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<title>Department of Physical Therapy Faculty Papers</title>
<copyright>Copyright (c) 2013 Thomas Jefferson University All rights reserved.</copyright>
<link>http://jdc.jefferson.edu/ptfp</link>
<description>Recent documents in Department of Physical Therapy Faculty Papers</description>
<language>en-us</language>
<lastBuildDate>Fri, 22 Feb 2013 17:23:28 PST</lastBuildDate>
<ttl>3600</ttl>








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<title>Aging contributes to inflammation in upper extremity tendons and declines in forelimb agility in a rat model of upper extremity overuse.</title>
<link>http://jdc.jefferson.edu/ptfp/13</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/13</guid>
<pubDate>Wed, 19 Dec 2012 13:03:22 PST</pubDate>
<description>
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	<p>We sought to determine if tendon inflammatory and histopathological responses increase in aged rats compared to young rats performing a voluntary upper extremity repetitive task, and if these changes are associated with motor declines. Ninety-six female Sprague-Dawley rats were used in the rat model of upper extremity overuse: 67 aged and 29 young adult rats. After a training period of 4 weeks, task rats performed a voluntary high repetition low force (HRLF) handle-pulling task for 2 hrs/day, 3 days/wk for up to 12 weeks. Upper extremity motor function was assessed, as were inflammatory and histomorphological changes in flexor digitorum and supraspinatus tendons. The percentage of successful reaches improved in young adult HRLF rats, but not in aged HRLF rats. Forelimb agility decreased transiently in young adult HRLF rats, but persistently in aged HRLF rats. HRLF task performance for 12 weeks lead to increased IL-1beta and IL-6 in flexor digitorum tendons of aged HRLF rats, compared to aged normal control (NC) as well as young adult HRLF rats. In contrast, TNF-alpha increased more in flexor digitorum tendons of young adult 12-week HRLF rats than in aged HRLF rats. Vascularity and collagen fibril organization were not affected by task performance in flexor digitorum tendons of either age group, although cellularity increased in both. By week 12 of HRLF task performance, vascularity and cellularity increased in the supraspinatus tendons of only aged rats. The increased cellularity was due to increased macrophages and connective tissue growth factor (CTGF)-immunoreactive fibroblasts in the peritendon. In conclusion, aged rat tendons were overall more affected by the HRLF task than young adult tendons, particularly supraspinatus tendons. Greater inflammatory changes in aged HRLF rat tendons were observed, increases associated temporally with decreased forelimb agility and lack of improvement in task success.</p>

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<author>David M Kietrys et al.</author>


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<title>Clinical Care Plan: Interdisciplinary Course (CCPIC)</title>
<link>http://jdc.jefferson.edu/ptfp/12</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/12</guid>
<pubDate>Tue, 01 May 2012 12:14:20 PDT</pubDate>
<description>
	<![CDATA[
	<p><strong>Background/Rationale: </strong></p>
<p>Interprofessional collaborative practice significantly improves patient outcomes, reduces mortality and enhances quality-of-life.</p>
<p>Person-focused care demands collaboration among professions in a team approach to address multiple issues including illness, prevention, and health promotion activities.</p>
<p>Key elements of successful implementation of interprofessional education supported by Clinical Care Plan, Interprofessional Course (CCPIC):</p>
<p>-Increasing knowledge of the roles, responsibilities, and competencies of multiple health professions.</p>
<p>-Collaborating in teams</p>
<p>-Recognizing the patient as the expert</p>
<p>-Communicating effectively</p>
<p><strong>Course Statistics:</strong></p>
<p>-176 students from various disciplines completed course (2008-2011).</p>
<p><strong>Disciplines include:</strong></p>
<p>-Medicine, Nursing, Occupational Therapy, Physical Therapy, Pharmacy</p>

