Research
Abstracts
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of Missouri Abstracts
Open versus Closed Kinetic Chain Strength Training
in Spastic Cerebral Palsy.
Authors: Norris KD, Pope JW. University
of Missouri.
Purpose: The purpose of this review
was to determine if open kinetic chain (OKC), or
closed kinetic chain (CKC) strength training elicited
greater functional gains in spastic cerebral palsy
(CP).
Patient Population: Subjects in the included studies
were ambulatory and ranged in age from 4-20 years.
Methods: The Ovid Medline database (1966 to February
Week 4, 2005) was searched using the following
search terms: "cerebral palsy", "strength
training", "resistance training", "resistance
exercise", "open kinetic chain",
and "closed kinetic chain." Full text
was obtained for articles meeting the following
inclusion criteria:
lower extremity strength training,
children or adolescents with spastic CP, and
functional outcome measures.
Lower-extremity strengthening protocols were examined
and designated as either OKC or CKC.
Results: Of the five studies included, three utilized
OKC training and two CKC training. Significant
functional improvements were reported for all OKC
and in one CKC studies.
Conclusions: The literature indicates both closed
and open kinetic chain strengthening exercises
improve function in children and adolescents with
spastic CP.
Discussion and Recommendation: Uncontrolled study
designs and small sample sizes limited the strength
of results and variable outcome measures hindered
comparison of the five studies. After considering
these limitations and finding no clear difference
in positive results, a definitive conclusion supporting
one training mode could not be made. It is recommended
that strengthening programs include both open and
closed kinetic chain exercises until strong evidence
exists supporting a single mode of strength-training
to improve functional abilities.
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Balance Screening Tools for the Elderly.
Authors: Tyler Majors, Carmon Abbott. University
of Missouri, Columbia, MO.
Introduction: As an individual ages changes in
motor and sensory systems result in a decreased
ability to sense and effectively respond to the
environment around them. These changes can affect
an individual's sense of safety and confidence
in performing daily activities. This lack of security
can have detrimental effects on a person's mobility
and lifestyle. Falls in these individuals frequently
become life threatening and result in surgeries
and hospitalization. These falls could be prevented
by communities and health organizations screening
elderly individuals on a regular basis and directing
care for those determined to have a higher risk
of falling.
Purpose: To identify three assessment tools which
could be used as a quick and easy screen for balance,
but remain a valid measure of each participants
fall risk without causing undue fatigue or strain
on elderly participants.
Test and Measures: The three balance assessment
tools that were chosen were
the Activities-specific Balance Confidence Scale
(ABC),
the FICSIT Static Balance Test, and
the Timed Up & Go Test (TUG).
These three specific tests were chosen because
of their high reliability and validity as well
as their ease in administering and time efficiency.
Methods: The testing group consisted of six physical
therapy students which divided into 3 groups of
two, with each group administering one of the balance
tests. Each of the 8 Eldercare participants were
chosen at random and asked individually if they
would like to participate. Each participant was
escorted to the specific balance test and their
safely ensured though out every task.
Conclusion: The ABC and FICSIT were found to be
inappropriate tools for a falls risk screening,
but the TUG is an efficient and effective balance
tools to use in a general screen for falls risk
in an elderly population.
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Teaching Neuroanatomy to 6th Graders Through Cooperative
Learning.
Authors: R Hayden. University of Missouri.
Purpose: Teach 48 6th graders anatomy of the CNS.
Method: A 2-hour interactive teaching session
was offered by a small group of 3rd year physical
therapy students for the 6th grade students at
Harrisburg Elementary School in Harrisburg, Missouri.
Components of the science module included anatomy/functioning
of the brain and spinal cord, brain and spinal
cord injury, and safety tips on how to prevent
injury. Students were organized into five groups
of 4-6 students per group. Each student was required
to fill out a pre-test to determine what they knew
about the brain, spinal cord, and brain/spinal
cord safety. The pre-test was designed as a free-lance
writing to determine the student's current knowledge
on those three topics. After the two-hour module,
students were required to fill out a post-test
to determine what they learned during our presentation.
One question from each component listed above was
included on the post-test. Group 1 (n=24 students)
was required to fill out the post-test immediately
after the science module without the assistance
of their information packet or other students.
They had a 10-minute time limit to finish the test.
