Department of Physical Therapy

Permanent URI for this collectionhttps://hdl.handle.net/2346.1/38395

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Now showing 1 - 14 of 14
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    Kinetic and Kinematic Differences of Barefoot versus High-Heeled Gait in Healthy, Young Adult Females: A Pilot Study
    (2016-05) Fath, Jennifer Lynn; Jurek, Shelby; Secoy, Jessica; Ko, Mansoo; Fath, Jennifer L; Jurek, Shelby B; Secoy, Jessica
    Background & Purpose: High-heeled shoes (HHSs) are a well known part of women’s footwear repertoire that can influence ankle and foot position during functional activities. Few studies have quantified the impact of HHSs on static standing posture, balance, and gait, leaving numerical values as to why HHSs are unfavorable to be determined. The purpose of this study was to identify the differences in weight distribution, area of sway during gait initiation (GI), and gait parameters between barefoot and HHSs. Methods: 12 healthy young adult female participants ambulated barefoot, then while wearing HHSs in a motion analysis laboratory. Data was collected using a Tekscan Mat (Tekscan Inc., South Boston, MA, USA) and Vicon Motion Analysis system (Vicon, Centennial, CO, USA). Paired t-tests were utilized for statistical analysis. Statistical significance was set at α = 0.05. Results: Weight shifting primarily occurs through the rearfoot in barefoot static standing, whereas in HHSs it occurs primarily through the forefoot. In addition, wearing HHSs anteriorly displaces the center of force (COF) in standing (p < 0.05). During barefoot GI, the area of COF movement was significantly greater (p < 0.05). Cadence and walking speed significantly decreased, and double-support phase of gait significantly increased in HHSs (p < 0.05). Vertical ground reaction forces at initial contact were significantly greater in HHSs (p < 0.05). Conclusion: With the results of this study, it appears that healthy young female adults demonstrate more caution with gait in HHSs as well as a disruption of natural postural alignment, imposing greater stresses on the lower extremities. While HHSs do not have a different motor strategy to execute the first step based on relative time of GI, it does require a compensated motor response to adjust to the altered postural alignment during both gait initiation and walking. This contributes to the theory that long-term use of HHSs could predispose women to lower extremity pathology through chronically altered biomechanics.
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    The Investigation of the Effects of Low Light Laser Therapy on Insulin Secretion in Porcine Islets, a Pilot Study
    (2016-05) Raptis, Darren James; Huang, Floyd; Mason, Carolyn; Moore, Kelly
    LED light technology is used in this pilot study to demonstrate the ability to create a cost effective light apparatus using 1-watt LEDs with wavelengths of 740nm,850nm, and 940nm to test for an increased insulin response using porcine islet of Langerhans cells. This is building on recent research showing increased insulin response in rat islet cells when exposed to LED light. However, due to the high variance and low sample size, statistically significant changes were not measured when irradiating cells with 740nm, 850nm, and 940nm LED light using 7.9 J/cm2 and 15.8 J/cm2 dosages along with low and high glucose conditions. There are however possible trends of increased insulin secretion that may become significant with increased sample size. There is a need to repeat this study to definitively determine if increased insulin secretion does occur in porcine islet of Langerhans cells along with any potential negative effects and what the optimal wavelengths and dosages would be. Using the cost effective light apparatus, additional wavelengths can be experimented with to cover between 300nm to over 1600nms. The information garnered from this research has the potential to improve islet of Langerhans cell transplantation for type one diabetes (T1D) patients by decreasing the number of cells needed to be therapeutic and increasing insulin release.
