bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is the Recovery of Stepping Following Spinal Cord Injury Mediated by Modifying Existing Neural Pathways or by Generating New Pathways? A Perspective
Authors: de Leon Ray D , Roy Roland R , Edgerton V Reggie 
Published: February 2017

Abstract
The recovery of stepping ability following a spinal cord injury may be achieved by restoring anatomical connectivity within the spinal cord. However, studies of locomotor recovery in animals with complete spinal cord transection suggest that the adult mammalian spinal cord can acquire the ability to generate stepping after all descending input is eliminated and in the absence of neuronal regeneration. Moreover, rehabilitative gait training has been shown to play a crucial role in teaching existing spinal pathways to generate locomotion and appropriately respond to sensory feedback. This brief review presents evidence that neural networks in the mammalian spinal cord can be modulated pharmacologically and/or with task-specific behavioral training to generate weight-bearing stepping after a spinal injury. Further, the role that spinal learning can play in the management of humans with spinal cord injury is discussed in relation to interventions that are designed primarily to enhance neuronal regeneration.
Relationship Between Duration of Therapy Services in a Comprehensive Rehabilitation Program and Mobility at Discharge in Patients With Orthopedic Problems
Authors: Kirk-Sanchez Neva J , Roach Kathryn E 
Published: February 2017

AbstractBackground and Purpose. The purpose of this study was to examine the relationship between duration of physical therapy and occupational therapy and mobility at the time of discharge from a comprehensive rehabilitation program in a group of patients with orthopedic diagnoses. Subjects. Subjects were 116 consecutive patients with orthopedic diagnoses (mean age=72.6 years, SD=12.0, range=21–99) who were admitted to a comprehensive inpatient rehabilitation program. Methods. This retrospective cohort study utilized the Uniform Data Set, social service records, and quality assurance records to provide demographic and medical information. The Functional Independence Measure (FIM) provided information regarding mobility at admission and discharge. The duration of physical therapy and occupational therapy was measured in hours. Results. Subjects received an average of 40.8 hours of therapy and showed an average change in FIM mobility subscale scores of 24.5. Multiple linear regression was used to demonstrate that duration of therapy was a predictor of FIM score at the time of discharge (partial correlation=.069) after controlling for length of stay, number of diagnoses, FIM cognitive subscale score at admission, and FIM mobility subscale score at admission. Duration of therapy accounted for 6.9% of the variance in the model. Conclusion and Discussion. This study indicates that the amount of physical therapy and occupational therapy that patients with orthopedic diagnoses receive during enrollment in an inpatient comprehensive rehabilitation program is related to the FIM mobility subscale score at the time of discharge. The authors suggest that increasing the hours of therapeutic intervention that a patient receives in inpatient rehabilitation could improve functional outcomes at discharge.
Physical Therapy for Spinal Accessory Nerve Injury Complicated by Adhesive Capsulitis
Authors: Laska Tadeusz , Hannig Kimberly 
Published: February 2017

Abstract
Background and Purpose. The authors found no literature describing adhesive capsulitis as a consequence of spinal accessory nerve injury and no exercise program or protocol for patients with spinal accessory nerve injury. The purpose of this case report is to describe the management of a patient with adhesive capsulitis and spinal accessory nerve injury following a carotid endarterectomy. Case Description. The patient was a 67-year-old woman referred for physical therapy following manipulation of the left shoulder and a diagnosis of adhesive capsulitis by her orthopedist. Spinal accessory nerve injury was identified during the initial physical therapy examination, and a program of neuromuscular electrical stimulation was initiated. Outcomes. The patient had almost full restoration of the involved muscle function after 5 months of physical therapy. Discussion. This case report illustrates the importance of accurate diagnosis and suggests physical therapy intervention to manage adhesive capsulitis as a consequence of spinal accessory nerve injury.
Physical Therapy Management of Low Back Pain: An Exploratory Survey of Therapist Approaches
Authors: Li Linda C , Bombardier Claire 
Published: February 2017

