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Title: A Comparison Between Physical Therapy and Chiropractor Billing and Patient Costs for Patients.
Creator: Landis, Sean, Marieb College of Health & Human Services
Abstract / Description: INTRODUCTION: Neck pain is the second most frequent reason patients take time off work in the United States. Research has been conducted examining the effectiveness in both chiropractic and physical therapy in the treatment of cervical spine dysfunction. To this date, no research can be found that directly compares reimbursement rates and patient costs between the two professions. Recent healthcare reform makes the analysis of reimbursement and patient costs vital for the future of the...
Show moreINTRODUCTION: Neck pain is the second most frequent reason patients take time off work in the United States. Research has been conducted examining the effectiveness in both chiropractic and physical therapy in the treatment of cervical spine dysfunction. To this date, no research can be found that directly compares reimbursement rates and patient costs between the two professions. Recent healthcare reform makes the analysis of reimbursement and patient costs vital for the future of the profession of physical therapy. METHODOLOGY: Personal interviews were conducted at (3) physical therapy and (3) chiropractic clinics in the Southwest Florida area. Data collected included reimbursement rates/fee schedules and patient costs for the copay, initial evaluation, manual therapy/chiropractic manipulative therapy, neuromuscular reeducation, mechanical traction, and therapeutic exercise. Data analysis was performed using descriptive statistics. Patient costs and reimbursement rates between the two professions, as well as between automobile and non-automobile insurance reimbursements rates, was analyzed. RESULTS: Reimbursement rates between the two professions does not show significant difference in the mean reimbursement rate for patient copay, initial evaluation, manual/chiropractic manipulative therapy, neuromuscular re-education, traction, nor therapeutic exercise. Chiropractic cash-for-services are cheaper in initial evaluation, traction, and therapeutic exercise. Manual therapy and neuromuscular re-education cash for- service rates are cheaper in physical therapy compared to chiropractic clinics. Automobile insurance companies also reimburse more in both physical therapy and chiropractic clinics when compared to non-automobile insurance companies. DISCUSSION: The large difference in chiropractic and physical therapy reimbursement rates for the initial evaluation is due to the (3) chiropractic clinics provided rates for initial evaluations that do not take as long as physical therapy. Therefore, the cost is cheaper, but the time spent with patient is not as much as physical therapy.
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Date Issued: 2013-04-21
Identifier: fgcu_ETD_0494
Format: Document (PDF)

Title: A COMPARISON OF ULNAR COLLATERAL LIGAMENT STRESS PROTOCOLS FOR ULTRASOUND IMAGING IN COLLEGE BASEBALL PLAYERS.
Creator: Caton, Sutter, Marieb College of Health & Human Services
Abstract / Description: Introduction: Musculoskeletal ultrasound imaging (UI) is an increasingly popular and reliable tool in addition to physical examination for assessment of anatomical structures and injuries. Ulnar collateral ligament (UCL) injuries in baseball players are becoming more frequent and account for a large portion of missed playing time. Studies have suggested that the ligamentous laxity of the UCL can be a predictor for future injury. There has been an effort to develop a standardized test for...
Show moreIntroduction: Musculoskeletal ultrasound imaging (UI) is an increasingly popular and reliable tool in addition to physical examination for assessment of anatomical structures and injuries. Ulnar collateral ligament (UCL) injuries in baseball players are becoming more frequent and account for a large portion of missed playing time. Studies have suggested that the ligamentous laxity of the UCL can be a predictor for future injury. There has been an effort to develop a standardized test for ligamentous laxity of the UCL using UI. Purpose: The purpose of this study was to assess the effect of gravity and manually applied valgus forces on humeroulnar joint gapping (HJG) compared to rest in the throwing arm of NCAA Division I collegiate baseball players using UI. Methods: This was a non-experimental quantitative repeated measures study. Ten NCAA Division I collegiate baseball players (mean age 20.3 ± 1.3 SD yrs) with no history of UCL injury participated. Images were obtained with a Phillips Lumify L12-4 ultrasound unit under three different conditions of valgus force. For measurement one, the subjects throwing shoulder was fully supported with the subject positioned supine with the throwing shoulder at 90 degrees of abduction, 45 degrees of external rotation, and 30 degrees of elbow flexion. For measurement two the subject’s forearm was unsupported with gravity applying a valgus force. For measurement three one clinician applied a 3 kg valgus stress using a handheld dynamometer (Hoggan Scientific MicroFET 2 hand held dynamometer) 20 cm distal to the medial epicondyle while also stabilizing the humerus. Post collection measurements were performed using a DICOM reader (MicroDicom DICOM viewer). The humeroulnar joint width measurements were taken from the distal edge of the trochlea and the proximal edge of the ulna in millimeters (mm). A Shapiro-Wilk test of normality was performed to determine whether the data followed a normal distribution. Due to the non-normal distribution of data, a Friedman Test was performed to assess whether a statically significant difference in HJG existed between the three groups. After a statistically significant difference between the three groups was found, three separate Wilcoxon Signed-Rank Tests were performed to assess for difference between pairs of groups. Results: There was a statistically significant increase in humeroulnar joint space with a gravity applied valgus force compared to rest (Z = -2.807, p < .005). There was also a statistically significant increase in humeroulnar joint space with a manually applied valgus force compared to gravity applied valgus force (Z = -2.805, p < .005). Finally, there was a statistically significant increase in humeroulnar joint space with a manually applied valgus force compared to rest (Z = -2.81 p < .005). Conclusion: A gravity induced valgus force can cause a statistically significant increase in HJG compared to rest, however further joint space opening was found when adding external valgus force. Further research is needed to investigate if the amount of HJG achieved through gravity is sufficient to identify ligamentous laxity.
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Date Issued: 2019-06-18
Identifier: fgcu_ETD_0311
Format: Document (PDF)

