Rehabilitation and Therapy Commons^™

The Effect Of Ice Pack On Lumbar Range Of Motion In Patients With Low Back Pain And Lumbar Sacralization, Shih-Chieh Lin, Yi-Chun Hung, Yin-Chou Lin, Wei-Han Chang, Yu-Tsai Tu, Shih-Wei Chou

Rehabilitation Practice and Science

Purpose: This research was designed to investigate the short-term effect of an ice pack on lumbar range of motion in patients. Patients with low back pain caused by sacralized fifth lumbar spine were selected after clinical diagnosis.Method: Twenty-four subjects were recruited for this study. Twelve subjects with low back pain who were diagnosed with sacralized fifth lumbar spine were selected as the experimental group, and twelve healthy subjects were selected as the control group. The age, body height, and weight of the patients in the two groups were compared. Measurements of lumbar range of motion were used as the pretest …

The Associated Factors In Home-Based Rehabilitation Utilization Of Stroke Patients, Shu-Chuan Wu, Yu-Chia Chang, Te-Feng Yeh, Ting-Yu Chang, Wei-Chaio Lu, Chien-Tsai Huang, Chuan-Hsiung Lin, Li-Ling Huang

Rehabilitation Practice and Science

This study explores the factors correlated to the use of home-based rehabilitation services by stroke patients for whom care is provided according to the state policy pertaining to the 10-year long-term care plan.During July 2008–June 2010, data were collected from 759 stroke patients by using a long-term care management service evaluation form. These patients had initially applied for services at the long-term care centers of the Bureau of Public Health in Taichung County. Of these, 119(15.7%) eventually used home-based rehabilitation services. Using the Andersen health behavior model, we investigated how various factors influence the use of home-based rehabilitation services by …

Properties And Applications Of Sensory Outcome Measures In Carpal Tunnel Syndrome, Derek Km Cheung

Electronic Thesis and Dissertation Repository

This thesis aimed to determine the psychometric properties and applications of sensory threshold tools and outcome measures in patients with Carpal Tunnel Syndrome (CTS). The first chapter is a psychometric study that defines clinically important difference (CID), construct validity and responsiveness of touch and vibration threshold tools and in the Symptoms Severity Scale (SSS). The study found the CID for the PSSD and for the SSS was 0.15g/mm² and 0.50 respectively. The study also found that the Vibrometer was more representative of hand function and responsive compared PSSD. The second objective of this thesis was to determine the feasibility …

Reconditioning Post Injury: Part 1 Musculoskeletal Injuries: Mechanisms And Causes, Rob Marc Orr

Rob Marc Orr

No abstract provided.

Subsidized Housing, Public Housing, And Adolescent Violence And Substance Use, Tamara Leech

Department of Public Health Scholarship and Creative Works

This study examines the separate relationships of public housing residents and subsidized housing residence to adolescent health risk behavior. Data included 2,530 adolescents aged 14 to 19 who were children of the National the Longitudinal Study of Youth. The author uses stratified propensity methods to compare the behaviors of each group—subsidized housing residents and public housing residents—to a matched control group of teens receiving no housing assistance. The results reveal no significant relationship between public housing residence and violence, heavy alcohol/marijuana use, or other drug use. However, subsidized housing residents have significantly lower rates of violence and hard drug use, …

Predicting Risk For Adverse Outcomes Following Distal Radius Fracture, Saurabh Mehta Phd

Physical Therapy Faculty Research

Some individuals remain at risk for adverse outcomes such as chronic wrist/hand pain, falls, and fall-related osteoporotic fractures after distal radius fracture (DRF) remain. This thesis includes five studies that were conducted to establish prediction rules or assessing the risk of these adverse outcomes following DRF.

The first manuscript outlines a theoretical framework (RACE - Reducing pain, Activating, Cognitive reshaping, Empowering) for managing the risk of adverse outcomes, mainly chronic pain, in individuals with DRF. The RACE is one of the first frameworks to suggest a risk-based management approach for individuals with DRF.

