Medicine and Health Sciences Commons^™

Veteran Wellness And Reintegration: Factors Contributing To Their Success In The Community, Melissa A. Escamilla

Theses and Dissertations

The purpose of the following study is to determine if there is a relationship between veteran wellness based on gender, discharge status, theatre of operations, substance use disorder, veteran self-efficacy, community reintegration post discharge, stigma and veteran physical and psychosocial factors. Military veteran wellness has been the focal point of service providers for ensuring post-discharge veterans' success. During the last decade there has been an increase in military veterans reintegrating into society with chronic ailments and undiagnosed conditions. The study examined 85 Texas veterans: (a) the relationship between veterans' substance abuse and their perception of stigma, (b) the relationship between …

Harnessing Nature For Occupational Therapy: Interventions And Health Promotion, Gina Ferra Kaplanis

Occupational Therapy Program Student Theses, Dissertations and Capstones

Literature is beginning to emerge which states that participation in natural environments can be restorative, provide much needed physical activity and assist with health promotion and prevention of illness. Theories such as Attention Restoration Theory (Kaplan, 1995) and Biophilia Hypothesis (Wilson, 1993) support the benefits for participation in natural outdoor environments. Health benefits of participation in nature including accessing Vitamin D, improving balance, attention restoration, reduced myopia, stress reduction are widely present in literature. Despite the health benefits of participation in nature, occupational therapists rarely complete interventions in the natural environment. Principles of adult learning and occupational adaptation were used …

Thrust Joint Manipulation To The Cervical Spine In Participants With A Primary Complaint Of Temporomandibular Disorder (Tmd): A Randomized Clinical Trial, Breanna C. Reynolds

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Temporomandibular disorder (TMD) is a common and costly problem often leading to chronic pain. There exists moderate evidence for physical therapy (PT) interventions in the management of TMD. A known relationship between TMD and the cervical spine exists with some evidence to support cervical intervention treatments. Cervical spine thrust joint manipulation (TJM) is an effective PT intervention explored in a limited fashion for this population. Objectives: To determine the immediate and short term (1 and 4 week) effects of cervical TJM on pain, dysfunction, and perception of change in individuals with a primary complaint of TMD. Methods: In this …

Cognitive Load Theory Principles Applied To Simulation Instructional Design For Novice Health Professional Learners, Susan M. Grieve

Department of Physical Therapy Student Theses, Dissertations and Capstones

While the body of evidence supporting the use of simulation-based learning in the education of health professionals is growing, howor why simulation-based learning works is not yet understood. There is a clear need for evidence, grounded in contemporary educational theory, to clarify the features of simulation instructional design that optimize learning outcomes and efficiency in health care professional students.

Cognitive Load Theory (CLT) is a theoretical framework focused on a learner’s working memory capacity. One principle of CLT is example based learning. While this principle has been applied in both traditional classroom and laboratory settings, and has shown positive …

Trigger Point Dry Needling, Manual Therapy And Exercise Versus Manual Therapy And Exercise For The Management Of Achilles Tendinopathy: A Feasibility Study, Alex Michael Koszalinski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: The effect of trigger point dry needling (TDN) on myofascial trigger points (MTP) in Achilles tendinopathy are unknown. Objectives: To determine the feasibility of a large randomized controlled trial (RCT) to compare the effects of TDN to exercise in a patient population with Achilles tendinopathy. Methods: This single-factor, pretest-posttest control group design included 22 subjects between the ages of 24 and 65 years with Achilles tendinopathy. Subjects were randomly assigned to either a control group (MT+Ex) or experimental group (TDN+MT+Ex). Subjects in both groups completed 8 physical therapy treatment sessions over 4 weeks. The intervention for the TDN+MT+Ex group …

Effects Of Generic Group-Based Versus Personalized Individual-Based Exercise Programs On Balance, Gait, And Functional Performance Of Older Adults With Mild Balance Dysfunction And Living In Residential Care Facilities - A Randomized Controlled Trial, Varatharajan Lingam

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). …

Effectiveness Of A Manual Therapy Approach In Treatment Of Patients With Lumbar Spinal Stenosis, Haitham Ramadan

