JUST ACCEPTED: “The Human Movement System in Neurologic Physical Therapy”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“The Human Movement System in Neurologic Physical Therapy”
By
Edelle Field-Fote, PT, PhD, FAPTA

Provisional Abstract:

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JUST ACCEPTED: “The Impact of Supervision and Setting when Using the Ability Boot Camp Program for Individuals with Parkinson’s Disease”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“The Impact of Supervision and Setting when Using the Ability Boot Camp Program for Individuals with Parkinson’s Disease”
By
Kirsten Potter, DPT; Marissa Clarke, MPT

Provisional Abstract:

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JUST ACCEPTED: “The effect of binocular vision abnormalities on visual vertigo symptoms and treatment outcome”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“The effect of binocular vision abnormalities on visual vertigo symptoms and treatment outcome”
By
Marousa Pavlou, BA, PhD; James Acheson, MRCP (UK) FRCS (Glas) FRCOphth; Despina Nicolaou, BMedSci (Hons), MMedSci Orthoptics; Adolfo M Bronstein, MD PhD FAAN FRCP; Rosalyn A Davies, FRCP PhD; Clare Fraser, MBBS (Hons), MMed, FRANZCO

Provisional Abstract:
Background and Purpose: Customized vestibular rehabilitation incorporating optokinetic (OK) stimulation improves visual vertigo (VV) symptoms; however, the degree of improvement varies between individuals. Binocular vision abnormalities (misalignment of ocular axis i.e. strabismus) may be a potential risk factor. This study aimed to investigate the influence of binocular vision abnormalities on VV symptoms and treatment outcome. Methods: Sixty subjects with refractory peripheral vestibular symptoms were invited for an orthoptic assessment after being recruited for participation in an 8-week customized program incorporating OK training via a full-field visual environment rotator or DVD, supervised or unsupervised. Treatment response was assessed at baseline and 8-weeks with dynamic posturography, Functional Gait Assessment (FGA), and questionnaires for symptoms, symptom triggers, and psychological state. As no significant effect of OK training type was noted for any variables, data was combined and new groups identified based on the absence or presence of a binocular vision abnormality. Results: 34/60 subjects consented to the orthoptic assessment of which 8/34 had binocular vision abnormalities and 30/34 subjects completed both the binocular function assessment and vestibular rehabilitation program. No significant between-group differences were noted at baseline. The only significant between-group difference was observed for pre-post VV symptom change (p=.01) with significant improvements noted only for the group without binocular vision abnormalities (p<.0005). Common vestibular symptoms, posturography, and the FGA improved significantly for both groups (p<0.05). Discussion: Binocular vision abnormalities may affect VV symptom improvement. Conclusion: These findings may have important implications for the management of subjects with refractory vestibular symptoms.(see Video, Supplemental Digital Content 1, which presents the clinical implication of the study findings).

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JUST ACCEPTED: “Barnes and Leahy Promotion of Doctoral Studies (PODS) 2015 Awards”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“Barnes and Leahy Promotion of Doctoral Studies (PODS) 2015 Awards”
By
Edelle Field-Fote, PT, PhD, FAPTA

Provisional Abstract:

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JUST ACCEPTED: “Effectiveness of Exercise Programs for Management of Shoulder Pain in Manual Wheelchair Users with Spinal Cord Injury: A Systematic Review”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“Effectiveness of Exercise Programs for Management of Shoulder Pain in Manual Wheelchair Users with Spinal Cord Injury: A Systematic Review”
By
Kimberle A. Cratsenberg, P.T., D.P.T.; Cassandra E. Deitrick, P.T., D.P.T.; Taylor K. Harrington, P.T., D.P.T.; Natasha R. Kopecky, P.T., D.P.T.; Bradley D. Matthews, P.T., D.P.T.; Lauren M. Ott, P.T., D.P.T.; Remy R. Coeytaux, M.D., Ph.D.

Provisional Abstract:
Background/Purpose: Shoulder pain is prevalent in manual wheelchair users (MWUs) with spinal cord injury (SCI). Therapeutic exercise has been demonstrated to be an effective, conservative approach to treating shoulder pain in able-bodied individuals. We sought to evaluate literature on the effectiveness of exercise programs on the reduction of shoulder pain in MWUs with SCI.

