bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Review of Therapeutic Ultrasound: Biophysical Effects
Authors: Baker Kerry G , Robertson Valma J , Duck Francis A 
Published: February 2017

Abstract
Almost 2 decades ago, it was pointed out that physical therapists tended to overlook the tenuous nature of the scientific basis for the use of therapeutic ultrasound. The purpose of this review is to examine the literature regarding the biophysical effects of therapeutic ultrasound to determine whether these effects may be considered sufficient to provide a reason (biological rationale) for the use of insonation for the treatment of people with pain and soft tissue injury. This review does not discuss articles that examined the clinical usefulness of ultrasound (see article by Robertson and Baker titled “A Review of Therapeutic Ultrasound: Effectiveness Studies” in this issue). The frequently described biophysical effects of ultrasound either do not occur in vivo under therapeutic conditions or have not been proven to have a clinical effect under these conditions. This review reveals that there is currently insufficient biophysical evidence to provide a scientific foundation for the clinical use of therapeutic ultrasound for the treatment of people with pain and soft tissue injury.
Spinal Movement and Performance of a Standing Reach Task in Participants With and Without Parkinson Disease
Authors: Schenkman Margaret L , Clark Kevin , Xie Tony , Kuchibhatla Maggie , Shinberg Mindi , Ray Laurie 
Published: February 2017

Abstract
Background and Purpose. Evidence suggests that individuals with early and mid-stage Parkinson disease (PD) have diminished range of motion (ROM). Spinal ROM influences the ability to function. In this investigation, the authors examined available spinal ROM, segmental excursions (the ROM used) during reaching, and their relationships in community-dwelling adults with and without PD. Subjects. The subjects were 16 volunteers with PD (modified Hoehn and Yahr stages 1.5–3) and 32 participants without PD who were matched for age, body mass index, and sex. Methods. Range of motion of the extremities was measured using a goniometer, and ROM of the spine was measured using the functional axial rotation (FAR) test, a measure of unrestricted cervico-thoracic-lumbar rotation in the seated position. Motion during reaching was determined using 3-dimensional motion analysis. Group differences were determined using multivariable analysis of variance followed by analysis of variance. Contributions to total reaching distance of segmental excursions (eg, thoracic rotation, thoracic lateral flexion) were determined using forward stepwise regression. Results. Subjects with PD as compared with subjects without PD had less ROM (FAR of 98.2° versus 110.3°, shoulder flexion of 151.9° versus 160.1°) and less forward reaching (29.5 cm versus 34.0 cm). Lateral trunk flexion and total rotation relative to the ground contributed to reaching, with the regression model explaining 36% of the variance. Discussion and Conclusion. These results contribute to the growing body of evidence demonstrating that spinal ROM is impaired early in PD.
Relationship of Therapists' Attitudes, Children's Motor Ability, and Parenting Stress to Mothers' Perceptions of Therapists' Behaviors During Early Intervention
Authors: O'Neil Margaret E , Palisano Robert J , Westcott Sarah L 
Published: February 2017

AbstractBackground and Purpose. Federal law mandates family-centered care as the service delivery model in early intervention programs for children from birth to 36 months of age. This study investigated the relationship of therapists' attitudes, children's motor ability, and parenting stress to mothers' perceptions of physical therapists' family-centered behaviors during early intervention. Subjects and Methods. Twenty-five physical therapists and 75 mother-child dyads (3 from each therapist's caseload) participated. The mean chronological age for the children was 21.2 months (SD=7.3, range=6–35). Mothers participated in a structured interview using the Measures of Processes of Care (MPOC-56), and they completed the Parenting Stress Index-Short Form (PSI-SF) and a questionnaire. The Bayley-II Motor Scale was administered to the children. Therapists completed a modified version of the Measures of Processes of Care for Service Providers (MPOC-SP) and a questionnaire. Results. Scores for mothers on the MPOC-56 and for therapists on the MPOC-SP indicated strong positive perceptions and attitudes toward family-centered behaviors. Hierarchical multiple regression analyses indicated that parenting stress explained a considerable amount of the variance in mothers' perceptions of family-centered behaviors, whereas therapists' attitudes explained a considerable amount of the variance in mothers' perceptions of respectful and supportive care. Children's motor ability was inversely related to parenting stress. Discussion and Conclusion. Findings suggest that mothers perceive that physical therapists are using family-centered behaviors in early intervention. Findings from the questionnaires suggest that some early intervention policies may be barriers for therapists and prevent them from actualizing attitudes toward family-centered behaviors.
Mental Practice Combined With Physical Practice for Upper-Limb Motor Deficit in Subacute Stroke
Authors: Page Stephen J , Levine Peter , Sisto Sue Ann , Johnston Mark V 
Published: February 2017

