Research
Abstracts
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Rockhurst University Abstracts
Narrated Video Vs. a Printed Brochure for Promoting
Correct Performance of a Home Exercise Program
After a One-Time Live Instructional Session.
Authors: Benedict, S., Hansen, E., Konrade, J.,
McKiernan, B.J. Department of Physical Therapy
Education, Rockhurst University, Kansas City, MO.
Purpose: Patients are often given instructional
materials to promote correct performance of home
exercise programs. This study compared the performance
of subjects on four selected exercises after using
either narrated video or a printed handout to supplement
a home program.
Subjects: Forty healthy male and female volunteers
between the ages of 18 and 43 were recruited.
Methods and Materials: Subjects were randomly
assigned to one of two groups: DVD (narrated video)
or Brochure (printed handout). All subjects were
instructed in four exercises: straight leg raise
(SLR), two-leg squat (2LS), single-leg squat (1LS),
and lunge with arm crossover (LWC). Subjects were
asked to review their instructional materials and
perform five repetitions of each exercise daily
for two weeks. Subjects were then videotaped while
performing the exercises from memory.
Analysis: A single investigator rated each subject's
performance as "correct" or "incorrect" for
predetermined criteria on each exercise while viewing
the videotape. A t-test for independent groups
compared the number of errors between groups for
all four exercises (significance level p<0.05).
Results: Analysis revealed no significant difference
in errors between the groups for the SLR or 2LS.
The DVD group demonstrated significantly fewer
errors during the 1SL (p<0.001) and LWC (p<0.001).
Conclusions: The results suggest that narrated
video may be a better tool than a printed handout
for promoting correct performance of home exercises
that are more complex or unfamiliar to patients.
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Comparing Bilateral Motion in Asymptomatic Subjects
During Upper Extremity Nerve Tension Testing.
Authors: Hamann, LM, Miller, RF, and Termini,
FS, Dronberger, JA, Foley, AS. Physical Therapy
Program, Rockhurst University, Kansas City, MO.
Purpose: Symmetrical motion between paired extremities
is one parameter often used to rule out peripheral
nerve entrapment. This study investigated the relationship
between left and right upper extremity peripheral
nerve extensibility in asymptomatic subjects to
determine (1) the prevalence of asymmetrical motion
and (2) if it is a reasonable criterion on which
to predict pathology.
Subjects: 76 asymptomatic individuals between
18 and 56 years old were recruited for testing.
Inclusion criteria required full active range of
motion of the upper extremities and cervical spine,
as based on standardized values.
Methods and Materials: Each subject first completed
a demographic questionnaire regarding gender, age,
handedness, height, and weight for use as subject
variables. The subject was then positioned on a
treatment table covered by a pegboard, which was
used to align subjects and to guide passive motion
during testing. A therapist was placed on either
side of the subject, and each moved an upper extremity
simultaneously to the subject's comfortable and/or
available end range position, in accordance with
three upper extremity peripheral nerve tension
tests (i.e. median, ulnar, and radial nerves).
Goniometric measurements were taken for each extremity
for each nerve tension test at end range positions.
Analyses: SPSS data analysis program was used
for all comparisons.
Results: Results indicated that there are no statistically
significant differences between left and right
upper extremity ranges of motion in any comparison
groups. Subjects were able to move through the
nerve specific test motions with relative symmetry.
Conclusions: We concluded that symmetrical upper
extremity motion may be a useful standard against
which pathology of peripheral tissue excursion
may be measured.
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Physical Therapists Support Exercise, Diet, and
Counseling for Management of Pediatric Obesity.
Authors: Couch, S. Thompson, C. Department of
Physical Therapy, Rockhurst University, Kansas
City, MO.
Purpose: Obesity is an epidemic affecting American
adults and children alike. The purpose of this
study was to determine physical therapists' opinions
about the management of pediatric obesity in Kansas
City.
Subjects: Of the 45 pediatric physical therapists
(PTs) contacted in the Kansas City metropolitan
area 11 PTs (F = 10, M = 1) responded, representing
a range of facilities, including inpatient, outpatient,
school, and home health facilities.
Methods and Materials: A multiple-choice/short-answer
survey was designed to examine PTs' involvement
in pediatric weight management programs as well
as their opinions about the types of services offered.
After review by the IRB, surveys were distributed
by mail and electronically. PTs were asked to complete
the survey describing their views on obesity treatment
and the types of services that should be incorporated
in a pediatric obesity program. Analyses: A frequency
analysis of all responses was performed through
SPSS to formulate descriptive results.
Results: 55% of respondents stated that their
facilities offered a pediatric obesity program.
Services included in each program varied, but all
programs included nutritional and exercise services.
While 45% did not offer obesity programs, 100%
agreed that exercise (aerobic, strengthening, activity,
or individualized), diet (traffic light, behavior
modification, or calorie restriction), and counseling
(parent-child, child alone, or parent and child
separately) are essential for a successful program
with 90% believing counseling should be performed
with the parent and child together.