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    SELF-CORRECTION OF DEADLIFT FORM UTILIZING REAL TIME VISUAL FEEDBACK INFORMATION
    (2016-05) Schmidt, Matthew Steven; Bradford, Jade; Weise, Shelly; Nicks, Kendra
    Practice in front of mirrors to enhance performance through visual feedback and knowledge of performance is common in athletics that require precision and fine body control like dance and gymnastics. It is also very common to enhance motor learning of a task through evaluation of performance after the completion of a motor task such as weight lifting. Competitive weightlifters often utilize recordings of their lifts to improve future performance by evaluating form, technique, speed of movements, and several other factors that influence the quality of the lift. Studies have been performed to analyze the effect of the use of mirrors during the performance of a power-clean, but no known study has been completed evaluating the use of a system that provides concurrent augmented visual feedback of a weightlifter’s sagittal plane. The visual feedback system utilized in this study projects a real-time video image of the subject’s sagittal plane to a screen directly in front of the subject allowing the subject to view their performance as they complete a deadlift. Each subject performed two deadlifting sessions, one utilizing concurrent visual feedback and one without. During each session the subject achieved a 1RM for the deadlift then performed successive repetitions at 90% of their 1RM to determine if the use of concurrent visual feedback effected maximum force production or the subject’s ability to self-correct discrepancies in their form allowing them to complete more repetitions with proper form as they fatigue. Statistical analysis showed a significant increase in maximal strength when concurrent visual feedback was provided; no significant difference was seen concerning the performance of repeated efforts at 90% 1RM.
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    Effectiveness of the LSVT BIG™ Exercise Protocol on Measures of Balance, Gait, and Cardiovascular Fitness in Two Persons with Parkinson’s Disease
    (2016-05) Arrazola, Paul; Henderson, Lisa; Mason, Carolyn
    Case Background and Purpose. Parkinson’s disease (PD) is a progressive neurological pathology which leads to a decrease in functional capabilities. Non-pharmacologic treatment programs do exist which can enable people to function better while living with this disease. The purpose of this study was to assess the effect of the LSVT BIG™ exercise protocol on measures of balance, gait, and cardiovascular fitness in two subjects with PD. Case Description. The case study was an A-B design. Two individuals with PD consented to perform the outcome measures weekly for four weeks followed by four weeks of the LSVT BIG™ treatment protocol plus weekly testing. The outcome measures included Multi-directional Reach Test (MDRT), the GAITRite™ gait analysis system, electromyography (EMG), postural stability and limits of stability tests on Biodex™ Balance SD (BBSD), Functional Gait Assessment (FGA), Brief Balance Evaluation Systems Test (Brief BESTest), Five Times Sit to Stand (FTSTS), Six Minute Walk Test (6MWT), heart rate, blood pressure, and pulse oximetry. Outcome. The two participants demonstrated significant benefits in the outcome measures used. However, the number of changed measures for each subject was not equal, due to differences in PD signs. PD05 was a better candidate as his primary signs were bradykinesia and rigidity. Conclusion. Results of this study suggest LSVT BIG™ protocol may be used by patients with bradykinesia and rigidity as their primary motor signs of PD to help improve aspects of balance and gait. Further research is needed to solidify the results including more selective sample, larger sample size, and monitoring results of outcome measures post intervention period.
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    Investigation of the Immediate Effects of the Facilitated Oscillatory Release Technique versus the Traditional Posterolateral Glide on Internal Rotation Range of the Asymptomatic Shoulder: A Pilot Study
    (2017-02-10) Rew, April; Powers, Tevin; Schneider, Ben; Secoy, Jessica; Villers, James; Rew, April; Powers, Tevin; Schneider, Ben; Secoy, Jessica; Weise, Shelly
    Background & Purpose: The Facilitated Oscillatory Release Technique (FORT), or “harmonics,” may be used in the treatment of shoulder injuries. Little evidence exists to support its use in physical therapy. The purpose of this study is to investigate the immediate effects of the FORT versus posterolateral glides on internal rotation range (IR) of asymptomatic shoulders. Methods: Participants were blocked-randomized by gender to the harmonics or posterolateral glides group and received 3 minutes of treatment. Passive IR range of motion (ROM) was measured at baseline and immediately following treatment. A 2-way ANOVA with repeated measures was utilized. Findings: The harmonics group had a greater change in mean passive IR (mean difference posterolateral glides=4.90 degrees, harmonics=7.16 degrees). The difference was found to be statistically significant between groups (p=0.025, alpha=0.05). Clinical Relevance & Conclusion: The FORT is a useful option to increase PROM of shoulder IR.
