Physical Therapy Commons^™

Can A Prescribed Walking Program With Or Without Monitoring Impact Dizziness In The Older Adults? A Pilot Study, Amie Marie Jasper

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background. Dizziness, a common complaint among older adults, is associated with multiple falls, loss of function and independence, and reduced balance confidence. The Clinical Practice Guideline for Peripheral Vestibular Hypofunction recommends walking for endurance as a component of vestibular rehabilitation (VR). However, studies on VR in the olderadults do not include walking in the intervention.

Research Design: 1) A pragmatic, randomized, experimental design to evaluate the impact of walking on vestibular outcomes, length of stay, and number of visits, and to examine whether pedometers increase the adherence of older adults with vestibular issues to a walking program; 2) a descriptive …

Cortical Activation During Shoulder And Finger Movements In Healthy Adults: A Functional Near-Infrared Spectroscopy (Fnirs) Study., Chieh-Ling Yang, Shannon B Lim, Sue Peters, Janice J Eng

Physical Therapy Publications

Characterization of cortical activation patterns during movement of the upper extremity in healthy adults is helpful in understanding recovery mechanisms following neurological disorders. This study explores cortical activation patterns associated with movements of the shoulder and fingers in healthy adults using functional near-infrared spectroscopy (fNIRS). Twelve healthy right-handed participants were recruited. Two motor tasks (shoulder abduction and finger extension) with two different trial lengths (10 s and 20 s) were performed in a sitting position at a rate of 0.5 Hz. The hemodynamic response, as indicated by oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR), over both hemispheres was acquired using a 54-channel …

A Case Of Thoracic Spondylosis Deformans And Multilevel Instrumented Spinal Fusion In An 84-Year-Old Male., Amy H Amabile, J Raymond Shea, Vishal Desai, Lisa T Hoglund, Jamie N Elcock, Anthony Lombardo, Matthew C Schiffino

Department of Physical Therapy Faculty Papers

Spondylosis deformans is a type of spinal claw osteophytosis which can be found on the anterolateral vertebral bodies of any region, and which consists of protrusions of intervertebral disc tissue covered by a bony shell. We report here a case of thoracic spondylosis deformans and multilevel instrumented fusion found during routine dissection of a cadaver. Theories of the etiology of this condition are reviewed in general, and with respect to this specific case and the potential interaction of the presenting comorbidities. The clinical implications of these osteophytes, including musculoskeletal and visceral sequelae, are also discussed.

Functional Electrical Stimulation Plus Visual Feedback Balance Training For Standing Balance Performance Among Individuals With Incomplete Spinal Cord Injury: A Case Series, David J Houston, Jae W Lee, Janelle Unger, Kei Masani, Kristin E Musselman

Physical Therapy Publications

Individuals with an incomplete spinal cord injury (iSCI) are highly susceptible to falls during walking or standing. Our objective was to evaluate a therapeutic tool for standing balance that combined functional electrical stimulation, applied bilaterally to the plantarflexors and dorsiflexors, with visual feedback balance training (FES+VFBT). Five adults with iSCI completed 12 FES+VFBT sessions over 4 weeks. During the training sessions, participants completed each of the four balance exercises twice. Visual feedback of the center-of-pressure (COP) location was provided as participants completed the balance exercises and received FES to assist with performance of the exercises. A closed-loop FES system was …

Effects Of Ankle Angular Position And Standing Surface On Postural Control Of Upright Stance, Fawaz A. Alwadani, Huaqing Liang, Alexander S. Aruin

Physical Therapy Faculty Research

The purpose of the study was to investigate the effects of ankle angular position and standing surface type on static upright balance. Ten young adults stood on a force platform or on a firm wedge that induced 15° of either dorsiflexion or plantarflexion. In addition, a piece of foam was placed on top of the force platform and on the wedge. The center of pressure distance and velocity in the anteroposterior and mediolateral directions were calculated. Significantly larger magnitudes in most of the investigated variables were seen while standing with ankles in the dorsiflexion when compared with standing with the …

