Medicine and Health Sciences Commons^™

Respite Care And Relief For Brain Injury Survivors And Their Caregivers, Sydney Bradley

OTD Capstone Projects

This doctoral capstone was completed through a partnership with Neuro Therapy Nashville. Neuro Therapy Nashville (NTN) is an outpatient interdisciplinary clinic that provides services to brain injury survivors including stroke, traumatic brain injury, Parkinson’s, etc. Their mission is work in collaboration with patients to regain as much normal function as possible and return to better, more productive lives through a positive, hopeful and expectant environment. The primary purpose of this project was to create and develop three different programs to provide respite and relief for the brain injury survivors and their caregivers. The process of the project involved collaboration with …

Social Participation And Navigation With Adolescent And Young Adult Brain Tumor Survivors: Usability And Potential Benefits, Gary Bedell, Nicole Porter, Miranda Cullen, Zachary Gould, Stephanie Freeman

The Open Journal of Occupational Therapy

Background: This study examined the usability and potential benefits of Social Participation and Navigation (SPAN), a virtual coaching goal planning intervention, which was modified for adolescent and young adult (AYA) brain tumor survivors who often experience social participation challenges.

Methods: Four AYA brain tumor survivors participated in a brief trial of the modified SPAN consisting of four weekly coaching sessions with trained supervised occupational therapy graduate students and use of a website and web application to assist with goal planning and achievement. The participants rated their social participation and SPAN-specific skills pre/post program. The participants and parents completed 1-week …

Supporting Motor, Cognitive, And Psychosocial Functions For Children And Youth With Acquired Brain Injury: A Scoping Review, Quandra Shanks, Angela Labrie Blackwell

Summer 2023 Virtual OTD Capstone Symposium

Acquired brain injury (ABI) refers to an injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma (Brain Injury Association [BIA], 2023). ABI is an umbrella term for all brain injuries, typically classified as traumatic (e.g., sports injury, fall) or non-traumatic (e.g., stroke, infection) (Wales et al., 2021). It is considered one of the leading causes of death and disability for individuals of all ages (Riccardi & Lundine, 2022). The BIA (2023) reports that ages 0-4 and 15-19 are at greater risk for brain injury. The severity of ABI among pediatrics is more severe than …

Addressing Vision Impairments Following Neurological Injuries: A Vision Protocol For Occupational Therapists, Dyrin Cordero

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vision impairments have a high prevalence in adults with a stroke or traumatic brain injury (TBI), potentially affecting up to 90% of this population. However, these impairments are often overlooked during the rehabilitation process due to a lack of education and training provided to occupational therapists (OTs). Limited research also contributes to no standardized best practice guidelines for OTs to follow (Aravich & Troxell., 2021). This issue is important to occupational therapy practitioners because vision impairments negatively affect a person's capacity for recovery, quality of life, safety, and mental health (Berger et al., 2016). Occupational therapists aim to utilize holistic …

Animal-Assisted Green Care Farming For Patients With Traumatic Brain Injury, Alex Sargsyan

Epsilon Sigma at-Large Research Conference

Animal-Assisted Green Care Farming for Patients with Traumatic Brain Injury

Purpose

To examine the effects of Animal Assisted Therapies with Farm Animals (AATF) with domesticated ducks on depression and anxiety.

Aim

The proposed study will use single-group time series design and collect survey data to explore the changes in anxiety and depression in patients exposed to AATF. The study will be guided by the Self-Efficacy Theory. The study will involve 30 patients with TBI living in The Crumley House Rehabilitation Center in Limestone, TN.

Hypothesis. Engaging in AATF with domesticated ducks will be associated with decrease in anxiety and depression. …

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 …

Occupational Therapists And Physiotherapists Weighing Up The Dignity Of Risk For People Living With A Brain Injury: Grounded Theory, Mandy Stanley, Gisela Van Kessel, Carolyn M. Murray, Deborah Forsythe, Shylie Mackintosh

Research outputs 2014 to 2021

Purpose:

Following a brain injury survivors may have physical, or cognitive changes or behaviours which bring safety risks into play when engaging in activities. Therapists experience tensions in enabling the dignity of participation in the context of managing risk.

