Digital Commons Network^™

Mobility Limitations And Fear Of Falling In Non-English Speaking Older Mexican-Americans, Eric G. James, Phillip Conatser, Murat Karabulut, Suzanne G. Leveille, Jeffrey M. Hausdorff, Sarah Cote, Katherine L. Tucker, Bruce Barton, Jonathan F. Bean, Soham Al Snih, Kyriakos S. Markides

Health & Human Performance Faculty Publications

Objective: To determine whether older Mexican-Americans who cannot speak and/or understand spoken English have higher rates of mobility limitations or fear of falling than their English-speaking counterparts.

Design: We conducted a cross-sectional analysis of 1169 community-dwelling Mexican-Americans aged 72–96 years from the 2000–2001 wave of the Hispanic Established Population for the Epidemiological Study of the Elderly. Mobility limitations were defined as having a Short Physical Performance Battery score ≤9, and fear of falling by participant report of being somewhat, fairly, or very afraid of falling. We determined the rates and odds ratios, for having mobility limitations and fear of falling …

The Effect Of Different Resistance Training Load Schemes On Strength And Body Composition In Trained Men, Charles Ricardo Lopes, Marcelo Saldanha Aoki, Alex Harley Crisp, Renê Scarpari De Mattos, Miguel Alves Lins, Gustavo Ribeiro Da Mota, Brad Jon Schoenfeld, Paulo Henrique Marchetti

Publications and Research

The purpose of this study was to evaluate the impact of moderate-load (10 RM) and low-load (20 RM) resistance training schemes on maximal strength and body composition. Sixteen resistance-trained men were randomly assigned to 1 of 2 groups: a moderate-load group (n = 8) or a low-load group (n = 8). The resistance training schemes consisted of 8 exercises performed 4 times per week for 6 weeks. In order to equate the number of repetitions performed by each group, the moderate load group performed 6 sets of 10 RM, while the low load group performed 3 sets of 20 RM. …

Perils And Pitfalls Of Ot Research In A Foreign Country: A Reflection, Brenda S. Howard

The Open Journal of Occupational Therapy

No abstract provided.

Occupational Therapy In Primary Care: Structures And Processes That Support Integration, Brenda Koverman, Lydia Royeen, Mary Stoykov

The Open Journal of Occupational Therapy

Few studies have outlined the processes and structures needed to develop and integrate occupational therapy into a primary care provider’s office setting. This paper focuses on implementation of the clinic model of occupational therapy in primary care and is intended to address the deficiencies in current literature, including detailed program development steps. Barriers identified in the 8-week pilot program and the successful development of a reimbursable occupational therapy service in primary care will be discussed. The results of the implementation of occupational therapy in primary care are positive. The providers have accepted and embraced the distinct value of occupational therapy …

Interprofessional Primary Care: The Value Of Occupational Therapy, Sue Dahl-Popolizio, Oaklee Rogers, Sherry Lynne Muir, Jennifer Carroll, Lesley Manson

The Open Journal of Occupational Therapy

The authors explore the training and expertise of occupational therapists and the cost benefit of the strategic use of occupational therapists as members of the interprofessional primary care (PC) team. PC practices can optimize successful and cost-effective patient care delivery, outcomes, and access to care by using interprofessional care teams and allowing physicians to off-load patients whose issues relate to routines and habits and do not require diagnostic or prescriptive intervention. This, and the occupational therapist’s ability to obtain reimbursement for his or her services, demonstrates that this professional can be an invaluable addition to the integrated PC team. The …

The Geriatrics Workforce Enhancement Program: Occupational Therapy’S Imperative Role In Interprofessional Education, Jeannine Nonaillada, Natalie C. Gangai, Chrysanne Eichner, Rosario Costas-Muniz

The Open Journal of Occupational Therapy

This paper will expound on the findings discovered from efforts made by including an occupational therapist on an interprofessional education initiative charged with developing content to enhance knowledge of geriatrics for health care providers, community-dwelling older adults, and caregivers in medically underserved areas. We will describe the actions of the interprofessional team and present data about the impact of collaborative, systematic input on one educational program taught primarily by the occupational therapist. We will then describe the personal and professional growth opportunities experienced by the occupational therapist on this initiative, and impart the challenges faced and provide recommendations to overcome …

