bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contributions of Lower-Limb Muscle Power in Gait of People Without Impairments
Authors: Sadeghi Heydar , Allard Paul , Duhaime Morris 
Published: February 2017

AbstractBackground and Purpose. Although gait asymmetry in rehabilitation has been documented, little is known about propulsion and control tasks performed by each limb and how these tasks are managed between the lower limbs. The purpose of this study was to test the hypothesis that the leading limb contributes mainly to forward progression, whereas the trailing limb provides control and propels the lower limb to a lesser extent. Subjects. Nineteen men with an average age of 26.2 years (SD=3.2, range=21–34) and no history of orthopedic ailments participated in the study. Methods. Muscle power was determined using an 8-camera high-speed video system synchronized with 2 force plates. The principal-component analysis method was applied to reduce and classify 52 gait variables for each limb, and Pearson correlations were used to determine the interactions within the data sets for each limb. Results. Gait propulsion was initiated by the hip of the leading limb shortly after heel-strike and was maintained throughout the stance phase. Control was the main task of the trailing limb, as evidenced by the power absorption bursts at the hip and knee. Conclusion and Discussion. Within-limb interaction further emphasized the functional relationship between forward progression and control tasks and highlighted the importance of frontal- and transverse-plane actions during gait.
Detrimental Effects of Short-term Glucocorticoid Use on the Rat Diaphragm
Authors: Eason Jane M , Dodd Stephen L , Powers Scott K , Martin A Daniel 
Published: February 2017

Abstract
Background and Purpose. The purpose of this study was to determine the effect of short-term, high doses of glucocorticoids on both body and diaphragm weights as well as contractile characteristics of the rat diaphragm. Subjects. Adult, female Sprague-Dawley rats were divided into 2 groups: a control group (n=16) and a prednisolone group (n=16). Methods. The prednisolone group received prednisolone at a dosage of 5 mg/kg, and the control group received sham saline injections for 5 days. Animals were weighed prior to and after completion of the drug injection period. At the completion of the drug injection period, the animals were sacrificed, and the diaphragm, soleus, and extensor digitorum longus muscles were removed and weighed. A small strip of the costal diaphragm was connected to a force transducer, and the following contractile characteristics were measured: maximal specific isometric tetanic tension, peak isometric twitch specific tension, one-half relaxation time, and time to peak tension. Results. Both body and diaphragm weights decreased by 15% in the prednisolone group as compared with the control group. Maximal specific isometric tetanic tension was reduced 13% in the prednisolone group as compared with the control group. There was no difference in any twitch contractile characteristics between the 2 groups. Conclusion and Discussion. These data support the hypothesis that glucocorticoid treatment over a 5-day period results in a decrease in specific tension as well as diaphragm and body weight. These results may have implications for the treatment of patients receiving high doses of glucocorticoids for acute medical conditions.
Examining Diagnostic Tests: An Evidence-Based Perspective
Authors: Fritz Julie M , Wainner Robert S 
Published: February 2017

Abstract
Diagnosis is an important aspect of physical therapist practice. Selecting tests that will provide the most accurate information and evaluating the results appropriately are important clinical skills. Most of the discussion in physical therapy to date has centered on defining diagnosis, with considerably less attention paid to elucidating the diagnostic process. Determining the best diagnostic tests for use in clinical situations requires an ability to appraise evidence in the literature that describes the accuracy and interpretation of the results of testing. Important issues for judging studies of diagnostic tests are not widely disseminated or adhered to in the literature. Lack of awareness of these issues may lead to misinterpretation of the results. The application of evidence to clinical practice also requires an understanding of evidence and its use in decision making. The purpose of this article is to present an evidence-based perspective on the diagnostic process in physical therapy. Issues relevant to the appraisal of evidence regarding diagnostic tests and integration of the evidence into patient management are presented.
Reliability of Measurements Obtained With the Modified Ashworth Scale in the Lower Extremities of People With Stroke
Authors: Blackburn Marjan , van Vliet Paulette , Mockett Simon P 
Published: February 2017

