Legalization of marijuana for medical and recreation use is occurring throughout the United States. This suggests that there will be increasing amounts of contamination of common items such as paper and coin currency with the chemical components of marijuana otherwise known as cannabis. To explore this hypothesis, we obtained a batch of US quarters that has the apparent residual contamination of cannabis. In this research, we plan to develop a method for analysis of cannabis standards, cannabinol, delta-9-THC and cannabidiol, by gas chromatography-mass spectrometry (GC-MS). We will test a batch of contaminated quarters versus a control batch of uncontaminated quarters. The method will include extraction of organic soluble materials from each quarter in each batch using methanol. If contamination of the quarters with cannabis is found, we will quantitatively determine the amount using a calibration curve of the standards.

The Student Behavior Checklist (SBC) is a tool which helps teachers monitor how students approach learning by measuring the constructs of learned helplessness and mastery orientation. Learned helplessness is a passive behavior that is characterized by an inability to learn, often displayed in students who are frequently subjected to stressful events. Individuals who develop learned helplessness attribute failures to personal inadequacy, which lead to negative attitudes towards tasks, becoming overwhelmed with frustration, and developing less effective strategies after failure. A concept of behavior in contrast to learned helplessness is mastery orientation. Mastery orientated students believe that they effort they put into their work will produce success and prefer to take on challenging tasks. Mastery orientated students view failure as a challenge to be worked on and mastered through effort, maintaining a positive outlook and focus on the task. The current scientific literature on both constructs of learning suggest that learning orientation is a good predictor of academic performance. This poster presentation will focus on the importance of measuring student learning orientation in the educational setting to maximize academic achievement. Implications for identifying learned helplessness and mastery orientation will promote understanding of individual learning orientations, and how assessing these constructs will lead to greater academic achievement by students.

Soil particle composition is one of the main physical properties of soil that affects soil fertility and quality. The fractal dimension of soil particle size distribution (PSD) can be used to quantitatively evaluate the particle composition of soils. Land cover change with corresponding management practices is recognized as one important driving force affecting soil PSD alterations. The objective of this project was to determine the changes in soil PSD under four plant covers (Woodland, Wetland, Prairie, and Savannah) at the Nachusa Grasslands in North Illinois. The soil PSD was determined by their settling rates in an aqueous solution using hydrometer. The use of ASTM 152H-type hydrometer is based on a standard temperature of 20℃, a particle density of 2.65g/cm³, and units expressed as grams of soil per liter. The results qualified the texture of the samples from woodlands and prairie as loamy sand - this type of soil allows for good drainage because it is made up of sand mixed with a majority of silt and clay. The samples from wetlands and savannah were determined as sandy loam - this type of soil cannot hold significant amounts of water or nutrients. Our results demonstrated soil particle size distribution and soil quality could be affected by land cover types and relevant management activities.

The Student Illinois Education Association held its spring conference on February 8^th and 9^th in Bloomington, Illinois. This conference is extremely beneficial for students that are entering the field of education. It was beneficial for the Student Education Association (SEA) Leaders at Governors State University, because it provided them with resources and tips that they brought back to the university and shared with others within the education field. This conference is a place for students in education to come together, share ideas, and learn new techniques. Going to the conference taught future teachers how to keep students’ attention and how to prepare for their first day of school. The conference also taught them how having a culturally diverse classroom is important, how to understand their future job contracts, and tips for their first year teaching. The SEA leaders were inspired by all of the speakers and workshops that they attended. This conference was such a great experience for the leaders to extend their knowledge on these topics, so they can do the same for others within the field of education.

Fine roots (< 0.2 cm in diameter) (FR) are the primary part among the root systems for the uptake of water and nutrients, but they are often poorly investigated elements in forest ecosystems. In this study, the vertical and horizontal distribution patterns of FR biomass were investigated in an oak forest in the Field Station of Governors State University, Illinois. Three different sizes individual trees (small, middle and large size trees) were selected in this oak forest and the soil auger was used to take soil samples from three locations (1, 2 and 3 m away from the trunk) along four geographic directions (East, West, North, and South) at 0-20 cm and 20-40 cm depths. Results showed no significant differences of FR biomass were found among the four geographic directions from the trunk for the selected trees (P = 0.7824), and among the three sampling locations (1, 2 and 3 m away from the trunk) of each examined oak tree (P > 0.05). At 0-20 cm soil depth, FR biomass of large tree was significantly different from the small tree (P = 0.03) and from the middle tree (P = 0.007). There was no significant difference of FR biomass between the small tree and the middle tree (P = 0.5237). No significant differences of FR biomass were found among the three examined trees at 20-40 cm depth (P > 0.05). Fine root biomass decreased with increasing soil depths. About 67% of fine root biomass was concentrated at the top soil layer (0-20 cm) in this study forest.

This study, sponsored by the Center for Junior Year grant, details the relationship between academic achievement and stressful life events.

Odonates are valuable indicators for assessingimpacts of human activities on aquatic habitats.The few studies that have examined the relationship between water quality and Odonate diversity have demonstrated a positive linear relationship between richness and the three water quality parameters: pH, dissolved oxygen and temperature. Previous research has mostly excluded the Odonate nymphs, which according to our hypothesis should be impacted the most by the water quality. To conduct this survey, DNA barcoding and sequence alignments were used to identify samples of nymph and adult Odonates from six different ponds at Indiana Dunes National Lakeshore. After the samples were identified, the total species richness for each location was correlated with three water quality parameters, pH, dissolved oxygen and temperature. Out of the 48 nymph samples identified, there were 16 unique species. The preliminary results show a positive linear relationship between pH, temperature, dissolved O₂and adult richness_, but no significant relationships have been found between any of these water quality variables and nymph richness_.The sample size was small for the nymphs compared to the adults because only half of the nymph samples of that year have been identified so far. If further laboratory analysis demonstrates that there is a relationship between nymph richness and the water quality measures above, species indices could provide a more efficient means to determine the presence of particular species as well as overall species richness. This information could then be used to assess the overall health of aquatic habitats.

Britain instituted the Kindertransport program after seeing the violence and persecution Jews experienced in Nazi-controlled territories. Relaxing its immigration restrictions, it allowed Jewish minors (Kinder) to temporarily enter the country under the guardianship of refugee organizations and British foster parents. This study examines British popular responses to Jewish refugees’ arrivals and how those responses affected the transport’s functionality and Kinders’ lives. It draws on British newspapers, which served as forums for public concerns over the integration and management of Jewish refugees and on Kinders’ interviews, which serve as testaments of their feelings about their reception and how those responses affected their lives. The study argues that the Kinder experienced mixed responses from the British public. For example, foster families who saw the Kindertransport as a means to benefit their economic or social positions or as a means to convert the children to Christianity supported the program. Fear that supporting the refugees would drain public resources or increase employment competition and anti-Semitism fueled negative responses to the program.

Examining British responses is vital to expanding scholarly literature on the Kindertransport, which has largely focused on the program’s positive aspects. This study seeks to achieve a fuller understanding of British responses’ effects on transport operations and Kinders’ development, to incorporate more perspectives than included in the existing literature, and to explore how local responses affected Jewish refugees’ transitions to living in a new country.

Breast cancer is the second leading cause of death in low income minority women. These women are less educated about breast cancer, so it is important to understand the risk of developing breast cancer, family history, and preventable interventions. Minority women are less likely to get a mammograph screening; therefore, implementing interventions will increase mammograph adherence. Previous studies exhibited a relationship with text message reminders and increased mammograph screening, but rarely examined women using technology to search for breast cancer information on their own. The objectives of this study are to (1) analyze and compare results from two focus groups about how they obtain health information, (2) if they use technology to acquire health information such as breast cancer, and (3) identify age gaps related to accessing health information. Is technology beneficial to African American women for acquiring breast cancer information? To address this question, we conducted a mixed methods study. We measured differences using Chi-square test. Women responded to a questionnaire from a previous focus group. Their responses were analyzed and compared to the focus groups from Mercy Hospital. In the sample, there were no significant differences in age in how women access health information. However, women < 40 preferred technology to access health information whereas women ≥40 preferred to received information from a physician. African American women health literacy increases when they use technology to access health information. Technology is becoming an important resource for African American women to understand health information and thus increase mammographic screening rates.

Algae have grown in popularity as a source for biofuels as some algae species, like Ochromonas danica, can produce energy-rich lipids for biofuels while simultaneously removing nutrients from wastewater. As such, use of biologic systems to mitigate pollutants are an attractive method of pollution control. Given the unique metabolic properties of O. danica, this organism is a promising candidate organism for this purpose. This study seeks to characterize the basic metabolic parameters of these algae as well as their population behaviors with attention to their growth rates and nitrate removal at varying pH over time. To do this, live cultures of O. danica were introduced to a standard simple defined organic medium and measurements of population, floc number and size, and nitrate concentration were obtained at several time points over a period of 7 days. The primary outcomes of interest were the population growth rate and relative rate of nitrate removal. The population increased at an average rate of 10.6 (95% CI 9.6-10.8) million algae per mL per day with an average rate of nitrate removal of 0.234 ug / million algae. Although these data are exploratory in nature, they show rapid population growth and nitrate removal in a defined medium by O. danica in a closed system. Further work will need to be performed to discern the optimal growth conditions for this strain and the efficacy of pH induced flocculation to improve harvesting methods.