AbstractBackground and Purpose. This case report describes a patient with upper-limb hemiparesis (ULH) who received a program combining physical therapy for the affected side with mental practice. Case Description. The patient was a 56-year-old man with stable motor deficits, including ULH, on his dominant side resulting from a right parietal infarct that occurred 5 months previously. He received physical therapy for an hour 3 times a week for 6 weeks. In addition, 2 times a week the patient listened to an audiotape instructing him to imagine himself functionally using the affected limb. The patient also listened to the audiotape at home 2 times a week. Pretreatment and posttreatment measures were the upper-extremity scale of the Fugl-Meyer Assessment of Sensorimotor Impairment (Fugl-Meyer Scale), the Action Research Arm Test (ARA), and the Stroke Rehabilitation Assessment of Movement (STREAM). Outcomes. The patient exhibited reduction in impairment (Fugl-Meyer Scale) and improvement in arm function, as measured by the ARA and STREAM. Discussion. Mental practice may complement physical therapy to improve motor function after stroke.
Effects of a Functional Therapy Program on Motor Abilities of Children With Cerebral Palsy
Authors: Ketelaar Marjolijn , Vermeer Adri , Hart Harm't , van Petegem-van Beek Els , Helders Paul JM 
Published: February 2017

Abstract
Background and Purpose. The purpose of this study was to determine whether the motor abilities of children with spastic cerebral palsy who were receiving functional physical therapy (physical therapy with an emphasis on practicing functional activities) improved more than the motor abilities of children in a reference group whose physical therapy was based on the principle of normalization of the quality of movement. Subjects. The subjects were 55 children with mild or moderate cerebral palsy aged 2 to 7 years (median=55 months). Methods. A randomized block design was used to assign the children to the 2 groups. After a pretest, the physical therapists for the functional physical therapy group received training in the systematic application of functional physical therapy. There were 3 follow-up assessments: 6, 12, and 18 months after the pretest. Both basic gross motor abilities and motor abilities in daily situations were studied, using the Gross Motor Function Measure (GMFM) and the self-care and mobility domains of the Pediatric Evaluation of Disability Inventory (PEDI), respectively. Results. Both groups had improved GMFM and PEDI scores after treatment. No time × group interactions were found on the GMFM. For the PEDI, time × group interactions were found for the functional skills and caregiver assistance scales in both the self-care and mobility domains. Discussion and Conclusion. The groups' improvements in basic gross motor abilities, as measured by the GMFM in a standardized environment, did not differ. When examining functional skills in daily situations, as measured by the PEDI, children in the functional physical therapy group improved more than children in the reference group.
Central Pattern Generation of Locomotion: A Review of the Evidence
Authors: MacKay-Lyons Marilyn 
Published: February 2017