Group 2 (n=19 students) was also required to fill
out the same post-test. However, they completed
the test later in the afternoon and were allotted
as much time as needed to complete it. The students
were allowed to complete the test with the assistance
of their information packet and other students
in their group.
Discussion: Research has shown that cooperative/interactive
learning in the classroom makes a dramatic difference
on a range of learning outcomes as well as enhancing
conceptual development in science.
What is the effect of a standing program on bone
mineral density in non-ambulatory children with
Cerebral Palsy?
Authors: Sarah Brown, SPT, Jessi Park, SPT, Connie
Blow, PT. University of Missouri-Columbia Physical
Therapy Graduate Program
Background: Cerebral Palsy (CP) is a disorder
of movement and posture due to a non-progressive
defect or lesion of the immature brain. CP affects
two to three out of 1,000 children over the age
of three in the United States. Childhood is a critical
time in developing adequate bone mineral density
(BMD) and it is the combination of the stress of
gravity and upright weight bearing that increase
and maintain appropriate bone strength. Several
studies have shown that non-ambulatory children
with CP have reduced bone mineral density compared
to their ambulatory peers. Standing programs are
characteristically used as part of a postural management
approach in children with CP. The most common intervention
approach for implementing a standing program in
children is the utilization of a standing frame.
There is a variety of standing frames available,
dependent upon the functional level of the child.
Purpose: The purpose of this poster is to find
evidence-based recommendations as it relates to
weight bearing strategies and bone mineral density
in non-ambulatory children with cerebral palsy.
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What is the effect of a standing program on bone
mineral density in non-ambulatory children with
Cerebral Palsy?
Authors: Sarah Brown, SPT, Jessi Park, SPT, Connie
Blow, PT. University of Missouri-Columbia Physical
Therapy Graduate Program
Background: Cerebral Palsy (CP) is a disorder
of movement and posture due to a non-progressive
defect or lesion of the immature brain. CP affects
two to three out of 1,000 children over the age
of three in the United States. Childhood is a critical
time in developing adequate bone mineral density
(BMD) and it is the combination of the stress of
gravity and upright weight bearing that increase
and maintain appropriate bone strength. Several
studies have shown that non-ambulatory children
with CP have reduced bone mineral density compared
to their ambulatory peers. Standing programs are
characteristically used as part of a postural management
approach in children with CP. The most common intervention
approach for implementing a standing program in
children is the utilization of a standing frame.
There is a variety of standing frames available,
dependent upon the functional level of the child.
Purpose: The purpose of this poster is to find
evidence-based recommendations as it relates to
weight bearing strategies and bone mineral density
in non-ambulatory children with cerebral palsy.
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The Effects of Partial Body Weight Support Gait
Training in Individuals with Incomplete Spinal
Cord Injuries.
A Literature Review By: Stephanie Albair SPT,
Stacie Duncan SPT, and Karen Wingert DPT. University
of Missouri-Columbia Physical Therapy Department
Background: Spinal cord injuries (SCI) affect
nearly 11,000 Americans each year and approximately
200,000 people in the United States are living
with a spinal cord injury. 56% of spinal cord injuries
occur in individuals between the ages of 16 and
30, and the most common cause is motor vehicle
accidents. Due to the anatomical relationship of
the spinal cord and nerve roots to the vertebral
bodies, an injury may be classified as complete
or incomplete. Roughly, 52% of spinal cord injuries
are incomplete. Incomplete lesions are characterized
by the preservation of some sensory and motor function
below the level of injury. Although some motor
function is spared, incomplete lesions cause altered
gait patterns associated with a decreased ability
to bear weight through the lower extremities, deficits
in single-limb stance and poor limb advancement.
One way to address altered gait patterns is to
use treadmill walking that incorporates a suspension
system. This treatment approach came about in the
late 1980's and is based on task-specific training
of lost function. This treatment approach allows
the therapist to control the amount of weight-bearing,
facilitate proper gait patterns and assist with
the proper placement of the lower extremities during
ambulation. Possible benefits of partial body weight
support (PBWS) gait training are the ability to
begin gait training earlier in the rehabilitation
process, a reduction in the fear of falling by
the patient, and the reinforcement of functional
gait patterns.
Purpose: The purpose of this poster is to provide
the evidence regarding body weight support treadmill
training and its effects on the locomotive capabilities
of individuals with incomplete spinal cord injuries.