Title: A Multidisciplinary, Behavioral Approach and Recommendations for High Intensity Resistance Training in the Treatment of Obese Children.
Creator: Miller, Joshua, Marieb College of Health & Human Services
Abstract / Description: It has been reported that nearly 17% of all children and adolescents are obese, with a BMI above the 95th percentile. Similarly, childhood obesity has risen in the last three decades, indicating that an evidence- based, best practice (EBBP) intervention is necessary for halting this epidemic and resolving associated health risks. High intensity resistance training (HIRT) could be an EBBP intervention for fat loss in obese children. This case report investigates the use of a multidisciplinary,...
Show moreIt has been reported that nearly 17% of all children and adolescents are obese, with a BMI above the 95th percentile. Similarly, childhood obesity has risen in the last three decades, indicating that an evidence- based, best practice (EBBP) intervention is necessary for halting this epidemic and resolving associated health risks. High intensity resistance training (HIRT) could be an EBBP intervention for fat loss in obese children. This case report investigates the use of a multidisciplinary, behavioral treatment approach, Fit4Allkids, for obese children. It also presents the potential for using HIRT as a treatment option for obese children, including the possible mechanisms for fat loss as a result of HIRT among obese children. Furthermore, this case report identifies important HIRT research outcomes that would be beneficial for developing an EBBP intervention for obese children. Suggested outcomes for future studies include exploring resting metabolic rate, lean body mass, fat free mass, total daily energy expenditure, and respiratory exchange ratio in obese children.
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Date Issued: 2014-05-28
Identifier: Miller_fgcu_1743_10078
Format: Document (PDF)

Title: A Qualitative Study of Professional Issues in Home Health Physical Therapy.
Creator: Hogan, Jeffrey B., Marieb College of Health & Human Services
Abstract / Description: Introduction: The home health care industry is growing and now employs nearly 7% of all physical therapists according to the American Physical Therapy Association. It is important that physical therapists new to home health care are able to access information that informs them about important issues that affect both the patient and themselves as a professional while considering employment in this field. This is two part study that implements a grounded theory method with snowball sampling...
Show moreIntroduction: The home health care industry is growing and now employs nearly 7% of all physical therapists according to the American Physical Therapy Association. It is important that physical therapists new to home health care are able to access information that informs them about important issues that affect both the patient and themselves as a professional while considering employment in this field. This is two part study that implements a grounded theory method with snowball sampling initially interviewing 11 home health physical therapists. Physical therapists targeted for interview came from a range of therapy specialties and experience levels. Each interview was recorded with the consent of the interviewee, transcribed and coded using grounded theory principles. The study investigated two major research questions: What professional factors are important to the provision of physical in the home environment for therapists coming into the home health industry for the first time? What type of benefits, barriers and social issues do physical therapists face when providing home health services? Results: Major categories identified included work environment, work characteristics, communication, patient and family, and work-life balance. Analysis of these categories suggest that factors influencing physical therapists provision of care in the home both positively and negatively most commonly include flexible scheduling, documentation, varied patient case types, accountability, the home environment, fulfillment from providing care in the home and transportation. Flexibility in scheduling and the ability to work in a real environment where you can adjust care to the functional environment of the patient were the two most common factors identified. Discussion: Focus groups and more descriptive interview questions should be included in future interviews to help improve the efficiency of the survey as well as to identify more unique specific factors related to the work structure, corporate culture, and other unidentified categories of factors affecting home care professionals.
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Date Issued: 2015
Identifier: Hogan_fgcu_1743_10136
Format: Document (PDF)

Title: A Qualitative Study on Clinical Decision Making Regarding the Use of Vital Signs in Physical Therapy.
Creator: Basskin, Allison, Thistle, Virginia G., Marieb College of Health & Human Services
Abstract / Description: Introduction Clinical decision making is an integral component of patient care. Vital signs are a component of the clinical decision making process each visit. These include body temperature, blood pressure, heart rate, respiratory rate, and pulse oximetry. Measuring vital signs allows physical therapists to screen for red flags, monitor a patient’s cardiovascular response to exercise, and incorporate relevant information into the plan of care. Previous studies have shown that physical...
Show moreIntroduction Clinical decision making is an integral component of patient care. Vital signs are a component of the clinical decision making process each visit. These include body temperature, blood pressure, heart rate, respiratory rate, and pulse oximetry. Measuring vital signs allows physical therapists to screen for red flags, monitor a patient’s cardiovascular response to exercise, and incorporate relevant information into the plan of care. Previous studies have shown that physical therapists do not always objectively measure vital signs each visit. With physical therapists emerging as autonomous practitioners, it is important to understand which factors strongly influence the clinical decision making of physical therapists to take vital signs. Methods Seventeen practicing physical therapists were given a questionnaire by phone, email, or in person. The questionnaire contained three sections including demographic data, clinical decision making questions, and two risk-based scenarios in which participants were asked to indicate whether or not they would assess vital signs. Results The primary factors cited in response to source of reference of assessing vital signs included clinical experience, education, and patient presentation. The primary factors included by physical therapists in response to the decision to treat or refer based on abnormal vital signs included patient history, clinical experience, various parameters, and contacting the physician. Several different themes emerged with respect to clinical decision making that included utilizing ACSM guidelines, clinical experience, physician’s protocol, education, patient presentation, criteria proposed by the cardiopulmonary section of the APTA, and facility policies and procedures. In addition, there did not appear to be an agreement by participants on the definition of abnormal vital signs seen clinically. Conclusion The variation of factors that influenced the decision making process by the participants may be reflective of the lack of guidelines and the broad understanding of the need and benefit of objectively assessing vital signs.
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Date Issued: 2016
Identifier: Basskin_fgcu_1743_10163
Format: Document (PDF)

