bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Therapy for a Patient in Acute Respiratory Failure
Authors: Wong Wai Pong 
Published: February 2017

Abstract
Background and Purpose. The main indications for physical therapy for patients in intensive care units (ICUs) are excessive pulmonary secretions or atelectasis. Timely physical therapy interventions may improve gas exchange and reverse pathological progression, thereby curtailing or avoiding artificial ventilation. The purpose of this case report is to illustrate 24-hour availability of physical therapy for a patient with acute respiratory failure. Case Description. The patient was a 66-year-old man who was admitted to an ICU for acute respiratory failure. Intensive physical therapy, based on Dean's physiologic treatment hierarchy for patients with impaired oxygen transport, consisted of upright body positioning, mobilization and exercise, and active cycles of breathing techniques every 2 hours for the first 12 hours he was in the ICU. Outcomes. In total, the patient received 11 physical therapy sessions over his 48-hour stay in the ICU (6 sessions on day 1 and 5 sessions on day 2). Arterial oxygenation improved markedly with radiographic resolution of infiltrates, and planned endotracheal intubation and mechanical ventilation were avoided. Discussion. This patient with acute respiratory failure received physical therapy in a timely manner afforded by 24-hour access to physical therapy. The intensive physical therapy might be more cost-effective than if the patient had been managed with intubation and mechanical ventilation. Patients in ICUs who have excessive pulmonary secretions or atelectasis may benefit from access to physical therapy 24 hours a day.
Vascular Events After Spinal Cord Injury: Contribution to Secondary Pathogenesis
Authors: Mautes Angelika EM , Weinzierl Martin R , Donovan Frances , Noble Linda J 
Published: February 2017

AbstractTraumatic spinal cord injury results in the disruption of neural and vascular structures (primary injury) and is characterized by an evolution of secondary pathogenic events that collectively define the extent of functional recovery. This article reviews the vascular responses to spinal cord injury, focusing on both early and delayed events, including intraparenchymal hemorrhage, inflammation, disruption of the blood-spinal cord barrier, and angiogenesis. These vascular-related events not only influence the evolution of secondary tissue damage but also define an environment that fosters neural plasticity in the chronically injured spinal cord.
Relationship Among Balance Impairments, Functional Performance, and Disability in People With Peripheral Vestibular Hypofunction
Authors: Gill-Body Kathleen M , Beninato Marianne , Krebs David E 
Published: February 2017

Abstract
Background and Purpose. Physical therapy interventions are often based on assumed relationships among impairments, functional performance, and disability. The purposes of this study were (1) to describe balance impairments, functional performance, and disability in subjects with unilateral peripheral vestibular hypofunction (UVH) and bilateral peripheral vestibular hypofunction (BVH), (2) to examine the relationship among these factors, and (3) to determine whether disability can be explained by commonly used tests of balance and functional performance. Subjects. Participants were 85 subjects (mean age=62.5 years, SD=16.5) with UVH (n=41) or BVH (n=44) diagnosed by vestibular function tests and clinical examination. Methods. Each subject completed the Dizziness Handicap Inventory (DHI) to obtain a measure of disability. Functional performance was measured with a modified Timed Up & Go Test (TUG). Balance impairments were measured with computerized posturography and balance tests. Descriptive statistics, correlational analyses, and stepwise regressions were performed. Results. Subjects with BVH had poorer balance but similar TUG scores and perceived levels of disability, as compared with subjects with UVH. Weak to moderate correlations existed among balance measurements, TUG scores, and DHI scores. Balance impairments and TUG scores together explained 78% of the variance in DHI scores of the subjects with BVH, whereas balance impairments alone explained 13% of the variance in DHI scores of the subjects with UVH. Conclusion and Discussion. Balance impairments and functional performance appear to be more closely related to disability in individuals with BVH as compared with those with UVH. Clinical tests of balance impairments and functional performance appear to be useful in explaining disability.
Relationships Among Selected Measures of Impairment, Functional Limitation, and Disability in Patients With Cervical Spine Disorders
Authors: Hermann Karl M , Reese C Shane 
Published: February 2017

