Join your colleagues for dynamic group discussions about best practice in pediatric physical therapy. Attendees will participate in Team-Based Learning activities, sharing their knowledge, experiences, and skills, to problem-solve and come to a team consensus on clinical decisions. Participants will review a case study that is designed to address pediatric therapy across the lifespan, incorporate multiple practice areas, and stimulate critical thinking. Team-Based Learning is an instructional strategy that uses a set of structured activities to create active, energetic, collaborative learning environments. Information designed to support individuals’ ability to participate in the activities and clinical decision-making will be provided prior to APPTAC to those registered for the session. This session will take place in multiple rooms.

Previous research suggests that strict rest following a concussion may prolong symptom presentation, but rest is still one of the most common treatments. Aerobic exercise has effectively reduced symptom burden and exercise intolerance in patients experiencing persistent symptoms longer than 30 days; however, treatment outcomes with sub-acutely concussed patients have not been described. PURPOSE: The purpose of this study was to (1) demonstrate the systemic dysfunction following a sport-related concussion; and (2) examine the safety and efficacy of a 20-minute, low- or moderate-intensity (40% or 60% of HRMAX) controlled treadmill aerobic exercise as a therapeutic modality to improve cardioautonomic, neurological, and psychological function. METHODS: Thirty participants [16.0 ± 1.3 years; 19 sport-related concussed (SRC) and 11 healthy, non-concussed (NC)] were assigned to one of three treatments [1) 40% Age-Predicted HRMAX; 2) 60% Age-Predicted HRMAX; or 3) seated rest using a randomized double block design. SRC participants were evaluated between Day 3-7 of their injury and performed the treatment on the same day. Serial monitoring was performed at rest, during the acute bout of exercise, and recovery. The SRC participants were tracked until clinical recovery. RESULTS: Demographic variables were no different across groups. Autonomic function was not different across groups. Diastolic blood pressure and mean arterial pressure were significantly higher in the SRC participants. A greater percentage of exercising SRC participants improved on measures of ocular motor and vestibular function and symptom reporting compared to the resting SRC participants. 100% of the 40% HRMAX SRC participants and 86% of the 60% HRMAX SRC participants completed the session. Student-athletes who were prescribed exercise following their initial visit reported approximately five days faster than those who were prescribed rest in a previous clinical dataset. CONCLUSIONS: The 40% treatment reported 100% completion rates while both the 40% and 60% groups improved symptoms. Future studies should seek to examine middle school, collegiate, and professional athletes as well as non-athlete populations. / A Dissertation submitted to the Department of Nutrition, Food and Exercise Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester 2019. / March 28, 2019. / active rehabilitation, aerobic exercise, recovery, sport-related concussion, sub-acute, therapeutic exercise / Includes bibliographical references. / Jeong-Su Kim, Professor Directing Dissertation; Cathy W. Levenson, University Representative; Lynn B. Panton, Committee Member; Michael J. Ormsbee, Committee Member; Scott O. Burkhart, Committee Member.

The objectives were to determine whether or not manual hyperinflation (MHI) is used as a treatment technique by physiotherapists on respiratory compromised patients in intensive care units (ICU), to determine physiotherapists‟ knowledge on the use of MHI (indications, contra-indications, treatment effect) as a treatment technique on respiratory compromised patients in ICU, to compare the physiotherapists‟ knowledge on the use of MHI to their utilisation of MHI in ICU, and to determine whether the effect of clinical experience has an influence on physiotherapists‟ decision making regarding the use of MHI in the ICU setting. The last objective was to investigate whether the working environment has an influence on the utilisation of MHI by physiotherapists practicing in adult ICUs in South Africa.