Abstract
Background and Purpose. Abnormal muscle tone is a common motor disorder following stroke, which may require rehabilitation. The Modified Ashworth Scale is a 6-point rating scale that is used to measure muscle tone. The interrater and intrarater reliability of measurements obtained with the scale remain equivocal. The purpose of this study was to investigate the reliability of measurements obtained with the scale in the lower limb of patients with stroke. Subjects. Twenty patients were tested 2 weeks after their stroke, and 12 patients were tested 12 weeks after their stroke. Methods. Gastrocnemius, soleus, and quadriceps femoris muscles on the hemiplegic side were tested. Results. Interrater reliability for 2 raters was poor, with a Kendall tau-b correlation for the combined muscle group of .062 (P=.461). For intrarater reliability, the Kendall tau-b correlation was .567 (P&lt;.001). The agreement within one rater occurred mostly on the grade of 0. Discussion and Conclusion. The Modified Ashworth Scale yielded reliable measurements in the lower limb for a single examiner, and agreement was best on the grade of 0. The reliability between examiners was not good, which may bring into question the validity of measurements obtained with the scale.
Loads on an Internal Spinal Fixation Device During Physical Therapy
Authors: Rohlmann Antonius , Graichen Friedmar , Bergmann Georg 
Published: February 2017

Abstract
Background and Purpose. Modified internal spinal fixation devices allow the measurement of the forces and moments acting on the implants. The aim of this study was to measure the loads on internal fixation devices for selected body positions and movements during physical therapy. Subjects and Methods. Loads on an internal spinal fixation device were measured in 10 patients with degenerative instability or compression fractures using a telemeterized implant. Results. Relatively low implant loads were found in the recumbent body positions. Most exercises performed in a lying position caused implant loads less than that measured for standing and are therefore not likely to increase the risk of screw breakage. Fixation device loads were lower for sitting relaxed than for standing. The highest implant loads (128% of the value for standing) were measured during walking. Standing up, sitting down, and lateral bending and axial rotation of the upper body while standing led to fixation device loads between 111% and 120% related to the value for standing. Even higher fixation device loads were measured for ventral flexion and extension of the upper body while standing. Kneeling on hands and knees, and flexing and extending the back in this position, caused implant loads that were lower than for standing. Discussion and Conclusion. Standing up, sitting down, and lateral bending and axial rotation of the upper body while standing may slightly increase the risk of pedicle screw breakage, whereas ventral flexion and extension of the upper body while standing may increase this risk considerably if the region bridged by the implant is distracted (the distance between upper and lower screws was increased) during surgery. However, walking is the exercise that plays the major role concerning pedicle screw breakage because it causes the highest bending moments of all exercises studied and it loads the fixation devices most frequently.
Body Weight Support Treadmill and Overground Ambulation Training for Two Patients With Chronic Disability Secondary to Stroke
Authors: Miller Ellen Winchell , Quinn Matthew E , Seddon Patricia Gawlik 
Published: February 2017

Abstract
Background and Purpose. Body weight support (BWS) treadmill training has recently been shown to be effective for gait training following stroke, but few researchers have measured the usefulness of this intervention in enhancing function, and there are no reports in which BWS overground ambulation was studied. The purposes of this case report were (1) to report the feasibility and patient tolerance for using a BWS system for overground ambulation, (2) to measure the function of patients with chronic stroke (2 years post-stroke) prior to and following BWS treadmill and overground ambulation training, and (3) to describe a protocol used for patient treatment progression using BWS treadmill training. Case Descriptions. The participants were 2 women, aged 87 and 93 years, who had strokes more than 2 years before data collection. A 10-m timed walk test, the Berg Balance Scale, the gait portion of the Tinetti Gait and Balance Assessment, and a measure of step length were administered. Intervention consisted of BWS ambulation training 3 times a week for 6 to 7 weeks. Each day there was BWS treadmill and overground training. Outcomes. Participant A improved most in 10-m walking time and Berg Balance Scale score. Participant B exhibited improvements in step length and 10-m walking time. Discussion. The outcomes suggest that very old patients with chronic functional deficits secondary to cerebrovascular accident tolerated BWS treadmill and overground ambulation training and made improvements following this intervention.
“Look Forward, Walk Tall”: Exploring Our “What If” Questions
Authors: Wolf Steven L 
Published: February 2017