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: The use of manual therapy for the management of lumbar spinal stenosis (LSS) has not been adequately systematically reviewed in an attempt to determine its effectiveness on patients with LSS. The lack of evidence in support ofcommonly used conservative interventions continues to result in a lack of clarity regarding what interventions should be used to manage patients with LSS. Objective: To use a randomized comparative trial to compare the functional clinical outcomes achieved by patients with LSS receiving two different physical therapy interventions. Methods: In this randomized controlled trial, a total of40 participants diagnosed with LSS were randomized into …

Factors Contributing To Successful Employment Outcomes For Individuals Who Are Hard-Of-Hearing, Sergio Cuevas

Theses and Dissertations

This study examined the relationship between demographic variables (gender, race and ethnicity, age, level of education, and secondary disability), state-federal vocational rehabilitation (VR) services, and VR employment outcomes among individuals who are hard-of-hearing. This study also explored what VR services contribute to employment outcomes for individuals who are hard-of-hearing. Data from The U.S. Department of Education Rehabilitation Service Administration Case Service Report (RSA-911) FY 2014 was used to focus on individuals who are hard-of-hearing. Logistic regression, Chi-square, and Chi-square Automatic Interaction Detector (CHAID) analyses were used to analyze the RSA-911 dataset.

A Study Of Counselor Trainees' Self-Perceived Competency In Social Justice Advocacy, Mary Ann Rocha

Theses and Dissertations

The purpose of the study is to examine the social justice advocacy competencies of rehabilitation counselor trainees. The study aims to explore rehabilitation counselor trainees’ self-perceived social justice advocacy competencies. More specifically, counselor trainees’ demographic and training variables will be examined to understand the process of social justice advocacy competency. Also, the study will explore the correlation between social justice advocacy competency and ethical awareness. A convenience sample of counselor trainees who are in a master’s-level or doctoral level rehabilitation counseling program or related counseling program was utilized for this study. In total, 132 counselors in training completed the online …

Vocational Rehabilitation Counselors' Experiences, Perceptions, And Readiness Related To Self-Employment Of People With Disabilities, Deborah Ashley

Theses and Dissertations

The purpose of this dissertation study was to explore the experiences, perceptions, and readiness (EPR) of vocational rehabilitation counselors (VRCs) supporting people with disabilities (PWD) in self-employment. While PWD are twice as likely to be self-employed than the general population, self-employment case closure rates within vocational rehabilitation remain historically low around 2%.

Descriptive, inferential, and correlational statistical analysis were used to investigate the EPR of 205 Certified Rehabilitation Counselors across the nation via an online survey, the Vocational Rehabilitation Counselor Self-Employment Process Survey (VRC-SEPS). The VRC-SEPS consists of demographic items, two Likert-type scales examining experiences and readiness, and a set …

Certified Rehabilitation Counselors' Self-Perceived Competency In Facilitating End-Of-Life Care Services, Miranda Lopez

Theses and Dissertations

As of 2010, certified rehabilitation counselors (CRC) have been provided ethical guidelines addressing end-of-life care (EOL) service delivery for persons with disabilities. Due to the plethora of pertinent knowledge and skills sets needed to facilitate comprehensive EOL issues, it is vital to examine rehabilitation counselors’ self-perceived competence in facilitating EOL care service delivery. The study was conducted as a non-experimental exploratory design. Based on the study’s sample (N = 188), descriptive statistics reported 70% of counselors lacked education while 69% had not participated in EOL training. Approximately 81% of the participants reported the need for EOL education and training. …

An Exploratory Factor Analysis: Factors That Influence Employers Disposition To Hire And Retain Persons With Disabilities, Javier Nazario Rodriguez

Theses and Dissertations

Despite the laws that are in place to ensure equal employment opportunities for persons with disabilities, there continues to be a disparity in employment rates for persons with disabilities when compared to persons without disabilities. Understanding factors that influence employers disposition to hire and retain persons with disabilities is the first step towards developing a guide for professionals that provide direct job placement services to this population in developing an educational intervention plan that is conducive to employers being more receptive to hiring persons with disabilities.

