Medicine and Health Sciences Commons^™

From Classroom To Practice: Implementing The Core Set Of Outcome Measures In A Student-Led Clinic, Anders Brown Spt, Amy Zhou Spt, Holly Roberts Pt, Dpt, Phd, Ncs

Physical Therapy Research Symposium

Background: Literature suggests that Clinical Practice Guidelines (CPGs) are insufficient for facilitating behavior change in clinicians. However, translating research to clinical practice is essential for evidence-based practice. Prior to publication of the Core Set of Outcome Measures (CSOMs) for Adults with Neurologic Conditions CPG, all recommended outcome measures (OMs) were included in the University of Puget Sound curriculum. Beginning Fall 2018, didactic instruction adjusted such that clinical decision-making for the CSOMs was instructed as outlined in the CPG.

Purpose: To determine whether utilization of CSOMs in a student-led neurologic outpatient physical therapy clinic changed after students received intentional didactic instruction …

What Motivates Highly Active Mothers? A Self-Determination Theory Perspective, Natalie Mcdaniel Spt, Stephane Robert Spt, Danny Mcmillian Pt, Dsc, Ocs

Physical Therapy Research Symposium

What Motivates Highly Active Mothers? A Self-Determination Theory Perspective

Natalie McDaniel, SPT; Stephane Robert, SPT

Mentor: Danny McMillian, PT, DSc, OCS

Background: Physical inactivity is a major global health concern linked to high mortality rates. Extensive research demonstrates the role of physical activity (PA) in enhancing overall well-being, longevity, and disease prevention. Mothers living with children face significant challenges in pursuing PA.

Purpose: This qualitative research uses Self-Determination Theory (SDT) to investigate experiences and beliefs influencing PA motivation and satisfaction in highly active mothers.

Methods: (N=5). Participants completed the Motives for Physical Activities Measure - Revised (MPAM-R) and the Basic …

Is There A Relationship Between Lived Discrimination And Chronic Pain? - A Pilot Study, Jordan Taylor Kasube Spt, Erin P. O'Neill Spt, Sean White Spt, Karin Steere Dpt, Phd

Physical Therapy Research Symposium

Background: The complexity of the human experience of pain involves myriad biological, psychological, and social factors, each contributing uniquely to the overall experience. Recent literature illustrates the impact of social determinants on health outcomes, including an association between chronic pain and lived-discrimination. Heart rate variability (HRV) is used as a measure of systemic health, with diminished HRV often accompanying chronic pain.

Purpose: The primary aim of this study is to provide a pilot feasibility protocol to investigate the relationship between lived discrimination and HRV across the spectrum of pain duration.

Methods: HRV data was collected from 39 participants while seated …

Is Upright Exploratory Play Influenced By Partial Body Weight Support In Infants With Down Syndrome?, Sofia Hardin Spt, Christa Lum Spt, Julia Looper Pt, Phd, Reham Abuatiq, Mia Hoffman, Alyssa Fiss Pt, Phd, Heather Feldner Pt, Phd

Physical Therapy Research Symposium

Is Upright Exploratory Play Influenced by Partial Body Weight Support in Infants with Down Syndrome?

Sofia Hardin, SPT; Christa Lum, SPT

Mentor: Julia Looper, PT, PhD

Background: Children with Down syndrome (DS) typically present with delayed gross motor skills, which may negatively impact their development in other realms, such as cognition and language. The partial body-weight supported system (PBWSS) is a possible early intervention for infants with DS in physical therapy settings and in the community to facilitate motor development through exploratory play.