Abstract
Background and Purpose. Since the release of acute low back pain management guidelines in 1994, little was known about the effect of these guidelines on clinical practice. The purpose of this study was to examine physical therapists' reported management of acute and subacute lumbar impairment. Subjects. One in 10 registered physical therapists who were randomly selected from southern Ontario, Canada, (n=454) and all registered physical therapists from northern Ontario (n=331) were surveyed. Methods. In the questionnaire, case scenarios covered 3 areas related to the management of lumbar impairment: (1) physical examination, (2) treatment and recommendations, and (3) therapists' beliefs regarding its management. Results. Five hundred sixty-nine questionnaires were returned (response rate=72.5%). Only data obtained for therapists (n=274) whose weekly workload included more than 10% of people with lumbar impairment were used in the analysis. Overall, patient education, exercise, and electrotherapeutic and thermal modalities were the preferred interventions for acute lumbar impairment (symptom onset of less than 5 weeks) with or without sciatica, whereas exercise and work modification were preferred for subacute lumbar impairment (symptom onset of 5 weeks or longer). There was a trend of using electrotherapeutic and thermal modalities of uncertain effectiveness. Only 46.3% of the therapists agreed or strongly agreed that practice guidelines were useful for managing lumbar impairment. Discussion and Conclusion. Although the physical therapists surveyed, in general, followed the guidelines in managing acute lumbar impairment, they felt uncertain regarding the value of practice guidelines. Future research should focus on identifying effective treatment approaches and exploring the effectiveness of practice guidelines.
A Randomized Controlled Trial of a Passive Accessory Joint Mobilization on Acute Ankle Inversion Sprains
Authors: Green Toni , Refshauge Kathryn , Crosbie Jack , Adams Roger 
Published: February 2017

AbstractBackground and Purpose. Passive joint mobilization is commonly used by physical therapists as an intervention for acute ankle inversion sprains. A randomized controlled trial with blinded assessors was conducted to investigate the effect of a specific joint mobilization, the anteroposterior glide on the talus, on increasing pain-free dorsiflexion and 3 gait variables: stride speed (gait speed), step length, and single support time. Subjects. Forty-one subjects with acute ankle inversion sprains (&lt;72 hours) and no other injury to the lower limb entered the trial. Methods. Subjects were randomly assigned to 1 of 2 treatment groups. The control group received a protocol of rest, ice, compression, and elevation (RICE). The experimental group received the anteroposterior mobilization, using a force that avoided incurring any increase in pain, in addition to the RICE protocol. Subjects in both groups were treated every second day for a maximum of 2 weeks or until the discharge criteria were met, and all subjects were given a home program of continued RICE application. Outcomes were measured before and after each treatment. Results. The results showed that the experimental group required fewer treatment sessions than the control group to achieve full pain-free dorsiflexion. The experimental group had greater improvement in range of movement before and after each of the first 3 treatment sessions. The experimental group also had greater increases in stride speed during the first and third treatment sessions. Discussion and Conclusion. Addition of a talocrural mobilization to the RICE protocol in the management of ankle inversion injuries necessitated fewer treatments to achieve pain-free dorsiflexion and to improve stride speed more than RICE alone. Improvement in step length symmetry and single support time was similar in both groups.
Changes in Attitudes and Perceptions About Research in Physical Therapy Among Professional Physical Therapist Students and New Graduates
Authors: Connolly Barbara H , Lupinnaci Norwood S , Bush Andrew J 
Published: February 2017

