Physiotherapy Commons^™

Bridging Clinical Capacity And Real-World Performance: Upper And Lower Limb Accelerometry In Pediatric Cerebral Palsy Rehabilitation, Youngsub Hwang, Jeong-Yi Kwon

Rehabilitation Practice and Science

The rehabilitation of children with cerebral palsy (CP) has progressively evolved from therapist-centered, impairment-focused models to child- and family-centered approaches that emphasize real-world participation. This narrative review summarizes conceptual and practical shifts in CP rehabilitation, highlighting the distinction between motor capacity and real-world performance. Accelerometry is a critical objective tool for assessing lower and upper limb physical activity. Devices such as StepWatch and ActiGraph provide ecologically valid data on lower limb activity levels, step counts, and energy expenditure. Studies have shown reduced physical activity in children with CP compared to their typically developing peers, with variations in age and GMFCS …

Assessing How Patients With Spinal Cord Injury Are Affected By Climate Change And Extreme Weather: A Scoping Review, Lien-Chieh Lin, Hung-Chou Chen, Tsan-Hon Liou

Rehabilitation Practice and Science

Climate change and the rising frequency of extreme weather events (EWEs) pose significant challenges to vulnerable populations, particularly individuals with spinal cord injury (SCI). These patients are at greater risk due to impaired thermoregulation, limited mobility, poor sensation, and dependence on caregivers or adaptive equipment, increasing their exposure to climate-related hazards and disrupting healthcare access during disasters. Although climate change impacts on the general population are well-documented, research on specific disability groups like SCI patients remains limited. This scoping review investigates how SCI patients perceive and experience health risks from climate change and EWEs, as well as factors influencing their …

The Effects Of 10-Ml Versus 40-Ml Capsular Dilatation Under Ultrasound Guidance In Patients With Adhesive Capsulitis: A Randomized Controlled Trial, Kollatee Buranarach, Rawipa Khunnarong, Chanasak Hathaiareerug

Rehabilitation Practice and Science

Background: Adhesive capsulitis causes pain and limited mobility. Hydrodilatation is an effective, minimally invasive treatment, but the optimal volume is unclear. This study compares the pain and function improvement from large-volume (40 mL) versus small-volume (10 mL) ultrasound-guided hydrodilatation in patients with adhesive capsulitis.

Methods: This study was conducted at Phramongkutklao Hospital in Bangkok, Thailand, with Thai adults aged 20 and older who had adhesive capsulitis. Participants had a pain score of 4 or higher on the Visual Analogue Scale (VAS) and limited movement in at least two directions. They were divided into two groups. One group received ultrasound-guided hydrodilatation …

Long-Term Benefits Of An Integrative Scoliosis-Specific Rehabilitation Program For High-Risk Adolescent Idiopathic Scoliosis: A Retrospective Cohort Study, Yu-Shan Fu, Lin-Fen Hsieh, Julian Wang, Wei-Chen Chang, Ya-Fang Liu, Hsuan-Han Lin

Rehabilitation Practice and Science

Background/Purpose: Adolescent idiopathic scoliosis (AIS) is a common spinal deformity in adolescents, but the optimal combination therapy remains to be established. Therefore, our purpose is to investigate the long-term benefits of a scoliosis-specific rehabilitation program integrating pattern-specific manual therapy, Schroth Best Practice exercises, and Gensingen brace application for patients with AIS.

Methods: The retrospective cohort study was conducted in an outpatient clinic, including 54 patients with AIS at a high risk of progression who participated in the aforementioned program. The primary outcomes were the angle of trunk rotation (ATR) and Cobb angle, whereas the secondary outcome was the lateral …

Principles And Practices Of Selecting Screening Tools For Oropharyngeal Dysphagia: A Narrative Review, Yu-Hsuan Lai, Tyng-Guey Wang, Nai-Hsin Meng

Rehabilitation Practice and Science

Oropharyngeal dysphagia is a potentially life-threatening condition, particularly affecting individuals with neurological diseases, head and neck cancers, and age-related issues. Its prevalence in the general population ranges from 2.3% to 16%, with much higher rates among patients with stroke, Parkinson’s disease, and traumatic brain injury. Dysphagia is prevalent in geriatric and long-term care settings, where over 50% of elderly residents may experience swallowing difficulties. Given its high prevalence and serious consequences, early detection through dysphagia screening in at-risk populations is essential. Since the 1990s, numerous screening tools for dysphagia have been developed, with over 160 non-instrumental tools identified in review …

Influence Of Local Application Of Lidocaine Patch On Peripheral Nerve Conduction – A Pilot Study, Thanh-Nhan Doan, Fang-Yin Liao, Yueh-Ling Hsieh, Li-Wei Chou

Rehabilitation Practice and Science

Background: This study aimed to investigate the effects of a lidocaine patch on peripheral nerve conduction.