A soil aggregate is a group of primary soil particles that cohere to each other more strongly than to other surrounding particles. Soil aggregates and their stability are fundamental properties and can serve as indicators of soil structure and quality, influencing carbon stabilization, water infiltration, soil compactability, hydraulic conductivity, and the ability to resist water erosion. Land uses and management practices are important factors in affecting soil aggregation through its impact on destruction forces and aggregate forming processes. However, the extent of the impact and the associated mechanisms of land use on soil aggregates remain unclear. In this study, soil aggregates were fractionated into four aggregate classes (>1, 0.25-1, 0.053-0.25, and < 0.053 mm) under four land use types (prairie, savanna, wetland, and woodland) in Nachusa Grasslands, northern Illinois, using a wet-sieving method to obtain the size distribution of soil water-stable aggregates. The main objective of this project was to investigate the influence of land use change on soil aggregate size distribution and aggregate stability. The results showed the fractions of macroaggregates (>0.053 mm) were higher in prairie and woodland soils than that in savanna and wetland sites. In contrast, wetland and savanna had higher proportion of microaggregates (woodland > savanna > wetland. This study suggested the conversion prairie to other plant types would result in decreasing of soil structure and soil quality in study area of Illinois.

Cryptosporidium is a microparasite that infects the respiratory and gastrointestinal tract of humans and animals. This microparasite can cause waterborne disease and can be in any type of water source. In natural areas, animals, such as coyotes, drink from different water sources, such as streams, ponds, and stagnant pools. These water sources tend to have an abundance of fecal material run off from the surrounding areas. Because humans are slowly taking over natural land, they are having more frequent contact with wildlife. As coyotes are very pliable in using a diversity of habitats, they are slowing roaming into areas with a high human density. That being said, coyotes, and humans alike, may be more susceptible to ingesting Cryptosporidium and thus having cryptosporidiosis, which is a diarrheal disease. Although, because humans are not coming into contact with coyotes and their scat as often as other animals, suburban areas may have a smaller abundance whereas the prevalence of Cryptosporidium may be higher in rural areas because that is where coyotes still reside in their home ranges.

By taking samples of coyote scat and using a modified version of Kinyoun’s Acid-Fast Staining, I was able to find positive Cryptosporidium samples in both rural and suburban areas. Contrary to my hypothesis, the count of Cryptosporidium oocysts are more prevalent within suburban areas. Maybe humans do contribute to the movement of this microparasite more than previously recognized.

Periodontal disease in dogs is common but can be detrimental to those that it affects - causing extreme pain, gum decay, tooth loss, and even bone loss. There are various treatments that are recommended by veterinarians which can be applied to avoid periodontal disease; however, some of these treatments may be harmful to the dog over time and some may be difficult or costly for the owners which lead to noncompliance from these owners and therefore a higher risk of periodontal disease for their dogs. This experiment studies the effects of zinc ascorbate gel applied orally in dogs over a 30-day study period. The 17 dogs studied were split into a treatment group and a control group. The treatment group received the oral zinc ascorbate gel treatment and the control group received no treatment. Clinical parameters evaluated bi-weekly were halitosis, gingivitis, and plaque. Bacterial growth content was evaluated two times within the study period: at day 0 and day 30. The intended outcome of this experiment was a decrease in halitosis, gingivitis, plaque, and periodontal disease causing bacteria from day 0 to day 30. This research is meant to provide evidence that oral zinc ascorbate gel can be used as a prevention of the bacterial growth that causes periodontal disease as well as an intervention to the effects. The results suggest that zinc ascorbate gel used as an oral antiseptic improves canine oral health, and may be most effective in decreasing total bacterial growth.

In the wake of the current dispute over recent Polish law criminalizing the term Polish Death Camps, this project aims at explaining the Polish role in the Holocaust by focusing on the life of Witold Pilecki. Pilecki, a Polish soldier and member of the Polish resistance during World War II, volunteered to be captured and sent to the Auschwitz- Birkenau concentration camp. His observations, compiled into Report W, provided the Allied governments with the much needed information about the true purposes of the Nazi camps and its inner workings. Using both primary and secondary sources in English and Polish -including Pilecki’s own reports- the project argues that Pilecki’s methods and bravery were exceptional but also represented a majority of the Polish population who willingly fought against the Nazi invaders and aided Jews during the Holocaust. The project attempts to dispel the notion that all Poles collaborated with the Nazis in the destruction of the Jews and to showcase the importance of his heroic deeds as they can be understood in the 21st century.

Background: Triathletes have an extremely high rate of injuries during training and competition. Studies vary from 50% -90% injury rate each year. Most studies find that the injuries most often occur during running (50%). This study and all other studies have been done in the laboratory setting, none of the studies were completed outdoor where competition typically take place.

Objective: The study analyzed the mechanics of triathletes during the bike-run transition and during the run following it to determine if there are biomechanical changes during training. Drone technology using GPS guidance will be used to follow the triathlete during this process to document the running mechanics.

Methods: This descriptive pilot case series recorded 3 triathletes while training for a triathlon. A drone followed the participants and recorded the biomechanics during a 5k run to get a baseline for their run, then they biked a 40k then finished with another 5k run.

Results: Significant differences in the hip angle, specifically the pelvic tilt, in 2 out of 3 triathletes. Subject 1 was p< .03, subject 3 was p< .01. There was a difference in subject 2 but it was not a significant level.

Conclusion: The biomechanical analysis showed a significant difference in anterior pelvic tilt during the run after the bike training. This has a significant impact on the stress in the lumbar-pelvis and lower lumbar areas, thus predisposing the triathlete to injuries to these areas.

Bacterial infections are becoming more difficult to treat with antibiotics. The bacteria are resistance to the antibiotics so they become much harder to kill. This becomes a problem for people who acquire infections throughout their life. The goal of this experiment is to see if limiting nutrients for Escherichia coli and Staphylococcus aureus will increase the tolerance for antibiotics. Bacteria were grown in nutrient broth with different dilution ratios and plated on agar plates with the same dilution. Antibiotics were added to the agar plates and the Kirby Bauer method was used to determine if the antibiotics were tolerant or resistant. For S. aureus, streptomycin, oxacillin, gentamycin and neomycin show an extremely significant p value of < .0001. Amoxicillin-clavulanic acid shows an extremely significant value of < .004. For E. coli, gentamycin, neomycin and kanamycin shows an extremely significant p value of < .0001. Streptomycin shows an extreme significant of < .0004. Overall, S aureus shows an increase in tolerance when limiting the nutrients. For E. coli most of the antibiotics show an increase in tolerance, but there are a few that do not show any significance at all. Oxacillin, gentamycin and neomycin show a significant decrease in antibiotic sensitivity when the dilution ratio increases. However, the tolerance level of the antibiotic went from susceptible to resistance.

Rationale: The Authentic Leadership: A Master Training program features an exploration of best models and research theories that support the successful development of authentic leadership skills. The primary goal is to enhance the leadership skills of professionals based on the authentic leadership theory. In addition, it offers opportunities for self-reflection, personal development, and practical exercises.

Objectives: Showcase of an innovative program developed based on the five main characteristics of authentic leaders by Bill George: understanding of purpose, strong values, trusting relationships, self-discipline, and acting from the heart (George, 2003).

Methods: The first phase intends to enhance training participants’ self-awareness. During this phase, participants will explore purpose, mission, values, behaviors, talents, skill, and abilities. In the second phase, participants will review effective strategies for self-discipline and high-performance and promote individual development in areas of conflict resolution, organization, and planning skills. The third phase will target effective relationships, coalition development, and dealing with self-vulnerability.

Conclusions: The program starts by providing self-assessments to promote a better self-understanding, followed by opportunities to identify areas of individual development such as self-discipline and conflict resolution. The training explores effective ways to create and maintain strong relationships by creating awareness of communication strategies, emotional intelligence, and professional success through embracing vulnerability. Participants will have the opportunity to assess their values, behaviors, talents, and skills, learn important authentic leadership characteristics, and reflect on how they can implement the new learning in their professional life.

Toxic masculinity is engrained into our world views as well as our culture, particularly within the United States. Toxic Masculinity can be referred to the sets of societal expectations guiding the lives of men, affecting all genders and the communities that they are involved in. The focus of this study is to ask the question, how does toxic masculinity affect the lives of men and those around them? In this study we will be focusing on both the effects of toxic masculinity, but also on the reasoning of toxic masculinity in regards to the phrase, “Boys will Be Boys”. In this study, we aim to address this question by conducting interviews with an anticipated sample of 10 men and 10 women. The age range of the participants that will be included within this study are the ages 18-28. The study conducted will be recognized as a qualitative study due to the factors of not being able to fully answer the question addressed in full because of the exploratory nature of said study. The ultimate goal of this study is to be able to pick apart the internal as well as external attributions of the acts of toxic masculinity and the reasoning behind the phrase “Boys will Be Boys”. It is worth noting that while there may be aspects that could explain the attributions towards the acts of toxic masculinity, the study is not looking to excuse the phrase “Boys will Be Boys”, but instead bringing the attribution of the reasoning behind it into new light.

Previous research has shown that context matters when it comes to examining the relationship between gender and the work-family interface. For instance, in a recent cross-cultural study of the work-family interface, Rajadhyaksha (2017) found that in countries with high gender equity, women with more egalitarian gender role attitudes experienced higher positive work-family spillover compared to egalitarian men. By contrast, in countries with low gender equity, women with traditional gender role attitudes experienced higher positive work-family spillover as compared to men with similar attitudes. This study conducts a similar exploration of the relationship between the work-family interface and gender, gender egalitarianism and context, except at the intra-country rather than cross-country level, using data gathered from 300+ working men and women from six different cities in India. The Indian context has seen the emergence of many urban centers along with a rise in working women in the organized workforce. This has resulted in marked regional socio-economic differences, especially when it comes to safety of women and attitudes towards working women. Cities will be ranked based on their safety score as made available in the 2018 Ease of Living index of Indian cities. Multivariate analyses will be used to explore for interactions between gender, gender egalitarianism and positive and negative aspects of the work-family interface. Results are expected to be significant, and of interest to work-family practitioners, HR professionals as well as to urban city planners looking to improve quality of life of working persons in India and in similar emerging market economies.