The Patient-Rated Wrist Evaluation (PRWE) is a …

Protecting The Hand: .Quantifying Pressures Involved In Daily Living Activities With Tools, Kelly Cotter, Trisha Thompson, Amanda Ward

Hand and Upper Extremity

This study utilized individuals with no known hand joint pathologies and analyzed the pressure exerted on varying spoon handle diameters during a simulated self-feeding exercise. This was done in an effort to determine which spoon handle diameter required the least amount of pressme. Individuals with no known hand joint pathologies were selected in order to prevent any inaccuracy of results due to underlying co-morbidities. Methods: The Novel Pliance-X hand sensor was wrapped around 15 mm, 25 IDDl, and 40 mm spoon handles. The participants were asked to complete a self-feeding exercise. The self-feeding exercise was simulated by scooping quarters from …

Electromyographical Analysis Of Lower Extremity Muscle Activation During Variations Of The Loaded Step-Up Exercise, Christopher J. Simenz, Luke Garceau, Brittney Lutsch, Timothy J. Suchomel, William P. Ebben

Exercise Science Faculty Research and Publications

The loaded step-up exercise allows strength and conditioning practitioners to incorporate a unilateral resistance for athletes while performing extension at the hip, knee, and plantar flexion at the ankle. This study evaluated the activation of the biceps femoris (BF), gluteus maximus (GMx), gluteus medius (GMe), rectus femoris, semitendinosus (ST), vastus lateralis, and vastus medialis during 4 variations of the step-up exercise to assess the specific muscle training stimulus of each exercise variation. The exercises included the step-up, crossover step-up, diagonal step-up, and lateral step-up. Fifteen women who regularly engaged in lower body resistance training performed the 4 exercises with 6 …

Skin Cell Proliferation Stimulated By Microneedles, Horst Liebl, Luther C. Kloth

Physical Therapy Faculty Research and Publications

A classical wound may be defined as a disruption of tissue integrity. Wounds, caused by trauma from accidents or surgery, that close via secondary intention rely on the biological phases of healing, i.e., hemostasis, inflammation, proliferation, and remodeling (HIPR). Depending on the wound type and severity, the inflammation phase begins immediately after injury and may last for an average of 7–14 days. Concurrent with the inflammation phase or slightly delayed, cell proliferation is stimulated followed by the activation of the remodeling (maturation) phase. The latter phase can last as long as 1 year or more, and the final healed state …

Funding Health-Related Vr Services: The Potential Impact Of The Affordable Care Act On The Use Of Private Health Insurance And Medicaid To Pay For Health-Related Vr Services, Robert Silverstein

All Institute for Community Inclusion Publications

One of the myriad of issues affecting the administration of the vocational rehabilitation (VR) program by State VR agencies under Title I of the Rehabilitation Act is how to maximize access to and use of all available funding sources to pay for VR services and supports for VR applicants and clients. In March 2010, Congress passed and the President signed into law the "Affordable Care Act" (ACA). 1 On June 28, 2012, the United States Supreme Court upheld all of the provisions of the ACA, with the exception of provisions mandating Medicaid expansion. The Supreme Court held that if a …

Load Carriage For The Tactical Operator: Impacts And Conditioning - A Review, Rob Marc Orr

Rob Marc Orr

Tactical operators are required to carry loads as part of their occupations. Carriage of these loads have been associated with causing physical injuries to the carrier and impairing their ability to perform occupational tasks. One potential means of negating these risks associated with load carriage tasks is through physically conditioning the carrier. Through use of the Frequency, Intensity, Time and Type (F.I.T.T.) formula this review explored the literature to determine the optimal conditioning stimulus to enhance the resilience of tactical operators required to perform load carriage tasks. It was determined that a conditioning stimulus of one load carriage session every …

Physical Therapy Following Shoulder Rotator Cuff Repair, Ravindiran Appunni

Electronic Thesis and Dissertation Repository

ABSTRACT

Introduction

Rotator cuff (RC) tears are one of the common causes of pain and disability in the upper extremity. Currently there are no fixed guidelines for choosing testing positions for shoulder range of motion measurement. Optimal rehabilitation following RC repair is yet to be defined.

Purpose and Method

The purpose was to inform about postoperative Physical therapy following rotator cuff repair, with the following objectives:

• To systematically review the content of clinical research, which addresses various physical therapy programs.
• To describe validity and responsiveness of different testing positions for goniometric measurement of shoulder active external rotation.
• To pilot test …

Art In Occupational Therapy: An Introduction To Occupation And The Artist, Molly Bathje

The Open Journal of Occupational Therapy

No abstract provided.