Currently there are many studies that focus on employers’ attitudes towards hiring and retaining …

Speech-Language Pathologist's Perspectives On The Efficacy Of Bilingual Education Programs In South Texas Public Schools For English As A Second Language Learners, Alexandra Rosas

Theses and Dissertations

Current research in regard to the assessment and treatment of ESLs is limited. Other problems found within the school setting, is that fact that SLPs have very limited resources and large caseloads. Hence, the fact that previous studies have found that SLPS working the school setting do not feel competent in serving ESL students.

The aim of this study is to investigate the efficacy of bilingual programs and explore the factors that impact English as a second language learners (ESLs), in public schools across the Rio Grande Valley. School based speech-language pathologists were surveyed for information concerning their perceptions and …

Cultural Awareness: Latinos Perceptions In A Multicultural Counseling Course [Concientización Cultural: Percepciones De Estudiantes Latinos En Un Curso De Consejería Multicultural], Leila Flores-Torres

Theses and Dissertations

This study explored the experiences and perceptions from a multicultural counseling course of Latino graduate counseling students at a Hispanic Serving Institution (HSI). The purpose of the study was to understand the students’ lived experience and its impact in developing their multicultural counselor identity and competencies. The research questions included the following: What course experiences and personal values do Latino graduate students identify as relevant to their multicultural counseling preparation? What psychological process do Latino graduate students use to make meaning of their experiences and values in their multicultural counseling preparation to serve the needs of culturally diverse clients?

The …

Knowledge And Attitudes Toward Persons With Schizophrenia Among Hispanic University Students Enrolled In Mental Health And Non-Mental Health Disciplines, Manisha Sharma

Theses and Dissertations

The present study was designed to examine university students’ knowledge regarding schizophrenia and factors that can influence university students’ attitudes toward persons with schizophrenia. An attribution questionnaire ([AQ-27], Corrigan, Markowitz, Watson, Rowan, & Kubiak, 2003), the Error Choice Test ([ECT], Michaels & Corrigan, 2013), and the Social Desirability Scale ([SDS-13], Reynolds, 1982) were utilized to collect data from undergraduate students attending The University of Texas Rio Grande Valley (UTRGV), the largest U.S. Hispanic serving university located on the Texas-Mexico border. Descriptive and inferential statistics were utilized to analyze the survey data. Results indicated a non-significant relationship between students’ knowledge regarding …

Perceptions Of Applied Behavioral Analysis In Speech-Therapy With Individuals With Autism, Irene Cortez

Theses and Dissertations

Speech language pathologists in the pediatric setting will typically find themselves working with children with autism and implementing behavior management strategies in order to implement the most effective therapy. Many of these behavior management strategies fall under the category of applied behavioral analysis, however applied behavioral analysis is not widely implemented as a whole in speech therapy. This thesis reviews current literature regarding autism, behavior management, and Applied Behavioral Analysis in speech therapy; and how speech language pathologists currently perceive applied behavioral analysis and its usefulness in speech therapy. General findings of this thesis revealed that the majority of speech …

The Effects Of Dance Therapy On Voice In Patients With Parkinson's Disease In A Multicultural Population, Ivon N. Ramirez

Theses and Dissertations

Current literature suggests that dance therapy in individuals with Parkinson’s disease shows noticeable improvement in motor functions, for example gait and balance improvement. Additionally, patients with Parkinson’s disease who participate in dance therapy may perceive positive benefits on their quality of life. Therefore, it is believed that increases in core support and improvements in posture, as a result of dance therapy, will have effects on the voice in patients with PD.

This thesis pulls from literature supporting treatment approaches in the field of speech-language pathology for voice patients with Parkinson’s disease. The aim of this study was to evaluate the …

Comprehensive Occupational Therapy In A Breast Cancer Program, Nicole Renee Scheiman

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this capstone project is to develop an evidenced-based, innovative, and comprehensive occupational therapy evaluation and intervention protocol for breast cancer care. The contents of this paper will include an introduction into the current care provided to survivors, literature review on best practice in breast cancer care, outline of the procedures completed to discover what best practice care should be, results of these procedures, discussion of the results, and conclusion with proposed program and recommendations for further investigation. The concern investigated is the inconsistencies in care provided to survivors from the time of diagnosis throughout their lifespan or …

Fine Motor Skills And The Occupations Of Young Adults With Multiple Sclerosis, Mary Squillace