Abstract
Background and Purpose. Little is known about the relationship among impairments, functional limitations, and disability in people with cervical spine disorders (CSD) despite the fact that these concepts are routinely used in clinical practice. The primary purpose of this study was to investigate the relationships among commonly assessed impairment, functional limitation, and disability measures in patients with CSD. A secondary purpose was to determine the influence of payment source and time since onset of symptoms on these same measures. Subjects. Eighty patients (mean age=45.7 years, SD=15.9, range= 20–88) with CSD who were referred for physical therapy participated in the study. Methods. Data were obtained for 3 measures of impairment, 2 measures of functional limitation, and 3 measures of self-reported disability during the initial visit. Results. All 3 sets of variables (ie, impairment, functional limitation, disability) correlated with each other, with the highest correlation occurring between the impairment measures and the functional limitation measures (r=.82). Other correlations were noted between individual variables. There was no effect of payment type or time since onset of symptoms on the variables. Conclusion and Discussion. Positive correlations were noted among the 3 sets of measures, which supports the assumption that impairments, functional limitations, and disability are related in patients with CSD.
Effects of Aerobic Exercise on Energy Metabolism in the Hypertensive Rat Heart
Authors: Kinney LaPier Tanya L , Rodnick Kenneth J 
Published: February 2017

AbstractBackground and Purpose. In order to explore the possible effects of physical therapy interventions on patients with hypertension, we evaluated the effects of aerobic exercise training on myocardial energy metabolism in an animal model of hypertension. Subjects. We used 36 female spontaneously hypertensive rats (rats with genetically induced hypertension) and 12 normotensive Wistar-Kyoto rats. Methods. The normotensive rats were sedentary and formed the CONsed group. The spontaneously hypertensive rats were randomly divided into 3 experimental groups (12 rats per group). Hypertensive rats that were sedentary formed the HTNsed group, those that received 8 weeks of exercise training formed the HTN×8 group, and those that received 16 weeks of exercise training formed the HTN×16 group. We measured systolic blood pressure, heart wet weight, maximal activities of cardiac energy metabolism enzymes, glucose transporter content, and total concentrations of protein, glycogen, and triglyceride. Results. Systolic blood pressure was greater than 200 mm Hg in the CONsed group at the time of testing. Exercise training modestly (∼11–18 mm Hg) lowered blood pressure in the HTN×8 and HTN×16 groups. Fatty acid enzyme activity was greater in the CONsed group than in the HTNsed and HTN×8 groups, but activity was roughly equivalent between the CONsed group and the HTN×16 group. Glucose enzyme activity was greater in the HTN×16 group than in the CONsed group and the HTNsed group. Intracellular glycogen concentration was greater in the HTN×8 group than in the HTNsed group. Discussion and Conclusion. Results of this study suggest that aerobic exercise training may help to normalize cardiac energy metabolism in mammals with hypertension.
Effect of Setup Configurations of Split Computer Keyboards on Wrist Angle
Authors: Marklin Richard W , Simoneau Guy G 
Published: February 2017

AbstractBackground and Purpose. Alternative computer keyboards whose halves can be slanted toward each other can reduce a risk factor (ulnar deviation) for work-related musculoskeletal disorders (WMSDs) affecting the upper limbs. Two questions that computer keyboard operators face when using keyboards that can be separated into halves (split keyboards) are: (1) At what angle should the keyboard halves be opened? and (2) At what distance apart should the keyboard halves be placed? The objective of this study was to investigate the effects of the opening angle and separation distance between halves of a split keyboard on wrist ulnar deviation and typing efficiency. Methods. Eleven experienced computer keyboard operators participated in this study and used a split keyboard that was set up in a conventional (nonsplit) format and also in 3 alternative configurations: (1) centers of keyboard halves were separated at 20-cm distance, (2) keyboard halves were separated half of the distance of shoulder width, and (3) keyboard halves were separated at shoulder width distance. Results. The 3 alternative configurations resulted in ulnar deviation of both wrists that were less than ulnar deviation from typing on a conventional setup. There were no differences in ulnar deviations among the 3 alternative configurations. Discussion and Conclusion. The results of this research provide physical therapists and ergonomists with a set of configurations of a split keyboard that they can recommend to their patients or clients. All of the alternative configurations of the split keyboard are beneficial in promoting a neutral wrist position, which theoretically would decrease exposure to WMSDs such as tenosynovitis in the wrist and carpal tunnel syndrome.
Quantification of the Differences in Electromyographic Activity Magnitude Between the Upper and Lower Portions of the Rectus Abdominis Muscle During Selected Trunk Exercises
Authors: Lehman Gregory J , McGill Stuart M 
Published: February 2017

