Research indicates that feedback is critical to the growth of preservice candidates, and technology is one method of providing immediate and purposeful feedback. Most feedback, however, tends to focus on developing instructional skills of preservice teachers and not attending to improving other soft skills like cultural responsiveness. While feedback using technology can be an effective tool for teacher candidates, successful implementation of this process can be better supported by first providing an opportunity for candidates to develop comfort with the tool. As pre-service teacher become more comfortable with feedback using technology, they can use this method to better develop their own culturally responsive lens. This study analyzes the effectiveness of one technology feedback platform on preservice candidates’ development cultural responsiveness.

Inmates experience higher rates of serious and chronic illness. Among the chronic illnesses experienced by this population is the diagnosis of cancer. During the past decade the incidence of cancer has slowly but steadily increased. One explanation for this increase in cancer diagnosis in correctional populations is the aging of the population. However, cancer diagnosis is not only evident in the aging inmate population (65 or older) but there is evidence of a younger population (30-45) presenting with cancer at intake or receiving a cancer diagnosis within months of admission to our jails and prisons. The consistent increase in patients with or diagnosis with cancer suggest a need to explore strategies to successfully manage and provide care meeting best practice standards for this special population. The increase in patients with a diagnosis of cancer further suggests a need to develop policies that decrease the risk of cancer disparities in the inmate population and among formerly incarcerated persons. Ensuring access to quality of care and continuity of care for patients with cancer requires health professionals to be vigilant in screening, health promotion, prevention and treatment. Presenters will discuss approaches to care and treatment and policy implications for this population.

Currently, Prostate cancer is the number one cancer among all men in Illinois with 42,773 identified cases between 2002 and 2006 for all races (Illinois Department of Public Heath (IDPH), Illinois Cancer Registry, 2008). Additionally, African American men living in Cook County have the highest rate for all racial groups at 227.1 per 100,000 between 2002 and 2006 (IDPH, Illinois Cancer Registry, 2008). This proposed research attempts to identify any influences of social disorganization on health-related quality of life (HRQL) in African American men living in south suburban cook county in Illinois with Prostate Cancer diagnosis using the International Classification of Functioning, Disability and Health (ICF) to measure and map disability by zip code using Geographic Information System (GIS). The proposed research attempts to identify preventable risk factors during phase one and in phase develop a community intervention for men at risk for prostate cancer, by increasing HRQL of African American men with current diagnosis of prostate cancer.

Lead ions is a very common pollutant in water which has the potential to be dangerous, causing serious disease and health problems which can affect people. Lead is toxic and prolonged exposure to lead ions will cause serious brain and nervous system damage. Chelation is a type of bonding of ions and molecules to metal ions and it involves the formation or presence of two or more separate coordinate bonds between a polydentate ligand and a single central atom. Most of the current analytical methods used to analyze Pb ²⁺ and Pb¹⁺ are inductively coupled plasma-optical emission spectroscopy, inductively coupled plasma-mass spectrometry, atomic absorption spectrometer and graphite furnace atomic absorption spectrometer. However, those methods require expensive equipment and those methods are more complicated in terms of the calibration and sample preparation. The spectroscopy method without chemical reagent proves to be useful and it is a non-destructive method. The benefits of using UV-Vis is its capability of measuring even trace amounts of lead under 1ppb and its applicable to all organic and inorganic samples including alkali earth elements. During this application, a total of six samples were prepared by using Pb ²⁺ and Pb¹⁺, reverse osmosis water, and distilled water. Samples were prepared by using micropipettes and then were measured using UV spectroscopy after the sample preparation. The spectrometer used during this research was the Thermo Scientific Spectronic 200 and the wavelengths were measured in increments of five starting at 400nm to 600nm.

The purpose of doing this study is to monitor the concentration of how lead performs in water by taking the UV-Vis spectrum of all the samples and see which spectrum correlates to the chelating agent. So instead of calculating the lead concentrations, we are looking at the baseline shift to see if the un-reacting chelating agent is affecting these results. After further verification we determined that Pb-1 contains potassium cyanide, so the mystery peak (shown below) is not due to the resorcinol reagent.

Microaggressions are described as brief and commonplace daily verbal or behavioral injustices, whether intentional or unintentional, (subtle, unconscious discrimination) that communicate hostile, derogatory, or negative messages and insults toward marginalized/minority populations (Sue et al., 2007b, p. 271). Unlike discrimination, microaggressions are often delivered by good-intentioned and well-meaning individuals who unconsciously hold biases and prejudice (Hodson, Dovidio, & Gaertner, 2010; Shelton & Delgado-Romero, 2011). Research on microaggressions started with McIntosh (1988) with the focus being on to the larger accepted privileges of sex, ethnicity, religion, sexual orientation, class, able-bodied, gender identity and some subclasses such as female athletes and sex trafficking victims. A mixed research design will be conducted using quantitative data collection of an IRB approved survey that examines the prevalence and impact of microaggressions on populations of different demographics (ethnicity, religion denomination, sexual identification & orientation, etc.). Exploration of data will follow, however, data and/or analysis may not be available for presentation. Implications for identifying microaggressions will promote understanding of the larger and lasting effects on minority populations, and how the majority population have remained in positions of power through reinforcing such stereotypes.

Background: Anti- N-methyl-D-aspartate (NMDA) receptor encephalitis is the second most common cause of autoimmune encephalitis after acute demyelinating encephalitis. Patients often present with acute behavioral changes, psychosis, and abnormal limb movements. Alternatively, they can also present with symptoms of catatonia. Treatment for anti-NMDA receptor encephalitis typically consists of an immunotherapy protocol consisting of IVIG, steroids, and plasmapheresis, with more aggressive therapy being reserved for sever or refractory disease. This retrospective case report describes the medical treatment, physical therapy interventions, and outcomes of a 16-year-old patient diagnosed with anti-NMDA receptor encephalitis with malignant catatonia in the acute inpatient hospital setting.

Outcomes: She had 26 physical therapy sessions which incorporated interventions such as training in bed mobility, transfer, gait, functional strengthening, balance re-education, and dual task activities. With these therapeutic modalities combined with electroconvulsive therapy (ECT), she progressed to a supervision level for mobility tasks. Her score on the Bush Francis Catatonia Rating Scale improved from 27 to 9, her score on the Boston AM-PAC improved from 11 to 23 and her score on the Pediatric Balance Scale improved from 24 to 45. Initial interventions including bed mobility, transfer, and gait training, as well as, parent education and later included balance re-education and age appropriate functional tasks such as throwing, kicking, obstacle courses, and ambulation outdoors. Ultimately, the patient was able to progress to completing mobility tasks with supervision.

Discussion: The addition of ECT to the PT interventions was important, as it improved the patient’s ability to actively participate in PT sessions. She demonstrated consistent progress towards meeting her PT goals which facilitated her discharge home with her family with continued PT treatment in the outpatient setting.

The concept of “multiple jeopardy” (King, 2007) was coined to expand the term “double jeopardy” (Beale, 1970), and it adequately describes the overwhelming impact of social class marginalization when compounded with experiences of racial and gender bias. Black females facing multiple jeopardy on college campuses are often silenced by institutional barriers and peer pressure especially if they lack sufficient resources to face these barriers. The marginalized treatment includes negative stereotypes, feeling isolated or alienated, experiencing micro insults and invalidation in the classroom, residence halls and accessing campus services.