Purpose: To explore the effects of a PBWSS on upright play positions during exploratory play among infants …

Does Caregiver Use Of Portable Technology Impact Attachment For Infants And Young Children?, Caitlyn Alejo, Kevin Antoine, Christine Caley, Tess Morgan

Occupational Therapy Evidence Projects

Ellie Olson, OTR/L, the primary collaborator for this project, is the owner of Fall City Children’s Therapy. In collaboration with occupational therapy (OT) students and faculty advisors, Renee Watling, Maggie Hayes, and Yvonne Swinth, the research question, “Does caregiver use of portable technology impact attachment for infants and young children?” was developed. This systematic review resulted in 12 articles meeting inclusion and exclusion criteria. The articles reported mixed results: (1) association between parent technology use and child attachment, (2) no association between parent technology use and child attachment, and (3) other associations besides parent technology use and child attachment, including …

Effectiveness Of Feeding Therapy Approaches On Consumption And Dietary Variety In Children With Sensory-Based Feeding Challenges, Josie Ash, Kayla Estes, Cecilia Morales, Rachel Mcelroy

Occupational Therapy Evidence Projects

This project was completed in collaboration with Hannah Michlmayer (OTR/L) at Therapy Services for Children in Seattle, Washington. The research team conducted a literature review to investigate the following question: For children ages 3-12 with sensory-based feeding challenges, what are the most effective interventions to improve dietary diversity and/or food acceptance? Evidence indicates that ABA-based interventions are the most studied, followed by video modeling and caregiver/parent training. These approaches demonstrate short-term increases in consumption and dietary variety. Most studies had small sample sizes with minimal long-term follow-up. There is a lack of research on group interventions, the SOS approach, and …

“Growing Together”: Addressing The Support Needs Of Caregivers Postpartum Through Occupational Therapy Intervention, Garrett Bagdon, Stephanie Iwasaki, Kelli Kawamoto, Alexa Mahoney

Occupational Therapy Evidence Projects

Through a collaboration with a practicing occupational therapist in Tacoma, Washington who is currently interested in opening a private practice focused on providing care to caregivers in the postpartum period, the researchers posed the question, “When treating caregivers with children under one year of age, what is the effectiveness of existing interventions within the scope of occupational therapy in improving occupational performance?” Through a critical appraisal of topic project, it was found that the existing evidence supports occupational therapy interventions in the form of brief motivational interviewing, behavioral treatments, self-regulation education, wrist stabilization techniques, and group treatments aimed at decreasing …

Interventions That Address Quality Of Life For Those Transitioning To Long Term Care, Sharan Bhander, Michaela Mikulis, Kiana Serrao, Laice Valera

Occupational Therapy Evidence Projects

This research was proposed by community collaborator Lauren Gilliland, OTR/L, the director of occupational therapy at the Villages, a skilled nursing and rehabilitation facility, in central Florida. Gilliland was interested in adding new interventions to her current practice, especially with older adults affected by transitioning to a long term care facility, who experience a shift of daily roles, routines, and identity that may impact their quality of life. The focus of this evidence-based project was to explore current literature of occupational therapy interventions aiming to improve quality of life for older adults, specifically transitioning into long term care facilities. The …

Pediatric Burn Management: Examining Efficacy And Affordability, Grace Bouker, Gabrielle Golinvaux, Kaytie Ridle, Makayla Stahl

Occupational Therapy Evidence Projects

Our research was led by Kelly Culhane, OTR/L, at California Children Services (CCS), in searching for efficacious and cost-effective occupational therapy treatments, or sequences of treatments, in chronic pediatric (ages 3-21) burn scar management. The primary outcomes following burn scar treatment are to increase functionality, mobility, well-being, and to improve the physical appearance of the scars. Research suggests that exercise, massage, silicon gel, and silicon patches can all be used as occupational therapy treatment for burn scars. Unstructured massages and silicon patches were found to be the most cost-effective solutions, resulting in less itch and scar vascularity, and increased range …

Evidence-Based Interventions To Teach Daily Life Skills To Adults Impacted By Disabilities In Transition-Based Programs, Noam Baruch, Natalie Daughton, Sarah Derifield, Chloe Herrera

Occupational Therapy Evidence Projects

In collaboration with an occupational therapist at a school-based outreach program, we conducted a systematic literature review exploring existing evidence-based interventions that support activities of daily living (ADL) and instrumental activities of daily living (IADL) skill acquisition for transition-aged students over the age of 18 highly impacted by cognitive or intellectual disabilities. Existing literature explored the use of video-based interventions such as video prompting (VP) and video modeling (VM); interactive technology such as augmented reality, iPad applications, or audio recordings; non-technology based interventions such as visual supports, self-regulated problem solving, and adapting the environment. The evidence favored the use of …