Abstract
Background and Purpose. Controversy exists around exercises and clinical tests that attempt to differentially activate the upper or lower portions of the rectus abdominis muscle. The purpose of this study was to assess the activation of the upper and lower portions of the rectus abdominis muscle during a variety of abdominal muscle contractions. Subjects. Subjects (N=11) were selected from a university population for athletic ability and low subcutaneous fat to optimize electromyographic (EMG) signal collection. Methods. Controlling for spine curvature, range of motion, and posture (and, therefore, muscle length), EMG activity of the external oblique muscle and upper and lower portions of rectus abdominis muscle was measured during the isometric portion of curl-ups, abdominal muscle lifts, leg raises, and restricted or attempted leg raises and curl-ups. A one-way repeated-measures analysis of variance was used to test for differences in activity between exercises in the external oblique and rectus abdominis muscles as well as between the portions of the rectus abdominis muscle. Results. No differences in muscle activity were found between the upper and lower portions of the rectus abdominis muscle within and between exercises. External oblique muscle activity, however, showed differences between exercises. Discussion and Conclusion. Normalizing the EMG signal led the authors to believe that the differences between the portions of the rectus abdominis muscle are small and may lack clinical or therapeutic relevance.
Maximum Voluntary Activation in Nonfatigued and Fatigued Muscle of Young and Elderly Individuals
Authors: Stackhouse Scott K , Stevens Jennifer E , Lee Samuel CK , Pearce Karen M , Snyder-Mackler Lynn , Binder-Macleod Stuart A 
Published: February 2017

Abstract
Background and Purpose. Researchers studying central activation of muscles in elderly subjects (≥65 years of age) have investigated activation in only the nonfatigued state. This study examined the ability of young and elderly people to activate their quadriceps femoris muscles voluntarily under both fatigued and nonfatigued conditions to determine the effect of central activation failure on age-related loss of force. Subjects and Methods. Twenty young subjects (11 men, 9 women; mean age=22.67 years, SD=4.14, range=18–32 years) and 17 elderly subjects (8 men, 9 women; mean age=71.5 years, SD=5.85, range=65–84 years) participated in this study. Subjects were seated on a dynamometer and stabilized. Central activation was quantified, based on the change in force produced by a 100-Hz, 12-pulse electrical train that was delivered during a 3- to 5-second isometric maximum voluntary contraction (MVC) of the quadriceps femoris muscle. Next, subjects performed 25 MVCs (a 5-second contraction with 2 seconds of rest) to fatigue the muscle. During the last MVC, central activation was measured again. Results. In the nonfatigued state, elderly subjects had lower central activation than younger subjects. In the fatigued state, this difference became larger. Discussion and Conclusion. Central activation of the quadriceps femoris muscle in elderly subjects was reduced in both the fatigued and nonfatigued states when compared with young subjects. Some part of age-related weakness, therefore, may be attributed to failure of central activation in both the fatigued and nonfatigued states.
Effect of Burst-Mode Transcutaneous Electrical Nerve Stimulation on Peripheral Vascular Resistance
Authors: Sherry Julie E , Oehrlein Kristin M , Hegge Kristin S , Morgan Barbara J 
Published: February 2017