Improvement In Overground Walking After Treadmill-Based Gait Training In A Child With Agenesis Of The Corpus Callosum, Gena Henderson, Matthew Beerse, Huaqing Liang, Diego Ferreira, Jianhua Wu

Physical Therapy Faculty Research

Background: Agenesis of the corpus callosum (ACC) is a rare congenital brain defect that produces a wide variety of cognitive and motor impairments. Literature regarding the response of pediatric populations with ACC to physical rehabilitation is scarce. Treadmill-based gait training (TT) has been shown to improve walking ability in some pediatric populations but has not been investigated in children with ACC.

Objective: The purpose of this study was to investigate the effect of a novel treadmill intervention paradigm on the gait parameters of a child with ACC.

Design: A single-participant design with 2 phases was used.

Methods: The settings were …

Validity Of The Paper Pull Test For Strength In Patients With Hallux Valgus, Marcey Keefer Hutchison, Jeff Houck, Jaymee Kau, Kristen E. Omohundro, Alex Hughes, Kara Oshiro, Taylor Eckel

Faculty Publications - College of Physical Therapy

Introduction/Purpose: The purpose of this study was to explore validity of the paper pull test (PPT) to assess hallux flexion strength and function in persons with hallux valgus (HV). The following hypotheses were tested: 1) The PPT is valid for inferring 1st MTP flexion strength and heel rise (HR) performance (e.g. heel height). 2) A specified threshold of force during the PPT can be identified that discriminates patients with HV. 3) Muscle activity (abductor hallucis [AH], flexor hallucis brevis [FHB]), in patients with HV will be distinct from controls across three tasks: 1) PPT, 2) lowering phase of a HR, …

Clinical Measurements Of The Posterior Shoulder Endurance Test (Pset), Neil A. Evans

Theses and Dissertations--Rehabilitation Sciences

Of the intrinsic factors responsible for non-traumatic shoulder pain, muscular endurance is often not measured by rehabilitation professionals due to the lack of available shoulder endurance measures. Measurement properties of the PSET have not been adequately assessed in previous studies. The purpose of this dissertation was to develop the clinical measurement properties of the Posterior Shoulder Endurance Test (PSET) so that it might be used as a clinical measure of shoulder muscular endurance.

Electromyography (EMG) offers the ability to identify which muscles in the posterior shoulder girdle are fatiguing during the PSET. Surface EMG of upper trapezius (UT), middle trapezius …

Psychosocial Predictors Of Chronic Pain And Pain-Related Disability 12 Months After Lower Extremity Fracture, Joshua Judson Van Wyngaarden

Theses and Dissertations--Rehabilitation Sciences

Over 700,000 lower extremity fractures occur each year with a large portion of these patients developing adverse long-term pain and disability outcomes. Current literature indicates that 39% to 62.7% of all patients report continued pain long after traumatic lower extremity fracture. Concurrent physical limitations and reduced quality of life are common, with nearly one-third of all patients reporting pain-related disability seven years after limb threatening trauma, and approximately 50% of these patients having limitations in functional mobility and activities of daily living at long-term follow-up. These poor long-term injury-related pain and disability outcomes are alarming and require further action to …

Outcomes Of Formalized Physical Therapy Vs. Self-Directed Home Exercise, Thomas Lee, Daniel Bowles

Phase 1

Introduction: After a formal microdiscectomy or 1-2 level anterior cervical discectomy and fusion (ACDF) there exists a lack of consensus on effectiveness of postoperative formal physical therapy (PT) rehabilitation efficacy. We seek to determine whether home PT is equivalent to standard PT using patient reported outcomes measures (PROMs) after the aforementioned operations.

Methods: This study is a prospective single center cohort study. The inclusion criteria is patients undergoing a microdiscectomy or ACDF operation excluding patients under 18, infection, trauma, tumor, or revision. Outcomes are measured using PROMs specific for each operation.

