Digital Commons Network^™

An Overview Of Systematic Reviews Investigating Clinical Features For Diagnosing Neck Pain And Its Associated Disorders, Ryan C. Mcconnell

Funded Scholarship

Background: Neck pain is a common condition that is often difficult to diagnose. Previous literature has investigated diagnostic accuracy of examination measures, but the strength and clinical applicability are limited. This overview of systematic reviews aimed to investigate clinical features for diagnosing neck pain and its associated disorders.

Methods: An overview of systematic reviews was conducted searching four electronic databases for systematic reviews evaluating diagnostic criteria for neck pain. Quality and risk of bias were assessed using the AMSTAR 2 and ROBIS. Clinical features for neck pain were investigated for diagnostic utility.

Results: Twenty-seven systematic reviews were included. Hand radiculopathy …

Completeness Of Dry Needling Intervention Reporting In Musculoskeletal Conditions Using The Standards For Reporting Interventions In Clinical Trials Of Acupuncture And Template For Intervention Description And Replication Checklists: A Systematic Review, Ryan C. Mcconnell

Funded Scholarship

OBJECTIVE: The purpose of this study was to determine the completeness of reporting of dry needling (DN) as a primary intervention, using the Template for Intervention Description and Replication (TIDieR) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklists.

DESIGN: This study is a systematic review of methodological reporting.

LITERATURE SEARCH: Electronic databases (Ovid MEDLINE ALL, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register for Controlled Trials, Embase, and SPORTDiscus) were searched from inception to April 2024.

STUDY SELECTION CRITERIA: Clinical trials addressing the effects of DN on pain, function, and/or musculoskeletal impairments in …

Navigating The Layers Of Concern For Safe Dry Needling Of The Rectus Abdominis: A Cadaveric Study, Ryan C. Mcconnell, Christi L. Williams

Funded Scholarship

Objectives: To assess needle placement accuracy in the rectus abdominis (RA) muscle during dry needling (DN) without entering the peritoneum.

Methods: Two physical therapists performed DN on a cadaver, making 10 attempts each to needle the RA without entering the peritoneum. Techniques followed two common DN approaches. Ultrasound verified needle depth and safety.

Results: Seventy percent of attempts were recorded as safe needle placement, while 30% were unsafe. Accurate RA needle placement without peritoneal entry occurred in 55% of attempts.

Discussion/Conclusion: Inadvertent peritoneal needle placement during RA DN poses risks regardless of experience. Ultrasound guidance may enhance safety and precision …

Addressing Sexual Health Concerns Across Settings, Abigail Jeske

Graduate Student Scholarship

Sexuality can affect many areas of people’s lives; not addressing it in therapy is a disservice to patients. There is a clear need for occupational therapy intervention in this domain, and it is well within occupational therapy’s scope of practice. Yet, many occupational therapy practitioners (OTPs) exclude addressing sexuality and sexual health in everyday practice. This study aimed to understand better the reasons for not addressing this topic with patients. The mixed methods approach consisted of an online questionnaire and semi-structured interviews. Respondents were OTPs currently practicing in various practice settings. The questionnaire was completed by 31 OTPs and the …

Exploration Of Educator Training Requirements And Curriculum Standards And How These Could Impact The Development Of Children Aged 3 – 4 Years In Daycare Centers: A Qualitative Study, Katie Conley, Melissa Learish, Ayric Fetty

Graduate Student Scholarship

Daycare teachers, in general, are responsible for the support and education of children as they develop skills and achieve milestones. This study aimed to investigate what training and education related to developmental delays are provided to daycare teachers, the actions taken by teachers or directors to identify developmental delays, and how daycare curricula are developed and personalized for individual needs. Researchers conducted semi-structured interviews with daycare teachers who taught three and four-year-olds as well as site directors at three different facilities in Morgantown, West Virginia. Responses were transcribed and coded into six themes. Results indicate teachers have limited training and …

Visit North Carolina: Trail Accessibility, Hannah Caitlyn Guschel

Graduate Theses, Dissertations, and Problem Reports (ETD)

This paper focuses on the perceived barriers to travel from marketing material for individuals with disabilities compared to those without disabilities and the direct impact on leisurely travel participation, particularly in outdoor spaces. Employing a cross-sectional study design encompassing both quantitative and qualitative data collection methods, this research investigates the experiences and transparency of trail accessibility in the state of North Carolina. Quantitative data were gathered through trail assessment accessibility checklists, while qualitative insights were obtained via in-depth interviews. The findings reveal an improved understanding of accessibility and the application of an accessibility checklist. Moreover, the study underscores the importance …

Exploring Factors That Influence Prosthetic Attention In Upper And Lower Limb Prosthesis Users, Tanu Bhargava, Cody L. Mcdonald, Elizabeth G. Halsne, Brian J. Hafner, Benjamin J. Darter

Graduate Research Posters

Background: Prosthetic limbs often lack the innate control and sensory feedback capabilities of natural limbs, requiring more cognitive effort or attention during motor tasks. While a conceptual model of prosthetic attention exists for lower limb (LL) users, its applicability to upper limb (UL) remains unclear. This study aimed to explore how LL and UL users experience prosthetic attention, and explore factors that influence the existing model.