Materials and methods:

Ten occupational therapists and seven physiotherapists participated in a grounded theory study utilising semi-structured in-depth interviews to explore the tensions between dignity and management of safety risks. Data were analysed using constant comparative method and a process of moving from open coding to categories to theory development.

Results:

The process of weighing up was central to the therapists’ …

Supporting Students After Concussion: What College Faculty Need To Know, Susan C. Davies

Thomas C. Hunt Building a Research Community Day

Returning to university life following concussion can be challenging for students. Our Brain Health Collaboratory, in conjunction with the Center on Brain Injury Research and Training, developed set of online resources to inform college faculty members about brain injuries. The module includes information about concussion effects, academic and environmental accommodations, and the role of college faculty in providing support. This session will share our research that led to development of the module, as well as our plan to evaluate its efficacy.

Brain Injury Clubhouse Model And Perceived Impact On Occupational Performance, Leslie Yap, Monica Watford, Lisa Griggs-Stapleton

Spring 2022 Virtual OTD Capstone Symposium

This project explored the impact that the brain injury Clubhouse model has on occupational performance through a qualitative research design method. Individuals with traumatic brain injury experience a disruption in occupational performance due to changes in physical, cognitive, or emotional factors from the injury (CDC, 2021). Even after the acute stage of rehabilitation, individuals with TBI may still experience difficulty participating in daily occupations. The brain injury Clubhouse model serves as a bridge between traditional rehabilitation services and community reintegration by giving members a safe environment to practice the skills needed for community-based occupations such as independent living and work …

Using Creative Making To Redesign Life After Stroke, Jennifer K. Fortuna

The Open Journal of Occupational Therapy

Kate Davies, a knitwear designer and author based in Scotland, provided the cover art for the Winter 2022 edition of the Open Journal of Occupational Therapy. “Balance for Better” is a blanket made from wool and mohair. The blanket consists of 30 individual squares designed and knitted by KDD & Co. employees. The colors and pattern of each square reflect the work, achievements, and legacy of the inspirational women celebrated in the blanket. At age 36, Kate suffered a near-fatal stroke that left her paralyzed on the left side of her body. Forced to give up her career as …

Statistical Analysis Plan For The Stepped-Wedge Clinical Trial Healing Right Way - Enhancing Rehabilitation Services For Aboriginal Australians After Brain Injury, Elizabeth Armstrong, Tapan Rai, Deborah Hersh, Sandra Thompson, Juli Coffin, Natalie Ciccone, Leon Flicker, Dominique Cadilhac, Erin Godecke, Deborah Woods, Colleen Hayward, Graeme J. Hankey, Meaghan Mcallister, Judith Katzenellenbogen

Research outputs 2022 to 2026

Background: Aboriginal Australians are known to suffer high levels of acquired brain injury (stroke and traumatic brain injury) yet experience significant barriers in accessing rehabilitation services. The aim of the Healing Right Way trial is to evaluate a culturally secure intervention for Aboriginal people with newly acquired brain injury to improve their rehabilitation experience and quality of life. Following publication of the trial protocol, this paper outlines the statistical analysis plan prior to locking the database. Methods: The trial involves a stepped wedge design with four steps over 3 years. Participants were 108 adult Aboriginal Australians admitted to one of …

Therapeutic Efficacy Of Dynamic Hand Splints In Spastic Hemiparetic Hands: A Randomized Controlled Single-Blind Trial, Yi-Ching Huang, Shih-Che Lin, Kai-Hua Chen, Chien-Min Chen, Chia-Hao Chang, Chu-Hsu Lin

Rehabilitation Practice and Science

Background: It is usually challenging to treat patients following stroke or brain injury with spastic hemiparetic upper limbs. Dynamic hand splints have been used to manage this issue for years, but evidence of their efficacy is still lacking. Objective: To investigate the treatment efficacy of dynamic hand splinting in spastic hemiparetic patients. Methods: In this randomized controlled single-blind clinical trial, patients with spastic hemiparesis lasting more than half a year after a stroke or brain injury were enrolled. They were randomly divided into a splint group and a control group, and received 1 month of task-oriented training with or without …

A Scoping Review Of Occupational Therapy Approaches To Enable Occupations For People Living With Behavioral Disturbance As A Result Of Acquired Brain Injury, Anahita Brown, Tamara Tse Dr, Tracy Fortune, Susan Petrie

The Open Journal of Occupational Therapy

Background: Behavioral disturbance impacts almost 50% of people living with acquired brain injury (ABI) and severely impedes occupational participation. Occupational therapists are appropriately qualified and well placed to address behavioral disturbance. This scoping review analyzes the literature to ascertain approaches used by occupational therapists to treat behavioral disturbance.

