Digital Commons Network^™

The Role Of Advocacy And Occupational Justice In Increasing The Accessibility Of Parks For Parents With Disabilities, Nathan Burke-Tan

Doctoral Projects

The purpose of this doctoral capstone project was to address ongoing accessibility barriers experienced by adults with disabilities, particularly those in caregiving roles, in public parks and playgrounds in the greater San Diego region. Although many parks meet the minimum requirements of the Americans with Disabilities Act (1990), research shows that caregivers with disabilities continue to encounter obstacles that limit safe, meaningful participation in community spaces (Dalpra, 2022; Fernelius, 2017; Firkin et al., 2024; Movahed et al., 2023; Ogletree et al., 2020; Prellwitz & Skar, 2007). These persistent gaps indicate a need for stronger advocacy and clearer public awareness of …

Grounded In Experience: A Collaborative Approach To Resource Development For Adults With Ehlers-Danlos Syndrome, Morgan Kam

Doctoral Projects

Background: Ehlers-Danlos syndrome (EDS) is a complex connective tissue disorder that significantly affects daily occupations, participation, and quality of life, yet early support for individuals pursuing or newly receiving a diagnosis remains limited. Occupational therapy (OT) is uniquely positioned to address these challenges through interventions that promote self-management and functional engagement.

Purpose: This project aimed to develop an experience- and evidence-informed educational resource for individuals undergoing or newly receiving an EDS diagnosis, while increasing awareness of OT’s role in managing this chronic, multisystemic condition.

Methods: A mixed-methods approach integrated qualitative insights from interviews, online support groups, and practitioner feedback. A …

Family-Level Impacts Of Equine-Assisted Occupational Therapy For Children With Disabilities: An Exploratory Mixed-Methods Pilot Study, Emily Canigiula

Doctoral Projects

Equine-assisted occupational therapy (EAOT) has been shown to enhance functional, social, and quality-of-life outcomes for children with disabilities (McDaniel Peters & Wood, 2017; Prieto et al., 2022). While child-focused outcomes are well documented, significantly less is known about how EAOT participation may influence caregivers and the broader family unit, as existing research largely prioritizes individual outcomes over family experiences (Peters et al., 2017; Tan & Simmonds, 2018; Trzmiel et al., 2019; Xiao et al., 2023). Emerging qualitative studies suggest potential family-level impacts including family engagement, reduced parental stress, and enhanced feelings of pride, empowerment, and connection (Kalmback et al., 2020; …

Bridging Gaps With Occupational Therapy: The Unique Role Of Occupational Therapy In Women’S Day Shelters, Alex Sato

Doctoral Projects

Homelessness is a multifaceted, complex issue that we face as a society. Mainstream services provided to homeless or vulnerable populations tend to focus on housing and basic services. While these are essential and meaningful, literature suggests there is a lack in trauma and self-care support (Marzana et al., 2023; Milaney et al., 2020). Looking through an Occupational Therapy (OT) lens, there are a multitude of ways the profession can provide holistic care. Current OT service provision within this population most commonly focuses on obtaining and maintaining housing and addressing the survival occupations these individuals may be engaging in (Cunningham & …

Applying Occupational Empowerment Principles In A Life Skills Program For Unhoused Transitional-Aged Youth: Feasibility And Early Outcomes, Eriza Navarro

Doctoral Projects

The purpose of this occupational therapy doctoral capstone project was to address a gap in community-based services for unhoused transitional-aged youth (TAY) by promoting life skill acquisition and supporting participation in meaningful activities in order to enhance self-efficacy. This project aimed to design, implement, and evaluate a structured occupation-based life skills program that builds upon existing services at a local drop-in center. The program incorporated life skill education and activity-based, experiential interventions tailored to meet the needs and learning styles of the population. Methods included conducting a needs assessment, developing the program curriculum, and piloting the 6-week program consisting of …

Promoting Participation And Self-Efficacy Among Youth With Disabilities In Community-Based Vocational Education, Allison Hollender

