...Definition of adverse events, serious adverse events. Possible adverse events for this pilot study include an uneasy, irritable feeling in the lower- extremity region, muscle tightness present throughout the rehabilitation session, and fatigue over the course of the session. Serious adverse events include severe muscle pain in the lower- extremity region, in which the subject is unable to move, a drop in blood pressure of the subject, and chest tightness during the session, along further health complications. Overall, physical therapy rehabilitation is a safe environment aimed with patient benefit and a positive anatomical and health impact. b. What procedures will be used to monitor subject safety? All exercise sessions will be administered by a physical therapist professional and the Principal Investigator (Veda Karan), an Exercise Science Student with a Healthcare Provider’s CPR and AED certification by American Red Cross. In addition, Veda Karan has accumulated two years of observation in an impatient physical therapy clinic (1240 Iroquois Ave #400, Naperville, IL 60563). The Exercise Science Department Laboratory is equipped with an AED machine along with close proximity to Loyola University...
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...Scand J Med Sci Sports 2014: 24: e180–e187 doi: 10.1111/sms.12120 © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Relationship between jump landing kinematics and peak ACL force during a jump in downhill skiing: A simulation study D. Heinrich1,2, A. J. van den Bogert3,4, W. Nachbauer1 Department of Sport Science, University of Innsbruck, Innsbruck, Austria, 2Centre of Technology of Ski and Alpine Sports, Innsbruck, Austria, 3Orchard Kinetics LLC, Cleveland, Ohio, USA, 4Department of Mechanical Engineering, Cleveland State University, Cleveland, Ohio, USA Corresponding author: Dieter Heinrich, Department of Sport Science, University of Innsbruck, Innsbruck, Austria. Tel.: +43 512 507 4467, Fax: +43 512 507 2656, E-mail: dieter.heinrich@uibk.ac.at 1 Accepted for publication 8 August 2013 Recent data highlight that competitive skiers face a high risk of injuries especially during off-balance jump landing maneuvers in downhill skiing. The purpose of the present study was to develop a musculo-skeletal modeling and simulation approach to investigate the cause-andeffect relationship between a perturbed landing position, i.e., joint angles and trunk orientation, and the peak force in the anterior cruciate ligament (ACL) during jump landing. A two-dimensional musculo-skeletal model was developed and a baseline simulation was obtained reproducing measurement data of a reference landing movement. Based on the baseline simulation, a series...
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...Hypotension in Cardiac Catheterization Laboratory: Patient Management Si m u l a t e d C l i n i c al E x p e r ie n c e (S CE ™) Over view Lear ning O b je c tiv e s Location: Cardiac Catheterization Laboratory History/Information: The patient is a 57-year-old woman transferred to the cardiac catheterization laboratory for a procedure after presenting to the Emergency Department (ED) this morning with a purple and extremely tender right lower extremity. She is alert and oriented to person, place and time. Her pain rating scale is a 10/10. She told the Emergency Department staff her foot began hurting about a week ago and had been becoming more and more tender and slightly more discolored as each day passed. She thought it would “go away with time.” When she awoke this morning, her toes were purple in color, and she was unable to touch them secondary to the immense pain. Her husband drove her to the hospital immediately. Her weight is 65.0 kg. Other findings include normal heart tones, clear lung sounds, positive bowel sounds and clear yellow urine from a urinary catheter inserted in the emergency department. Her medical history consists of hypertension, partial lumpectomy of the right breast seven years ago, alcohol abuse and hyperlipidemia. She is allergic to angiotensin converting enzymes inhibitors and angiotensin receptor blockers. She takes metoprolol 25mg twice per day at home for hypertension management. She has been married for 25 years and has two adult children....
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...The objective was to find patterns of injury rates in 5 boys sports and 4 girl sports of the 2005-2006 school year. The method conducted was a pool of 100 high schools were selected to participate in the study and their athletic trainers submitted data to the research team about the injury rates and types of injuries that happened and then they were compared by analytical analysis. Results concluded in a few things. One, out of all the athletes in the study, they sustained “4350 injuries (2110 in practice and 2240 in competition)”. Also, the rate of injury was higher in competition(4.63 people got injured out of 100) than in practice (1.69). But the biggest get from this study was what kind of injuries they suffered. According to Rechel, most injuries occured in the lower extremities. This would be your legs, feet, ankles, and etc. 57.2% of all injuries fell in this category. That’s over half! To add to that, the ankle was the most affected region of the body with 22.7% of all injuries being that. Over 75% of all boys injuries were of the lower extremities especially in...
