Physical Function and Mobility in Children with Congenital Myotonic Dystrophy

INTRODUCTION: Congenital myotonic dystrophy (CDM) occurs when symptoms of myotonic dystrophy present at birth. In this study we evaluated the relationship between physical function, muscle mass, and age to provide an assessment of the disease and help prepare for therapeutic trials. METHODS: CDM participants performed timed functional tests (TFTs), the first 2 minutes of 6-minute walk tests (2/6MWTs), and myometry tests, and also performed dual-energy X-ray absorption (DEXA) scans. Healthy controls (HCs) performed TFTs, 6MWTs, and myometry. RESULTS: Thirty-seven children with CDM and 27 HCs (age range 3-13 years) participated in the study. There were significant differences in the 10-meter walk (11.3 seconds in CDM vs. 6.8 seconds in HC) and 2MWT (91 meters in CDM vs. 193 meters in HCs). DEXA lean mass of the right arm correlated with grip strength (r = 0.91), and lean mass of the right leg correlated with 6MWT (r = 0.62). CONCLUSION: Children with CDM have significant limitations in strength and mobility. The tests performed were reliable, and lean muscle mass may serve as a useful biomarker

Walkin’ On Air: Alter-G Gait Training in a Male with Hereditary Spastic Paraplegia

The purpose of this case report is to determine the effectiveness of LBPPS treadmill training, using the Alter-G, to improve the spatiotemporal parameters of gait for a patient with HSP.https://soar.usa.edu/flsaspring2018/1010/thumbnail.jp

Myofascial Manipulation to Alleviate Forearm and Hand Weakness and Numbness in a Female Competitive Rock Climber

The purpose of this case report is to describe the effectiveness of myofascial manipulation along with therapeutic exercise on a patient with weakness, numbness, and tingling in the distal upper extremities in order to return to competitive rock climbing.https://soar.usa.edu/flsaspring2018/1006/thumbnail.jp

Metacognition and Self-regulation Influence Academic Performance in Occupational and Physical Therapy Students

An understanding of student learning strategies is an important component of supporting academic success and avoiding difficulty. Prior inquiry has demonstrated certain learning strategies are more closely related to academic performance than others. The purpose of this study was to describe predictive relationships between the Metacognitive Awareness Inventory (MAI), Learning and Study Strategies Inventory (LASSI), and grade point average (GPA) in occupational therapy (OT) and physical therapy (PT) programs. A multi-center convenience sample of N=75(100%) entry-level students [OT: 34(45%); PT: 41(55%)] was included from Florida 32(42.7%), California 21(28%), and Texas 22(29.3%). A hierarchical linear regression analysis demonstrated the combination of predictors (MAI, Anxiety, Concentration, and Time Management [r=0.83; p2=0.35; p2=0.34; p2=0.31;

Learning Strategies and Academic Difficulty in Physical and Occupational Therapy Online Education

The purpose of this study was to explore the Learning and Study Strategies Inventory (LASSI) in relation to hybrid-online clinical neuroscience course outcomes in occupational therapy (OT) and physical therapy (PT) students. OT and PT students self-administered the LASSI during the Spring of 2019. N=34 students (14 OT; 20 PT) completed the LASSI. The scales of Information Processing (r = -0.43;

Effects of Weight Shifting and Heel Lift on Gait, Posture, and Balance in an Elderly Female with Backward Disequilibrium: A Case Report

The purpose of this case report is to investigate how weight shifts and a heel lift affects a patient\u27s center of mass in respect to their base of support to improve posture, balance, and gait which will aid in decreasing falls. The patient demonstrated functional improvements by reducing the amount of assistance required from a caregiver for transfers and gait. Improvements in balance will allow the patient to sit on the toilet and edge of bed for toileting and dressing more independently. Older adults with BD or other similar balance disorders are at risk for increased falls.5 This case report shows the benefits of incorporating anterior weight shifts and a heel lift into physical therapy interventions to improve gait, balance, and posture, ultimately decreasing falls.https://soar.usa.edu/flsafall2018/1010/thumbnail.jp

The High-Level Mobility Assessment Tool (HiMAT) in Myotonic Dystrophy Type 2: A Case Report

Myotonic dystrophy type 2 (DM2) is a progressive muscular dystrophy with multi-system manifestations and can affect functional mobility, gait, and balance. Currently, there are few reports of functional outcome measures in this population. This case describes the change in function detected by the High-level Mobility Assessment Tool (HiMAT) and 30-second Chair Stand Test (CST) in a high-functioning adult female with DM2 after physical therapy treatment. The patient’s chief complaint was muscular pain and fatigue that affected activities of daily living (ADLs). Multimodal physical therapy focused on neuromuscular re-education, balance and strength training, patient education, and moderate cardiorespiratory training. Improvements were observed in manual muscle testing and in single-limb standing balance. A nine-point total improvement was observed in HiMAT score, and the CST detected a 100% improvement in number of sit-to-stands. The patient returned to prior level of function and was able to resume ADLs and recreational activities without complaints of muscular pain or fatigue

Disability and Physical Therapy Services in Rural Nicaragua: A Pilot Study

The World Health Organization (WHO) estimates that 15% of the world’s population is living with disability, a large majority of which can be found in developing nations. Previous studies in Nicaragua have investigated the perceptions of disability among caregivers and noted limited access to rehabilitative services. However, the general knowledge and perceptions of physical therapy services in Nicaragua remains unclear. As a result, this pilot study sought to explore the local knowledge and perceptions of disability and physical therapy services and to characterize the sample from a remote area of northwestern Nicaragua. Participants were recruited using convenience sampling during multidisciplinary medical outreach clinics with OneWorld Health. A nine-question, face-to-face questionnaire was administered using local Nicaraguan translators certified in medical Spanish. A total of 101 participants [16 (15.8%) male, 85 (84.2%) female] were surveyed. A total of 70 (69.3%) report having no knowledge of physical therapy, 79 (78.2%) report no knowledge of anyone who has received physical therapy, and 89 (88.1%) were unaware of any physical therapy services available to them. A total of 94 (93.1%) report having musculoskeletal pain, and 89 (88.2%) report that medications are better at treating their pain. Our results describe the general perception and background knowledge of physical therapy in a unique region of Nicaragua. A very high burden of musculoskeletal complaints, especially neck, low back, and elbow/wrist/hand pain was noted. In large part, it appears that participants from this region have little knowledge of physical therapy and how these services may help them. This study demonstrates that there may be underlying contextual factors, still yet to be uncovered, that influence this communities’ knowledge, perception, and utilization of physical therapy services for physical disability

Management of Charcot–Marie–Tooth Disease: Improving Long-Term Care with a Multidisciplinary Approach

Charcot–Marie–Tooth (CMT) disease is the most common inherited neuropathy and one of the most common inherited diseases in humans. The diagnosis of CMT is traditionally made by the neurologic specialist, yet the optimal management of CMT patients includes genetic counselors, physical and occupational therapists, physiatrists, orthotists, mental health providers, and community resources. Rapidly developing genetic discoveries and novel gene discovery techniques continue to add a growing number of genetic subtypes of CMT. The first large clinical natural history and therapeutic trials have added to our knowledge of each CMT subtype and revealed how CMT impacts patient quality of life. In this review, we discuss several important trends in CMT research factors that will require a collaborative multidisciplinary approach. These include the development of large multicenter patient registries, standardized clinical instruments to assess disease progression and disability, and increasing recognition and use of patient-reported outcome measures. These developments will continue to guide strategies in long-term multidisciplinary efforts to maintain quality of life and preserve functionality in CMT patients