School of Physical Therapy
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Item A West Texas County Food Insecurity Survey Findings(2020-10-08) Brown, Jay; Huang, Floyd; Brown, Ji'LyndaDespite living in the world’s largest food-producing nation, children and adults face poverty and hunger in every county across America. According to Feeding America [1], more than 38 million Americans are living in poverty. More than 37 million people struggle with hunger in this country, including more than 11 million children. 1 in every 9 Americans are food insecure. The situation is even worse in the state of Texas where 1 in every 7 Texans are food insecure. This makes Texas one of just 15 states with higher food insecurity than the national average [2]. In 2018, The Tom Green County Hunger Coalition (TGCHC) conducted a Food Access Survey (FAS) to help determine areas of need regarding food assistance in the city of San Angelo, Texas. The 328 respondents were divided into two groups (Food Secure and Food Insecure) based on their responses and compared. There were significant differences found between the two groups in regards to their age, household size, housing tenure, access, and assistance.Item Active Video Game Program for People with Type 2 Diabetes- a Pilot Study(2021-11-22) Huang, Han-Hung; Gathright, Brianna; Holik, Rachel; Iverson, Hannah; Saville, Emily; Curtis, Drew A.The objective of this study was to assess the effects of an active video game (AVG) program in physiological parameters, fitness levels, motivation to physical activity, and quality of life on people with type 2 diabetes (T2D). Eight T2D patients participated in the 8-week AVG program using Xbox Kinect and/or Nintendo Wii. Heart rate (HR) and rating of perceived exertion (RPE) were monitored during exercise. Physiological and fitness assessment included hemoglobin A1C (HbA1c), HR, blood pressure (BP), body mass index, body composition, aerobic and muscular endurance, muscular strength, and flexibility. Psychological outcome measures included the Physical Activity Measure-Revised (MPAM-R), Situational Motivation Scale (SIMS), and World Health Organization Quality of Life (WHOQOL)-BREF. Participants demonstrated a moderate level of exercise intensity during AVG based on average HR and RPE. HbA1c, BP, and lower extremity muscle strength were improved, but were not statistically significant. The changes on psychological assessment were not significant. However, most participants demonstrated positive behavior and attitudes toward health and physical activity at one-month follow-up. This pilot study demonstrated that the AVG program might be an effective and alternative way of exercise for people with T2D. A future RCT is warranted to determine the physical and psychological effects of AVG on T2D population.Item Aerobic exercise in people with multiple sclerosis(Consortium of Multiple Sclerosis Centers, 2013) Swank, Chad; Thompson, Mary; Medley, AnnThe aims of this study were to explore the feasibility of structured aerobic exercise followed by a period of unstructured physical activity and determine the impact of such exercise on cognition, mood, and quality of life in people with multiple sclerosis (MS). A convenience sample of 9 individuals with relapsing-remitting MS performed 30 minutes of aerobic exercise (upper- and lower-extremity ergometry and treadmill ambulation) twice weekly for 8 weeks, followed by 3 months of unstructured physical activity. Eight participants completed the intervention and posttest; 6 returned for the 3-month follow-up. Cardiovascular fitness, cognition, mood (measured with the Beck Depression Inventory–II; BDI-II), and quality of life (measured with the Multiple Sclerosis Quality of Life–54; MSQOL-54) were assessed. Participants completed 27.9 minutes of exercise per session, with an 85.1% attendance rate. Evaluation using the Wilcoxon signed rank test revealed no deleterious effects and improved results on the BDI-II and MSQOL-54 mental subscale. Analysis of change scores using the one-sample t test revealed that the BDI-II and MSQOL-54 were changed from zero after structured exercise, but only the BDI-II maintained improvement after unstructured physical activity. Further analysis of BDI-II subscales revealed that improvement occurred only in the Somato-Affective subscale. In this study, program feasibility was demonstrated in several ways. There were no declines in cognitive function over the 5-month period. Despite unchanged cognitive function, participants may value the improved mood enough to continue both the structured and unstructured physical activity. The role of unstructured physical activity in concert with periodic structured exercise programs merits further