Medicine and Health Sciences Commons^™

Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Dr. Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

Certified Hand Therapists’ Perceptions Of The Impact And Implications Of Psychosocial Factors On Patients With Complex Traumatic Hand Injuries, Noha A. Elfar, Otr/L, Cht

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Background: Hand therapists utilize special skills in assessing, planning, and treating patients to prevent dysfunction, restore function, and/or reverse the progress of pathology of the upper limb to enhance an individual’s ability to execute tasks and participate fully in life. However, little is known about how hand therapists address psychosocial factors in patients with complex traumatic hand injuries (CTHIs) and their perspectives on how physical and psychological adaptation is required following hand trauma to optimize care.¹

Purpose: To identify Certified Hand Therapists’ (CHTs) perceptions of the impact and implications of psychosocial factors in patients with CTHIs by analyzing qualitative …

The Implementation Of Animal Assisted Therapy In Adult Neurological Rehabilitation, Rachel Camilleri

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with Pi Beta Phi Rehabilitation Institute at Vanderbilt University Medical Center. The focus of this project was to develop animal assisted therapy interventions that could be utilized amongst occupational therapy practitioners with the clinic’s facility dog in an effort to increase utilization of animal assisted therapy. The process for this project required a thorough review of the literature on animal assisted therapy and neurological rehabilitation, conversations with current and past facility dog teams to learn about their work, and trialing animal assisted therapy activities in patient sessions. The outcome of this …

The Role Of Ot In Treating Ecmo Patients In The Icu: A Scoping Review, Sophia C. Roe, Angela Blackwell, Whitney Hohman

Spring 2024 Virtual OTD Capstone Symposium

This scoping review investigated the role of occupational therapists in treating extracorporeal membrane oxygenation (ECMO) patients within the intensive care unit (ICU) setting. The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Databases analyzed included CINAHL, PubMed, and ProQuest. The primary research question aimed to identify the role of occupational therapists in ECMO patient care. The secondary research question aimed to determine the percentage of ECMO patients who received occupational therapy services in the ICU and were discharged home. The search retrieved a total of 400 records. After …

Barriers And Facilitators To Enhance Interprofessional Education For Rehabilitation Science Graduate Students, Mary A. Riopel, Kimberly Wynarczuk, Taylor Grube

The Qualitative Report

Interprofessional education (IPE) aims to develop healthcare practitioners who work effectively in teams, demonstrate strong communication skills, respect others, and have a working knowledge of the roles and responsibilities of other professionals. Of identified research to date, it is unclear what students perceive as important for effective IPE delivery and learning. The purpose of this study was to identify graduate students' perceptions of facilitators and barriers to learning interprofessional practice using phenomenology. Three semi-structured focus groups were conducted including athletic training, occupational therapy, or speech-language pathology students and the transcripts were analyzed using thematic analysis. Four themes emerged about IPE …

What Is Task-Oriented Training? A Scoping Review, Erin Halford, Samantha Jakubiszak, Kassidy Krug, Amanda Umphress

Student Journal of Occupational Therapy

Task-Oriented Training (TOT) is an proven stroke rehabilitation intervention with significant evidence-based research that supports its effectiveness. The absence of a clear definition has led to variability in research reporting and subsequent confusion with practical implementation. A consistent definition seeks to remedy this ambiguity to facilitate knowledge translation. The objective of this study was to determine a comprehensive definition of TOT that encapsulates previous definitions and descriptions in the literature. In order to derive this definition, a two stage scoping review process was conducted across four databases searching for articles on the use of TOT in adult stroke rehabilitation therapy. …

Outcomes Of The Nurosleeve And Occupational Therapy On Upper Limb Function Of An Individual With Chronic Hemiparesis Following A Stroke: A Case Report, Nicole M. Gerhardt, Jeremy P. Armstrong, Mijail D. Serruya, Mj Mulcahey

The Open Journal of Occupational Therapy

Background: Upper limb neuromuscular impairments can adversely impact function. This case report investigates the process and outcomes of occupational therapy (OT) for training in the use of the NuroSleeve, a novel research-grade exoskeletal powered orthosis, with a participant with chronic right hemiparesis following a stroke.