Abstract
Neural networks in the spinal cord, referred to as “central pattern generators” (CPGs), are capable of producing rhythmic movements, such as swimming, walking, and hopping, even when isolated from the brain and sensory inputs. This article reviews the evidence for CPGs governing locomotion and addresses other factors, including supraspinal, sensory, and neuromodulatory influences, that interact with CPGs to shape the final motor output. Supraspinal inputs play a major role not only in initiating locomotion but also in adapting the locomotor pattern to environmental and motivational conditions. Sensory afferents involved in muscle and cutaneous reflexes have important regulatory functions in preserving balance and ensuring stable phase transitions in the locomotor cycle. Neuromodulators evoke changes in cellular and synaptic properties of CPG neurons, conferring flexibility to CPG circuits. Briefly addressed is the interaction of CPG networks to produce intersegmental coordination for locomotion. Evidence for CPGs in humans is reviewed, and although a comprehensive clinical review is not an objective, examples are provided of animal and human studies that apply knowledge of CPG mechanisms to improve locomotion. The final section deals with future directions in CPG research.
Use of a Static Adjustable Ankle-Foot Orthosis Following Tibial Nerve Block to Reduce Plantar-Flexion Contracture in an Individual With Brain Injury
Authors: Blanton Sarah , Grissom Samuel P , Riolo Lisa 
Published: February 2017

AbstractBackground and Purpose. Ankle plantar-flexion contractures are a common complication of brain injuries and can lead to secondary limitations in mobility. Case Description. The patient was a 44-year-old woman with left hemiplegia following a right frontal arteriovenous malformation resection. She had a left ankle plantar-flexion contracture of −31 degrees from neutral. After a tibial nerve block, an adjustable ankle-foot orthosis was applied 23 hours a day for 27 days. Adjustments of the orthosis were made as the contracture was reduced. The patient received physical therapy during the 27-day period for functional mobility activities and stretching the plantar flexors outside of the orthosis. Outcomes. The patient's dorsiflexion passive range of motion increased from −31 degrees to +10 degrees. Discussion. The application of an adjustable ankle-foot orthosis following a tibial nerve block, as an addition to a physical therapy regimen of stretching and mobility training, may reduce plantar-flexion contractures in patients with brain injury.
Self-Reported Measurement of Heart Rate and Blood Pressure in Patients by Physical Therapy Clinical Instructors
Authors: Frese Ethel M , Richter Randy R , Burlis Tamara V 
Published: February 2017

Abstract
Background and Purpose. The Guide to Physical Therapist Practice (Guide) recommends that heart rate (HR) and blood pressure (BP) measurement be included in the examination of new patients. The purpose of this study was to survey physical therapy clinical instructors to determine the frequency of HR and BP measurement in new patients and in patients already on the physical therapists' caseload. The use of information obtained from HR and BP measures in decision making for patient care and the effects of practice setting and academic preparation on the measurement and use of HR and BP also were examined. Subjects and Methods. A sample of 597 subjects was selected from a list of 2,663 clinical instructors at the clinical education sites of the 2 participating universities. Clinical instructors from a variety of practice settings were surveyed. A 26-item survey questionnaire was mailed to the clinical instructors. Results. Usable survey questionnaires were received from 387 respondents (64.8%); 43.4% reported working in an outpatient facility. The majority of the respondents strongly agreed or agreed (59.5%) that measurement of HR and BP should be included in physical therapy screening. When asked if routinely measuring HR and BP during clinical practice is essential, opinions were nearly split (strongly agree or agree=45.0%, strongly disagree or disagree=43.7%, no opinion=11.3%). More than one third (38.0%) of the respondents reported never measuring HR in the week before the survey as part of their examination of new patients. A slightly larger percentage (43.0%) reported never measuring BP of new patients in the week before the survey. Conversely, 6.0% and 4.4% of the respondents reported always measuring HR and BP, respectively, of new patients in the week before the survey. When given a list of reasons why HR and BP were not routinely measured in their clinical practice, respondents most frequently chose “not important for my patient population” (52.3%). Relationships were found between practice setting and frequency of HR and BP measurement in new patients. Discussion and Conclusion. Practices related to HR and BP measurement reported by this sample of clinical instructors do not meet the recommendations for physical therapy care described in the Guide.
Upper-Extremity Volume Measurements in Women With Lymphedema: A Comparison of Measurements Obtained Via Water Displacement With Geometrically Determined Volume
Authors: Sander Antoinette P , Hajer Nicole M , Hemenway Kristie , Miller Amy C 
Published: February 2017