Results: Preliminary data suggests that post-operative …

Physical Therapy For Gait, Balance, And Cognition In Individuals With Cognitive Impairment: A Retrospective Analysis, Jason Longhurst, Jason Phan, Elbert Chen, Steven Jackson, Merrill R. Landers

Integrated Health Sciences Faculty Research

© 2020 Jason Longhurst et al. Objectives. The purpose of this study was to determine if a pragmatic physical therapy (PT) program was associated with improved cognition, gait, and balance in individuals with cognitive impairment. This study investigated these associations for individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI) in order to better characterize outcomes to PT for each diagnostic group. Methods. Data before and after one month of physical therapy were extracted from patient records (67 with AD, 34 with VaD, 35 with DLB, and 37 with MCI). The …

The Influence Of A Positive Empathetic Interaction On Conditioned Pain Modulation And Manipulation Induced Analgesia In People With Lateral Epicondylalgia, Ahmad Muhsen, Penny Moss, William Gibson, Bruce Walker, Angela Jacques, Stephan A. Schug, Anthony Wright

Physiotherapy Papers and Journal Articles

Objective: Conditioned pain modulation (CPM) and manipulation induced analgesia (MIA) are two forms of endogenous analgesia. Many forms of analgesia can be influenced by the nature of the patient clinician interaction. The aim of this study was to evaluate the influence of an empathetic and supportive interaction on CPM and MIA in people with Lateral Epicondylalgia (LE).

Methods: In a double-blind, randomised, controlled trial, 68 participants with LE were assigned to two groups: the empathetic and neutral interaction groups. The interactions were carried out by a trained, professional role play actor, playing the part of a research assistant (RA). The …

Blood Flow Restriction Training For The Rotator Cuff: A Randomized Controlled Trial, Jason Brumitt, Marcey Keefer Hutchison, Daniel Kang, Zach Klemmer, Mike Stroud, Edward Cheng, Neil Patrick Cayanan, Sheldon Shishido

Faculty Publications - College of Physical Therapy

Context: Blood flow restriction (BFR) training utilizes a tourniquet, applied to the proximal portion of one or more extremities, to occlude blood flow during exercise. Significant gains in strength and cross-sectional area can be achieved in muscles, both distal and proximal to BFR cuff application. Purpose: To compare strength gains of the rotator cuff and changes in tendon size in subjects who performed side-lying external-rotation exercise with or without BFR. Methods: Forty-six subjects (mean age 25.0 [2.2] y) were randomized to either a BFR + exercise group or to the exercise-only group. Subjects performed 4 sets of the exercise (30/15/15/15 …

Is There A Difference In Outcomes Between Patients Who Received A Double Or Triple Arthrodesis For Hindfoot Arthritis?, Amanda H. Holleran, Judith F. Baumhauer, Jeff Houck, Daniel Homeier, Adolph S. Flemister, John P. Ketz, Benedict F. Digiovanni, Irvin Oh

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Triple arthrodesis has historically been considered the standard of treatment for arthritis of the hindfoot with or without deformity. The complications of this surgery including non-union, malunion, nerve injury, infection and wound healing problems can occur at any of the three joints. Double arthrodesis is capable of producing a similar reduction in degrees of motion and correction of foot deformity but may also cause less patient morbidity in regard to these complications due to one less joint being incorporated into the fusion procedure. What is unknown is the patient reported outcomes, specifically physical function (PF) and pain interference (PI) …