Doctoral Projects

Occupational therapy, with its focus on participation, contextual adaptation, and strength-based practice, is uniquely suited to support the growth and inclusion of youth in transition (Angell et al., 2018; Cahill et al., 2020; Carroll et al., 2025). Research indicates that transitional-aged youth (TAY) with disabilities, ages 14-24, are less likely to graduate from high school, pursue postsecondary education, or live independently (BLS, 2024; Cheng & Shaewitz, 2022; Cook et al., 2015). These disparities are compounded by occupational deprivation, or limited opportunities for meaningful participation, which can negatively impact long-term self-efficacy and belonging (Arbesman & Logsdon, 2011; Cahill et al., 2020). …

From Silos To Synergies: How To Enhance Interdisciplinary Collaboration Among Graduate Students, Jennifer Jimenez

Doctoral Projects

Interprofessional education (IPE) is essential for preparing collaborative healthcare practitioners, yet opportunities at San José State University (SJSU) have been limited, inconsistent, and largely dependent on individual faculty initiative. This capstone project aimed to strengthen IPE at SJSU by assessing institutional capacity and developing feasible, sustainable strategies to enhance exposure and participation across health-related programs. Guided by the Person–Environment–Occupation–Performance (PEOP) model and adult learning theory, the project combined a needs assessment, literature review, and partnership with the Healthy Development Community Clinic (HDCC) to create an instructor implementation guide and student introductory modules for HDCC service-learning onboarding. An IRB-approved mixed-methods faculty …

A Guide To Falls In A Skilled Nursing Facility, Sarah Ghione

Doctoral Projects

Approximately one in four older adults experiences a fall each year in the United States (Centers for Disease Control and Prevention [CDC], 2024b; Kakara et al., 2023). Among those residing in nursing homes for either short-term rehabilitation or long-term care, the risk of falls is doubled (Acker & Janssen, 2017; Shao et al., 2023). The purpose of this doctoral capstone project was to develop an educational resource aimed at enhancing staff education and fall prevention efforts within a single nursing home, supporting the facility’s goal of reducing fall rates. Methods included a needs assessment, observational experiences, resource development, and the …

The Impact Of Social Participation Through Adaptive Sports On Quality Of Life In Individuals With Spinal Cord Injury, Mikayla Martin, Zeida Gutierrez

Spring 2025 OTD Capstone Symposium

This project researched and explored how socialization through adaptive sports in this case impacts the perception of quality of life among individuals who have sustained a spinal cord injury.

Multifaceted Life Skills Training And Job-Orientation Supports For Individuals In Vocational Rehabilitation Programming, Laura R. Mccray

Graduate Theses, Dissertations, and Problem Reports (ETD)

There is growing support for those with an intellectual or developmental disability (IDD) in the transition process and within the workplace, however, there are areas that need to be addressed to facilitate further inclusion and success in this domain. There are structured institutions within the community that extend support for those transitioning out of high school, focusing on aligning with life training and professional skills while promoting societal integration by delivering services directly and avoiding isolation within traditional service environments (Accardo & Whitman, 2011). Growing research highlights the necessity of providing resources that support individuals with intellectual and developmental disabilities …

The Quick Dash Reformed: Increasing The Holisticity And Occupational Nature Of Upper Extremity Therapeutic Evaluation, Lauren E. Garcia

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The QuickDASH is one of the most common upper extremity (UE) focused patient-reported outcome measures (PROMs) utilized within current practice. Despite its high utilization rate, there are still many concerns surrounding the QuickDASH, including its applicability to certain populations, difficulty with cross-cultural adaptation, and limited psychosocial evaluation. Purpose: The purpose of this study was to develop and implement a reformed version of the QuickDASH, the OT-DASH, that included modernized and occupation-focused language to achieve increased client applicability and yield more accurate comparisons between client perceptions of dysfunction and their true clinical presentations. Theoretical framework: The Person-Environment-Occupation-Performance model was utilized …

Physical Activity For Anxiety For Autistic People: A Systematic Review, Kathryn Riis, Brittany Samulski, Kristina A. Neely, Patricia Laverdure

Rehabilitation Sciences Faculty Publications

Clinical anxiety is a common comorbidity in autistic people. Due to the prevalence of anxiety in the autism population and the adverse effects it causes, there is a critical need to develop effective interventions which address anxiety symptoms for autistic people. Therefore, the purpose of this systematic review was to examine the effectiveness of the use of physical activity as an intervention to reduce anxiety in autistic people. Three databases PubMed, PsychInfo, and Cochrane RCTs, were searched utilizing key terms. PRISMA systematic search procedures identified 44 studies meeting predetermined inclusion criteria. Participant characteristics, the type of physical activity performed, the …

Newly Credentialed Athletic Trainers' Onboarding Process During The Transition To Practice, Ashley B. Thrasher, Stacy E. Walker, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: As new athletic trainers (ATs) transition into their roles, some employers provide orientation and onboarding to assist with the transition to practice. Research in which authors outline the ideal onboarding process for new ATs transitioning to practice is lacking.