investigation.Item Autonomic nervous system assessment in people with HIV: A cross-sectional study [version 1; peer review: 1 not approved](F1000Research, 2018-06) Rosario, Martin; Gonzalez-Sola, MaryviBackground: People diagnosed with HIV may exhibit orthostatic hypotension (OH) as a result of the infection and of secondary effects of medications. Such impairments are attributed to autonomic nervous system (ANS) deficits. The purpose of this study was to assess OH during a balance sensory condition test (SCT) and evaluate the role of the cardiac autonomic system, regarding blood pressure (BP) and heart rate (HR), during this balancing task. We hypothesized that BP and heart rate would rise with an increase in postural instability, thus revealing OH. Methods: Eight individuals diagnosed with HIV were recruited from a community health center in the area of San Juan, Puerto Rico. BP and HR were measured after 5 minutes of sitting, immediately after standing up and 1 minute after this, during the SCT. A t-test was used to assess the difference between BP in sitting, BP in standing, and BP while performing the SCT. HR was also evaluated the same way. Results: There was an increase of more than 10 mmHg in systolic BP (SBP) from sitting compared to standing while performing the SCT (p≤0.01). Likewise, HR and SBP standing versus standing during the SCT increased significantly (p≤0.01). Conclusion: The results of this study show that the ANS may be impaired in people with HIV.Item Balance as an assessment of health-related quality of life in people living with HIV(Universidad de Alicante, 2019) Quiles, Norberto N.; Rosario, Martin; Ortiz, AlexisBackground: Balance and cognitive decline are impairments in people living with HIV (PLWH). These impairments predispose to fall-related injuries, affecting health-related quality of life (HRQoL). This study assessed standing balance and cognition after a three-month fitness program and its relationship to HRQoL.Item Body position affects ultrasonographic measurement of diaphragm contractility(Wolters Kluwer Health, Inc., 2018-10) Brown, Christopher; Tseng, Shih-Chiao; Mitchell, Katy; Roddey, ToniPURPOSE: (1) Determine whether ultrasonography can detect differences in diaphragm contractility between body positions. (2) Perform reliability analysis of diaphragm thickness measurements in each test condition.Item Can a simulated hospital interprofessional experience between Allied Health and nursing students change self-efficacy beliefs?(2023) Lohman, Alicia F.; Flynn, Stacy; Aulbach, Rebecca; Brewer, WayneThe purpose of this study was to determine if participation in a hospital simulation experience could change the students’ self-efficacy to engage in interprofessional behaviors. This single-group pre-test and post-test design study utilized students from: Occupational Therapy, Physical Therapy, and Nursing programs. The student assumed their roles as health-care practitioners collaboratively in a simulated hospital IPE session (SHIPES) while they managed patients admitted to the hospital played by live actors. The student participants completed the Self-Efficacy for Interprofessional Experiential Learning (SEIEL) questionnaire that consists of a total score and two subscales scores (Interprofessional interaction and Interprofessional team evaluation and feedback) before and after the SHIPES. Results: significant (p<0.001) increase in the total and two subscales scores indicating an increased student self-efficacy to engage in interprofessional learning after participation in the SHIPES. Increased self-efficacy is a positive indicator of future behavior and could facilitate more interprofessional collaboration in clinical settings.Item Cardiovascular Responses in Physically Elderly Active People Living with HIV(2023-07-27) Rosario, Martin G.; Kidwell, McKenzie; Nelson, NicoleCardiovascular system (CVS) problems are one of the various complications in people living with HIV (PLHIV). In PLHIV, the CVS' capacity to adapt to activities is inadequate. Purpose: To distinguish the responses of the CVS to a step test in physically active PLHIV. Results: Significant differences between resting HR and HR after the step test were identified, while there was no significant difference between recovery HR and HR at 76% capacity. Additionally, all cardiovascular measurements were significantly higher than the recovery heart rate. Conclusion: It appears that physically active participants are experiencing some degree of autonomic dysfunction. However, physical activity seems to help slow down common CV effects.Item Characteristics of lower extremity muscle activation in response to change in inclination while walking on a treadmill(EJ-SPORT, 