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...The DDS proposes a fully favorable allowance for this claimant with an EOD 04/01/2016. The evidence in file supports a later onset date. CASE DISCUSSION & POLICY ANALYSIS (INCLUDING SPECIFIC REFERENCES) This 58-year-old claimant is filing a concurrent claim alleging disability due to chronic obstructive pulmonary disease, high blood pressure, and an enlarged heart as of 04/01/2016. The evidence in file shows the claimant was seen 8/1/2016. He reported feeling fine and his lungs were clear. He was seen again on 1/24/17 complaining of congestion. On exam, he was positive for wheezing. He was seen in the emergency room 2/7/18 due to chest pain and shortness of breath. On 3/1/17 He complained again of shortness of breath. The physical exam showed bilateral edema in the lower extremities. The chest CT taken on 4/3/17 showed a stable compression deformity on T6 with a lytic lesion at T5, which was similar to prior exam. Hazy infiltrates in the right lung and minimally mid and upper lung was noted. On 4/4/17, he had shortness of breath walking from the waiting room to the exam room and the bilateral pitting edema in the lower extremities....
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...language that can be used crossculturally.6, 7 The Lower Extremity Functional Scale (LEFS) and Numerical Pain Rating Scale (NPRS) are outcome measures often used to assess a subject at the initial evaluation. Outcome measures can be helpful for evaluating a patient throughout the course of treatment and into patient discharge. LEFS is an appropriate scale for gauging a patient's function in their lower extremity from the initial treatment, throughout therapy, and at discharge. The test-retest reliability of the LEFS is excellent (R=.94) and there is a moderate correlation for construct validity between the LEFS and SF-36.8 The NPRS, according to a 2011 systematic review, is an appropriate measure of a patient’s pain intensity (PI) throughout the course of therapy.9 NRPS has a high inter-rater reliability (100%) and excellent construct validity (.96).10 Gait assessment is often used to observe the way a patient moves to determine impairments and to evaluate a patient's progress throughout treatment while they ambulating.11 The reliability of the gait analysis is greater the more experienced the clinician is who is analyzing the gait, with experts demonstrating an average intrarater reliability of .63 and novices an average of .57.11 Experts and novice clinicians display similar interrater reliability with scores of ICC=.42 and ICC=.40 respectively.11 No conclusions have yet been made regarding the validity of gait analysis. ...
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...If any participant was noncompliant, determined by the number of sessions of rehabilitation that were attended, or got an injury that was nonrelated in the lower extremity they were pulled from the trial after the beginning. Baseline testing was done on only the involved limb to test functional performance, isometric strength, perceived instability, and dynamic balance. From there the participant was placed into either the PNF, control (CON), or RBP group where they completed their protocol three times a week for six weeks. At the end of the six weeks posttests were administered to measure the changes in the aforementioned areas. To assess strength an isometric handheld dynamometer was used with testing done in all four directions. A total of three trials, lasting three seconds, were conducted with a rest period of ten seconds between each trial. The triple-crossover hop test for distance, for assessment of power, and figure-eight hop test, to test speed and agility, were used in the functional performance testing. The fastest time out of the two attempts for the figure-eight hop test was used in the analysis of the results. The...
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...Haydee Munoz 01063896 ANT2033 15- April-2010 Physioanatomical Analysis of Australopithecus Afarensis The first Australopithecus afarensis was found in 1974 by Don Johanson at Hadar in Ethiopia, Africa, and dates from about 3.9 to 3 million years ago. The very complete fossil is thought to be a female skeleton and it is called “Lucy” after a Beatles song. Because the skeleton is 40 percent complete, it facilitates a more accurate analysis in a broader sense. When comparing A. afarensis to a chimpanzee, a species with many traits that for hominins are considered primitive, and a modern human, it is concluded that the subject is very primitive, because it shows few developed traits. The Lucy skeleton is female and it is approximately 3 or 4 feet tall, while other A. afarensis male fossils have been found that are about 5 feet tall. While male chimpanzees average height is 4 feet tall and female average height is 3 feet tall, the male human height average is 5 feet 9 inches and the female average is 5 feet 3 inches. Therefore, like chimpanzees, Australopithecus afarensis has smaller body size than the modern human. Also, A. afarensis is sexually dimorphic, which is a trait that is common for attraction and reproduction among apes, while humans are not very different in body size among sexes. One of the most characteristic derived traits of modern humans is brain size. Modern humans have between 1150 to 1750 cm3, chimpanzees have 285 to 500 cm3, and A. afarensis...
