bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishing the Reliability and Validity of Measurements of Walking Time Using the Emory Functional Ambulation Profile
Authors: Wolf Steven L , Catlin Pamela A , Gage Katherine , Gurucharri Karen , Robertson Renee , Stephen Kathleen 
Published: February 2017

Abstract
Background and Purpose. The Emory Functional Ambulation Profile (E-FAP) measures time to walk in different environments and accounts for use of assistive devices. This study assessed the reliability and validity of walking time measurements using these components. Subjects. Twenty-eight subjects who had strokes and 28 subjects without impairment were recruited. Methods. The E-FAP, Berg Balance Test, Functional Reach Test, and Timed 10-Meter Walk Test were administered in random order during a single data collection session. Results. Interrater reliability for the total E-FAP was ≥.997. Subjects without impairment performed better on all 4 tests than did subjects who had strokes. Increased times on the E-FAP correlated with poor performance on the Berg Balance Test and slow gait speeds on the Timed 10-Meter Walk Test in the subjects who had strokes. The E-FAP scores and the Functional Reach Test scores were not correlated. Conclusion and Discussion. The E-FAP can be administered easily and inexpensively. Because the E-FAP scores differentiated subject groups and correlated with known measures of function, the E-FAP may be a clinically useful measure of ambulation.
An Electromyographic Study of the Hip Abductor Muscles as Subjects With a Hip Prosthesis Walked With Different Methods of Using a Cane and Carrying a Load
Authors: Neumann Donald A 
Published: February 2017

Abstract
Background and Purpose. Certain methods of carrying handheld loads or using a cane can reduce the demands placed on the hip abductor (HA) muscles and the loads on the underlying prosthetic hip. In certain conditions, unusually large forces from the HA muscles may contribute to premature loosening of a prosthetic hip. The purpose of this study was to examine HA use by measuring the amplitude of the electromyographic (EMG) signal from the HA muscles as subjects carried a load and simultaneously used a cane. Subjects. Twenty-four active subjects (mean age=63.3 years, SD=10.7, range=40–86) with a unilateral prosthetic hip were tested. Methods. The HA muscle surface EMG activity was analyzed as subjects carried loads weighing 5%, 10%, or 15% of body weight held by either their contralateral or ipsilateral arm relative to their prosthetic hip. They simultaneously used a cane with their free hand. Results. The contralateral cane and ipsilateral load conditions produced HA muscle EMG activity that was approximately 40% less than the EMG activity produced while walking without carrying a load or using a cane. Conclusion and Discussion. People who are in danger of premature loosening of their prosthetic hip should, if possible, avoid carrying loads. If a load must be carried, however, then the contralateral cane and ipsilateral load condition appears to minimize the loads placed on the prosthetic hip due to HA muscle activity.
Lower-Extremity Muscle Force and Balance Performance in Adults Aged 65 Years and Older
Authors: Daubney Marguerite Elizabeth , Culham Elsie G 
Published: February 2017

AbstractBackground and Purpose.Measures of postural control may be useful for determining fall risk in older people and for determining the outcomes of treatments aimed at improving balance. Commonly used tools measure the output of the postural control system. The purpose of this study was to determine the degree to which one component of postural control (muscle force) contributes to scores on 3 functional balance measures. Subjects. Fifty community-dwelling volunteers between 65 and 91 years of age (X̄=74.82, SD=6.11) participated. Based on their histories, 11 subjects were classified as being at risk for falling. Methods. Measures were the Berg Balance Scale (BBS), the Functional Reach Test (FRT), and the Timed Get Up & Go Test (GUG). The force generated by 12 lower-extremity muscle groups was measured using a handheld dynamometer. Results. In the group reporting no falls, dorsiflexor and subtalar evertor force accounted for 58% of the score on the BBS, ankle plantar-flexor and subtalar invertor force accounted for 48.4% of the score on the GUG, and ankle plantar-flexor force accounted for 13% of the score on the FRT. Ankle dorsiflexor and hip extensor forces were lower in subjects reporting falls, and force of the ankle dorsiflexors predicted fall status. Conclusion and Discussion. Distal muscle force measures may be able to contribute to the prediction of functional balance scores; however, the muscles involved in the prediction differ depending on the measure of balance.
Hospital Restructuring and the Changing Nature of the Physical Therapist's Role
Authors: Lopopolo Rosalie B 
Published: February 2017