2022) Orozco, Elizabeth; Joslin, Hannah; Blumenthal, Katelyn; Rosario, MartinTreadmill walking is a popular form of exercise that offers many benefits to its users, such as improvements in cardiovascular health and gait patterns. Few research studies have explored muscle activation of various lower extremity joints at different levels of inclination on a treadmill. Therefore, this study aims to further characterize muscle activation during gait in healthy individuals in response to changes in treadmill inclination at a constant speed. Twenty healthy participants (24.5 ± 4.3 years of age) were recruited for this study. Participants were instructed to walk on a treadmill at six different inclines (0%, 3%, 6%, 9%, 12%, and 15%) while maintaining a constant speed of 3.4 mph. Muscle activation of the tibialis anterior (TA), gastrocnemius (GA), gluteus maximus (GMAX), gluteus medius (GMED), vastus medialis (QUADS), and biceps femoris (HS) were collected using surface EMG. There were slight differences in muscle activation between the muscle groups during the various intervals. However, there were no significant differences between muscle groups. The results revealed that the extensor muscles (GA, HS, and GMAX) of the lower extremity showed trends of longer activation periods with an increase in inclination. This study found that as inclination increases, activation of the extensor muscles of the lower extremity also increases while walking on a treadmill. The findings of this study will serve as a baseline for research to compare populations with known gait impairments, such as individuals with HIV, post-stroke, or the elderly, to better understand EMG analysis leading to gait deviations or abnormalities with neuromuscular activation.Item Comparison of eccentric and concentric exercise interventions in adults with Subacromial Impingement Syndrome(North American Sports Medicine Institute, 2015-08) Blume, Christiana; Wang-Price, Sharon; Trudelle-Jackson, Elaine; Ortiz, AlexisBACKGROUND: Researchers have demonstrated moderate evidence for the use of exercise in the treatment of subacromial impingement syndrome (SAIS). Recent evidence also supports eccentric exercise for patients with lower extremity and wrist tendinopathies. However, only a few investigators have examined the effects of eccentric exercise on patients with rotator cuff tendinopathy.Item Comparison of three diabetes risk screening tools among Non-Hispanic Asian Indian Americans: Ada Drt, MDRF IDRS and HbA1c(Gexin Publications, 2022) Patel, Rupal M.; Misra, Ranjita; Bickley, Christina; Mitchell, KatyThe purpose of this study was to compare the relationship between two non-invasive screening tools, the American Diabetes Association Diabetes Risk Test (ADA DRT) and the Madras Diabetes Research Foundation Indian Diabetes Risk Score (MDRF IDRS), with glycated hemoglobin (HbA1c) to determine which tool best predicted HbA1c in Asian Indian Americans. Among Asian Americans, Asian Indian Americans have the highest prevalence of Type 2 diabetes (12.6%). Furthermore, they have a unique genetic predisposition as well as cultural and religious lifestyle practices that may contribute to increased risk. Type 2 diabetes screening tools do not address the unique risk characteristics of Asian Indian Americans. We used clinical and survey data from our previous longitudinal study with a convenience sample of adult Asian Indian Americans (n = 70) selected from a community setting. Following the consenting procedure, all participants completed the ADA DRT and MDRF IDRS questionnaires to identify their diabetes risk. After the initial screening, individuals with an MDRF IDRS score of 50 or above (n = 70) were tested for HbA1c within a month. For this, trained volunteers collected capillary blood using standardized protocol. Descriptive statistics were calculated along with Spearman correlations, Chi-Square test of independence, and linear regressions at an alpha level set at p = .05. A significant, positive relationship (rs = .30, p = .01) was found between the MDRF IDRS score and HbA1c. A positive but weak relationship was also found between ADA DRT and HbA1c (rs = .23). The MDRF IDRS was a better predictor of diabetes risk in Asian Indian Americans than ADA DRT. The MDRF IDRS is a validated, simple, low-cost tool for the detection of diabetes risk in high-risk Asian Indian Americans. Hence, it is a good tool to use for community screenings and patient education for the prevention and management of the risk of Type 2 diabetes.Item A comparison of work-related physical activity levels between inpatient and outpatient physical therapists: An observational cohort trial(BMC, 2016-06-16) Brewer, Wayne A.; Ogbazi, Raluchukwu; Ohl, Devan; Daniels, Jeffry; Ortiz, AlexisBackground: