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Item Health benefits of seated speed, resistance, and power training for an individual with spastic quadriplegic cerebral palsy: A case report(IOS Press, 2015-09-06) Gannotti, Mary E.; Fuchs, Robyn Kimberly; Roberts, Dawn E.; Hobbs, Nedda; Cannon, Ian M.; Department of Physical Therapy, School of Health and Rehabilitation SciencesChildren with moderate to severe cerebral palsy are at risk for low bone mass for chronological age, which compounds risk in adulthood for progressive deformity and chronic pain. Physical activity and exercise can be a key component to optimizing bone health. In this case report we present a young adult male with non-ambulatory, spastic quadriplegia CP whom began a seated speed, resistance, and power training exercise program at age 14.5 years. Exercise program continued into adulthood as part of an active lifestyle. The individual had a history of failure to thrive, bowel and bladder incontinence, reduced bone mineral density (BMD) for age, and spinal deformity at the time exercise was initiated. Participation in the exercise program began once a week for 1.5-2 hours/session, and progressed to 3-5 times per week after two years. This exercise program is now a component of his habitual lifestyle. Over the 6 years he was followed, lumbar spine and total hip BMD Z-scores did not worsen, which may be viewed as a positive outcome given his level of gross motor impairment. Additionally, the individual reported less back pain, improved bowel and bladder control, increased energy level, and never sustained an exercise related injury. Findings from this case report suggest a regular program of seated speed, resistance, power training may promote overall well-being, are safe, and should be considered as a mechanism for optimizing bone health.Item Increasing Therapist Knowledge in Trauma-Informed Care(2021-05-04) Conrady, Haley; Petrenchik, Terry; Petrenchik, Terry; Department of Occupational Therapy, School of Health and Human Sciences; Kiel, HollyResearch surrounding childhood trauma and maltreatment has consistently demonstrated a strong positive correlation between the amount of adverse experiences a child experiences and future physical and mental health consequences, as well as a strong negative correlation between childhood trauma and brain development. Occupational therapists, physical therapists, and speech language pathologists work with children that have endured traumatic experiences on a daily basis. As healthcare professionals that work with these children on their development and skill acquisition, it is critical that they understand the negative impacts of childhood trauma and how to implement trauma-informed practices. This program was created with the intention of increasing therapist knowledge and confidence on identifying traumatic experiences and symptoms, the impact on brain development, and how to plan trauma-informed therapy sessions. The content of this training program was created by completing an extensive literature search in order to provide the therapists with evidence-based knowledge and skills. All formal information was provided throughout two in-service presentations. Fourteen therapists were present at both sessions and used a self-reported rating scale to assess their confidence prior to the training and just following. Following the in-service presentations, a 128% increase in confidence was found, with p<.001. Through this training program, the therapists at IU Health Ball Pediatric Rehabilitation gained a basic understanding of the developmental effects of trauma and began to incorporate trauma-informed practices. The results of this study suggest that by providing therapists with two in-service presentations solely dedicated to the effects of childhood trauma and its role in childhood development, their confidence in working with children that have experienced trauma statistically significantly increases.Item Kinematic changes following robotic-assisted upper extremity rehabilitation in children with hemiplegia : dosage effects on movement time(2018-04-30) Cardinal, Ryan Edward; Altenburger, Peter; Fuchs, Robyn; Massie, Crystal; Warden, StuartBackground: Rehabilitation Robotics (RR) has become a more widely used and better understood treatment intervention and research tool in the last 15 years. Traditional research involves pre and post-test outcomes, making it difficult to analyze changes in behavior during the treatment process. Harnessing kinematics captured throughout each treatment allows motor learning to be quantified and questions of application and dosing to be answered. Objective: The aims of this secondary analysis were: (i) to investigate the impact of treatment presentation during RR on upper extremity movement time (mt) in children with hemiplegic cerebral palsy (CP) and (ii) to investigate the impact of training structure (dose and intensity) on mt in children with CP participating in RR. Methods: Subjects completed 16 intervention sessions of RR (2 x week; 8 weeks) with a total of 1,024 repetitions of movement per session and three assessments: pre, post and 6 month f/u. During each assessment and intervention, subjects completed “one-way record” assessments tracking performance on a planar task without robotic assistance. Kinematics from these records were extracted to assess subject performance over the course of and within sessions. Results: For all participants, a significant decrease in mt was found at post-test and follow-up. No significant differences were found in mt for age, severity or group placement. A significant interaction was found between treatment day, block and group (p = .033). Significant mt differences were found between the three blocks of intervention within individual days (p = .001). Specifically, significant differences were found over the last block of treatment (p = .032) and between successive treatment days (p = .001). Conclusion: The results indicate that for children with CP participating in RR, the number of repetitions per session is important. We hypothesized that children’s performance would plateau during a treatment day as attention waned, the opposite proved to be true. Despite the high-number of repetitions and associated cognitive demand, subjects’ performance actually trended upwards throughout the 1,024 repetitions suggesting that children were able to tolerate and learn from a high volume of repetitions.Item