Rehabilitation and Therapy Commons^™

Evidence-Based Ot Practice For Patients With Cancer Related Fatigue, Kelsey Spitzley, Laura Tatu

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Clinical Scenario: 38-year-old male diagnosed with Non-Hodgkins Lymphoma seeking outpatient occupational therapy services to address sleeplessness, pain, fatigue and return to work opportunities.

Constraint-Induced Movement Therapy Vs. Bimanual Therapy For Children With Hemiplegic Cerebral Palsy, Rachael Harroun, Emily Wirtz

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background

About half the children with hemiplegic cerebral palsy (CP) experience limitations in activities of daily living and involvement in education, leisure, and other occupational activities due to impairment in hand and arm function (Tevahauta, Girolami, and Øberg, 2017).

Constraint-Induced Movement Therapy (CIMT) is a common intervention for children with hemiplegic cerebral palsy (Chen, Pope, Tyler, and Warren, 2014). By restraining the unaffected arm during functional participation, CIMT aims to increase spontaneous use of the affected arm (Dong, Tung, Siu & Fong, 2013).

Bimanual therapy (BIT) is also implemented with this population and includes intensive training in functional bimanual tasks …

Efficacy Of Early Mobilization In Acute Care, Brianna Byrd, Lauren Korte

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case:

A 53-year-old female was hospitalized after suffering a R CVA resulting in L hemiplegia and cognitive impairments. She has been stabilized and is in an acute care rehabilitation setting to regain strength and functioning. The rehabilitation team, including occupational therapists, are debating if implementing an early mobilization treatment plan, within 24 hours of onset, would be beneficial for improving function.

Benefits And Risks Of Botulinum Toxin-A Injections For Tone Management, Brittany Perlaki, Kate Soens

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background Information:

Botulinum Toxin-A (BoNT/A) is being used as an adjunct to therapy to reduce focal spasticity, increase range of motion (ROM), manage pain, improve function, and possibly delay surgical intervention (Hoare & Imms, 2004). BoNT/A inhibits acetylcholine release at the neuromuscular junction resulting in temporary denervation and decreased muscular activity. Reinnervation eventually restores muscle function. Adverse effects include excessive weakness and atrophy of injected muscle, unintended weakness in adjacent muscles, and immunoresistance to BoNT/A (Ghasemi, Salari, Khorvash, & Shaygannejad, 2013).

The Effects Of A Driving Simulator On Driving-Related Skills Necessary For Adl And Iadl Function, Rebecca Pope, Haley Szpara

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background

Returning to driving is often a goal for an individual following a neurological impairment. Critical skills for success in returning to driving include intact cognition, visual, and visual-perceptual skills which are skills that are commonly compromised in individuals who have had a neurological accident. In addition, these skills are necessary for other areas of instrumental activities of daily living (IADLS), as well as activities of daily living road driving performance (Crotty & George, 2009). Emerging evidence has shown the use of driving simulator training as an intervention to increase and the generalizability this may have on ADL function and …

Benefits Of Group Therapy For Traumatic Brain Injury (Tbi), Victoria Vaughan, Kristyn Bickley

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background Information: According to the CDC:

• The economic cost of TBI in 2010, including direct and indirect medical costs, was estimated to be approximately $76.5 billion.
• Effects of TBI can include impaired thinking or memory, movement, sensation (e.g., vision or hearing), or emotional functioning (e.g., personality changes, depression).
• Those who survive a TBI can face effects that last a few days, or the rest of their lives.

Objective Measures Of Iadl Kitchen Safety Of Individuals With Cognitive And Visual Impairments, Kylie Townsley, Marisa Gonzalez

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case Study:

72 year old woman fell donning pants, acquiring a moderate traumatic brain injury (TBI), scoring 9 on the Glasgow Coma Scale (GCS). Symptoms include confusion, headaches, memory loss, and fatigue. Comorbidities include age-related macular degeneration. She is in acute rehabilitation to be evaluated on her ability to complete kitchen tasks independently to determine her discharge plan.