Abstract
Background and Purpose. This study was conducted to identify role behavior changes of acute care physical therapists and changes in the organizational and professional context of hospitals following restructuring. Methods. A Delphi technique, which involved a panel of 100 randomly selected acute care physical therapy managers, was used as the research design for this study. Responses from rounds 1 and 2 were synthesized and organized into exhaustive and mutually exclusive categories for round 3. Data obtained from round 3 were used to develop a comprehensive perspective on the changes that have occurred. Results. Changed role behaviors in patient care and professional interaction, including increased emphasis on evaluation, planning, teaching, supervising, and collaboration, appeared to be extensions of unchanged role behaviors. Reported changes in the structural and professional context of physical therapy services included using critical pathways to guide care, providing services system-wide, and using educational activities and meetings to maintain a sense of community. The importance of professionalism to physical therapists' work was identified and related to specific role behavior changes. Conclusion and Discussion. The changing role of physical therapists in acute care hospitals includes an increased emphasis on higher-level skills in patient care and professional interaction and the continuing importance of professionalism.
Effect of Number of Home Exercises on Compliance and Performance in Adults Over 65 Years of Age
Authors: Henry Kristin D , Rosemond Cherie , Eckert Lynn B 
Published: February 2017

Abstract
Background and Purpose. There is limited research on the effects of the number of exercises a person is told to perform on compliance and performance, as defined by cueing requirements, correct alignment, and quality of movement. Some studies of medication suggest that compliance decreases as the number of medications increases. The purpose of this study was to determine whether older adults comply and perform better (ie, requiring less cueing, exhibiting correct alignment, and exhibiting controlled, coordinated, and continuous movements) when they are asked to do 2, 5, or 8 exercises. Subjects. Subjects were 11 women and 4 men, aged 67 to 82 years (X̄=72.8), who were living independently in their communities. Methods. Subjects were randomly prescribed 2, 5, or 8 general strengthening home exercises. They were instructed on their exercises at an initial session and asked to record the number of repetitions performed each day in a self-report exercise log. At a return session 7 to 10 days later, subjects were scored on their performance of the prescribed exercises using a newly designed assessment tool. Results. The group that was prescribed 2 exercises performed better, as defined by their performance tool score, than the group that was prescribed 8 exercises. The group that was prescribed 5 exercises was not different from the groups that performed 2 or 8 exercises. No differences were found among groups regarding the self-report measurement of compliance. There was a moderate correlation between performance scores and the self-report percentage rates. Conclusion and Discussion. Subjects who were prescribed 2 exercises performed better than subjects who were prescribed 8 exercises. The question of an optimal number of exercises to prescribe to elderly people warrants further study.
Hip Moments During Level Walking, Stair Climbing, and Exercise in Individuals Aged 55 Years or Older
Authors: Kirkwood Renata Noce , Culham Elsie G , Costigan Patrick 
Published: February 2017

AbstractBackground and Purpose. Low bone mass of the proximal femur is a risk factor for hip fractures. Exercise has been shown to reduce bone loss in older individuals; however, the exercises most likely to influence bone mass of the proximal femur have not been identified. Net moments of force at the hip provide an indication of the mechanical load on the proximal femur. The purpose of this study was to examine various exercises to determine which exercises result in the greatest magnitude and rate of change in moments of force at the hip in older individuals. Subjects and Methods. Walking and exercise patterns were analyzed for 30 subjects (17 men, 13 women) who were 55 years of age or older (X̄=65.4, SD=6.02, range=55–75) and who had no identified musculoskeletal or neurological impairment. Kinematic and kinetic data were obtained with an optoelectronic system and a force platform. Results. Of the exercises investigated, only ascending stairs generated peak moments higher than those obtained during level walking and only in the transverse plane. Most of the exercises generated moments and rate of change in moments with magnitudes similar to or lower than those obtained during gait. Conclusion and Discussion. Level walking and exercises that generated moments with magnitudes comparable to or higher than those obtained during gait could be combined in an exercise program designed to maintain or increase bone mass at the hip.
Kinematic and Qualitative Analysis of Lower-Extremity Movements in Preterm Infants With Brain Lesions
Authors: van der Heide Jolanda C , Paolicelli Paola B , Boldrini Antonio , Cioni Giovanni 
Published: February 2017

