Rehabilitation and Therapy Commons^™

Development Of An Eeg Brain-Machine Interface To Aid In Recovery Of Motor Function After Neurological Injury, Elizabeth Salmon

Theses and Dissertations--Biomedical Engineering

Impaired motor function following neurological injury may be overcome through therapies that induce neuroplastic changes in the brain. Therapeutic methods include repetitive exercises that promote use-dependent plasticity (UDP), the benefit of which may be increased by first administering peripheral nerve stimulation (PNS) to activate afferent fibers, resulting in increased cortical excitability. We speculate that PNS delivered only in response to attempted movement would induce timing-dependent plasticity (TDP), a mechanism essential to normal motor learning. Here we develop a brain-machine interface (BMI) to detect movement intent and effort in healthy volunteers (n=5) from their electroencephalogram (EEG). This could be used ...

Lactate Threshold: Land Versus Water Treadmill Running, Ron T. Garner

All Graduate Plan B and other Reports

Aquatic treadmill running has become increasingly popular for rehabilitation and training purposes due to decreased joint impact on the lower extremities, which is beneficial for special populations such as the injured, elderly, arthritic, and obese (Greene et al., 2009; Hall, Grant, Blake, Taylor, & Garbutt, 2004). Accordingly, researchers have compared key differences such as heart rate (HR), oxygen consumption (VO2), respiratory exchange ratio (RER), stride frequency, and rating of perceived exertion (RPE) between land and water running at maximal and submaximal efforts (Brubaker, Ozemek, Gonzalez, Wiley, & Collins, 2011; Rife, Myrer, Feland, Hunter, & Fellingham, 2010; Rutledge, Silvers, Browder, & Dolny, 2007; Silvers, Rutledge, & Dolny, 2007). As the benefits of aquatic treadmill running continue to be unveiled, there is an interest for healthy individuals to use the system to supplement training while limiting joint stress.

Rutledge et al. (2007) revealed VO2 values at 6.5, 7.5 and 8.5 mph on an aquatic treadmill with no jet resistance to be 33.97 ± 4.0, 37.96 ± 4.0, and 43.6 ± 4.0 mL•kg-1•min-1, respectively. Watson et al. (2012) also revealed VO2 values on an aquatic treadmill at 4.5, 6.0, and 7.5 mph with no jet resistance to be 20.58 ± 3.36, 29.27 ± 3.89, and 35.77 ± 4.02 mL•kg-1•min-1, respectively. These articles demonstrate the linear relationship that exists with increasing workloads with concomitant increases in VO2 with aquatic treadmill running. As metabolic demands increase, a reliance on anaerobic metabolism ensues and the work rate at which lactate begins to accumulate in the blood is called the lactate threshold (LT) (Stainsby & Brooks, 1990). The importance of determining LT is supported by a large body of evidence to predict aerobic endurance capacity (Faude, Kindermann, & Meyer, 2009). As such, researchers have employed great efforts to predict LT via field tests to determine the correct training intensity for endurance athletes (McGehee, Tanner, & Houmard, 2005).

An early study of LT revealed a strong relationship (r ≥ .91) between treadmill velocity at the onset of plasma lactate accumulation and running performance at distances ranging from 3.2 km to 42 km (Farrell, Wilmore, Coyle, Billing, and Costill, 1979). In other words, a faster sustainable work rate prior to a lactate accumulation or threshold will increase performance.

Comparisons for lactate concentrations during deep water and land treadmill running have been examined previously. Frangolias and Rhodes (1996) reviewed that during submaximal intensities of deep water versus land running, at the same relative VO2 water exercise resulted in a lower HR with higher blood lactate, RER, and RPE. These same authors previously reported that at maximal efforts on land versus deep water running, there was no statistical difference between lactate concentrations 30 s and 5 min post-exercise (Frangolias & Rhodes, 1995). However, not all water immersion running studies support similar peak lactate values (Frangolias & Rhodes, 1996; Svedenhag & Seger, 1992).

In a shallow water pool, a study by Town and Bradley (1991) revealed no statistical differences between land and water running for peak lactate values. However, lactate concentration in the water was 80% of that from land exercise. The authors stated that the “push-off” phase ...

Modern Technology And An Aging Population: Can The Use Of Wii Fit Gaming System Improve Functional Balance In Community Dwelling Seniors?, Curtis N. Phillips

All Graduate Theses and Dissertations

Seniors are a growing segment of the population of the United States. By 2030 they will make up nearly 20% of the general population. Senior citizens face many health challenges as they age. Injury due to falling is a major concern for many in this age group. Research shows that approximately one third of seniors will fall each year. Injuries that result from falls have been identified as the number one cause of accidental death in this age group each year. While falls have been studied by researchers for a number of years, and some progress has been made in ...

What Are The Relations Among Stress Perception, Health Perception And Activity Participation In School-Aged Children?, Allison Caplin

Honors Theses

This correlational study examined possible relations among children’s activity patterns, perceived stress, and perceived health. A variety of self-report questionnaires were administered to a sample of 33 school age children. The Pediatric Activity Sort (PACS) was used to measure activity participation, a health questionnaire was used to assess health, and the Childhood Stress Questionnaire (CSQ) was used to measure perceived stress. Correlations showed no significant relationships between stress level and the amount of reported activity participation. The absence of significant relationships may be due to testing a sample of middle to upper class, Caucasian children, as there was a ...