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</description>

<author>Marcia Levinson, PT, PhD, MFT et al.</author>


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<title>The graded redefined assessment of strength sensibility and prehension: reliability and validity.</title>
<link>http://jdc.jefferson.edu/ptfp/11</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/11</guid>
<pubDate>Thu, 15 Mar 2012 13:52:17 PDT</pubDate>
<description>
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	<p>Abstract With the advent of new interventions targeted at both acute and chronic spinal cord injury (SCI), it is critical that techniques and protocols are developed that reliably evaluate changes in upper limb impairment/function. The Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) protocol, which includes five subtests, is a quantitative clinical upper limb impairment measure designed for use in acute and chronic cervical SCI. The objectives of this study were to: (1) establish the inter-rater and test-retest reliability, and (2) establish the construct and concurrent validity with the International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI), Spinal Cord Independence Measure II (SCIM), and the Capabilities of Upper Extremity Questionnaire (CUE). The study protocol included repeated administration of the GRASSP to a cross-section of individuals with tetraplegia who were neurologically stable (n=72). ISNCSCI, CUE, and SCIM assessments were also administered. Two assessors examined the individuals over a 7-day period. Reliability was tested with intra-class correlation coefficients; construct validity was established with agreement/discordance analysis between the GRASSP and ISNCSCI sensory and motor items; and concurrent validity was tested with Spearman correlation coefficients. Inter-rater and test-retest reliability for all subtests within the GRASSP were above the hypothesized value of 0.80 (0.84-0.96 and 0.86-0.98, respectively). The GRASSP is about 50% more sensitive (construct validity) than the ISNCSCI when defining sensory and motor integrity of the upper limb; the subtests showed concurrence with the SCIM, SCIM self-care subscale, and CUE. The strongest concurrence to impairment was with self-perception of function (CUE) (0.57-0.83, p<0.0001). The GRASSP was found to demonstrate reliability, construct validity, and concurrent validity for use as a standardized upper limb impairment measure for individuals with tetraplegia.</p>

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<author>Sukhvinder Kalsi-Ryan et al.</author>


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<title>Aging enhances serum cytokine response but not task-induced grip strength declines in a rat model of work-related musculoskeletal disorders.</title>
<link>http://jdc.jefferson.edu/ptfp/10</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/10</guid>
<pubDate>Mon, 20 Feb 2012 12:59:59 PST</pubDate>
<description>
	<![CDATA[
	<p>BACKGROUND: We previously reported early tissue injury, increased serum and tissue inflammatory cytokines and decreased grip in young rats performing a moderate demand repetitive task. The tissue cytokine response was transient, the serum response and decreased grip were still evident by 8 weeks. Thus, here, we examined their levels at 12 weeks in young rats. Since aging is known to enhance serum cytokine levels, we also examined aged rats.</p>
<p>METHODS: Aged and young rats, 14 mo and 2.5 mo of age at onset, respectfully, were trained 15 min/day for 4 weeks, and then performed a high repetition, low force (HRLF) reaching and grasping task for 2 hours/day, for 12 weeks. Serum was assayed for 6 cytokines: IL-1alpha, IL-6, IFN-gamma, TNF-alpha, MIP2, IL-10. Grip strength was assayed, since we have previously shown an inverse correlation between grip strength and serum inflammatory cytokines. Results were compared to naïve (grip), and normal, food-restricted and trained-only controls.</p>
<p>RESULTS: Serum cytokines were higher overall in aged than young rats, with increases in IL-1alpha, IFN-gamma and IL-6 in aged Trained and 12-week HRLF rats, compared to young Trained and HRLF rats (p < 0.05 and p < 0.001, respectively, each). IL-6 was also increased in aged 12-week HRLF versus aged normal controls (p < 0.05). Serum IFN-gamma and MIP2 levels were also increased in young 6-week HRLF rats, but no cytokines were above baseline levels in young 12-week HRLF rats. Grip strength declined in both young and aged 12-week HRLF rats, compared to naïve and normal controls (p < 0.05 each), but these declines correlated only with IL-6 levels in aged rats (r = -0.39).</p>
<p>CONCLUSION: Aging enhanced a serum cytokine response in general, a response that was even greater with repetitive task performance. Grip strength was adversely affected by task performance in both age groups, but was apparently influenced by factors other than serum cytokine levels in young rats.</p>

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<author>Dong L Xin et al.</author>


<category>Aging</category>

<category>Animals</category>

<category>Cumulative Trauma Disorders</category>

<category>Disease Models, Animal</category>

<category>Female</category>

<category>Hand Strength</category>

<category>Interleukin-6</category>

<category>Muscle Strength</category>

<category>Musculoskeletal Diseases</category>

<category>Rats</category>

<category>Rats, Sprague-Dawley</category>

<category>Time Factors</category>

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<title>A clincial outcomes commentary on &quot;A longitudinal study of outcome measures for children receiving early intervention services&quot;</title>
<link>http://jdc.jefferson.edu/ptfp/9</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/9</guid>
<pubDate>Fri, 17 Sep 2010 11:25:48 PDT</pubDate>
<description>
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	<p>Pediatric physical therapy, especially in early intervention (EI), focuses on children’s function in natural environments and within daily routines. Valid and reliable tests measuring the ICF participation component are important to consider if we are to align our treatment focus and goals to our measures of progress. This article demonstrates that the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skill scaled scores are sensitive to change in children receiving EI with and without motor involvement.</p>