A high priority for addressing cancer health disparities is to increase the representativeness of the research workforce. A large number of potential investigators from groups underrepresented in cancer research are employed in minority-serving institutions that are teaching-intensive. A high teaching intensity with a comparatively low level of campus-wide research activity can make scholarly productivity challenging. In the GSU-UICC Disparities Education Cancer Research Training and Education Project (The GUIDE Project) our aim was to develop a cohort of early stage cancer health disparities researchers by putting in place supportive practices that were highly sustainable and cost-effective. In this poster, we examine the impact of planned mentoring and faculty development activities on faculty perceptions of productivity, overall scholarly productivity, and proportion of cancer /health disparities related work products over the four-year period of the grant. The experiences of these 7 researchers from underrepresented groups can inform best practices in training researchers at teaching-intensive institutions.

The gram-negative bacteria, E. coli, is an indicator of fecal input for both point and non-point source origin. The veterinarian hospital located on Deer Creek may contribute to high antibiotic levels, which are known to select for resistant strains of bacteria living in impacted waters. The water running north of the veterinarian hospital was considered potentially antibiotic influenced as it was downstream of the site. The origin of the stream and sites upstream from the hospital were considered influent water. Sediments were also collected from these sites to determine if more long term resident E. coli were present with elevated antibiotic resistance in stretches of the creek influenced by potential fecal input from the Veterinary Hospital. The antibiotics used in the experiment were chosen as they are specific to E. coli which are often associated with mammalian gut pathogens. The antibiotics; penicillin, tetracycline, gentamicin, amoxicillin, streptomycin and amoxicillin-clavulanate were tested using the Kirby Bauer method. The most extreme antibiotic sensitivity and resistance was present within water collected from the veterinarian hospital site. In water samples, the largest yield of bacteria were present at the site downstream from the hospital, indicating a potential impact on E. coli isolates antibiotic sensitivity/resistance patterns. Sediments from a neighborhood along the creek upstream of the Hospital contained the greatest amount of E. coli and other coliform bacteria. This indicated other potential sources of contamination could include homes and their septic systems in that part of the creek. Future studies will focus on these sites.

Governors State University was founded to be forward thinking, flexible, and efficient. Over the course of its first decade the school made use of innovative educational practices. Competency based evaluation which featured no letter grades was just one of several exciting and unique practices employed by the founding members of the U. Through archival research and oral interviews I have recreated what innovation education looked like, how it worked, and will offer an explanation as to what factors lead to the changes in the U's educational model towards the end of 70's . I propose that just as things change over time so did the needs of the students at GSU and innovate education evolved alongside them. I would enjoy an opportunity to inform and educate interested parties about a University that was truly one of kind in both its methods and design.

Ethnographic research allows the researcher to observe and record the space they are occupying while learning and refining fieldwork skills. Students in Dr. Kostarelos’ ethnographic methods course partook in an ethnographic exercise on the Governors State University campus, including Alumni Path. The GSU campus served as the site to learn and practice data gathering skills. Students mapped, observed, took field notes, photographed campus landscapes, and collaborated to collect data for this presentation. Students analyzed their data and discovered a diverse cultural landscape encoded on works of art, artifacts, and student activities that took place on campus during the fieldwork in September and October 2018. The exercise included reflexive discussion and writing on campus diversity among other social themes recorded in field notes, maps, and photographs.

Photos presented on the poster are the result of individual and collaborative fieldwork and in class workshops concerning field photography, visual data, and the representation of campus culture and community in the light of the Statement of Ethics framed by the American Anthropology Association.

Pomegranates have been used for medicinal purposes for centuries and through repeated experiments have been shown to slow down the growth of viruses and bacteria, in some cases inhibiting them completely. Staphylococcus aureus is one bacterium that has been able to build its resistance against modern medicine over the past century. The purpose of this experiment is to see if pomegranate extract can inhibit S. aureus growth. Data will be collected from spectrophotometer and plate counting. In order to perform this experiment, Brain Heart Infusion broth (BHI broth) was diluted with pomegranate extract into 6 tubes to obtain various concentrations. Dilutions used were 1:1, 4:5, 3:5, 2:5, 1:5, and a control that contained specifically BHI broth. While preparing dilution, S. aureus cells were cultured and added to each tube. The tubes were left in an incubator for 24 hours. The next morning, 100 micro liters was taken from each set of tubes and plated on prepared BHI agar plates for growth. Spectrophotometer readings and growth was examined over a span of five days. The control group averaged 220 colonies per plate for a serial dilution of 1:10,000. The 1:5 dilutions averaged 157.3 colonies per plate. The 2:5 dilution average 0.667 colonies per plate, 3:5 averaged 5.3 colonies per plate, 4:5 averaged 2 colonies per plate while 1:1 averaged 1.67 colonies per plate. Evidence indicates that pomegranate extract has an inhibitory effect on S. aureus growth. The absorbance of each tube also gradually decreased each day.

Approximately 80 million adults in the U.S., which is 36% of the population, have low health literacy. The impact of low health literacy is most prevalent in vulnerable subgroups including the elderly, minorities, those who speak English as a second language, and is compounded with the presence of chronic diseases such as diabetes. Reliable assessments, such as REALM, TOFHLA, and NVS are used to measure patient health literacy. However, reliable assessments are necessary to measure the provider’s use of communication accommodation strategies. The purpose of this study was to develop and to determine a reliable low health literacy accommodation (LHLA) measure for future provider-patient communication studies. The survey instrument was designed to measure the Socioecological (SEM) Critical Pedagogy communication strategies utilized by providers to accommodate patients with low health literacy.

Convenience and snowball sampling were used. Participants, which included physicians, nurse practitioners, physician assistants, and medical nurses, completed the anonymous online self-administered 32-item survey. Participants were recruited through social media and professional networks, direct contacts at hospitals, and medical conferences (N=98). The Principal Component Analysis (PCA) and Cronbach’s alpha were used to assess the instrument’s validity and reliability. The PCA was performed and the final 11-component two-dimensional dataset resulted with a 70.138% cumulative variance and a highly acceptable .926 Cronbach’s Alpha score. The descriptive statistics was N=96, Range = 28.00, Mean = 43.58, SD = 6.50, and Variance = 43.33. The 11-component LHLA encompasses the greatest variance and is a time saving, easy-to-use, and reliable questionnaire for future studies.

Introduction: Tobacco use is the most common preventable cause of death and it increases one’s risk for numerous diseases, associated illness, and death. Unfortunately, certain populations are disproportionality burdened by tobacco-related morbidity and death. These populations consist of individuals from low-income areas, people with mental illnesses, lesbians, gays, bisexuals, transsexuals, African-Americans, and Hispanics/Latinos.

Methods: Articles were retrieved using Google Scholar, University of Illinois at Chicago Library (UIC) search engine, and PubMed. The Centers for Disease Control and Prevention (CDC) website was used as source to find information about certain demographics. Articles were chosen if they were published between the years of 2008-2018. Articles were searched using the terms “tobacco,”, “marketing”, “vulnerable populations”, “low-income”, “mental illnesses”, “LGBT” and “minorities”. Overall, a total of 12 articles and one weblink from the CDC was used.

Findings: African-Americans, Hispanics/Latinos, and individuals from low-income communities are exposed more to tobacco products and marketing. Findings showed that transgender adults use tobacco a much higher rates than cisgender adults, menthol cigarettes were originally marketed as being healthier than non-menthol cigarettes, mental health and addiction treatment providers have rationalized that their failure to treat tobacco dependence is a form of harm reduction in that it is viewed as a healthier alternative, and the tobacco industry targeted low SES women as early as the 1970s.

Conclusion: Tobacco companies have been targeting these vulnerable populations for years. There still needs to be more research done on “healthier” alternatives to smoking cigarettes.

Background: Since its founding in 1969, Governors State University Faculty and staff have created new knowledge and disseminated research results, impacting knowledge globally.

Objective: This study seeks to measure the impact of GSU faculty and staff research. Who are the most productive authors, and what are the top most cited publications? What is GSU's impact on our region, state, and beyond?

Methods: A descriptive study to identify methods for reviewing primary sources and research tools for reviewing faculty research outputs retrospectively for a 50 year period. Tools available to GSU such as Web of Science, Digital Commons, were utilized and Archival primary sources identified to review faculty research outputs using bibliographic research methods.

Results and Implications: Hilites of GSU faculty research were identified. A "snapshot" of a portion of faculty and staff research activity documents the increase in faculty and staff research outputs in relationship with the evolution of the University's research objectives and reallocation of teaching assignments. Gail B. Kempster is the most productive Faculty author, in a 1993 article published in the Journal of Speech and Hearing Research, with 359 citations, and producing 13 citations annually. The evolution of faculty contracts increased support for research through research release time is directly related to an increase in publication in top-tier peer reviewed journals, book chapters, and professional presentations. Increased support for research results in growth in research products over time.

Thank you to the University Library Dean Lydia Morrow Ruetten for supporting the development and printing of this poster.

Government agencies, popular media, and sensationalizing higher education 'crisis novels' are leading many students to question the role of higher education before they arrive on campus. As a result, many students have misconceptions about the role of academic advising and the college major selection process. This poster will detail research on how popular media misrepresents higher education and academic advising. The poster will share how movie clips, quotes, and newscasts that showcase the misrepresentation and provide scholarly evidence that debunks many of these assertions. This poster is the accumulation of five separate researchers conducting a rigorous content analysis of popular media sources, including, Netflix, Amazon, Youtube, scholarly journals, books, and television programs.

The term fictive kin is used to describe social ties that are based on neither blood ties, nor by marriage. Fictive kin are granted many of the same rights as family members and are expected to participate in the roles of the extended family. Research on fictive kin relationships often examines the African-American community and focuses on the effects of building strong social bonds outside the family. The constructive role fictive kin play in a person’s life suggests that these relationships serve as an important foundation in engaging in helping behavior. Helping behavior refers to actions intended to benefit another and is a characteristic of possessing a positive attributional style. Research suggests that development of attributional style originates in experiences of trust or lack of trust. This poster presentation will discuss how social support provided by fictive kin relationships can impact the development of one’s attributional style in a positive manner. Implications for identifying the benefits of fictive kin relationships will promote understanding and acceptance of these relationships in society.