Objective: To examine the onboarding process for new ATs.

Design: Grounded theory.

Setting: College or university, secondary school, and hospital or clinic.

Patients or other participants: Seventeen newly credentialed, employed ATs who recently graduated from professional masters' programs (11 female, 6 male; 25.6 ± 2.2 years) and 12 employers (6 female, 6 male; years in role supervising new ATs: 8.5 …

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

Case Report: Multifactorial Intervention For Safe Aging In Place, Ashwini Kulkarni

Rehabilitation Sciences Faculty Publications

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the …

The Landscape Of Virtual Reality Use In Mobility Rehabilitation From 2010-2023: A Scoping Review, Danielle T. Felsberg, Reza Pousti, Charlend K. Howard, Scott E. Ross, Louisa D. Raisbeck, Jared T. Mcguirt, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Significant advancements in virtual reality (VR) technology have occurred in the past decade, allowing clinical researchers to take advantage of these reduced barriers to explore the use of VR in patient populations. This scoping review on VR interventions to improve mobility in adults and children focuses on the literature from 2010-2023. A total of 2736 articles were screened and 126 articles met the inclusion criteria. Most of the studies were conducted in inpatient clinical settings (n = 41) and investigated VR interventions to improve balance (n = 118). Less immersive (n = 108) products such as Nintendo Wii or Xbox …

Comparing Immersive And Nonimmersive Clinical Experiences In Athletic Training Education: Effects On Student Engagement And Confidence, Julie M. Cavallario, Shana Pribesh, S. E. Walker

Rehabilitation Sciences Faculty Publications

Context

With the shift to a graduate-level professional degree in athletic training, it was hypothesized that immersive clinical experiences (ICEs) would be more effectively integrated into curricula than non-ICEs (N-ICEs) and better prepare students for practice.

Objective

To longitudinally compare clinical engagement opportunities in ICEs versus N-ICEs and assess if these opportunities are associated with changes in student confidence in performing related tasks.

Design

Prospective, longitudinal, time-diary study using a Web-based survey. Patients or Other Participants: Fifty-three first-year, master’s-level athletic training students from 21 programs.

Main Outcome Measure(s)

Participants reported their type of clinical experience (ICE, N-ICE, or none), the …

How Many Trials Are Needed For Consistent Clinical Gait Assessment?, Charlend K. Howard, Christopher K. Rhea, Jacquelyn R. Moxey, Kyle Langerhans, Paphawee Prupetkaew, Brittany S. Samulski

Rehabilitation Sciences Faculty Publications

Background: Clinical assessment of gait typically consists of patients walking a few trials at various speeds while the clinician assesses performance. Unfortunately, there is no clear guidance on how gait changes across trials, leaving clinicians uncertain about the optimal number of trials needed to observe consistent (non-variable) performance. To address this issue, we examined gait performance from a large dataset of older adults who participated in a community-based comprehensive fall risk assessment. Methods: Community-dwelling, older adults (n = 340; 70.8 ± 7.4 years; 120 men, 220 women) performed gait trials under two conditions: preferred and maximum walking speed. …

Emergency Action Plan Adoption Across Athletic Training Practice Settings, Samantha E. Scarneo-Miller, Rebecca L. Stearns, Christianne M. Eason, Alicia M. Pike Lacy, Rebecca M. Lopez, Zachary K. Winkelmann, Rebecca M. Hirschhorn, Susan W. Yeargin

Rehabilitation Sciences Faculty Publications

Context:

The 2024 NATA Position Statement provides updated recommendations for EAP adoption. Past research on the 2002 statement showed limited adoption by ATs. Assessing current adoption across practice settings offers a clearer picture of the EAP implementation landscape.