Best Approach To Treating Distal Radius Fractures, Ashley Godawski, Caceti Dobrowolski

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background Information:

Distal Radius Fractures (wrist) are commonly caused by falling on an outstretched hand. The two treatments for distal radius fractures are surgical intervention through Open Reduction Internal Fixation (ORIF) or conservative non-surgical treatment. The ORIF surgery includes reducing the broken bone and then setting it back in place with screws, plates, rods or pins. Conservative treatment includes casting or immobilization of the wrist in order to promote natural healing.

Assessing And Predicting Safe Power Mobility Use In Adults, Vannessa Valadez, Cally Mcshane

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

The current body of knowledge is lacking criteria for vision, cognition, and psychological functioning and how they affect power wheelchair use. Assessment and training is a common issue for all clinicians working in the field during powered mobility rehabilitation. Research has shown that the skills required for safe powered wheelchair driving are consistent with the skills needed for safe automobile driving (Massengale et al., 2005).

For the first time instead of using task skills, process skills were introduced as part of a powered mobility assessment with the development of the Assessment of Learning Powered mobility (ALP) tool.

Combining Strategies For Improved Outcomes Of Social Interaction Skills In Children With Autism In Occupational Therapy, Kelly Allen, Kaitlyn Felt

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

Autism spectrum disorder (ASD) is a complex developmental condition that often presents with struggles in behavioral problems arising from sensory processing abnormalities, emotional dysregulation, self-stimulatory behavior, and anxiety, negatively impacting social interaction skills and limit the ability to engage with peers, productivity in school, and participating in daily routines (Wood, et al, 2009). Sensory integration therapy (SIT), often used in OT with clients with ASD, focuses on neurological processing of sensory information and helps clients modulate sensory responses (Khodabaskhshi, Abedi & Malekpour, 2014). This approach differs greatly from another commonly-used strategy focused on cognitive behavioral therapy (CBT). Cognitive-based approaches …

Impact Of Fall Prevention And Home Modification Programs For Older Adults, Alyssa Collins, Kate Weston

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

By 2030, the number of U.S. adults aged 65 or older will more than double to about 71 million (CDC, 2015). With these rapidly changing demographics, fall prevention and home modification programs provide preventative support for aging in place. The lack of fall prevention services is both costly and impacts quality of life for older adults. $50 million dollars were spent on medical costs due to falls in 2015 (Florence, et al., 2018). By reviewing the literature and critically evaluating the results of the research studies, conclusions can be made as to the most effective fall prevention methods for …

Effectiveness Of Ultrasound (Us) On Adults With Lateral Epicondylitis (Le), Jensen Aubry, Ashley Ott

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

• Individuals diagnosed with LE often present with increased pain and decreased functioning in daily activities. LE, commonly referred to as "tennis elbow," which results from stress and pain to the lateral epicondyle or extensor carpi radialis brevis (ERCB). This can develop from a single incident, injury or trauma, which results in pain with gripping and lifting (Leadbetter, 2016).
• Ultrasound (US) utilizes wave production to cause thermal or nonthermal sound waves to stimulate tissue by increasing collagen extensibility and enabling the inflammatory process (Knight & Draper, 2013).
• Areas being treated by US require different depths; a 1.0 mHz sound head …

Effective Ot Interventions For Pain Management In Persons With Rheumatoid Arthritis, Danielle Rudd, Andra Stormer

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

• Chronic pain is recognized as pain persisting past normal healing time and that may last or recur for more than 3 to 6 months. It affects about 20% of individuals worldwide (Treede et al., 2015).
• Persons diagnosed with rheumatoid arthritis (RA) identify pain as the most common reason they seek medical attention and 68-88% of persons with RA rate pain as one of their top three priorities (Lee, 2013).
• Pain for RA is often treated using a pharmacological approach involving disease modifying antirheumatic drugs, glucocorticoids, non-steroidal anti-inflammatories, and opioids. Among rheumatoid arthritis patients, chronic opioid use increased from 7.4% …

Mirror Therapy & Motor Function With Chronic Stroke, Elise Grubb, Sara Ponischil

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Aim of this CAT

Existing literature provides evidence for mirror therapy interventions during the subacute stage of stroke; the purpose of this CAT is to discover evidence for mirror therapy during the chronic stage of stroke.

