Physical Therapy For A Patient With Poor Balance Secondary To Charcot-Marie Tooth Disease And Chronic Low Back Pain: A Case Report

Background: Charcot-Marie-Tooth disease (CMT) is one of the most common inherited neuromuscular disorders with a prevalence rate of 1 in 2,500 in the United States. CMT is a form of muscular dystrophy, and is an umbrella term for certain inherited genetic disorders that affect the peripheral nervous system. The genetic disorder is characterized by muscular wasting, weakness, and sensory loss, and is most severe in the distal lower extremities. Common symptoms include foot drop, high-stepped gait with frequent tripping or falls, foot deformities such as high arches and hammer toes, and loss of muscle bulk in the distal lower extremities. Neuropathic pain and fatigue upon exertion are also common symptoms that are underreported. The onset of symptoms is variable depending on the type; however, it is usually prevalent during adolescence or early adulthood. There is no pharmacological treatment for CMT. Clinical approaches include physical therapy (PT) management, orthotics, and surgical interventions for treatment of skeletal deformities. Purpose: This patient was selected for a case report because there was relatively little research on therapeutic interventions for a patient with chronic low back pain alongside balance deficits in this particular patient population, especially for a patient in this age demographic, 45-65. The purpose of this case report was to provide an overview of CMT disease and a description of PT management strategies used for a patient with poor balance secondary to CMT disease and chronic low back pain.https://dune.une.edu/pt_studcrposter/1026/thumbnail.jp

Increasing sensitivity toward handicapped children through inclusion

The purpose of this study was to observe the benefits for non-handicapped students in an inclusive setting. The hypothesis suggested that regular education students would be more sensitive and aware of handicapped individuals when they are read stories about handicapped individuals and participate in a sensitivity program than regular education students who do not receive this form of intervention. The Acceptance Scale for Kindergarten-Revised (ASK-R) helped to assess fifty-eight second graders\u27 perceptions of handicapped individuals. The difference between the pre-test and post-test scores of Classroom B (experimental group given sensitivity program and read stories regarding individual differences; has included child) to Classroom A (control group; no included child) and Classroom B to Classroom C (has included child; no intervention given) on the ASK-R was evaluated. The independent variable was the type of sensitivity training received in each classroom. The dependent variable was an increase in sensitivity toward individual differences. It was found that Classroom B was significantly more sensitive than Classroom C toward handicapped individuals. However, Classroom B was not significantly more sensitive than Classroom C toward handicapped individuals. Overall, children who had more contact with handicapped individuals were more accepting of differences than children in low/no contact groups

Politics and directors\u27 performance evaluation: Perceptions of senior student affairs officers and directors

The purposes of this study were to determine whether directors and the senior student affairs officers who supervise them perceive the formal performance evaluation process to be accurate, fair, and meaningful, and whether they perceive the process to be influenced by the politics involved in the position

The meaning in the message: Impact and implications of university presidential statements regarding sexual assault

This study aims to critically analyze university presidential statements made regarding sexual assault on campus and how those statements might impact campus culture. Through critical content analysis, manifest content and latent content were examined. The results explain that while the statements made are satisfactory and making a statement is better than not doing so, the statements are vague and indistinct. In order for the statements to have more meaning and impact, it is clear that messaging needs to be more specific to each individual institution, and be more critical, using unique language so the campus community can feel seen, understood, and safe. Recommendations for future research on this topic are included. These recommendations for continued research would aid scholars in further understanding how institutions can make more meaningful, impactful statements