Pediatric exercise scientists generally agree that children are less economical during running than adults. Most research in this area has examined economy at a common speed which may introduce a work intensity difference across age groups. The purpose of this study was to test the current assumption and to identify predictors of running economy in boys (n = 21) and men (n = 25). The caloric cost relative to mass (F = 43.3, p $<$.05), HR (F = 31.1, p $<$.05), and ventilatory equivalent (Veq) (F = 20.9, p $<$.05) were higher for the boys at the absolute running speed, but there were no differences at the relative speed. The men had significantly greater mass distribution based on mesomorphy (F = 4.61, p $<$.05), surface area/mass (F = 175.8, p $<$.05), and leg volume/leg length (F = 59.3, p $<$.05) measures. Biomechanical differences between men and boys were limited to stride frequency (SF) and length (SL) with the boys having greater SF (abs: F = 13.2, p $<$.05; F = 64.6, p $<$.05) and the men longer SL (abs: F = 111.5, p $<$.05; F = 176.3, p $<$.05) at both speeds. However, SL/leg length was greater for the boys at the absolute speed, and for the men at the relative speed. The boys were significantly more flexible than the men (F = 5.48, p $<$.05), but there were no differences in strain. Predictors of running economy for the adults included endomorphy, ectomorphy, flexibility, SF, SL, HR, mass, and whole body strain (abs: R$\sp2$ =.92; rel: R$\sp2$ =.96). Leg strain, mass, SF, SL, HR, flexibility and ectomorphy were predictors for the boys (abs: R$\sp2$ =.92; rel: R$\sp2$ =.92). Although there were common predictors, the effects of flexibility and strain were opposite for the two groups. Where stiffness (less flexibility and strain) is associated with more economical running in adults, the opposite is true for children. This may be due to less developed muscle and tendon in the children. The results of this study suggest that comparisons made between adults and children during running at a common speed introduce a confounding effect of work intensity which can directly influence physiological response. This problem appears to be eliminated by having each subject run at a speed set relative to leg length. (Abstract shortened by UMI.)

Thesis (Ed.D.)--Boston University

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In order to examine age-related differences in ability to respond and move rapidly to a visual stimulus, a total of 13 young (mean age = 23.8) and 13 older women (mean age = 61.8) underwent seven days of testing over a 6-week period on a rapid, self-terminated elbow flexion task, with two inertial load conditions (with added load and no added load). The subjects underwent four consecutive days of testing to assess age-related differences in practice improvements and to ensure stability of criterion measures. Subjects were required to rapidly move the lower arm through 90 degrees of movement stopping at a terminal position. Performance was judged across a variety of measures, including reaction time, kinematic characteristics, and electrical activity (EMG) of the biceps brachii and triceps brachii muscles. Following the practice days, all women received a 7-10 day layoff prior to re-testing, designed to assess short-term retention of any practice improvements. Following this re-test day, subjects received an additional 30 day layoff, prior to two final tests days designed to assess long-term retention and possible relearning. Results indicated that the older women were no slower in reaction time and improved reaction time following practice to the same extent as younger women. Once movement was initiated, the older women displayed slower movements, slower velocity and acceleration in both load conditions. The older women were more accurate initially and following practice, although younger women also improved accuracy following practice. The performance decrements seen in the older women were magnified when no added load was present. No age-related forgetting was seen across retention periods, with the exception of the older group becoming less accurate following the periods of no testing. Both groups of women displayed asymmetrical acceleration profiles and other EMG characteristics that suggested they had difficulty in activating the triceps brachii muscle to stop the movement at the terminal position. It can be concluded that the younger women displayed inefficient EMG characteristics during the loaded condition, while the older women were compromised in their ability to move rapidly in both load conditions.

Book Summary: Recognized as two of the world's leading authorities on the subject, Susan Herdman and Richard Clendaniel, joined by a team of expert contributors, deliver the 4th Edition of the field's definitive text on the management of vestibular diseases and disorders. From assessment through therapy, they present the scientific and clinical knowledge you need to distinguish between vestibular and non-vestibular dizziness and to plan and implement the appropriate treatments.