National Survey of Lymphedema Therapists’ Dosing of Complete Decongestive Therapy in Breast Cancer Survivors with Lymphedema

Purpose: The purpose of this study was to identify dosing levels of complete decongestive therapy (CDT) with survivors with Breast Cancer-Related Lymphedema (BCRL) and describe factors related to how occupational therapists, occupational therapy assistants, physical therapists, and physical therapists assistants with advanced lymphedema training determine dosing. Methods: An electronic survey was sent to 598 occupational therapists, occupational therapy assistants, physical therapists, and physical therapists assistants with training in lymphedema. Respondents completed questions regarding demographics, dosing practices, and factors related to dose determination in complete decongestive therapy of survivors with Breast Cancer-Related Lymphedema. Results: 107 surveys were returned (18% response rate). Most of the respondents (95.1%) reported providing less than the recommended daily dosing (7x/wk) of complete decongestive therapy to their survivors with Breast Cancer-Related Lymphedema. The mean dosing of complete decongestive therapy from respondents was approximately half of the recommended daily dosing (M=3.71). A statistically significant Pearson’s correlation was noted among frequency of dosing and treatment adherence (r=.275) and frequency of dosing and treatment readiness (r=.242). A multiple regression analysis found adherence accounted for a significant proportion of variability in dosing frequency (R²=.077; F change p Conclusions: A majority of therapists treating survivors with Breast Cancer-Related Lymphedema in an outpatient setting are not following daily recommended dosing of complete decongestive therapy. Clinicians’ dose determination is significantly impacted by their perception of a survivor’s readiness and adherence to lymphedema treatment and self-management. Comparative clinical outcomes studies of various therapeutic dosage levels (times per week) and duration (length of delivery) of complete decongestive therapy are imperative for development of best treatment protocols for survivors with Breast Cancer-Related Lymphedema. This study serves as a first step toward evidence based planning for complete decongestive therapy treatment of Breast Cancer-Related Lymphedema

The Effect of Kinesio Tape on Scapular Kinematics in Collegiate Baseball Players

Introduction Baseball is a repetitive overhead sport requiring coordinated shoulder movements with great speed and power, placing a high amount of stress on the shoulder complex Baseball players\u27 throwing shoulders demonstrate altered scapular kinematics compared to their non-throwing shoulder We hypothesize that kinesio tape application will significantly alter the scapular kinematics of the throwing shoulder in collegiate baseball players Participants 15 current or former Division 2 and 3 collegiate baseball players from Concordia University, St. Paul and Hamline University Inclusion Criteria: Subjects had played collegiately within the last 5 years Exclusion Criteria: Extrinsic conditions or underlying pathology that effects the kinematics of the scapula, recent surgery, referred symptoms, or allergy to adhesive Methods Kinesio tape was applied to the dominant throwing shoulder 3D motion of the humerous and scapula were measured using the G4 electromagnetic motion capture system and MotionMonitor software Shoulder flexion, abduction, and scapular plane elevation were performed on the dominant arm with, then without, tape; then once again on the non-dominant arm without tape Repeated-measures ANOVA and matched paired t-tests Results Fifteen collegiate Division 2 and Division 3 baseball players participated, 12 of which were right hand dominant. Ages ranged from 18-24; an average of 20.9 plus or minus 1.8. No participants were excluded. During humerothoracic elevation in the scapular plane, there were no significant differences in scapular motion. During humerothoracic abduction, dominant arm with KT was statistically significant for change in posterior tilting (Table 1). The results of the matched pairs t tests demonstrated that Dominant KT was statistically significant from Dominant No-KT and non-dominant (Table 2). This indicated that Dominant KT resulted in increased posterior tilting. Conclusion KT application resulted in increased scapular posterior tilting of the throwing shoulder during abduction Increased upward rotation and posterior tilting contributes to increased subacromial space Future recommendations would include further research on symptomatic baseball players Clinical Relevance The use of kinesio tape is a potential avenue to decreasing shoulder pain in collegiate baseball players based on the loss of posterior tilting associated with subacromial impingement

