Rumit Singh Kakar

Opportunities for Regenerative Rehabilitation and Advanced Technologies in Physical Therapy: Perspective From Academia

As rehabilitation specialists, physical therapists must continue to stay current with advances in technologies to provide appropriate rehabilitation protocols, improve patient outcomes, and be the preferred clinician of choice. To accomplish this vision, the physical therapy profession must begin to develop a culture of lifelong learning at the early stages of education and clinical training in order to embrace cutting-edge advancements such as stem cell therapies, tissue engineering, and robotics, to name a few. The purposes of this article are: (1) to provide a current perspective on faculty and graduate student awareness of regenerative rehabilitation concepts and (2) to advocate for increased integration of these emerging technologies within the doctor of physical therapy (DPT) curriculum. An online survey was designed to gauge awareness of principles in regenerative rehabilitation and to determine whether the topic was included and assessed in doctoral curricula. The survey yielded 1,006 responses from 82 DPT programs nationwide and indicated a disconnect in familiarity with the term “regenerative rehabilitation” and awareness of the inclusion of this material in the curriculum. To resolve this disconnect, the framework of the curriculum can be used to integrate new material via guest lecturers, interdisciplinary partnerships, and research opportunities. Successfully mentoring a generation of clinicians and rehabilitation scientists who incorporate new medical knowledge and technology into their own clinical and research practice depends greatly on sharing the responsibility among graduate students, professors, the American Physical Therapy Association (APTA), and DPT programs. Creating an interdisciplinary culture and integrating regenerative medicine and rehabilitation concepts into the curriculum will cultivate individuals who will be advocates for interprofessional behaviors and will ensure that the profession meets the goals stated in APTA Vision 2020.

Impact of cognitive fatigue on gait and sway among older adults: A literature review

Cognitive fatigue is an alteration in central nervous system (CNS) processing due to prolonged performance of mentally demanding tasks. Decreased gait speed and increased stride length variability have been noted in cognitively fatigued older adults (≥ 65 years). Further, cognitive fatigue may weaken the visual, vestibular, and proprioceptive systems of the CNS, contributing to increased postural sway. Detriments in gait and sway caused by cognitive fatigue could increase fall risk. The objective of this literature review was to evaluate the impact of cognitive fatigue on changes in gait and postural sway and its role in fall risk.

Intratrunk Coordination During High-Effort Treadmill Running in Individuals With Spinal Fusion for Adolescent Idiopathic Scoliosis

The purpose of the study was to determine if the intratrunk coordination of axial rotation exhibited by individuals with spinal fusion for adolescent idiopathic scoliosis (SF-AIS) during running varies from healthy individuals and how the coordination differs among adjacent trunk-segment pairs. Axial rotations of trunk segments (upper, middle, lower trunk) and pelvis were collected for 11 SF-AIS participants and 11 matched controls during running. Cross-correlation determined the phase lag between the adjacent segment motions. The coupling angle was generated using the vector coding method and classified into 1 of the 4 major, modified coordination patterns: in-phase, anti-phase, superior, and inferior phase. Two-way, mixed-model ANCOVA was employed to test phase lag, cross-correlation r, and time spent in each major coordination pattern. A significantly lower phase lag for SF-AIS was observed compared with controls. Qualitatively, there was a tendency that SF-AIS participants spent less time in anti-phase for middle-lower trunk and lower trunk-pelvis coordinations compared to controls. Phase lag and anti-phase time was significantly increased from cephalic to caudal segment pairs, regardless of group. In conclusion, SF-AIS participants and controls displayed similar patterns of intra-trunk coordination; however, the spinal fusion hindered decoupling of intra-trunk motions particularly between the lower trunk-pelvic motion.