St. Augustine, Fall 2018

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  Are You Ready to get High? High Repetition Exercise for Radial Nerve Palsy

  Tayler Adams and Matthew L. Daugherty

  Research suggests the need for early surgical nerve exploration for secondary radial nerve palsy based upon a 75% recovery rate with early exploration.⁵ In using typical conservative management plus high-repetition movement, the patient in this case report was able to avoid surgery for radial nerve exploration, attain complete recovery within 4 months of his initial injury, and fully return to work and daily function.

  This case report offers the possibility of high-repetition movement being a beneficial treatment intervention. This is a simple, low-cost treatment and can be accomplished by the patient at home as part of a home exercise program. For this patient, full recovery was attained without additional surgery for nerve exploration. Perhaps this case report serves as a catalyst for further research in the area of radial nerve palsy in applying a conservative treatment approach that aids in the regeneration of the radial nerve without having to turn towards surgical interventions.

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  Incorporation of Balance and Vestibular Exercises in a 45-year-old Female with Bell’s Palsy: A Case Report

  Kelsey Andersson and Erica Kiernan

  The purpose of this case report is to determine the effectiveness of balance and vestibular exercises in conjunction with facial strengthening exercises on a patient with Bell’s palsy.

  By incorporating vestibular exercises into the patient’s therapy sessions, she was able to demonstrate improved single leg stance and self-reported decrease in onset of symptoms with a progression of vestibular exercises. Facial muscle strengthening exercises demonstrated significant improvements in eye closure and smiling but she exhibited little changes in facial symmetry, strength and self-perceived function. The patient reported she was starting to drive and participate in more social events by the 4th treatment session.

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  Anti-gravity Treadmill Training with 19-year-old Soccer Player Status Post-leukemia

  Britni Barber and Lisa Chase

  The purpose of this case report was to describe the effects of anti-gravity treadmill training, in addition to standard treatment protocol, on endurance performance in a 19-year-old female collegiate soccer player following chemotherapy treatment for leukemia.

  Physical therapy rehabilitation of patients who are experiencing chemotherapy-related fatigue may benefit from anti-gravity treadmill training. This case report not only identifies a successful outcoming using such intervention but also introduces a more aggressive approach to treatment for a patient whose goals included going back to play division one sports. The patient was not only able to reach her goals of being able to perform activities of daily living but also make significant improvements in other skills required to play her sport such as improvements in balance, coordination, and agility.

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  Core Stabilization and Pelvic Motility Training for a 28-week Pregnant Female with Low Back Pain and Sciatic Nerve Pain

  Jenna Belser and Anne H. Boddy

  The purpose of this case study is to determine the effects of core stabilization and pelvis mobility training for a 28-week pregnant female to improve function and decrease pain.

  Low back pain during pregnancy is a common occurrence that affects a majority of the population.¹ Over the five treatment sessions, the patient was able to tolerate a full ten-hour work shift and sleep through the night. She also showed improvements in muscle strength and flexibility. As seen in non-pregnant females, the patient was able to have a decrease in pain and improvement in function with these techniques.⁴

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  Power Up with Parkinson's: A Case Report

  Sean Ekekwe and Anne H. Boddy

  The purpose of this study is to highlight the use of power training in a patient with low back pain and Parkinson’s disease.

  Power training demonstrated a more significant change in gait speed, mobility, and function compared to other phases in rehabilitation. After power training was implemented at visit 11, there was a dramatic increase gait speed with the 10-meter walk test, a reduction in Oswestry Disability Index score (ODI), and a decrease in Timed Up and Go (TUG) time. The increase in 10 MWT gait speed and reduction in ODI and TUG score were greater than their MDC values of 0.18m/s, 4.8 points, and 3.5 seconds, respectively.^6,7,8

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  Proprioceptive Neuromuscular Facilitation In A Male Wrestler Post Type II Slap Lesion Surgical Repair

  George Eskander and Matthew L. Daugherty

  The primary purpose of this case report was to assess the effects of a specific progression of PNF and Rhythmic Stabilization Exercises (RSE) in conjunction with traditional physical therapy for a seventeen-year-old wrestler post Type II SLAP lesion surgical repair.

  This case report indicated that the utilization of PNF and RSE is a beneficial component to physical therapy treatment of a seventeen-year-old wrestling athlete with a Type II SLAP lesion surgical repair. Designing a treatment plan with emphasis on PNF and RSE is cost-efficient, as it does not require expensive equipment or additional certifications. Also, physical therapists utilizing PNF and RSE could further control the safety of therapeutic interventions by providing manually controlled resistance and perturbations.

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  External Load on the Hemi-paretic Lower Limb with Task-oriented Training to Improve Gait Post Right ACA Stroke

  Jacob France and Lindsey Perry

  The purpose of this case report is to describe the treatment of a 77-year-old male post-stroke with the application of an external load to the paretic lower limb in conjunction with task-oriented training to improve gait.

  Strength, balance, gait speed, and functional tasks all improved over the course of physical therapy. At the end of 2 weeks, the patient exceeded the minimal detectable change (MDC) for the TUG (2.9 sec) and achieved the minimal clinically important difference (MCID) for the FIM (22 points).^4-5 Although the MCID is not established for the Modified Ashworth Scale (MAS), the patient experienced improvements after 2 weeks.