Bladder secretion of inhibitors of calcium oxalate crystal growth

Bladder secretion of inhibitors of calcium oxalate crystal growth.Differences in calcium oxalate crystal growth inhibition were studied in normally voided urine (bladder urine) and in urine collected directly from the kidney (kidney urine) in nine dogs. Urine samples were collected before and 10 days after bilateral ureterostomies. Calcium oxalate crystal growth inhibition was measured in a standard seeded crystal growth system. The alcian blue-precipitable material of the urine samples was determined. Significantly lower values were observed in kidney urine than in bladder urine for calcium oxalate crystal inhibition (mean difference, 0.07 ± 0.02 inhibitor units/mg creatinine; P < 0.01) and for the alcian blue-precipitable material (mean difference, 0.07 ± 0.02 mg/mg creatinine; P < 0.01). We conclude that the bladder adds calcium oxalate crystal growth inhibition to urine. Glycosaminoglycans from the bladder mucosa may be responsible; however, other acidic polymers such as RNA fragments or glycopeptides have been shown to be a constituent of the alcian blue-precipitable material. These are potent inhibitors of calcium oxalate crystal growth, and their participation in the increase of inhibition observed in bladder urine cannot be excluded. Total calcium oxalate crystal growth inhibition present in normally voided urine may be an overestimation of the actual inhibition present at the level of the kidney, where calculi usually form

Comparing Dominant to Non-Dominant Shoulder Complex Kinematics in Collegiate Volleyball Players

Introduction Mobility and function of the shoulder may impact performance and injury in volleyball. Most previous research identifying humerothoracic (HT), glenohumeral (GH), and scapulothoracic (ST) kinematics is limited through measurements with a goniometer or inclinometer. Objective To identify HT, GH, and/or ST differences between DOM and NDOM shoulders of asymptomatic volleyball players. Participants 22 asymptomatic female NCAA Division II volleyball players from Concordia University St. Paul (CSP) Methods Demographics: age, height, weight, player position, injury history within past 5 years, years of participation Screen: ROM, MMT, special tests for radiculopathy, scapular dyskinesis, impingement, and instability The G4 electromagnetic motion capture system was used to measure HT flexion, ST upward rotation (UR) and posterior tilting at 120 degrees of GH scapular plane elevation, and GH external rotation (ER) with arm at 90-degrees abduction. Results ST UR differences were statistically significantly different (p=0.006). 10 additional participants would be needed for the difference in GH ER to be statistically significantly different. Conclusion Female volleyball players demonstrated a significant difference in scapular UR on the DOM side vs NDOM side. There were no statistically significant differences between DOM and NDOM HT elevation, posterior tilting at 120 degrees of elevation, and maximal ER of the GH joint with shoulder at 90-degrees of abduction. Clinical Relevance Scapular upward rotation may be an area that a physical therapist may address to prevent or treat conditions such as shoulder impingement Patients presenting with SAIS demonstrate a decrease in ST upward rotation and posterior tilting

The Effects of Kinesiotape on Scapular Kinematics in Symptomatic Baseball Players

Introduction Baseball players are at an increased risk for shoulder dysfunction due to repetitive overhead throwing. Patients with symptomatic shoulders present with altered scapular kinematics, with the greatest variations found in upward rotation and posterior tilt which modify subacromial space. Previous investigations of the effects of kinesiotape (KT) on scapular kinematics have been inconclusive. Objective To determine the effects of KT on scapular kinematics in symptomatic collegiate baseball players. Participants Six Division II and III baseball players between 21 and 25 years old (mean 22.7) with a symptomatic throwing shoulder. Four were right hand dominant. Methods Symptomatic was defined as a report or pain or dysfunction in their throwing shoulder Participants were screened by student physical therapists (SPTs) to determine if they fit the inclusion criteria Kinesiotape was applied via a mechanical correction stabilization technique by a certified KT practitioner (Figure 1) Scapular posterior tilting (PT) and upward rotation (UR) were collected by a designated SPT during three planes of shoulder humerothoracic (HT) elevation with the G4 electromagnetic motion capture system (Innsport , Chicago, IL) Scapular kinematics with and without KT were analyzed between 30-90 degree elevation Differences in PT and UR during the three planes of elevation were explored descriptively Differences between conditions were compared proportionally to the maximum range of motion available Results PT was consistently greater in the KT condition. The largest difference was in abduction, where PT was 2.92 degrees greater. UR was consistently less in the KT condition. The largest difference was in abduction, where UR was 3.22 degrees less. The difference in PT was a larger proportion of available motion in abduction and was an equal proportion of available motion in elevation in the scapular plane as compared to UR. The PT proportion in abduction was 16 percent. The UR proportion in scapular plane elevation was 13 percent. Conclusions Increased posterior tilting widens the subacromial space, which is thought to decrease risk of subacromial impingement in overhead athletes. 3 Kinesiotape increased posterior tilting in symptomatic subjects during elevation in all 3 elevation planes. This advantage is somewhat countered by the decrease in upward rotation. Future work with an increased sample size may determine if there are statistical or clinically significant differences. Matched pair t tests with a Bonferonni correction would be an appropriate analysis. Clinical Implications These results indicate that KT may be an effective non invasive intervention to improve scapular kinematics and/or decrease injury risk in individuals with symptomatic shoulders

