Medicine and Health Sciences Commons^™

Episodic Versus Continuous Care In Outpatient Pediatric Clinics, Rebecca Newman, Kimberly Mcgarvey, Laura Hoppe

School of Occupational Therapy Master's Capstone Projects (2016-2021)

UW Medicine Valley Medical Center, Children’s Therapy (VMC-CT) has experienced difficulties with consistent service delivery schedules for their clients. Long waitlists, absences, and scheduling and insurance constraints have impeded client ability to receive standard, continuous therapy. Thus, this critically appraised topic (CAT) paper addresses a research question developed in conjunction with Kari Tanta, PhD, OTR/L, FAOTA, the Rehabilitation Manager at VMC-CT, to understand the most effective methods of service delivery: episodic therapy (i.e. high frequency over a short duration) or continuous therapy (i.e., low frequency over a longer duration). The following research question was developed: Is episodic pediatric care as …

Anxiety In Children: Intervention Strategies, Nina Handojo, Christine Hsu-Nazzal, Nadia Kabbani

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Three occupational therapy graduate students at the University of Puget Sound partnered with a practicing pediatric occupational therapist to investigate effective interventions for anxiety in children in the literature. A Critically-Appraised-Topic (CAT) was performed on the research question: Which interventions geared towards school-aged children between 5 and 18 with anxiety and related disorders are effective in reducing symptoms and increasing participation in school and meaningful occupations as compared to no intervention?

Cognitive Behavioral Therapy (CBT) was found to have the strongest research base and the strongest positive outcomes. Gains were maintained following CBT even 10-26 weeks post-treatment. Other promising interventions …

Identifying And Implementing Assessments Of Upper Extremity Motor Control For Patients With Stroke Or Parkinson’S Disease, Julia Albright, Kayla Karelsen, Allison Lucas

School of Occupational Therapy Master's Capstone Projects (2016-2021)

The authors collaborated with a team of clinicians at a skilled nursing facility (SNF) in Gig Harbor, WA to identify the need for measures of UE functional use that are most appropriate to utilize with the two largest client populations at their facility, stroke and Parkinson’s disease (PD). In order to meet the clinical utility characteristics identified as important by the clinicians, the authors searched two databases that contain overviews of assessments. This search identified five stroke assessments and two PD assessments that met the clinical utility parameters outlined by the clinicians. The authors then conducted a systematic literature search …

Seeing Relief: Mirror Box Therapy As A Treatment For Chronic Regional Pain Syndrome, Danielle Watson, Mel Velsher

School of Occupational Therapy Master's Capstone Projects (2016-2021)

In collaboration with an occupational therapist who works in a physical therapy private practice as a hand therapist, the following clinical questions were identified: Is mirror box therapy (MT) effective in reducing pain for patients with complex regional pain syndrome (CRPS); secondary to orthopedic injury or peripheral nerve damage in the upper extremity (UE)? What protocols and dosages are the most effective? A structured review of the literature identified 18 studies that focus on the use of MT for CRPS of the UE: one meta-analysis of systematic reviews, five systematic reviews (SR) and 12 individual studies of which four are …

Four Effective And Feasible Interventions For Hemi-Inattention Post Cva: Systematic Review And Collaboration For Knowledge Translation In An Inpatient Rehab Setting., Elizabeth Armbrust, Domonique Herrin, Christi Lewallen, Karin Van Duzer

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Purpose: To locate, evaluate, and summarize the evidence for effective and feasible interventions to treat hemi-inattention in inpatient rehabilitation settings and ensure knowledge translation with a collaborating clinician Timothy Rich, OTR/L and his team at Harborview Medical Center. Design: Systematic literature review, participatory active research with a collaborating clinician, and knowledge translation. Methods: Included studies that tested effectiveness of mirror therapy (MT), transcutaneous electric nerve stimulation (TENS), limb activation therapy (LAT), and visual scanning therapy (VST). 11 databases were searched to yield 31 articles included in a critically appraised topic (CAT) table. A concise protocol for each …

Comparison Of Four Cognitive Screening Tools: Clinical Utility In A Skilled Nursing Setting And Relationship To Discharge Location, Liliya Bachinskaya, Alina Muller

School of Occupational Therapy Master's Capstone Projects (2016-2021)