Objectives:

To examine ATs' adoption of new EAP best-practice recommendations across practice settings.

Design:

Cross-Sectional study.

Setting:

Online questionnaire.

Patients or Other Participants:

Clinically active ATs (n=614) working in any practice setting (Youth, Secondary School, Division 1 Power 4, Collegiate athletics – Not Power 4, Non-Major Professional Sports, Professional Sports, Non-Sideline).

Main Outcome Measures:

Prevalence of an EAP, adoption of recommendations, and …

The Impact Of Onboarding During Transition To Practice For Newly Credentialed Athletic Trainers, Ashley B. Thrasher, Stacy E. Walker, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context

As new athletic trainers (ATs) transition into their roles, some employers provide extensive orientation and onboarding to assist with the transition to practice (TTP); however, onboarding practices are inconsistent. Understanding how onboarding affects TTP can help employers implement impactful onboarding tactics.

Objective

Examine how the onboarding experience impacted the TTP and the effects of the process on individuals.

Design

Grounded theory.

Setting

Secondary school, hospital/clinic, college/university.

Patients or Other Participants

Seventeen newly credentialed, employed ATs who had graduated from professional masters' programs (11 female, 6 male; age = 25.6 ± 2.2 years) participated in this grounded theory study.

Data …

Understanding Injury-Related Fear In Individuals With Chronic Ankle Instability: A Qualitative Approach, Ashley M. B. Suttmiller, Julie M. Cavallario, Shelby E. Baez, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Context

The Tampa Scale of Kinesiophobia (TSK-11) is used to identify injury-related fear (IR-Fear) in individuals with chronic ankle instability (CAI) and is a predictor of poor health outcomes. Limited knowledge beyond quantitative scores necessitates a deeper, qualitative understanding of IR-Fear to reduce the burden of fear within CAI patients.

Objective

To explore the perceptions and experiences that influence IR-Fear within the CAI population.

Design

Consensual qualitative research.

Setting

Individual semistructured video conference interviews.

Patients or Other Participants

Nine participants with CAI were selected as a follow-up from a web-based questionnaire investigating the fear-avoidance model. Potential participants were contacted based …

Eccentric-Emphasis Exercise Program For Supraspinatus Partial Tear In Retired Police Officer An Intervention Case Report, German Eduardo Isea Fernandezx

Capstone Showcase

Abstract

Background and Purpose: Eccentric exercise has been shown to reduce pain in patients with multiple comorbidities, orthopedic surgeries, and neurologic conditions, while providing safety for greater loading during resistance training. The purpose of this case report is to describe changes in function and pain of a patient with a partial rotator cuff tear, following rehabilitation exercises focusing on eccentric action.

Case Description: A 65 y/o retired police male officer who presented right shoulder pain secondary to a partial tear of the supraspinatus tendon. The case reported mild to severe pain under the visual analog scale (VAS) of 75mm that …

Functional Recovery Of A Patient In Her Home Environment Following A Stroke Using Proprioceptive Neuromuscular Facilitation And Task-Specific Training: A Case Report, Andrea L. Crawford-Perry

Capstone Showcase

Abstract Background and Purpose: Stroke is a growingly common disability that affects an individual’s bodily function, activity and participation levels and thus impacts the whole livelihood of that individual. Proprioceptive Neuromuscular Facilitation (PNF) and Task-specific Training have been shown to improve the overall functional recovery of a patient and affect neuroplasticity. Most studies tend to compare the individual effect of these techniques; hence the purpose of this case report is to describe how both PNF and task-specific training are used to improve the functional recovery of a patient in her home environment following an acute stroke. Case Description: The patient …

Effects Of Tecar Therapy With Conventional Physical Therapy In Patient With Knee Osteoarthritis (Oa): A Case Report, Mitzi Joy O. Fernandez

Capstone Showcase

Background and Purpose: Transfer energy capacitive and resistive (TECAR) therapy is a relatively new form of technology used as an adjunct for the rehabilitation of musculoskeletal conditions. Several studies have found its beneficial effects in reducing pain and improving quality of life in numerous orthopedic conditions. Knee osteoarthritis (OA) is one of the most common causes of global disability and pain, with accompanying complaints of morning stiffness, limitation of motion, knee buckling, swelling and inflammation, muscle weakness, functional limitations, and bony enlargement that affects the activities of daily living, occupation, and leisure activities. The purpose of this case report is …