Validation of spinal motion with the spine reposition sense device

© 2009 Petersen and Rundquist; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Determining Cognitive and Non-Cognitive Predictors of Success on the National Physical Therapy Examination

Background and Purpose: A variety of admission criteria have been utilized to assist in the selection of viable candidates in physical therapy programs. These criteria include cognitive measurements such as grade point average (GPA) and standardized test scores. However, only a few studies correlated these cognitive measurements to predicting success on the National Physical Therapy Examination (NPTE). The purpose of this study was to examine the performance of entry-level doctoral physical therapy (DPT) students on prior cognitive measurements and correlate it to passing on the first attempt of the NPTE. This study also aimed to determine if two inventory surveys examining personality traits and coping skills were appropriate predictors for passing the NPTE on the first attempt. Subjects: Forty-nine students from seven physical therapy programs which offer the DPT program participated in the study. Methods: Participants provided their Scholastic Aptitude Test (SAT) scores and undergraduate grade point average (GPA) and completed three surveys including a survey on past academic performance, the Big Five Inventory (BFI) personality survey and the Coping Inventory for Stressful Situations (CISS). Logistic regression and correlation coefficients were used to analyze the relationship of these factors to the NPTE and to each other. Results: SAT score was the only significant variable identified as a predictor for passing the NPTE on the first attempt. Discussion and Conclusion: SAT scores may be utilized to predict performance on the NPTE. Personality traits and coping skills were not found to be statistically significant predictors

Effect of Kinesio®tape on Scapular Kinematics of the Asymptomatic Shoulder in Healthy Younger Adults

Introduction Limited scapular upward rotation and posterior tilting during upper extremity elevation are correlated with subacromial impingement syndrome (SAIS) Previous research found significant increases in scapular posterior tilting with Kinesio®tape (KT) application Purpose: To find a taping method that increases scapular upward rotation and posterior tilting Hypothesis: KT application for mechanical facilitation will increase scapular upward rotation during upper extremity elevation Objective Investigate the effects of KT on scapular kinematics during upper extremity elevation Participants Twenty asymptomatic participants aged 23-36 years old (mean 25.45) No cervical, thoracic, or shoulder conditions affecting shoulder ROM Right hand dominant Methods Kinesio ® tape was applied to the dominant upper extremity 3D motion of the humerus and scapula were measured using the G4 electromagnetic motion capture system and MotionMonitor software Upper extremely elevation was performed in the sagittal, frontal, and scapular planes without tape and with tape. The non-tape condition was repeated Repeated measures ANOVA utilizing SPSS v 28 for statistical analysis Results No statistically significant difference in scapular upward rotation with upper extremity elevation between KT, non-KT, and repeated non-KT conditions (p=0.603) No statistically significant difference in scapular posterior tilting with upper extremity elevation between KT, non-KT, and repeated non-KT conditions (p=0.376) Results are outlined in figure 2. Conclusion It is hypothesized that KT can alter the kinematics of the scapula and could be used to help treat individuals with SAIS The current literature has not reached a consensus as to whether or not KT has the ability to alter the kinematics of the scapula Current study found no change in either scapular posterior tilting or upward rotation Further research is needed to see if this taping method would be effective at reducing pain in individuals with symptomatic SAIS Clinical Relevance Increasing posterior tilt and upward rotation of the scapula may improve SAIS symptoms Kinesiotape may provide improvements in scapular motion during UE elevatio