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    AEROBIC AND RESISTANCE EXERCISE PROTOCOLS FOR OVERWEIGHT AND OBESE CHILDREN: A SYSTEMATIC REVIEW
    (2015-05) Estrada, Martin Salmon; Ko, Mansoo
    Background: In recent times, the prevalence of childhood obesity has been increasing in the United States. Obese individuals have been shown to be at an increased risk for developing health complications such as metabolic syndrome, type 2 diabetes (T2DM), and other cardiovascular disorders. Exercise is one of the methods used to prevent and treat obesity. Current exercise recommendations from the U.S. Department of Health and Human Services (USDDHS) and the American College of Sports Medicine (ACSM) are directed to healthy children or obese adults. However, they do not provide detailed exercise recommendations for overweight or obese children. This review derives aerobic and resistance exercise protocols for children with a body mass index (BMI) ≥25 from studies that have administered exercise prescriptions to overweight and obese children. Methods: A systematic review using PubMed, CINAHL, MEDLINE, PEDro, and Cochrane databases was performed. Search terms used were combinations of: obese, overweight, children, adolescent, exercise, aerobic, and resistance. Quality assessment of articles was performed using the PEDro assessment tool. Results: The primary search strategy yielded 10 studies for inclusion in this review. Seven studies utilized aerobic interventions and 3 utilized resistance interventions. The aerobic exercise protocol was derived by calculating the means of exercise parameters from the 7 aerobic studies. The resultant aerobic exercise protocol consisted of 47.1 minutes per session, 4 times per week at an intensity of 61.9% VO2 max or at least 150 bpm utilizing aerobic exercise equipment or aerobic games for at least 11.9 weeks. The resistance exercise protocol was derived by calculating the means of exercise parameters from the 3 resistance studies The resistance exercise protocol resulted in 2 sets of 10 repetitions at 72.5% of the subjects 1 repetition max 2.3 times per week. A mean of 8 exercises were performed per session focusing on both lower and upper body exercises for 12 weeks. Conclusion: Each exercise protocol was derived from studies that showed significant improvements in risk factors associated with metabolic syndrome, T2DM, and other cardiovascular diseases. These exercise protocols provide a viable exercise prescription specifically for risk factor reduction in overweight and obese children.
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    Changes in Weight Distribution and Subsequent Biomechanical Characteristics Across Starting, Transitional, and End Phases of the Back Squat in Healthy Adults
    (2015-05) Cugini, Katherine Leigh; Cugini, Katherine L; Ayers, Lance P; Key, Cary S; Ko, Mansoo
    The back squat is a common exercise used in strengthening and conditioning as well as activities of daily living. Purpose: Determine weight distribution in all phases of the back squat, kinematics and muscle forces of the vastus lateralis and vastus medialis at the starting, transition, and end points of the exercise. Methods: 27 healthy, asymptomatic individuals volunteered to participate in performing back squats for the study. Height (cm), weight (kg), Q-angle, and shoulder width were measured before the back squat was performed. They then completed 3 sets of 3RM and 5 sets of 1 repetition at 65 percent of their 3RM. Data was recorded during the squats using the TekScan HR mat, EMG surface electrodes, and electric goniometers. Results: Sample t test revealed significant weight shift on the left side compared to the right across all phases of the back squat (p<.05). Weight distribution on the right was significantly different among the three phases (F2,50=5.091, p=0.010), and the end phase was significantly lower than the transitional phases on the right side (p=0.024). Weight distribution was significantly different during all three phases on the left (p=0.002, F2.50= 6.772) and significantly higher at the end phase on the left side (p=0.010). Vastus medialis and lateralis muscle force increased significantly during ascending phase. Conclusion: These findings suggest that the transition phase is the most important phase of the squat in terms of maintaining consistency with weight shift, and that weight distribution is not necessarily equal between lower extremities even in a healthy, asymptomatic population. This study lends itself to future studies focusing on symptomatic participants as well as further definition and study of the transitional phase of the back squat.