Abstract
Steven L Wolf, PT, PhD, FAPTA
Dr Wolf has given much to the physical therapy profession through his teaching, research, and service. He has an extensive publication record of more than 100 peer-reviewed publications that reflect his interest and expertise in biofeedback, neuromuscular re-education, and management of patients with chronic pain, among others. His work spanned the basic science areas early in his career and has shifted more recently to large-scale clinical research that corresponds to the most urgent need within the profession of physical therapy. Dr Wolf's influence has reached beyond the United States, and he is a much sought-after lecturer internationally. As a researcher, he has had a profound effect as one of the most consistent and productive researchers. Over his career, he has been a part of 37 funded peer-reviewed grant proposals, and he is listed in more than half as either the Principal or Co-Principal Investigator. The funding totals an astounding $30 million.
His profound experience as one of the cutting-edge researchers in physical therapy and as a superb educator and his international reputation—in addition to his many contributions to the professional association—have qualified him for this highest award the Association can provide.
Dr Wolf's distinguished career is highlighted by numerous awards, including the Marian Williams Research Award, Gold Pen Award, Catherine Worthingham Fellow of the APTA, Lucy Blair Service Award, Helen J Hislop Award for Excellence in Contributions to Professional Literature, the Foundation for Physical Therapy's Robert C Bartlett Recognition Award, the Section on Geriatrics Outstanding Published Paper Award, and the Neurology Section Outstanding Research Award.
A Calibration Study of Therapeutic Ultrasound Units
Authors: Artho Paul A , Thyne Jason G , Warring Barry P , Willis Chris D , Brismée Jean-Michel , Latman Neal S 
Published: February 2017

Abstract
Background and Purpose. Physiological effects of therapeutic ultrasound (US) are dependent on the intensity and duration of application. The purpose of this study was to test US machines used in clinical settings for proper calibration of time and power output. Methods. Measurements of power output and timer accuracy were obtained from 83 US units in clinical use. The machines were tested at 4 intensity settings (0.5, 1.0, 1.5, and 2.0 W/cm2) using a continuous waveform and a 1-MHz frequency. The measured intensities were converted to percentages of error and compared with the ±20% standard. Results. Of the machines tested, 32 (39%) were outside the calibration standard for at least one output setting. Of these machines, 15 (18%) were above the +20% standard, and 17 (21%) were below the −20% standard for at least one output setting. Of the 32 machines outside the standard, 26 (31%) were outside the standard for 2 or more settings, and 3 (4%) produced no output at any of the settings. Of the mechanical timers tested, 7 (28%) were outside of the ±10% standard for timer accuracy at the 5-minute interval, and 6 (24%) were outside of the standard at the 10-minute interval. All digital timers tested were within the standard. Discussion and Conclusion. More than one third of machines tested in this study were outside the standard for power output, and approximately one fourth of the mechanical timers were outside the standard. Therefore, further improvements in the accuracy of US machine calibration are needed.
The Use of Casts in the Management of Joint Mobility and Hypertonia Following Brain Injury in Adults: A Systematic Review
Authors: Mortenson Patricia A , Eng Janice J 
Published: February 2017