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<author>Marcia Levinson, PT, PhD, MFT et al.</author>


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<title>Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system (GAITRite).</title>
<link>http://jdc.jefferson.edu/ptfp/8</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/8</guid>
<pubDate>Sun, 09 May 2010 17:36:04 PDT</pubDate>
<description>
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	<p>BACKGROUND: The purpose of this study was to determine the test-retest reliability of temporal and spatial gait measurements over a one-week period as measured using an instrumented walkway system (GAITRite). METHODS: Subjects were tested on two occasions one week apart. Measurements were made at preferred and fast walking speeds using the GAITRite system. Measurements tested included walking speed, step length, stride length, base of support, step time, stride time, swing time, stance time, single and double support times, and toe in-toe out angle. RESULTS: Twenty-one healthy subjects participated in this study. The group consisted of 12 men and 9 women, with an average age of 34 years (range: 19-59 years). At preferred walking speed, all gait measurements had ICC's of 0.92 and higher, except base of support which had an ICC of 0.80. At fast walking speed all gait measurements had ICC's above 0.89 except base of support (ICC = 0.79), CONCLUSIONS: Spatial-temporal gait measurements demonstrate good to excellent test-retest reliability over a one-week time span.</p>

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<author>Cornelis J T van Uden et al.</author>


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<title>Investigation of the optimal load-bearing characteristics of patellar tendon bearing (PTB) prostheses</title>
<link>http://jdc.jefferson.edu/ptfp/7</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/7</guid>
<pubDate>Fri, 28 Dec 2007 09:09:13 PST</pubDate>
<description>
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	<p>The long-term goal of the research team is to automate the construction of lower limb prostheses using computer integrated manufacturing (CIM) techniques.</p>

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<author>Rahamim Seliktar et al.</author>


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<title>Investigation of the optimal load-bearing characteristics of patellar tendon bearing (PTB) prostheses</title>
<link>http://jdc.jefferson.edu/ptfp/6</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/6</guid>
<pubDate>Fri, 28 Dec 2007 09:09:11 PST</pubDate>
<description>
	<![CDATA[
	<p>The long term goal of the research team is to automate the construction of the lower limb prostheses using Computer Integrated Manufacturing (CIM) techniques.</p>

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<author>Rahamim Seliktar et al.</author>


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<title>Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system (GAITRite&reg;)</title>
<link>http://jdc.jefferson.edu/ptfp/5</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/5</guid>
<pubDate>Thu, 27 Dec 2007 11:49:21 PST</pubDate>
<description>
	<![CDATA[
	<p><strong>Background</strong><br /> The purpose of this study was to determine the test-retest reliability of temporal and spatial gait measurements over a one-week period as measured using an instrumented walkway system (GAITRite®).</p>
<p><strong>Methods</strong><br /> Subjects were tested on two occasions one week apart. Measurements were made at preferred and fast walking speeds using the GAITRite® system. Measurements tested included walking speed, step length, stride length, base of support, step time, stride time, swing time, stance time, single and double support times, and toe in-toe out angle.</p>
<p><strong>Results</strong><br /> Twenty-one healthy subjects participated in this study. The group consisted of 12 men and 9 women, with an average age of 34 years (range: 19 – 59 years). At preferred walking speed, all gait measurements had ICC's of 0.92 and higher, except <em>base of support</em> which had an ICC of 0.80. At fast walking speed all gait measurements had ICC's above 0.89 except <em>base of support</em> (ICC = 0.79).</p>
<p><strong>Conclusions</strong><br /> Spatial-temporal gait measurements demonstrate good to excellent test-retest reliability over a one-week time span.</p>

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<author>Cornelius J.T. van Uden et al.</author>