Methods: Fifteen healthy volunteers with no symptoms or signs of neuropathy in either upper limb were recruited for this double-blind, placebo-controlled study over a 10-month period. A lidocaine patch or a placebo patch was applied to the volar aspect of the wrist during sleep. The treatment procedure was repeated for 14 consecutive nights. Nerve conduction studies were performed and analyzed at each assessment point. All participants were re-evaluated, with electrophysiological studies of the median and ulnar nerves repeated at 1 week and 2 weeks …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Understanding The Impact Of Admissions Variables On Admissions Diversity: A Single Doctor Of Physical Therapy Program Review, Michael Bourassa, Allison Bourassa, Saurabh Mehta

Health Professions Education

Purpose: The U.S. physical therapy workforce lacks diversity, largely influenced by healthcare program admission procedures that affect student diversity and, in turn, the profession itself. This study aimed to characterize applicants' demographic and educational profiles applying to a single accredited Doctor of Physical Therapy program and examine factors associated with admission outcomes when considering race.

Methods: This retrospective descriptive study analyzed data from 1,409 applicants to the U.S. Doctor of Physical Therapy program from 2017 to 2022. Data from pre-admission applications encompassed demographic details, overall grade point average (GPA), prerequisite GPA, graduate record examination (GRE) scores, average professional reference scores, …

Modified Constraint-Induced Movement Therapy After Stroke: A Process Evaluation Of Implementation In An Early-Supported Discharge Rehabilitation Service, Ashan Bimalka Weerakkody

Theses: Doctorates and Masters

Background

Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) function after stroke, but its routine delivery in rehabilitation settings remains limited.

Aims

The objectives were to determine the feasibility, acceptability, and sustainability of implementing mCIMT within an early-supported discharge (ESD) rehabilitation service, using existing resources and staffing.

Aims were to:

• Develop and deliver a multi-modal behaviour change intervention to clinicians to increase mCIMT delivery.
• Explore the acceptability of mCIMT among stroke survivors, carers, therapists, and allied health managers.
• Identify program adaptations to better suit stakeholder needs.
• Evaluate the process of implementing mCIMT in the ESD service.

Methods

This thesis …

Eccentric-Emphasis Exercise Program For Supraspinatus Partial Tear In Retired Police Officer An Intervention Case Report, German Eduardo Isea Fernandezx

Capstone Showcase

Abstract

Background and Purpose: Eccentric exercise has been shown to reduce pain in patients with multiple comorbidities, orthopedic surgeries, and neurologic conditions, while providing safety for greater loading during resistance training. The purpose of this case report is to describe changes in function and pain of a patient with a partial rotator cuff tear, following rehabilitation exercises focusing on eccentric action.

Case Description: A 65 y/o retired police male officer who presented right shoulder pain secondary to a partial tear of the supraspinatus tendon. The case reported mild to severe pain under the visual analog scale (VAS) of 75mm that …

Functional Recovery Of A Patient In Her Home Environment Following A Stroke Using Proprioceptive Neuromuscular Facilitation And Task-Specific Training: A Case Report, Andrea L. Crawford-Perry

Capstone Showcase

Abstract Background and Purpose: Stroke is a growingly common disability that affects an individual’s bodily function, activity and participation levels and thus impacts the whole livelihood of that individual. Proprioceptive Neuromuscular Facilitation (PNF) and Task-specific Training have been shown to improve the overall functional recovery of a patient and affect neuroplasticity. Most studies tend to compare the individual effect of these techniques; hence the purpose of this case report is to describe how both PNF and task-specific training are used to improve the functional recovery of a patient in her home environment following an acute stroke. Case Description: The patient …

Developing A Gpt-Based Virtual Training System For Medical Undergraduates' History Taking In Stroke Rehabilitation, Chao-Yu Hsu, Ching-Lin Hsieh, Jeng-Cheng Wu, Wen-Hsuan Hou

Rehabilitation Practice and Science

Background: Effective history taking in stroke rehabilitation requires comprehensive assessment skills, yet opportunities for medical undergraduates to practice such skills remain limited. Virtual patients (VPs), especially those powered by large language models (LLMs), offer a promising solution. This study aimed to develop and evaluate a GPT-based virtual training system for functional assessments in stroke rehabilitation history taking.