Method: The participant engaged in 24 OT sessions using the NuroSleeve over 10 weeks. Therapeutic interventions included neuromuscular reeducation, device management, and engagement in occupation-based activities with training to use the NuroSleeve. The Canadian Occupational Performance Measure (COPM), ABILHAND, Patient Reported Outcomes Measurement Information System Upper Extremity Short Form 7a (PROMIS UE SF), …

Occupational Therapy Interventions For Visual Impairments Among Adolescents With Mild Traumatic Brain Injury, Olivia Vander Haar, Molly Whitlow, Sarah Fellman

Student Systematic Reviews: Occupational Therapy

PUPROSE: The purpose of this systematic review was to synthesize the evidence of occupational therapy (OT) interventions for adolescents who have sustained a mTBI and experience visual dysfunction.

DESIGN AND METHOD: A systematic review of peer-reviewed literature was conducted. Articles were included if participants were eight to nineteen years of age and diagnosed with an mTBI. Titles and abstracts of 506 articles from three databases were screened. The full text of 26 articles was reviewed. Seven met inclusion criteria. The U.S. Preventive Services Task Force levels of certainty and grade definitions described the strength of evidence.

RESULTS: Physical conditioning, vision …

Dance Intervention For Stroke Rehabilitation: Restoring Occupational Performance Through Creative Movement, Olivia Paige Allen

Graduate Theses, Dissertations, and Problem Reports

Thousands of individuals are affected by cerebral vascular accidents, (CVA), also known as strokes in the United States each year, (CDC, 2023). Cerebral vascular accidents are one of the leading causes of death among the elderly population in the U.S. each year, (NIH et al., 2023). The deficits caused by a CVA can be global, from hemiparetic limbs and sensory loss to psychosocial impacts on an individual and their support system. In occupational therapy, the goal is to regain as much function and independence as possible for the individual who has experienced a CVA. Although many evidence-based intervention tools are …

Examining Rehabilitation Referral Patterns For Breast Cancer Patients With Mastectomy: A Retrospective Descriptive Chart Review, Jessie Perchaluk, Ms, Otr/L, Cht

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Advances in health care for those with breast cancer (BC), have led to people living longer lives, however many continue to have difficulty completing daily activities (Hwang et al., 2015; Keesing et al., 2018; Lovelace et al., 2019; Stout et al., 2015; Stubblefield, ). Research explains that physical rehabilitation is beneficial for people with BC, however is not always being recommended (Cheville et al., 2008; Hwang et al., 2015; Pergoletti, 2014; Rafn et al., 2020; Stout et al., 2016; Stout et al., 2015).

Objectives: This study looked at rehabilitation referral patterns and trends for women diagnosed with BC who …

Developing Rehabilitation Treatment Decision Aid For People Living With Complex Regional Pain Syndrome (Crps), Erfan Shafiee

Electronic Thesis and Dissertation Repository

This Ph.D. dissertation aimed to develop a treatment decision aid for people with Complex Regional Pain Syndrome (CRPS) using the Ottawa Decision Support Framework (ODSF). The decision aid was developed throughout a two-phase process.

The first phase involved understanding the existing evidence and the factors influencing decision-making in CRPS rehabilitation: priorities and preferences of patients and therapists were considered. This phase encompassed the integration of diverse sources of evidence, including systematic reviews, overview of systematic reviews, critical appraisal of guidelines, and a survey exploring patients' and therapists' priorities and preferences for CRPS rehabilitation interventions. All forms of evidence were used …

Expanding The Occupational Therapy Oncology Rehabilitation Program At James A. Haley Veterans' Hospital, Annalisa M. Rodriguez

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Integrating Sleep Promotion Education Into Acute Care Orthopedics Occupational Therapy Practice: A Case Series Study, Rebecca Ludwig, Aaron M. Eakman, Catherine Siengsukon

The Open Journal of Occupational Therapy

Background: The occupation of sleep is frequently under-addressed by occupational therapists with their clients. This may be in part because of a lack of general training on addressing this occupational domain or a lack of education about the basics of sleep. The domain of sleep has been in the Occupational Therapy Practice Framework since 2008. However, it remains unclear how to address the domain of sleep in occupational therapy practice. Therefore, the purpose of this case series is to describe the practical application of sleep promotion education.