Diagnostic Statistical Manual 5 Changes To The Autism Diagnostic Criteria: A Critical Moment For Occupational Therapists, Rondalyn Varney Whitney, Heather Miller-Kuhaneck

The Open Journal of Occupational Therapy

Changes in the soon to be released Diagnostic Statistical Manual (DSM) – 5 (American Psychiatric Association, 2012) bring new opportunities for occupational therapy, but the profession must prepare for the impact these changes forecast. While well positioned to capitalize on newly defined specifications of Autism Spectrum Disorders (ASD) and the elevation of sensory processing difficulties to a core feature of the disorder, the profession must be alert to the potential downside of the pending changes. The more stringent diagnostic rubric will likely exclude a significant number of individuals currently eligible for therapeutic and academic services. Autism will be defined as …

Ot-Pep: Development Of A Professional Education Paradigm For Occupational Therapy, Christine E. Wright

The Open Journal of Occupational Therapy

This study aims to determine the fundamental tenets that define the occupational therapy education process, and to develop a professional education paradigm that corresponds to those principles. Interpretive phenomenology with Heideggerian hermeneutic philosophy was used to explicate the paradigmatic themes embedded in the occupational therapy body of knowledge. The results yielded the Occupational Therapy Professional Education Paradigm (OT-PEP), which is organized around three core concepts: Adaptive thinking, reflection, and creation of meaning. The OT-PEP is important to occupational therapy because it addresses the elements of the education process that are reflective of the philosophical underpinnings of the profession and brings …

Examining The Sensory Profiles Of At-Risk Youth Participating In A Pre-Employment Program, Chi-Kwan Shea, Robyn Wu

The Open Journal of Occupational Therapy

The purpose of this study is to use Dunn’s model of sensory processing to investigate the sensory profiles of youth participating in a community-based occupational therapy pre-employment program. The youth participants had been involved in the juvenile justice system and were placed on probation. The study analyzed data from the Adolescent/Adult Sensory Profile (AASP) questionnaires (Brown & Dunn, 2002) completed by 79 youth participants. Analysis of the participants’ scores on the AASP showed statistically significant differences from the norm in two quadrants; the delinquent youth scored lower in Sensation Seeking and higher in Sensation Avoiding. The delinquent youth participants demonstrated …

Enhancing Social Skills In Adolescents With High Functioning Autism Using Motor-Based Role-Play Intervention, Sharon A. Gutman, Emily I. Raphael-Greenfield, Neal Carlson, Rachel Friedman, Amanda Iger

The Open Journal of Occupational Therapy

The purpose of this pilot study was to collect pilot data evaluating whether a motor-based role-play intervention using a canine animal assistant can enhance social skill use in two adolescents with HFA. A single subject ABA design across two participants was used. The intervention consisted of four 1-hour sessions over 4 weeks. The quality of social interaction was measured by the Evaluation of Social Interaction (ESI) administered at baseline and the 3-month probe. Frequency of targeted social skill use was measured during baseline, intervention, and probe phases. Participant 1 experienced statistically significant increases in both ESI scores (p = …

Associations Of Physiological Factors, Age, And Sensory Over-Responsivity With Food Selectivity In Children With Autism Spectrum Disorders, Michelle A. Suarez, Nickola W. Nelson, Amy B. Curtis

The Open Journal of Occupational Therapy

PURPOSE: The aim of this study was to investigate the relationship among physiological factors, age, sensory over-responsivity (SOR) and food selectivity in children with autism spectrum disorders (ASD).

METHODS: One hundred forty-one parents of children with ASD were recruited through a national autism organization, Autism Speaks, to fill out a survey regarding their child’s mealtime behavior. Survey contained items to measure the severity of food selectivity behavior, the presence of physiological factors (i.e., reflux, constipation, food allergies and the need for a specialized diet) and sensory over-responsivity (SOR). Results were analyzed using Chi Square, ANOVA and logistic regression.

RESULTS: No …

Exploring The Depths Of Health Literacy Are We Teaching This And Why Does It Matter?, Susan Toth-Cohen, Phd, Otr/L, Tracey Vause-Earland, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Background: Why does Health Literacy Matter?