Background and Purpose: The purpose is to illustrate the utilization of the Clinical Practice Guidelines for two cases of LBP that were managed differently according to classifications provided by the CPG.

Case Descriptions: Patient A was a 64-year-old female who presented with primary complaints of low back pain and sciatica. She experienced pain in the lumbar area radiating into her left buttock, with radicular symptoms of numbness and tingling that encompassed her entire L LE. Using the MDT classification of derangement, specific interventions were based on her preferential direction and her symptoms response to directional preference. Patient B was a 49-year-old African American man who presented with low back pain. His back pain was located in the lumbar area and radiated bilaterally to the gluteal region. This patient demonstrated impairments consistent with the stabilization classification. Physical therapy interventions were implemented to manage those impairments.

Outcomes: Both patients with the primary symptom of LBP, however clinically fit different classification schemes and therefore required a tailored physical therapy intervention. Management of each patient’s respective impairments were successful, both patients saw improvement with their individual treatment plans.

Discussion: This comparison of treatment approaches is meant to highlight the fact that different patients with a similar primary symptom of LBP may, on examination, present with different impairments. These impairments need to be managed on an individual basis for successful outcomes to occur. Classification of impairments based on existing guidelines may also help in the successful management of patients with similar primary symptoms.

Abstract: The purpose of this retrospective case report is to describe the usefulness of a comprehensive assessment of the musculoskeletal and neurological systems and treatment of components of the kinetic chain in a teenage athlete with chronic lateral knee pain. Method: This is a retrospective case report. Discussion: Significant qualities of this case include identification of possible tibiofibular dislocation, optimization of lower extremity (LE) alignment, use of foot orthoses during phases of recovery and utilization of the Knee injury and Osteoarthritis Outcome Score (KOOS) during this cycle of care. Conclusion: When treating a patient with lateral knee pain, full consideration of alignment, fibular position and stability, proprioception, balance, strength and motor control of hip, knee, ankle and foot as well as the contralateral LE and trunk should be considered as influential factors that may need to be addressed.

Background and Purpose: Comprehensive components of discharge planning have not been reported in the literature. The Functional Independence Measure (FIM) is often utilized as a functional outcome measure in the inpatient rehabilitation setting that can be utilized for discharge planning. The purpose of this case report is to describe limitations of the FIM and to identify functional measures that augmented the FIM for discharge planning for a patient status post right TKA.

Case description: This patient was a 47-year-old African-American male who was admitted to the inpatient rehabilitation hospital after undergoing a right TKA. He had many comorbidities and health complications which increased his length of stay in the rehabilitation hospital, and the hospital where he had undergone TKA.

Discussion: Gait distance, stair negotiation, and physical assistance needed for these tasks were outcomes measured by the FIM that were able to indicate that the patient could function safely at home. However, variables as described above such as gait speed, distance ambulated before needing a rest break, use of assistive devices/hand rails for stair negotiation, all represent safety considerations that aren’t represented by the FIM for safe community mobility. He also may have been at risk for falls as measured by the 5 Times Sit to Stand Test, and could potentially have challenges with hemodynamic stability during prolonged standing tasks as required for multiple ADLs, all of which were not represented by the FIM. It may be beneficial to utilize other functional outcome measures to augment the FIM to formulate robust discharge considerations.

Background/purpose: The purpose of this retrospective case report was to describe and discuss the use of several outcome measures in an outpatient setting for a child with PURA syndrome.

Case Description: A four year old male with PURA syndrome and a physical therapy diagnosis of hypotonia, was seen in an outpatient pediatric clinic for the past 2 years. The goal attainment scaling (GAS) has been used to individualize the treatment for a child with a rare syndrome.

Outcomes: The child received 43 visits in an outpatient pediatric setting with slow but steady progress. He has improved functional skills including transitions, standing and ambulation with a reverse wheel walker. GAS was effective in demonstrating achievement of goals over the past two years.

Discussion: The diagnosis of PURA syndrome is a recent medical advancement and scant physical therapy research exists. Children with PURA syndrome may have motor dysfunctions and may benefit from physical therapy to maximize mobility and reduce comorbidities. GAS can be used as an outcome measure for children with rare diagnosis, such as PURA syndrome.

Background/purpose: Anterior cruciate ligament (ACL) injury can be devastating and result in a sequalae of complications. Arthroscopic surgery remains the gold standard for diagnosing an ACL rupture but is invasive, costly, and time consuming for arriving at a diagnosis. Physical examinations are quick, noninvasive, and inexpensive exams. Magnetic resonance imaging is a valid and noninvasive diagnostic method but remains costly. The purpose of this case study will examine a common knee injury, an ACL tear, and the management of conservative treatment for 6 weeks without imaging to confirm the ACL tear diagnosis.

Case Description: A 33-year-old Caucasian male with no significant past medical history, surgeries, medications, or imaging results underwent a noncontact hyperextension moment in his right knee. The patient presented to physical therapy unable to achieve terminal knee extension, lacked active knee flexion, reported knee instability, and exhibited suprapatellar swelling; all signs and symptoms of a likely ACL tear with meniscus involvement. A conservative approach was incorporated to reduce the likelihood of surgery and return to a fast-paced work environment.

Outcomes: Throughout the 6 weeks of treatment, improvements were documented in knee and hip strength, knee range of motion, and decreased pain. At discharge, the patient also reported he felt steady in his right knee when ambulating at a comfortable pace, and could manage full work days. The patient also reported decreased pain levels via the NPRS from 7 to 3.

Discussion: This case report illustrates the effectiveness of a conservative approach to a potential ACL and meniscal tear in an adult patient in the outpatient setting. The results in this case report are consistent with similar studies regarding conservative treatment of an ACL tear. Additional research should be conducted to focus on conservative treatment rather than surgery to contribute to future clinical practice guidelines, and to provide more options to patients who elect not to undergo surgical repair.

Background: Brain injuries (BI) are reported as the leading cause of death and disability in children and adults. More than 3.3 million diagnoses of brain injury occur per year with an annual cost to society in excess of $100 billion. Therapeutic alliance (TA) is a term commonly cited in psychotherapy as the collaboration between the client and therapist. Current literature reinforces the concept of a positive TA correlating with adherence to treatment outcomes in both general medicine and psychotherapy settings; however, there is limited support to describe how the TA and patients’ compliance or awareness develop and interact during the process of post-acute brain injury rehabilitation (PABIR).

Objective: To identify and evaluate studies within the body of literature utilizing the Cochrane guidelines to determine elements and/or factors associated with a TA for adults with brain injuries during post-acute rehabilitation.

Search methods: Databases, including Cochrane Library, PubMed, CINAHL Complete, PEDro, and PsycINFO from January 2006-October 2018, reference list of articles, and distinct papers were searched and yielded a total of 767 titles.

Selection criteria: Various types of study designs of adult patients with BI participating in PABIR programs inclusive of PT services with at least one measure of TA and treatment outcome. Two authors independently reviewed and screened all full-text, eligible studies.

Data collection: Two author independently extracted relevant data from each included study into tables. Risk of bias was assessed using ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) tool.

Main results: Six studies involving approximately 1,435 participants were included. The results indicated a strong TA is associated with the (1) role of caregiver and/or family perceptions and functioning and (2) client-therapist interactions aided by communication strategies. Strategies reported to contribute to a positive TA included early engagement, meeting cultural needs, keeping families together, actively listening, active involvement, education, skills training, and support for community re-integration.

Authors’ conclusions: From this review, a TA between individuals participating in PABIR and PTs have both supporting and hindering factors associated with treatment outcomes after a BI. The use of strategies to aid caregiver or family engagement can be a key element in the success of a PABIR program. Further research needed to identify appropriate clinometric properties of outcome measures assessing a TA in adults with brain injuries during post-acute rehabilitation.

Since the Back to Sleep program was started in 1994, more infants have successfully been sleeping on their backs. An unfortunate secondary effect of this program is that infants are being given fewer opportunities for awake prone play. Awake prone positioning benefits respiration, reflux reduction, head shape and motor skill development. This pilot program intends to inform parents of the benefits of prone awake time and give options for routine handling and positioning to give the infant increasing opportunities for prone awake play and exploration.

Background/purpose: Impairments in the vestibular system are a common diagnosis seen in physical therapy today. The most common vestibular diagnosis is Benign Positional Vertigo (BPPV) with vestibular hypofunction occurring second most common. Vestibular hypofunction usually results from neuritis, chronic inflammation of peripheral system, or infection. Previous studies examined the effectiveness of vestibular rehabilitation training on postural stability and gaze stabilization for individuals with bilateral or unilateral vestibular hypofunction but research is limited for vestibular rehabilitation training following radiation treatment. Therefore, the purpose of this retrospective case report is to document the impact of a vestibular rehabilitation program on improving vestibular hypofunction, resulting from neurotoxicity following radiation treatment.

Case Description: The subject was an 88 year old Caucasian female who had reported symptoms including: dizziness, lightheadedness, and “feeling off” when moving her head and changing positions, specifically from supine to sitting. The patient reported symptoms began approximately 3 weeks ago following the end of her last radiation treatment for palatine tonsil cancer in her neck.

Outcomes: The patient was seen by an SPT, supervised by a PT for a total of six visits. Improvements in both the DGI and DHI were found when compared to baseline following 6 visits of physical therapy.