Operative Intervention Does Not Change Pain Perception In Patients With Diabetic Foot Ulcers, Olivia V. Waldman, Stephanie P. Hao, Jeff R. Houck, Nicolette J. Lee, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Researchers investigated pain perception in patients with diabetic foot ulcers (DFUs) by analyzing pre- and postoperative physical function (PF), pain interference (PI), and depression domains of the Patient-Reported Outcome Measurement Information System (PROMIS). They hypothesized that 1) because of painful diabetic peripheral neuropathy (DPN), a majority of patients with DFUs would have high PROMIS PI scores unchanged by operative intervention, and 2) the initially assessed PI, PF, and depression levels would be correlated with final outcomes. Seventy-five percent of patients with DFUs reported pain, most likely because of painful DPN. Those who reported high PI and low PF were likely …

Development Of The Steppin' Up For Success Program, Darlene F. Guckenberger

Occupational Therapy Program Student Theses, Dissertations and Capstones

School transitions can be challenging for students, especially when students enter junior high school. Junior high school students experience significant developmental growth in the areas of autonomy, relationships, acceptance, cognitive skills, as well as physical differences associated with hormonal changes. When a student transitions into junior high school, evidence indicates possible declines in motivation, school interest, and academic achievement. Personal relationships, self-worth, and coping skills are essential for a successful transition between schools. Adolescents engage in the occupations of education, leisure, social participation, and activities of daily living. Occupational therapy is perfectly positioned as a support service within the school …

New Author Guidelines In Statistical Reporting: Embracing An Era Beyond P < .05, Samantha Johnson, Whitley J. Stone, Jennifer Bunn, Scott Lyons, James W. Navalta

Kinesiology and Nutrition Sciences Faculty Research

Statistical reporting of quantitative research data has been plagued by potential bias and reporting suppression due to a single numerical output: the p-value. While there is great importance in its merit, creating a pass-fail system (set at point of .05) has created a culture of researchers submitting their project’s data to a filing cabinet if it does not yield “statistical significance” based on this value. The editors of the International Journal of Exercise Science are following the American Statistical Association’s call for statistical reform by adjusting our reporting guidelines to the following requirements: [1.] make an intentional effort to move …

Comparison Of Home Therapy Vs Formal Outpatient Physical Therapy In Post-Operative Management Of Two-Incision Distal Bicep Tendon Repair, Joseph Botros, John Horneff Iii, Md, Thomas Harper, Brent Page

Phase 1

Background: Distal bicep tendon tears are a relatively uncommon injury, affecting 1.2/ 100,000 persons per year; they can also cause substantial loss in supination and flexion strength. The most common treatment is a double incision distal bicep tendon repair, which involves surgical reinsertion of the bicep tendon onto the radial tuberosity. Following surgery, physicians have traditionally recommended the patient undergo 5-12 weeks of formal outpatient physical therapy. This can be a significant cost and time burden to the patient. Therefore, some physicians have instead opted for home physical therapy, in which the patient is given instructions on exercises to complete …

The Effects Of Virtual Reality In The Treatment Of Stroke Patients, Melissa Schoettle

Capstone Showcase

The Effects of Virtual Reality in the Treatment of Stroke Patients

Stroke patients face many challenges on their road to recovery. Patients may lose motor function, speech abilities, and other important cognitive functions. They go through various forms of therapy to help rehabilitate them and improve their cognition, including physical, occupational, and speech therapy. Physical therapy helps improve motor function and muscle control, occupational therapy improves those skills needed for success in work and life, and speech therapy helps patients recover the ability to speak and the cognitive processes to think and form words and sentences. While these therapies are …

Clinical And Neurophysiological Effects Of Dry Needling On Individuals With Chronic Ankle Instability, Jennifer Mullins

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are generally considered innocuous injuries; however, as many as 74% of patients will develop chronic symptoms. 1-3 Chronic ankle instability (CAI) is defined by a history of ankle sprain accompanied by ongoing bouts of giving way, residual ankle sprain symptoms, and a decrease in patient-perceived function. As understanding of sensorimotor deficits in individuals with CAI have advanced, treatment strategies have evolved to include a robust focus on balance training to mitigate dynamic and static postural control impairments exhibited in individuals with CAI. A problem arises as these improvements have not been conclusively linked to a decrease in CAI. …