Conclusion: PTs agree that pediatric obesity programs
including diet, exercise, and counseling services
are needed, but disagree on specific types of services
offered. More research is needed to confirm what
types of services should be involved to ensure
effective obesity management and pediatric physical
therapists need to advocate for increased involvement
in these types of programs.
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The Effects of an Ankle Stretching Program on
Balance in Community Dwelling Older Women.
Authors: Follmer E, LeCluyse M, Scott J, Cooke
D, Rockhurst University, Kansas City, MO.
Purpose: The purpose of this study was to evaluate
the effects of a stretching program on ankle range
of motion (ROM) and balance in older women.
Subjects: Candidates were community dwelling woman
over the age of 60 screened to meet the criteria
of active ankle dorsiflexion of 5° or less on one
side. Ten women between the ages of 62 - 84 qualified
and agreed to participate.
Methods: Two baseline measurements were taken
two weeks apart. These included active ankle dorsiflexion,
comfortable and fast timed walk, single leg stance
time, static sway and limits of stability with
active sway. Participants were instructed in a
standing calf stretch to be performed for four
30-second repetitions, 5 days a week for 5 weeks.
Post-tests on the above measures were performed
at weeks 3 and 5.
Analisys: Analysis was performed on data from
nine subjects. Repeated measure ANOVA, with paired
t-tests for post hoc analysis, was used on all
measures except the limits of stability and static
sway variables, which were analyzed with paired
t-tests.
Results: A significant increase in right ankle
dorsiflexion was found at p = .017 after 3 weeks.
A significant change in comfortable walking speed
was found at p = .003 at week 3. There were no
significant changes between weeks 3 and 5.
Conclusion: Right ankle ROM and comfortable walking
speed increased significantly in the first 3 weeks
of a standing calf stretching program. Increased
ankle dorsiflexion may improve foot placement thereby
increasing step length and gait speed.
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The Effects of a Low-Impact Exercise Program on
Self-Efficacy in Women Residing in a Domestic Violence
Shelter.
Authors: Iosbaker, K, Knierim, S, and Hiebert,
J. Physical Therapy Education, Rockhurst University,
Kansas City, MO.
Purpose: Research has shown that participation
in exercise improves one's self-efficacy. The purpose
of the study was to determine whether self-efficacy
of women who reside in a domestic violence shelter
would be similarly influenced by exercise.
Subjects: Subjects were volunteers from a residential
women's shelter in the Kansas City, Missouri area.
The women had no reported cardiopulmonary, neurological,
or musculoskeletal problems.
Methods: Subjects read and signed an informed
consent prior to participation. They then completed
The General Self-Efficacy Scale (GSE), which required
reading ten statements and rating degree of agreement
with each. Surveys were completed upon arrival
to and departure from the shelter. Groups were
self-selected: the control group consisted of women
who chose not to exercise; the experimental group
consisted of women who chose to exercise. The exercise
program consisted of low-impact aerobics and strength
training one hour each week. Surveys were collected
over a five month period and analyzed.
Analysis and Results: Only five women completed
both surveys (three from control group and two
from experimental group). Bivariate correlations
were determined on total GSE score using SPSS 12.0.
Results indicated both groups improved in GSE scores,
with no difference between groups at time of departure.
However, women in the experimental group had higher
GSE scores upon arrival at the shelter and had
self-report of previous exercise participation.
The control group women self-reported no previous
exercise history.
Conclusion: Due to the small number of surveys
no general conclusions can be made. The higher
GSE scores in the experimental group at time of
arrival, does suggest exercise influences self-efficacy.
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Effects of Seating on Fine Motor Control in Children
with Cerebral Palsy with Spastic Diplegia.
Authors: Duke, M., Weiss, A., Thompson, C., Department
of Physical Therapy Education, Rockhurst University,
Kansas City, MO.
Purpose: Physical therapists commonly recommend
adapted seating to ensure postural control for
optimal fine motor function. This study examines
the effects of adapted versus standard seating
on the fine motor performance of two children with
spastic diplegia.
Participants: Two children with spastic diplegia
(5-year-old male, 6-year-old female) participated
in this study.
Methods: Participants were recruited from a UCP
support group with letters sent to parents detailing
the study and inviting participation. Phone surveys
identifying each child's impairments/functional
abilities determined inclusion. In each chair fine
motor skills were examined using the Peabody Development
Motor Skills 2 (PDMS-2) and videotaped performance
duration. An ABBA design was used to collect data.
Analyses: PDMS 2 scores and performance duration
were compared for each case in each chair for descriptive
analysis.
Results: 75% of the time both children completed
fine motor tasks in less time when seated in the
adapted chair. Peabody scores for certain skills
(block towers, pellets in jar) were higher with
the adapted chair, but lower for cutting circles.
Conclusion: These results suggest that adapted
seating appears to decrease performance duration,
but does not necessarily improve the quality of
performance, as measured by the PDMS 2. Before
recommending specific seating PTs should use sensitive
measures to determine duration and quality of performance.
Additional studies are needed to examine factors
contributing to postural support needed for fine
motor tasks with more sensitive measures than the
PDMS 2 to assess fine motor control.