Discussion: The purpose of this case report was to analyze the effects of a vestibular rehabilitation program with inclusion of balance training, vestibular rehabilitation, and lower extremity strength training on improvement in dizziness and instability with walking. Results from tests and measures suggested vestibular hypofunction was the diagnosis present in this patient, not BPPV. Considerable improvement in Romberg test was observed along with improved results from the Head Impulse test, DHI & DGI outcome measure scores, and subjective decreased reports of dizziness. With the dizziness reportedly beginning a few weeks following radiation treatment in the cervical region for tonsil cancer, radiation damage to the vestibular system must be considered as a possible contributor to the onset of her symptoms. Physical therapy is not well understood for post-radiation damage to the vestibular system and warrants further research.

The purpose of this retrospective case report is to add to the current body of literature discussing the efficacy of gait and balance specific training for a patient with a severe diffuse axonal injury (DAI) / severe traumatic brain injury (TBI) who participated in physical therapy to return to safe ambulation in the community, driving, and return to sport activities. Case Description: The patient was a 21 year old Caucasian male and collegiate athlete who incurred a DAI/TBI in a motor vehicle accident while waiting at a stoplight. The patient presented to outpatient physical therapy to improve his gait, balance, and coordination in order to improve his safety and return to his prior level of function. Outcomes: The patient achieved the maximum score for the Dynamic Gait Index (DGI) and Lower Extremity Functional Scale (LEFS) and returned to all functional and recreational activities of daily living without complaints of difficulty. Discussion: The patient’s improvements may be an indication of the efficacy of gait and balance-specific interventions for improving impaired balance, gait, and locomotion in patients who have incurred a severe DAI/TBI.

Background and Purpose: The purpose of this poster is to investigate the effects of pelvic floor physical therapy (PFPT) on urinary incontinence (UI) in an individual 2 years post radical prostatectomy (RP). This information is essential to developing a body of literature guides future treatment of men in this patient population.

Case Description: The subject was a 57-year-old male with UI and pelvic floor hypertonicity 2 years post RP secondary to prostate cancer. He was treated in an outpatient physical therapy clinic using PFPT for a total of 7 weeks.

Outcomes: The resting tone of the subject’s pelvic floor muscles decreased however, this did not correlate with significant improvement in continence.

Discussion: Research indicates that PFPT is most effective at alleviating UI post RP, when initiated prior to surgery or shortly thereafter. The patient’s poor outcomes are likely due in part to the late initiation of PFPT.

Phthalates are a common chemical compound used as plasticizers in various industries and exposure to these compounds has been linked to adverse effects on health. Due to their widespread use, they have become a common environmental pollutant of soil and water. The persistence and distribution of phthalate esters in the environment has given rise to many microorganisms that are able to incorporate phthalates into various metabolic pathways and degrade them into harmless substances. This study seeks to identify the genes that fungi carry that are responsible for phthalate degradation by using polymerase chain reaction. Diversity of fungal communities in response to presence of phthalates within soil will also be assessed and their capacity for phthalate degradation will be examined. Research has shown that the ability to degrade phthalate is widespread and nearly all fungal isolates were able to grow on media with phthalate as the sole carbon source. Fungi from samples derived from phthalate-contaminated sites had a higher diversity of and fungi than uncontaminated samples.

Health care costs are rising to unprecedented levels. One way to address this rise in healthcare spending would be to reduce medical costs associated with lack of adherence to medical recommendations. Patients with low adherence tend to over-utilize the healthcare system and have a greater risk for hospitalization, leading to increased overall healthcare spending. Lack of adherence to medical recommendations is associated with poor communication and poor health literacy. Physical therapists can address these factors by building a collaborative relationship with the patient and the patient’s family and providing both patient and family education in order to improve adherence.

This retrospective case report examined the impact of patient education provided to a Caucasian male admitted to the acute rehabilitation unit (ARU) following cardiac myopathy secondary to coronary artery bypass graft x 3 (CABG x 3). The patient had multiple potentially avoidable co-morbidities associated with complications arising from diabetes-mellitus type 2, suggesting a possible history of medical non-adherence. While in the ARU, the patient received physical therapy interventions. While he initially made functional gains, the patient declined in function in the couple days leading to self-discharge.

Additionally, the case report will outline a strategy plan which relates how to better target and address lack of adherence to medical recommendations within the hospital setting for patients with a documented history of medical non-adherence. This plan includes strategies such as motivational interviewing, health coaching, and goal-setting which can be used in addition to specific, client-centered patient education as a way to further enhance adherence. Finally, discharge recommendations for ways to continue to facilitate medical adherence upon return home are suggested.

Background/Purpose: Myelopathy is defined as compression of the spinal cord due to a narrowing of the canal by various mechanisms, with the most common form being cervical myelopathy, which has the possibility of impacting overall bodily function. The purpose of this retrospective case report is to demonstrate the impact of a delayed surgical intervention for a diagnosis of cervical myelopathy, which contributed to functional limitations in an elderly individual leading to a decreased quality of life, and reduced prognosis.

Case Description: The subject was an 82-year-old Caucasian female, admitted to IP rehab following a posterior cervical decompressive laminectomy with foraminotomy of C2-C5 following a diagnosis of cervical myelopathy. The subject presented with decreased bilateral extremity strength, decreased endurance, reduced functional mobility and gait impairments. Interventions focused on gait training, neuromuscular re-education and therapeutic exercise.

Outcomes: The subject completed 38 physical therapy sessions while in inpatient rehabilitation. Improvements were measured in lower extremity strength of bilateral hip flexors and knee extensors, increased in functional mobility based on scores of the Functional Independence Measure (FIM), and decreased assistance required for ambulation.

Discussion: This report demonstrates the impact a delayed surgical intervention for a diagnosis of cervical myelopathy on an elderly individual who had a complicated medical and surgical history. The subject demonstrated improvements in functional mobility that exceeded her prior level of function. Further research could provide additional information that could be utilized to prevent a delayed diagnosis, and to explore appropriate treatment plans to improve the quality of life of individuals with a delayed diagnosis of cervical myelopathy

Background and Purpose: Lee et al. discovered a correlation between cervical radiculopathy and medial epicondylitis. 1 There have been no follow up studies indicating whether one pathology leads to the others or whether treating cervical radiculopathy affects the concomitant medial epicondylitis. The purpose of this case report is to outline a treatment program for individuals with cervical radiculopathy and concomitant medial epicondylitis . Case Description: The patient was a 54 - year - old, Hispanic female who presented with complaints of right - sided, m edial elbow pain as well as grip, wrist, and elbow weakness. Upon further evaluation, the patient also presented with cervical radiculopathy. The patient did not receive any steroid injections for medial epicondylitis. Patient had significant past medical history including right shoulder adhesive capsulitis and bilateral lateral epicondylitis. Outcome Measures: The patient was assessed using the QuickDASH, pain rating via Numeric Pain Rating Scale (NPRS), strength via Manual Muscle Testing (MMT), grip stren gth via dynamometer, as well as a cervical radiculopathy cluster exam. The patient was seen for a total of 7 visits over the course of 4 weeks. Discussion: Treating concomitant cervical radiculopathy in a patient with medial epicondylitis appeared to be a safe and effective intervention program for decreasing elbow pain and improving grip strength. The presenting case report may be useful in helping clinicians determine optimal plan of care for patients with “golfers elbow”. Future randomized control trials should evaluate the relationship between cervical radiculopathy and medial epicondylitis as well as whether treating cervical radiculopathy improves patient outcomes in those with “golfers elbow”.

Congenital muscular torticollis (CMT) is one of the most common musculoskeletal deformities in newborns that can lead to secondary developmental implications. Conservative treatment with physical therapy services is common. The 2018 clinical practice guideline by the American Physical Therapy Association Academy of Pediatric Physical Therapy describes first choice interventions for the management CMT with kinesiotape as a supplemental intervention. However, the evidence and benefits of the use of kinesiotape for torticollis lacks. The aim of this retrospective case report is to describe the application of kinesiotape with other therapeutic interventions utilized in the plan of care of a young infant with a typical presentation of torticollis. Case Description: The patient was a young female infant with a diagnosis of CMT with positional plagiocephaly. The infant presented with a significant preference for cervical left lateral flexion and right rotation with a nodule at the left sternocleidomastoid muscle. Outcomes: An estimated 10% improvement was observed in cervical right lateral flexion and left rotation range of motion with a visible decrease in redness and in the nodule. Additionally, the infant acquired rolling and sitting skills though a left sided preference remained. Discussion: This retrospective case report discusses the lack of research regarding kinesiotape as in intervention and describes its application in addition to other therapeutic interventions for the plan of care of an infant with CMT. Future research is needed to investigate the therapeutic effects of kinesiotape on the trunk in conjunction with conservative interventions. A longer duration of the plan of care is recommended.

Background/Purpose: There is a paucity of literature that describes the results of physical therapy interventions and evidence-based guidelines for after biceps tenodesis/subacromial decompression surgery. The purpose of this case report is to examine the outcomes of interventions used in physical therapy for a young adult patient who underwent biceps tenodesis and subacromial decompression surgery.

Case Description: The patient was a 25-year-old male who was referred to physical therapy 2 days post-surgery for a bicep tenodesis and subacromial decompression of the right shoulder. He originally injured his shoulder while performing a pectoral fly exercise on a cable machine at the gym and had received conservative physical therapy before seeking out surgery. The patient presented with decreased right shoulder strength, decreased right shoulder range of motion, increased pain with activity, and limited functional mobility. Interventions focused on strength, range of motion, functional activities, and pain relief. These interventions were guided by a rehabilitation protocol for biceps tenodesis provided by the surgeon.

Outcomes: The patient completed 35 physical therapy session in a 15-week period. Improvements were seen in right glenohumeral range of motion, right upper extremity strength, decreased pain with activity, and 81% change in functional ability of the right upper extremity using the Shoulder Pain and Disability Index (43% = clinically relevant).