Methods: Twenty five UL users and thirty LL users with at or above wrist or ankle-level limb loss participated. Focus groups (FG), guided by open-ended questions, delved into user’s lived experiences with prosthetic attention. …

Proportional Sway-Based Electrotactile Feedback Improves Lateral Standing Balance, V S Raghav Hari Krishna, Jeonghee Kim, Shuo-Hsiu Chang, Yoonsuck Choe, Hangue Park

Faculty, Staff and Student Publications

INTRODUCTION: Plantar cutaneous augmentation is a promising approach in balance rehabilitation by enhancing motion-dependent sensory feedback. The effect of plantar cutaneous augmentation on balance has been mainly investigated in its passive form (e.g., textured insole) or on lower-limb amputees. In this study, we tested the effect of plantar cutaneous augmentation on balance in its active form (i.e., electrical stimulation) for individuals with intact limbs.

METHODS: Ten healthy subjects participated in the study and were instructed to maintain their balance as long as possible on the balance board, with or without electrotactile feedback evoked on the medial side of the heel, …

Ergonomics Of Various Modalities For Ear Surgery, Matthew E Lin, Sheng Zhou, Seiji Kakeheta, Tsukasa Ito, Seiji B Shibata

Faculty, Staff and Student Publications

OBJECTIVE: Evaluate ergonomic differences of various modalities for performing middle ear surgery.

STUDY DESIGN: Observational study.

SETTING: Two academic tertiary care centers.

METHODS: Attending physicians and residents performing middle ear surgery were photographed intraoperatively. Intraoperative photographs were analyzed using the validated Rapid Upper Limb Assessment (RULA) tool to measure musculoskeletal disease (MSD) risk. Descriptive statistics and significance testing were used to characterize and compare ergonomic differences between surgical modalities. Multivariable ordinal regression was performed to assess factors associated with increased MSD risk, as determined by the final RULA score.

RESULTS: Most of our 110 intraoperative photos featured attendings (82.7%) performing …

High Doses Of Caffeine-Induced Cerebral Infarction Leading To Partial Locked-In Syndrome In A Young Adult: A Novel Association?, Vijay Sinha, Loc Lam, Michael V Nguyen

Faculty, Staff and Student Publications

INTRODUCTION: This is a case of a 30-year-old male with no prior medical conditions presented to the emergency department for presumed seizures after ingesting 900 mg of caffeine via pre-workout drinks and pills.

CASE PRESENTATION: The patient was described as having nearly 15 min of generalized seizure activity observed by emergency medical service, requiring midazolam. A head computerized tomography (CT) demonstrated a possible thrombus, and further, CT angiography and CT perfusion confirmed a basilar artery occlusion. He was treated with tissue plasminogen activator and underwent thrombectomy achieving TICI grade 3 in the left posterior cerebral artery and TICI grade 2b …

How Can We Treat If We Do Not Measure: A Systematic Review Of Neurogenic Bowel Objective Measures, Argy Stampas, Amisha Patel, Komal Luthra, Madeline Dicks, Radha Korupolu, Leila Neshatian, George Triadafilopoulos

Faculty, Staff and Student Publications

Background: Guidelines fail to recommend objective measures to assist with treatment of neurogenic bowel dysfunction (NBD) in spinal cord injury (SCI).

Objectives: The main objective was to review the literature to identify the objective measures used in all NBD populations and to present their results and any correlations performed to validated subjective measures.

Methods: A systematic review of the literature was performed in accordance with PRISMA (2020) guidelines, including all records from January 2012 to May 2023 with MeSH terms like "neurogenic bowel" indexed in the following databases: PubMed, EMBASE, CINAHL, Cochrane Central Trials Register, and ClinicalTrials.gov. Abstracts were excluded …

Multimodal Therapy And Use Of Adjunctive Therapies To Bont-A In Spasticity Management: Defining Terminology To Help Enhance Spasticity Treatment, Rajiv Reebye, Luis Jorge Jacinto, Alexander Balbert, Bo Biering-Sørensen, Stefano Carda, Nathalie Draulans, Franco Molteni, Michael W O'Dell, Alessandro Picelli, Andrea Santamato, Monica Verduzco-Gutierrez, Heather Walker, Joerg Wissel, Gerard E Francisco