Methods: A practicing occupational therapist with sleep training provided sleep promotion …

Education And Perceptions Of Post-Therapy Maintenance Programs In Long-Term Care: A Mixed Methods Exploratory Study, Laura S. Novak, Vanessa D. Jewell, Michael Gerg, Andrea Thinnes

The Open Journal of Occupational Therapy

Background: Occupational therapists develop maintenance programs (MPs) for long-term care (LTC) residents to optimize participation in everyday activities. The purpose of this study was to examine nursing professional attitudes and knowledge of MPs and to evaluate the effectiveness of an occupational therapist-led in-service.

Method: Nursing staff (n = 20) attended the in-service, completed a pre and posttest, and completed interviews (n = 5). We used an exploratory sequential mixed methods design with a one-group quasi-experimental design for the quantitative portion and a descriptive qualitative approach for the interviews.

Results: The results indicated significantly increased knowledge regarding MPs, …

Developing Group Protocols In An Inpatient Rehabilitation Setting, Madison Quan

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with Vanderbilt Stallworth Rehabilitation Hospital (VSRH) in Nashville, TN. The focus of this project was the development and implementation of various protocols to be used in group therapy sessions in an inpatient rehabilitation setting. The project sought to provide guidelines for treating a variety of conditions in a group setting and promote individualized patient care. The process for project completion included a thorough review of current literature and available resources at VSRH to guide the creation of multiple evidence-based protocols. This process also included collaboration with the therapy staff to ensure …

A Scoping Review Of Occupation-Based Interventions For Women With Breast Cancer, Whitney Lucas Molitor, Erika Clark, Brittney Moser

The Open Journal of Occupational Therapy

Background: Globally, breast cancer is the most commonly diagnosed cancer. Women diagnosed with breast cancer often experience physical and psychosocial changes influencing occupational participation and quality of life. Limited evidence exists that reports outcomes of occupation-based occupational therapy interventions for women with breast cancer.

Method: In this scoping review, we map occupation-based occupational therapy interventions conducted by occupational therapy professionals for women undergoing rehabilitation for breast cancer. The Joanna Briggs Institute Guidelines provided a structure for the review.

Results: Six articles met the inclusion criteria. Interventions included health management, leisure, and social participation occupations.

Conclusion: Occupational …

The Impact Of Patient Characteristics On Dysphagia Therapy Utilization And Feeding Outcomes For Premature Infants In The Neonatal Intensive Care Unit, Tiana Nguyen

Theses and Dissertations

Medical advances have significantly increased the survival rates of preterm infants at lower gestational ages. However, infants born at lower gestational ages have an increased risk for developmental disabilities and oral feeding difficulties. A stay in the neonatal intensive care unit (NICU) is very costly and inadequate oral feeding is the most common barrier to discharge for premature infants. Infants can receive dysphagia therapy services during their NICU stay that focuses on the development of oral feeding and swallowing skills. However, literature to this date has mainly focused on the impact of therapy services for premature infants after NICU discharge. …

The Clinical Value Of Oculomotor Assessments Across The Continuum Of Concussion, Dillon Richards

Electronic Thesis and Dissertation Repository

Concussions are complex conditions that are difficult to manage medically. Variations in symptom presentation, intricate neurophysiological processes, and the availability of a variety of possible assessment tools may contribute to this complexity. Clinicians must use a broad approach, employing both subjective symptom assessment and objective assessments to confirm a diagnosis and/or monitor progression and recovery. Oculomotor function after concussion may be an important indicator of injury, given the interconnectedness of oculomotor function, vestibulo-ocular and visual systems, and even cognition. Oculomotor function may be assessed objectively or indirectly using patient-reported symptom checklists as part of subjective assessments. One way of objectively …

Three-Dimensional Motion Analysis For Occupational Therapy Upper Extremity Assessment And Rehabilitation: A Scoping Review, Stephen W. Hill, Samantha Mong, Quyen Vo

The Open Journal of Occupational Therapy

Background: Three-dimensional (3D) human motion analysis provides objective, quantitative, and reliable kinematic data that are valuable in rehabilitation. Clinicians, including occupational therapists and other specialists, can apply this technology to quantify patients’ upper extremity (UE) motion during functional tasks. A better comprehension of altered body mechanics serves to guide clinical reasoning, develop evidence-based interventions, and monitor patients’ progress through follow-up. However, the scientific literature has yet to emphasize the practicality of using 3D motion analysis as a clinical measurement tool.

