (DPT) programs. This case report will illustrate how reflection can be used to facilitate a student’s growth into becoming more prepared to practice in a culturally aware and effective way. In addition, this report seeks to provide a student’s perspective on her efficacy providing culturally …

Clinician Productivity During Student Full Time Clinical Experiences, Jamie Dehan, Michele Avery, Trevor Elmer, Yvonne Colgrove

Internet Journal of Allied Health Sciences and Practice

Purpose: Clinical education is an essential part of physical therapy education. Clinicians who provide student clinical training have the primary responsibility of patient care and meeting their job demands including meeting productivity standards. Adding a student to the mix is often perceived as negatively impacting productivity. The purpose of this study is to examine the impact on clinician productivity in direct patient care while hosting a student for a clinical experience. This study (a) investigates differences seen when hosting a DPT student or a PTA student; (b) compares differences seen influenced by which curricular stage the student is in for …

Kinematic Analysis Of A Series Of Jumps In First Position In Professional Ballet Dancers, Jessica Smith, Kevin Robinson, Pat Sells

Internet Journal of Allied Health Sciences and Practice

Purpose: Few ballet-specific studies in the literature examine kinematics during dance activities. Sports studies have identified injury risk in athletes by observing kinematics during specific activity, but this has not yet been explored for ballet. Evaluating kinematics in dancers has the potential to identify injury risk and influence treatment for prevention and rehabilitation. Therefore, the purpose of this study was to examine the landing kinematics of professional ballet dancers during a series of 16 ballet-specific jumps. Methods: This study was a multi-factor repeated measures design. Participants (3 males, 16 females aged 19-33 years; first or second company members) performed 16 …