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  Effectiveness of Stretching and Arch Strengthening in a 10-year-old male with Calcaneal Apophysitis

  Hannah Hardesty and Catherine M. Andrea

  The aim of this case report is to create an independent exercise program to minimize pain while allowing continued participation in recreational activities.

  Calcaneal apophysitis is a common condition in children that often results in the cessation of physical activity and participation in social activities, which can have a negative effect on both physical and mental well-being.^2-5 This case demonstrates positive outcomes with the use of static/dynamic stretching combined with arch strengthening in the rehabilitation of a patient with bilateral calcaneal apophysitis without reducing the child’s participation in daily and recreational activities.

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  SARA Plus and Task Specific Training in a Patient with Anoxic Encephalopathy

  Olivia Levi and Erica Kiernan

  The purpose of this case report is to describe the benefits of using a task-specific approach and the SARA plus to improve balance and gait in a patient with anoxic encephalopathy.

  This case demonstrated the positive results of incorporating repetitive, task-specific, and early use of the SARA plus for gait training. With these interventions, the patient was able to ambulate 25 ft and transfer from sit to stand with the use of a rolling walker and minimum assistance. He was also able to maintain static sitting balance for 32 seconds independently and reach 17 inches outside of his base of support.

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  Effects of Trigger Point Dry Needling in Conjunction with Intramuscular Electrical Stimulation for a Patient with Lumbar Radiculopathy: A Case Report

  Mayur Patel and Todd Bourgeois

  The purpose of this case was to see the benefits of Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for the treatment of lumbar radiculopathy regarding the range of motion, strength, sensation, reduction of pain, improve functional ability, and quality of life.

  Traditional interventions for this diagnosis include strengthening exercises, modalities such as transcutaneous electrical stimulation, and even surgery as a last resort. There is limited research available regarding Trigger Point Dry Needling in conjunction with Intramuscular Electrical Stimulation for lumbar radiculopathy.⁴ This case report supports the idea that this physical therapy treatment intervention has positive outcomes in a short duration improving quality of life and functional ability.

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  Scapulothoracic Mobility and Strengthening after a Posterior Capsular Reconstruction of the Glenohumeral Joint with an Allograft: A Case Report

  Kris Saunders and David Kempfert

  The purpose of this case report is to emphasize the importance of scapular mobility and strengthening exercises in rehabilitation protocols for patients after a posterior capsular reconstruction surgery of the glenohumeral joint.

  The objective outcomes by week three are displayed in Table 1.0. The patient was discharged after nine visits over a period of three weeks. During the final session, the patient was able to perform standing shoulder abduction to 90 degrees with a one-pound dumbbell pain-free. The patient was able to reach into a shelf at 120 degrees of shoulder flexion with a pain scale rating of 2/10. He was unable to return to work or play basketball with his son, but he was able to reach his kitchen cabinets at home if he stood on a small step. The patient’s QuickDASH score improved to 59.09% disability.

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  Effects of Weight Shifting and Heel Lift on Gait, Posture, and Balance in an Elderly Female with Backward Disequilibrium: A Case Report

  Gilissa T. Schjang and Evan M. Pucillo

  The purpose of this case report is to investigate how weight shifts and a heel lift affects a patient's center of mass in respect to their base of support to improve posture, balance, and gait which will aid in decreasing falls.

  The patient demonstrated functional improvements by reducing the amount of assistance required from a caregiver for transfers and gait. Improvements in balance will allow the patient to sit on the toilet and edge of bed for toileting and dressing more independently.

  Older adults with BD or other similar balance disorders are at risk for increased falls.⁵ This case report shows the benefits of incorporating anterior weight shifts and a heel lift into physical therapy interventions to improve gait, balance, and posture, ultimately decreasing falls.

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  Soft Tissue Mobilization with Movement to Improve Cervical and Shoulder Range of Motion Post-thyroidectomy in a 36-year-old Male: A Case Report

  Sarah Tomes and Megann Schooley

  The purpose of this case report is to describe the effectiveness of soft tissue mobilization with movement (STMM) to improve cervical and shoulder range of motion status-post thyroidectomy in a 36-year-old male.

  When addressing hypertrophic scarring and ROM restrictions after total thyroidectomy, a beneficial myofascial treatment may include STMM. A home program could incorporate STMM or self-myofascial release as well.

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  Shall We Dance: A Parkinson’s Dance-Based Program

  Rebecca Zawodny and Anne H. Boddy

  This poster presents the implementation of a community-based dance program for individuals diagnosed with Parkinson’s disease.

  Dance interventions for individuals with PD are shown to be superior to exercise for improving balance and mobility^5,6,7 thus, effectively addressing both motor as well non-motor symptoms such as depression, fear, anxiety, and declined self-efficacy.^8,9,10 Further positive effects include improved flexibility and coordination7^,11 and forced-use of the senses of sight, sound, and touch to assist with movement and balance.¹² The use of choreography further allows for the rehearsal of movement sequences, new motor skill learning, and improved cognitive functions.¹³ Such improvements have been shown to have an overall positive effect on decreasing fall risk and on improving outcome measures such as the Berg Balance Scale and 6-Minute Walk Test.⁷ Lastly, participants have found dance-based programs to be more enjoyable than traditional therapy intervention; promoting long-term compliance, which research has shown may slow the progression of disability in PD.