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The Effects of Different Supine Positions on Trunk
Wall Measurements on Pre-school aged Children.
Authors: Delaney, E, Weber, N, and Hiebert, J.
Physical Therapy Education, Rockhurst University,
Kansas City, MO.
Purpose: It has been observed in adults that body
position affects trunk circumference while breathing.
However, little research exists on how body position
affects the trunk of young children. Therefore,
this study was performed to investigate the effect
of body position on trunk movement during breathing
in young children.
Subjects: Twenty-two healthy subjects (8 males
and 14 females, 2-5 years of age) recruited from
a local daycare in Kansas City, MO, participated
in this study. Parent/caregiver informed consent
was obtained. Subjects had no pre-existing cardiopulmonary
diseases or thoracoabdominal adhesions.
Methods and Materials: Measurements at the level
of the third rib and halfway between the xiphoid
process and umbilicus were recorded during normal
breathing with subjects in three supine positions:
hips in neutral, arms at side (baseline position);
hips flexed to 45°, arms at side; and
hips in neutral, arms abducted with hands behind
head.
Subjects maintained each position for one minute,
returning to baseline after each test position.
The first three chest excursions and the last three
chest excursions in each position were measured
using a Gulick II, Model 67020 (Gays Mills, Wisconsin),
which applies a constant four-ounce tension during
measurements.
Analyses and Results: Data was analyzed on SPSS
12.0 using paired t-tests to compare trunk measurements
in each position. Results indicate trunk measurements
were not affected by lower extremity position,
but were affected by upper extremity position.
Conclusions: These results suggest that a standardized
test position should be used when using trunk girth
measurements to assess breathing in young children.
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Reflective Practice: The Effect of Participation
in a Legislative Authentic Learning Environment
on the Professional Development of Entry-Level
Physical Therapist Students.
Authors: Sailor, J.C., Parker, D.B., Spake, E.F.,
Calvert, D., Rockhurst University.
Purpose: To explore the effect of participation
in a legislative authentic learning environment
on the professional development of entry-level
physical therapist students.
Subjects: A sample of convenience comprised of
14 physical therapist students.
Methods and Materials: Fourteen students agreed
upon a legislative initiative at the state level
in which to become involved. Each student kept
reflective journals across the semester and wrote
a paper on the overall experience. The journals
were qualitatively analyzed to describe and explain
how active participation in an authentic learning
environment impacts professional development.
Analyses: Four independent examiners, utilizing
content analysis, identified recurring regularities
in data which reproduced patterns. These regularities
were sorted into emergent themes which were then
compared across examiners. Reliability was ensured
by using multiple, independent examiners and the
use of low inference descriptors. Validity was
ensured by using systematic coding, analytical
triangulation, and a search for negative evidence.
Results: Seven themes were derived utilizing content
analysis from student journals and papers.
Conclusion: The results of this study indicate
utilizing authentic learning environments, in combination
with reflection, aids in development of professional
behaviors. All three types of reflection, reflection-in-action,
reflection-on-action, and reflection-for-action
were displayed by the subjects. The professional
behaviors developed by the students are consistent
with professional practice expectations identified
in the Normative Model of Physical Therapist Education,
2004.
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Health and wellness practice in traditional physical
therapy practice settings: Is it happening?
Authors: Merbitz-Balda WC, Sparrow KL., Decker,
AM, Department of Physical Therapy Education, Rockhurst
University
Background/Purpose: The purpose of this study
is to determine if health, wellness and prevention
activities are being conducted by physical therapist
in traditional practice settings where student
physical therapist engage in clinical education.
Subjects: One hundred and eleven physical therapists
(PT's) voluntarily participated in study. Subjects
ranged from 23-61 years of age, PT education ranged
from bachelors to clinical doctorates degrees.
Years of clinical practice ranged from .08-40 year's
experience (mean 20.08). Subjects represented various
geographical areas across the United States.
Methods: Participants voluntarily completed a
survey with demographic information and practice
information related to health, wellness and prevention
activities.
Analysis: Data was analyzed using SPSS v.12.0.
Descriptive statistics related to subjects and
responses were collected. Pearson correlations
(bivariate analysis) were used to determine the
relationships between a variety of descriptive
variables and health and wellness practice patterns.
Results: In general, 79.3% (n=110) of the subjects
report that they engage in health and wellness
promotion activities. 44.1% of PT's reported engaging
in primary prevention (preventing a target condition
in a susceptible or potentially at risk population)
and 91% report engaging in tertiary prevention
(limiting the degree of disability in clients with
chronic and irreversible diseases). Significant
correlations were found between years of practice;
education level; and primary, secondary, and tertiary
prevention practice.
Conclusion: A large percentage of PT's report
participating in health and wellness activities.
These activities are primarily related to problems
associated with chronic and irreversible diseases.
PT's with their master's and doctorate degrees
report engaging in health/wellness and prevention
activities to a greater extent than PT's with their
bachelor's degrees. Years of experience are positively
associated with engaging in health/wellness and
prevention activities with clients.
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