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    High Intensity Interval Training (HIIT) vs. Traditional Continuous Training (CT): Testing the Cardiovascular Benefits Across A Wide Age Specturm- A Pilot Study
    (2015-06-03) Parker, Brandy; Grobler, Neil S.; Weise, Shelly
    High intensity interval training (HIIT) has evolved into a popular method of cardiovascular training over recent years, however its benefits have only been explored in specific populations. It has rarely been studied in comparison to continuous training (CT). Thirteen healthy participants (21-44 years; 5 males, 8 females) were assigned to 1 of 2 groups based on baseline VO2max, gender, and age. Six participants (4 female, 2 male; VO2max average 37.370 ± 3.812 ml/kg/min) executed a HIIT regimen lasting 5 weeks, while the remaining seven individuals (4 female, 3 male; VO2max avg 39.896 ± 5.161 ml/ kg/min) participated in a CT regimen of equal duration. Subjects assigned to the CT group realized a significant change in exercise test time from initial to final testing, which resulted in an overall significant change in VO2max values. Subjects who were assigned to the HIIT group did prove an overall change, however, the level of change was not statistically significant. Although the CT group experienced significant change from initial to final testing (within group), the between group analysis did not yield significant results, perhaps due to small sample size. All individuals experienced an increase in overall exercise time and VO2max values from initial to final testing, regardless of exercise group assignment. Although no significant difference was apparent when analyzing exercise time and subsequently VO2max values between the two experimental groups, the statistical significance experienced independently within the CT group warrants further investigation with a larger sample size to yield more conclusive results. In this regard, when compared, neither HIIT nor CT truly proved to be a more beneficial or effective form of training, potentially allowing HIIT to be a viable substitute for CT in terms of cardiovascular exercise.
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    The Efficacy of LSVT BIG on Parkinson's Disease: A Pilot Study
    (2015-05) Gallagher, Hannah Elizabeth; Yantas, Jenn; Mason, Carolyn
    Objectives: Parkinson’s Disease (PD) is a debilitating, neurodegenerative disorder with many different intervention techniques. The investigators sought to test the LSVT BIG treatment on local participants who have PD using multiple clinical and instrumented outcome measures to determine efficacy of the intervention. The investigators also sought to provide evidence showing the accuracy of using clinical measures compared to “gold standard” instrumented measures. Finally, the investigators were interested in determining if there was a change at the muscular level after completing the LSVT BIG intervention. Methods: Balance measures included Five Times Sit to Stand (FTSTS), Brief BESTest, Multi-Directional Reach Test (MDRT), and Postural Stability on the Biodex Balance SD (BBSD). Gait measures included Six Minute Walk Test (6MWT), Functional Gait Assessment (FGA), gait velocity, relative and absolute anticipatory response time, EMG force generated, double limb stance, single limb stance, and integrated EMG. This pilot study of two participants showed little conclusive evidence that LSVT BIG is an effective treatment for PD; however, significant benefits were shown in the Functional Gait Assessment and Brief-BESTest, demonstrating improvements in gait, balance, and fall risk. Unfortunately, multiple limitations diminished the ability to make firm conclusions in this study. Future research opportunities include gathering a larger sample size for better participant selection as well as studying the effects of LSVT BIG on other neurodegenerative disorders, studying whether BIG treatment is most effective during “on” or “off” stages of medication, and utilizing upper extremity outcome measures.