A four week mentoring program was created to improve our understanding of how race, class and gender intersect in the lives of these students and to assess the students’ self-efficacy with key coping strategies. Throughout the workshop series, techniques and strategies were taught by visiting guest speakers representing distinct career paths and industries based on their unique stories of resilience. Resources were offered to assist students in identifying both internal and systemic barriers, and existing campus resources were highlighted to develop a network of support for students facing challenges to their academic and career goals. Participants participated in an IRB approved study called “Coping with daily stress.” The pre-screening instruments for this study includes: demographic survey questions, Perceived Ethnic Discrimination Questionnaire (PEDQ), Perceptions of Racism and Oppression Scale (PROS-10), Positive and Negative Affect Scale (PANAS), and Interpersonal Support Evaluation List (ISEL-12). We hypothesize that black female students will have higher scores on perceptions of discrimination and that interpersonal support will mediate the relationship between perceived discrimination and negative affect. Implications for further research, equitable and inclusive teaching and campus programming will also be discussed.

Currently, half of the global population already lives in cities, and by 2050 two-thirds of the world’s people are expected to live in urban areas. Urbanization refers such a continue, rapid and huge population shift from rural to urban area, which has become a global issue because urbanization process has been occurring in nearly every part of the world inhabited by humans. Urbanization has led to a greater quality of life for many, but it also has its challenged. In this proposal, the causes, benefits and challenges, and sustainable management of urbanization will be introduced to GSU community through class-lectures and discusses, poster-exhibition, and GSU Research Day presentation during 2018 Spring semester. The purpose of the project is to enrich intellectual life in the entire GSU community through introduction of urbanization, its positive and negative effects on economy, environment, health, and social life. The specific objectives of this project are (1) to provide the latest data and information about urbanization to the students in GSU, (2) to enhance the university community to better understanding of the causes and effects of urbanization, and (2) to encourage all members of the GSU community to participate in protecting urban environments.

A frequent occurrence in the field of scientific research is the design and construction of equipment which is built to suit a specific set of experimental needs. Building such instruments provides both the knowledge of how the equipment works and allows a tool to be customized and crafted to exactly match the requirements of the experiment. This research exercise will involve the design, construction, and calibration of a spectrometer as well as the characterization of its performance. During the experiments that will be carried out using this tool the aspects of the design which limit performance will be identified and modified accordingly to produce the most accurate resolution of bands.

Spectrometers are instruments which are utilized to measure the discrete wavelengths emitted from a light source. Through the spatial separation of wavelengths, called bands, the discrete wavelengths which are being emitted on an atomic level can be measured. The two commonly most commonly implemented elements for the separation of light into its constituent wavelengths are prisms and diffraction gratings. Glass or crystal prisms use their inherent index of refraction to refract the light at various angles depending on each wavelength passing through the prism. Diffraction grating works via interference causing the light to diverge in separate directions, based on wavelength, where there is constructive interference between light scattering off the pattern on the grating. Utilizing these components to build a functioning, precise, and accurate spectrometer will be the final goal of this research.

The past decade there has been a surge in research investigating how and when immigrant children experience discrimination, and what the psychological and the educational consequences are (Spears Brown, 2015). Research has suggested that children who experience discrimination from their teachers and peers are not only more likely to have negative attitudes about school but also they may express lower academic motivation and performance (Spears Brown, 2015). The proposed research aims to fill in the gap in knowledge by addressing the impact of immigration on students at different age levels in the K-12 system and further explore the experiences of immigrants from Africa in U.S. education.

The purpose of this study is to explore the experiences of African children in K-12 system using a qualitative, narrative methodology. A narrative methodology combined with a critical race theoretical framework will illuminate the experiences of these students. In this proposal, I will detail my research questions, extant literature, and my research methods to gain more insight into this population. This will illuminate the challenges African immigrant Research indicates that ethnic-racial discrimination is expected to increase during middle school due to the rapid physical, cognitive, and social-emotional development, as well as changes in relationships with peers and adults (Roeser, Eccles, & Sameroff,2000; Niwa, E. Y., Way, N., & Hughes, D. L. 2014). I hope that my research will shed light on the challenges African immigrant children face in navigating through a different and unfamiliar system of educational system.

It has been noted that the effects of teen pregnancy on the mother are numerous. Majority of the time the mother is the sole provider and care taker of the child, resulting in less time for the mother to pursue her own educational goals. The purpose of this research is to analyze the various higher education institution support programs – or lack thereof – that are available to mothers who experienced teen pregnancy. The most applicable support program that mothers request is affordable childcare. This study will conduct research to gather information on the various experiences that teen mothers have with on-campus childcare services. Research will also be conducted on other programs that higher education institutions currently have in place for mothers along with their obtainability and effectiveness. Additional potential interventions will also be addressed to offer assistance in the enrollment and retention of teen mothers as students in higher education.

Environmental DNA has been shown to be a useful tool in studying populations. Many studies have demonstrated its ability to reveal the presence of an organism in an environment. While there are many studies that utilize eDNA to monitor aquatic species, there are few studies that use eDNA to study feline species. To explore the viability of using eDNA to monitor felids, we allowed domestic cats (Felis catus) to drink from water bowls of different sizes. After each cat drank from each bowl, eDNA samples were taken using filtered syringes over the course of a week. A qPCR analysis was performed to determine presence and quantity of cat DNA recovered from each sample. Results suggest that even a short interaction with water provides enough DNA for cat population studies.

Research has found that boys are more likely to have language impairments than girls. In fact, the ratio for language impairments comparing boys to girls is 3:1 (Hulit, Fahey, & Howard, 2015, p. 255). This means that for every girl that has a language impairment, there are three boys who have a language impairment. Therefore, it would be reasonable to conclude that gender differences can affect language. This poster session explores the topic of gender differences in early language development. More specifically, this poster session analyzes the neurological differences found between boys and girls in their early language development. Additionally, gender differences found in form, content, and use in the early language development of boys and girls will be analyzed.

It is evident that with the growth and development of our world, global leadership is becoming more important and more relevant in a variety of organizational platforms and political agendas. The purpose of this study is to discover and review what it means to lead globally. How an individual becomes successful within this leadership role is predicted through researching the most important competencies and characteristics of effective global leaders. An original intervention was also constructed to prove that there are a variety of strategies that can be implemented to better educate, coach, and train future leaders to be more prepared to lead with a global mindset. Higher education programs are one of the most applicable intervention strategies for developing future global leaders because the programs can be guided through focused curriculums and training methods taught by trained and experienced individuals in the field of leadership. Global leadership programs need to value transparency, authenticity, collaboration, action, and integrity as leaders will be working closely with individuals of various cultures and backgrounds. A primary focus of the higher education global leadership programs will be to immerse the more senior students into a corporation that communicates directly with diverse populations so that they are gaining first-hand experience as they near the completion of the program. It is vital to the success of the programs that students are not only educating themselves about diverse cultures and leadership but that they also have the opportunity to practice these skills in a controlled environment – such as working alongside the leaders of global corporations through internship-like positions.

In ANTH4600 Ethnographic Methods we learned how to methodically study the environment around us. The domains the class observed include the Governors State University D entrance, the cafeteria, and Alumni Path. We conducted mapping, structured observations, and used cameras to observe and record data. The photos in this presentation were selected from a collection of about two hundred photos taken by students in field. The photos were discussed and evaluated in class in the light of the American Anthropology Association Ethics guidelines, lessons gleaned from class readings concerning representing culture, and field notes. This poster represents everyday and iconic artifacts the class discovered and recorded in the field.

