Department of Physical Therapy Articles

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Browsing Department of Physical Therapy Articles by Author "Altenburger, Peter"

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    Change in Depression, Confidence, and Physical Function Among Older Adults With Mild Cognitive Impairment
    (Wolters Kluwer, 2019-09-01) Ellis, Jennifer L.; Altenburger, Peter; Lu, Yvonne; Physical Therapy, School of Health and Rehabilitation Sciences
    Background and Purpose Nearly a quarter of those in the US over age 71 experience mild cognitive impairment (MCI). Persons with MCI (PwMCI) battle depression and progressive disengagement from daily activities, which contribute to participation restriction and activity limitation. Daily engagement in meaningful activity (DEMA) is a tailored intervention designed to benefit PwMCI and their caregivers through preserved engagement and supported adjustment to cognitive changes. This secondary analysis was guided by the International Classification of Functioning, Disability and Health (ICF) model. Aims were to (i) explore the extent to which change in self-rated activity performance and physical function can predict change in depressive symptoms, (ii) evaluate for difference in confidence and depressive symptoms at ICF levels of activity and participation, and (iii) quantify the impact of daily engagement at the ICF level of participation on physical function. Methods A secondary analysis was conducted using data from the parent study, which was a two-group randomized trial involving PwMCI and their informal caregivers participating in the Indiana Alzheimer Disease Center DEMA program. Quantitative analysis (dyads: DEMA N = 20, Information Support N = 20) examined outcomes at posttest and follow-up. Analysis employed linear regression to model the relationship between explanatory and dependent variables and independent t-test to examine for difference in confidence, depression, and physical function. Results and Discussion At posttest, change in self-rated performance predicted change in depressive symptoms. Those in the DEMA group who engaged in activity at the ICF level of participation demonstrated a significant increase in confidence and physical function. Although not significant, the control group posttest results showed a mean decrease in confidence. Conclusions Results demonstrate a positive impact of DEMA on depressive symptoms, confidence, and physical function. Change in occupational performance predicted change in depressive symptoms. Confidence significantly improved among those who engaged at the ICF participation level. A larger, randomized controlled longitudinal trial is needed to better assess the impact of DEMA on physical function, activity, participation restriction and quality of life.
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    Changes in Walking Spatiotemporal Parameters After Therapeutic Yoga in People with Chronic Stroke
    (Iris, 2019) Miller, Kristine K.; Altenburger, Peter; Dierks, Tracy; Mason, Arianne; Van Puymbroeck, Marieke; Schmid, Arlene A.; Physical Therapy, School of Health and Rehabilitation Sciences
    Walking limitations after stroke can contribute to long-term functional impairments. Walking characteristics such as spatiotemporal step parameters may be associated with these persistent walking limitations. The purpose of this study was to investigate changes in specific spatiotemporal walking parameters such as: walking speed; step length; swing time; step parameter symmetry; and double support time in adults with stroke who were participating in a therapeutic yoga intervention. The therapeutic yoga intervention was offered as a post-rehabilitation wellness activity 2 times per week for 8 weeks and was led by a yoga therapist. Spatiotemporal walking data were collected using the GAITRite Walkway System on a sub sample (n=24) of participants in a randomized controlled trial testing the efficacy of therapeutic yoga for improving balance in adults with chronic stroke. These data demonstrated that therapeutic yoga may have a positive impact on some spatiotemporal walking characteristics such as comfortable walking speed, step length, and double support time, while other spatiotemporal walking characteristics did not change (step parameter symmetry) or change at a significant level (sustained walking speed). The clinical relevance of this study is that participation in therapeutic yoga as a post-rehabilitation wellness activity may have a positive impact on walking characteristics in adults with chronic stroke.
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    A Model for Providing Free Patient Care and Integrating Student Learning and Professional Development in an Interprofessional Student-Led Clinic
    (Wolters Kluwer, 2017) George, Lydia; Bemenderfer, Sara; Cappel, Maggie; Goncalves, Kathryn; Hornstein, Micaela; Savage, Chelsea; Altenburger, Peter; Bellew, James; Loghmani, Terry; Physical Therapy, School of Health and Rehabilitation Sciences
    Background and Purpose. The need to reduce the barriers of access and affordability in health care is evident. The Indiana University Student Outreach Clinic (IU SOC) is a community-based, pro bono, interprofessional, student-led clinic dedicated to removing barriers to health care. The purpose of this report is to describe the implementation approach, sustainability efforts, and initial outcomes of this community-based physical therapy clinic model with the aim of making it transparent for others to replicate. Method/Model Description and Evaluation. An overview of the IU SOC, implementation and sustainability of the physical therapy clinic model, and student learning opportunities are described. Keys to successful implementation are enumerated. Learning opportunities include: clinical competency, professional values, civic engagement, interprofessional education and collaborative practice (IPECP), peer mentorship, and leadership development. Outcomes. Preliminary clinic and learning opportunity outcomes collected from patient databases and student surveys and reflections suggest the IU SOC is having a positive impact on the community it serves by providing care patients would otherwise have not received, while simultaneously supporting learning. Patient volume and student participation are expanding. Initial outcomes suggest this model is valuable for the professional growth of future physical therapists. Discussion and Conclusion. The impact of this clinic model on the community and students is just beginning to be realized and understood. Key elements of success are that it's (a) community-based, (b) interprofessional, and (c) highly collaborative. Free, student-led, interprofessional health care clinics may offer an important means for improving health care access while simultaneously preparing entrylevel professionals for practice.