Method: A literature search of three databases revealed 379 papers for consideration, five of which met inclusion criteria. The Critical Appraisal Skills Programme (CASP) checklists were used for the analysis. This paper employs the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework.

Results: Sensory modulation interventions, community-based …

Perspectives Of Individuals With Acquired Neurogenic Communication Disorders And Co-Survivors On Person-Centered Care Within Speech-Language Therapy, Logan Macrae Ellis

Online Theses and Dissertations

Main Argument: Acquired brain injury impacts 2.8 million individuals each year in the United States (Taylor et al., 2017). Stroke, traumatic brain injury, tumor, infection, and other conditions cause life-altering changes to the way humans interact with each other. Social interaction and communication are important in many aspects of life, including but not limited to work, community, relationships, and mental health, etc. Damage to the brain often changes the ability to communicate drastically, which can impact all of the aforementioned aspects of life (Ardila & Rubilo, 2018). Speech-language pathologists (SLPs) address the acquired neurogenic communication disorders associated with brain injury …

“You Felt Like A Prisoner In Your Own Self, Trapped”: The Experiences Of Aboriginal People With Acquired Communication Disorders, Elizabeth Armstrong, Juli Coffin, Deborah Hersh, Judith M. Katzenellenbogen, Sandra C. Thompson, Natalie Ciccone, Leon Flicker, Deborah Woods, Colleen Hayward, Catelyn Dowell, Meaghan Mcallister

Research outputs 2014 to 2021

Purpose:

Aboriginal Australians are under-represented in brain injury rehabilitation services despite a high incidence of both stroke and traumatic brain injury in this population. This study aimed to explore the experiences of Aboriginal Australian adults with acquired communication disorders (ACDs) after brain injury for the first time to inform the development of accessible and culturally secure service delivery models.

Methods and materials:

Semi-structured interviews were undertaken with 32 Aboriginal people who had experienced a brain injury resulting in ACDs (aged 35–79 years) and 18 family members/carers across Western Australia. Thematic analysis identified common themes across participants.

Results:

Overall themes related …

Healing Right Way: Study Protocol For A Stepped Wedge Cluster Randomised Controlled Trial To Enhance Rehabilitation Services And Improve Quality Of Life In Aboriginal Australians After Brain Injury, Elizabeth Armstrong, Juli Coffin, Deborah J. Hersh, Judith M. Katzenellenbogen, Sandra Thompson, Leon Flicker, Meaghan Mcallister, Dominique A. Cadilhac, Tapan Rai, Erin Godecke, Colleen Hayward, Graeme J. Hankey, Neil M. Drew, Ivan Lin, Deborah Woods, Natalie Ciccone

Research outputs 2014 to 2021

Introduction: Despite higher incidence of brain injury among Aboriginal compared with non-Aboriginal Australians, suboptimal engagement exists between rehabilitation services and Aboriginal brain injury survivors. Aboriginal patients often feel culturally insecure in hospital and navigation of services post discharge is complex. Health professionals report feeling ill-equipped working with Aboriginal patients. This study will test the impact of a research-informed culturally secure intervention model for Aboriginal people with brain injury.

Methods and Analysis: Design: Stepped wedge cluster randomised control trial design; intervention sequentially introduced at four pairs of healthcare sites across Western Australia at 26-week intervals.