Methods: A mixed-methods design was employed in which VPs were modeled on a clinical stroke case and 10 core domains of functional assessments in stroke rehabilitation were integrated. A virtual examiner (VE) module provided automated scoring and feedback. Phase 1 evaluated the reliability …

Novel Sarcopenia Screening Using 1dcnn And Lidar-Enhanced Timed Up And Go Test, Yu-Ming Zhang, Cheng-Yu Tsai, Jiunn Horng Kang

Rehabilitation Practice and Science

Introduction

Sarcopenia is a systemic condition characterized by the loss of muscle mass, decreased strength and physical performance, leading to increased morbidity and mortality. To address this issue, we developed a rapid, cost-effective, and accurate screening model that integrated basic patient characteristics with a one-dimensional Convolutional Neural Network (1DCNN) analyzing Timed Up and Go (TUG) test data, captured using a simple light detection and ranging (LiDAR) device.

Methods

This study included 145 participants (38 diagnosed with sarcopenia and 107 without). During the TUG test, a LiDAR sensor semi-automatically recorded distance-time data, which was processed using a 1DCNN and combined with …

Leveraging Deep Learning For The Automated Detection Of Hemophilic Arthropathy In Knee Radiographs, En-Wei Lin, Edzer Wu, Ming-Ching Shen, Shao-Li Han

Rehabilitation Practice and Science

Background/Purpose:

Hemophilic arthropathy (HA) is a progressive joint disease caused by recurrent hemarthroses in patients with hemophilia. Early radiographic identification of HA is critical for timely intervention and long-term joint preservation. This study aimed to develop and evaluate deep learning models for automated detection of HA in knee radiographs.

Methods:

A retrospective dataset of 849 knee radiographs (AP and lateral views) was used to train three convolutional neural networks: ResNet-34, DenseNet-121, and EfficientNet-B0. Model performance was assessed using standard classification metrics, including accuracy, precision, recall, F1-score, and AUC. Interpretability was evaluated using Grad-CAM heatmaps.

Results:

DenseNet-121 achieved balanced performance on …

Persistent Oropharyngeal Dysphagia Caused By Systemic Light Chain Amyloidosis Despite Hematologic Response: A Case Report, Haw-Wen Jeng, Tyng-Guey Wang, Kuo-Chang Wei

Rehabilitation Practice and Science

We report a case of a 44-year-old woman who developed progressive dysphagia and shoulder stiffness, ultimately leading to a diagnosis of multiple myeloma (MM) with systemic light-chain (AL) amyloidosis. Despite intensive systemic therapy for MM with good serological response and nine months of comprehensive swallowing rehabilitation, her tongue mobility remained severely restricted, with only minimal improvement in laryngeal elevation. Videofluoroscopic swallowing study (VFSS) confirmed poor tongue control, reduced laryngeal elevation, and penetration of thin liquids. She ultimately passed away despite hematologic control. This case underscores the profound impact of amyloid deposition on swallowing function, even in the context of medically …

Comparison Of Baumgaertner Reduction Quality Criteria , Chang Criteria And Ap3×Ml3 Classification And Their Ability To Predict Mechanical Complications Of Trochanteric Fractures Fixed With Proximal Femoral Nail, Amr Elhadidy Elhadidy, Ahmed Abdelbadie Ibrahim, Sallam Ibrahim Fawzy, Ehab Youssef Hassanin