• Healthcare practitioners often work with older persons with low health literacy without realizing that this issues limiting the success of their interventions. They may also lack awareness of the serious impact that low health literacy can have, since it is associated with lower reported health status, increased hospitalizations, and increased morbidity (Levasseur & Carrier, 2011).
• The current US healthcare system places increase demands on consumers to manage their own health (Smith & Gutman, 2011).
• Educators in the health professions must instill a sense of responsibility in future practitioners to understand the important role they …

Activating Healthcare Advocates: A Collaboration Between Npa And The Ihi Open School, Ashlee Goldsmith, Md, Valerie Pracilio, Mph, Cpps

Department of Rehabilitation Medicine Faculty Papers

Presented at: National Physician's Alliance National Conference in Alexandria Virginia.

AIM

To facilitate opportunities for interdisciplinary learning and aligning the missions of the two organizations, we organized an educational program for current and future healthcare professionals focused on the relationship between quality and cost using the Top 5 lists to promote good stewardship in clinical practice, initially developed by the NPA, as a tool to initiate collaboration.

Use Of Item Response Analysis To Investigate Measurement Properties And Clinical Validity Of Data For The Dynamic Gait Index, Yi-Po Chiu, Stacy L. Fritz, Kathye E. Light, Craig A. Velozo

Yi-Po Chiu

Background and Purpose. The Dynamic Gait Index (DGI) is a standardized clinical assessment that aids in evaluating a subject’s ability to modify gait in response to changing demands. The purpose of this study was to use Rasch measurement theory to examine whether the DGI rating scale meets suggested psychometric guidelines, whether the hierarchical order of DGI tasks is consistent with a clinically logical testing procedure, and whether the DGI represents a unidimensional construct. Subjects. Subjects were 84 community-dwelling male veterans (age range=64–88 years; mean±SD=75±6.47 years). Methods. Data were retrieved retrospectively from the participants’ clinical records. The Rasch measurement model with …

Feasibility Of Electromyography-Triggered Neuromuscular Stimulation As An Adjunct To Constraint-Induced Movement Therapy, Stacy L. Fritz, Yi-Po Chiu, Matthew P. Malcolm, Tara S. Patterson, Kathye E. Light

Yi-Po Chiu

Background and Purpose. The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT). Case Description. The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient's weaker arm for one half of the CIMT training hours. Outcomes. The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements …

Extreme Levels Of Noise Constitute A Key Neuromuscular Deficit In The Elderly, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Fluctuations during isometric force production tasks occur due to the inability of musculature to generate purely constant submaximal forces and are considered to be an estimation of neuromuscular noise. The human sensori-motor system regulates complex interactions between multiple afferent and efferent systems, which results in variability during functional task performance. Since muscles are the only active component of the motor system, it therefore seems reasonable that neuromuscular noise plays a key role in governing variability during both standing and walking. Seventy elderly women (including 34 fallers) performed multiple repetitions of isometric force production, quiet standing and walking tasks. No relationship …

The Effectiveness Of Music Therapy In The Pediatric Population, Megan Brewer, Jaclyn Lewis

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Music therapy (MT) is defined as, “the systematic use of music or musical elements-along with the resulting interpersonal relationship with a trained music therapist to achieve optimal health outcomes…” (The Effectiveness, 2010). Nurses are able to implement music therapy in care. Decreasing fear, anxiety, and ultimately pain will enhance the patient’s experience at the hospital and will lessen the burden of performing care on the patient, decrease stress on caregivers, and ease the provision of care on health professionals.

Proposal For A Clinic Based Model Of Physical Therapist Consultation In A Geriatric Outpatient Clinic, Rania Karim, Patricia A. Higgins, Thomas R. Hornick

Physical Therapy Faculty Research

Purpose: The purpose of this article is to describe the role of a certified geriatric physical therapist (PT) in a geriatric outpatient clinic.

Methods: This pilot study used a model in which a geriatric certified doctor of physical therapy (DPT) provided consultations one afternoon a week for patients in the Outpatient Geriatric Clinic at the Louis Stokes Cleveland Veterans Affairs Medical Center (VAMC). Data collection included reason for referral, DPT’s interventions, and clinicians’ and patients’ perceptions.