Abstract
Background and Purpose. The purposes of this study were to evaluate the effects of preterm birth, severe brain lesions, and postterm age on kicking movements of young infants and to compare the prognostic value of kinematic analysis of kicking with a qualitative assessment of infants' spontaneous movements. Subjects. The subjects were 12 full-term infants without brain injury, 12 low-risk preterm infants without brain injury, and 11 preterm infants with severe brain lesions (periventricular leukomalacia). Methods. Videotape recordings of each infant's motor behavior in a supine position were made at 1 and 3 months postterm age. Kicking frequency, temporal organization of the kick cycle, coordination among different joints, and interlimb coordination were measured. A qualitative assessment for lower-extremity movements and a Gestalt judgment of general movement quality according to Prechtl's method were made from the same videotape recordings. Results. Kinematic analysis showed only mild differences among the 3 groups of infants. Qualitative assessment of the lower-extremity movements, however, showed that preterm infants with brain lesions, and particularly those who later were found to have cerebral palsy, consistently had fewer segmental movements of the foot and abnormal general movements at both ages. Conclusion and Discussion. The data suggest that the mechanisms responsible for kicking movements in newborns and young infants do not appear to be influenced by the extrauterine environment or by brain lesions, at least at the ages studied. Qualitative assessment of lower-extremity and general movements seems to be more appropriate for clinical purposes.
Cause, Prevalence, and Response to Occupational Musculoskeletal Injuries Reported by Physical Therapists and Physical Therapist Assistants
Authors: Holder Nicole L , Clark Holly A , DiBlasio John M , Hughes Carol L , Scherpf John W , Harding Linn , Shepard Katherine F 
Published: February 2017

AbstractBackground and Purpose. Physical therapists (PTs) and physical therapist assistants (PTAs) are susceptible to occupational musculoskeletal injuries. The purpose of this study was to examine the reported causes and prevalence of occupational musculoskeletal injuries to PTs and PTAs during a 2-year period. Subjects. A questionnaire was mailed to 500 PTs and 500 PTAs randomly selected from the American Physical Therapy Association 1996 active membership list. Six hundred sixty-seven questionnaires were returned, giving a response rate of 67%. Method. Based on a literature review and a pilot study, an occupational injury questionnaire was constructed and mailed. Self-reports of injuries were obtained. Results. Thirty-two percent of the PTs and 35% of the PTAs reported sustaining a musculoskeletal injury. The highest prevalence of injury was to the low back (62% of injured PTs and 56% of injured PTAs). The PTs reported the upper back and the wrist and hand as having the second highest prevalence (23%). The PTAs reported the upper back as having the second highest prevalence (28%). The PTs and PTAs reported making changes in their work habits of improved body mechanics, increased use of other personnel, and frequent change of work position. The majority of PTs and PTAs reported they did not limit patient contact time or area of practice after sustaining an injury. Conclusion and Discussion. Although PTs and PTAs are recognized to knowledgeable in prevention and treatment of musculoskeletal injuries, they are susceptible to sustaining occupational musculoskeletal injuries because of performing labor-intensive tasks.
Association of Low Back Pain With Self-Reported Risk Factors Among Patients Seeking Physical Therapy Services
Authors: Levangie Pamela K 
Published: February 2017