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...Please use this worksheet to complete the activity analysis below. Refer to table 7 of the OTPF for details. 1. Activity: Driving to work 2. Relevance to client: Independent and significant for community mobility 3. Equipment: Tools: Supplies: Car: side and rearview mirrors, seat, steering wheel, foot pedals for brake and accelerate, and blinker signal. Regarding the objects above are they easily accessible? Costly? Describe some inherent properties of the supplies needed: The objects are easily accessible and costly. Some inherent properties of the supply are heavy, painted, and comfortable. 4. Space demands: The reasonable room inside a car to move arms and feets. All things are in arms reach....
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...VACUUMING INTRODUCTION Vacuuming: nearly everyone is doing it! Unlike jumping a horse or throwing a curve-ball, vacuuming does not discriminate or limit itself to highly trained individuals or athletes. A vacuum cleaner, or commonly known as a vacuum, is typically an electric device that by means of suction collects dirt and small particles from a variety of surfaces. All it functionally requires is electricity, a vacuum cleaner appliance and a willing and able individual. This common invention is everywhere; household closets, hotels, general workplaces, restaurants and just about any other place that has carpeting or accumulates dust. 700 B.C. was the first noted appearance of woven forms of floor coverings and one could debate that primitive cleaning methods were developed thereafter (carpetandrugpedia.com). A cleaning method other than the traditional “carpet beater” was born in the mid-1800s. This time is known as the industrial revolution and was a critical in the invention of the vacuum cleaner. Factories were producing thousands of manufactured items and with it came an overwhelming amount of dust, soot and industrial pollution. This was also during the same time that infectious disease was being linked to germs. The need for hygiene and cleanliness was born and gave birth to the idea of the vacuum cleaner. By a patent issue date in 1860, Daniel Hess appears to have invented the first device to have the some of the basic principles of the modern vacuum. The...
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...Disease Achondroplasia is the most frequent form of short-limb dwarfism (Nahar R et al 2009). As well as short stature due to shortening of limbs, affected individuals have characteristic facies with frontal bossing and mid-face hypoplasia, exaggerated lumbar lordosis, limitation of elbow extension, genu varum and trident-like hands. Incidence increases with paternal age. Achondroplasia is caused, in virtually all of the cases, by a G380R mutation in fibroblast growth factor receptor 3 (FGFR3) (Di Rocco F et al 2014). FGFR3 is also important in craniofacial, vertebral and neurological development such that this mutation has multiple effects in an affected individual (Horton WA et al 2007). Clinical Presentation Gross motor development frequently is delayed. Motor milestones such as head control and independent sitting, standing, and ambulation may lag by 3-6 months. Speech and language problems may be caused by tongue thrust (due to abnormal maxillomandibular relationship) but often resolve spontaneously. Twenty percent of patients experience delayed speech acquisition. Cognitive skills are preserved, and the intelligence level is within normal limits. Cranial enlargement and poor head control place the infant at risk for extension injuries. An Australian study assessed the functional milestones of achondroplasia children aged 3-7 years. The data noted that while milestones were delayed across all ages studied, functioning improved between age 3 and 5 years, although not...