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    Discharge gait speed and hospital readmission for the elderly population: A pilot study
    (2015-06-02) Martinez, Gabriela E.; Lawson, Kayla; Braden, Heather
    ABSTRACT Objective: To describe whether discharge gait speed, after a course of physical therapy, is related to hospital readmission in the elderly population. Design: Observational cross-sectional study of discharge gait speed and a tracking system linking those who were readmitted to the hospital in 3 and 6 months post-discharge. Setting: Acute care, skilled nursing, and inpatient rehabilitation facilities of a regional medical center in the United States. Participants: Individuals (N=172) that were admitted with physical therapy orders with full weight bearing status who could ambulate 20 feet and consented to participate. Participants who had orthopedic or neurologic primary diagnoses or elective surgeries were excluded. Participants were contacted at home at 3 month and 6 months after inpatient stays to determine subsequent readmissions to any inpatient facility. Main Outcome Measure: Discharge gait speed and 3 and 6 month inpatient readmission. Results: Participants who required readmission to an inpatient setting had discharge gait speed of 0.44 m/s ±0.08 (N=12) while those not readmitted had a discharge gait speed of 0.52 m/s ±0.10 (N=23). Independent t-tests failed to show significant differences in the two speeds with the limited participant size. Conclusions: Although significant differences in discharge gait speed were not realized in this small pilot study, discharge gait speed has the potential to be an informative measure of patient status after initial inpatient stay, given the appropriate statistical power. This is a pilot study that requires additional data collection (N=318) to obtain a power of 80% with the possibility of realized differences in the two groups.
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    The Effects of Instructional Media on Learning Outcomes in Graduate Nursing and Physical Therapy Students at Angelo State University
    (2015-05) Petrie, Matthew S.; Michael, Russell Harrison; Braden, Heather J
    Instructional media is the use of aids by an instructor to supplement student learning. Such aids have improved over the years in congruence with advances in technology. In this study, graduate physical therapy students (DPT) and graduate nursing students (GN) enrolled at Angelo State University were divided into two groups to examine the effects of supplemental instructional media on their learning experience. One group received instructional media resources in addition to PowerPoint lectures, while the control group received only the PowerPoint lectures. The intent was to determine if these additional resources contributed to improvements in the students’ grades as well as their level of engagement during a DPT and GN course. Students were separated into two GPA-matched groups with researchers blinded to participants’ group assignment. Learning outcomes were 3 quizzes, a written assignment, a test, and a survey regarding the instructional media interactions (administered to only the intervention group). Increased age of participants was negatively correlated with lack of engagement in the instructional media while all other outcomes were not found to be statistically significant. At this point, supplemental instructional media may not be necessary for students at the graduate level of healthcare education. However, as exposure to technology occurs at an earlier age, it may be necessary for teaching styles to adapt to accommodate technology influenced learning styles. Further studies should be conducted to determine if such adjustments will be necessary.
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    COMPARISON OF SKINFOLD AND BIOELECTRICAL IMPEDANCE ANALYSIS WITH DUAL-ENERGY X-RAY ABSORPTIOMETRY FOR BODY COMPOSITION ANALYSIS IN COLLEGE STUDENTS
    (2015-05) Grove, Jared Robert; Hung, You-Jou
    Dual-energy x-ray absorptiometry (DXA) can provide precise measurement of soft tissue composition with minimal radiation exposure. However, having access to DXA is very costly and limited, and other noninvasive and more accessible techniques such as bioelectrical impedance analysis (BIA) and skinfold measurements are commonly used by clinicians. The purpose of this study was to compare body composition examined with BIA and 3-sites skinfold analysis to the results examined with DXA, and develop body fat prediction equations for BIA and skinfold measurements, using DXA data as the criterion Design: Cross sectional. Subjects: Sixty three college age students (28 male, 35 female) aged 18 to 27 participated in the study. Results: Body fat percentage measured with DXA is significantly higher than those measured with skinfold (p = .01) and BIA (p = .01). However, body fat percentage measured with DXA is highly correlated with those measured with skinfold (r = .895; p = .01) and BIA (r = .875; p = .01). The DXA criterion regression equations were created for skinfold and BIA: DXA%BF=4.65 + 0.43 * S3SF (sum of 3 site skinfold); DXA%BF=3.79 + 1.09 * BIA%BF. The new regression equations were further validated using 75/25% subjects cross validation. Conclusion: Skinfold and BIA measurements significantly underestimate body fat percentage compared to DXA in healthy college students. Adjustments are necessary to accurately predict body fat percentage when using skinfold or BIA at a clinical setting. To accommodate the higher body fat percentage measured with the gold standard such as DXA, the results from this study suggest the need for the current %BF standards and norms for healthy young adults to be adjusted upward.