Occupational Therapy Program Student Theses, Dissertations and Capstones

Objective: Multiple sclerosis (MS) is one of the most common neurological diseases affecting adults of working age, and those of younger ages of onset have been increasingly recognized. Twenty-seven percent of people with MS (PwMS) are age 30 years old or younger. The burden of MS for young adults puts them at risk for poorer outcomes regarding their education, family planning, vocation, and social skills as they transition to adulthood. Fine motor (FM) skill impairment might impede performance within the daily occupations of young adults who are transitioning into adulthood. Few studies focus on the occupations and occupational performance of …

Enhancing Collaboration Regarding Long-Term Therapy Planning For Children With Chronic Conditions Using Participatory Action Research, Victoria Ann Mcquiddy

Occupational Therapy Program Student Theses, Dissertations and Capstones

Children with chronic conditions often participate in therapy, but there is little information about how often or for how long therapy services should be provided. Participatory action research (PAR) methods were utilized in this study and, therefore, involved both parents and occupational and physical therapists throughout the study. Parental interviews were conducted to understand parent perception of self-management and how parents felt their child’s therapist was doing or could do to facilitate self-management, particularly as it related to discharge planning or having their child take a break from ongoing therapy. Through analysis of parent interviews completed by the therapist team …

Influence Of A Post-­Graduate Physical Therapy Residency Program On Clinical Reasoning, Professional Development, And Career Advancement In Nairobi, Kenya, Shala Cunningham

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement

Residency programs that emphasize clinical reasoning and manual therapy can provide a means to optimize the outcomes of physical therapy without the need for or access to expensive equipment. The residency format of continuing education could allow physical therapists in developing countries access to specialty training and ongoing mentorship. However, there are limited studies that investigate the influence of residency training on the progression of clinical reasoning, professional development, and career advancement.

Purpose

The purpose of this study was threefold. The first objective was to describe the outcome of a post-graduate orthopaedic manual therapy residency program on development …

Effect Of Individual Height And Testing Methods On Outcome Of The Forward Functional Reach Test, Jill Elaine Heitzman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: With falls a leading cause of injuries among those over age 65, early recognition of risk is imperative to reduce rising rates. The Forward Functional Reach test (FFRT) (Duncan et al., 1990) is frequently used to identify fall risk, however, the variability in cut values found in the research may be related to height and reach strategies.

Purpose: The purpose of this study was to determine if FFRT is affected by an individual’s height and if bilateral reach to height ratio could more accurately identify fall risk.

Methods: Sixty-six participants (60 and older) were recruited from a senior center …

Use Of A Telerehabilitation Delivery System For Fall Risk Screening, Robert W. Nithman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem: The Centers for Disease Control and Prevention indicates that falls are the “leading cause of injury death and the most common cause of nonfatal injuries and hospital admission for trauma among people ages 65 and older.”1 Falls can have significant economic consequences to the individual and payer sources. To address these consequences, telerehabilitation was hypothesized to be a suitable supplement for fall screening efforts. Several sources concluded that support for synchronous telerehab was underdeveloped in the literature. Purpose: The purpose of this study was to explore the acceptability, feasibility, reliability, and validity of telehealth-delivered fall screening among community-dwelling older …

Predictors Of Shoulder Injuries In Female Collegiate Swimmers, Eric Lee Lippincott

Department of Physical Therapy Student Theses, Dissertations and Capstones

Competitive swimmers frequently injure their shoulders. The risk factors for shoulder injuries in competitive swimmers have not been clearly identified. The primary purposes of this study were to describe the characteristics of female collegiate swimmers at the onset of a swim season, identify the risk factors of shoulder injury in female collegiate swimmers, characterize the swim volume of female collegiate swimmers, and determine if swim volume is a predictor of shoulder injury.