Title: A study of urinary incontinence curricula content in entry-level physical therapy programs in the United States recognized by the commission on accreditation in physical therapy education.
Creator: Laatsch, Kimberly Ann, Marieb College of Health & Human Services
Abstract / Description: Urinary incontinence (UI) is currently a major, under-reported and costly health issue that is becoming more prevalent as the United States population continues to age. Studies have shown that physical therapists have a role in treating UI. The purpose of this study was to (1) determine the amount and type of UI curricula content instruction in entry-level physical therapy programs and (2) investigate some of the underlying factors that may relate to the UI curricula. Participants were the...
Show moreUrinary incontinence (UI) is currently a major, under-reported and costly health issue that is becoming more prevalent as the United States population continues to age. Studies have shown that physical therapists have a role in treating UI. The purpose of this study was to (1) determine the amount and type of UI curricula content instruction in entry-level physical therapy programs and (2) investigate some of the underlying factors that may relate to the UI curricula. Participants were the primary faculty member teaching UI curricular content at the 201 physical therapist professional degree programs in the United States recognized by the Commission on Accreditation in Physical Therapy (CAPTE). The web-based survey documented institutional demographics, faculty education and attitudes, UI curricular content and instruction methods, and faculty assessment of the UI curricula. Of the programs surveyed for this descriptive study (n = 201), 54 programs (27%) completed the questionnaire. The study found a moderate relationship (r = .451) between the amount of faculty specialized training in UI and the amount of UI curricular content. A similar correlation (r = .433) occurred between the subjects view of the role of the PT in evaluation and intervention in the area of UI and the actual time spent in UI instruction. A strong relationship (r = .825) was found between the amount of UI specialized training and the confidence to teach the subject. The study's results provide an avenue for the assessment of current PT progran1s' UI curricula in relation to the reported aggregate. Results may encourage research that would compare how recent graduates of these programs evaluate the UI instruction they received with the responses in this research study.
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Date Issued: 2008-04-21
Identifier: fgcu_ETD_0500
Format: Document (PDF)

Title: A UNIQUE APPROACH TO INCREASING PATIENT ADHERENCE THROUGH THE USE OF TRACKABLE TECHNOLOGY: A CASE REPORT.
Creator: Royal, Caitlyn L., Marieb College of Health & Human Services
Abstract / Description: Background and Purpose: This case report reviews the barriers to adherence to home exercise programs (HEPs) and the implementation of trackable technology as a potential solution to promote adherence. It is estimated that nearly two-thirds of patients receiving HEPs from a physical therapist do not adhere to the program or perform exercises as prescribed due to a number of identified barriers. Case Description: The case patient was a 60-year-old, athletic female with a physical therapy...
Show moreBackground and Purpose: This case report reviews the barriers to adherence to home exercise programs (HEPs) and the implementation of trackable technology as a potential solution to promote adherence. It is estimated that nearly two-thirds of patients receiving HEPs from a physical therapist do not adhere to the program or perform exercises as prescribed due to a number of identified barriers. Case Description: The case patient was a 60-year-old, athletic female with a physical therapy diagnosis of right medial meniscus tear. She reported pain with physical activity limiting participation in recreational activities, such as yoga and horseback riding. Intervention: The Mywellness® app allows for seamless integration of the Technogym® Ecosystem of online platforms, allowing health professionals to add and update patient exercises through the use of the web-based portal and cloud technology. This grants patients timely guidance, advice, and motivation to perform their prescribed HEP. Furthermore, the app portal allows the health professional to monitor patient compliance to recommendations and prescribed exercise plans. Outcome: In a five-week episode of care, the case patient completed 7 out of 10 prescribed sessions of her HEP for an adherence rate of 70%. For each completed session (7), the patient demonstrated sufficient adherence of 71.4%, completing all of her prescribed exercises. Technical difficulties occurred during one out of seven sessions. Discussion: Demonstrated by the positive patient outcomes in this case report, trackable technologies such as the Mywellness® app may provide the support and accountability necessary to promote patient adherence to HEPs in an outpatient physical therapy setting. Future research is needed on a larger-scale to conclude if trackable technology produces a positive effect on levels of patient adherence when performing HEPs.
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Date Issued: 2019-04-30
Identifier: fgcu_ETD_0286
Format: Document (PDF)