Physical therapists (PTs) work in a variety of healthcare settings with varied levels of physical activity demands placed on them. The purpose of this study is to compare the physical activity (PA) levels between PTs in inpatient versus outpatient environments for one work week using a cross-sectional design. Methods: Sixty-one PTs (30 inpatient, 31 outpatient) wore a tri-axial accelerometer and inclinometer for one work-week. The number steps-per-day, PA intensities, energy expenditures and postural positions adopted during the work day were recorded. Result: Significantly longer amounts of time spent sitting was found for inpatient PTs regardless of the significantly higher number of steps-per-day. Outpatient PTs had a higher number of breaks from sedentary activity with those breaks being longer than the inpatient PTs. The percentage of time spent performing moderate-vigorous PA approached significance implying more time was spent performing these types of activities for outpatient PTs. The energy expenditures between the two groups of PTs were not different. Conclusion: This study compared the differences in physical activity levels between physical therapists who worked at inpatient versus outpatient environment as little is known about their activity levels. Inpatient physical therapists took more steps per day than outpatient physical therapists but the outpatient physical therapists were less sedentary and took more frequent and longer breaks from sedentary activities. The energy expenditures were similar between both types of therapists and this may be reflective of the gender and bodyweight differences between the groups that equalizes the energy expenditures. The findings of this study suggests that there are differences in the physical activity demands between inpatient and outpatient physical therapists. The results of this study may serve dual purposes: (1) employers may be able to more accurately describe the expected physical activity demands to future employees; (2) individuals tasked with preparing PTs to physically manage their work environment can outline training programs that are diverse based on the specific work environment of PTs.Item Constant resistant at different speeds while pushing a sled prompts different adaptations in neuromuscular timing on back and lower limb muscles(Asian Research Association, 2022) Rosario, Martin G.; Keitel, Kelly; Meyer, Josey; Weber, MarkResistance training (RT) is commonly used to target specific weakened muscle groups. Among the plethora of methods employed as RT, the current study focused on a sled that provides constant resistance proportional to speed. This study aimed to examine neuromuscular patterns of the lower extremity and trunk muscles in response to pushing a sled with constant resistance at two different speeds. Twenty-six young adults (average age, 23.8) participated in this study. Surface electromyography electrodes were placed on gluteus maximus (GMAX), gluteus medius (GMED), tibialis anterior (TA), gastrocnemius (GA), and erector spinae (lumbar and thoracic) of their dominant leg or side (unilateral at the same side as the dominant lower limb). Neuromuscular timing was collected during four tasks: walking, running, walking-pushing the sled (WP), and running-pushing the sled (RP). All gait activities were repeated twice, with self-selected speed and an equivalent distance of 40 feet. A MANOVA analysis showed that during WP, GMED and GMAX showed more neuromuscular recruitment than leg and trunk muscles when compared to walking. During RP, the thoracic musculature was significantly more involved than any other muscle during running. Based on our findings, we recommend that physiotherapists and trainers use this sled with constant resistance during walking in patients with pelvic or hip weakness. Further, we suggested utilizing the sled in subjects requiring mid-trunk activation at faster speeds, such as fast walking or running.Item Determination of the effectiveness of a community based exercise program, Tai Chi, for people with multiple sclerosis, a pilot program(Open Access Text, 2016-04-28) Csiza, Linda; Medley, AnnBACKGROUND: Multiple Sclerosis (MS) a progressive demyelinating disease of the central nervous system affects 2,300,000 people worldwide. Impaired balance is seen in up to 75% of individuals with MS which can lead to falls and further disability. Tai Chi, a form of martial arts, involves slow controlled movements and deep breathing. The physical benefits of Tai Chi include improved balance and flexibility.Item Differences in insulin biosynthesis pathway between small and large islets do not correspond to insulin secretion(2016-02-16) Huang, Han-Hung; Stehno-Bittel, LisaIn