Recruitment: Aboriginal participants aged ≥18 years …

The Effects Of Dual-Tasking On Fall Risks In Adults With Brain Injury, Kaley Campbell, Anayston Casey, Madison Culpepper, Elizabeth Denton, Katie Morgan

Master of Occupational Therapy Student Critically Appraised Topics

Clinical Scenario: Dual-tasking combines both physical and cognitive components into one therapeutic intervention. There has been limited research on the benefits of dual tasking in relation to fall risks in adults with brain injury. Currently, it is common for various therapy interventions to spend the majority of time targeting physical or cognitive components, but not both at once. After appraisal, a total of five articles were used. These included two level I studies involving a high-quality randomized control trial and a meta-analysis, two level II studies that were both small-scale randomized control trials, and one level IV study that was …

Implications Of A Multicomponent Sleep Program After Brain Injury: A Mixed Methods Study, Brandi M. Fulwider

Occupational Therapy Program Student Theses, Dissertations and Capstones

Decreased sleep can negatively affect mental and physical health and can significantly disrupt participation in daily occupations and leisure interests. Even though sleep is an area of occupation, there is limited evidence on the effectiveness of occupational therapy interventions for sleep. The purpose of this embedded mixed methods research study was to identify how disruptions in sleep affected daily occupational performance and to understand the effectiveness of occupational therapy- directed non-pharmacological sleep interventions for three participants in a community re-entry program for brain injury. This study utilized a single-subject research design during a 4- to 5-week multicomponent sleep program using …

Evaluation Of Head Impact Exposure Between One Season Of Youth Versus High School Football, Kim D. Barber Foss, Christopher Dicesare, Jed A. Diekfuss, Weihong Yuan, Gregory D. Myer

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

In Volume 4, Issue 1 of the JSMAHS you will find Professional research abstracts, as well as Under Graduate student research abstracts, case reports, and critically appraised topics.

Thank you for viewing this 4^th Annual OATA Special Edition.

Concussion Rehabilitation: Vestibular And Physiotherapy, Amia Pelletier, Jordan Wing

Thinking Matters Symposium Archive

Recent research has come out to suggest that a prolonged resting period after a concussion may not be the most beneficial way to recover. Many doctors of physical therapy seem to have a consensus that athletes that acquire a sports-related concussion should seek treatment through body movement, not the typical resting and abstaining from exercise protocol. Recent research has shown that vestibular and physiotherapy will reduce the recovery time after a concussion. Seventy-one percent of a treatment group had returned within eight weeks, compared to seven percent in a control group. The participants in the treatment group were four times …

Smart Speaker Usability By Military Service Members With Mtbi And Ptsd, Tracey Wallace

Tracey Wallace

Determining The Feasibility, Content Validity, And Internal Consistency Of A Newly Developed Care Coordination Scale For People With Brain Injury, Brian P. Johnson, Mark V. Johnston

The Open Journal of Occupational Therapy

Background: With the increasing complexity of care, people with disabilities and supportive significant others (SSO) must often coordinate key aspects of their own care, but no validated scale currently exists to comprehensively characterize the activities done to manage and coordinate their care.

Method: This study aimed to improve the feasibility, acceptability, and content validity of the Care and Service Coordination and Management (CASCAM) scale and to test its internal consistency. Questionnaire items were administered to 23 individuals with acquired brain injury and 17 SSO.

Results: Respondents confirmed content validity and that the instrument addresses important care coordination and management issues. …

The Use Of Personal Projects Analysis To Enhance Occupational Therapy Goal Identification, Mary Egan, Lori Scott-Lowery, Cynthia De Serres Larose, Liane Gallant, Chantal Canada Jaillet

The Open Journal of Occupational Therapy

Background: Client-centered occupational therapy begins with the identification of personally-relevant patient goals. This study aimed to determine whether the elicitation module of Personal Projects Analysis (PPA) could help patients in an acquired brain injury day hospital program identify more meaningful goals than those identified using the Canadian Occupational Performance Measure (COPM) alone.

Method: Ten patients completed the COPM. They rated the importance of each goal and their confidence that they could attain each goal. During the next session, using the elicitation module of PPA, they identified personal projects just prior to their brain injuries, current personal projects, and future desired …

Traumatic Brain Injury: The Efficacy Of A Half-Day Training For School Psychologists, Susan C. Davies, Ashlyn M. Ray

Susan C. Davies

The incidence rates of traumatic brain injuries (TBI) are increasing, yet educators continue to be inadequately trained in assessing and serving students with TBIs. This study examined the efficacy of a half-day TBI training program for school psychologists designed to improve their knowledge and skills. Results of quantitative and qualitative survey analysis indicated there was little increase in knowledge and skills from pre-training to one-year follow-up, although participants did increase in confidence related to their decision-making abilities in working with students with TBI. The data indicate a need for future study of more effective training models.

