Thirty female outpatients with metastatic breast carcinoma were evaluated using two operational models constructed for the purpose of assessing and assigning a quantitative score for (A) extent of metastatic disease and (B) level of functional disability. These patients were drawn from the population of patients with disseminated breast carcinoma attending the medical oncology clinics at the Medical College of Virginia Tumor Clinics for a 49 day period in 1975. The data from this patient sample were used to test several hypotheses. Each patient underwent an initial screening procedure designed to clearly identify those patients with disseminated disease. This was followed by a preliminary evaluation involving related background information. The selected patient sample was then evaluated and scored on the operational models. The numerical data were tabulated and statistically analyzed for the full patient sample and subsequently for inclusive groupings using the following parameters: age, length of disease, length of disease free interval, duration of metastatic disease, clinic attended, and major metastatic sites. In addition, the distribution of the patient sample over functional classification categories, the frequency of specific disabilities, and related sample characteristics were tabulated and analyzed. A summary of the major findings of this research project are enumerated below: 1. There is a positive statistical correlation between the extent of metastatic disease and the level of disability and physical dysfunction for the full sample of patients with metastatic breast carcinoma. 2. Those patients over the age of 60, and those patients having their disease longer than 3.3 years do not exhibit significantly greater levels of functional disability than those patients under the age of 60 or those patients having their disease less than 3.3 years. 3. The length of the disease free interval, the duration of metastatic disease, and the tumor clinic attended did not have a significant effect on the extent of metastases or the level of physical dysfunction in these patients. 4. For each of the six major metastatic sites (lung, pleura, bone, liver, brain, and distant lymphatic or skin and soft tissue), there was a positive statistical correlation between the extent of metastatic disease and the level of physical dysfunction. The value for r exceeded .7 and was significant for each group except Group PD — those patients with pleural effusions. 5. Patients with pleural effusions had significantly less metastatic disease in comparison to the full patient sample. These patients also correlated the lowest between extent of metastases and level of functional disability. 6. Patients with liver metastases showed the highest correlation coefficient of any of the other groups; this value was significantly different from the full patient sample correlation coefficient. 7. Patients with brain metastases had significantly greater amounts of metastatic disease, and significantly greater levels of functional disability in comparison to all patients combined. 8. Patients with pleural effusions or bone metastases were less likely to have several additional anatomical sites involved with metastatic tumor. 9. Patients with lung, liver, brain, or skin and soft tissue — distant lymphatic involvement were more likely to have several additional anatomical sites involved with metastatic tumor. 10. There was a statistically uneven distribution of patients over a six category functional classification schema, the majority of patients not being severely dysfunctional. 11. Approximately three fourths of the patients with metastatic breast carcinoma would have the supportive goal selected for their rehabilitation needs. 12. Approximately one fourth of the patients could be classified as terminal or preterminal and would have the palliative goal selected for their rehabilitation needs. 13. Less than one third of the patient sample could be classified in performance status levels which would indicate that they need assistance of some kind to care for their personal needs, carry on normal daily activities, or return to part time employment, duties, or age-appropriate tasks. The physical therapy needs for this group are correspondingly greater.

This study examines the relationship between an individual's health locus of control belief and four variables: previous job injury experience, the duration of work absence due to previous job injury, appointment keeping behavior, and the wage replacement ratio. Seventy-two subjects with job related injuries referred to an industrial physical therapist were administered the Multidimensional Health Locus of Control Scale (MHLC). There was an uneven distribution of subjects according to MHLC belief patterns with more subjects demonstrating a "pure internal" health locus of control belief. No significance (Q > .05) was found between our four variables associated with a job injury and a high powerful others (PHLC) and chance (CHLC) locus of control beliefs. Not all the subjects had experienced a previous job injury and, therefore, had not developed learned expectancies regarding this type of situation. Their health locus of control belief may be a general measure whereas for those subjects with prior job injury experience, the health locus of control for this situation is likely to be a more specific construct. The researcher concludes that a worker's belief that the external factors of chance or a significant powerful other may not relate to experience with previous injury on the job, the duration of previous job injuries, financial factors associated with job injury and the stage of the injury.

