Research
Abstracts
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Southwest Missouri State University (SMSU) Abstracts
Avascular Necrosis of the Hip with Concomitant
Contralateral Leg Length Discrepancy and Evaluation
of a Heel Lift as a Treatment Option to Decrease
Associated Vertical Forces and to Control Pain:
a single-subject design.
Authors: Chy, Me'Lissa, Robinson, BS. Southwest
Missouri State University.
Purpose: Little clinical evidence exists on the
effects of leg length discrepancy (LLD) on vertical
forces through the hip. In addition, no research
could be found that attempts to examine the effects
of use of a heel lift to minimize vertical forces
through an already symptomatic, necrotic hip. The
purpose of this study was to determine the effectiveness
of a 5mm heel lift in the reduction of vertical
forces through the longer leg hip for a patient
with a 10mm LLD and concomitant symptomatic avascular
necrosis of the contralateral hip.
Methods: A 37 y/o male with a 31-year history
of LLD and a 1-month history of contralateral hip
pain was assessed using the visual analog scale
and the F-scan pressure distribution system. The
A-B design method was utilized. The heel lift was
applied to the shorter leg side during the A condition
and taken away under the B condition.
Results: Trend line analysis revealed that use
of the heel lift reduced the subject's reports
of pain in the symptomatic, necrotic hip. Average
vertical pressures through the hips, as measured
by the F-Scan system demonstrated that vertical
pressure through the symptomatic hip was decreased
by 3.88lbs.
Discussion: These findings suggest that use of
a heel lift can decrease contralateral vertical
forces through a symptomatic, necrotic hip, and
reduce subjective reports of related pain. Reduction
of vertical forces may decrease the rate of degeneration
of the affected hip and may postpone surgical intervention.
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Effects of Monochromatic Near-Infrared Treatment
on Phantom Limb Pain: a single subject design.
Authors: Chy, Me'Lissa, Robinson, BS, Cook, JL.
Southwest Missouri State University.
Purpose: No clinical research exists on the use
of Anodyne Therapy Systems (ATS) for treatment
of phantom limb pain (PLP). On the assumption that
PLP is the result of decreased blood flow to the
residual limb, this study examined the effectiveness
of ATS for the relief of PLP using a randomized,
sham-controlled, double-blind, crossover design.
Methods: A 58 y/o male with a 4-year history of
a right below the knee amputation and a 4-year
history of PLP was assessed using the visual analog
scale (VAS), the Beck Depression Inventory (BDI),
the pain and impairment relationship scale (PAIRS),
and the DRT4 Laser Doppler for blood flow (flux)
and cutaneous temperature (Celsius) measurements.
The subject received the active, (3-weeks) treatment,
followed by a 3-week washout period, to control
carryover effects, and then sham (3-weeks) treatment.
Results: Results indicate that during treatment
with ATS, the subject reported lower pain (x=1.85)
when compared to the washout period (x=2.2) and
the sham treatment (x=2.25). Comparison of the
ATS treatment to the sham treatment using the 2-standard
deviation band method and C statistic revealed
no significant difference for blood flow (flux)
or cutaneous temperature (Celsius) at either the
distal or proximal lead for Laser Doppler flowmetry
measurements.
Discussion: The results of this study suggest
that ATS may be of benefit for the reduction of
PLP, however more extensive research is required
to determine the etiology and subsequent treatment
for PLP. Alterations on the cortical level that
can not be affected by peripherally-based mechanisms
of pain control, such as ATS, may explain the lack
of efficacy of these treatments.
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The Effects of Backpack Usage on Forward Trunk
Lean, Forward Head Posture, and Back, Shoulder,
or Neck Symptoms in College-Age Students.
Authors: Edwards DM, Wallentine SW, Robinson BS.
Southwest Missouri State University, Department
of Physical Therapy.
Purpose: The purpose of this study was to determine
if carrying backpacks with heavy loads or improper
techniques leads to increased forward trunk lean
(FTL), forward head posture (FHP), or increased
back, shoulder, or neck symptoms (symptoms) in
college-age students.
Subjects: Thirty-nine college students (age 18-34)
participated.
Methods and Materials: Subjects completed a backpack
survey via the inQsit Computer Software Program
(an Integrated Network Quizzing, Surveying, and
Interactive Testing System), and each backpack
weight was measured using a standard scale. FTL
and FHP were measured using the Life Mechanics
Institute Mid-Sagittal Contour Gauge.
Analyses: Descriptive statistics were used to
describe subject characteristics and Spearman's
rho tests were completed to determine significant
correlations between variables.
Results: Significant correlations existed at the
p = .05 level between the following: load and symptoms
(rs = .34); carrying a backpack lower than the
curve of the low back and numbness and tingling
of the arms or hands (rs = .34); time and symptoms
(rs = .48); gender and symptoms (rs = .36); and
age and symptoms (rs = -.41). Neither load nor
carrying technique were significantly associated
with FTL or FHP.
Conclusions: Results support the hypotheses that
carrying heavy loads, including loads less than
the recommended maximum (15% body weight), and
carrying backpacks with improper techniques increases
symptoms in college-age students. The results did
not support the hypotheses that carrying heavy
loads and carrying backpacks with improper techniques
leads to FTL and FHP.
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Healthcare Access and the Homeless.
Authors: Hudson ML, Robinson BS, Cook JL. Southwest
Missouri State University, Department of Physical
Therapy.
Purpose: The purpose of this study was to examine
the demographics of individuals who are homeless
in Greene County, Missouri and to identify barriers
which prevent them from accessing and utilizing
appropriate healthcare.
Subjects: Forty-four adult volunteers participated.
Methods: The subjects participated in a survey,
via interview, containing information regarding
demographic characteristics and access to healthcare
services.
Analysis: Descriptive statistics were completed
for all demographic data. Pearson Product correlation
was used to determine the relationship between
some of the variables.
Results: The subjects ranged in age from 20-63
(X= 42.3 yrs 12.3yrs) and were predominantly female
(70%). The majority of subjects were Caucasian
(75%). Seventy- three percent had a high school
level of education or higher; however, only 27%
reported being employed. A significant relationship
existed between females and days of poor mental
health (r = .41). Thirty-nine percent of the subjects
were uninsured and 55% were covered by Medicaid.
Sixty-one percent reported they had a regular source
of care and reported little difficulty accessing
medical services.
Conclusions: The findings of this study were similar
to that of previous research. Cost, lack of healthcare
coverage, limited access to specialized healthcare
services, and patient satisfaction have all been
identified as problem areas for homeless individuals
seeking medical care. More research and cost analysis
is needed in this area to promote awareness of
the problem and secure proper funding to alleviate
healthcare barriers faced by the homeless population.
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