Results: Over 7 months, the DPT consulted on 25 male patients ranging from 65 to 91 years, with a mean age …

Self-Perceptions Of Proximal Stability As Measured By The Functional Movement Screen, Thomas Palmer, Dana Howell, Car L G Mattacola, Kert Viele

Occupational Science and Occupational Therapy Faculty and Staff Research

This mixed method study was designed to investigate self-perceptions before and after experiencing an activity that dynamically and statically challenges proximal stability of the pelvis, spine, and trunk. Twenty-eight, healthy Division II female soccer and volleyball collegiate players (17 soccer, 11 volley-ball) completed a self-reported Tegner activity scale, pretest questionnaire and posttest interview. A self-perceived numeric rating of the athletes’ proximal stability and performance on a functional movement screen (FMS) were recorded. A guided interview was used to examine the self perceptions of proximal stability after the FMS testing session. Differences and correlations between the pretest and posttest ratings of …

Assessing The Psychometric Properties Of Both A Global And A Domain-Specific Perceived Quality Of Life Measure When Used With Youth Who Have Chronic Conditions, Janette Mcdougall, Virginia Wright, Megan Nichols, Linda Miller

Occupational Therapy Publications

The purpose of this paper was to assess the psychometric properties of the Students’ Life Satisfaction Scale (SLSS) and the Brief Multidimensional Students’ Life Satisfaction Scale (BMSLSS) when used with youth who have chronic conditions. Baseline data from a longitudinal study examining predictors of changes in perceived quality of life (PQOL) for youth with chronic conditions were used. SLSS and BMSLSS data were collected on over 400 youth aged 11–17 using youth self-report and parent proxy-report versions. Internal consistency, convergent validity, and factor structure were examined for both versions. Extent of agreement and magnitude of differences between youth and parent …

Using Dual Tasks To Test Immediate Transfer Of Training Between Naturalistic Movements: A Proof-Of-Principle Study, Sydney Y. Schaefer, Catherine E. Lang

Kinesiology and Health Science Faculty Publications

Theories of motor learning predict that training a movement reduces the amount of attention needed for its performance (i.e. more automatic). If training one movement transfers, then the amount of attention needed for performing a second movement should also be reduced, as measured under dual task conditions. The purpose of this study was to test whether dual task paradigms are feasible for detecting transfer of training between two naturalistic movements. Immediately following motor training, subjects improved performance of a second untrained movement under both single and dual task conditions. Subjects with no training did not. Improved performance in the untrained …

Influence Of Knee Flexion Angle And Age On Triceps Surae Muscle Fatigue During Heel Raises, Kim Hébert-Losier, Anthony G. Schneiders, José A. García, S. John Sullivan, Guy G. Simoneau

Physical Therapy Faculty Research and Publications

Hébert-Losier, K, Schneiders, AG, García, JA, Sullivan, SJ, and Simoneau, GG. Influence of knee flexion angle and age on triceps surae muscle fatigue during heel raises. J Strength Cond Res 26(11): 3134–3147, 2012—The triceps surae (TS) muscle-tendon unit is 1 of the most commonly injured in elite and recreational athletes, with a high prevalence in middle-aged adults. The performance of maximal numbers of unilateral heel raises is used to assess, train, and rehabilitate TS endurance and conventionally prescribed in 0° knee flexion (KF) for the gastrocnemius and 45° for the soleus (SOL). However, the extent of muscle selectivity conferred through …

Longitudinal Documentation Of Serum Cartilage Oligomeric Matrix Protein And Patient-Reported Outcomes In Collegiate Soccer Athletes Over The Course Of An Athletic Season, Johanna M. Hoch, Carl G. Mattacola, Heather M. Bush, Jennifer M. Medina Mckeon, Timothy E. Hewett, Christian Lattermann

Physical Therapy Faculty Publications

BACKGROUND: Serum cartilage oligomeric matrix protein (sCOMP) is a biomarker for cartilage degradation. Patient-reported outcomes (PRO) are used to document postinjury recovery and may be used to prospectively identify changes in the course of a season. It is unknown what effect intense, continuous physical activity has on sCOMP levels and PRO values in athletes over the duration of a soccer season.

HYPOTHESIS/PURPOSE: The purpose of this study was to longitudinally document sCOMP levels and to determine whether changes in PROs occur in collegiate soccer athletes during a season. The hypotheses tested were that sCOMP levels and PRO scores would remain …