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

Occupational Therapy Faculty Publications

The new definition of Autism Spectrum Disorders (ASD) is expected to appear in May 2013 in the finalized Diagnostic Statistical Manual (DSM) -5 (American Psychiatric Association, 2012). The current DSM-IV criteria uses Pervasive Developmental Disorder (PDD) as the umbrella term for autism, a classification that many professionals believe has been outdated for several years. ASD will be the new name for the category that includes “autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified” (APA, 2012). It will also serve to better differentiate autism spectrum disorder from typical development as well as from ...

The Influence Of Cytokines On Obesity-Associated Pain, Stacy Stolzman

Maria Dittman Library Research Competition: Student Award Winners

No abstract provided.

Advancing Occupational Therapy In Workplace Health And Wellbeing: A Scoping Review, Lynn Shaw Dr., Amanda Kollee, Helen Ren, Kayla Lofgren, Savannah Saarloos, Kirsten Slaven, Ann Bossers

Lynn Shaw

Advancing Occupational Therapy in Workplace Health and Well-being: A Scoping Review Amanda Kollee, Helen Ren, Kayla Lofgren, Savannah Saarloos, Kirsten Slaven, Ann Bossers & Lynn Shaw Background: Workplace health continues to be a goal that workers and employers desire. For instance, organizations want to adapt and find ways to accommodate the changing needs of workers as they grow older and develop chronic health conditions. Preventative strategies are required to maintain health and limit the burden on both organizations and individual workers. Occupational therapists can support workplaces to foster the personal health and well-being of workers and to develop workplace environments that support productivity and positive workplace culture. Knowledge is needed to support the evolving role of OTs in evidence based practice in the workplace. Purpose: This paper presents a synthesis of existing knowledge regarding occupational therapy (OT) involvement in the development and maintenance of worker health. Methods: A scoping review was conducted by searching 11 electronic databases, including CINAHL, Medline-OVID, Sociological Abstracts, PsycINFO, JSTOR, ProQuest Nursing and Allied Health Source, ProQuest Dissertations and Theses, EMBASE, Scopus, PubMed and OTDBASE. By using search terms including occupational therapy, workplace, workplace health, and well-being, 1814 articles published between 1992 and July, 2012 were identified Forty-six articles were extracted using a 5-point relevancy scale. Data was analyzed based on study location, year, health condition or injury focus, and study design. Information regarding OT involvement, outcome measures, enablement skills, and collaborative models were examined, with particular attention on the areas of primary, secondary and tertiary prevention, assessments/interventions, and enablement skills as outlined by the Canadian Model of Client-Centred Enablement. Findings: The majority of studies were completed in the United States and Canada, with Sweden and the Netherlands following closely. Thirty-four quantitative, 11 qualitative and 1 mixed study were reviewed. Sixty-three percent of studies focused on persons with physical injuries or conditions and 28% on mental illness. The majority of articles demonstrated OT involvement using tertiary prevention for chronic and complex conditions. Focus on ‘return to work’ and ‘productivity’ was evident, and ‘well-being’, ‘maintaining work’ and ‘safety’ was less prevalent. The majority of articles highlighted the use of enablement skills that are more inter-relational in nature, including ‘collaborate’, ‘educate’, ‘coach’, and ‘engage’. Thirty-five percent of the articles stated that the assessment or intervention was carried out solely by OTs; the remaining articles included 61% involving multidisciplinary, interdisciplinary or transdisciplinary teams, and 4% did not specify the collaborative model. Implications: There is descriptive and intervention-based evidence to support the involvement of OTs in workplace practice. Future research is needed to enhance understanding of mental health, primary prevention, and OTs role on teams, and needs to consider further specifying and defining outcome measures and enablement skills. There is a need for higher level evidence and more qualitative studies ...

Description And Service Innovation In Adolescent Transition Within Kentucky State Agency Education Programs, Amy C. Marshall

Theses and Dissertations--Rehabilitation Sciences

Of all Kentucky youth, state agency children are at the highest risk of making unsuccessful post-secondary transitions to adulthood. The intent of both studies comprising this dissertation was to understand and guide transition planning to make future improvements to transitions of adolescents in state agency programs.

The Kentucky Youth at Risk in Transition Study was a mixed methods study that identified and described the understandings of student transitions in state agency education programs from the perspectives of youth and administrators. The study included 105 nontraditional education programs funded and supervised by the Kentucky Educational Collaborative for State Agency Children (KECSAC ...