The purposes of this study were to: (1) describe posture and movement of non-disabled children while English horseback riding at a walk, (2) propose a developmental sequence for each of three components of body posture and movement: the upper extremity the lower extremity, and the head and trunk, and (3) describe age differences in posture and movement while riding. The study was designed as a cross-sectional descriptive study. Thirty children without disabilities: ten five-year-olds who had never received formal riding lessons; ten seven- and eight-year-olds who had received six months or less of formal riding lessons; and ten nine and ten-year-olds who had received seven months or more cf formal riding lessons; were videotaped while horseback riding at a walk. Posture and movement of the upper extremity, the lower extremity, and the head and trunk, were each described in writing and categories were established to summarize the different postures and movements observed within each component. Horseback riding literature, which describes an "advanced" form for English riding was consulted to propose a developmental sequence for each component. The frequency of occurrence of each category in each age group was determined and graphed with respect to age. This graph was compared with the sequence proposed after consulting the riding literature. As a result of the study, five categories of posture and movement were formed for each of the components. As a group, the children demonstrated 54 different combinations of component posture or movement while riding. Each age group demonstrated a different modal combination of component posture or movement. None of the developmental sequences proposed from riding literature were supported by the data. However, age differences observed in this study enabled new developmental sequences to be proposed for development of component posture in the task of English horseback riding.

This study was undertaken in order to investigate the effect of different feedback variables on isometric strength performance. The variables studied were auditory EMG biofeedback, knowledge of results, and verbal cues. Nineteen normal adult women volunteered as subjects for the study. Each subject performed nine isometric contractions of the triceps brachii muscle against the resistance of a cable tensiometer. One of three different types of feedback was given during each contraction in order to motivate subjects to generate as much force as possible. Feedback variables were applied in random order; each variable was used three times. Peak force readings were recorded from the cable tensiometer at the end of each trial. Force readings were converted into pounds by matching than to a calibration curve. The actual force values underwent analysis of variance to determine if one type of feedback variable was more effective in motivating subjects to put forth a maximum effort during isometric muscle contraction. Results showed that the type of variable used during task performance had no differing effect on the amount of tension generated. Thus, the null hypothesis that the application of either EMG biofeedback, knowledge of results, or verbal cueing has no "differing effect on the amount of force that is exerted during isometric contraction of the triceps brachii muscle could not be rejected.

The purpose of this study was to determine in normal knees, and in knees with anterior cruciate ligament absence, what effect maximal voluntary isometric contraction of the quadriceps has on translation of the tibia on the femur. Ten subjects with bilaterally normal knees, and nine subjects with one normal knee and the contralateral knee having an arthroscopic finding of absent anterior cruciate ligament were tested. Tibial translation was measured with a dial indicator at 15, 45 and 60 degrees of knee flexion. There was a measurable anterior translation of the tibia in all knees. An analysis of variance with post hoc testing of two weighted contrasts showed a significant increase from normal in anterior tibial translation in subjects with absence of the anterior cruciate ligament, P < 0.05. In subjects with normal knees, there was no significant difference in tibial translation between subject's right and left knees. Regardless of the status of the anterior cruciate ligament, there was no significant difference in translation between maximal voluntary isometric contractions of the quadriceps at 15, 45 or 60 degrees of knee flexion. It was concluded that in subjects with an absent anterior cruciate ligament, voluntary maximal isometric exercises of the quadriceps should be avoided through the range of 60 to 15 degrees of knee flexion. Another conclusion was that a valid comparison of anterior tibial translation during maximal voluntary isometric contraction of the quadriceps may be made between knees within the same subject. A third conclusion was that a difference of greater than 3.1 mm of anterior tibial translation between knees measured during maximal voluntary isometric contraction of the quadriceps may be a sign of anterior cruciate ligament deficiency. Suggestions for further research were proposed.

As physical therapists are becoming more involved with the pregnant population both in traditional patient care as well as in childbirth education, a better understanding of the influence of pregnancy on the pain system is needed. The purpose of this study was to determine if an endogenous analgesia system is present in pregnant humans as has been shown to be present in animals (Ginzler, 1980). Women's affective and intensity responses were measured during late pregnancy, labor and post-partum. Using a repeated measures design, fifteen women responded to thermal stimuli (43-52 degrees C) by marking a visual analogue scale. No significant difference was found to exist demonstrating that stages of pregnancy have no effect on subjects' responses to thermal stimuli. Additional research has shown that levels of endorphins in the cerebrospinal fluid also do not change with stages of pregnancy (Steinbrook et al, 1982). This study provides a behavioral measurement of pain perception that supports the clinical finding that no endogenous analgesia is present in humans during stages of pregnancy. Lastly, by reviewing research examining levels of endorphins present in the plasma and cerebrospinal fluid during stages of pregnancy, this study also supports the growing body of knowledge which suggests that pain mediation by endorphins occurs centrally and not in the periphery.