Methods: We searched the literature using search terms related to SCI, manual wheelchairs, and shoulder pain. Eligibility criteria included: prospective study design, exercise intervention for MWUs with shoulder pain, and use of the Wheelchair User’s Shoulder Pain Index (WUSPI) as an outcome measure. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and assessed study quality using the checklist proposed by Downs and Black.

Results: Three randomized control trials and four cohort studies met inclusion criteria. Two studies were rated as good quality and five as fair quality. Three interventions were evaluated in the included studies: arm ergometry, resistive strengthening with or without EMG biofeedback, and stretching that targeted the shoulder girdle. Across the seven studies, the exercise intervention was associated with reduction in shoulder pain that exceeded the estimated minimal detectable change of 5.10 points for the WUSPI.

Discussion/Conclusion: Exercise is a feasible, conservative, therapeutic intervention for the treatment of shoulder pain among MWUs. Additional studies are needed to differentiate techniques for the reduction of shoulder pain, to determine the most effective duration of intervention, and to estimate the magnitude of effect associated with therapeutic exercise for shoulder pain among MWUs.

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JUST ACCEPTED: “Predicting Heart Rate at the Ventilatory Threshold for Aerobic Exercise Prescription in Chronic Stroke”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“Predicting Heart Rate at the Ventilatory Threshold for Aerobic Exercise Prescription in Chronic Stroke”
By
Pierce Boyne, PT, DPT, NCS; Sarah Buhr; Bradley Rockwell; Jane Khoury; Daniel Carl; Myron Gerson; Brett Kissela; Kari Dunning

Provisional Abstract:
Background and Purpose. Treadmill aerobic exercise improves gait, aerobic capacity and cardiovascular health after stroke, but a lack of specificity in current guidelines could lead to underdosing or overdosing of aerobic intensity. The ventilatory threshold (VT) has been recommended as an optimal, specific starting point for continuous aerobic exercise. However, VT measurement is not available in clinical stroke settings. Therefore, the purpose of this study was to identify an accurate method to predict heart rate at the VT (HRVT) for use as a surrogate.
Methods. A cross-sectional design was employed. Using symptom-limited graded exercise test (GXT) data from 17 subjects >6 months post stroke, prediction methods for HRVT were derived by traditional target HR calculations (%HRpeak achieved during GXT, %Peak-HR reserve [%HRRpeak], %Age-predicted maximal HR, %Age-predicted maximal HR reserve) and by regression analysis. The validity of the prediction methods was then tested among 8 additional subjects.
Results. All prediction methods were validated by the second sample, so data were pooled to calculate refined prediction equations. HRVT was accurately predicted by 80% HRpeak (R², 0.62; standard deviation of error [SDerror], 7 bpm), 62% HRRpeak (R², 0.66; SDerror, 7 bpm) and regression models that included HRpeak (R², 0.62-0.75; SDerror, 5-6 bpm).
Discussion and Conclusions. Derived regression equations, 80% HRpeak and 62% HRRpeak provide a specific target intensity for initial aerobic exercise prescription that should minimize underdosing and overdosing for persons with chronic stroke. The specificity of these methods may lead to more efficient and effective treatment for post-stroke deconditioning.

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JUST ACCEPTED: “Effects of group, individual and home exercise in Parkinson’s disease: a randomized clinical trial”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“Effects of group, individual and home exercise in Parkinson’s disease: a randomized clinical trial”
By
Laurie King, PhD, PT; Jennifer Wilhelm, DPT; Yiyi Chen, PhD; Ron Blehm, DPT; John Nutt, M.D.; Zunqiu Chen, M.S.; Andrea Serdar, PT; Fay B Horak, PT, PhD

Provisional Abstract:
Background and Purpose: Comparative studies of exercise interventions for people with Parkinson Disease (PD) rarely consider how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by 1) home exercise program, 2) individualized physical therapy, or 3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention.

Methods: Fifty-eight people (age 63.9 ± 8) with PD participated. People were randomized into: 1) home exercise program 2) individual physical therapy or 3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test (PPT). Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS motor and ADL scores were included.

Results: Only the individual group significantly improved in PPT. The individual exercise showed the most improvements in functional and balance measures, while the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group.