Title: Analyzing the Effects of Virtual Reality and Treadmill Gait Training Following a Cerebrovascular Accident.
Creator: Shwket, Hadeer, Sauerwald, James R., Marieb College of Health & Human Services
Abstract / Description: Background: Cerebrovascular accidents (CVAs) have an adverse effect on strength, balance, and gait, resulting in a number of functional ambulation deficits. Previous studies indicate that with consistent gait training, participants effectively increase gait velocity, as well as gait assessment functional outcome scores. Purpose: The purpose of this case study was to examine the effects of treadmill gait training with virtual reality (VR) on the functional recovery of gait in a participant...
Show moreBackground: Cerebrovascular accidents (CVAs) have an adverse effect on strength, balance, and gait, resulting in a number of functional ambulation deficits. Previous studies indicate that with consistent gait training, participants effectively increase gait velocity, as well as gait assessment functional outcome scores. Purpose: The purpose of this case study was to examine the effects of treadmill gait training with virtual reality (VR) on the functional recovery of gait in a participant affected by chronic CVA. VR is a computer-simulated, interactive, multi-dimensional environment. The purpose of the VR is to provide normal visual flow (optic flow) while walking in a controlled environment (on a treadmill). Methods: The participant was a 24-year old female who was 13 months post stroke. She participated in the study for 21 sessions over 14 weeks. She went through four sessions of initial assessments followed by gait training sessions and finally two follow up assessments to track changes in her gait. An Oculus head mounted stereoscopic display provided optic flow in the form of virtual environments during gait training on a modified belt-driven treadmill. Physical Therapy students provided facilitation to the participant while gait training on the treadmill with a goal of 30 minutes of continuous ambulation. Data Analysis: The outcomes of the gait training method that were assessed included: motion capture via Qualisys camera system, the Functional Gait Assessment, and the 6-Minute Walk Test. Minimal detectable change, percent changes, and Pearson Correlation Coefficients were calculated to assess significance. Results: The study found improved gait velocity, step length, stride length, cadence, FGA scores, & 6MWT scores throughout the study and also after the intervention ceased. Conclusion: The findings of the study show promise in the integration of virtual reality with treadmill gait training for rehabilitative purposes. However, the results cannot be generalized to larger populations until further research is completed.
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Date Issued: 2017
Identifier: Shwket_fgcu_1743_10243
Format: Document (PDF)

Title: BENEFITS OF PHYSICAL THERAPY INTERVENTIONS IN BARIATRIC HEALTH PROMOTION AND WELLNESS.
Creator: Kirk, Paul Brendan, Marieb College of Health & Human Services
Abstract / Description: Background and Purpose: The prevalence and severity of obesity among the American public is steadily rising. It is well-recognized that increased body mass is a major preventable risk factor for cardiovascular disease, hypertension, type 2 diabetes, stroke, osteoarthritis, certain types of cancer, and a variety of mental health issues such as depression and anxiety. Prevention and treatment therefore focuses on promoting a change in nutritional choices and physical activity. As movement...
Show moreBackground and Purpose: The prevalence and severity of obesity among the American public is steadily rising. It is well-recognized that increased body mass is a major preventable risk factor for cardiovascular disease, hypertension, type 2 diabetes, stroke, osteoarthritis, certain types of cancer, and a variety of mental health issues such as depression and anxiety. Prevention and treatment therefore focuses on promoting a change in nutritional choices and physical activity. As movement specialists and experts in non-invasive health management, physical therapists have a unique opportunity to expand their impact on public wellness by promoting physical activity and exercise, particularly among those affected by elevated body mass and its associated risks. Case Description: The patient was a 28-year old administrative assistant at a health care facility. She expressed interest in receiving consultation to improve her health and learn behaviors that would help her continue to improve her overall wellness beyond the intervention period. Outcomes: After a 22 day intervention period, the subject made improvements in several key areas. Weight decreased by 4 pounds, waist-to-hip ratio decreased from 0.97 to 0.89 (with a drop in waist circumference of 13cm), BMI dropped from 40.4 to 39.5, plank time improved from 11 to 33 seconds, and pectoral flexibility improved by 15o. In addition, the patient showed improvements in self-efficacy, decisional balance, and process of change. Discussion: As specialists of function and movement, physical therapists are in a unique position to offer overweight and obese clients expertise in improving their overall wellness. Customized wellness plans can be developed that maximize the chance of patient success through an understanding of patient motivation and potential barriers to success, especially when taking into account the patient’s psychosocial state of mind. By following closely with patients, plans can be tailored so that the patient can continue to succeed in their wellness goals long after discharge.
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Date Issued: 2016
Identifier: Kirk_fgcu_1743_10197
Format: Document (PDF)