Method: This scoping review appraised 20 articles that used 3D motion analysis to quantify UE movements for individuals …

Occupational Therapists And Covid-19 Pandemic: An Observational Survey In Europe, Christian Pozzi, Alessandro Lanzoni, Pier Carlo Battain, Evelyn Alvarez, Eduardo Tobar, Ruth Hersche, Stefano Cavalli, Anna Monsò, Eva Llarch, Giuseppe Bellelli, Alessandro Morandi, Maud Graff

The Open Journal of Occupational Therapy

Background: The COVID-19 pandemic has resulted in a health care emergency in Europe since the first wave in 2020. Several challenges have arisen for occupational therapists, as well as all the health care professionals. The aim of this study was to determine what occupational therapists have changed to adapt their therapeutic processes for this catastrophic situation.

Method: An online survey was developed and sent in conjunction with the Council of Occupational Therapy for European Countries (COTEC) to European national associations of occupational therapists.

Results: The study was based on a sample of 65 occupational therapists who worked …

Narrative Review - Optimal Occupational Therapy Experience, Kaylee G. Clay

Honors College Theses

This narrative review examines factors associated with optimal occupational therapy experiences, including patient perspectives of occupational therapy, cost-effectiveness, use of practices, organization, and patient involvement/experiences. The information found within this review provides information to those interested in creating the most optimal experiences for their occupational therapy patients.

The Experience Of Meditation, And Its Effects On Attention, For Adults With Stroke Or Attention Deficit Hyperactivity Disorder: A Three-Part Dissertation With Qualitative And Quantitative Evidence, Cheryl Carrico

Theses and Dissertations--Rehabilitation Sciences

Impairment of attention is common after stroke; is a defining characteristic of attention deficit hyperactivity disorder (ADHD); and has been shown to correlate significantly with difficulties in daily life for individuals with these conditions. More research is needed to establish effective interventions addressing impaired attention in such cases. Meditation is not a standard-of-care intervention for this purpose but may have therapeutic potential. Meditation has been broadly defined as an activity which has self-regulation of attention as its main aim. In other words, it can be considered a training of attention. To shed light on the therapeutic potential of meditation, including …

Sexual Health And Wellness For Women In Recovery From Substance Use Disorder, Paige Cassidy, Otr/L

Occupational Therapy Research Projects

The aim of this Capstone project was to produce a sexual health and wellness program for women in recovery from substance use disorder (SUD). Creation of the program includes an in-depth literature review and thorough needs assessment using key stake holders in the community of Southern Ohio. Through clinical practice, literature review, and needs assessment, two modules and six sections were developed. The two modules are physical and mental health aspects of sexual health. Module one is physical health and is composed of three sections that include practicing safe sex, postpartum care, and pelvic floor strengthening. Module two is mental …

Coaching In Context, M.-C. Potvin, M. J. Mulcahey, N. Gerhardt

Department of Occupational Therapy Faculty Papers

Coaching in Context (CinC) is a conversation-based approach intended to foster clients’ goal attainment through coach-facilitated self-discovery of insights and solutions. Anchored in positive psychology, Coaching in Context situates clients as resourceful experts, and builds upon clients’ strengths to promote awareness and insights about factors that potentially impact their goals, and to strengthen problem-solving skills that are solution-focused. CinC conversations are contextualized by lived environments and requirements for competent and satisfying life roles.

A Qualitative Study Investigating Stroke Survivors’ Perceptions Of Their Psychosocial Needs Being Met During Rehabilitation, Robin A. Wenzel, Emily A. Zgoda, Mia C. St. Clair, Lisa J. Knecht-Sabres

The Open Journal of Occupational Therapy

Background: Depression and anxiety can negatively impact one’s recovery, outcomes, and quality of life. Even though therapists consider the mental health needs of their clients to be a priority, they are dissatisfied with their ability to completely address these needs. The purpose of this study was to examine the client’s perspective regarding the extent to which health care professionals addressed their psychosocial needs after a stroke.