A prospective longitudinal cohort multi-center design was utilized. Female collegiate swimmers [n=53, mean age=19.3+/– 1.2] from four NCAA Division II universities were recruited to participate in this study. …

Diagnostic Musculoskeletal Imaging: How Physical Therapists Utilize Imaging In Clinical Decision-Making, Hilmir Agustsson

Department of Physical Therapy Student Theses, Dissertations and Capstones

This qualitative study describes how physical therapist experts in musculoskeletal disorders evaluate and interpret imaging studies and how they employ imaging in clinical decision-making. The informants are physical therapists who are certified orthopedic clinical specialists (OCS) and/or fellows of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). The study employed web conferencing to display patient cases, record screen-capture videos, and to conduct interviews. Informants were observed and their activity video-captured as they evaluated imaging studies and, afterwards, interviews were employed to explore the processes they utilized to evaluate and interpret the images and to discuss imaging-related clinical decision-making, including …

Relationship Between Rehabilitative Ultrasound Imaging And The Modified Prone Straight Leg Raise Test To Identify Multifidus Weakness, Mitchell T. Maione

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Low back pain (LBP) is often associated with lumbar spinal instability (LSI). The multifidus muscle is considered a stabilizer of the spine and has been studied extensively with Rehabilitative Ultrasound Imaging (RUSI). There may be a relationshipbetween clinical signs of LSI, decreased cross-sectional area (CSA) of the multifidus and weakness. Having the ability to detect multifidus weakness without the use of RUSI may serve to be invaluable to the clinician in detecting multifidus weakness.Purpose: To investigate the relationship between the modified prone straight leg raise test (MPSLR) and CSA of the multifidusmuscle as measured by RUSI and to investigate …

Physical Therapists’ Beliefs About Preparation To Work In Special Care Nurseries And Neonatal Intensive Care Units, Joyce Lammers

Department of Physical Therapy Student Theses, Dissertations and Capstones

BACKGROUND: Physical therapists (PTs) may care for full-term or premature newborns in all levels of hospital nurseries. There is some endorsement in the published physical therapy literature for restricting practice in the nursery setting to only those PTs with specialized training.1-4 PURPOSE: The purpose of this study was to understand the experiences of becoming and being a physical therapist in a special care nursery (SCN) or neonatal intensive care unit (NICU) from the therapists’ perspective. METHODS: The participants were physical therapists who have practiced in a SCN or NICU in the United States. A phenomenological approach was used and data …

Shoulder Symptom Irritability: Development And Testing Of A New Construct, Stephen Michael Kareha

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Physical therapists regularly make decisions regarding intervention intensity based upon pathoanatomy and symptom irritability, but the reliability and validity of classifying patients by symptom irritability are unknown. Purpose: Examine the reliability and construct validity of the shoulder symptom irritability classification (SSIC) system for the purposes of determining an appropriate treatment intensity. Design: Prospective repeated-measures cross-sectional single-blinded design. Methods: 101 consecutive subjects with primary complaints of shoulder pain were assessed by a pair of blinded raters. Raters recorded the SSIC level and selected the appropriate intervention intensities for the subjects. Data Analysis: Prevalence-adjusted, bias-adjusted Kappa for ordinal scales (PABAK-OS) and …

Impact Of An Exercise Program On Stress, Fatigue, And Quality Of Life For Individuals Living With Primary Immunodeficiency Disease, Kerri Sowers

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: There are over 300 Primary Immunodeficiency diseases (PID) that are a result of a genetic or idiopathic dysfunction of any aspect of the immune system. These conditions result in a higher frequency of infections, autoimmune conditions, or malignancies. Moderate intensity exercise is thought to help the immune system, while high intensity exercise may have a negative impact on immune function. The impact of exercise on individuals with an impaired immune system due to PID is not yet understood. Purpose: The purpose of this study was to investigate whether a low to moderate intensity exercise program would have an effect …

Effects Of Functional Electrical Stimulation Cycling Versus Cycling Only On Walking Performance And Quality Of Life In Individuals With Multiple Sclerosis: A Randomized, Clinical Pilot Study, Lori Hochman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Functional Electrical Stimulation (FES) stimulates peripheral nerves via electrical current to evoke muscle contractions and when combined with lower extremity cycling (LE), creates patterned leg movements. Previous studies demonstrated FES cycling is safe and effective in the spinal cord injury and stroke populations with improvements seen in walking speed, muscle mass, and bone density. Few studies have applied FES cycling to a neurodegenerative disorder, such as multiple sclerosis (MS). The aim of this study is to assess the effect of an 8-week training program using FES cycling, compared to Cycling Only, in people with MS (PWMS). Methods: Using a …