During that experience, we learned how to observe our surroundings and record data. We engaged in reflective and reflexive writing exercises. As a result of this field experience we were able to see familiar campus domains from a point of view that we had previously overlooked. The field work, recorded observations, and this representation of campus culture give way to several questions worthy of further ethnographic inquiry including concerns about waste and recycling, transportation, food security, preservation, sense of place and placelessness among other topics.

Predators can respond to changes in prey abundance through either numerical or functional responses. Numerical responses may occur rapidly, where the predator numbers closely track those of the prey; alternatively, there may be time lags exhibiting slow changes in predator numbers. Functional responses occur when predators switch between prey species or redistribute to regions of high prey abundance. The Keweenaw Peninsula, in Michigan's Upper Peninsula, extends into Lake Superior. This region is northern coniferous hardwood forests and supports 17 species of carnivores. Potential small mammal prey were trapped, tagged, and released on 1 ha grids to estimate density. Data was recorded on age, species, gender, mass, location, and ectoparasites. Predator numbers at the site were estimated using tracks, scat, remote sensing cameras, and traps. The most common prey items were the woodland deer mouse (Peromyscus maniculatus) and the red-backed vole (Myodes gapperi); to date, seven species of carnivores have been recorded at the field site. Throughout the summer and fall of 2017, small mammal numbers were three-fold less than in 2016. Pine marten (Martes americana) were the most abundant predator at the site, with some of the highest densities reported in the literature. These high predator densities remained after the decline in prey, suggesting a time lag. Concurrently, prey densities remained high on an island in Lake Superior that is devoid of mammalian predators.

This paper will prove that the Social Learning Theory purports that violent behavior witnessed or experienced by a criminal in their family and environment can contribute to their eventual deviant criminal behavior. It was important in my paper to understand the connection between the social learning theory and deviant criminal behaviors that described lack of attachment, past abuse, and family characteristics. A closer look will be taken that criminal behavior is learned by association with other criminals is factored into learned behaviors. This will show the social environment such as families, peer influence, and socioeconomics are explanations of crime. Also, my study will involve the history and basis of the Social Learning Theory. Albert Bandura developed the Social Learning Theory in 1977 and suggested that individual’s model behavior that is witnessed that contributes to delinquency and criminal behavior. The results will show a famous Bobo Doll experiment developed by Albert Bandura, in which this will prove children observe the people around them behaving in various ways.

NOTE: This poster was cancelled by the author.

Dragonflies are known to be a good indicator species, which means that by observing the effects that the environment as well as human activities have on them, the general impact to other organisms in that habitat can also be assessed. Very few studies have examined the relationship between water pH and dragonfly diversity. The research that has been done has shown a general trend of increasing dragonfly richness (number of unique species) with increasing pH. This relationship has not been examined thoroughly for the life stage most impacted by the water quality, the dragonfly nymphs. This is due in part to difficulties in visual identification of nymphs. DNA analyses must be done in order to identify species within this stage and thus to determine the relationship that exists between pH and overall richness. To conduct this study, DNA barcoding is being used to identify nymph samples from 10 different ponds, between Indiana and Illinois, collected over the past 3 years. After the samples are identified, they will be correlated with pH values of the ponds sampled, which ranged from 7 to 11, in order to determine the relationship that exists between richness and pH. The hypothesis, based on the scarce research available on the topic, is that richness will be positively correlated with pH. This study aims to show how pond water pH affects dragonflies, which will increase the general knowledgebase of the impacts the environment has on them.

The purpose of this research is to examine specific works by Edgar Allan Poe that best emulate his literary obsession with insanity and the grotesque, arguing that these elements of his literature serve as the source of inspiration for many contemporary gothic artists. When analyzing 20^th and 21^st century gothic artists such as authors Mary Wilkins Freeman, H.P. Lovecraft, Stephen King, singer Rob Zombie, and filmmaker Kevin Williamson, striking similarities to Poe’s work are discovered. Although most research focuses primarily on Poe’s inspiration over other writers, this study researches his literary influence in a variety of artistic outlets; implying that Poe has been an inspiration to many styles of contemporary gothic and horror artists in the later centuries. Understanding the significant inspiration that Poe’s work has on how other artists present their gothic pieces suggests just how big of an impact he is within American art history and how we can predict that he will continue to have significant influence in the centuries to come.

When configuring a delay tolerant network (DTN), there are many aspects that need to be taken into consideration for an effective and efficient network. One aspect is a buffer management strategy. Buffer strategies are used to determine which packets need to be forwarded or dropped. This paper will focus on the variety of buffer management strategies available, providing a comprehensive survey and analysis. They have all been taken into consideration, evaluated, and then classified into different categories based on their features.

Background and Purpose: The incidence of patients undergoing a total hip or total knee arthroplasty is continually increasing. Despite this increase in prevalence, few studies have reported the outcomes of physical therapy (PT) intervention for a patient who has undergone a simultaneous ipsilateral total hip and total knee arthroplasty. The purpose of this retrospective case report is to describe the clinical, functional, and patient reported outcomes impacted by skilled PT intervention in the rehabilitation of a patient who presented to acute care PT immediately post-op simultaneous right total hip (postero-lateral approach) and right total knee arthroplasty.

Case Description: The patient described within this retrospective case report was a 53-year-old Caucasian male who presented to acute care PT post-op day 1 after a simultaneous right total hip and right total knee arthroplasty. This patient had also undergone a simultaneous left total hip and left total knee arthroplasty within six months prior to this episode of care.

Outcomes: Following two days of PT intervention, with two PT sessions per day, the patient demonstrated improvements in pain ratings, functional mobility, gait velocity, ambulation distance, stairs ascended, and active range of motion (AROM) of the right knee and right hip.

Discussion: PT intervention appeared to be correlated with improvements in functional and clinical outcomes for the patient described in this case report. Future research is needed to determine the long-term effects of PT intervention on clinical and functional outcomes for patients who have undergone a simultaneous ipsilateral total hip and total knee arthroplasty.

Introduction: With falls in the elderly being an increasing epidemic in our country, investigation has begun as to what could have the largest influence on the prevalence or recurrence of falls. According to the CDC, “older Americans experienced 29 million falls causing seven million injuries and costing an estimated $31 billion in annual Medicare costs.”¹ On top of the financial costs, falls are ranked as the 6th leading cause of death among this population.³

Methods: We related manual muscle test scores, gait distance, and numeric pain rating score to changes in scores on the falls efficacy scale(FES) to see if that could be correlated to functional gains or limitations according to the Functional independence measure.

Results: The patient was able to show improvements in quality measures scoring for the motor component from evaluation to discharge improving from total assist for transfers to contact guard assist. Also seen in our test and measures our patient left with a FES score of 35/100. It was curious that the only area that the patient scored a 10/10 meaning he was very fearful of performing the task was reaching into cabinets or closets. Discussion: There is a professional call to action to provide more patient centered care, therefore the patient’s quality of life should be something measured in all settings. Usage of the FES to focus on building confidence during transfers after a fall as opposed to strength, ambulation distance, or access to community resources seems to be a novel concept.