Parenting After Traumatic Brain Injury: A Web-Based Support For Caregivers, Arien N. Mcomber, Kristin W. Moore

School of Occupational Therapy Master's Theses (2010-2015)

Aggression is common in traumatic brain injury (TBI) survivors (Rao et al., 2009) and can increase caregiver burden (Gan et al., 2006). For TBI survivors who are parents, aggression may also negatively impact parenting skills (Charles, et al., 2007). Resources that support survivors as parents are few (Kieffer-Kristensen, Teasdale, & Bilenberg, 2011), as are supports for their caregivers (Turner et al., 2010). We created a website to educate caregivers about TBI, stressmanagement techniques that help TBI survivors manage aggression, and family activities that facilitate positive interactions with children. When piloted to four people, feedback demonstrated that all goals were met …

Bridge/Adapt: A Systematic Cognitive Rehabilitation Curriculum, Julie S. Bergen, Natalie Repin, Amy Bennet, Abigail Lafrenz

Dissertations, Masters Theses, Capstones, and Culminating Projects

Cognitive impairment, including deficits in memory, attention, visual perception, executive functioning, and self-awareness, is a common consequence of acquired brain injury (ABI). Subsequently, these cognitive impairments result in functional impairments in daily life activities for clients with ABI. Rehabilitation efforts are categorized under two broad approaches: remediation and adaptation. Computer-assisted cognitive retraining (CACR) is a remediation approach using a computer platform to deliver cognitive exercises. CACR therapy can lead to improvements in memory and attention for adults with chronic ABI. However, memory and attention improvements from CACR may not carry over to functional improvements in occupational performance. Research suggested that …

Traumatic Brain Injury: The Efficacy Of A Half-Day Training For School Psychologists, Susan C. Davies, Ashlyn M. Ray

Counselor Education and Human Services Faculty Publications

The incidence rates of traumatic brain injuries (TBI) are increasing, yet educators continue to be inadequately trained in assessing and serving students with TBIs. This study examined the efficacy of a half-day TBI training program for school psychologists designed to improve their knowledge and skills. Results of quantitative and qualitative survey analysis indicated there was little increase in knowledge and skills from pre-training to one-year follow-up, although participants did increase in confidence related to their decision-making abilities in working with students with TBI. The data indicate a need for future study of more effective training models.

Phenomena Correlated To Stroke Patients With Pusher Syndrome, Hung-Che Wang, Ling-Fu Meng

Rehabilitation Practice and Science

Stroke patients who cannot maintain a balanced sitting or standing position fall toward one specific side. There can be a strong tendency to actively use non-hemiplegic extremities to push the body away from the sound side. As well, patients may resist any attempt to correct their postures and finally fall toward the hemiplegic side. This falling asymmetry phenomenon has been termed ”Pusher syndrome.” The syndrome often occurs coincident with frequent lapses in consciousness, poor motor control, impaired sensory status, spatial neglect, and limited perceptual function. Recent observations have indicated that Pusher syndrome is strongly related to body orientation deficit and …

“Tears In My Eyes ’Cause Somebody Finally Understood”: Client Perceptions Of Practitioners Following Brain Injury, Amy R. Darragh, Pat L. Sample, Stephanie R. Krieger

Occupational Therapy Faculty Publications

Objective: The purpose of this study was to identify practitioner qualities and traits that clients with brain injury see as important. Method: An opportunistic sample of 51 participants with brain injury was interviewed about perceptions of service access and effectiveness. An interview guide was used to gather data for this phenomenological qualitative study. Four interviewers individually conducted audiotaped interviews, which were then transcribed. Coding and theme development were completed using HyperRESEARCH™ software. Results: Three themes regarding practitioner qualities emerged from the data: (a) roles of the provider, (b) perceived helpfulness of services, and (c) personal characteristics of the providers. Beneficial …