Evaluation And Treatment Of Baseball Pitchers: There’S More To Assess Than The Arm, Matthew L. Gauthier, Casey A. Unverzagt, George J. Davies

Physical Therapy Faculty Publications

Injuries are commonplace in the overhead athlete, with many occurring to the shoulder and elbow. The increasing prevalence of injuries to the shoulder and elbow has been discussed at length in recent years, with increased research focus being placed on arm care for rehabilitation and prevention strategies. Even though the pitching motion is well-established as a whole-body kinetic chain movement, most attention in rehabilitation and prevention efforts is often placed on the upper extremity. The purpose of this clinical commentary is to highlight the impact the lower extremity and trunk have on the upper extremity during the throwing motion, better …

Indirect Calorimetry: The Effects Of Overfeeding And Underfeeding Mechanically Ventilated Patients, Hailee Schirm

Williams Honors College, Honors Research Projects

This research focuses on the effects of overfeeding and underfeeding mechanically ventilated patients in the ICU and how indirect calorimetry plays a role in improving patient outcomes. Research was pulled from eight peer reviewed sources written within the last ten years to support this statement. It includes multiple types of studies including but not limited to a retrospective cohort study, meta-analysis, review, and deterministic cost-sequences analysis. Indirect calorimetry measures carbon dioxide production and oxygen consumption to calculate energy expenditure and determine the number of calories needed to sustain one’s body. This allows us to determine the number of calories a …

Perceived Shoulder Discomfort In Adolescent Swimmers, Abigail Daniel

Williams Honors College, Honors Research Projects

Competitive swimming is a sport that athletes traditionally start at a young age, training for many years to build up an aerobic base, learn the best techniques of the sport, and gain experience racing. While this increases the ability to perform and adapt to training in the sport, it also can lead to shoulder tightness, soreness, and even injury. PURPOSE: To investigate any correlation between the perceived shoulder discomfort of adolescents to flexion and extension measurements. METHODS: Participants (N=25) were recruited in person from a swimming club. Swimmers were between 13-18 years old and varied in participation level from recreational …

Effects Of Exercise On Cognitive Performance, Autumn Bailey

Williams Honors College, Honors Research Projects

This research project “Effects of Exercise on Cognitive Performance” will be conducted with the purpose of determining the relationship between exercise and cognitive performance. The relationship between injury and cognitive performance will also be investigated. In order to investigate these relationships 60 participants who are current students at the University of Akron will be asked to complete three cognitive assessments, one while at rest, one while riding an exercise bike, and one following the completion of exercise. The results of these three assessments will be compared to determine the relationship between cognitive performance in all three states. Participants will include …

Organizational And Structural Factors In Building The Therapeutic Alliance In A Work Rehabilitation Program With Injured Immigrant Workers In Quebec, Daniel Côté, Maude Arsenault, Jessica Dubé

Études primaires

Abstract

The therapeutic alliance is central to occupational rehabilitation, particularly for immigrant workers who face unique challenges of migration and of social and occupational integration. This study explores the development and maintenance of this alliance between immigrant workers with compensated work injuries and their care providers during work rehabilitation. Using ethnography, semi-structured interviews, and focus groups, the qualitative case study involved 7 injured immigrant workers and their interdisciplinary clinical team. The study identified several factors that weakened the alliance, including administrative complexity, conflicting views on pain and disability, cultural stereotypes, and interorganizational communication issues. Many of these challenges were systemic …

Interventions To Improve Community Mobility In Autistic People: A Systematized Review, Sydney Maddox, Jada Ford, Heather Olson, Danielle Westmark, Stacy Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

Importance: Community mobility (CM) enables access to locations outside the home, allowing participation in work, leisure, and social environments. Autistic adults have reported less access to public transportation and driving than the general population (Wilson et al., 2021), impacting their community participation, life satisfaction, and likelihood of employment and further education (Egilson et al., 2016, Song et al., 2022, Wilson et al., 2021). Occupational therapists can support autistic people by providing interventions to increase CM.

Objective: To evaluate the effectiveness of interventions to improve CM in autistic people.

Methods: We collaborated with a medical librarian to conduct a systematic review …