Discussion: This case report demonstrated the positive physical therapy outcomes of specific exercises in combination with manual therapy and modalities on the patient’s functional abilities following biceps tenodesis/subacromial decompression on his right shoulder. The results of this case report may not be generalized to a larger population. Further research incorporating a greater sample size in a randomized control trial would be beneficial to examine the effects of specific therapies.

Background/purpose: The incidence of spinal cord injury (SCI) in the United States of America is estimated to be approximately 17,000 individuals per year.¹ Following a spinal cord injury, patients often develop cardiovascular complications at some point in time.² One such cardiovascular complication is orthostatic hypotension. The purpose of this retrospective case report is to describe an approach to managing the secondary risks associated with orthostatic hypotension in a patient with a spinal cord injury.

Case Description: The patient was a 52-year-old Latino-American male admitted to an inpatient subacute facility for rehabilitation following a traumatic spinal cord injury at work. Patient experienced orthostatic hypotension episodes which limited rehabilitation and increased risk of the patient developing secondary complications.

Outcomes: The patient’s blood pressure was stabilized by use of compression stockings, an abdominal binder, and midodrine. The patient significantly increased function and mobility following decreased orthostatic hypotension episodes. He improved to at least Moderate Independence for all functional activity.

Discussion: This case report highlights the importance of managing the rehabilitation of a patient with a spinal cord injury experiencing orthostatic hypotension to reduce risk of deep vein thrombosis, contractures, and pressure injuries. The pace of improvement and functional gains increased following stabilization of the patient’s blood pressure.

Background/Purpose: Roughly 6% of the general population will experience some type of Achilles tendon pain. Of the 6% that will report Achilles tendon pain, approximately one-third will be diagnosed with insertional Achill es tendinopathy. Insertional Achilles tendinopathy can be difficult to manage conservatively. Typically, if conservative management fails, surgical interventions are used to promote tissue healing and return to prior level of function. The purpose of this case report is to describe the physical therapy outcomes for a patient who underwent a unique insertional Achilles tendinopathy surgical procedure. Case Description: The patient was a 58-year-old male that presented to an outpatient orthopedic clinic a year after a unique insertional Achilles tendinopathy surgery to address residual and functional impairments of his right ankle. During the initial examination, the patient demonstrated limited ankle range of motion, decreased plantarflexor strength, and poor ankle proprioception which impacted functional tasks. Outcomes: The patient demonstrated improvements with all tests and measures conducted during the initial examination.Common physical therapy interventions were utilized to address functional impairments. Despite improvements noted, this patient was unable to return to his active level of function prior to his initial ankle injury one year ago. Discussion: The patient demonstrated outcomes that are consistent with past literature findings for this patient population. Open debridement surgery has been shown optimal outcomes for this patient population, while an isolated gastrocnemius recession surgery has less favorable outcomes for patients who live an active lifestyle. The patient demonstrated improvements after physical therapy interventions but was unable to meet all his goals.

Background/purpose: Low back pain is a highly prevalent cause of disability in adult populations, sometimes resulting in surgery if the pain becomes too severe. Patients affected vary in age, but more elderly patients (65 or older) are receiving spinal surgeries due to increased longevity and functional levels. Limited research exists on the impact of level of function and surgical outcomes in the elderly populations. The purpose of this case report was to examine the outcomes of an elderly woman’s outpatient rehabilitation after an L4-L5 spinal fusion, 2 months after receiving surgical intervention. Case Description: The patient was a 68 year-old female who received an L4-L5 spinal fusion after an acute injury that occurred while she was changing her clothes. Prior to surgery she experienced loss in strength in the right lower extremity and severe pain that impaired her ability to ambulate. After surgery, she regained some lower extremity strength, but pain and weakness persisted, leading her to seek outpatient physical therapy. Interventions focused on pain control, strengthening, lumbar stability, and functional movements. Outcomes: The patient completed ten outpatient physical therapy sessions for the duration of this case report. Her treatments occurred over a four-week period. She demonstrated gross improvements in lower extremity strength as well as improvements in the Modified Oswestry Disability Index, with a 14% improvement in reported function (MDC 10%). Overall, after four weeks of outpatient rehabilitation, the patient reportedthat she felt like she was 95% back to her prior functional level. Discussion: This case report demonstrated a positive outcome from physical therapy interventions that were not initiated until 2 months post spinal surgery. The importance of maintaining physical activity with increased age is noted as this patient was very active prior to surgery. More research is required to validate the importance of increase functional levels, especially before spinal surgeries in the elderly to improve surgical outcomes.

Background and Purpose: The purpose of this retrospective case report is to investigate, in detail, the positive course of treatment that increased her aggravating symptoms with activities for example bending forward (tying her shoes), looking overhead (changing a lightbulb), or laying supine in bed. indicating a vestibular dysfunction. With the incorporation of treatment methods such as the Epley maneuver, VOR training, as well as focusing on reducing deficits noted in the Modified Clinical Test of Sensory Interaction in Balance (mCTSIB ) and Dynamic Gait Index (DGI ), the patient reported an improved quality of life (QOL) which allowed her to regain her prior level of function (PLOF).

Case Description: The patient was a 66-year-old Caucasian female patient diagnosed with Meniere’s Disease by her Ear Nose & Throat (ENT) doctor approximately 1 month prior to starting therapy. The patient presented to an outpatient physical therapy (PT) clinic to be evaluated and treated.

Outcomes: The patient attended 5 treatment sessions over the course of a 5-week period for the duration of the Student Physical Therapist’s clinical experience. The patient demonstrated improvements with the Modified Clinical Test of Sensory Interaction in Balance (mCTSIB), Dynamic Gait Index (DGI), and the Activities-specific Balance Confidence Scale (ABC), Additionally she demonstrated increased tolerance to standing on compliant surface, and reported no symptoms with unsteadiness.

Discussion: The combined use of the Epley maneuver and VOR re-integration has shown positive outcomes for Benign Paroxysmal Positional Vertigo (BPPV) along with Meniere’s Disease (MD) symptoms and impairments for this specific case allowing the patient to return to her prior level of function (PLOF) and restore her quality of life (QOL).

Background and Purpose: Cervicogenic dizziness (CGD) is believed to be a result of altered proprioception secondary to cervical spine pain and/or dysfunction.^..There currently are no validated clinical tests or clinical prediction rules to accurately identify CGD, however, there are published physical therapy clinical decision-making guidelines available. This retrospective case report describes the use of published guidelines to aid clinical decision-making regarding the physical therapy examination, interventions, and outcomes of a patient with CGD.

Case Description: The patient was a 66-year old woman referred to PT with the medical diagnosis of dizziness. A detailed history and thorough examination revealed that the patient had signs and symptoms consistent with CGD. The clinical hypothesis was confirmed using a test-retest approach following a trial of manual therapy addressing the identified cervical spine dysfunction. Additional interventions included stretching, postural re-education, gaze stabilization, and proprioceptive training.

Outcomes: Immediately following the initial treatment, the patient no longer reported dizziness during active seated neck rotation, which helped confirm clinical hypothesis of CGD. After six PT sessions, the patient reported complete resolution of dizziness during daily activities. The Dizziness Handicap Inventory score improved from 56/100 to 0/100, and the global rating of change (GROC) score was +6, representing “a great deal better."

Discussion: In order to identify CGD, the physical therapist must skillfully screen for the presence of signs/symptoms of medical pathologies, vestibular disorders, and/or trauma. A test-retest method following a trial of manual therapy may be useful to confirm the clinical hypothesis. A multimodal approach combining musculoskeletal and somatosensory training was successfully implemented for this patient.

Greater trochanteric pain syndrome (GTPS), often diagnosed as lateral hip pain or hip bursitis, is a condition often found in runners and athletes. There currently exists no clinical practice guideline or protocol in the treatment of GTPS, but current trends have shifted towards treating the gluteal tendinous junction of the hip. The purpose of this case report was to examine the outcomes of physical therapy focused on this method of treatment in the case of a 38-year-old marathon runner presenting with left GTPS. The patient completed six outpatient physical therapy sessions over a six-week period. Improvements were seen in lower extremity strength of left hip, reduced pain with sitting and running, and increased pelvic stabilization with movement. The subject made a return to running so as to begin training for an upcoming marathon. This report focused on the use of eccentric hip exercises to promote tendon healing as well as pelvic stabilization in the treatment of hip pain. As this subject presented with recurring hip pain, an emphasis was also placed on patient education for body awareness and self-management of symptoms outside of the clinic while returning to marathon training.

Background/purpose: Sepsis is a life-threatening condition that can affect multiple organs resulting in impaired physical and cognitive function that can persist for many years following the resolution of sepsis. There is limited research on the benefits of physical therapy rehabilitation after a patient with sepsis is discharged from a hospital to a skilled nursing facility. The purpose of this case report is to describe the functional outcomes and the effectiveness of physical therapy using a multicomponent intervention approach for a non-ambulatory female with sepsis in a skilled nursing facility after seven weeks of physical therapy.

Case Description: The patient was an 82-year-old Caucasian female with a medical diagnosis of sepsis bacteremia. The patient presented to physical therapy with decreased bilateral lower extremity strength and range of motion, impaired balance, low back and knee pain, difficulty with bed mobility and transfers, and inability to ambulate. A multicomponent exercise program was incorporated into the patient’s plan of care.

Outcomes: After seven weeks of physical therapy, the patient made improvements in bilateral lower extremity strength, right knee flexion range of motion, balance, bed mobility, transfers, gait, and decreased low back and knee pain. The patient was unexpectedly discharged to the hospital.

Discussion: This case report demonstrates the functional benefits of a multicomponent physical therapy rehabilitation program for a non-ambulatory female with sepsis in a skilled nursing facility. The results from this study are consistent with other studies’ findings on the effectiveness of a multicomponent exercise program for the older adult population.