Impacts Of Cultural Competency Training On Patient Outcomes, Claire Sinner, Lani Messmer, Sharon Oh

Occupational Therapy Evidence Projects

The collaborating provider is Malcolm Reed, OTR/L who works at an outpatient clinic with the Office of Veterans Affairs (VA) in Tacoma, WA. The outpatient clinic that Malcom practices in is a multidisciplinary rehabilitation setting that provides therapy services of PT, OT, SLP, and chiropractic care treating a wide variety of diagnoses. Mr. Reed believes there is a growing need for a strategy to provide effective culturally competent care at the VA, particularly for the African American population. The need to provide care to the increasingly diverse veteran population guided student researchers to conduct a literature review asking if cultural …

Strength-Based Occupational Therapy Interventions For Neurodiverse Adolescents And Young Adults, Ellen Howard, Christina Connell

Occupational Therapy Evidence Projects

In collaboration with Seattle Therapy Network, an outpatient pediatric occupational and speech therapy clinic, a critical appraisal of the literature was conducted to answer the following question: How can occupational therapists provide strength-based interventions for adolescents and young adults with autism and/or ADHD that support progression toward personally meaningful outcomes? Nineteen articles were critically appraised and were found to support using such interventions to promote meaningful outcomes in seven occupational areas. It is recommended that occupational therapy practitioners utilize strength-based, identity-affirming approaches that leverage client interests and abilities when working with neurodiverse youth in order to facilitate progress toward meaningful …

Factors That Influence Handwriting Legibility For School-Aged Children, Briegan Bester, Tori Chaffee, Jenna Miller, Laura Soper

Occupational Therapy Evidence Projects

Four occupational therapy students collaborated with 360 Pediatric Therapy, a Seattle based pediatric occupational therapy practice. The collaborating practitioners, Catherine (Cate), Heather, and Miriam, were interested in the current and relevant evidence surrounding factors impacting handwriting legibility with children. Student researchers systematically reviewed the literature from 2007-2023 to address the question, "What are the main factors that affect or correlate with handwriting legibility for school- aged children K-5?” Out of the 936 articles screened, researchers found 36 articles that met the inclusion criteria. Research demonstrates that handwriting interventions (in and out of the classroom) involving multiple skills (cognition, visual motor, …

Effects Of Treadmill Interventions On Infants With Developmental Delays Presenting With Mild And Severe Impairments: A Case Series, Eric Nguyen Spt, Nicolle Gerchak Spt

Physical Therapy Research Symposium

Background: Physical development delays can severely limit a child’s ability to explore and learn about their environment. Evidence supports that this exploration promotes a child’s development in cognition, language acquisition, social skills, and further physical skills. Thus, interventions that target and improve early mobility can be highly valuable to a child’s life. Treadmill training in infants with developmental delays has shown to be an effective intervention in moving infants toward earlier independent walking and improved gross motor function.

Purpose: This study aims to explore the potential benefits of an established treadmill training program in infants with varying degrees of motor …

Covid Restrictions Did Not Decrease Physical Activity In Community-Dwelling Older Adults, Jillian Stoewer Spt, Cara Filce Spt, Holly J. Roberts Pt, Phd, Gcs, Ncs

Physical Therapy Research Symposium

Background

Understanding the long-term impacts of COVID-19-related stay-at-home orders on physical activity can help clinicians prepare for consequences that may impact their patient populations.

Purpose

This study examined effects of the 2020 COVID-19 stay-at-home orders on physical activity levels in community-dwelling older adults including the number of hours they spent walking outside of the home and working/volunteering in the community.