Abstract
Background and Purpose. This study investigated the magnitude of association between low back pain (LBP) and self-reported factors thought to increase the risk of LBP. Subjects and Methods. Questionnaires were completed by 150 patients who were receiving physical therapy for LBP and by 138 patients who were being treated for other reasons. The solicited information was used to estimate odds ratios and 95% confidence intervals for the LBP-risk factor association. Results. Low back pain was positively associated with smoking status, pregnancy, industrial vibration exposure, and time spent in a car (odds ratios ≥ 2.21). Daily lifting, body mass index, activity level, and time sitting or standing showed at most a weak positive association with LBP. Comparisons with estimated associations from other studies were made. Conclusion and Discussion. Data from this study support a statistically significant association between LBP and some factors found in other research to increase the risk of LBP. Study findings may have implications for targeting at-risk groups for back care education or intervention programs.
Treatment of Neuropathic Pain in a Patient With Diabetic Neuropathy Using Transcutaneous Electrical Nerve Stimulation Applied to the Skin of the Lumbar Region
Authors: Somers David L , Somers Martha F 
Published: February 2017

AbstractBackground and Purpose. Diabetic neuropathy can produce severe pain. The purpose of this case report is to describe the alteration of pain in a patient with severe, painful diabetic neuropathy following application of transcutaneous electrical nerve stimulation (TENS) to the low back. Case Description. The patient was a 73-year-old woman with pain in the left lower extremity over the lateral aspect of the hip and the entire leg below the knee. The pain prevented sound sleep. The intensity of pain was assessed with a visual analog scale. Intervention. The TENS (80 Hz) was delivered 1 to 2 hours a day and during the entire night through electrodes placed on the lumbar area of the back. Outcomes. Following 20 minutes of TENS on the first day of treatment, the patient reported a 38% reduction in intensity of pain. After 17 days, the patient reported no pain following 20 minutes of TENS and that she could sleep through the night. Application of TENS to the skin of the lumbar area may be an effective treatment for the pain of diabetic neuropathy.
Balance and Ankle Range of Motion in Community-Dwelling Women Aged 64 to 87 Years: A Correlational Study
Authors: Mecagni Chiara , Smith Janet Pulliam , Roberts Kay E , O'Sullivan Susan B 
Published: February 2017

Abstract
Background and Purpose. This study investigated the relationship between balance measures and ankle range of motion (ROM) in community-dwelling elderly women with no health problems. Identification of modifiable factors associated with balance may enable clinicians to design treatments to help reduce the risk of falls in elderly people. Subjects. The sample consisted of 34 women between the ages of 64 and 87 years (X̄=74.7, SD=6.0). Methods. Goniometry was used to determine bilateral ankle active-assistive range of motion (AAROM) and passive range of motion. Balance capabilities were measured with the Functional Reach Test (FRT) and the Tinetti Performance-Oriented Mobility Assessment (POMA). Balance data for the FRT, POMA balance subtest, POMA gait subtest, and POMA total score were correlated with ankle ROM using the Pearson product moment correlation coefficient (PCC). Results. Correlations between ROM and balance scores were found, ranging from .29 to .63. The POMA gait subtest and FRT resulted in higher correlations with ROM than did the POMA balance subtest (left total AAROM PCC=.63, .51, and .31). Correlations using composite ankle ROM scores were higher than individual motions. The strongest correlation existed between bilateral, total ankle AAROM and the POMA gait subtest scores (PCC=.63) Conclusion and Discussion. Correlations exist between ankle ROM and balance in community-dwelling elderly women. Additional research is needed to determine whether treatment directed at increasing ankle ROM can improve balance.
Patellar Kinematics, Part II: The Influence of the Depth of the Trochlear Groove in Subjects With and Without Patellofemoral Pain
Authors: Powers Christopher M 
Published: February 2017