Background/purpose: Greater trochanteric pain syndrome (GTPS) is a tendinopathy of the gluteus medius tendon accompanied by pain upon palpation in the area of the greater trochanter of the femur. It has been associated with lower levels of full-time employment, significant pain,, and lower quality of life and it occurs in approximately two percent of people in the primary care setting. However, there is no evidence-based protocol in treating GTPS. ASTYM® is a technique which has evidence supporting its use in treating chronic tendon impairments, but no formal research is available in its treatment of GTPS. Thus, the purpose of this case report was to report on the use of ASTYM ® and stretching and strengthening in treating GTPS.

Case Description: The individual was a 52-year-old female with symptoms indicative of GTPS, with an insidious onset beginning four to five months prior. She had complaints of constant pain with worsening symptoms.

Outcomes: The individual attended 11 total physical therapy visits, but demonstrated no clinically significant improvements in function or pain as measured by the Lower Extremity Functional Scale and the Numeric Pain Rating Scale, respectively. The individual verbalized improvement in her symptoms and her gait mechanics demonstrated improvement.

Discussion: Limited improvement in quantitative measures suggests ASTYM® was an ineffective treatment. Improvement in the individual’s gait mechanics and in her qualitative report could indicate otherwise. Further research on the use of ASTYM® in treating GTPS should occur before it is concluded ineffective in treating GTPS.

Background/purpose: Guidelines for PT to PTA delegation are vague. Coupled with decision-making processes for delegation not being well-defined in the literature and limited published research on this topic, PTs may find themselves in the midst of an ethical dilemma. The purpose of this case report is to explore and describe the decision-making process behind PT to PTA delegation of a medically complex patient with congestive heart failure (CHF) in the acute care setting to further the discussion of appropriate delegation practices within the physical therapy profession.

Case Description: An 88-year-old African American male recently admitted to an acute care facility with acute on chronic diastolic and systolic CHF. The therapy team that provided acute rehabilitative services consisted of two PTs and one PTA. PT to PTA delegation practices at this hospital were primarily determined by census and patient need for skilled services.

Outcomes: The patient was seen by an SPT for a total of four visits. Despite discharge recommendations to receive more care at a skilled nursing facility, the patient chose to return to his assisted living facility housing.

Discussion: Delegation practices in acute care are often based on hospital census, caseload demands, productivity, and services required without full consideration of ethical best practice. Renewed focus on a patient-centered approach is needed when making delegation decisions in the acute care setting. Patient factors, interventions within the plan of care, scope of practice, risk management, and the code of ethics should be considered prior to delegating patient care to a PTA in this setting.

The high affinity folate receptor (FR) is overexpressed on approximately 80% of all cancer types and activated macrophages associated with numerous inflammatory conditions. Consequently, FR has emerged as an attractive target for the selective delivery of folate guided therapeutic agents and for development of diagnostic strategies that are able to identify folate receptor positive cancer and immune cells in both in vitro and in vivo assays. This report describes a rapid method for the construction of a folate fluorophore targeting ligand with a biotin functional group, for the facile and rapid conjugation of streptavidin species containing either imaging agents for multimodal imaging or therapeutic agents. This strategy should prove useful for other targeting ligands and surface labeling schemes.

Background/Purpose: Approximately 4.0 million adults in the United States are living with a total knee replacement. Many patient-related factors such as age, race, BMI, comorbidities, and prior level of function are known to influence functional outcomes and discharge destination following total knee arthroplasty (TKA) surgery, however, little research has been done on the specific factors that influence length of hospital stay and discharge to the home environment.

Case Description: The patient was a 68-year-old African American female who presented to acute care physical therapy in a hospital setting, the day after she had undergone a left total knee arthroplasty.

Outcomes: The patient attended a total of 5 physical therapy sessions over the course of 3 days following her surgery. She was discharged home on her fourth day of hospitalization, having met her functional goals of achieving modified independence in bed mobility, transfers, and ambulation, rendering her safe for return to her home environment.

Discussion: The early initiation of rehabilitation and the patient’s lack of significant comorbidities likely contributed to her quick functional improvements and discharge to her home environment. This patient’s outcomes suggest that comorbidities play a larger role than race in predicting discharge destination following hospitalization in patients who underwent a TKA. Further research can help determine the specific weight these factors carry in determining length of hospital stay, discharge destination, and functional outcomes after a TKA

Background and Purpose: Injury to the ACL is seen across many populations, however there is a preponderance of ACL lesion in adolescent, female soccer athletes. While “accelerated” protocols boast significantly shorter recovery times, uncertainty still remains regarding their long-term success, compared to “traditional” protocols. Determining, understanding, and administering a proper ACL rehabilitation program is of vital societal, medical, and financial imperative.

Case Description: The patient was a 15 year-old African American female who presented to physical therapy following an injury to her right leg during a soccer match, which occurred when planting her right foot to shoot. Her orthopedist confirmed a tear of the right ACL and possible involvement of the right meniscus via MRI and recommended 7 weeks of physical therapy before reconstructive surgery. The patient then took part in 7 weeks of postoperative therapy on an accelerated protocol.

Outcomes: The patient completed 16 sessions of postoperative physical therapy (PT) and outcomes were positive, with notable improvements in strength, ROM, function, and quality of life. At the time of discharge, the patient was on course for an eventual return to athletics.

Discussion: The patient improvements throughout the 7 weeks of accelerated postoperative physical therapy were likely aided by several personal factors, most importantly a high level of motivation for the rehabilitation process. The accelerated protocol, although showing promising evidence in select populations, should be implemented only after careful consideration of all patient factors.

Background and purpose: According to the CDC 1.5 million people get sepsis each year, with 250,000 people dying each year from septicemia. Sepsis has an impact on physical and cognitive function and evidence shows decline after episode that continues to persist after the sepsis has resolved. Decline in physical function deems rehabilitation needs in efforts to return to prior level of function.

Case description: Patient is a 72 year old female status post a fall requiring hospitalization with a diagnosis of sepsis and clostridium difficile presenting for rehabilitation services at a skilled nursing facility with severe deconditioning.

Objective: The purpose of this case study is to investigate the impact of C.difficile septicemia on functional mobility outcomes of an elderly patient in a skilled nursing setting..

Design: Retrospective case report.

Outcomes: The patient completed 26 sessions of physical therapy in a skilled nursing facility for a span of three weeks with the inclusion of occupational therapy and speech language pathology. The patient improved in bed mobility, transfers and ambulation with significant decrease in level of assistance. Additionally, the patient improved in strength through improvements in manual muscle testing, sitting balance activities through use of the Function in Sitting Test and most significantly standing balance and gait through evidence in the Tinetti Gait and Balance Test scores. Although the patient made significant gains she did not reach her baseline and continues to be at high risk for falls.

Conclusion: Clostridium difficile induced septicemia can have a detrimental effect on physical and cognitive function. A multitude of therapy services, including physical therapy are required to prevent further decline in function, aid in returning the patient to prior level of function, regain strength and promote physical activity.

Background and Purpose: West Nile virus (WNV) was first introduced into the United States in 1999 and continues to be an annual epidemic, particularly in the Midwest region. Approximately 1% of WNV cases are neuroinvasive. The subtypes of neuroinvasive WNV include encephalitis, meningitis and poliomyelitis. The purpose of this case report is to describe the physical therapy plan of care and functional outcomes for a 54 year old female patient with West Nile virus encephalitis in the long term acute care hospital (LTACH).