Osteoarthritis (OA) is a leading cause of disability, and individuals with severe OA often opt to undergo an elective total knee arthroplasty (TKA). Minimally invasive TKAs are described in literature as an alternative technique that overall promote an earlier return to function. Minimally invasive techniques have shown immediate post-operative benefits, however, limited research is available that describes the short and long term physical therapy outcomes between the traditional and MIS techniques. The purpose of the case report was to describe the outcomes following a MIS TKA as well as to describe the exercise progression and physical therapy interventions utilized to return a patient to all functional activities. The patient was a 63-year-old female who presented to outpatient physical therapy status-post left minimally invasive total knee arthroplasty. She presented to physical therapy on postoperative day two with chief complaints of knee pain, decreased mobility, and difficulty ambulating. The patient completed 19 treatment sessions and showed clinically significant improvements in functional outcomes measures such as the Timed Up and Go (TUG) and Lower Functional Extremity Scale (LEFS). She also demonstrated improvements in both active and passive ROM, stair negotiation, and gait with an overall decrease in post-operative pain. This particular case report demonstrated the exercise progression of a patient following a MIS TKA as well as how various factors such as a low pain threshold, anxious behaviors, and polypharmacy lead to the individualized plan or care.

Background and Purpose: The purpose of this retrospective case report is to describe functional outcomes for pain, range of motion (ROM), strength, motor control, and functional mobility of a 39-year-old Caucasian male patient following a left shoulder arthroscopy with anterior capsulorrhaphy and a bony Bankart repair after 10 weeks of physical therapy.

Case Description: The patient was a 39-year-old Caucasian male referred to physical therapy status post left shoulder surgery due to recurrent anterior instability and a Bankart lesion of the left shoulder following a skiing accident. The patient was treated in outpatient physical therapy setting for left shoulder pain, decreased range of motion (ROM), decreased strength, poor posture.

Outcomes: By the end of the 20 visits, the patient only met one out of four long-term goals relating to pain management and partially met the remaining three goals regarding improving functional mobility, ROM, and strength.

Discussion: It’s important that the patients’ expectations of their postoperative level of activity are considered and managed properly prior to initiating a postoperative rehabilitation program. Further research examining postoperative outcomes for ROM following shoulder capsulorrhaphy and a bony Bankart repair is needed to establish physical therapy goals in a realistic and attainable timeframe.

Background/Purpose: Septic arthritis may be caused by subsequent infections of pneumonia. Individuals with chronic obstructive pulmonary disease (COPD) are at an increased risk for developing pneumonia. Patients with septic arthritis are seen by physical therapist to alleviate impairments. Negative impacts from COPD may present as a barrier to successful therapy for arthritis and require modifications to interventions. The purpose of this retrospective case report is to highlight safe interventions for a patient with septic arthritis and COPD, while also suggesting ways that behavioral modifications could have been incorporated into the episode of care.

Case Description: The patient was a 65-year-old male with septic arthritis, COPD, and recurring pneumonia infections. The patient presented with decreased range of motion and strength in his lower extremities. The patient also had a decrease in aerobic endurance due to the COPD.

Outcomes: After 4 weeks, the patients had improvements in knee range of motion and strength. Unfortunately, there was also a decline in aerobic endurance. The patient reached as low as 81% SaO₂ during a 2-Minute Walk Test. The patient was referred to his primary care physician before continuing physical therapy.

Discussion: Tobacco usage is prevalent among individuals with COPD, which may further exacerbate negative effects of the COPD and also present as a barrier to successful therapy. Given the outcomes of this case, the transtheoretical model would have been an appropriate framework to direct this patient’s care. The transtheoretical model can be utilized by healthcare professionals to incorporate smoking cessation into their treatments.

Abstract: The purpose of this retrospective case report is to illustrate a successful recovery and return to work, recreational activities and motorsports following shoulder replacement with a pegged glenoid and a stemless humeral implant with traditional therapy interventions and a highly compliant patient. Method: This report is a retrospective single case-study design. Discussion: Total shoulder arthroplasty utilizing a pegged, otherwise known as short-stemmed implant, should be considered for utilization in those individuals requiring a high level of post-operative function. Conclusion: There is little research on short-stemmed implants utilized in shoulder arthroplasty or their utilization in motorsport, and shooting sport athletes thus additional research in these areas should be considered. It is ultimately up to the patient and surgeon to establish conservative parameters for participation in recreational activities post-surgery in the interest of preserving the longevity of the shoulder implant.

Background and Purpose : Chronic low back pain is a common musculoskeletal condition treated by physical therapists. An association between chronic low back pain and pelvic floor dysfunction in female ath letes was made in recent literature however the current clinical practice guidelines for the treatment of low back pain continue to exclude pelvic floor assessment and intervention. The purpose of this case report is to describe a need for the addition of pelvic floor subjective screening to augment the initial systems review for female athletes presenting to physical therapy with chronic low back pain in order to provide holistic and comprehensive care to optimize outcomes. Case Description : This case de scribes the physical therapy care delivered to a 20 year old Caucasian female with a medical diagnosis of chronic low back pain. During the course of treatment the patient noted pelvic floor dysfunction which was described as pain with vaginal penetration & changes in bowel and bladder. Outcomes : Both low back pain and pain with vaginal penetration was relieved, functional movement was restored, pelvic floor dysfunction resolved with normalcy in bowel/bladder and return to work/weight - lifting activities re sumed following 13 weeks of physical therapy. Discussion : A potential relationship between chronic low back pain and pelvic floor dysfunction in female athletes may be considered. The initial examinations for physical therapy should therefore be inclusive of subjective screening specific to pelvic floor function. The outcomes in this patient’s specific case began to improve remarkably after subjective screening and the addition of pelvic floor intervention. This retrospective case study demonstrates a need for pelvic floor subjective screening questions during an initial systems review in order to provide holistic and comprehensive care to optimize outcomes.

Background and Purpose: Participation in high school sports has steadily risen over the past three decades with baseball being the fourth most popular sport. A common injury sustained in overhead throwing athletes, such as baseball players, is injury to the ulnar collateral ligament (UCL) of the elbow. The purpose of this case report is to evaluate the impact of a comprehensive physical therapy rehabilitation program on the upper extremity of an adolescent overhead throwing athlete with an ulnar collateral ligament sprain.

Case Description: The patient was a 17-year-old male baseball player who had a diagnosis of UCL sprain of the right elbow and generalized muscle weakness. He presented with elbow pain, decreased shoulder and hip range of motion (ROM) and strength, scapular dyskinesia, and poor thoracic mobility. The patient was treated in outpatient physical therapy with a plan of care focused on increasing ROM, strength and flexibility to return the patient to throwing and to prevent future injury.

Outcomes: The patient demonstrated functional improvements as evidenced by his improved Upper Extremity Functional Index (UEFI) score and absence of pain with activity. His shoulder and hip ROM and strength improved along with thoracic mobility. While scapular strength did not show an overall improvement, his scapular dyskinesia was improved.

Discussion: The research supports the use of a progressive stretching and strengthening program as effective treatment strategies for an ulnar collateral ligament injury. While there was no way to understand if the interventions provided for the patient will help to prevent a future injury, injury prevention continues to be an important topic to investigate as participation in youth sports continues to rise.

Description: Over the past 30 years, the survival rate of infants with myelomeningocele has increased causing myelomeningocele to become a cause of chronic disability. Neurodevelopmental treatment (NDT) and task-specific interventions have not been analyzed in children with myelomeningocele. The purpose of this retrospective case report is to investigate the impact that a multi-treatment early intervention (EI) physical therapy approach on the progression of delayed gross motor milestones.

Case Description: The patient was an infant Caucasian female with L5 myelomeningocele and many secondary diagnoses. At the initial evaluation at 2 months of age, the patient was found to have a 50% delay in the reflexes and stationary gross motor subsets of the Peabody Developmental Motor Scales-2 and had developmental quotient of 66.67 indicating a mild delay.

Outcomes: The patient’s reflexes and stationary gross motor subsets decreased from a 50% delay at initial evaluation to a 0% delay at 8 months. The reflexes sub-test increased to 11% delayed at 9 months. Her locomotion sub-test increased to a 12.5% delay at 8 months and a 22% delay at 9 months. Her developmental quotient was within normal limits at 8 and 9 months.

Discussion: These improvements demonstrate the progression of the patient’s gross motor skills indicating improved strength, ability to transition in and out of functional positions, and functional mobility related to her chronological age. This retrospective case report demonstrates the benefits of multi-treatment approach utilizing NDT techniques in combination with task-specific interventions for an individualized physical therapy treatment plan for a young child with L5 myelomeningocele

Background/purpose: There is an increase in the population of older adults that lack social support in the United states. Many older adults that live outside hospitals and nursing homes live alone by themselves. Lack of social support has effects on older adults; physically, psychologically, socially. One of the instances of when lack of social support can be negative is when an older adult is recovering from a surgical procedure such as hip replacement. The purpose of this case report is to analyze recovery after hip hemiarthroplasty for a patient lacking social support

Case Description: The patient was a 79-year-old female that had a hip hemiarthroplasty to surgically treat a fractured hip following a fall. The patient presented with high pain levels, bilateral lower extremity weakness, limited hip range of motion and limited functional mobility. Interventions were focused on patient education, bed mobility, functional transfer and ambulation.

Outcomes: The patient completed seven physical therapy session while in an acute care setting. Improvement were seen in her lower extremity strength, pain levels and functional dependence. The patient was able to ambulate greater distance, increase ambulation velocity, improve bed mobility and transfer by discharge from inpatient acute setting.

Discussion: This report highlights the impact of social support in the recovery process following a hip hemiarthroplasty. Rehabilitation was geared towards returning patient to functional independence with regular daily activities. Further research needs to be done to determine what aspects of social support will lead to better outcomes during recovery.