Title: Cannabinoid receptors in the human brain as a pathway as a pathway for the treatment of anxiety, Post-Traumatic stress disorder, and depression.
Creator: Lopez-Whitney, Maria, Marieb College of Health & Human Services
Abstract / Description: Introduction: The endocannabinoid system is widely distributed throughout the brain, with high concentration in areas of mood regulation and emotional processing. This indicates a possible pathway for the treatment of mood disorders, in particular, depression, PTSD, and anxiety.2 This literature review aims to examine and pinpoint possible targets within the endocannabinoid system as a pathway for the treatment of depression, PTSD, and anxiety. Methods: This literature review presents an...
Show moreIntroduction: The endocannabinoid system is widely distributed throughout the brain, with high concentration in areas of mood regulation and emotional processing. This indicates a possible pathway for the treatment of mood disorders, in particular, depression, PTSD, and anxiety.2 This literature review aims to examine and pinpoint possible targets within the endocannabinoid system as a pathway for the treatment of depression, PTSD, and anxiety. Methods: This literature review presents an overview of studies where specific portions of the endocannabinoid system have been tested on either animals or humans as a target in the treatment of PTSD, anxiety, and depression. Discussion: The CB1 receptor has a role in the regulation of depression and anxiety, and the CB1 receptor agonists HU210, rimonabant, and AM251 are promising treatments for depression and anxiety. However, the endocannabinoid degradative pathway FAAH, AEA, and 2-AG are questionable targets in anxiety since certain doses could cause an increase in anxiety.1,4,5 Endocannabinoid system agonist show a promising treatment pathway for PTSD that encompasses the reduction of most symptoms related to the disorder, but only nabilone has been studied. Conclusion: Most studies indicate that using CB1 receptor agonists and the degradative pathway, there is significant reduction in depression and anxiety. However, most of the studies are animal based, which is why there needs to be a transition to human studies in order to develop therapeutic agents. In addition, the role of AEA in anxiety needs to be further researched as a possible pathway with animal studies. Also, while the endocannabinoid agonists show a promising comprehensive treatment for PTSD, more studies must be done to support the role of the endocannabinoid system in the treatment of PTSD.
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Date Issued: 2019-12-16
Identifier: fgcu_ETD_0314
Format: Document (PDF)

Title: Challenging the Testing Protocol of the BOD POD.
Creator: , Griffin, Sierra, , Bengtson, Sarah, Marieb College of Health & Human Services
Abstract / Description: Introduction: The BOD POD uses air displacement plethysmography to determine an individual’s body composition as percentages of fat mass and fat free mass. Based on ethnicity, it uses either the Siri or Shutte equation to calculate body composition via gas laws and the volume of air and pressure differences exerted within a confined space. Objective: The purpose of this study was to determine if the BOD POD protocol, as set forth by Life Measurement, Inc., needs to be followed in its entirety...
Show moreIntroduction: The BOD POD uses air displacement plethysmography to determine an individual’s body composition as percentages of fat mass and fat free mass. Based on ethnicity, it uses either the Siri or Shutte equation to calculate body composition via gas laws and the volume of air and pressure differences exerted within a confined space. Objective: The purpose of this study was to determine if the BOD POD protocol, as set forth by Life Measurement, Inc., needs to be followed in its entirety to ensure validity of body composition results. Our hypothesis was that breaking the established protocol would not have any statistically significant effects on body composition results. This study examined two components of the BOD POD protocol: urination prior to testing and fluid consumption prior to testing. Methods: 32 soccer athletes as a dividion 1 University participants were asked to follow the established pretesting protocol which included refraining from eating or drinking, as well as not exercising four hours prior to testing. An additional stipulation was added that participants refrain from urinating two hours prior to testing to ensure presence of urine content in the bladder upon testing. Four separate measurements of body composition were taken: the first being pre-urination, the second and third followed standard LMI protocol for BOD POD testing, and the fourth consisted of the participants consuming an amount of water equal to 10% of their body weight in ounces of water prior to this final measurement. Results: A Pearson moment correlation ran between the second condition (post urination) and the third condition (post urination retest) yielded a p value =0.977, signifying a good to excellent relationship between the standard test and the retest conditions. Analyses ran comparing the pre-urination test and the post-urination test/retest yielded a p value = 0.322/0.452 respectively, indicating that not urinating prior to testing had little to no effect on the body composition measurement (test/re-test p values = 0.322/0.452 respectively) Interestingly, the act of consuming water did have a significant effect on the results of the body composition measurements (Male/Female p value = 0.002/0.000 respectively). The study results did not support the need to empty the bladder prior to testing while supporting the need to refrain from water consumption directly prior to testing. Discussion: It is thought that excess fluids in the body will be inappropriately categorized as fat mass when using the BOD POD for body composition measurements. The LMI protocol requires participants to urinate prior to testing in attempts to remove any excess fluids that may skew the results of the fat mass versus fat free mass compositions. All participants in this study acknowledged that they followed the no urination for two hours prior to testing requirement. The major finding of the present study was that breaking protocol for BOD POD testing resulted in a significant difference on body composition measurements. Compared with standard protocol testing, consumption of water provided significantly different results in body composition testing (p = 0.002), meanwhile voiding before testing did not have a significant difference (p = 0.322). This is the first study, to our knowledge, that examined the consumption of water and its effects on body composition as measured by the BOD POD, as well as contents of urine in the bladder. Conclusion: It appears that excess fluid in the body and its effects on body composition using ADP, are dependent on fluid location. This study did not support the need to empty the bladder prior to testing while supporting the need to refrain from water consumption directly prior to testing. Future studies may look to determine how much consumed fluid results in a statistically significant difference between body composition measurements. This can be accomplished by measuring the input output ratio to determine if there is a critical level of fluid that should be avoided, and also if there is a time factor to consider when accounting for the interval between consumption and testing.
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Date Issued: 2016-12
Identifier: Griffin_fgcu_1743_10219
Format: Document (PDF)