Neural Mechanisms Supporting Differential Auditory Fear Conditioning

Pavlovian fear conditioning provides an ideal way to study memory formation, retention, and updating. Plasticity in the auditory thalamus is required during the acquisition and consolidation of a fear memory when a tone signals a foot shock. The medial geniculate nucleus (MgN) of the auditory thalamus sends projections to the amygdala and auditory cortex and is functionally divided into two different regions, the medial division (MGm) and the ventral division (MGv). Traditionally, these divisions are thought to relay auditory information to the amygdala during fear-related associative learning. However, recent research has suggested a more complex role for the MgN when processing auditory stimuli during conditioning. In the current study, we identified synaptic activity necessary for memory formation in the MgN as well as how this plasticity impacts the amygdala. In order to target MgN plasticity, we used a discriminative fear conditioning procedure to recruit auditory thalamus plasticity during conditioning. We predicted that memory consolidation in the MgN requires mRNA translation, which will initiate amygdala receptor trafficking following auditory fear conditioning. We found that protein synthesis in the MgN is required for amygdala AMPA receptor surface expression and synaptic scaffolding necessary for auditory memory consolidation

Online Versus Face-to-Face Communication Sciences and Disorders Graduate Student Outcomes: A Causal-Comparative and Correlational Study

The purpose of this quantitative causal-comparative and predictive correlational study was to investigate how online CSD graduate students compare to their face-to-face peers based on three measurable student outcomes with an additional investigation of how their age impacts these outcomes. This study is important because the number of online graduate programs in CSD is growing despite a lack of evidence in the research that online programs in this field have similar student outcomes as their face-to-face counterparts. This ex post facto study investigated outcomes from 188 students who graduated from or were previously enrolled in a CSD graduate program from one university that offered both an online program and a face-to-face program. Data were analyzed using a two-way ANOVA and logistic regression. The results of the study found that there was not a statistically significant difference between online CSD graduate students and face-to-face students on three measurable outcomes: passing the Praxis II certification exam in Speech-Language Pathology, scores on the Praxis II certification examination in Speech-Language Pathology, and degree completion rates in program-defined timelines. The results of this study suggest that both online and face-to-face students have an equal opportunity to be successful in a CSD graduate program no matter their age category. Future research would be beneficial to investigate these outcomes across a larger population and additional outcomes (e.g., student perceptions, clinical supervisors, and using both qualitative and quantitative measures)

Created Equal? Comparing Disturbing Media Outcomes Across Occupations

The present study was conducted in order to compare outcomes across distinct occupations that are exposed to disturbing media. Using four previously researched samples, I compared results across negative and positive outcomes such as STSD, burnout, social support, and growth. Samples included employees in roles within federal law enforcement and military legal professions. Results indicated that there were some significant differences between occupations on levels of STSD, burnout, and social support. In addition, results showed all samples measuring growth were scoring within the mid-range of scores, indicative of some growth potential. These results also showed that exposure type (Indirect, Combined Exposure) may not be an appropriate classification for roles within disturbing media, as results were not conclusive. Future research should continue to explore disturbing media between varying occupational roles while including measures such as growth

Observational Play Assessment in Recreational Therapy (OPART): Applications for the Validation of Assessment in Recreational Therapy

The need for standardized assessments in healthcare is rapidly growing as new discoveries are made. In the field of Recreational Therapy (RT), there are primarily agency specific developed assessments that have not yet been analyzed and proven reliable or valid1. As a growing occupation, it is critical that RT assessments are evaluated to provide evidence of the effectiveness of treatment. This study analyzed the reliability and validity of a new RT Assessment, the Observational Play Assessment in Recreational Therapy (OPART). The assessment was designed to provide recreational therapists the opportunity to assess levels of physical, cognitive, emotional, and social skills of children with disabilities while observed in play settings. Reliability and validity evidence was generated through the comparison of the OPART to another psychometrically sound assessment used in RT, the Comprehensive Evaluation in Recreation Therapy (CERT). Results suggested that the OPART had some evidence of interrater reliability (overall % agreement = .73; section agreement ranging from .60-.87%) with higher agreements when measuring functional skills with physical attributes (e.g., gross motor skills, fine motor skills, endurance/weakness). The OPART had some evidence of convergent validity with overall (rs= .611; p=.016) and adjusted (rs = .738; p=.002) scores when compared with the CERT. Further analysis of individual sub-sections of the OPART with the CERT suggested limited evidence of convergent validity as only one of the four sections approached statistical significance. The OPART also demonstrated some evidence of predictive validity in its’ ability to accurately classify the functional level of the participants when compared to those assigned by staff familiar with individuals observed. The OPART was accurate in 8/15 (53.3%) cases while the standardized CERT was slightly more accurate at classifying participants in 9/15 (60.0%) cases. Overall, the OPART had some evidence of convergent validity with the CERT in terms of adjusted scores (rs=.738; p= .002) and total scores (rs=.611; p= .016) with total scores. While this initial step to validate a new instrument was promising, it is clear that significant development and validation is indicated. Recommendations and future considerations are provided for the validation of agency specific RT assessments