Case Scenario

Male, 63, right-sided chronic stroke with moderate left hemiparesis

Mirror Therapy Defined

Mirror therapy is a therapeutic intervention using the motions of the unaffected side of the body, reflected in a mirror, as visual feedback; this feedback enables bilateral motor training and stimulates functional improvement of the brain.¹

Effect Of Ability To Cross Midline On Performance Of Handwriting, Lindsey Richmond, Michaela Marks

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background

In the school setting, occupational therapists work with students to develop or improve handwriting skills, such as letter legibility, to support educational participation (Case-Smith, 2002). Handwriting is compromised of many essential skills and clinicians focus specifically on areas including motor planning, upper extremity range of motion, and bilateral integration (Giroux, Woodall, Weber, & Bailey, 2012) which are related to the ability to cross midline. Crossing body midline is the ability to reach across the center of one's body, which is essential for many everyday tasks.

Persons With Dementia And Their Capacity For Helping: An Exploratory Study, Maria Mcdaniel, Maureen Mickus

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

This observational study explored helping behaviors (HBs) among persons with dementia (PWD) in a communal dining space of a memory care facility. HBs were observed regularly and related to assistance with another resident, staff, and stuffed animal. PWD, even in the moderate stages of the disease, have the capacity to help others.

Current Normative Data For Grip, Pinch, And Fine Motor Control For Pediatrics And Adults, Jackie Kaiser, Kyle Richards

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

Fine motor control can be measured with the Functional Dexterity Test (FDT) and the 9 Hole Peg Test (Aaron & Jansen, 2003; Oxford Grice et al., 2003). Grip and pinch strength are measured with a dynamometer and pinch gauge respectively, which are tools that measure strength in both pounds and kilograms (McQuiddy, Scheerer, Lavalley, McGarth, & Lin, 2015). The normative data for these tools from the mid-1980s is still being used in practice today and that needs to change.

Methods Of Self-Regulation In Children With Anxiety, Jordyn Madden, Maya Lamer

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background

• Children with anxiety symptoms often present with self-regulation deficits affecting their coping and problem solving performance skills, in turn impacting school performance. Research identifies self-regulation as the ability to manage appropriate behaviors to fully engage in daily occupations.
• Cognitive Behavioral Therapy (CBT) was developed to regulate mental health needs and firmly planted in occupational therapy. OT's utilize CBT as a frame of reference to guide their treatment with clients who have difficulties in occupational performance.
• CBT is a "structured, short-term, present-oriented psychotherapy..., directed toward solving current problems and modifying dysfunctional (inaccurate and/or unhelpful) thinking and behavior" (Beck, 2011, p. …

Standardized Comprehensive Measure To Guide Older Adult Discharge In Acute Care, Katlyn Agren, Madison Hirsch

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Background:

• In the acute care setting, occupational therapists play an important role in providing recommendations for discharge. Striving for appropriate and safe discharge is critical in avoiding hospital readmission, reducing safety risks, and promoting optimal functioning in older adults.
• 3.3 million adults are readmitted into the hospital within 30 days after discharge in the U.S., costing $41.3 billion annually (LaPointe, 2019).
• The average patient stay in the acute care setting is 5.5 days in the United States, putting occupational therapists in a time crunch to evaluate, treat, and prepare patients for discharge (OECD, 2017).

Effectiveness Of Sensory-Based Intervention In A Classroom Setting, Daneel Dickson, Emily Resmer

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case

A 9 year old male student is having difficulty staying focused during class. He is easily distracted and interacts with his peers at inappropriate times, such as when a teacher is providing instruction to the class. The student's teacher voices her concerns about the student's attention during academic tasks to an OT where the use of sensory integration is then explained to help with classroom behaviors.