Capacity Building To Improve Interprofessional Collaboration Through A Faculty Learning Community, Shannon L. Mcmorrow, Kate E. Decleene Huber, Steve Wiley

The Open Journal of Occupational Therapy

Though much has been written on Interprofessional Education (IPE) and Faculty Learning Communities (FLCs) independently, there is limited literature devoted to examining the use of

FLCs to enhance IPE for the health professions. A FLC dedicated to building capacity for IPE in a small, private midwestern university comprised of faculty representing occupational therapy, physical therapy, nursing, public health, gerontology, medical anthropology, psychology, social work, and exercise science was conducted over the course of one semester. This article details the implementation process for the IPE FLC; describes outcomes related to teaching, scholarship, and service of faculty from a qualitative evaluation conducted …

Taking Steps To Prevent Falls, Kimberly Okechukwu

Doctor of Occupational Therapy Capstone Projects

Fall prevention is imperative in skilled nursing and long-term care facilities. According to the CDC, “about 1,800 older adults living in nursing homes die each year from fall-related injuries and those who survive frequently sustain injuries that result in permanent disability and reduced quality of life”. “Falls can also result in severe pain, high medical costs, fear of falling, less participation in activities, and reduced quality of life “(CDC 2015). Appropriate and effective fall prevention programs need to be established and implemented to reduce falls in nursing homes, which will in turn improve the quality of care.

Optimizing Critical Illness Outcomes Through The Family Experience-A Theoretical Review, Kirby P. Mayer, Samantha A. Mancuso, Dana M. Howell

EKU Faculty and Staff Scholarship

An estimated six to eight million patients are admitted to the intensive care unit (ICU) in the United States every year [1, 2]. It is possible that new and innovative medical therapies have provided patients with treatment options that enhance survival of a critical illness and allow them go home with more medical support than previously available in earlier years. This may explain why there are now millions of ICU survivors are a result of declining mortality rates (8-19%) even though there are increased ICU admissions [3, 4]. This also indicates a change in direction of the attitudes and beliefs …

Effects Of Head Motion On Postural Stability In Participants With Chronic Motion Sensitivity, Abdulaziz A. Albalwi

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Motion sensitivity, or motion sickness, is common among individuals in modern vehicular and visually stimulating environments; notably, people with normal vestibular function are susceptible to this condition. Motion-provoked dizziness often causes postural instability. Purposes: This study aimed to compare the effects of head motion on postural stability in healthy adults with and without chronic motion sensitivity (CMS) and to determine the effects of head motion direction (horizontal versus vertical) on postural stability. Methods: Sixty healthy adult males and females aged 20 to 40 years old were assigned to two groups, 30 participants with CMS and 30 participants without CMS. …

Hippotherapy: An Alternative Treatment From The Perceptions Of Practitioners, Leah Tinkham

Honors Program Theses and Projects

Hippotherapy can be defined as a dynamic service offered by occupational, physical, and speech-language pathologists that utilizes a horse’s unique movement to achieve functional outcomes. While there are an abundance of studies demonstrating the effectiveness of hippotherapy, very few have examined the perceptions of the practitioners. The purposes of this thesis are to investigate hippotherapy’s effectiveness as well as to examine the beliefs and attitudes towards hippotherapy use among occupational therapists, physical therapists, and speech therapists. A literature review was conducted to examine the effectiveness of hippotherapy.