Methods

Eighty-nine participants completed a monthly Physical Activity Scale for the Elderly (PASE) for 10 months. One-way repeated measures ANOVAs with post hoc analyses were calculated to determine differences among PASE scores, PASE item 2 scores, and work/volunteer hours at …

A Systematic Review Of Chronic Pain Mechanism Differential Assessment Strategies For Physical Therapy, Kate Hovde Spt, Kenny Li Dpt, Kylie Wong Bs, Roger Allen Phd, Pt

Physical Therapy Research Symposium

Background

Recently, the International Association for the Study of Pain (IASP) redefined pain, the American Physical Therapy Association proposed pain education guidelines, and a new pain mechanism category (PMC) was defined as “nociplastic pain”. IASP defines three PMCs - nociceptive, neuroplastic, and nociplastic.

Purpose

Identify current clinical assessment strategies for differentiating between nociceptive, neuropathic, and nociplastic chronic pain, feasible for implementation by physical therapists (PTs).

Methods

In 2020, investigators independently searched databases for studies evaluating assessment methods differentiating “nociceptive,” “neuropathic,” “central,” “mixed pain” and “central sensitization,” with follow-up on “nociplastic pain”. A qualitative systematic review was performed utilizing defined inclusion …

Motivational Characteristics And Fulfillment Of Psychological Needs Among Physically Active Undergraduate Students, Rohan Cobb-Ozanne Spt, Kayla Renee Withers Spt, Danny Mcmillian Pt, Dsc

Physical Therapy Research Symposium

Background: Physical activity (PA) guidelines describe positive correlations between PA and health outcomes. Self-determination theory (SDT) was used to identify motivational factors crucial to a physically active lifestyle.

Purpose: Identify and analyze how motivational characteristics, fulfillment of psychological needs, and individual experiences/beliefs influence PA.

Methods: Participants defined as moderately to vigorously physically active by the International Physical Activity Questionnaire were recruited using nominated sampling and public advertising. Motivational characteristics and psychological needs were assessed using SDT, Motives for Physical Activities Measure – Revised (MPAM-R), and The Basic Psychological Need Satisfaction and Frustration Scale – General (BPNSF). Semi-structured interviews were recorded …

Pain Catastrophizing, Pain Intensity And Perceived Injustice Do Not Predict Hrv In Acute Pain, Jacqueline Diulio Spt, Hailey Kettel Spt, Karin Steere Dpt, Phd

Physical Therapy Research Symposium

BACKGROUND: The nature of chronic pain conditions is well documented, with systemic biological, psychological and social factors interacting in an emergent fashion. Autonomic nervous system dysregulation, reflected as decreased heart rate variability (HRV), is suggested to be a biomarker of systemic dysfunction. Previous research has demonstrated correlations between numerous chronic pain disorders and diminished HRV.

PURPOSE: To determine the relationship between pain and HRV in the acute phase of pain, and to examine the predictive value of psychosocial variables on HRV. This study is meant to enhance our sense of how early in the pain experience decreased HRV may occur. …

Critically Appraised Topic (Cat) Project Benefits And Methods For Promoting A Cue-Based Feeding Protocol For Premature Infants In The Nicu, Katy Knackstedt, Cooper Cochran, Tiffany Frias, Sara Parish

Occupational Therapy Evidence Projects

In collaboration with Cuyler Romeo, an occupational therapist working in the NICU at Banner-University Medical Center in Arizona, a systematic review was conducted to answer the question "What evidence exists for implementing cue-based feeding in the NICU?" Six databases were searched and eleven articles were selected for critical appraisal after meeting search criteria. The results indicate moderate evidence that supports the implementation of cue-based feeding (CBF) for preterm infants in the NICU. It is recommended that CBF be implemented in the NICU as a team approach with a protocol in order to provide positive feeding experiences for preterm infants. A …

A Critical Appraisal Of The Vital Components Of Vocational Rehabilitations Counselors On Return To Work Outcomes For Injured Workers, Danielle Van Dusen, Kate Schooley, Sarah Riddle

Occupational Therapy Evidence Projects

Our collaborating practitioner is Lee Caton, PT, is the Regional Vice President of Peoples Injury Northwest (PINN), which has multidisciplinary industrial rehabilitation facilities across Washington and Oregon. The research question was: "Is there a difference in the rate of return to work (RTW) for injured workers who use vocational rehabilitation counselors (VRCs) versus injured workers who do not use vocational rehabilitation counselors?" A literature review discovered 57 articles that were then reviewed and synthesized into 24 total articles that included 23 quantitative and 1 qualitative article and were then assessed in a critically appraised topic (CAT). Strong evidence was found …