A Comparative Review Of Pediatric Traumatic Brain Injury Assessments, Danielle Costantini, Kyle Ailes

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

No abstract provided.

Impact Of Touchscreen Technology On Children’S Fine Motor Development, Rachael Barbarich, Courtney Stewart

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case

A five-year-old boy is being seen by his school occupational therapist (OT) to work on fine motor deficits which seem to be delaying his handwriting development. His mother met with the OT and informed her that she is a single parent and is often busy, so her son spends most of his time at home playing on his tablet. The OT is interested in understanding if there is a relationship between the tablet use and the client's fine motor skills.

Effectiveness Of Proprioceptive Neuromuscular Facilitation (Pnf) On Gait And Balance In Older Adults, Alyssa Bradenburg, Savannah Dugan

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Proprioceptive Neuromuscular Facilitation (PNF) approach uses the anatomical structures of the agonist and antagonist muscles to sequence muscle movements thus improving body functions and engagement in occupations in those with functional limitations. Proprioception involved sensory receptors that provide information regarding body position and movement. The neuromuscular system involves the nerves, muscles, and facilitation to make tasks easier for the client to perform. PNF patterns are performed in a spiral diagonal direction with resistance provided by an occupational therapist, putting emphasis on functional training and motor learning.

A Comparative Review Of Cognitive Assessment Tools For Adults In The Acute Care Setting, Nicole Gagnet, Bethany Noffke

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

The MMSE and MoCA have the strongest psychometric properties for adults in the acute care setting.

The Effect Of Screen Time On Development In Elementary-Aged Children, Kelly Kislowski, Abigail Harpe

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Play and education are two primary occupations influencing development in elementary-aged children. As screen time has impacted these childhood occupations, the outpatient pediatric OT is noticing clients are struggling with motor, cognitive, and psychosocial skills. She wants to understand the relationship between increased screen time and child development.

Effectiveness Of Movement-Based Interventions To Improve Low Tone In School-Aged Children, Morgan Pugh, Katie Bell

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Description of Movement-Based Intervention

Movement-based approached have been classified as task-oriented interventions and focus on children's 'occupations,' such as tying shoelaces, ball catching, and handwriting. Children with developmental co-ordination disorder (DCD) have difficulty performing coordinated motor skills required for self-care, social activities, and academic achievement (Miyahara, Hillier, Pridham, & Nakagawa, 2017). Low muscle tone is a core feature of DCD as most children have low tone in their trunk, making stable sitting difficult and creates movement challenges while in the classroom (About Causes, n.d.).

Effective Interventions For Sensory Modulation Disorder In Children That Experienced Complex Trauma, Mahalia Adams, Madison Herfert

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case

George is a six-year-old boy that has experienced post-utero trauma. His biological parents often neglected and abused him. At the age of two, George was adopted. He is now demonstrating difficulty processing and responding to sensory input approximately. Specifically, George is over-responsive to auditory input and under-responsive to tactile input. Due to these sensory modulation difficulties, George is struggling to succeed in class and behave at home.

Lack Of Sleep And The Effects Of Performance During Therapy Sessions In Acute Care, Lena Siciliano, Erica Knight

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Disrupted sleep in acute care setting is common, but it's relationship with functional performance is unknown.

Effectiveness Of Fall Prevention In Individuals With Dementia, Jeana Smith, Madison Kowalewski

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Case

Betty is an 82 year old woman living with dementia. She is beginning to experience impaired balance and deviated gait. She was recently hospitalized with fall related injuries. Since her impaired balance is progressing, her occupational therapist plans to implement fall prevention into her treatment plan.

Best Practice For Increasing Upper Extremity Sensory Function After A Cva, Holly Nagy, Christie Schmitt

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

Intermittent pneumatic compression is most effective for tactile sensation (touch and texture discrimination) recovery post stroke, while SENSe (neuro rehabilitation) is the most effective for other somatosensory function (vibration and pressure) post stroke.