The study included a total of 15 occupational, physical, and speech-language therapists who …

The Impact Of Visual Impairments On Mobility Performance In Community-Dwelling Older Adults, Lauren Andrew, Talia Davis, Christian Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Falls are a major concern for elderly adults and can have a significant impact on overall health and well-being. Declines in vision with aging may be related to the development of fear of falling (FOF) and impaired mobility. It is possible that impaired vision due to common eye diseases can increase the FOF avoidance behavior and affect mobility function in this population. The purpose of this study was to investigate the relation among visual impairment, mobility performance, and FOF avoidance behavior in older adults. Methods: Inclusion criteria for eligible participants were: 50 years of age and older, …

Gait And Balance In Alzheimer's Disease: A Retrospective Analysis Across Varying Levels Of Cognitive Impairment, Diana Contreras, Jessica Heim, Jun Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: It was once thought that Alzheimer’s disease (AD) affected mostly cognition with minor motor impairment; however, it is becoming apparent that motor impairment may also be a prominent feature. Determining the extent of motor impairments throughout the continuum of cognitive impairment is critical in developing timely interventions for this population. Purpose/Hypothesis: The aim of this study was to gain a greater understanding of motor impairment in AD by exploring the relationships among gait, balance, and falls. Specifically, we explored the association of fall history to measures of cognition and performance-based balance measures in individuals with AD. We hypothesized that …

Implementing Multifactorial Education Modules With Older Adults: Individualized And Interactive Fall Prevention Education, Salvador Chavez, Jocelle Flores, Rachelle Yambao

Dissertations, Masters Theses, Capstones, and Culminating Projects

Falls are a significant concern for community-dwelling older adults (OAs), with one in four OAs reporting a fall every year. Occupational therapy students collaborated with first responders of the Novato Fire District to identify gaps in fall prevention community outreach programs and found that many interventions lack an interactive or individualized approach. Based on the gap analysis and current literature, seven education modules were developed to address key risk factors including home safety hazards, polypharmacy, fear of falling, and strength and balance exercises. Thirty community-dwelling OAs participated in the education modules that were implemented at two senior community sites in …

The Duc Healthy Aging Website: Providing Online Occupation-Based Information, Haley Caruthers, Samantha Talavera, Jackeline Ulloa, Stephanie Vera

Dissertations, Masters Theses, Capstones, and Culminating Projects

Access to current, evidence-based health information is an important step to the promotion of health and wellness for all age groups, including OAs. Since the virtual world is easily accessible and is being used more frequently by OAs, an effective way to convey relevant up-to-date health information is through a website devoted to the dissemination of health promotion information tailored for OAs, including tips for integrating healthy habits into their lifestyle. Dominican University of California’s (DUC) Healthy Aging website, developed in May 2014, contains relevant and evidence-based research, including activities and local community based programs that promote healthy aging on …

Decreasing Social Isolation Through An Intergenerational Social Engagement Program, Jacqueline Kendona

Doctor of Occupational Therapy Capstone Projects

Social isolation is the absence of meaningful contact with others. Older adults who perceived themselves as socially isolated are at risk of negative health outcomes. A person’s psychological wellbeing can be improved through engaging in meaningful leisure activities.

The Intergenerational Social Engagement Program, or the ISEP, was developed to connect older adults and high school students to help decrease social isolation in older adults. The ISEP incorporates concepts from the Canadian Model of Occupational Performance and is intended for implementation in senior living communities. The program is to be led by an occupational therapist. Occupational therapy practitioners have an understanding …

Dual-Task Does Not Increase Slip And Fall Risk In Healthy Young And Older Adults During Walking, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Dual-task tests can identify gait characteristics peculiar to fallers and nonfallers. Understanding the relationship between gait performance and dual-task related cognitive-motor interference is important for fall prevention. Dual-task adapted changes in gait instability/variability can adversely affect fall risks. Although implicated, it is unclear if healthy participants’ fall risks aremodified by dual-task walking conditions. Seven healthy young and seven healthy older adults were randomly assigned to normal walking and dual-task walking sessions with a slip perturbation. In the dual-task session, the participants walked and simultaneously counted backwards from a randomly provided number. The results indicate that the gait changes in dual-task …

Effect Of Life Review On Quality Of Life For Older Adults Living In Nursing Homes, Rene' Wren

Occupational Therapy Collection

Aim: To examine the effects of life review on daily activities, social participation, outlook on life, and perceptions of living in a nursing home measured by life satisfaction and quality of life in older adults.