Method: A phenomenological research design was used to collect data from six participants. Interviews and focus group were audiotaped, transcribed verbatim, and thematically analyzed. Member checks, peer-review, multiple coders, triangulation, and expert …

Development Of Clinical Practice Guidelines For Chemotherapy-Induced Peripheral Neuropathy Rehabilitation, Rikki Silver

OT Student Capstones

In the past four decades, there have been significant improvements in early cancer detection and efficacy of cancer treatments, resulting in a growing number of cancer survivors. People diagnosed with cancer are now living longer than ever before; while lifespan after cancer is increasing, cancer survivors are experiencing health and functional challenges due to the persistent effects of curative therapy (Rowland et al., 2018). One of these effects includes chemotherapy-induced peripheral neuropathy (CIPN). Approximately 70% of patients receiving neurotoxic chemotherapy experience CIPN, an uncomfortable and sometimes painful sensation in the hands and feet (Seretny et al., 2014). The likelihood of …

An Exploratory Study Of Rehabilitation Services Available For Soft Tissue Sarcoma Patients In The Outpatient Setting, Amber Wojcik

OT Student Capstones

Little is known about the experiences of rehabilitation therapists treating soft tissue sarcoma (STS) patients in the outpatient setting. As the number of survivors of STS increases, so does the need for therapists who have the knowledge and skillsets vital for providing the highest quality of holistic care for this unique cancer population. Holistic cancer rehabilitation includes considerations for the physical, cognitive, and psychosocial needs of the soft tissue sarcoma patient. This paper explores the subspeciality of cancer rehabilitation and the experiences of physical therapists (PT) treating STS patients in the outpatient setting. A secondary aim of this study is …

Bundling Payment Initiatives For Total Hip And Knee Arthroplasties: Perspectives Of Health Care Professionals, Katherine Lally, Melinda Schultze, Hannah Ehresman, Helene L. Lohman, Vanessa D. Jewell

The Open Journal of Occupational Therapy

Background: A broad qualitative research study explored the perceptions of rehabilitation health care professionals and administrative leadership on coordination of care for rehabilitation patients who received hip or knee arthroplasties under the bundling initiative.

Method: Data was collected through the conduction of a focus group, email communication, and individual phone interviews. Researchers analyzed data collected from five administrative personnel and eight rehabilitation health care professionals who work in a facility that participates in a bundling initiative payment model.

Results: Four major themes were identified: importance of care coordination, increased efficiency and effectiveness, establishing protocols, and challenges of …

Are All Instrumental Activities Of Daily Living Equal? A Pilot Study On The Performances Of Adults With Acquired Brain Injury, Crystal Lee, Samantha Schauer, Amy Tam, Yareli Vargas

Occupational Therapy | Graduate Capstone Projects

Aim: To determine if a relationship exists among performances of different instrumental activities of daily living (IADLs) in adults with acquired brain injury (ABI).

Methods: A two-group correlational design was used to examine the relationship among performances in cooking, medication management, and financial management in nine adults with ABI who returned to driving and nine adults with ABI who did not return to driving. The Executive Function Performance Test (EFPT) measured initiation, organization, sequencing, judgment and safety, and completion.

Aota Continuing Education: Occupational Therapy’S Role In Addressing Sexuality And Intimacy, Tiffany E. Lee, Jacqueline M. Marquez

OTD Capstone Projects

The purpose of this capstone project was to create a continuing education course for the American Occupational Therapy Association (AOTA) on the topic of OT’s role in addressing sexuality and intimacy. The topic of sexuality and intimacy is often under-addressed by healthcare professionals, despite its importance to clients. According to the Occupational Therapy Practice Framework, engagement in sexual activity is not only an ADL, but can be a key aspect of social participation in the context of familial and peer/ friend roles. Therefore, it is well within OT’s scope of practice to address sexuality and intimacy with clients. However, there …