A systematic review of 34 articles was conducted to answer the following clinical questions posed by Joette Jindra, the Director of Rehabilitation, at ManorCare of Tacoma: “Which cognitive screen, out of the four we are currently using, most accurately measures a patient's functional cognitive performance?” and “How well do cognitive tools and measures predict a client’s discharge setting from a skilled nursing facility (SNF)?”. Results indicate the Montreal Cognitive Assessment (MoCA) to be the most clinically useful tool for detecting mild cognitive impairment (MCI) as it demonstrated the greatest sensitivity across studies and diagnoses. The evidence did not support the …

A Critical Appraisal And Participatory Action Research Project On Effectiveness Of Weighed Vests For Early Elementary Children With Asd, Luna Blossom, Arielle Langworthy, Sarah Steckel

School of Occupational Therapy Master's Capstone Projects (2016-2021)

A Tacoma Public School clinician approached the University of Puget Sound with a research question regarding the effectiveness of weighted vests to increase on-task behaviors and decrease problem behaviors (such as self-injurious behaviors) of students ages 3-12 with ASD. A structured literature review produced eleven studies (six single subject experimental studies and five systematic reviews) published on or after 2005 and presented evidence ranging from no evidence of effectiveness, to inconclusive results, to some rare positive effect results with weighted vest usage related to increasing on-task and decreasing self-injurious behaviors within the target population. Of the six single subject experimental …

Clinical Utility Of The Weefim As A Mandated Outcome Measure: Navigating The Needs Of The Organization, Client And Clinician, Elise Brown, Andrea Hokanson, Tricia Turner

School of Occupational Therapy Master's Capstone Projects (2016-2021)

Local outpatient pediatric occupational therapists expressed a need for evidence to support the use of the Functional Independence Measure for Children (WeeFIM) as a universal measure for evaluations in their facility. We summarized the evidence addressing the psychometrics of the WeeFIM and a comparison instrument, the Pediatric Evaluation of Disability Inventory (PEDI). We ultimately made a recommendation for the PEDI based on its better evidence history for children with autism. The collaborating clinicians received an organizational mandate to implement use of the WeeFIM. We surveyed them to better understand their knowledge translation process. Themes from surveys were inserted into the …

Sensory Interventions In Schools: A Literature Review And Knowledge Translation Project, Cordelia Nwogu, Kelly Peterson

School of Occupational Therapy Master's Capstone Projects (2016-2021)

A literature review of sensory interventions that are possible in a school setting by occupational therapists was completed based on Jennifer Burke’s, a Franklin Pierce Public Schools occupational therapist, question. Her question was what sensory interventions have been shown to be effective for decreasing negative behaviors and/or increasing participation that could be used in a school setting. Most sensory based interventions (SBI) had only weak evidence in support. Sensory integration therapy (SIT) showed more promise for achieving individual goals. Because of the mix of evidence it was recommended that if a clinician chooses to use SBI or SIT they should …

Cognition In Clients With Acute Tetraplegia: Why Assessment Matters, Olivia Allen, Michael Dewilde, Jon-Erik Golob

School of Occupational Therapy Master's Capstone Projects (2016-2021)

The authors of this research project collaborated with Sarah Bicker, OTR/L, an acute care therapist working at Harborview Medical Center in Seattle, WA to investigate two clinical questions: [1] “What is the correlation between high-level (C1-C7) spinal cord injury (SCI) and cognitive impairment?” [2] “Which assessments are most effective for evaluating cognition in adult clients who have very limited motor and/or verbal abilities and could potentially be used with clients who have acute high-level spinal cord injuries?” A review of the research revealed that common comorbidities, including orthostatic hypotension, sleep apnea, and traumatic brain injury, often affect cognition in clients …

Impact Of Garden Spaces On Dementia Residents: Translating Evidence-Based Research Into Clinical Practice, Angela Ko, Jenna Williams

School of Occupational Therapy Master's Capstone Projects (2016-2021)

The research addressed the following focused question: “Do garden spaces decrease the incidence of behaviors such as combativeness and agitation, psychiatric medication use, depression, falls, cognitive decline, and sleep disturbance in clients with dementia in a residential facility?” The research team collaborated with staff at a skilled nursing facility in an urban area of the Pacific Northwest. Appraisal of existing research revealed multiple potential benefits of residents’ with dementia utilizing garden spaces for wandering and/or therapeutic activities. Based on these findings, the research team recommended implementation of an on-site garden. To support the implementation of these findings, the research team …