AbstractBackground and Purpose. Upper-extremity (UE) swelling following breast cancer treatment is a frequent manifestation of lymphedema. In order to document outcomes from lymphedema treatments, reliable, valid, and practical measurements of UE swelling are necessary. The purpose of this study was to compare geometric methods of determining UE volumes with water displacement methods. Subjects. The edematous hand, forearm, and upper arm of 50 women with UE swelling secondary to lymphedema were measured. Methods. Upper-extremity volumes were determined by water displacement using arm and hand volumeters. Displaced water was weighed to determine volume. Circumferential girth measurements were taken. Width and depth measurements of the hand were taken with a tension-controlled caliper. Geometric volume formulas for a cylinder, frustum, rectangular solid, and trapezoidal solid were used to calculate volumes of the arm and hand at different measurement intervals. Results. Intraclass correlation coefficients [2,1] for interrater and intrarater reliability of all water and geometric measurements of the arm and hand were .91 to .99 and .92 to .99, respectively. Water displacement correlated with geometric measurements in the arm (r=.97–.98) and in the hand (r=.81–.91). The limits of agreement (LOA) indicated that water and geometric measurements of arm volume differed by 479 to 655 mL. Scatterplots of the LOA data indicated in that geometric volumes were either larger or smaller than water volumes. The smallest standard error of measurement for the arm measurements was for the 6-cm frustum method at 115 mL; for the hand measurements, the smallest standard error of measurement was for the frustum method at 16 mL. Discussion and Conclusion. Volume of an edematous UE calculated by geometric formulas correlated strongly with volume determined by water displacement. Although strongly correlated, the measurements obtained by the 2 methods did not agree.
Is Base of Support Greater in Unsteady Gait?
Authors: Krebs David E , Goldvasser Dov , Lockert Joyce D , Portney Leslie G , Gill-Body Kathleen M 
Published: February 2017

Abstract
Background and Purpose. We investigated dynamic interfoot distance (IFD) throughout the gait cycle in people with unsteady gait caused by vestibulopathy and in people without known neuromuscular pathology. We expected that the subjects with unsteady gait would use a greater IFD than subjects without neuromuscular pathology and that this IFD would be correlated with other measures of locomotor stability. Subjects and Methods. Simultaneous whole-body (11-segment) dynamic kinematic data were collected from 22 subjects with vestibulopathy and 22 subjects without known neuromuscular pathology who were matched for age, height, weight, and body mass index. Two trials each of the participants' gait at preferred speed and paced gait at 120 steps/min were analyzed with a repeated-measures design with multiple dependent variables. Quantitative data were analyzed descriptively and with inferential statistics. Results. Interfoot distance at preferred gait speed did not differentiate unsteady subjects with vestibulopathy from the comparison subjects. Paced gait IFD total range and IFD in single-limb support differed between groups, but IFD at heel-strike did not. However, IFD at heel-strike, the traditional measure of “base-of-support width,” was correlated with measurements of whole-body center-of-gravity stability (r=.32–.55). Discussion and Conclusion. Gait at preferred speed permitted the unsteady subjects and the comparison subjects to select similar IFD values, but at the cost of slower gait in the unsteady subjects. When required to walk at a “normal” pace of 120 steps/min, subjects with vestibulopathy increased their IFD. These data suggest that wide-based gait alone cannot differentiate between subjects with and without balance impairments. Base of support and other whole-body kinematic variables are mechanical compensations of vestibulopathic instability. Further studies are needed to determine whether development of active control of these whole-body control variables can occur after vestibular rehabilitation.
Voluntary Upper-Extremity Movements in Patients With Unilateral Peripheral Vestibular Hypofunction
Authors: Borello-France Diane F , Gallagher Jere D , Furman Joseph M , Redfern Mark S , Carvell George E 
Published: February 2017