The Patient Protection and Affordability Care Act has targeted hospital readmission rates. Jette et al. suggested the theoretical discharge decision making model to reduce hospital readmission rates. The purpose of this retrospective case report was to discuss the influence of health care regulations while applying the theoretical model of discharge decision making in a patient who was admitted to acute care with uncontrolled diabetes, sepsis, and progressive wounds. Case Descriptions: The patient was a 63-year old Caucasian female with greater than six comorbidities. This patient experienced a negative health sequela due to the loss of health care services from a loss of health care coverage. She was then admitted into the acute care unit of the hospital after observed lethargy that was later determined from uncontrolled diabetes, sepsis, and progressive wounds. Throughout care, this patient improved functional bed mobilities and her function in the seated position. However, the patient was unable to achieve a sit to stand and ambulate at discharge. Outcomes: Through the application of the theoretical model of discharge decision making that was proposed by Jette et al., the recommended discharge destination was skilled nursing services. However, due to health care regulations, the patient received home health with nursing and pro bono podiatry appointments. Discussion: Although the physical therapy student determined that skilled nursing services were appropriate for this patient after discharge, there was a discrepancy that was attributed to health care regulations. Due to this discrepancy, this patient is potentially at risk for readmission into the hospital which would cause further strain on Medicare and Medicaid Services.

: This case report examines the influence of prosthesis fit and quality, among other factors, in the incidence and treatment of low back pain in a 62 year -old man with a unilateral lower extremity amputation. The subject had lived with a poor-fitting prosthesis that may have influenced body mechanics, potentially leading to the onset of low back pain. With 10 physical therapy visits pain was decreased from 10/10 on the Numerical Pain Rating Scale to 0/0. It is hypothesized that the use of the poor fitting prosthesis would have caused a reoccurrence of his low back pain if it were not addressed through referral to a prosthetist and skilled physical therapy intervention.

Background/ purpose: There are a few treatment options for diastasis recti. This is a rare condition to be seen in the male population and there is little research in the literature that discuss which interventions would be best in treating this population. The purpose of this case report is to help to establish an intervention and training program in order to help correct the condition of diastasis recti in a male population.

Case Description: 67-year-old male that presented to outpatient physical therapy with a diagnosis of weakness of trunk musculature. Therapists lead the patient through an exercise program focused around the neuromuscular re-education and strengthening of the transverse abdominis.

Outcomes: Patient was seen for a total of four physical therapy visits over a 13-day span before patient self-discharge. Improvements in objective measures after the episode of care included ½ grade increase in all abdominal musculature, about 50% decrease in abdominal bulging, improved muscle activation, and improved functional movement patterns.

Discussion: Positive findings and full correction of diastasis recti have been seen with physical therapy typically between 2-6 months in females. This patient appeared to be on a similar timeframe at the time of patient’s self-discharge. Physical therapy interventions and focus of an exercise program targeting the transverse abdominis can be an effective treatment method for males with diastasis recti.

Background and Purpose: Patellar tendon injury is most commonly seen young to middle aged adults who participate in sports or lead an active life style. These patients many times are apprehension and are fearful of reinjury and may avoid return to sports and function. This fearful avoidance and subsequent decrease in self-efficacy are directly related to functional ability of a patient. The purpose of this case study is to investigate the relationship between fear avoidance behaviors, self-efficacy, and functional mobility in a patient who has undergone a patellar tendon repair.

Case description: The patient was a 24-year-old male who was a collegiate soccer athlete at the time of injury. This patient underwent a left knee arthroscopy that included extensive debridement of the patellar tendon, and a percutaneous repair of partial thickness tear of the patellar tendon, followed by an injection of platelet-rich plasma.

Outcomes: This patient had significant improvements of functional mobility and overall strength and range of motion. Improvements in qualitative improvements in self-efficacy and fear avoidance behaviors were also seen, although Lower extremity function scale did not show a significant improvement in the patient’s perception in his abilities.

Discussion: Patient functional improvements are thought to relate to his subsequent decrease in fear avoidance and increase in self-efficacy. As the patient progressed during therapy sessions, he would exhibit less apprehension during new tasks and have greater willingness to encounter new challenges. As such, progressive functional task training and exercises have been found to be an effective method to improve function and self-efficacy while decreasing fear avoidance.

Balance among other factors play a large role in the elderly population’s fall risk. Evidence demonstrates that falls in older people can be prevented with specifically designed interventions. Dance or dance-based balance interventions have been reported to help improve balance in elderly individuals. Limited research exists on the use of Latin music in dance-based balance interventions in the elderly population. The purpose of this retrospective case report was to examine the use of Latin dance–based balance interventions with bachata, merengue, and cumbia music, for an elderly individual who had functional mobility but was unsteady on uneven surfaces.

The patient was a 73 year-old female that reported difficulty walking on uneven sidewalks, streets, and grass. The patient presented with deficits in maintaining balance in single leg stance bilaterally and while standing on a foam surface with eyes closed, a component of the modified Clinical Test of Sensory Interaction on Balance (CTSIB). Interventions focused on improving stability with decreased base of support, single-leg stance, and turns, on and off compliant surfaces with the use of Latin music.

Improvements were seen in single-leg stance for the left leg, increasing by 3 seconds (MDC 24.1 seconds) and in time for eyes closed on foam surface for the modified CTSIB, increasing by 20 seconds.

This report examined the use of Latin dance-based balance interventions in a community-dwelling elderly patient. Further research with increased sample size, static and dynamic balance outcome measures, and increased period of time for interventions is needed.

ABSTRACT

Background/Purpose: Over 2 million people in the United States are injured each year in motor vehicle accidents (MVA) and experience subsequent low back pain (LBP). The purpose of this retrospective case report is to present the evidence and clinical reasoning behind a Mechanical Diagnosis and Treatment (MDT)-based physical therapy plan of care for a patient with LBP post-MVA.

Case Description: The patient was a 31-year-old African-American female with LBP after a MVA. The patient’s goals for physical therapy were to reduce pain with functional activities such as sitting, standing, walking, and return to pain-free function in duties such as caring for her young child and working as a web producer.

Outcomes: After 8-weeks in therapy, the patient demonstrated improvements in LBP, increased lumbar active range of motion (AROM), increased lower extremity muscle strength, and improvements on the Oswestry Disability Index (ODI).

Discussion: This case report suggests that MDT-based physical therapy intervention may be used to treat a patient with LBP post-MVA. This is demonstrated by improvements in LBP, AROM, lower extremity muscle strength, and the ODI.

Keywords: Mechanical diagnosis and treatment, low back pain, physical therapy, motor vehicle accident

Prior to the passing of HB 4643–Direct Access to Physical Therapy Services, citizens living in the state of Illinois required a mandated physician referral before receiving services from a physical therapist. Individuals with comorbidities and chronic physical impairments concerned about improving their health & wellness are performing exercise under the instruction of unqualified individuals via independent exercising utilizing online resources or working with a personal trainer. Comorbidities or chronic physical impairments may go unacknowledged and necessary modifications and adaptations to exercise may not occur. Ultimately, performing exercise under the supervision of unqualified individuals may further aggravate or exacerbate these health conditions and lead to potential injury. The purpose of this retrospective case report is to determine not only how an elderly patient utilized the benefits of the newly endowed Direct Access for preventative/wellness reasons, but how treatment, prescription, and independent adherence to an exercise program from a physical therapist can impact BMD levels and prevent the development of Osteoporosis in an already osteopenic patient.

Background and Purpose: Essential tremor is one of the most common progressive neurological conditions affecting many adults and older individuals, however there is limited research of the effects of therapeutic interventions in relation to physical therapy. The purpose of this retrospective case report is to highlight interventions used in the treatment of a patient with essential tremor in an outpatient physical therapy clinic and the outcomes of those interventions.

Case Description: The patient was a 68 year-old female with essential tremor. She also presented with severe COPD, impaired distal extremity sensation, and history of mini strokes, asthma, pneumonia, and kidney issues. The interventions utilized in this study included resistance training, neuromuscular training, soft tissue and joint mobilization, the modality anodyne and functional training.

Outcomes: The patient was seen for a total of eleven visits over a seven-week period with four cancelations due to illness. Improvements in Berg Balance Scale (BBS) of 5 points, Functional Gait Assessment (FGA) of 8 points and Lower Extremity Functional Scale of 18 points. She also demonstrated improvements in sensation, strength and a decrease in pain and reported cervical stiffness.

Discussion: This case report demonstrates the role physical therapy can have on the treatment of a patient with essential tremor and the need for continued research of specific interventions as it relates to physical therapy. Due to the complexity and evolving nature of the patient, clinical reasoning was highly utilized in creating and modifying this patient’s plan of care.

Background/purpose: The cerebellum plays an essential role in motor control and coordination.When the cerebellum is damaged, such as from chronic alcohol overuse, the result is ataxia. The purpose of this retrospective case report is to describe how the Dynamical Systems Theory was used to develop physical therapy interventions for a patient with alcohol-related ataxia and cerebellar degeneration.

Case Description: The patient was a 60-year-old African American male who presented to physical therapy with ataxia, poor balance, oculomotor impairments, and cognitive deficits consistent with his diagnosis of alcohol-related ataxia and cortical degeneration. His major goals for physical therapy were to improve his walking and stair navigation, decrease his risk of falls, and improve his ability to perform activities of daily living.

Outcomes: After 12 sessions of physical therapy the patient demonstrated improvements in balance, gait speed, task recall and dual tasking, and had a clinically significant increase in his Lower Extremity Functional Scale score. He could independently navigate 4 steps into his house and reported an overall increase in participation at home.

Discussion: This case report describes the application of the Dynamical Systems Theory of motor control as an approach to developing physical therapy interventions for a patient with alcohol-related ataxia and cerebellar degeneration. The outcomes of this case suggest that physical therapy was overall successful at decreasing this patient’s impairments, enhancing his movement and motor control, and helping the patient to reach his rehabilitation goals using the Dynamical Systems Theory approach.