The purpose of this research was to determine if there was a relationship between physical therapy students' personalities and their preferences in clinical education. Associated problems addressed by the research were to determine if there were differences in personality measures between the physical therapy students as well as differences from one another in how they rank ordered a list of clinical education methods and behaviors. Thirty-four senior physical therapy students who had completed the academic and clinical requirements of the curriculum rank ordered a list of twenty clinical education methods and behaviors which was compiled from factors cited in the literature. During the same session, they also completed the Fundamental Interpersonal Relations Orientations-Behavior (FIRO-B) Questionnaire. A master list of the mean rank s of the clinical education preferences was calculated and examined for content. The students seemed to prefer behaviors which were passive and related to communication and security. Non-metric three-dimensional multidimensional scaling procedures were used to examine whether there were clusters of students near any of the clinical education behaviors and to interpret similarities and differences between the clinical education methods and behaviors. Continuums between active and passive behaviors, student or professional behaviors, and needs for security and communication were identified along with some clusters of related clinical behaviors; there were no different clusters of students. Multiple analysis of variance and canonical correlations computed showed no significant relationship between the manner by which the students rank ordered the list of behaviors and their FIRO-B scores. Profiles for the student group based on their FIRO-B scores in each of the need areas were described and discussed. The group demonstrated moderate to high needs for affection and inclusion and low needs in control. Describing the entire group based on the mean scores was potentially misleading as there was much variability between students except in the area of control. The implications of the personality profiles was discussed related to stability and normative scores, the admissions process, and professional development.

Thesis (M.Sc.(Physiotherapy))--University of the Witwatersrand, Faculty of Health Sciences, 2013. / The aim of this study was to compare the effect of myofascial trigger point therapy and stretching to myofascial trigger point therapy and medicine ball exercises on elite golfers’ range of motion, biomechanics, club performance and ball flight.

<p> <b>Background:</b> The effect of trigger point dry needling (TDN) on myofascial trigger points (MTP) in Achilles tendinopathy are unknown. <b> Objectives:</b> To determine the feasibility of a large randomized controlled trial (RCT) to compare the effects of TDN to exercise in a patient population with Achilles tendinopathy. <b>Methods:</b> This single-factor, pretest-posttest control group design included 22 subjects between the ages of 24 and 65 years with Achilles tendinopathy. Subjects were randomly assigned to either a control group (MT+Ex) or experimental group (TDN+MT+Ex). Subjects in both groups completed 8 physical therapy treatment sessions over 4 weeks. The intervention for the TDN+MT+Ex group included TDN to MTPs in the gastrocnemius, soleus or tibialis posterior each session while the same soft tissue mobilization and exercise program was conducted in both groups. <b>Results:</b> Within group analysis was performed for each group at 4 week and 90 day follow up. Significant improvement (p &lt; .05) was achieved for FAAM, NPRS, pain pressure threshold and strength in both groups at 4 weeks and 90 days. The GROC was significant for MT + Ex at 90 days. The MCID for the FAAM, GROC were surpassed in both groups at 4 weeks and 90 days. NPRS surpassed the MCID for the MT + Ex group at 4 weeks. <b> Conclusion:</b> A large RCT to investigate the effects of TDN on MTP in Achilles tendinopathy is feasible with modifications. <b>Recommendations: </b> Special considerations for data collection sites should be given to the health care system, insurance payor, and financial burden to subjects.</p><p>

The purpose of this study was to investigate relationships between performance by children on computerized rehabilitation tasks, age and standardized assessment instruments. It was hypothesized that children's performance would differ by age on standardized assessment instruments and computer tasks developed for rehabilitation of attention, visual/perceptual and visual memory skills.;Two hundred five children from three schools in Chesapeake, Virginia, completed the Benton Visual Retention Test - Administration C, the Trail Making Test (B), and six computer tasks. Significant correlation was found between age, and both assessment instruments as well as five of the computer tasks. Standardized instruments correlated with one of each type of computer task for attention, visual/perceptual and visual memory skills. Additionally, correlation was found between one computer program and the Trail Making Test for visual/perceptual skills.;Further study is needed to develop standardization of these computer tasks for use rehabilitation of attention, visual/perceptual and memory skills dysfunction.