AbstractBackground and Purpose. People with peripheral vestibular pathology demonstrate motor impairments when responding and adapting to postural platform perturbations and during performance of sit-to-stand and locomotor tasks. This study investigated the influence of unilateral peripheral vestibular hypofunction on voluntary arm movement. Subjects and Methods. Subjects without known neurological impairments and subjects with vestibular impairments performed 3 voluntary arm movements: an overhead reach to a target, a sideward reach to a target, and a forward flexion movement through 90 degrees. Subjects performed these tasks under precued and choice reaction time conditions. During all tasks, body segment motion was measured. Head velocity measurements were calculated for the side task only. Results. Subjects with vestibular loss restricted upper body segment motion within the frontal and transverse planes for the 90-degree and overhead tasks. Average angular head velocity was lower for the group with vestibular hypofunction. Task uncertainty (the introduction of a choice reaction time paradigm) differentially influenced the groups regarding head velocity at target acquisition. Discussion and Conclusion. Individuals with vestibular loss altered their performance of voluntary arm movements. Such alterations may have served to minimize the functional consequences of gaze instability.
Identifying Early Decline of Physical Function in Community-Dwelling Older Women: Performance-Based and Self-Report Measures
Authors: Brach Jennifer S , VanSwearingen Jessie M , Newman Anne B , Kriska Andrea M 
Published: February 2017

Abstract
Background and Purpose. The ability to identify early decline in physical function is important, but older people experiencing decline may fail to report the early changes in physical function. The purpose of this study was to compare the descriptions of physical function in community-dwelling older women obtained using performance-based and self-report measures. Subjects and Methods. One hundred seventy community-dwelling women with a mean age of 74.3 years (SD=4.3, range=56.6–83.6) completed the activities of daily living (ADL), instrumental activities of daily living (IADL), and social activity (SA) sections of the Functional Status Questionnaire (FSQ). They also completed performance-based measures of gait speed and the 7-item Physical Performance Test (PPT). Results. The majority of the women scored at the ceiling for the self-report measures of function (ADL=77%, IADL=61%, SA=94%), whereas only 7% scored at the ceiling for the PPT and 30% scored at the ceiling for gait speed (defined as &gt;1.2 m/s). For 2 items of the FSQ, sensitivity was low (8% and 9%) and specificity was high (97% and 98%) compared with performance on the PPT. Discussion and Conclusion. In this sample of community-dwelling older women, performance-based measures identified more limitations in physical function than did self-report measures.
Tissue Adaptation to Physical Stress: A Proposed “Physical Stress Theory” to Guide Physical Therapist Practice, Education, and Research
Authors: Mueller Michael J , Maluf Katrina S 
Published: February 2017

AbstractThe purpose of this perspective is to present a general theory—the Physical Stress Theory (PST). The basic premise of the PST is that changes in the relative level of physical stress cause a predictable adaptive response in all biological tissue. Specific thresholds define the upper and lower stress levels for each characteristic tissue response. Qualitatively, the 5 tissue responses to physical stress are decreased stress tolerance (eg, atrophy), maintenance, increased stress tolerance (eg, hypertrophy), injury, and death. Fundamental principles of tissue adaptation to physical stress are described that, in the authors' opinion, can be used to help guide physical therapy practice, education, and research. The description of fundamental principles is followed by a review of selected literature describing adaptation to physical stress for each of the 4 main organ systems described in the Guide to Physical Therapist Practice (ie, cardiovascular/pulmonary, integumentary, musculoskeletal, neuromuscular). Limitations and implications of the PST for practice, research, and education are presented.