AbstractBackground and Purpose. A shallow intercondylar groove has been implicated as being contributory to abnormal patellar alignment. The purpose of this study was to assess the influence of the depth of the intercondylar groove on patellar kinematics. Subjects. Twenty-three women (mean age=26.8 years, SD=8.5, range=14–46) with a diagnosis of patellofemoral pain and 12 women (mean age=29.1 years, SD=5.0, range=24–38) without patellofemoral pain participated. Only female subjects were studied because of potential biomechanical differences between sexes. Methods. Patellar kinematics were assessed during resisted knee extension using kinematic magnetic resonance imaging. Measurements of medial and lateral patellar displacement and tilt were correlated with the depth of the trochlear groove (sulcus angle) at 45, 36, 27, 18, 9, and 0 degrees of knee flexion using regression analysis. Results. The depth of the trochlear groove was found to be correlated with patellar kinematics, with increased shallowness being predictive of lateral patellar tilt at 27, 18, 9, and 0 degrees of flexion and of lateral patellar displacement at 9 and 0 degrees of flexion (r=.51–.76). Conclusions and Discussion. The results of this study indicate that bony structure is an important determinant of patellar kinematics at end-range knee extension (0°–30°).
Development of an Activity Scale for Individuals With Advanced Parkinson Disease: Reliability and “On-Off” Variability
Authors: Nieuwboer Alice , De Weerdt Willy , Dom René , Bogaerts Kris , Nuyens Godelieve 
Published: February 2017

Abstract
Background and Purpose. Functional mobility in people with advanced Parkinson disease, some of whom have a variable response to drug treatment, is often difficult to evaluate. The objectives of this study were to investigate the interrater reliability of measurements obtained with a scale designed to measure mobility and to determine the impact of self-rated dyskinesias and fluctuations on the measure. Subjects. Twenty-nine people with Parkinson disease and with disability and considerable disease duration (X̄=11.7 years, SD=4.9, range=6–22) took part in the study. Methods. The subjects' performance on a 10-item scale was videotaped. The videotapes were then scored by 2 independent raters, and the scores were used to determine interrater reliability. The stability of 6 repeated measurements was examined in the home situation, taking into account self-rated fluctuations of motor performance. Results. Weighted Kappa values of agreement (.86–.98) confirmed the reliability between testers. Measurement during the “on” phase (when medication was working optimally) and the “off” phase (when the action of medication was strongly decreased or absent) led to different measurements. Measuring frequently within “on” and “off” phases gave relatively stable measurements for total function, bed transfers, and gait akinesia, the latter during the “off” phase only (intraclass correlation coefficients [ICCs]=.70–.93). However, more modest repeatability applied to transfers from a chair (ICC=.65–.67). Conclusion and Discussion. To ensure valid results in future effect studies, clinical differentiation between “on” and “off” phase measurements is proposed on the basis of patients' own perception of their medication status.
Lower-Extremity Compensations Following Anterior Cruciate Ligament Reconstruction
Authors: Ernst Gregory P , Saliba Ethan , Diduch David R , Hurwitz Shepard R , Ball Donald W 
Published: February 2017

AbstractBackground and Purpose. Several studies have demonstrated that patients with knee injury scored within a normal range during one-legged hop tests yet showed quadriceps femoris muscle weakness with non–weight-bearing isokinetic testing. This study evaluated lower-extremity kinetics while subjects performed a single-leg vertical jump (VJ) and a lateral step-up (LSU) in an attempt to explain this phenomenon. Subjects and Methods. Using a motion analysis and force platform system, hip, knee, and ankle extension moments of 20 subjects with anterior cruciate ligament (ACL) reconstructions and 20 matched subjects were measured while they performed an LSU and a VJ. Results. An analysis of variance revealed that the knee extension moment of the ACL-reconstructed extremity was lower than that of the uninjured and matched extremities during the LSU, VJ take-off, and VJ landing. However, there was no difference in summated extension moment (hip + knee + ankle) among extremities during the LSU and VJ take-off. The summated extension moment of the ACL-reconstructed extremity during VJ landing was less than that of the uninvolved and matched extremities. Conclusions and Discussion. These results suggest that the hip or ankle extensors may compensate for the knee extension moment deficit. The decrease in summated extension moment in the ACL-reconstructed extremity during VJ landing represents inadequate attenuation of landing forces, which may expose the skeleton and joint structures to injury.