Abstract
Background and Purpose. The physical therapy profession, through its published educational accreditation standards and its normative model of professional education, has addressed the importance of educating physical therapist students in the basic principles and application of research. The purpose of this study was to conduct a longitudinal study of students relative to (1) their perception of knowledge with respect to research, (2) their perception of what source should be used (evidence-based practice or traditional protocols) for clinical decision making, and (3) their perception of what should be used in a clinical setting for patient management. Subjects. Thirty-six students during the final year of their professional program from a sample of 115 physical therapist students who requested 2 consecutive physical therapist classes completed the entire sequence of pretest and posttest survey administrations. Seventy-nine students did not complete the entire sequence. Methods. A 10-item 5-point Likert-type questionnaire was designed by the authors to probe the students' attitudes and perceptions about research, their level of comfort and confidence in reading and applying research findings published in the literature, and their personal habits regarding reading the professional literature. An expert panel consisting of internal and external reviewers was used for construction of the questionnaire. The questionnaire was completed by the students immediately preceding their research methods course, immediately after the completion of that course, and following the second research course, which included statistics and development of a research proposal. The subjects also completed the questionnaire after 1 year of physical therapy practice. Friedman's analysis of variance was used as an omnibus test to detect differences across time. In addition, a follow-up analysis using the Wilcoxon signed-rank procedure to examine differences between baseline data and data obtained during each follow-up was done for all items to determine whether a difference occurred at a time other than at the final posttest survey administration. Results. The students showed differences on 5 of the 10 items on the questionnaire during the study. Discussion and Conclusion. These items related to reading peer-reviewed professional journals, critically reading professional literature, relevance and importance of evidence-based clinical practice, and level of comfort with knowledge in research.
Physical Therapist Management of Tuberculous Arthritis of the Elbow
Authors: Dahl Corey S 
Published: February 2017

AbstractBackground and Purpose. Tuberculous arthritis is not commonly seen by physical therapists in the United States. The purpose of this case report is to describe a case of tuberculous arthritis of the elbow. Case Description. The patient was a 36-year-old man referred for physical therapist evaluation and intervention for chronic elbow pain. After an evaluation and a trial of physical therapy, the patient was referred back to a primary care provider for additional tests to rule out systemic pathology. An open debridement of the synovium and a biopsy of the capitellum and radial head was positive for acid-fast bacilli, which was later identified as Mycobacterium tuberculosis. Outcomes. The patient was placed on a 4-drug antituberculosis regimen that resolved all patient complaints and restored full elbow function. Discussion. Tuberculous arthritis has characteristic findings during examination and in diagnostic tests. Although tuberculous arthritis is uncommon, it should be considered when patients have chronic or vague musculoskeletal complaints.
Development of the Professional Role Behaviors Survey (PROBES)
Authors: Lopopolo Rosalie B 
Published: February 2017

Abstract
Background and Purpose. This study examined the content validity, internal consistency, and underlying dimensions of the Professional Role Behaviors Survey (PROBES) for its use in future research. Methods. Using the 26-item PROBES, 253 clinical managers reported on the direction and magnitude of change in the role behaviors of physical therapists following hospital restructuring. Results. Descriptive and correlational statistics of the responses indicated that the nature of the role behavior changes was consistent with those identified in the literature and that the survey instrument had good internal consistency. A principal component factor analysis yielded 5 underlying role behavior dimensions: “evaluating and planning,” “productivity,” “inter-acting,” “information sharing,” and “administration/clinical.” This factor structure was found to provide a good fit with role classification schemes and a clear differentiation of physical therapist role behaviors. In addition, the finding supports viewing the professional role behaviors as a single construct rather than as multiple constructs. Discussion and Conclusion. The PROBES was found to have good content validity and internal consistency. It provides a useful tool for the study of the changing roles of professional practitioners and a link in the study of the effect of organizational change on organizational outcomes such as job satisfaction and organizational commitment.
Use of Prolonged Standing for Individuals With Spinal Cord Injuries
Authors: Eng Janice J , Levins Stephen M , Townson Andrea F , Mah-Jones Dianna , Bremner Joy , Huston Grant 
Published: February 2017