Title: COMPARISON OF RECOVERY FROM INITIAL CONCUSSION AND SECOND IMPACT: A CASE REPORT.
Creator: Reed, Morgan, Marieb College of Health & Human Services
Abstract / Description: Introduction Post Concussion Syndrome (PCS) occurs when a patient who has sustained a concussion continues to experience symptoms after a seven to fourteen day period.3 It is estimated up to 40% of individuals who sustain a concussion will experience PCS.1,5,6,7,8,9,10 Second impact syndrome (SIS), a phenomena that may occur anytime during the recovery process of a concussion, is defined as an individual experiencing a second blow to the head while recovering from an initial concussion.12...
Show moreIntroduction Post Concussion Syndrome (PCS) occurs when a patient who has sustained a concussion continues to experience symptoms after a seven to fourteen day period.3 It is estimated up to 40% of individuals who sustain a concussion will experience PCS.1,5,6,7,8,9,10 Second impact syndrome (SIS), a phenomena that may occur anytime during the recovery process of a concussion, is defined as an individual experiencing a second blow to the head while recovering from an initial concussion.12 Outcomes from a second impact vary greatly from increased symptoms to functional deficits such as decreased balance and use of limbs to even death.15 Case Patient A fifteen-year-old male presented to the clinic 10 days post initial impact presenting with a combination of cognitive fatigue, oculomotor deficits, and vestibular symptoms. The patient was feeling 100% back to normal when a second impact to his head occurred 24 days post initial impact. Following the second impact the patient again began experiencing concussion symptoms. At 61 days post initial impact, and 37 days post second impact, the patient was feeling 98-99% back to normal and was ready to begin a return to play program through his school. Discussion Though there is little evidence and research regarding SIS and the recovery from a second impact, this case report demonstrates two things: timing between initial impact and second impact may influence recovery and a second impact may cause the loss of or reversal of any recovery from the initial impact. Conclusion Further research is needed to gain a better understanding of how second impacts influence recovery from concussion.
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Date Issued: 2019-03-31
Identifier: fgcu_ETD_0279
Format: Document (PDF)

Title: COMPLEXITIES IN MEASURING HEMISPATIAL NEGLECT: A CASE REPORT COMPARISON OF OBJECTIVE MEASURES IN A PROFESSIONAL BODY BUILDER POST-STROKE.
Creator: Golde, Tyler C., Marieb College of Health & Human Services
Abstract / Description: It is known that the presence of hemispatial neglect is one complication of stroke that causes a greater functional impairment and burden on the patient. Objective measurement of this deficit is an important part of the process of identifying the level of impairment, and being able to then dig deeper for an assessment measure to better realize the level of the deficit. This case report comparison of the line cancellation test and the star cancellation test aims to provide insight on how the...
Show moreIt is known that the presence of hemispatial neglect is one complication of stroke that causes a greater functional impairment and burden on the patient. Objective measurement of this deficit is an important part of the process of identifying the level of impairment, and being able to then dig deeper for an assessment measure to better realize the level of the deficit. This case report comparison of the line cancellation test and the star cancellation test aims to provide insight on how the clinician may tailor their choice of the most appropriate screening tool for neglect. Methods. The Case Report is based on a patient that was seen at Naples Community Hospital, all information was obtained during a single treatment session. He was a middle-aged Croatian male, professional bodybuilder. He presented post right MCA embolus with left sided deficits, and a left hemispatial neglect. During the session, he completed 3 different objective measures in varying testing positions, with uniform verbal directions and prompts. Results. All objective measures were able to be completed. The results of the line cancellation test were abnormal when compared with the previous test scenarios on patients with similar deficits. The difference was that this patient performed better on the line cancellation when in standing (considered the more challenging, i.e. multitasking position). Discussion. A normal response for many patients, on all 3 shown outcome measures, was to perform more poorly (by crossing less items, or marking off further from midline) in the standing position. The assumption for this response was that a patient is more comfortable in a seated position, and can focus more attention to the task, or measure, at hand. It was thought that standing would be difficult, enhancing the patients neglected visual field, causing them to perform more poorly. This patients’ interesting case has given rise to considerations for more detailed talks on how concepts in neuroplasticity, specifically salience and specificity, can affect performance on these measures.
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Date Issued: 2017
Identifier: Golde_fgcu_1743_10220
Format: Document (PDF)

Title: Constraint Induced Movement Therapy as a Physical Therapy Intervention for Pediatric Hemiplegia: a Case Report.
Creator: Murphy, Melissa, Marieb College of Health & Human Services
Abstract / Description: Objective: This case report describes the intervention of constraint induced movement therapy (CI therapy) to improve upper extremity function and hand use in a twenty-five month old child with left hemiplegia. Method: The participant received the recommended CI therapy protocol. Treatment consisted of a uni-valve cast worn on the uninvolved upper extremity for twenty-three hours per day, three hours of intensive therapy in the clinical setting offered five days a week, and a consistent daily...
Show moreObjective: This case report describes the intervention of constraint induced movement therapy (CI therapy) to improve upper extremity function and hand use in a twenty-five month old child with left hemiplegia. Method: The participant received the recommended CI therapy protocol. Treatment consisted of a uni-valve cast worn on the uninvolved upper extremity for twenty-three hours per day, three hours of intensive therapy in the clinical setting offered five days a week, and a consistent daily home exercise program (HEP) for task practice and carryover at home over a three week period. Assessment measures included the upper extremity Pediatric Motor Activity Log (PMAL) and the Pediatric Arm Function Test (PAFT) as pre and post-test measures and PMAL administration daily during the intervention. Results: The child made significant gains in upper extremity use and hand function. Discussion: The findings from this case report suggest that CI therapy can be effectively utilized in the out-patient clinical setting.
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Date Issued: 2015
Identifier: Murphy_fgcu_1743_10109
Format: Document (PDF)

