PURPOSE/BACKGROUND: Cryotherapy is commonly used in physical therapy with many known benefits; however several investigations have reported decreased functional performance following therapeutic application thereof. The purpose of this study was to determine the effect of cryotherapy applied to the ankle on static and dynamic standing balance. It was hypothesized that balance would be decreased after cryotherapy application. METHODS: Twenty individuals (aged 18 to 40 years) participated in this research project. Each participant was tested under two conditions: an experimental condition where subjects received ice water immersion of the foot and ankle for 15 minutes immediately before balance testing and a control condition completed at room temperature. A Biodex® Balance System was used to quantify balance using anterior/posterior (AP), medial/lateral (ML), and overall balance indices. Paired t-tests were used to compare the balance indices for the two conditions with alpha set at 0.05 a priori. Effect size was also calculated to account for the multiple comparisons made. RESULTS: The static balance indices did not display statistically significant differences between the post-cryotherapy and the control conditions with low effect sizes. Dynamic ML indices significantly increased following the cryotherapy application compared to the control exhibiting a moderate effect size indicating decreased balance following cryotherapy application. No differences were noted between experimental and control conditions for the dynamic AP or overall balance indices while a small effect size was noted for both. CONCLUSIONS: The results suggest that cryotherapy to the ankle has a negative effect on the ML component of dynamic balance following ice water immersion. CLINICAL RELEVANCE: Immediate return to play following cryotherapy application is cautioned given the decreased dynamic ML balance and potential for increased injury risk. LEVEL OF EVIDENCE: 3b Case-control study.

BACKGROUND: Exercise is an established treatment to alleviate pain and improve function among adults with knee osteoarthritis (KOA). However, long-term adherence to exercise is poor and effective approaches to support adherence are limited. The objective of this dissertation was to 'gain a new look' into long-term exercise adherence. With study #1, the experiences of participants in the Boston Overcoming Osteoarthritis through Strength Training (BOOST) study, were explored to identify participants' experiences, feelings and perspectives with exercise over 2-years and factors that influenced adherence to a prescribed exercise program after 2 years. With study #2, we examined if kinesiophobia: i) was associated with physical performance measures, ii) improved after a 6-week exercise program and iii) change was associated with change in pain and function among adults with KOA. METHODS: Participants of both studies completed a 6-week exercise program. For study #1 all participants received an automated telephone reminder to continue with their exercises and complete their logs, in addition, those randomized into the intervention group received a motivational computer adaptive telephone program. Participants were purposively sampled and in-depth interviews were conducted at the 2-year assessment. For study #2, data analysis was conducted prior to randomization with a sample of participants who completed the Tampa Scale of Kinesiophobia (TSK) questionnaire. Additional data included stair negotiation, 5 and 10 time sit-to-stand, and timed-up-and go tests. RESULTS: Study #1: Three themes were identified describing beliefs about exercise: i) monitoring, ii) knowledge of how to manage exercise behaviors, and iii) benefits of exercise. Those who reported high-adherence exhibited self-determination and self-efficacy, those who reported low-adherence expressed ambivalence about the benefits of exercise and a desire for more social support. Participants valued monitoring by peers and instructors during the exercise class and telephone technology. Study #2: Higher TSK was associated with slower stair and 5 time sit-to-stand times. TSK decreased after the exercise class but did not attain statistical significance. Change in TSK was associated with change in self-report physical function. CONCLUSIONS: Future research on the use of telephone technology and importance of self-determination and kinesiophobia on exercise adherence among adults with KOA is warranted.