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<title>Trial and error versus errorless learning of functional skills in patients with acute stroke</title>
<link>http://jdc.jefferson.edu/ptfp/4</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/4</guid>
<pubDate>Tue, 23 Oct 2007 11:49:39 PDT</pubDate>
<description>
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	<p><strong>Objective</strong>: To compare the effectiveness of errorless learning versus trial and error learning for teaching activities of daily living to patients with acute stroke with or without explicit memory impairments.</p>
<p><strong>Design</strong>: Randomized crossover.</p>
<p><strong>Setting</strong>: Rehabilitation hospital.</p>
<p><strong>Participants</strong>: 33 adult subjects following an acute stroke.</p>
<p><strong>Intervention</strong>: Subjects were taught to prepare a wheelchair for a transfer and to put on a sock with a sock-donner. Tasks were taught using errorless learning or trial and error learning.  Explicit memory was assessed using the Neurobehavioral Cognitive Status Exam.</p>
<p><strong>Main Outcome Measures</strong>: Days until subject was able to demonstrate retention of the task, and success or failure at carry-over to a similar task.</p>
<p><strong>Results</strong>:  No significant differences were found in days to retention for either functional task when taught using errorless learning or trial and error learning in subjects with or without explicit memory impairments. Carry-over was significantly better when trial and error learning was used for learning sock donning.</p>
<p><strong>Conclusions</strong>:  When choosing the best learning method for patients undergoing rehabilitation for stroke, the nature of the task should be considered. Additional research is needed to identify the best approach for teaching activities of daily living and facilitating carry-over of learning in individuals with acute stroke.</p>

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<author>Julie Mount et al.</author>


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<title>Movement patterns used by the elderly when getting out of bed</title>
<link>http://jdc.jefferson.edu/ptfp/2</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/2</guid>
<pubDate>Thu, 22 Feb 2007 14:59:22 PST</pubDate>
<description>
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	<p><strong>Background and Purpose.</strong>  Getting out of bed is difficult for 27.6% of people over 65.  The purpose of this study is to describe movement patterns used by older adults for rising from bed.</p>
<p><strong>Subjects.</strong>  42 healthy subjects between the ages of 65 and 90.</p>
<p><strong>Methods.</strong>  Subjects were videotaped performing 5 trials of getting out of bed.  Movement patterns were categorized for each body part.</p>
<p><strong>Results.</strong> A number of movement patterns occurred that were not reported in younger people. The most frequent movement patterns used were: “roll off” (38.3%) for the trunk, “double push” (34.7%) for the far arm, “multi-push” (36.0%) for the near arm, and “synchronous” (31.2%) for the legs.</p>
<p><strong>Discussion and Conclusion.</strong>  A variety of movement patterns are used by older people for rising from bed.  Movement patterns described in this study can be used as a guide for physical therapists and occupational therapists in teaching age-appropriate strategies for getting out of bed.</p>

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<author>Julie Mount et al.</author>


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<title>Effects of dorsiflexor endurance exercises on foot drop secondary to multiple sclerosis:  A pilot study</title>
<link>http://jdc.jefferson.edu/ptfp/1</link>
<guid isPermaLink="true">http://jdc.jefferson.edu/ptfp/1</guid>
<pubDate>Wed, 21 Feb 2007 09:34:08 PST</pubDate>
<description>
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	<p>PURPOSE: This is a pilot study to determine if endurance exercises for dorsiflexors will improve walking for people with foot drop secondary to MS, and if improvement in muscle endurance for persons with MS can be predicted based on the amount of central fatigue (CF) in the muscle.</p>
<p>SUBJECTS: Five individuals with foot drop secondary to MS and five age-matched controls.</p>
<p>METHODS: The intervention was 4 sets of 10 isometric contractions, at 60% of MVC, 3X/week, 8 weeks. Pretests-posttests included a dorsiflexor endurance test with superimposed electrical stimulation to measure CF, and a gait assessment including measurement of dorsiflexion at initial contact.</p>
<p>RESULTS: Two of 5 subjects with MS had significant improvement in muscle endurance in both legs and in dorsiflexor control during walking. Correlation between CF and improved endurance was not significant (r=−0.07). One of the subjects with significant improvement in endurance had a significant decrease in central activation failure.</p>
<p>CONCLUSIONS AND DISCUSSION: For individuals with foot drop secondary to MS, endurance exercises for the dorsiflexors can result in improved walking. CF may not be useful in predicting whether a muscle will improve in endurance with exercise. Improvement may result from either a peripheral training effect, a central learning effect, or both.</p>

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<author>Julie Mount et al.</author>


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