Title: Core Stabilization: Considerations for Physical Therapists Treating Children with Obesity.
Creator: Mikaiel, Joanne Sherie, Marieb College of Health & Human Services
Abstract / Description: Research has established that obese children have decreased core stabilization and balance as compared to normal weight children. The decrease in core stabilization causes obese children to ambulate with a slower walking velocity, longer double leg stance, wider stance width, and a greater degree of asymmetry. This case report details the use of a core strengthening program with a middle school child who was obese and was demonstrating impaired gait mechanics. The child was referred to...
Show moreResearch has established that obese children have decreased core stabilization and balance as compared to normal weight children. The decrease in core stabilization causes obese children to ambulate with a slower walking velocity, longer double leg stance, wider stance width, and a greater degree of asymmetry. This case report details the use of a core strengthening program with a middle school child who was obese and was demonstrating impaired gait mechanics. The child was referred to physical therapy with an acute low back sprain, treatment was focused toward improving her core stabilization to decrease her current low back pain and to improve her gait mechanics. This case provides an example of how providing a core strengthening program to an obese middle school-age child can help improve the impaired gait mechanics found in obese children.
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Date Issued: 2014
Identifier: Mikaiel_fgcu_1743_10076
Format: Document (PDF)

Title: Developing a video learning tool as a learning strategy in the instruction of physical therapy documenatation.
Creator: Kaplan, Michael S., Marieb College of Health & Human Services
Abstract / Description: This project was designed to present an alternative teaching method for documentation in the curriculum for doctorate of physical therapy students. Accurate and detailed documentation is a requirement for communication between health care professionals as well as a means of reimbursement for services provided. Thorough documentation prevents costly medical errors and ultimately improves health care delivery. Current curriculum for documentation consists of case scenarios written in paragraph...
Show moreThis project was designed to present an alternative teaching method for documentation in the curriculum for doctorate of physical therapy students. Accurate and detailed documentation is a requirement for communication between health care professionals as well as a means of reimbursement for services provided. Thorough documentation prevents costly medical errors and ultimately improves health care delivery. Current curriculum for documentation consists of case scenarios written in paragraph format with corresponding lectures. The alternative teaching method presented in this study consists of videos depicting four different evaluation scenarios: shoulder impingement, spinal cord injury (ASIA assessment), low back pain, and plantar fasciitis. Students are asked to watch a video, individually complete the appropriate documentation forms that coincide with that video, and then form small groups to discuss individual findings. Students are also prompted to answer questions at the end of each video. This project offers an integrative approach to documentation instruction by accommodating various student learning styles and by simulating a genuine patient-therapist relationship. This study seeks to prepare physical therapy students in their first year of the doctorate program and increase their knowledge and confidence in documentation skills prior to their first full-time clinical experience.
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Date Issued: 2013
Identifier: fgcu_ETD_0516
Format: Document (PDF)

Title: DRY CUPPING AS A MODALITY IN THE PHYSICAL THERAPY TREATMENT OF A PATIENT WITH CARPAL TUNNEL SYNDROME: A CASE REPORT.
Creator: Lomangino, Fred, Marieb College of Health & Human Services
Abstract / Description: Carpal tunnel syndrome is a musculoskeletal disorder producing a variety of debilitating side effects. The management of carpal tunnel syndrome typically includes splinting, corticosteroid injection and (if severe enough) surgical intervention. Differing techniques have been utilized in the physical therapy treatment of carpal tunnel syndrome, and this case report highlights the use of dry cupping as a modality in the treatment of a patient diagnosed with carpal tunnel syndrome.
Date Issued: 2018-08-02
Identifier: fgcu_ETD_0252
Format: Document (PDF)

Title: EFFECT OF KINESIO ® TAPE ON STABILIZATION AND STRENGTHENING IN PEOPLE WITH CHRONIC ANKLE SPRAINS.
Creator: Shea, Dana Catherine, Lucchesi, Joseph, Marieb College of Health & Human Services
Abstract / Description: Introduction: Kinesio® Tape is an elastic therapeutic tape used for treating a variety of dysfunctions including sports injuries to promote healing, decrease pain, increase range of motion and increase strength according to its creator, Dr. Kenso Kase. It is claimed to provide treatment by lifting the skin and allowing increased blood flow. The aim of this experiment was to measure the effect of KT® Tape on stabilization and strengthening the ankle musculature in those with chronic ankle...
Show moreIntroduction: Kinesio® Tape is an elastic therapeutic tape used for treating a variety of dysfunctions including sports injuries to promote healing, decrease pain, increase range of motion and increase strength according to its creator, Dr. Kenso Kase. It is claimed to provide treatment by lifting the skin and allowing increased blood flow. The aim of this experiment was to measure the effect of KT® Tape on stabilization and strengthening the ankle musculature in those with chronic ankle instability. Methods: Two participants completed a provided strengthening program with one subject using the KT® Tape during the workouts to assess the effect. Ankle stability and peak torque of the ankle evertors was measured prior to and following the strengthening program using the Biodex Balance System SD and Biodex Isokinetic Dynamometer. Results: The results found that the KT® Tape added to a strengthening regime showed greater increase in peak torque of ankle evertors compared to completing the ankle strengthening program alone. Ankle stability however decreased in both the experimental and control group. Conclusion: This study’s results indicate that the KT® Tape has a positive effect on muscle strength, increasing peak torque of the evertors, compared to strengthening program alone, however the experimental group had greater decreased ankle stability overall compared to the control group. This study’s results are limited due to small sample size and requires more research to prove results are legitimate.
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Date Issued: 2018-04-26
Identifier: fgcu_ETD_0231
Format: Document (PDF)