Developing The Rehabilitation Education For Caregivers And Patients (Recap) Model: Application To Physical Therapy In Stroke Rehabilitation, Megan M. Danzl

Theses and Dissertations--Rehabilitation Sciences

Patient and caregiver education is recognized as a critical component of stroke rehabilitation and physical therapy practice yet the informational needs of stroke survivors and caregivers are largely unmet and optimal educational interventions need to be established. The objective of this dissertation was to develop a theory and model of “Rehabilitation Education for Caregivers and Patients” (RECAP) in the context of physical therapy and stroke rehabilitation, grounded in the experiences and perceptions of stroke survivors, their caregivers, and physical therapists.

Qualitative research methods with a novel grounded theory approach were used. Potential constructs of RECAP were identified from existing research ...

Promoting Health Literacy Through Leading Edge Occupational Therapy Education, Susan Toth-Cohen, Phd, Otr/L, Annalisa Synnestvedt, Ba, Ots, Alyssa Frey Peachey, Ots

Department of Occupational Therapy, Presentations

Synopsis:

Health literacy has become a vital focus of U.S. healthcare. By incorporating health literacy knowledge, attitudes, and skills into entry-­‐level education, occupational therapy professionals can enact a leading role in health and human services teams to address our national healthcare goals.

Poster presentation at the American Occupational Therapy Association Annual Conference, San Diego, CA, April 2013.

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, 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 play in ...

Experiences Of Speech-Language Pathology Graduate Students: An Exploratory Phenomenological Study, Anysia J. Ensslen

Theses and Dissertations--Educational Leadership Studies

Within the past decade little research has been conducted in the United States to examine the preparedness of beginning speech-language pathologists; the seminal article used for this research study comes from the United Kingdom (Horton, Byng, Bunning, & Pring, 2004). Literature from the past few decades indicates that there may be deficiencies in the way that beginning speech-language pathologists are being trained clinically.

The review of the literature suggests that the field may lack a clear and broadly supported learning theory or framework for the clinical supervision and training of speech-language pathology graduate students. The literature further supports the importance of ...

Canada's Aging Population: Should Students Be Worried?, Emily Milko, Sherna Tamboly

The Meducator

No abstract provided.

Occupational Load Carriage: Formal And Informal Conditioning, Rob Orr

Health Sciences & Medicine papers

No abstract provided.

Gait Retraining In Parkinson’S Disease: A Cognitive Cueing Approach, Stephanie J. Morrison

University of Western Ontario - Electronic Thesis and Dissertation Repository

Parkinson’s disease (PD) is characterized by resting tremor, bradykinesia, rigidity, and postural instability. These cardinal symptoms commonly affect gait performance and therefore researchers have been investigating techniques to manage and treat gait impairment in individuals with PD. This thesis explores a progressive approach to gait rehabilitation using a novel intervention that combines traditional gait cueing techniques with motor learning approaches to facilitate self-cued gait improvement. Five participants with PD-related gait impairment completed the home-based gait training intervention. This intervention included video footage of each individual participant walking with and without verbal instructional cues, audio coaching, and practice periods. Participants ...

The Association Between Preoperative Spinal Cord Rotation And Postoperative C5 Nerve Palsy, Mark S. Eskander, Steve Balsis, Chris Balinger, Caitlin M. Howard, Nicholas W. Lewing, Jonathan P. Eskander, Michelle E. Aubin, Jeffrey Lange, Jason C. Eck, Patrick J. Connolly, Louis G. Jenis

Orthopedics and Physical Rehabilitation Publications and Presentations

BACKGROUND: C5 nerve palsy is a known complication of cervical spine surgery. The development and etiology of this complication are not completely understood. The purpose of the present study was to determine whether rotation of the cervical spinal cord predicts the development of a C5 palsy.

METHODS: We performed a retrospective review of prospectively collected spine registry data as well as magnetic resonance images. We reviewed the records for 176 patients with degenerative disorders of the cervical spine who underwent anterior cervical decompression or corpectomy within the C4 to C6 levels. Our measurements included area for the spinal cord, space ...

Movement Orientated Training For The Kinetic And Cyber Warrior, Rob Orr

Health Sciences & Medicine papers

No abstract provided.

University Campus Accessibility Measure, Lea E. Klinger

Occupational Therapy Publications

No abstract provided.

Physical Accessibility Measure For Schools, Lea E. Klinger

Occupational Therapy Publications

No abstract provided.

Intensive Goal-Directed Treatments In Enriched Environments Augments Patient Outcomes Post-Stroke, Blake A. Kandah, Michael A. Klonowski, Ryan M. Pelo, Nicole M. Williams, Raquel V. Santiago, Christopher K. Thompson, Kristan A. Leech, Carey L. Holleran, Abigail L. Leddy, T. George Hornby

GW Research Days 2013

Objective: Previous research indicates that patients post-stroke, average 400-800 steps within physical therapy sessions and demonstrate heart rate values of 24-35% of HR Max. This dosage and intensity is inadequate to promote neuroplastic changes and maximize recovery. The goal of this study was to quantify and examine the amount of high-intensity stepping practice that was delivered within an Acute Inpatient Rehabilitation (AIR) setting for individuals with sub-acute stroke.

Methods: 14 patients with a diagnosis of sub-acute stroke were admitted to AIR. Standardized outcomes included the 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), the Berg Balance Scale (BBS) and the ...