Case Description: The patient was a 54 year old Caucasian woman in good health who became acutely ill. The patient was diagnosed with West Nile virus encephalitis with respiratory failure and presented with debility, weakness and flaccid paralysis in her left upper extremity. She was admitted to the long term acute care hospital for ventilator weaning and physical therapy was introduced to address the patient’s functional limitations.

Outcomes: After receiving care for 19 days and participating in 9 physical therapy treatment sessions, the patient’s functional status improved from being dependent for standing and non-ambulatory to ambulating 24 feet with a rolling walker. There was a clinically significant improvement in the patient’s AM-PAC “6-Clicks” Basic Mobility score and an improvement in her FIM score, although not clinically significant. Following care in the LTACH, the patient advanced to an acute inpatient rehabilitation facility.

Discussion: The patient’s improvements in bed mobility and transfers are promising indicators that functional mobilization helped increase endurance and strength necessary for these activities. Further research may help determine preferred treatment options for patients with West Nile encephalitis (WNE) and the possibility of post-West Nile virus poliomyelitis syndrome.

Purpose: Home healthcare professionals providing services to patients with heart failure (HF), should consider the current high rates of hospital readmissions. The purpose of this retrospective study is to determine if home health physical therapy impacts hospital readmissions in patients with HF.

Methods: Electronic charts for patients with HF were analyzed, looking at the number of hospital readmissions during a single home health care episode, regardless of physical therapy (PT) delivery. Charts were also analyzed for number of PT visits and associated patient demographics, to determine their impact on rehospitalizations in this population.

Results: Most of the sample included patients 65 to 84 years of age with Medicare benefits. 949 total charts were analyzed with 340 cases meeting the inclusion criteria using the SAS program. Of this sample size, 230 (67.6%) patients received physical therapy services with an average of 6 to 10 visits provided. 127 (35.4%) patients were readmitted to the hospital, with majority of the admits due to non-HF related reasons.

Conclusions: There was no significance found in rehospitalization rate for patients receiving PT services verses those that did not. When PT services occurred, there was an average of 6 to 10 therapy visits provided and this may have some significance with the findings from this study. The results from this study indicate, women had a higher readmission rate (p=0.01) and majority of patient readmissions were Medicare beneficiaries (p=0.08). The varied clinical practicing styles and types of therapy interventions provided, could have influenced the findings in this study. Further research with a lager sample size and geographical region, may help healthcare professionals provide better clinical services to patients with HF.

Background and purpose: Total Knee Arthroplasty (TKA) is the most frequently performed joint replacement surgery in North America. There is limited information on the preferred type of exercise to be performed in the later stages of rehabilitation following TKA in order to promote pain relief and muscular strength. The purpose of this case study was to describe the outcomes of closed chain exercises (CCE) post TKA as it relates to pain relief and muscular strength.

Case description: A 58 year old female reported right knee pain and instability. The onset occurred immediately following her right TKA seven years prior and has occurred intermittently since that time. Her plan of care for physical therapy (PT) was to be seen 2x per week for six weeks. The interventions were focused on strengthening weak musculature and improving poor motor control of her right knee and hip muscless, emphasizing eccentric limb control during closed chain lower extremity exercises.

Outcomes: Following 10 sessions of PT, she demonstrated improvements in pain reduction, overall function, and objective measurements in muscle strength, dynamic muscle testing, lower extremity functional scale, and single leg stance time.

Discussion: A rehabilitation program that focused on CCE emphasizing eccentric control appeared beneficial in pain reduction and improved function in a middle aged female. Further research would be beneficial to address the longitudinal benefits of CCE.

Background: Cancer continues to be a leading cause of mortality in the United States today, second only to heart disease in annual number of deaths due to the disease. A common treatment for malignant forms of abdominal cancer is surgical resection of the cancerous tissue. And while general guidelines for exercise interventions and other treatment strategies for individuals with cancer have been made available, a peer-reviewed, comprehensive clinical practice guideline, does not yet exist. Thus, due to the ever-increasing demand for high quality, cost effective cancer care, the current retrospective case report seeks to contribute to the eventual formulation of such a guideline with a focus on appropriate physical therapy outcome measures and interventions for postsurgical patients with abdominal cancer in the acute care setting.

Case Description: A 67-year-old Caucasian female was admitted to the hospital with invasive, moderately differentiated, gastric adenocarcinoma status post 4 previous cycles of FLOT therapy. Repeat imaging demonstrated a mass-like prominence at the GE junction compatible with known gastric cancer with no evidence of metastatic disease. The patient’s PMH is significant for breast cancer (1993) with subsequent bilateral mastectomy, hypertension, and osteoporosis. She is a retired teacher who currently lives with her husband in bi-level house, reports never being a smoker, no history of drug use and 12 oz./week of alcohol consumption. She reports being functionally independent prior to admission and now presents to physical therapy status post exploratory laparoscopy, total gastrectomy with en bloc splenectomy, Roux-en-Y esophagojejunostomy, needle catheter feeding jejunostomy, and left closed-tube thoracostomy. Therapeutic interventions throughout the patient’s plan of care focused primarily on functional mobility, including bed mobility, transfer training, gait training, ambulation tolerance, and functional balance training.

Outcomes: On the day of discharge, following an 8-day inpatient stay, the patient was independent and timely with all bed mobility and transfers and was capable of at least 500 ft of continuous, independent ambulation. Thus, the patient was deemed functionally independent and appropriate for discharge home with recommendation for continued therapy via Home Health PT.

Discussion: This care report describes possible interventions and outcome measures for the treatment of postsurgical patients with abdominal cancer in the acute care setting.

Background: A general description of common symptoms and impairments related to tennis leg have been presented in the literature. However, little has been written about specific treatment guidelines and possible intervention options in treating cases of tennis leg in elderly populations.

Case Description: A 70-year-old male, retired tennis coach was self-referred to physical therapy for acute knee and calf pain after a quick stop during a recreational tennis match. The pain was preventing him participating in tennis and was bothering him when walking. Examination of the knee did not reveal any abnormal findings beyond slight swelling and loss in knee ROM. Additional examination of the proximal kinetic chain revealed muscular imbalances and strength and ROM deficits in the hip and knee. Seven sessions of physical therapy were provided to target these impairments.

Outcomes: The patient was able to ambulate functional distances and complete activities of daily living (ADL) without pain. He was also able to participate in tennis activities low intensity and volume.

Discussion: This case describes possible intervention strategies to treat impairments resulting from acute tennis leg in active, elderly male patients.

Background and Purpose: Peroneal tendons play a significant role in functional ankle stability. Fear avoidance of activity may affect recovery in patients with ankle instability. Currently, there is a lack in research in fear avoidance identification and change in plan of care to include pain education for patients with ankle instability. The aim of this case report was to determine plausible modification of the Yellow Flags Questionnaire (YFQ) at identifying fear avoidance behaviors in a patient with concomitant peroneus longus and brevis tears. A secondary purpose was to assess short term functional outcomes following the addition of pain educational interventions for this patient.

Case Description: A 55-year-old female with greater than one-year history of chronic left ankle sprain, which resulted in decreased performance of ADLs due to significant amount of left ankle pain. Conservative therapy was attempted to no avail. Surgery was performed after an MRI revealed a complete peroneal longus and brevis tendon tear.