Method: The study design was a two-phase quasi-experimental pre-post-tests including development and testing of a life review protocol. Nine residents, age ≥65, participated in a life review group once weekly for 6 weeks. Outcomes were analyzed using the Life Satisfaction Index-Z (LSI-Z) and pre-post surveys.

Results: LSI-Z scores improved post-intervention and survey outcomes indicated participation in activities of daily living (ADLs), socialization, …

Pre- Versus Post-Exercise Protein Intake Has Similar Effects On Muscular Adaptations, Brad J. Schoenfeld, Alan A. Aragon, Colin Wilborn, Stacie L. Urbina, Sara E. Hayward, James Kriegor

Publications and Research

The purpose of this study was to test the anabolic window theory by investigating muscle strength, hypertrophy, and body composition changes in response to an equal dose of protein consumed either immediately pre- versus post-resistance training (RT) in trained men. Subjects were 21 resistance-trained men (>1 year RT experience) recruited from a university population. After baseline testing, participants were randomly assigned to 1 of 2 experimental groups: a group that consumed a supplement containing 25 g protein and 1 g carbohydrate immediately prior to exercise (PRE-SUPP) (nD9) or a group that consumed the same supplement immediately post-exercise (POST- SUPP) …

A Systems Approach To The Problem Of Falls In Old Age, Patrick A. Dillon

Theses and Dissertations--Gerontology

The problem of falls in old age is enormously costly and disruptive for the older individual, others, and society, and its severity is likely to intensify as our population ages. This dissertation takes a systems-oriented approach toward the falls problem and is presented in two parts. The first part critically develops a new approach to the problem of falls. The second part describes an empirical study that applies this new approach in a pragmatic manner.

Conventional fall prevention strategies employ a reductionist approach to the problem of falls. This approach is questioned because it corresponds poorly to the holistic nature …

Physical Therapy 2017, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Occupational Therapy Program 2017, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Total Knee Arthroplasty Rehabilitation: Case Report, Allen Kennedy

Physical Therapy Scholarly Projects

Background and Purpose: Osteoarthritis (OA) of the knee is a common problem in the world population and total knee replacement has become the gold standard for repair when the OA becomes severe enough. Total knee replacement, however, is not the complete answer to knee OA. Without rehabilitation these patients may struggle to be fully functional. The purpose of this case study was to describe the rehabilitation of a geriatric patient who underwent TKA and benefited from the use of hydrotherapy in his recovery.

Case Description: This report will look at the rehabilitation of one 73-year-old male patient and interventions …

Opening Minds Through Art: Engaging Art Agencies To Foster Community Participation And Commitment, Ashlyn Cunningham

Occupational Therapy Doctorate Capstone Projects

Opening Minds through Art [OMA] is a visual arts program for individuals with dementia which aims to enhance the quality of life for individuals living with dementia, as well as their caregivers, through a creative opportunity held within their own community. The intent of this project was for community art agencies and galleries to participate in dementia-specific training to develop programming for individuals with dementia so that clients with memory needs can actively engage in the creative arts in St. Louis. This project used a pre-post design to analyze perceptions regarding arts based programming with people who have memory …

The Effect Of Complex Falls Prevention Interventions On Falls In Residential Aged Care Settings: A Systematic Review Protocol, Jacqueline Francis-Coad, Christopher Etherton-Beer, Debbie Nobre, Chiara Naseri, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident.

Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings?

Effectiveness Of The Timed Up And Go (Tug) Test In Assessing Fall Risk In Community-Dwelling Elders Participating In The Stepping On Program, Megan Shanahan

Physical Therapy Scholarly Projects

Background: The Timed Up and Go (TUG) is intended to predict fall risk through assessment of balance, functional mobility, and gait in community-dwelling adults age 65 and older. The Stepping On program aims toward fall prevention through education, exercise, and shared experiences among participants. Previous evidence has displayed positive, significant results for Stepping On and the TUG, indicating use of the assessment to track participants' progress in the program.

