Browsing by Author "Loghmani, Terry"

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    A Data Requisition Treatment Instrument For Clinical Quantifiable Soft Tissue Manipulation
    (2019-05) Bhattacharjee, Abhinaba; Chien, Stanley Y. P.; Anwar, Sohel; Loghmani, Terry; King, Brian
    Soft tissue manipulation is a widely used practice by manual therapists from a variety of healthcare disciplines to evaluate and treat neuromusculoskeletal impairments using mechanical stimulation either by hand massage or specially-designed tools. The practice of a specific approach of targeted pressure application using distinguished rigid mechanical tools to breakdown adhesions, scar tissues and improve range of motion for affected joints is called Instrument-Assisted Soft Tissue Manipulation (IASTM). The efficacy of IASTM has been demonstrated as a means to improve mobility of joints, reduce pain, enhance flexibility and restore function. However, unlike the techniques of ultrasound, traction, electrical stimulation, etc. the practice of IASTM doesn't involve any standard to objectively characterize massage with physical parameters. Thus, most IASTM treatments are subjective to practitioner or patient subjective feedback, which essentially addresses a need to quantify therapeutic massage or IASTM treatment with adequate treatment parameters to document, better analyze, compare and validate STM treatment as an established, state-of-the-art practice. This thesis focuses on the development and implementation of Quantifiable Soft Tissue Manipulation (QSTM™) Technology by designing an ergonomic, portable and miniaturized wired localized pressure applicator medical device (Q1), for characterizing soft tissue manipulation. Dose-load response in terms of forces in Newtons; pitch angle of the device ; stroke frequency of massage measured within stipulated time of treatment; all in real-time has been captured to characterize a QSTM session. A QSTM PC software (Q-WARE©) featuring a Treatment Record System subjective to individual patients to save and retrieve treatment diagnostics and a real-time graphical visual monitoring system has been developed from scratch on WINDOWS platform to successfully implement the technology. This quantitative analysis of STM treatment without visual monitoring has demonstrated inter-reliability and intra-reliability inconsistencies by clinicians in STM force application. While improved consistency of treatment application has been found when using visual monitoring from the QSTM feedback system. This system has also discriminated variabilities in application of high, medium and low dose-loads and stroke frequency analysis during targeted treatment sessions.
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    Intervention Effects on Musculoskeletal Health and Physical Function in CKD-MBD Using a Rat Model
    (2024-12) Troutman, Ashley Danielle; Avin, Keith; Warden, Stuart; Loghmani, Terry; Schulte, Michael
    Chronic kidney disease (CKD) is a systemic condition that affects approximately 14% of adults in the United States. Kidney damage disrupts biochemical concentrations which can lead to a condition known as CKD-mineral bone disorder (CKD-MBD). CKD-MBD consists of altered biochemistries, vascular calcification, and bone abnormalities. Skeletal muscle impairments have also been observed in those with CKD. Bone abnormalities lead to an increased risk of fracture that is 2-100 times higher in the CKD population than the non-CKD population. In CKD, muscular atrophy in combination with muscle weakness and/or poor physical function (i.e., sarcopenia) occurs in 4-63% of patients while muscular weakness alone (i.e., dynapenia) has a prevalence of 18-46%. The collective musculoskeletal impairments lead to a reduction in physical function, increased risk of hospitalization, and increased mortality. Exercise is commonly used to treat impaired bone and skeletal muscle in non-CKD populations. However, in CKD, exercise has demonstrated inconsistent results which are likely due to the varying exercise prescriptions reported in the literature. Additionally, the prescription of exercise necessary to cause musculoskeletal adaptation may be too intense for CKD patients in the mid-to-late stages of disease, especially since many were sedentary prior to diagnosis. This suggests that exercise alone may not be sufficient to elicit the desired muscle and bone outcomes. The use of nutraceuticals such as carnitine and pharmaceuticals that act as “exercise mimetics” are becoming more popular, however their impact on musculoskeletal health in CKD has not been extensively researched.
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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.