Associations Between Otitis Media And Social Development And Behavior, Samantha Reed, Inga Rohde, Hannah Yu

Occupational Therapy Evidence Projects

Doreen Hunt, MA, OTR/L, is an occupational therapist at Children's Therapy of Woodinville, an outpatient pediatric clinic. She served as the primary collaborator with three University of Puget Sound occupational therapy (OT) doctoral students to address the research question, "How are chronic ear infections (otitis media) in early childhood associated with children's behavioral outcomes and social development?" A literature review identified 29 relevant articles which led to establishing themes of social skills, attention and behavior. Strong evidence indicates an association between chronic ear infections and social skills. However, due to mixed evidence, no clear associations could be found between chronic …

Best Practices For Toilet Training Children With Disabilities, Sara Kne, Gabriela Gonzalez, Jorge Medina

Occupational Therapy Evidence Projects

This research project was conducted in collaboration with Paige Kensil, OTR/L and Erica Petru, OTR/L at Little Fin Therapies. Through discussion with Paige and Erica, we determined that there was a need to examine the effectiveness of various toilet training interventions for children with disabilities. Therefore, a systematic review of the literature was conducted on strategies and interventions for toilet training focused on promoting independence of children between the ages of 2-18 years old with disabilities. The literature review yielded a total of 20 research articles published in peer-reviewed journals. Ten toileting interventions were examined in these articles for children …

Evidence Appraisal On Indocyanine Green Lymphography's (Icg-L) Efficacy In Diagnosing Lymphedema Compared To Other Assessment Methods, Jasmin Cardenas, Catherine Daggi, Leah Parsons

Occupational Therapy Evidence Projects

The authors collaborated with Kate Long, OTR/L, CL T who is currently practicing at Legacy Salmon Creek Rehabilitation outpatient clinic, to answer the research question, "How effective is indocyanine green lymphography (ICG-L) in diagnosing and guiding treatment of adult clients suspected of having lymphedema compared to other assessment methods?" Results of the in depth literature review provided moderate evidence to support the use of the ICG-L assessment method for obtaining an early, conclusive diagnosis of lymphedema. Findings also showed that imaging of individual lymphatic flow can assist certified lymphedema therapists (CLTs) in delivering personalized treatment to their clients. Compared to …

Lower Extremity Compression Bandaging: A Treatment Option For Edema In Certain Clients With Heart Failure, Tatiana Klein, Samantha Kalmbacher, Katie Strain

Occupational Therapy Evidence Projects

The collaborating practitioner for this evidence project, Lauren Brown, OTRJL, works in an inpatient acute care setting in the Colorado University hospital. The researchable (PICO) question for this evidence project was raised by the collaborating practitioner as, "What is the evidence that using lower extremity multilayer compression bandaging is a safe and effective intervention for clients with heart failure in acute care to decrease lower extremity edema or lessen the impact of venous ulcers?" The evidence appraisal process found that lower extremity compression is safe for clients with stable heart failure, and may be safe for clients with severe heart …

Self-Feeding Interventions For Adults With Tremors, Kd Bradley, Kristine Miller, Samantha Patterson, Madelyn Siemer

Occupational Therapy Evidence Projects

This research analysis was completed in collaboration with Carol Schramek, OTR/L, who works at a skilled nursing facility (SNF) in Iowa run by ABCM corporations. A systematic review of literature was conducted to explore the research question: "What evidence-based interventions have been shown to be effective for reducing tremors, improving occupational performance, and/or increasing client satisfaction during self-feeding in adults with resting and/or action tremors?" After initial review of 73 articles based on title, 33 articles met our inclusion criteria and were included in our critical appraisal of our topic (CAT). We found there to be a lack of research …

Evidence For Sensory Integration And Sensory-Based Interventions For Mental Health In Pediatric Populations, Elyse Johnston, Kelsey Graeber, Monica Lyons