a variety of mammalian species, small islets secrete more insulin per volume than large islets. This difference may be due to diffusional limitations of large islets, or inherent differences in the insulin production pathways. The purpose of this study was to identify possible differences in the early phase of glucose-stimulated insulin biosynthesis between large and small islets. Isolated small and large rat islets were challenged with 30 minutes of high glucose. The expression of insulin gene transcription factors (MafA, NeuroD/ Beta2, and PDX-1), preproinsulin mRNA, proinsulin and insulin were compared between large and small islets. Under basal (low glucose) conditions, MafA and NeuroD had higher mRNA levels and greater protein amounts in large islets compared to small when normalized to GAPDH levels. 30 minutes of high glucose stimulation failed to alter the mRNA or subsequent protein levels of either gene. However, 30 minutes of high glucose suppressed activated PDX-1 protein levels in both small and large islets. High glucose stimulation did not statistically alter the preproinsulin mRNA (insulin 1 and insulin 2) levels. At the translational level, high glucose increased the proinsulin levels, and large islets showed a higher proinsulin content per cell than small islets. Insulin content per cell was not significantly different between small and large islets under basal or high glucose levels. The results fail to explain the higher level of insulin secretion noted in small versus large islets and may suggest that possible differences lie downstream in the secretory pathway rather than insulin biosynthesis.Item Differences in temporal gait parameters when walking on even surface walkway, treadmill, and pushing a constant resistant sled(Asian Research Association, 2022) Rosario, Martin G.; Orozco, ElizabethMotorized treadmills and weighted sleds are employed in clinical settings to improve lower extremity strength, power, and endurance. However, little is known about how the spatio-temporal parameters compare when walking on an even surface walkway, walking on a treadmill, or pushing a sled. This study aimed to examine the variations in spatial and temporal gait parameters when walking on an even surface walkway (EW), on a treadmill (TW), and while pushing a sled (SP). Forty healthy subjects participated in this pilot study. The mean age and BMI of all participants were 24.39 (± 2.86) years and 68.26 (± 13.92) kg/m^2, respectively. Spatio-temporal parameters were gathered using the Mobility Lab ADPM software and six sensors containing accelerometers and gyroscopes. Participants were directed to walk at a normal and comfortable speed for 7 m on an even surface walkway for two trials. Next, the subjects walked on the treadmill for two trials at a speed basedon age. For males aged <30 and females 20-40 years of age, the speed was 1.3 m/s. While for males aged 30 or older, the speed was set to 1.4 m/s. Finally, participants were instructed to walk at their normal pace while pushing a 60 lb sled for 9.1 meters (m). Treadmill walking provoked a significant increase in temporal variables, whereas pushing a sled significantly reduced the temporal variables. Treadmill walking resulted in a decrease in double limb support time and an increase in single-limb support time compared with even surface walking. Although cadence was greater when walking on a treadmill versus an even surface walkway, the difference may be attributed to a fixed speed on the treadmill, which was determined by age. Treadmill gait training is recommended for subjects that could benefit from an increase single limb support time to improve dynamic balance such as Parkinson patients. On the other hand, for those participants that dynamic activities are challenging, such as concussion and vestibular patients, pushing the sled will slow down gait parameters allowing gait training with an added resistance benefit. Finally, it has been proposed that further investigation should focus on the differences in lower extremity muscle activation and recruitment patterns under various walking conditions.Item Do muscle strength deficits of the uninvolved hip and knee exist in young athletes before anterior cruciate ligament reconstruction?(SAGE, 2017) Hannon, Joseph; Wang-Price, Sharon; Goto, Shiho; Garrison, J. Craig; Bothwell, James M.Background: Muscle strength of the involved limb is known to be decreased after injury. Comparison with the uninvolved limb has become standard of practice to measure progress and for calculation of limb symmetry indices (LSIs) to determine readiness to return to sport. However, some literature suggests strength changes in the uninvolved limb also are present after lower extremity injury.Item Does a customized musical song promote a more positive experience vs. rhythmic auditory stimulation when used to enhance walking for people with Parkinson's Disease?