Volume 6:2
The Role of the Astym® Process in the Management of Osteoarthritis of the Knee: A Single-Subject Research Design
Allison Tyler, SPT; Emily Slaven, PT, PhD, OCS, FAAOMPT
University of Indianapolis – Indianapolis, IN
Abstract
Study Design: This single-subject case study followed an A-B-C format. Phase A established the baseline phase, phase B consisted of a progressive stretching and strengthening program, and phase C added Astym® to the stretching and strengthening program.
Background: Osteoarthritis (OA) is the most common form of arthritis and frequently affects the hip and knee joints. In 2008 the National Institute for Health and Clinical Excellence recommended manual therapy as an adjunct therapy to exercise for the management of OA. The Astym® protocol is a form of manual therapy using instruments to assist with soft tissue mobilization that can be utilized in the management of limited and painful motion that can result from OA.
Case Description and Methodology: The participant was a sixty-one-year-old male with an eighteen-month history of right knee pain. During phase A, baseline measurements were obtained. In phase B, the participant attended two sessions per week of a stretching and progressive strengthening program and completed these exercises at home when he did not attend physical therapy. During phase C Astym® treatment was added to the exercise program from phase B.
Outcomes: Outcome measures used were the Ten-Meter Walk Test (10MWT), the Lower Extremity Functional Scale (LEFS), and the Visual Analog Scale (VAS); the 10MWT was completed weekly, and the LEFS and VAS were recorded at every session. Visual analysis of the data showed an upward trend in the LEFS Score and walking speed and showed a downward trend for the VAS.
Conclusion: A conservative management program for knee OA that systematically introduced stretching and strengthening and then the Astym® protocol led to gains in self-perceived function, walking speed, and a reduction in pain.
Are Physical Therapy Residencies on the Radar of Doctor of Physical Therapy Students in Indiana? A Cross-Sectional Research Design
Kyle Gatesy, SPT; Emily Slaven, PT, PhD, OCS, FAAOMPT
University of Indianapolis – Indianapolis, IN
Abstract
Objective: The purpose of this study was to determine the perceptions and knowledge of physical therapy clinical residency (PTCR) programs by third-year Indiana Doctor of Physical Therapy (DPT) students.
Background: With all the potential benefits to completing a PTCR program, it is unclear what DPT students in Indiana know about residency programs and if they are interested in applying to residencies.
Materials and Methods: The survey was distributed electronically to 115 students in three DPT programs in the state ofIndiana. The data collection instrument consisted of sixteen multiple choice questions of which three contained open-ended “other” categories. The questions were designed to gather information on how students learned about residencies, their interest in applying for a residency upon graduation, and if they would choose to practice in Indiana if more residency programs were available in Indiana. Content validity of the survey questions was established through input from several physical therapists who had completed a residency.
Results: Of the 115 students who were sent the survey, 42% completed the survey. Sixty-three percent of students reported being very knowledgable or somewhat knowledgeable about PTCR programs. The majority of these students learned about residencies either from a professor during class (39%) or from a fellow DPT student (35%). Despite this lack of formal education about residencies, 73% of students were somewhat interested in applying. Thirty-three percent of students do not plan to practice in Indiana after graduation; however, 40% of those students would consider practicing in Indiana if more residency positions were available. The most significant barriers to pursuing a PTCR were lack of information, lack of available programs in Indiana, and school burnout. Conclusions: Many DPT students in Indiana have limited knowledge regarding PTCR programs. The data from this survey reveals that formal education regarding residencies may be lacking in DPT programs in Indiana. Also, implementing more residency programs in Indiana may help retain DPT graduates in Indiana.
Correlation of Performance-Based Balance Measures and Posturography in Individuals with Traumatic Brain Injury
Jessica Garcia, DPT; Amy Lancaster, DPT; Heather Rinkevich, DPT;Bethany Stemple, DPT; Tracy Rice, PT, MPH; Corrie Mancinelli, PT, PhD
West Virginia University School of Medicine Department of Human Performance and Applied Exercise Science, Division of Physical Therapy – Morgantown, WV
Abstract
Objective: The purpose of this study was to analyze the relationships among clinical performance tests and computerized posturography in individuals with traumatic brain injury (TBI).
Background: The understanding of balance performance in individuals with TBI is key to identifying mechanisms contributing to fall risk. Performance based measures have been studied in older adults and some neurologic subsets such as stroke and Parkinson’s Diseases, but little has been done with these tools in individuals who have sustained a TBI. Even less has been done using computerized posturography compared to performance-based measures.
Method: Twelve men (mean age 40+18 years) and seven women (mean age 49+16 years) were recruited through West Virginia’s brain injury support group. Each of these individuals were assessed with the Berg Balance Scale (BBS), Timed Up and Go (TUG), and Limits of Stability (LOS) using posturography.
Results: Moderate to strong significant negative correlations were found between the TUG and BBS (rs=-0.81, p=0.001), and TUG and LOS Directional Control (rs=-0.69, p= 0.01). Moderate to strong significant positive correlations were found between the BBS and LOS Directional Control (rs=0.75, p=0.005), and BBS and LOS Maximal Excursion (rs =0.64, p=0.02).
Conclusions: A strong correlation between the BBS and TUG found in this small sample of individuals with TBI is consistent with previous findings regarding the correlation of the BBS and TUG in other populations with balance impairments and suggests that these are useful clinical measures in those individuals who sustain a TBI. A moderate correlation between BBS, TUG, and computerized posturography suggests that both performance-based clinical tests measure different constructs of balance compared to posturography. More research needs to be done to determine the predictive value of such tests in determining future fall risk for individuals with TBI.