Abstract
Background and Purpose. Based on changes in skin temperature alone, some authors have proposed that postganglionic sympathetic vasoconstrictor fibers can be stimulated transcutaneously. Our goal was to determine the effects of low-frequency (2 bursts per second), burst-mode transcutaneous electrical nerve stimulation (TENS) on calf vascular resistance, a more direct marker of sympathetic vasoconstrictor outflow than skin temperature, in subjects with no known pathology. Subjects. Fourteen women and 6 men (mean age=31 years, SD=13, range=18–58) participated in this study. Methods. Calf blood flow, arterial pressure, and skin temperature were measured while TENS was applied over the common peroneal and tibial nerves. Results. Blood flow immediately following stimulation was not affected by TENS applied just under or just above the threshold for muscle contraction. Transcutaneous electrical nerve stimulation applied at 25% above the motor threshold caused a transient increase in calf blood flow. Regardless of stimulation intensity, TENS had no effect on arterial pressure; therefore, calf vascular resistance decreased only during the trial that was 25% above the motor threshold. Regardless of stimulation intensity, TENS failed to alter dorsal or plantar skin temperature. Discussion and Conclusion. These results demonstrate that the effects of TENS on circulation depend on stimulation intensity. When the intensity was sufficient to cause a moderate muscle contraction, a transient, local increase in blood flow occurred. Cooling of the dorsal and plantar skin occurred in both the stimulated and control legs, most likely because skin temperature acclimatized to ambient room temperature, rather than because of any effect of TENS on circulation. The data, therefore, call into question the idea that postganglionic sympathetic efferent fibers are stimulated when TENS is applied at clinically relevant intensities to people without symptoms of cardiovascular or neuromuscular pathology.
Development and Validation of a Telephone Questionnaire to Characterize Lymphedema in Women Treated for Breast Cancer
Authors: Norman Sandra A , Miller Linda T , Erikson H Bernadette , Norman M Frank , McCorkle Ruth 
Published: February 2017

Abstract
Background and Purpose. Accurate and economical characterization of lymphedema is needed for population-based studies of incidence and risk. The purpose of this study was to develop and validate a telephone questionnaire for characterizing lymphedema. Subjects. Forty-three women who were treated previously for breast cancer and who were recruited from physical therapy practices and a cancer support organization were studied. Methods. Questionnaire assessment of the presence and degree of lymphedema was compared with physical therapists' diagnoses, based primarily on circumferential measurements. Twenty-five of the 43 subjects were measured independently by 2 physical therapists to assess interobserver agreement. Results. Interobserver agreement on clinical assessments of the presence and degree of lymphedema was high (20/25, weighted kappa=.80); all of the disagreements were between judgments of whether there was no lymphedema or mild lymphedema. For the diagnosis of at least moderate lymphedema (differential in the circumferences of the upper extremities greater than 2 cm), sensitivity of the questionnaire varied from 0.86 to 0.92 and specificity was 0.90. However, sensitivity (varying from 0.93 to 0.96) was higher than specificity (varying from 0.69 to 0.75) for the diagnosis of any lymphedema. Discussion and Conclusion. A few straightforward questions exhibited excellent agreement with physical therapists' assessments for identifying at least moderate lymphedema.
Effect of Superficial Heat, Deep Heat, and Active Exercise Warm-up on the Extensibility of the Plantar Flexors
Authors: Knight Claudia A , Rutledge Carrie R , Cox Michael E , Acosta Martha , Hall Susan J 
Published: February 2017

Abstract
Background and Purpose. Warm-up prior to static stretching enhances muscle extensibility. The relative effectiveness of different modes of warm-up, however, is unknown. The purpose of this study was to evaluate the effectiveness of superficial heat, deep heat, and active exercise warm-up prior to stretching compared with stretching alone on the extensibility of the plantar-flexor muscles. Subjects. Ninety-seven subjects (59 women, 38 men) with limited dorsiflexion range of motion (ROM) were randomly assigned to 1 of 5 groups. Female subjects had a mean age of 27.6 years (SD=7.68, range=17–50), and male subjects had a mean age of 26.8 years (SD=6.87, range=18–48). Methods. The first group (group 1) was a control group and did not perform the stretching protocol. The 4 experimental groups (groups 2–5) performed a stretching protocol 3 days per week for 6 weeks. Group 2 performed the static stretching protocol only; group 3 performed active heel raises before stretching; group 4 received 15 minutes of superficial, moist heat to the plantar-flexor muscles before stretching; and group 5 received continuous ultrasound for 7 minutes before stretching. Dorsiflexion ROM measurements were taken initially and after 2, 4, and 6 weeks. Results. All experimental groups increased active and passive range of motion (AROM and PROM). The mean AROM/PROM differences at 6 weeks were 1.11/1.39 degrees for group 1, 4.10/6.11 degrees for group 2, 4.16/4.21 degrees for group 3, 4.38/4.90 degrees for group 4, and 6.20/7.35 degrees for group 5. The group receiving ultrasound before performing the stretching protocol (group 5) displayed the greatest increase in both AROM (6.20°) and PROM (7.35°). Discussion and Conclusion. Among the modalities tested, the use of ultrasound for 7 minutes prior to stretching may be the most effective for increasing ankle dorsiflexion ROM.
Examination Findings and Self-Reported Walking Capacity in Patients With Lumbar Spinal Stenosis
Authors: Iversen Maura D , Katz Jeffrey N 
Published: February 2017