Title: Effect of Running and Swimming on Bone Mineral Density Throughout the Lifespan.
Creator: Valdovinos, Kenna, Millheim, Taylor, Marieb College of Health & Human Services
Abstract / Description: Background: Deterioration of bone density and quality is of serious concern due to the high incidence of fracture in older individuals. As people age and their level of physical activity decreases, too much bone resorption occurs in relation to formation, resulting in overall loss of bone mass and structural integrity. Bone mineral density (BMD) is used as an indirect indicator of risk of osteoporosis and bone fracture. Both swimming and running have been found to have a positive effect on...
Show moreBackground: Deterioration of bone density and quality is of serious concern due to the high incidence of fracture in older individuals. As people age and their level of physical activity decreases, too much bone resorption occurs in relation to formation, resulting in overall loss of bone mass and structural integrity. Bone mineral density (BMD) is used as an indirect indicator of risk of osteoporosis and bone fracture. Both swimming and running have been found to have a positive effect on bone mineral density. A comparison of the effects of swimming and running on bone mineral density in humans has not yet been performed. Objective: The objective of this study was to compare the effects of running and swimming on bone mineral density in young individuals versus mature individuals and to compare intrinsic variables of body weight, height, gender, years swimming or running, distance ran or swam per week, and hours of physical activity per week. Design: This was a quantitative, correlational study that sought to determine whether statistically significant differences in bone mineral density exist between swimmers and runners across the lifespan. Methods: This study included 54 total participants with 12 runners under age 30, 18 runners over age 30, 11 swimmers under age 30, and 13 swimmers over age 30. Heel bone mineral density of each participant was assessed using the GE Achilles Ultrasonometer. Results: No statistically significant difference in bone mineral density existed between swimmers and runners in the young adult or mature adult groups (P = 0.618). Athlete weight was the only factor that had statistically significant differences in bone mineral density. The results do not indicate that the mode of activity (swimming/running) correlates with significantly different findings in BMD. Limitations: The small sample size may decrease statistical power and the ability to generalize these findings to the populations. The degree of causality cannot be determined due to the study’s correlational nature. The mature population who participates in these activities may act as a confounding variable due to their unique characteristics. Conclusions: No correlation between mode of activity and bone mineral density can be established at this time. The results demonstrate that swimming and running have similar effects on bone density. Athlete weight had statistically significant differences in bone mineral density. This indicates that the overall body weight plays a larger role in the formation/maintenance of bone mineral density than activity selection.
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Date Issued: 2019-05-13
Identifier: fgcu_ETD_0293
Format: Document (PDF)

Title: Effects of Exercise in Pulmonary Rehabilitation on a Patient with Uncontrolled Symptomatic Asthma.
Creator: Hernandez, Charles Joseph Farley, Marieb College of Health & Human Services
Abstract / Description: Background and Purpose: This case report describes the efficacy of 5 weeks of pulmonary rehabilitation intervention for a seventy-one-year-old subject with uncontrolled symptomatic asthma. This case reported aimed to investigate functional improvements seen in the individual after completing graded, supervised exercise as a component of pulmonary rehabilitation. Case Description: The patient was referred to pulmonary rehabilitation due to shortness of breath, general deconditioning, and fear...
Show moreBackground and Purpose: This case report describes the efficacy of 5 weeks of pulmonary rehabilitation intervention for a seventy-one-year-old subject with uncontrolled symptomatic asthma. This case reported aimed to investigate functional improvements seen in the individual after completing graded, supervised exercise as a component of pulmonary rehabilitation. Case Description: The patient was referred to pulmonary rehabilitation due to shortness of breath, general deconditioning, and fear of activity. A Six Minute Walk Test was administered before 5 weeks of pulmonary rehabilitation, during which there was a drop of O2 saturation from 98% to 91% on room air, a Rate of Perceived Exertion of 2 and a distance traveled of 336.8 m with no rest breaks at the end of the test. The patient participated in twice weekly pulmonary rehabilitation sessions for a total of 10 sessions in 5 weeks. Each 100-minute session consisted of graded exercise on aerobic exercise equipment along with 10 minutes of light general strengthening and prescheduled mixed-diagnosis patient education class that consisted of a variety of topics. Additionally, patient education on use of a respiratory muscle trainer for 20 minutes a day at home was administered. Outcome: At the post intervention Six Minute Walk Test the patient’s O2 saturation maintained between 98-99% throughout the test, Rate of Perceived Exertion was 0, and distance traveled was 412. 1 m. The patient’s aerobic exercise tolerance improved from 18 minutes to 40 minutes with increased resistance across all modalities and the patient reported a large decrease in the degree that her symptoms affected her quality of life as assessed via outcome questionnaires. The patient had post intervention scores of a 4 out of 120 on the SOBQ, a 4 out of 40 on the CAT, a 1 out of 4 on the MMRC and a 1 out of 27 on the PHQ-9. Discussion: The findings of this case report suggest that graded aerobic exercise is efficacious for severely asthmatic patients and should be considered in conjunction with pharmacotherapy in managing the disease.
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Date Issued: 2019-04-30
Identifier: fgcu_ETD_0284
Format: Document (PDF)

Physical therapy (60)	+ -
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