Thesis (Sc.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Therapy to restore functional movement of stroke patients is based on assumptions about what deficits occur in motor control as a result of stroke. These assumptions are derived from observational studies of movement behavior. The success of therapy to restore voluntary movement has been limited, perhaps as a result of insufficient information concerning the characteristics of movement post stroke. Technology now exists to quantitatively describe the characteristics of movement behavior. In this study WATSMARTtm, a non-contact, optoelectric motion analysis system, was used in combination with surface electromyography to measure voluntary movement in the symptomatic and nonsymptomatic arms of five subjects with left hemiparesis as they attempted to reach to one of three targets placed to require movement inside and outside of extensor synergy. Each subject was tested five times over approximately a nine week period. Results indicated that the symptomatic arms were significantly less able to generate muscular activity and to move in a smooth coordinated way [execute the program] than the nonsymptomatic arms whose scores were essentially within normal limits. Target location made no significant difference to the speed or smoothness of movement, but did significantly affect level of muscle activity because of the biomechanical demands of each location. Over the two month period, there were no significant improvements in the nonaffected arms, as would be expected. In the affected arms, amplitude of peak velocity and sense of limb position significantly improved. Improved amplitude of peak velocity was related more to a decrease in the discontinuity of movement (r=-.49, p<.02), a sign of increased maturity of reach, than to electrical activity of the prime movers (anterior deltoid: r=.l9; biceps: r =.37, p<.05). Since the goals of therapy to restore functional movement are to reverse deficient aspects of movement, the findings suggest that strengthening and relearning of motor programs would be appropriate therapeutic goals for these patients. The effectiveness of therapy to actually reverse these deficits must, of course, be established in future studies. / 2031-01-01

No description available.

The purpose of this study was to analyze the effects of an 8-week judo program on self-competency, physical activity (PA) motivation, and enjoyment of PA in children diagnosed with Autism Spectrum Disorder (ASD). METHODS: The sample included 20 children (ages 8 – 17) with a primary diagnosis of ASD. The participants completed an 8-week judo program that occurred once a week for 45 minutes. Participants were instructed to complete a series of questionnaires that measured athletic self-competency, PA motivation, and PA enjoyment at baseline and at the end of the 8-week judo program. Paired t-tests were conducted to examine differences in psychosocial factors from baseline and post-judo. Additionally, correlational analyses were conducted to examine the association between the psychosocial variables and attendance during the 8-week program. RESULTS: Although increases in psychosocial factors were observed following the cessation of the judo program, these changes were not statistically significant for any of the psychosocial factors following the 8-week program. There was a significant, positive association between PA motivation and judo attendance (r=.43, p=.05), however, neither athletic competency nor PA enjoyment were correlated with judo attendance. CONCLUSION: Although not significant, improvement in psychosocial factors were observed post-judo program. Future studies should consider increasing the duration and frequency of the judo program to potentially elicit greater changes in psychosocial factors related to PA.

No description available.

Shoulder impingement is the most common cause of shoulder pain. It is often described as mechanical irritation of the tendons of the rotator cuff or long head of the biceps due to compression against either the structures of the subacromial arch or the glenoid and glenoid labrum. Various treatment options exist to address impingement, and recent studies suggest thoracic spine manipulation may be a useful option. The purpose of this study was to assess changes in range of motion (ROM), pain and shoulder function both immediately post- and 7 to 10 days after receiving thoracic spine manipulations. We also attempted to identify changes in scapular kinematics and shoulder muscle activity associated with thoracic spine manipulation in subjects with shoulder impingement. Thirty subjects between the ages of 18 and 45 with signs of shoulder impingement participated in this repeated measures study. All subjects received both a mid-thoracic spine and a cervicothoracic junction manipulation. Changes in pain were assessed using an 11 point numeric pain rating scale. Subjects reported pain with performance of provocative testing (Jobes Empty Can, Hawkins-Kennedy and Neer's tests for impingement) as well as with performance of cervical rotation, thoracic spine flexion and extension and weighted humeral elevation. Shoulder elevation force production pre- and post- manipulation was assessed using hand-held dynamometry. Additionally, subjects completed the Penn Shoulder Score (PSS) and the Sports and Performing Arts Module of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire to assess shoulder pain and function 7 to 10 days post thoracic spine manipulation. Electromagnetic sensors tracked three-dimensional scapular and clavicular kinematics as well as cervical, thoracic and humerothoracic ROM. Surface electromyography data were collected from the infraspinatus, serratus anterior, and the upper, middle and lower trapezius muscles with loaded humerothoracic elevation. A repeated measures analysis of variance (ANOVA) was used to compare scapular orientation and muscle activity at 30, 60, 90 ad 120 degrees of humerothoracic elevation before and after spinal manipulation. Paired t - tests revealed significant decreases in pain [(Jobes 2.6 ± 1.1, Neer's 2.6 ± 1.3, Hawkins-Kennedy 2.8 ± 1.3; p&lt;0.001 for all three tests) (weighted shoulder elevation 2.0 ± 1.5, p&lt;0.001; cervical rotation 0.4 ± .9, p=0.039)] as well as improvements in shoulder function (Force production 5.5±3.1, PSS 7.7 ± 9.4 and DASH 16.4 ± 13.2; p&lt;0.001 for each). No significant changes in any of the ROM assessments were observed. No changes in scapular or clavicular kinematics were observed, with the exception of small decrease in scapular upward rotation (p = .04). A small but significant increase in middle trapezius activity (p = .03) was detected; however, no other significant differences in muscle activity were observed following manipulation. Moreover, paired t-tests revealed no significant differences in muscle onset times after manipulation. The findings of this study indicate that thoracic spine manipulation may be an effective intervention to treat pain associated with shoulder impingement; however, the improvements associated with thoracic spine manipulation are not likely explained by changes in scapular kinematics or shoulder muscle activity. Thoracic spine manipulation did not substantially alter scapular kinematics or motor control at the shoulder. / Physical Therapy