AbstractBackground and Purpose. Prolonged standing in people with spinal cord injuries (SCIs) has the potential to affect a number of health-related areas such as reflex activity, joint range of motion, or well-being. The purpose of this study was to document the patterns of use of prolonged standing and their perceived effects in subjects with SCIs. Subjects. The subjects were 152 adults with SCIs (103 male, 49 female; mean age=34 years, SD=8, range=18–55) who returned mailed survey questionnaires. Methods. A 17-item self-report survey questionnaire was sent to the 463 members of a provincial spinal cord support organization. Results. Survey responses for 26 of the 152 respondents were eliminated from the analysis because they had minimal effects from their injuries and did not need prolonged standing as an extra activity. Of the 126 remaining respondents, 38 respondents (30%) reported that they engaged in prolonged standing for an average of 40 minutes per session, 3 to 4 times a week, as a method to improve or maintain their health. The perceived benefits included improvements in several health-related areas such as well-being, circulation, skin integrity, reflex activity, bowel and bladder function, digestion, sleep, pain, and fatigue. The most common reason that prevented the respondents from standing was the cost of equipment to enable standing. Discussion and Conclusion. Considering the many reported benefits of standing, this activity may be useful for people with SCI. This study identified a number of body systems and functions that may need to be investigated if clinical trials of prolonged standing in people with SCI are undertaken.
Variation by Diagnostic and Practice Pattern Groups in the Mobility Outcomes of Inpatient Rehabilitation Programs for Children and Youth
Authors: Haley Stephen M , Dumas Helene M , Ludlow Larry H 
Published: February 2017

AbstractBackground and Purpose. The purpose of this study was to describe variation in functional mobility outcomes among children and youth with different diagnoses and belonging to groups with different practice patterns from an inpatient pediatric rehabilitation hospital setting. Subjects. A sample of 138 individuals between the ages of 1 and 22 years (X̄=9.4, SD=5.3) was enrolled. Methods. Physical therapists administered the “Mobility” domain of the Pediatric Evaluation of Disability Inventory at the time of admission and at the time of discharge. Mobility level (combined admission and discharge scores) and amount of change between and within 4 diagnostic groups (traumatic brain injury, non–traumatic brain injury, orthopedic, and neurological) and 5 neuromuscular and musculoskeletal practice pattern groups were calculated, and post hoc analyses were done for specific contrast comparisons. Results. Mobility scores between admission and discharge for all subgroups were different. Practice pattern groups were useful for identifying variations in level of motor performance. Diagnostic groups best described differences in mobility change during inpatient rehabilitation. Discussion and Conclusion. The use of practice patterns as grouping categories may enhance our understanding of variation in clinical outcomes of children during inpatient rehabilitation.
Sociocultural Influences on Disability Status in Puerto Rican Children
Authors: Gannotti Mary E , Handwerker W Penn , Groce Nora Ellen , Cruz Cynthia 
Published: February 2017

AbstractBackground and Purpose. This article describes culturally defined meanings of childhood function and disability in Puerto Rico to provide a context for the interpretation of test scores from the Spanish translation of the Pediatric Evaluation of Disability Inventory (PEDI). Subjects and Methods. More than 600 Puerto Rican teachers, parents and caregivers of children with and without disabilities, and members of the general community participated in ethnographic interviews, which were designed to describe their beliefs, attitudes, and knowledge about childhood function and disability. Results. Qualitative and quantitative data analysis confirmed that differences exist between Puerto Ricans and the norms established in the United States for the performance of functional skills by children, and the analysis also described Puerto Rican beliefs and attitudes toward disability. Discussion and Conclusion. Puerto Rican values of interdependence, añoñar (pampering or nurturing behaviors), and sobre protectiva (overprotectiveness) influence parental expectations for the capability of children with disabilities and should be considered when interpreting scores from the PEDI and establishing plans of care. Additional research is needed on the influence of contextual variables on child development and behavioral adaptations to disability.
Effects of Distally Fixated Versus Nondistally Fixated Leg Extensor Resistance Training on Knee Pain in the Early Period After Anterior Cruciate Ligament Reconstruction
Authors: Morrissey Matthew C , Drechsler Wendy I , Morrissey Dylan , Knight Philippa R , Armstrong Paul W , McAuliffe Thomas B 
Published: February 2017