Generalization of Negatively Reinforced Mands in Children with Developmental Disabilities

Everyone, including children with developmental disabilities, encounters stimuli they find aversive every day (e.g., the sound of a classmate tapping their pencil). These aversive stimuli may not be problematic for typically developing individuals, because they learn to behave in ways that allow them to escape or avoid this aversive stimulation. They could, for example, mand (i.e., request) for something to be changed in the environment (e.g., ask their classmates to stop tapping their pencils). A child with developmental disabilities, however, may not have the communication skills necessary to request the termination of aversive stimuli, which may result in frequent exposure to aversive situations. For these children, it may be useful to acquire a general mand (e.g., saying, No, thank you ) which could be used to avoid or terminate a variety of aversive stimuli. Previous researchers teaching mands for negative reinforcement have focused on replacing problem behavior maintained by escape from task demands. The current study extended the literature on teaching mands for negative reinforcement by teaching children with developmental disabilities to mand for escape from a variety of nonpreferred stimuli, while assessing generalization to untrained stimuli and settings. Participants were two school-aged boys with autism who engaged in problem behavior when they encountered nonpreferred stimuli, and did not use an appropriate mand for negative reinforcement. First, we employed a non-preferred stimulus assessment to identify stimuli for subsequent use in mand training. Next, we conducted mand training sequentially across nonpreferred stimuli until sufficient exemplars were trained for generalization to untrained stimuli to occur. Finally, we conducted probes to assess generalization of the mand response to nontraining contexts outside of the experimental setting. For both participants, training was required across two stimuli before cross-stimulus generalization was observed. Because generalization did not bring the mand to criterion levels with the third stimulus, for either participant, training was introduced to facilitate acquisition. The mand response was acquired with a fourth stimulus in the absence of training. Through the inclusion of appropriate control conditions, we showed that the stimulus control of the mand response was appropriate, occurring almost exclusively in the presence of nonpreferred stimuli. In addition, we showed decreases in problem behavior, for both participants, which corresponded to acquisition of the mand response. We also provided evidence of generalization to nontraining contexts. We discuss limitations of the current study and present suggestions for future research

Auditory and Contextual Contributions to Memory Lability and Synaptic Destabilization in the Amygdala

Pavlovian fear conditioning provides a way to investigate memory formation and retrieval. During fear conditioning, a conditional stimulus (CS) is paired with an aversive outcome and the CS acquires aversive value over several pairings. The CS may then be presented during a retrieval session where fear responding is measured as an indicator of memory strength. Retrieval sessions may allow for the incorporation of new information into the original memory trace by destabilizing amygdala synapses. However, the specific circuits and neural inputs that contribute to memory lability and synaptic destabilization during a retrieval session are poorly understood. Previous work has shown that contextual novelty during an auditory retrieval session is necessary for memory lability, suggesting that brain regions encoding auditory and contextual information interact during memory retrieval. The dorsal hippocampus and auditory thalamus play selective roles in processing contextual and auditory information, respectively, during fear conditioning. In the current study, we manipulate functional inputs from each region to determine how each impacts memory lability at amygdala synapses. We found that 1) silencing auditory thalamic inputs in the amygdala during a brief retrieval session reduces fear to an auditory cue and leads to long lasting reductions in fear, and 2) inactivation of the dorsal hippocampus prior to training allows for memory impairment when anisomycin is infused into the amygdala after a retrieval session in an anisomycin resistant memory. This work highlights an important role for brain regions processing sensory information during training and the impact on fear memory recall and modification