The human body is designed for movement. It has to move, it desires to move. Our bodies will find a way to express that desire. The way we as humans inhabit the built environment reflects our ability and desire for our bodies to move. Architecture has always been designed with that in mind, whether intentionally or unintentionally. This thesis is an investigation to reveal the various ways the human body moves in the built environment and how architecture and design can accommodate or dictate human movement. The thesis project of a physical therapy facility on an existing park in Washington, D.C. alludes to the opportunities for varying movements of the body. It also provides an extensive program that largely posits a myriad of relationships between the varying functions of architectural space and human movements. / Master of Architecture

Because various lower extremity injuries have been linked with an excessive amount of subtalar pronation, orthotics designed to reduce pronation are commonly prescribed for their treatment. In addition, harder shoe midsoles are recommended because they have also been shown to reduce subtalar pronation. It is hypothesized that these measures reduce knee stresses. Although orthotics have proven to be clinically successful, the mechanism has not been clearly demonstrated. The purpose of this study was to investigate the effects of orthotics and midsole hardness on 3D running lower extremity kinematics and muscle activation patterns. High speed video data was obtained as twelve subjects who routinely wear prescription orthotics to control pronation ran on the treadmill. Lower extremity joint and segment angles were obtained for ten left and right footfalls for each condition (with and without orthotics, soft and hard midsoles). Electromyographic (EMG) activity of the rectus femoris, semitendinosus, tibialis anterior, and gastrocnemius muscles was monitored with surface electrodes during ten left and right strides, and the onset, offset, and rectified, integrated area during each period of activation were analyzed. Significant reductions in maximum ankle and foot eversion were observed with the use of orthotics, and significant reductions in maximum foot eversion were observed with the use of hard midsoles (p $<$ 0.01). No significant differences (p $>$ 0.01) were found for the time of maximum foot or ankle eversion, or maximum knee internal rotation. However, with hard versus soft midsoles, the thigh was in a more externally rotated position throughout the stance phase (p $<$ 0.01). The use of orthotics also showed a similar though not significant trend. This shift in external rotation of the thigh with hard midsoles and, to a lesser extent, orthotics may reduce stress at the knee joint by reducing forces which tend to make the patella track abnormally. Rectus femoris muscle EMG activity was significantly larger in area and longer in duration when orthotics were used (p $<$ 0.05). It appears that this increase in EMG intensity and duration is linked to the observed increase in knee flexion when running with orthotics. The orthotic and midsole hardness factors minimally affected the other EMG parameters analyzed.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01