AbstractMany controversies exist regarding the practicality, the theoretical premises, and the supporting evidence for the use of casts in the management of joint hypomobility and hypertonia (ie, increase in joint resistance to passive movement resulting from hyperactivity of the stretch reflex and/or changes in the muscles and connective tissues). The purpose of this review was to determine current best practice for the use of casting in the rehabilitation of adults with brain injury. A systematic review was undertaken to find studies that quantified the effectiveness of casting in adults with brain injury. Thirteen articles that presented experimental or case report evidence on casting were analyzed using Sackett's levels of evidence and were examined for scientific rigor. A grade B recommendation is given for the use of casting to increase passive range of motion or to prevent its loss, and implications for further research are provided.
Effect of Seat Inclination on Seated Pressures of Individuals With Spinal Cord Injury
Authors: Maurer Christine L , Sprigle Stephen 
Published: February 2017

AbstractBackground and Purpose. Manual wheelchair configurations commonly include “squeezing” the wheelchair frame to improve balance for users with spinal cord injuries. This squeezing is achieved by lowering the rear portion of the seat relative to the front of the seat while maintaining the same back angle. The study's purpose was to examine the effect of increasing posterior seat inclination on buttock interface pressures. Subjects. Nine male and 5 female subjects (mean age=37 years, SD=11.2, range=19–55) with complete thoracic or lumbar spinal cord injury were tested. Methods. Subjects sat on a pressure mat placed over a foam cushion. Pressure readings were taken at seat angles reflecting seat height decreases of 0, 5.1, 7.6, and 10.2 cm (0, 2, 3, and 4 in) of the rear of the seat relative to the front of the seat. An analysis of variance and a Duncan multiple range test were used for data analysis. Results. No meaningful differences were found in measurements of interface pressure (dispersion index, contact area, and seat pressure index), total force on seat, or peak pressure index with posterior seat inclination. Discussion and Conclusion. The data indicate no meaningful evidence that squeezing a wheelchair frame increases seat interface pressures.
Management of Postsurgical Hyperhidrosis With Direct Current and Tap Water
Authors: Gillick Bernadette T , Kloth Luther C , Starsky Andrew , Cincinelli-Walker Laura 
Published: February 2017

Abstract
Background and Purpose. Excessive sweating, known as hyperhidrosis, involves the eccrine sweat glands of the axillae, soles, palms, and/or forehead. The use of iontophoresis to reduce or eliminate excessive sweating has been described since 1952. The purpose of this case report is to describe the use of tap water galvanism (TWG) using direct current (DC) with a patient who had postsurgical hyperhidrosis. Case Description. The patient was a 36-year-old male electrician with traumatic phalangeal amputation and postsurgical development of hyperhidrosis. Tap water galvanism was administered using a DC generator, 2 to 3 times per week for 10 treatments. The patient's hands were individually submerged in 2 containers of tap water with the electrodes immersed directly into the containers. Each hand was treated with 30 minutes of TWG at 12 mA. Hyperhidrosis was measured by a 5-second imprint and subsequent tracing of the left hand placed on dry paper toweling. Outcomes. The patient's hyperhidrosis decreased from the full left palmar pad, with a surface area of 10.3×12.0 cm, to a reduced area of wetness that covered a 2.2-×2.7-cm area. The patient returned to work as an electrician without needing absorbent gloves, which had prevented him from performing electrical work. Discussion. Following use of TWG, the patient's palmar hyperhidrosis returned to normhidrosis.
The Muscular Dystrophies: From Genes to Therapies
Authors: Lovering Richard M , Porter Neil C , Bloch Robert J 
Published: February 2017

AbstractThe genetic basis of many muscular disorders, including many of the more common muscular dystrophies, is now known. Clinically, the recent genetic advances have improved diagnostic capabilities, but they have not yet provided clues about treatment or management. Thanks to better management strategies and therapeutic interventions, however, many patients with a muscular dystrophy are more active and are living longer. Physical therapists, therefore, are more likely to see a patient with a muscular dystrophy, so understanding these muscle disorders and their management is essential. Physical therapy offers the most promise in caring for the majority of patients with these conditions, because it is unlikely that advances in gene therapy will significantly alter their clinical treatment in the near future. This perspective covers some of the basic molecular biological advances together with the clinical manifestations of the muscular dystrophies and the latest approaches to their management.
Implementation of Clinical Guidelines on Physical Therapy for Patients With Low Back Pain: Randomized Trial Comparing Patient Outcomes After a Standard and Active Implementation Strategy
Authors: Bekkering Geertruida E , van Tulder Maurits W , Hendriks Erik JM , Koopmanschap Marc A , Knol Dirk L , Bouter Lex M , Oostendorp Rob AB 
Published: February 2017