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...University of Phoenix NUR/588 Professor Jennie Pattison May 12, 2014 Educational Needs Assessment Paper An educational needs assessment is a procedure that identifies training and ranks educational needs in order of priority ((Yuskiewicz, 1975). An educational needs assessment helps the organization to discover the knowledge, skills, and abilities of staff and those needed by the organization to function at a desired level ((Wynne, n.d.). The following information will be discussed in this paper: type of institution, type of nursing care or services provided, volume of activity of the G.V. Sonny Montgomery Veterans Affairs Medical Center, levels of nursing care involved, a summary of the results of the educational needs, assessment, and analysis, identification of the highest priority educational need, identification of institutional forces and those against responding to educational needs, and identification of the next step to respond to the educational need. Type of institution The G. V. Sonny Montgomery Medical Center (VA) is a federal hospital that provides convenient access to high quality medical and surgical service to more than 125,000 veterans ("VA Medical Center," 2014). VA is also a teaching hospital that is accredited by the Commission in Accreditation of Rehabilitation Facilities (“VA Medical Center, 2014). The hospital provides primary, secondary, and tertiary medical, neurological, and mental health inpatient care. The hospital also provides services in outpatient...
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...Rehabilitation of Acromioclavicular Joint Separations: Operative and Nonoperative Considerations Mark P. Cote, PT, DPTa, Karen E. Wojcik, MSPT, ATCb, Gregg Gomlinski, MSPT, CSCSb, Augustus D. Mazzocca, MS, MDa,* Acromioclavicular joint (AC) separations are one of the most common injuries seen in orthopedic and sports medicine practices, accounting for 9% of all injuries to the shoulder girdle.1–3 Various operative and nonoperative treatment schemes have been described for the management of AC joint injuries.4–33 Although considerable controversy exists over the efficacy of surgical reconstruction versus nonoperative intervention for grade III type injuries, grade I and II separations seem to respond favorably to conservative management. Conversely, grades IV, V, and VI often require surgical reconstruction. Regardless of the type of injury, rehabilitation as a part of conservative management and postoperative care plays an important role in the management of these injuries. This article presents the authors’ rehabilitation approach to treatment of acromioclavicular separations pre- and postoperatively. CONCEPTUAL FRAMEWORK To provide instruction and insight for rehabilitation clinicians, protocols are often provided for a specific injury or procedure. A protocol is a system of rules or procedures for a given situation. Although intended to be informative, protocols often result in a restrictive list of exercises and arbitrary time frames that a clinician...
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...Respiratory/cardio Assessment. Fall 2012 CHIEF COMPLAINT (1/1): “heaviness on the chest, and shortness of breath” Symptom Analysis (History of present illness): 43 year old male presents today for evaluation with complains of chest heaviness and shortness of breath and Associated signs and symptom including nausea, and feeling of tiredness. The patient has been treated with similar symptoms before. Patient reports that he has had these symptoms for 2 days. Patient describes the heaviness on the chest as a feeling like someone is stepping on the chest. He describes the SOB as feeling out of air, and gasping for air when taking the stairs to his apartment, or doing daily chore at home. Patient reports of having to stop his daily activities and unable to do anything that he usually does. Patient reports of not getting any relief from his nebulizer. He denies having any pain. Past medical History: Patient’s problem list includes Dx of COPD in 2010 and CHF in 2007. Patient has no known medical allergies, or any allergies to food, denies any previous surgeries has previously been hospitalized for CHF and COPD. He reports receiving yearly flu shot; he also reports having not received Tetanus and Tdap immunizations. He is currently taking Lasix 20 mg daily for CHF and he is also taking albuterol Neb PRN for SOB SOCIAL HISTORY: Patient reports that he quit smoking 3 years ago; he had been a smoker for 15 years smoking an average of 7 cigarettes per day. Patient previously...
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...sub-specialties of surgery. Staffing for the clinic consists of one surgeon, two senior resident students, three clerks and four registered nurses. Patient flow for the clinic was approximately 80 patients per day, with 60 percent being for follow-up appointments. The process at the clinic can be broken down into several steps. First, at the front-desk, patients must register and verify all necessary medical and identification documents with three nurses and three clerks. Registration ends promptly at 11:30am, while verification continues until 12:45pm. Next, patients are taken to the radiology department where there is six imaging rooms and six technicians on staff. In this step, patients take two types of generic x-rays: upper extremity or lower extremity. Depending on the type of x-ray, extra time must be allotted for adjusting the machine. Patients then also had to wait for development and review of their films by radiologists. Finally, the patients had to return to the clinic and wait for a doctor to review their films with them regarding their injuries. Dr. Kellie Leitch, Chief of Paediatric Orthaepedic Surgery at CHWO was concerned with mounting wait times that were being reported, and decided...
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