Outcomes: A modified Yellow Flags Questionnaire (YFQ) was administered at week 8 of 10 with clinical signs of pain catastrophizing with low intensity weight bearing activities. The YFQ score was 46[SD1] , indicating that the patient was at moderate risk of developing chronic pain as a functional limitation. The Lower Extremity Functional Scale (LEFS) and the numeric pain rating scale (NPRS) were the main targeted outcomes throughout treatment. The percent change from re-examination to discharge was greater than examination to re-examination for both LEFS and NPRS scores (58% vs 29% and 67% vs 25%, respectively), indicating an increase in patient perceived function in ADLs.

Discussion: A modified YFQ is plausible for detecting fear avoidance behaviors and guiding a change in interventions to include patient education on pain[SD2] with movement. The history of ongoing diminished functional capabilities due to a chronic ankle sprain prior to surgery may have contributed to a re-wiring in the nervous system, causing inappropriate fear avoidance behaviors. This case study sheds light on the need for further research on developing reliable fear avoidance questionnaires for patients with chronic ankle conditions.

[SD1]How does this score relate to the onset or development of fear avoiding behaviors?

[SD2]What about pain – causes, impact, etc? Please explain briefly.

Background and Purpose: The purpose of this retrospective case report is to investigate the impact of educational interventions (EI) focused on safety with functional mobility and physical activity (PA) in a patient with secondary progressive multiple sclerosis (SPMS) and her family in order to ensure future patients with multiple sclerosis (MS) are able to maximize independence following outpatient day rehabilitation (DR).

Case Description: The patient was a 59-year-old female with SPMS who developed a left lower extremity (LE) deep vein thrombosis (DVT), resulting in decreased mobility. The patient was treated in outpatient DR for decreased mobility with patient/family education, functional mobility practice, and therapeutic exercise.

Outcomes: The patient made little net improvement with functional mobility as demonstrated through continued need for reiteration on patient/family education topics, required physical assistance with functional mobility, and score on Day Rehabilitation Outcome Measure (Day ROS), a measurement tool for assessing independence on activities of daily living.

Discussion: Research supports the need for health coaching using behavior of change models in patients with chronic illnesses, though the patient demonstrated little net progress in mobility and with comprehension of education topics. The addition of coaching may have changed the patient outcomes

Purpose: The purpose of the case report is to describe the therapeutic approach of using directional preference and gait training on a patient with low back pain with radicular symptoms post bilateral bunionectomy with second toe reconstruction.

Case Description: Patient was a 57 year old male that presented to physical therapy with chief complaint low back pain with radicular symptoms into his right hip and posterior thigh and bilateral foot pain. The patient reported a history of bilateral bunionectomy and second toe reconstruction in 2016 that was also treated for 4 weeks into his treatment time secondary to pain and decreased sensation during ambulation. The patient participated in 12 sessions of outpatient physical therapy for his low back pain with radicular symptoms and 9 visits of outpatient physical therapy for bilateral foot pain, consisting of directional preference exercises, manual therapy, cryotherapy, gait training, therapeutic exercise, neuromuscular re-education, therapeutic activity and patient education.

Outcomes: The patient’s pain was assessed using the numeric pain scale at the initial evaluation and was 5/10 that would increase to 8/10. His pain decreased to 2/10 at his last physical therapy session for his low back pain. The patient reported centralization of lower extremity symptoms at discharge. Bilateral foot symptoms changed minimally but he was able to ambulate further before onset of symptoms compared to before treatment. The modified Oswestry disability index (ODI) initial score improved from 64% disability to 46% disability and the lower extremity functional scale (LEFS) score was unchanged at final session.

Discussion: This case report suggests using directional preference, specific exercise and gait training may improve outcomes for a patient with low back pain with radicular symptoms and bilateral foot pain.

Background and Purpose: The purpose of the case report was to describe a plan of care to address pulmonary and musculoskeletal impairments in an individual with an acute complete spinal cord injury to assist in weaning the patient off mechanical ventilation and progress in rehabilitation. Mechanical ventilation is associated with nosocomial infections such as pneumonia which increase ICU stays and costs to the hospital.

Case Description: 37-year-old African American male presenting with C8 complete spinal cord injury and fractured proximal humerus, scapula, and clavicle secondary to multiple gunshot wounds in an acute care setting. The patient received interventions to improve function during his rehabilitation at the hospital. The patient was seen by physical therapy over a three-week period.

Outcomes: Patient demonstrated improvement in respiratory function with being discontinued from mechanical ventilation by the second physical therapy session and more consistent vital signs such as respiratory rate and oxygen saturation. The patient was discharged to an inpatient rehabilitation clinic to continue physical therapy.

Discussions: The case report supports the importance of pulmonary rehabilitation in acute care physical therapy to improve rehabilitation potential and quality of life. Physical therapy may not have been the major focus in the plan of care but did play a vital role in the healthcare team

Background and Purpose: Reverse shoulder arthroplasty is indicated for an increasing number of conditions, but evidence is limited regarding a post-operative physical therapy protocol for these individuals. The purpose of this retrospective case report is to describe the physical therapy intervention provided for treatment of a patient who received a reverse total shoulder arthroplasty following a proximal humerus fracture.

Case Description: The patient was a 68-year-old male who underwent a right reverse total shoulder arthroplasty after sustaining a comminuted right humeral neck fracture during a fall. The patient presented with limitations in range of motion, strength, upper extremity function and disability.

Outcomes: Patient completed 16 outpatient physical therapy treatment sessions and showed improvements in range of motion, strength, and shoulder function and disability, as demonstrated by improved scores on the QuickDASH.

Discussion: There is limited data supporting the use of any rehabilitation protocol following a reverse total shoulder arthroplasty. The outcomes of this case report suggest that the implementation of a structured physical therapy protocol may be beneficial in improving function for these patients. Further research is warranted with larger sample sizes to evaluate the efficacy of implementing any particular physical therapy protocol for patients following RSA.

Background: Injuries from falls may require hospitalization. Trauma to the body from the fall may present as hematomas, and alterations to the blood components, limited mobility, and prolonged bed rest may increase the risk of deep vein thrombosis (DVT) formation.

Purpose: The purpose of this case report was to demonstrate the plan of care of a 97-year-old female diagnosed with a DVT in her right calf nine days after surgical irrigation and debridement of a hematoma in her right knee following a fall.

Case Description: The patient was a 97-year-old female who required surgical irrigation and debridement of a hematoma in her right knee following a fall. Nine days after the procedure, she developed a DVT in her right calf. The patient initially presented with high fall risk, with an immobilizer at the right lower extremity, pain in the right lower extremity, and required maximum assistance for sit to stand transfers.

Outcomes: After 21 days of physical therapy, the patient continued to report pain, continued to require a right knee immobilizer, was at high fall risk on the Morse Fall Scale (MFS), and was unable to perform a sit to stand transfer. After consultation with the patient and her family, the family decided to place her into hospice care for increased comfort, and was discharge from physical therapy.

Discussion: Although, the interventions were focused on maintain and increasing the patient’s functional mobility, the patient’s medical status did not improve. The lack of information in the medical history and the physical and psychological stress from the fall, the surgery, and being hospitalized could have caused a slowing in the patient’s recovery following the DVT.

Background and Purpose: Patients’ access to physical therapy can be limited by out-of-pocket costs, including insurance co-payments. Cost of co-payments has become an issue in the field of physical therapy. Patients often request reduced visits secondary to the cost of the co-payment, which requires the physical therapist to adjust the plan of care to effectively address the patients’ impairments. Cervical radiculopathy is a common condition in the geriatric population and can be effectively addressed with physical therapy.