Abstract
Background and Purpose. An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain. The effect of this strategy on patients' physical functioning, coping strategy, and beliefs regarding their low back pain was studied. Subjects. One hundred thirteen primary care physical therapists treated a total of 500 patients. Methods. The physical therapists were randomly assigned to 1 of 2 groups. The control group received the guidelines by mail (standard passive method of dissemination). The intervention group, in contrast, received an additional active training strategy consisting of 2 sessions with education, group discussion, role playing, feedback, and reminders. Patients with low back pain, treated by the participating therapists, completed questionnaires on physical functioning, pain, sick leave, coping, and beliefs. Results. Physical functioning and pain in the 2 groups improved substantially in the first 12 weeks. Multilevel longitudinal analysis showed no differences between the 2 groups on any outcome measure during follow-up. Discussion and Conclusion. The authors found no additional benefit to applying an active strategy to implement the physical therapy guidelines for patients with low back pain. Active implementation strategies are not recommended if patient outcomes are to be improved.
Mandatory Continuing Education in Physical Therapy: Survey of Physical Therapists in States With and States Without a Mandate
Authors: Landers Merrill R , McWhorter James W , Krum Laura L , Glovinsky David 
Published: February 2017

AbstractBackground and Purpose Although formal continuing education (CE) in physical therapy is one part of professional development, its value for renewing licensure is not shared by all states. The purpose of this study was to explore the differences in how physical therapists pursue formal continuing education on the basis of state mandate, sex, years of experience, practice specialty, American Physical Therapy Association membership, motivation, and perception of the benefits of CE. Subjects and Methods A survey questionnaire was sent to 3,000 physical therapists in 7 states—1,500 to physical therapists in states with mandatory CE and 1,500 to physical therapists in states without a requirement. A total of 1,145 usable survey questionnaires were returned, for a response rate of 38.2%. Results Physical therapists in states with mandatory CE averaged 33.8 hours of CE per year, whereas physical therapists in states without a mandate averaged 28.3 hours per year; 5.9% of therapists in states without a mandate reported taking no CE at all, and 10.8% reported taking 2 or fewer hours of CE within the preceding 5 years. No statistically significant relationships were observed between the amount of CE taken and years of experience, sex, or practice specialty. Therapists who reported membership in the American Physical Therapy Association participated in 7.2 more hours of CE per year than therapists who did not report membership. Significant motivational variables that respondents noted for taking CE were state mandate, increased clinical competence, and certification. Therapists overwhelmingly (96.2%) believed that CE had a beneficial effect on their clinical practice. Discussion and Conclusion Results from this study suggest that mandatory CE does have a significant association with the number of formal CE hours taken by physical therapists.
Is there evidence that phonophoresis is more effective than ultrasound in treating pain associated with lateral epicondylitis?
Authors: Hoppenrath Terri , Ciccone Charles D 
Published: February 2017

Abstract
A48-year-old woman was referred to our clinic with pain in the lateral epicondyle region of her right elbow. She is right-hand dominant. This pain started about 1 year ago, and the pain gradually increased throughout the past summer. During the warmer months she rides a motorcycle almost every day. The right hand is responsible for controlling the throttle of her motorcycle, and the wrist extensor muscles must contract to maintain active wrist extension for long periods of time. The right hand also controls the front brake lever, which is squeezed to apply the brake. This action also requires that the wrist extensor muscles contract to stabilize the wrist as the finger flexor muscles contract to squeeze the lever. The patient, therefore, uses her right wrist extensors continuously when riding a motorcycle, and these muscles might be overused during frequent or lengthy rides.