AbstractBackground and Purpose. Spinal stenosis is a common, often disabling, condition resulting from compression of the cauda equina and nerve roots. This study was designed to: (1) characterize the impairments of patients with lumbar spinal stenosis (LSS) and (2) to identify predictors of self-reported walking capacity. Subjects. Forty-three patients with symptomatic LSS, from 3 specialty clinics, were evaluated. Twenty-eight subjects (65%) were female. The subjects' median age was 73.6 years (X̄=72.4, SD=10.3, range=45.–90.7), and the median duration of low back pain was 24 months (X̄=36.6, SD=41.6, range=0–216). Methods. Demographic data, medical history, and information about low back pain and symptoms (eg, numbness, tingling, and lower-extremity weakness) were collected using a standardized questionnaire and physical examination. Results. Twenty-two subjects (51%) had lower-extremity weakness, primarily of the extensor hallucis longus muscle. Thirty-five subjects (81%) had absent or decreased neurosensory responses (eg, pinprick, vibration, reflexes), and 28 subjects (66%) reported that they were unable to walk farther than 2 blocks. Women were more likely than men to report difficulties walking, as were subjects with abnormal Romberg test scores and those with greater pain during walking. Discussion and Conclusion. Pain and balance problems appeared to be the primary factors limiting ambulation in our subjects with LSS.
Quadriceps Femoris Muscle Torques and Fatigue Generated by Neuromuscular Electrical Stimulation With Three Different Waveforms
Authors: Laufer Yocheved , Ries Julie Deanne , Leininger Peter M , Alon Gad 
Published: February 2017

Abstract
Background and Purpose. Neuromuscular electrical stimulation is used by physical therapists to improve muscle performance. Optimal forms of stimulation settings are yet to be determined, as are possible sex-related differences in responsiveness to electrical stimulation. The objectives of the study were: (1) to compare the ability of 3 different waveforms to generate isometric contractions of the quadriceps femoris muscles of individuals without known impairments, (2) to compare muscle fatigue caused by repeated contractions induced by these same waveforms, and (3) to examine the effect of sex on muscle force production and fatigue induced by electrical stimulation. Subjects. Fifteen women and 15 men (mean age=29.5 years, SD=5.4, range=22–38) participated in the study. Methods. A portable battery-operated stimulator was used to generate either a monophasic or biphasic rectangular waveform. A stimulator that was plugged into an electrical outlet was used to generate a 2,500-Hz alternating current. Phase duration, frequency, and on-off ratios were kept identical for both stimulators. Participants did not know the type of waveform being used. Torque was measured using a computerized dynamometer: a maximal voluntary isometric contraction (MVIC) of the right quadriceps femoris muscle set at 60 degrees of knee flexion was determined during the first session. In each of the 3 testing sessions, torque of contraction and fatigue elicited by one waveform were measured. Order of testing was randomized. Torque elicited by electrical stimulation was expressed as a percentage of average MVIC. A mixed-model analysis of variance was used to determine the effect of stimulation and sex on strength of contraction and fatigue. Bonferroni-corrected post hoc tests were used to further distinguish between the effects of the 3 stimulus waveforms. Results. The results indicated that the monophasic and biphasic waveforms generated contractions with greater torque than the polyphasic waveform. These 2 waveforms also were less fatiguing. The torques from the maximally tolerated electrically elicited contractions were greater for the male subjects than for the female subjects. Discussion and Conclusion. Muscle torque and fatigue of electrically induced contractions depend on the waveform used to stimulate the contraction, with monophasic and biphasic waveforms having an advantage over the polyphasic waveform. All tested waveforms elicited, on average, stronger contractions in male subjects than in female subjects when measured as a percentage of MVIC.