(World Federation of Music Therapy, 2019) Barta, Kristen; Da Silva, Carolyn P.; Tseng, Shih-Chiao; Roddey, ToniExternal auditory cueing has been shown to improve gait for individuals with Parkinson’s disease (PD). Rhythmic Auditory Stimulation (RAS) uses a fixed beat while other strategies rely on a musical composition. Despite the extensive research on mobility with auditory cues, there has been little research that addresses the perceived benefits of music and the preferred method of stimulation. The Synchronized Optimization Auditory Rehabilitation (SOAR) tool is a new approach to simulate auditory cueing in the form of music. The purpose of this study was to answer the question, “Do participants report a higher level of satisfaction and motivation when using the SOAR tool as compared to RAS or no auditory cue during ambulation?” Participants ambulated with no auditory cueing, metronome, and music customized by the SOAR tool. The investigator asked open-ended questions during a semistructured face-to-face interview session with each participant after the training. All participants preferred music to RAS and felt music best impacted walking. The emerging themes were auditory effects and utility that included the subthemes of motor impact, nonmotor impact, and issues within the testing and home environment. The perception was that music contributed to improved spatio-temporal parameters, balance, coordination, motivation, and happiness.Item Dual-motor balance tasks prompts slight lower limb neuromuscular adaptations in healthy young adults(Conscientia Beam, 2022) Rosario, Martin G.; Smith, Tavia; Buckingham, SuzannaPrevious literature has analyzed muscular recruitment patterns in various populations during complex balance conditions that involve a secondary task. This inquiry seeks to determine whether challenging sensory systems in young adults during single and dual-motor tasks can prompt modifications in neuromuscular patterns at the hip and leg musculature. Our study included twenty-nine healthy young adults (3 males and 25 females) with an average age of 24.3+/-2.4. Electromyography (EMG) electrodes were used to collect EMG data, and the variables of interest include the onset of muscle contraction, the decay of muscle contraction, peak muscle activation, and duration of muscle contraction. Five balance activities were conducted while performing a dual-motor task, while sensory input was altered in each condition. No significant changes in EMG activity were observed in the gastrocnemius (GA) and (TA)muscle activity. However, a tendency was observed in the onset and duration values of the gluteal muscles. Recruitment of the TA andGA remained uniform across variables, but gluteus maximus (GMax) and medius (GMed) activity appeared sooner (onset) and lasted longer (duration). Comparability in muscle recruitment during dual-task balance activities indicates healthy young adults can successfully rely on other sensory systems for balance when one or more networks are altered. Increases in GA and TA activitysuggested a greater need for ankle strategies during the condition trials, while increased GMax and GMed activity indicated the samefor hip strategies. Further research should examine joint kinematic to discern any adaptations during dual-motor tasks in young, healthy adults.Item Eccentric/concentric torque deficits in the quadriceps muscle(The Journal of Orthopaedic & Sports Physical Therapy®, Inc. (JOSPT®), 1989-10-01) Trudelle-Jackson, Elaine; Meske, Neil; Highgenboten, Carl; Jackson, AllenThe purpose of the present investigation was to estimate the percentage of asymptomatic subjects who demonstrate an eccentric/concentric torque deficit in leg extension. One hundred and five subjects with a mean age of 23.51 were tested on the KIN-COM® dynamometer for maximum eccentric and concentric torque during leg extension using an 80° range of motion at 50°/sec velocity. The subjects were categorized as demonstrating a deficit if at any point in the range of motion the eccentric torque was 85% or less of the corresponding concentric torque. The results revealed that 35–54% of the subjects, depending upon sex or leg tested, demonstrated a deficit. These results suggest that many asymptomatic individuals possess an eccentric/concentric torque deficit. These findings question the validity of previous clinical research indicating that patients with anterior knee pain tend to possess an eccentric/concentric torque deficit and that correction of the deficit alleviates the pain.