AbstractBackground and Purpose. Nondistally fixated (ie, what is often referred to as “open kinetic chain” [OKC]) knee extensor resistance training appears to have lost favor for some forms of rehabilitation due partly to concerns that this exercise will irritate the extensor mechanism. In this randomized, single-blind clinical trial, nondistally fixated versus distally fixated (ie, often called “closed kinetic chain” [CKC]) leg extensor training were compared for their effects on knee pain. Subjects. Forty-three patients recovering from anterior cruciate ligament (ACL) reconstruction surgery (34 male, 9 female; mean age=29 years, SD=7.9, range=16–54). Methods. Knee pain was measured at 2 and 6 weeks after ACL reconstruction surgery using visual analog scales in a self-assessment questionnaire and during maximal isometric contractions of the knee extensors. Between test sessions, subjects trained 3 times per week using either OKC or CKC resistance of their knee and hip extensors as part of their physical therapy. Results. No differences in knee pain were found between the treatment groups. Discussion and Conclusion. Open kinetic chain and CKC leg extensor training in the early period after ACL reconstruction surgery do not differ in their immediate effects on anterior knee pain. Based on these findings, further studies are needed using different exercise dosages and patient groups.
Physical Therapy Intervention Following Surgical Treatment of Carpal Tunnel Syndrome in an Individual With a History of Postmastectomy Lymphedema
Authors: Donachy Julie E , Christian Emily L 
Published: February 2017

AbstractBackground and Purpose. This case report describes the physical therapy examination, intervention, and outcomes for a patient with lymphedema following breast cancer treatment who underwent carpal tunnel release. Case Description. The patient was a 53-year-old woman with right upper-limb lymphedema and symptoms of carpal tunnel syndrome (CTS) in her right hand who underwent a carpal tunnel release. Management of her lymphedema included the use of general anesthesia with reduced tourniquet time in conjunction with physical therapy, which included use of compression bandaging, limb positioning, and exercise. Outcomes. Following surgical release, the patient' s numbness and pain were alleviated. Right-hand grip strength increased following active exercise. Girth of the forearm decreased 1 to 1.5 cm at the 2 most distal measurement sites, and girth of the arm increased 1.5 to 2 cm 6 months after surgery. Discussion. This case supports the option of elective hand surgery for CTS in an individual with chronic lymphedema.
Physical Therapist Management of Fluoroquinolone-Induced Achilles Tendinopathy
Authors: Greene Brenda L 
Published: February 2017

AbstractBackground and Purpose. Use of fluoroquinolone antibiotics is reported to be a cause of adverse musculoskeletal effects, such as tendinopathies and tendon ruptures. The purpose of this case report is to describe the management and outcomes of a patient with bilateral Achilles tendinopathy secondary to fluoroquinolone antibiotic use. Case Description. The patient was a 41-year-old man who developed bilateral Achilles tendon pain on the third day of levofloxacin use. The physical therapy intervention consisted of an initial phase to reduce stress on the tendon through the use of crutches and orthoses and a second phase to progressively stress the tendon through exercise and functional activities. Outcomes. After 11 weeks of physical therapy (14 treatments), the patient's pain decreased from 3/10 to 1/10 on a visual analog scale and his Lower Extremity Functional Scale score increased from 28/80 to 71/80. Discussion. An overlapping 2-phased intervention approach based on connective tissue remodeling principles may be effective in elimination of pain and restoration of function following fluoroquinolone-induced Achilles tendinopathy.
Skin Cancer Screening
Authors: Wills Mary 
Published: February 2017

Abstract
Background. Skin cancer is the most common malignancy occurring in humans, affecting 1 in 5 Americans at some time during their lives. Early detection of cancerous lesions is important for reducing morbidity and mortality. Case Description. The patient was a 79-year-old woman who was receiving physical therapy for cervical stenosis. The physical therapist identified a mole with suspicious characteristics, using the ABCD checklist for skin cancer screening. The patient was referred to her primary care physician, and the lesion was removed and identified as basal cell carcinoma. Outcomes. Early detection of this lesion allowed for complete excision, with no further treatment of the area warranted. Discussion. Physical therapists can aid in detection of suspect lesions with knowledge of the basic screening techniques for skin cancer, which may help reduce the morbidity and mortality caused by these lesions.