Case Description: The patient was a 74-year-old female with cervical radiculopathy with complaints of left upper arm pain with numbness/tingling that radiated to her hand. She also had a co-payment of $25.00 due at each visit and requested reduced visits.

Outcomes: The patient completed four outpatient treatment sessions and demonstrated a complete decrease in her pain. She also showed a clinically significant improvement in score on the QuickDASH.

Discussion: This case report provides an example of the effects of co-payments on patient access to physical therapy, as well as how the plan of care is delivered based on reduced number of visits. This issue has been brought up to the forefront and is being addressed by several states across the country. Until further changes can be made to reduce the cost of co-payments, physical therapists must adapt the plan of care to adequately meet all of the patients’ needs while effectively treating the impairments. Creating a cost-effective plan of care is crucial in situations like this and incorporating evidence-based care can help improve the outcomes. Interventions, including therapeutic exercises and manual therapy, have been shown to help improve patients’ symptoms with cervical radiculopathy

Background and Purpose: According to the National Spinal Cord Injury Statistical Center, the 2017 estimate for the annual incidence of spinal cord injury (SCI) in the United States was approximately 17,500 new SCI cases each year. Studies have shown that geriatric patients are particularly vulnerable to SCIs; however, there is limited research focusing on this population. The purpose of this case report is to describe the effects of activity-based therapy on functional outcomes for a geriatric patient with functional quadriplegia and multiple co-morbidities after six weeks of multidisciplinary rehabilitation, including physical therapy.

Case Description: The patient was a 77 year-old African American female who was admitted to a skilled nursing facility after hospitalization for suprapubic pain, multiple sacral pressure ulcers, and anemia. She also had functional quadriplegia secondary to complications of a cervical laminectomy one year prior. Prior to admission, the patient lived at home with family members, was non-ambulatory, and was dependent on family members for bed mobility and transfers.

Outcomes: Patient completed 29 activity-based therapy sessions, 4-5 times per week, over the course of 6 weeks. She made improvements in balance, lower extremity strength and range of motion (ROM). The Function in Sitting Test (FIST) outcome measure improved from 28/56 to 30/56 (MCID≥6.5 points) and Spinal Cord Independence Measure III (SCIM-III) improved greater than the minimal clinically important difference (MCID) from 10/100 to 18/100 (MCID: 4 points).

Discussion: The patient made significant improvements in functional outcomes after 6 weeks of progressive activity-based therapy. Despite the patient’s outcomes, the patient’s insurance did not authorize for more therapy which resulted in the patient being discharged home. Further research is needed to determine the benefits of activity-based therapy following SCI in geriatric patients, and how those may help decrease readmission rates and costs related to care.

Background/Purpose: Neck pain is one of the most common disorders worldwide, causing increased morbidity and decreased function. Neck pain has many treatment options; however, the exact cause of some cases of neck pain are unknown. The Mechanical Diagnosis and Therapy approach treats patients based on their response to movements since there is limited accuracy with medical diagnoses. The purpose of this case study was to describe the effectiveness of the MDT approach and exercise progression to address functional limitations and restore function in a patient with neck pain.

Case Description: 75-year-old Caucasian female with sudden onset of neck pain when she awoke. Pain radiated into her shoulders and face. CT Scan had no remarkable findings. Patient was unable to drive and complete ADLs secondary to pain. Patient wanted to go to her grandson’s wedding without pain.

Outcomes: After the 3^rd visit, the patient was able to attend her grandson’s wedding without pain. On the 4^th and final visit, the patient was able to complete functional activities without an increase in neck pain and was able to return to her ADLs at home. Her NDI score was a 0% at discharge, showed improved cervical range of motion, and pain was 0/10 since the 3^rd visit.

Discussion: A simple MDT exercise progression consisting of cervical ROM exercises and patient education, with good patient adherence, showed positive results in the decrease of pain and restoration of function. Further studies would be beneficial in determining the recurrence of neck pain.

Background and Purpose: Cerebral Palsy describes a group of developmental disorders of movement and posture, resulting in activity limitations. Recent literature has shown a shift from impairment-focused treatment to functional training targeted at the activities/participation level. However, there is limited research on the effectiveness of functional training and optimal treatment dosage for clinically significant functional improvements in children with cerebral palsy. Therefore, the purpose of this case report was to examine the effects of a functional training program consisting of 30-minute sessions once weekly for 6 weeks on changes in postural control and functional mobility in a child with cerebral palsy.

Case Description: The subject was an 11-year old girl with Gross Motor Function Classification Scale level II diplegic cerebral palsy and a hearing impairment. She received individualized functional training in a middle school setting, which focused on task-oriented dynamic balance and mobility tasks, once per week for 30-minute sessions for a total of 6 visits over a 6-week period. Postural control and functional mobility were assessed at initial visit and post 6-week intervention with the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2), Trunk Control Measurement Scale (TCMS), Timed Up and Go (TUG), and Five Times Sit to Stand Test (FTSST).

Outcomes: Following the 6-week training period, the subject showed improvements in static/dynamic balance and functional mobility as evidenced by improved results on BOT-2, TCMS, TUG, and FTSST. There was a clinically significant improvement of 8 points on the TCMS and a minimal clinically important difference of -1.8 s on the TUG following treatment.

Discussion: The application of a functional training program conducted for 30 minutes once weekly for 6 weeks produced positive functional outcomes such as increased functional lower extremity strength and improved postural control during functional tasks in the school environment. These results support similar studies that found improvements in functional strength, mobility, and gait kinematics in children with cerebral palsy.

Falls can be devastating to the health and wellbeing of patients with Parkinson’s disease (PD). 60.5% of patients with PD have at least one fall and 39% have recurrent falls. Previous studies have shown high velocity movement therapy have had positive results in treating patients with PD. The purpose of this study is to determine the efficacy of high velocity movement therapy in decreasing fall risk in patients with PD.

This case report revolved around a 76 year old male diagnosed with PD in 2010. Patient presented with traditional parkinsonian symptoms and had no history of falls. The patient was treated in six treatment sessions with emphasis on high velocity exercises and gait training. Tests and measures used included Tinetti balance tool, Timed Up and Go (TUG), single leg stance time (SLS), and tandem stance time.

He increased his Tinetti score by 6 points, decreased his TUG time by 1.36 seconds, and increased his tandem stance time to over one minute on bilateral legs on a compliant surface. SLS time did not change following therapy.