Discussion and Conclusions: An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist.

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JUST ACCEPTED: “Neurorehabilitation strategies that focus on the ankle may improve the mobility and posture of individuals with multiple sclerosis”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“Neurorehabilitation strategies that focus on the ankle may improve the mobility and posture of individuals with multiple sclerosis”
By
Brenda L Davies; David J Arpin; Kathleen G Volkman; Bradley Corr; Heidi Reelfs; Regina T Harbourne; Kathleen Healey; Rana Zabad; Max Kurz, PhD

Provisional Abstract:
Background: The neuromuscular impairments seen in the ankle plantarflexors have been identified as a primary factor that limits the mobility and standing postural balance of individuals with multiple sclerosis (MS). However, few efforts have been made to find effective treatment strategies that will improve the ankle plantarflexor control.
Objective: To determine whether an intensive 14-week neurorehabilitation protocol has the potential to improve the ankle plantarflexor control of individuals with MS. The secondary objectives were to determine whether the protocol would also improve postural control, plantarflexion strength, and mobility.
Methods: Fifteen individuals with MS participated in a 14-week neurorehabilitation protocol and 20 healthy adults acted as controls. The primary measure was the amount of variability in the submaximal steady-state isometric torque which assessed plantarflexor control. Secondary measures were the Sensory Organization Test composite score, maximum plantarflexion torque, and the spatiotemporal gait kinematics.
Results: There was less variability in the plantarflexion torques after the neurorehabilitation protocol. In addition, there was less postural sway, greater plantarflexion strength, and faster walking speeds. All of the outcome variables matched or trended towards those seen in the controls.
Conclusions: The outcomes of this exploratory investigation suggests that the neurorehabilitation protocol employed in this investigation has the potential to promote clinically relevant improvements in the ankle plantarflexor control, standing postural balance, ankle plantarflexion strength, and the mobility of individuals with MS (see Video, Supplemental Digital Content 1. Video Abstract).

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JUST ACCEPTED: “Physical fitness assessment across the disability spectrum in multiple sclerosis: A comparison of testing modalities”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“Physical fitness assessment across the disability spectrum in multiple sclerosis: A comparison of testing modalities”
By
Lara Pilutti, PhD; Brian Sandroff; Rachel Klaren; Yvonne Learmonth; Matthew Platta; Elizabeth Hubbard; Michelle Stratton; Robert Motl

Provisional Abstract:
Background and Purpose: Appropriate assessment of physical fitness (i.e., aerobic capacity and muscular strength) is necessary for the design and evaluation of exercise training in multiple sclerosis (MS). However, this is challenging in persons with substantial disability, due to physical inaccessibility and insensitivity of certain exercise testing modalities. This study compared different methods of measuring cardiorespiratory (arm ergometer vs. recumbent stepper) and muscular (hand held dynamometry vs. computerized dynamometry) fitness across the multiple sclerosis (MS) disability spectrum. Associations between physical fitness and other measures that represented all domains of the International Classification of Functioning, Disability and Health (ICF) were also examined.

Methods: 64 participants with MS completed two symptom-limited cardiorespiratory fitness and muscular strength tests. We also assessed disability, cognition, fatigue, walking speed and endurance, health-related quality of life, and activities of daily living.

Results: Peak aerobic capacity assessed by recumbent stepping was higher compared with arm ergometry (p<.001). Peak torque of the knee extensors and knee flexors was significantly higher assessed by computerized dynamometry compared to hand held dynamometry (p<.001). Aerobic capacity and peak torque decreased as a function of increasing disability (p<.001).
Significant, moderate-to-strong correlations were observed between the physical fitness measures and measures representing all domains of the ICF, irrespective of the fitness testing mode.

Discussion and Conclusions: Overall, peak physical capacity was higher when assessed by recumbent stepping and computerized dynamometry. The assessment and prescription of exercise in MS should be based on these modalities to provide the most appropriate stimulus for exercise training adaptations. There continues to be an important association between physical fitness and other measures that represent all domains of the ICF, regardless of fitness assessment mode.

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JUST ACCEPTED: “2015 Neurology Section Election Results”

The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:

“2015 Neurology Section Election Results”
By
Edelle Field-Fote, PT, PhD, FAPTA

Provisional Abstract:

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