Mansoura Medical Journal

Background Trochanteric fractures are common injuries among the elderly. Despite advances in fixation with proximal femoral nails (PFN), Mechanical complication remain significant. Several reduction quality systems have been proposed, but their predictive value and reproducibility remain debated. Aim To evaluate and compare the predictive value and reproducibility of Baumgaertner Reduction Quality Criteria (BRQC), Chang Reduction Quality Criteria (CRQC), and AP3×ML3 classification in patients with AO Foundation/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 trochanteric fractures fixed with PFN. Methods A prospective observational study was conducted on 146 patients with 31-A1 and A2 trochanteric fractures treated by PFN. Postoperative radiographs were assessed …

Physiotherapy Experiences Of Injured Immigrant Workers In Quebec: An Intersectional Perspective, Victoria Gómez, Debbie Ehrmann Fieldman, Daniel Côté, Dahlia Kairy, Marie Laberge, Amelia León, Maxi Miciak, Maud Morin, Sara Saunders, Tatiana Orozco, Anne Hudon

Études primaires

Purpose: Immigrant workers are more likely to suffer work-related injuries compared to native-bornCanadians. Their physical rehabilitation usually involves physiotherapy. This study sought to betterunderstand the experiences of injured immigrant workers receiving compensation and physiotherapytreatments.Materials and methods: We conducted a qualitative study using an interpretive descriptivemethodology. Semi-structured interviews were completed with 10 compensated immigrant workersabout the physiotherapy services they received. Transcripts were analyzed thematically and with anintersectional lens.Results: Two major themes were identified: 1) complex pathways to physiotherapy, and 2) key pillarsof physiotherapy experiences. The first theme demonstrates that a lack of familiarity with the healthand compensation systems, delayed access to …

Guideline Of Pulmonary Rehabilitation In Patients With Interstitial Lung Disease, Chia-Ho Lin, Seong-Woong Kang, Ming-Lung Chuang, Pin-Kuei Fu, Chin-Ming Chen, Ko-Long Lin, Ssu-Yuan Chen, Li-Wei Chou, Kuan-Cheng Chen, Yuan-Yang Cheng

Rehabilitation Practice and Science

Interstitial lung disease (ILD) includes a group of chronic respiratory disorders characterized by pulmonary inflammation and fibrosis, often resulting in dyspnea, exercise intolerance, and reduced quality of life. Although pulmonary rehabilitation (PR) is effective in managing these symptoms, no guideline has comprehensively summarized its principles, components, and supporting evidence in ILD. This guideline provides an evidence-based framework for designing and implementing PR tailored to ILD patients. Core recommendations include individualized exercise prescription following the FITT principle, aerobic and resistance training, breathing exercises, supplemental oxygen use, and disease-specific self-management strategies. The guideline also presents validated assessment tools to aid clinical application …

Protocol For Development And Validation Of An Early Intervention Device And Its Influence Using Structured Early Physiotherapy (Preemiestep) Intervention On Neuromotor Development In Preterm Infants, Indira D. B. Naidu Boddapati, Sivakumar Gopalakrishnan, Sonia Khurana, Jayashree Purkayastha, Bhaskar Bhatt, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Early physiotherapy interventions for Moderate to Late Preterm (MLP) infants often lack continuity of care from hospital to home settings. This research aims to develop an Early Intervention (EI) device for home program and determine its influence using STructured Early Physiotherapy (Preemie STEP) intervention in MLP infants. For phase I, qualitative interviews will be conducted with healthcare professionals and parents, to understand user needs on developed prototype. Based on identified needs, an EI device will be developed using a human-centered design approach and iterative design process. In phase II, usability and validity of EI device will be …

Hemiplegic Shoulder Pain: A Narrative Review, Yeh-Kai Liao, Chueh-Hung Wu, Levent Özçakar

Rehabilitation Practice and Science

Hemiplegic shoulder pain is a common post-stroke complication that negatively affects functional recovery. It is caused by both mechanical and neurological factors. Prevention focuses on proper positioning, patient education, and maintenance of motion. Treatment remains largely conservative; with increasing research surrounding injection therapies, including intra-articular corticosteroid injection, subacromial hyaluronic acid injection, suprascapular nerve blocks, and botulinum toxin injection, all of which have demonstrated improved pain control. Functional electrical stimulation appears to be beneficial, and adjunct therapies such as supportive devices and robotic training may further enhance conventional treatment. Herewith, evidence regarding medications and acupuncture remains limited. Emerging treatments including high-intensity …