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    Implications of age appropriate attainment of early motor skills on fine and gross motor skills in four and five year old children
    (2015-05) Matthews, Stephanie Kayleen; Kolodziej, Elizabeth; Mason, Carolyn
    Objective: The aim of this study is to discover the possible implications of early gross motor skills such as rolling, crawling, creeping, and scooting on the later fine and gross motor development of four and five year olds. Methods: A description of the research study, a consent form, and a retrospective parent questionnaire regarding early milestones were distributed to the parents and/or guardians of all four and five year old children enrolled in the San Angelo Early Childhood Center. Twenty-seven participants were included in data collection. After forms were returned, the Peabody Developmental Motor Scales - 2 was then administered to assess each participant’s gross and fine motor skills. Results: No statistically significant differences were found when comparing early gross motor skill achievement – rolling stomach to back, rolling back to stomach, crawling, creeping, and scooting - and later PDMS-2 gross motor quotients. Similarly, no statistically significant differences were found comparing rolling stomach to back, rolling back to stomach, crawling, and scooting achievement and later fine motor quotients. However, when comparing the achievement of creeping and later fine gross motor quotients, a statistically significant difference was found between groups of early, average, and late attainment. Despite only one of our comparisons being statistically significant, there were multiple between groups comparisons displaying a negative correlation between early motor skill achievement and motor quotients. Discussion: The importance of achieving early milestones generally occurring before the age of one is debated among healthcare professionals and research worldwide. Although statistical analysis did not reveal significant differences between groups of early, average, and late attainment of early milestones such as rolling, crawling, creeping, and scooting compared to later motor skills, our study did demonstrate expected negative correlation between the variables for most skills.
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    Rate of Agreement between an Experienced and Novice Clinician in the Application of a Clinical Diagnostic Rule for Subacromial Impingement Syndrome: A Pilot Study
    (2015-05) Laura, Sherrill; Jurado, Jan; Thomas, Andrew Charles; Thomas, Andrew Charles; Jurado, Jan; Villers, James F
    Background and Purpose: To determine the rate of agreement between a novice clinician and an expert clinician based on their ability to apply special tests from a clinical decision rule (CDR) for subacromial impingement syndrome (SAIS) proposed by Michener et al (2009). Design: One group, repeated-measures reliability study. Methods: Examination of 12 subjects with shoulder pain by a novice and expert rater included five SAIS tests: painful arc, Neer, Hawkins-Kennedy, empty can, and the external rotation test. A kappa analysis was performed to assess rate of agreement between examiners. Results: 100% agreement (K = 1.000) existed between novice and expert findings for the Hawkins-Kennedy test and the diagnosis of SAIS through the CDR. Moderate agreement was established for the painful arc test (K = 0.567), and fair agreement was indicated by the Neer (K = 0.316), Empty Can (K = 0.297), and External Rotation (K = 0.217) tests. Conclusions: The results of this study suggest usage of CDRs may normalize clinical knowledge between novice and expert clinicians in the physical diagnosis of SAIS.