Objective: The purpose of this study was: 1) to determine if the Stepping On program decreases fall risk in community-dwelling elderly individuals as measured by the TUG test, 2) …

Changes In Postural Sway Behavior Across The Life Span, Maria M B N R Santos

Graduate Student Theses, Dissertations, & Professional Papers

The present study aimed to investigate human balance control by assessing postural sway on three groups representing three stages of life (6-12, 19-40 and 65-74 years old). There were 14 individuals in each group and they were tested during upright bipedal stance with either eyes open or closed. Focus was given to multiple sway indices representing multi-dimensional features of postural sway in quiet stance and included: the center of pressure area, amplitude, root mean square (RMS), velocity, jerkiness, and sample entropy. Results confirmed that children and seniors swayed more (p<.004), faster (p<.001) and their body sway was shakier (p<.001) than young adults. Seniors also presented faster (p<.006) and shakier (p<.001) sway than children and a more unpredictable pattern of body sway in time (p<.002) than children and young adults. In addition, children presented a more random anterior-posterior sway (p<.034) and a more regular medio-lateral sway (p<.043) than young adults, and a higher synchronization between anterior-posterior and medio-lateral body sway (p<.012) than young adults and seniors. We also observed that postural control of children and young adults becomes relatively more challenged in experimental situations when eyes were closed for most postural indices. In conclusion, this study suggests that multi-dimension posturography is sensitive to detect subtle age-related changes in the postural behavior and each stage of life may have their own signature patterns of postural behavior. Therefore, we expect that quantifications of this nature may be used to assess not only postural instability and fall risk but also to aid the testing of the efficacy of balance interventional protocols.

Using Evidence To Address Psychosocial Impairments Post-Stroke: A Guide For Occupational Therapy, Michael Thurn, Emilee Rath

Occupational Therapy Capstones

Introduction: Following a stroke, individuals experience a wide variety of physical and psychosocial impairments. While physical impairments are commonly given attention by medical practitioners, psychosocial impairments are often overlooked or undiagnosed. (Hildebrand, 2015). Unfortunately, the same is true in occupational therapy, where physical and psychosocial issues have not been receiving the same amount of attention, physical issues being addressed far more than psychosocial issues (Gillen, 2014). The purpose of this scholarly project is to provide occupational therapists a guide to use of current evidence-based assessments and interventions to address psychosocial impairments following stroke. The guide focuses on evidence-based assessments, and …

Effect Of A Sliding Scale Vitamin D Supplementation Protocol On 25(Oh)D Status In Elite Athletes With Spinal Cord Injury, Lauren Stark, Kelly Pritchett, Robert Pritchett, Elizabeth Broad

All Master's Theses

Recent studies suggest that a substantial proportion of elite athletes with SCI (spinal cord injury) have insufficient 25(OH)D status which may be associated with decreased muscle strength. This study: 1) examined the effects of a 16-week sliding scale Vitamin D supplementation protocol on 25(OH)D concentration and 2) determined whether subsequent 25(OH)D status impacts muscle performance in elite athletes with SCI. Thirty-four members of the US Olympic Committee Paralympic program, and the Canadian Wheelchair Sports Association from outdoor sports participated. Serum 25(OH)D concentrations, lifestyle and dietary factors were assessed during the Winter and Spring. Participants were assigned a 16-week sliding scale …

Promis Physical Function Scale Bookmarking And Validation, Luke Skerjanec, Amanda Tamanaha, Alex Wegner, Zane Wise, Jeff Houck

Student-Faculty Research - College of Physical Therapy

• Quick, valid and responsive outcome measure are critical for physical therapists

• The NIH’s Patient Reported Outcomes Measurement Information System (PROMIS) is a universal, 124 item, computer adapted system (CAT) that evaluates various health domains including physical function without a ceiling or floor effect.

• PROMIS demonstrates good convergent validity with the Health Assessment Questionnaire Disability Index (HAQ-DI) and Short-form 36 (SF-36) physical function subscale1 and also with ‘gold standard' International Knee Documentation Committee (IKDC) scale. PROMIS score can also predict poor outcomes at various follow-up lengths ranging from 3-52 weeks2.

• The modified physical performance test (mPPT) is …