Occupational Therapy Evidence Projects

There is an increasing prevalence of mental health concerns within the pediatric population (Centers for Disease Control and Prevention [CDC], 2022). To equip practitioners to address this need, researchers examined the literature to consolidate the evidence for the following question: "For children with mental health conditions, do Ayres' Sensory Integration and/or sensory-based interventions reduce mental health symptoms?". This project was undertaken in collaboration with Dr. Jackie Brown, DrOT, OTR/L, owner of Apple Tree Therapy, a private pediatric occupational therapy (OT) clinic in Kitsap County, WA. In sum, there is a moderate evidence base to support the use of Ayres' Sensory …

Investigating Professional Development: Comparing Students Self-Assessment With Assessment Of The Clinical Instructors, Johana Kontarovsky Spt, Jennifer Hastings Pt, Phd

Physical Therapy Research Symposium

Investigating Professional Development: Comparing Students Self-Assessment with Assessment of the Clinical Instructors

Johana Kontarovsky, SPT
Mentor: Jennifer Hastings PT, PhD

Background: Professional behavior and self-assessment are aspects that are paramount to being a successful medical professional.

Purpose: This purpose of this study was to look at the development of professionalism in the cohort of 2020 at our institution. The concept was to investigate the students’ use of reflection as a foundation for personal and professional development.

Methods: The Self Reflection and Insight Scale (SRIS) was given to the SPTs September and December 2017 as well as May of 2020. The …

The Relationship Of Catastrophization, Pain Intensity, And Heart Rate Variability In Acute Pain - A Pilot Study, Carolyn Barbee Spt, Elizabeth A. Waddell Spt, Karin Steere Dpt

Physical Therapy Research Symposium

Background: Reduction in heart rate variability (HRV) can strongly and independently predict adverse health outcomes.Chronic pain conditions are associated with reduced HRV, and HRV may be a biomarker for predicting chronic pain.

Purpose: While pain intensity and catastrophization are associated with chronic pain,the aim of this study is to investigate their relationship with HRV in individuals with acute pain.

Methods: Fourteen subjects from two facilities participated. Data from two participants was excluded. HRV was collected while seated as participants completed an iPad survey. Raw inter-beat interval (IBI) data was analyzed with Kubios software.

Results: Multiple regression analyses were …

Influences Of Balance Confidence, Fear Of Falling, And Fall History On Physical Activity Levels In Community-Dwelling Older Adults, Alison Yang Spt, Holly Roberts Pt, Phd

Physical Therapy Research Symposium

Background: Physical activity levels generally decline with increasing age. Few studies have examined the influences of balance confidence, fear of falling, and fall history on physical activity levels in older adults.

Purpose: To determine the relationships between balance confidence, fear of falling, fall history, and physical activity level in community-dwelling older adults.

Methods: Eighty-eight participants completed the Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behavior Questionnaire (FFABQ), and a self-reported fall history. They reported their monthly activity levels using the Physical Activity Scale for the Elderly (PASE). Pearson correlation coefficients (r) were used to analyze …

Resiliency, Anxiety And Depression Amongst Dpt Students - A Survey During The Covid-19 Pandemic, Michaela Corbitt Spt, Amber Odo Spt, Robert Boyles Pt, Dsc, Ocs, Faaompt

Physical Therapy Research Symposium

Resiliency, Anxiety and Depression Amongst DPT Students–A Survey of Three Cohorts During the COVID-19 Pandemic

Michaela Corbitt, SPT; Amber Odo, SPT

Mentor: Robert Boyles, PT, DSc

Background: Doctor of Physical Therapy (DPT) programs are challenging due to the academic rigor, fast-paced learning environment, tuition cost, and feelings of inadequacy. Resiliency involves the ability to cope with stressors presented in daily life. Higher levels of resiliency has been associated with lower levels of depression, stress, and anxiety. This negative correlation may be key for preventing burnout, increasing life satisfaction, and prolonging careers for DPT graduates.

Purpose: To assess resiliency, anxiety and …