The patient’s improvements in the Tinetti and TUG were encouraging thou were not deemed statistically significant. The tandem stance time was the only measurement that increased significantly indicating a decrease in fall risk. Though the patient outcomes were only mildly improved this study provides evidence that high velocity movement therapy can decrease the fall risk in a patient with Parkinson’s disease

Multiple sclerosis (MS) is one of the most common neurological diseases in the United States, with relapsing-remitting multiple sclerosis (RRMS) being the most prevalent form, involving recurrent exacerbations that result in residual impairments between episodes. Limited research exists for effective physical therapy (PT) interventions for patients with MS immediately following a relapse or exacerbation. Therefore, the purpose of this retrospective case report was to describe the impact of an individualized and intensive inpatient PT program for a patient with RRMS immediately following an exacerbation. The patient in this case report was a 64-year-old male who presented to an inpatient facility with RRMS following toxic encephalopathy secondary to polypharmacy. The patient completed 60-90 minutes of skilled physical therapy per day for a total of 10 days in the inpatient rehabilitation facility. The patient showed considerable progress in functional mobility as measured by the Functional Independence Measure (FIM). Based on the patient’s functional impairments, PT treatment sessions included safety awareness, patient education, therapeutic exercise (lower extremity strengthening and stretching), neuromuscular re-education (balance/coordination training and postural education/facilitation), functional training (bed mobility training, transfer training using a rolling walker, gait training using a rolling walker, stair training, curb transfer training, wheelchair mobility) and fall recovery. Performed interventions were individualized and unique to this particular patient, thus these interventions should be not generalized to all individuals with MS. Further research involving studies with an extended rehabilitation period and/or a follow-up assessment would help contribute to validated treatment methods for patients with RRMS following an exacerbation

Background and Purpose: Dizziness and vertigo account for roughly 4% of chief symptoms in the emergency department. Ependymomas are rare brain tumors, consisting of 1-5% of central nervous system tumors, that arise from the ependymal lining of the ventricular system of the spinal canal. Signs and symptoms tend to consist of headaches, vomiting, papilloedema, ataxia, dizziness, and nausea. Vestibular physical therapy can be a valuable asset for these individuals to increase functional independence.

Case Description: The patient was a 64-year-old Caucasian male who presented to the physical therapy initial evaluation status post craniotomy with symptoms of dizziness, vision issues, decreased endurance, and balance deficits. The patient’s MRI revealed a 4th ventricle tumor, which was removed via uncomplicated resection, approximately 2 weeks before the initial evaluation. In surgery, the tumor could only be partially resected, leading to a radiology consult for complete abolishment of the tumor. Partial resection is a common result of intracranial ependymoma resection surgeries, especially in the 4th ventricle where a complete resection is often not possible. One study found that only 4 out of 33 patients had complete ependymomal tumor resection. Upon resection, the tumor was sent to the lab where it was determined to be an ependymoma World Health Organization (WHO) grade II. The patient’s chief complaints included vertigo, vision problems (diplopia), balance deficits, and self-reported decreased endurance.

Background and Purpose: The current opioid epidemic facing the United States has brought with it increased rates of morbidity and mortality. One such condition that can develop following inappropriate opioid use rhabdomyolysis. Limited research exists on the role of physical therapy in non-exertional rhabdomyolysis, especially in the acute care setting. The purpose of this report was to describe the physical therapy treatment of non-exertional rhabdomyolysis in the acute care setting and determinants impacting decision making.

Case Description: The patient was a 17 year-old female that developed rhabdomyolysis following illicit drug use. The patient presented with decreased lower extremity strength, sensation, and functional mobility. Interventions focused on ambulation, neuromuscular re-education and patient education. The framework of decision making in acute care described by Jette was employed to guide interventions and discharge planning.

Outcomes: The patient completed nine physical therapy sessions while in acute care. Improvements were seen in lower extremity strength of hip flexors and knee extensors, a 0.393 m/s improvement gait speed (MCID 0.16 m/s) in the 10 Meter Walk Test, a 205.74 m improvement in gait distance in the 6 Minute Walk Test and greater independence with functional mobility. Recommendation for inpatient rehabilitation remained throughout due to several factors, however insurance denied the request.

Discussion: This report highlights the role of physical therapy in a unique case of rhabdomyolysis. Due to the limited research on treatment and prognosis, various factors were considered to guide intervention selection and discharge recommendation. Further research regarding specific treatment and the role of societal factors impacting long-term outcomes following drug-related rhabdomyolysis is needed.

Background and Purpose: The purpose of this retrospective case report is to report on the utility of the goal attainment scale in the selection of developmentally appropriate interventions for a child with agenesis of corpus callosum and 1p36 deletion syndrome.

Case Description: The patient is a 3-year-old female who has a diagnosis of agenesis of the corpus collosum and a chromosomal disorder which includes 1P36 syndrome. She has been receiving services at a school-based physical setting. The child presents with hypotonia, global developmental delay, seizures, and severe hearing loss in her right ear. She uses a personal wheelchair but needs assistance for mobility. She has decreased sitting balance and cannot bear weight through her lower extremities.

Outcomes: At the time of evaluation, there were no outcome measures reported. A modified goal attainment scale [mGAS] was performed to monitor patient progress throughout the course of treatment. The patient demonstrated improvements in range of motion [ROM] of her lower extremities, and strength of abdominal musculature as therapy progressed.

Discussion: The mGAS was able to capture the patient’s progress throughout the course of 6 weeks in a school based physical therapy setting. The mGAS provided information which guided treatment and provided data to represent patient performance. This outcome measure can allow clinicians to easily track improvement in a relatively short period of time.

Background and Purpose: Shoulder pain is a commonly seen complaint in healthcare settings today. The currently used pathophysiological model produces a number of diagnostic labels that are not always accurate or reliable. A patient-driven method which is known as Mechanical Diagnosis and Therapy (MDT) or the McKenzie Method is well known for its application to patients with lumbar and cervical spine conditions. However, there is little research validating the use of this method for the treatment of patients with shoulder pain. The purpose of this case report was to examine the use and efficiency of MDT in the treatment of a patient with chronic shoulder pain.

Case Description: The patient was a 53 year old male with chronic right shoulder pain of insidious onset. The patient’s symptoms included anterior right shoulder pain without radicular symptoms. The pain was impairing his ability to sleep, dress/bathe himself, retrieve his wallet from his back pocket, and hug family members.

Outcomes: The patient completed 7 outpatient treatment sessions using MDT principles and demonstrated improvements in pain and function as evidenced by improvements on the Short Form 36 and Numerical Pain Rating Scale. He also demonstrated improvements in right shoulder active range of motion, strength, and function.

Discussion: The subject’s decreased pain and improved function are indicators that treatment using MDT principles might be effective in the treatment of shoulder pain. Future research can continue to grow the body of evidence for the use of this method in patients with shoulder pain.

Background and Purpose: Developmental delay is a common condition seen in the pediatric populations that can negatively impact a child’s ability to achieve age-appropriate developmental milestones. Current literature supports Early Intervention of physical therapy (PT) as a means to address these concerns. In the pediatric population the Peabody Developmental Motor Scales-2 (PDMS-2) and the Gross Motor Function Measure (GMFM-88) are common outcome assessments used to establish and track progress of the effectiveness of a physical therapy plan of care. Specific and effective interventions as part of a PT plan of care in the young pediatric population to improve gross motor ability has not been extensively researched. The purpose of this retrospective case report is to examine the impact of a comprehensive outpatient PT program for a young pediatric patient referred for concerns regarding gross motor developmental delay as well as offer insight into the use of the GMFM-88 for developmental delay.

Case Description: A 15-month old male patient was referred to physical therapy for concerns regarding gross motor developmental delay. He participated in a 4 week comprehensive PT plan of care in an outpatient setting. The patient was assessed using the Peabody Developmental Motor Scales-2 (PDMS-2) and the Gross Motor Function Measure (GMFM-88).

Outcomes: Patient completed 7 treatment sessions comprising such interventions as neuro-developmental treatment (NDT), caregiver education, and functional training and made notable improvements in posture, mobility, and ability to achieve age-appropriate gross motor developmental skills when assessed using the PDMS-2 and GMFM-88.

Discussion: The patient’s significant improvements on the PDMS-2 and GMFM-88 outcome assessments suggest that an outpatient comprehensive PT plan of care may be effective as a means to address concerns with gross motor developmental delay in the young pediatric population.