Faculty, Staff and Student Publications

Spasticity management should be provided within the context of a comprehensive person-centered rehabilitation program. Furthermore, active goal setting for specific spasticity interventions is also important, with a well-established "more is better" approach. It is critical to consider adjunctive therapy and multimodal approaches if patients are not attaining their treatment goals. Often used interchangeably, there may be confusion between the terms adjunctive and multimodal therapy. Yet it is imperative to understand the differences between these approaches to achieve treatment goals in spasticity management. Addition of a secondary pharmacologic or non-pharmacologic treatment to optimize the efficacy of the initial modality, such as …

Safety And Feasibility Of Paired Vagus Nerve Stimulation With Rehabilitation For Improving Upper Extremity Function In People With Cervical Spinal Cord Injury: Study Protocol For A Pilot Randomized Controlled Trial, Nuray Yozbatiran, Gerard E Francisco, Radha Korupolu

Faculty, Staff and Student Publications

Introduction: Pairing vagus nerve stimulation with traditional rehabilitation therapies results in improved motor recovery in people with stroke. However, this approach has not yet been studied in people with spinal cord injury (SCI). Motor recovery continues to be challenging after SCI, and there is a need for innovative research strategies to enhance motor recovery after SCI. Hence, this pilot randomized controlled trial aims to evaluate the safety, feasibility, and potential efficacy of pairing vagus nerve stimulation (VNS) with rehabilitation therapy to restore the motor function of the paretic upper limbs in people with cervical SCI.

Methods and analysis: In this …

Motoneuron Persistent Inward Current Contribution To Increased Torque Responses To Wide-Pulse High-Frequency Neuromuscular Electrical Stimulation, Timothée Popesco, Lucas Bet Da Rosa Orssatto, François Hug, Anthony John Blazevich, Gabriel Siqueira Trajano, Nicolas Place

Research outputs 2022 to 2026

Purpose: To assess the effect of a remote handgrip contraction during wide-pulse high-frequency (WPHF) neuromuscular electrical stimulation (NMES) on the magnitude of extra torque, progressive increase in torque during stimulation, and estimates of the persistent inward current (PIC) contribution to motoneuron firing in the plantar flexors. Methods: Ten participants performed triangular shaped contractions to 20% of maximal plantar flexion torque before and after WPHF NMES with and without a handgrip contraction, and control conditions. Extra torque, the relative difference between the initial and final torque during stimulation, and sustained electromyographic (EMG) activity were assessed. High-density EMG was recorded during triangular …

The Delta Concept Does Not Effectively Normalise Exercise Responses To Exhaustive Interval Training, Arthur Henrique Bossi, Wouter Timmerman, Diana Cole, Louis Passfield, James Hopker

Research outputs 2022 to 2026

Objectives: This study was designed to quantify inter- and intra-individual variability in performance, physiological, and perceptual responses to high-intensity interval training prescribed using the percentage of delta (%Δ) method, in which the gas exchange threshold and maximal oxygen uptake (V̇O2max) are taken into account to normalise relative exercise intensity. Design: Repeated-measures, within-subjects design with mixed-effects modelling. Methods: Eighteen male and four female cyclists (age: 36 ± 12 years, height: 178 ± 10 cm, body mass: 75.2 ± 13.7 kg, V̇O2max: 51.6 ± 5.3 ml·kg−1·min−1) undertook an incremental test to exhaustion to determine the gas exchange threshold and V̇O2max as prescription …

Criteria And Indicators For Centers Of Clinical Excellence In Stroke Recovery And Rehabilitation: A Global Consensus Facilitated By Isrra, Rachel C. Stockley, Marion F. Walker, Margit A. Murphy, Noor A. A. Aziz, Philemon Amooba, Leonid Churliov, Amanda Farrin, Natalie A. Fini, Emma Ghaziani, Erin Godecke, Tania Gutierrez-Panchana, Jie Jia, Thoshenthri Kandasamy, Patrice Lindsay, John Solomon, Vincent Thijs, Tierney Tindall, Donna C. Tippett, Caroline Watkins, Elizabeth Lynch

Research outputs 2022 to 2026

Background: The aim of the International Stroke Recovery and Rehabilitation Alliance is to create a world where worldwide collaboration brings major breakthroughs for the millions of people living with stroke. A key pillar of this work is to define globally relevant criteria for centers that aspire to deliver excellent clinical rehabilitation and generate exceptional outcomes for patients. Objectives: This paper presents consensus work conducted with an international group of expert stroke recovery and rehabilitation researchers, clinicians, and people living with stroke to identify and define criteria and measurable indicators for Centers of Clinical Excellence (CoCE) in stroke recovery and rehabilitation. …

Quantifying Uptake And Completion Of Pulmonary Rehabilitation Programs In People With Chronic Obstructive Pulmonary Disease Known To Tertiary Care, Sarah Hug, Vinicius Cavalheri, Daniel F. Gucciardi, Kylie Hill

Research outputs 2022 to 2026

Background: People with symptomatic chronic obstructive pulmonary disease (COPD) benefit from pulmonary rehabilitation programs (PRPs), but program attrition is common. Methods: For people with COPD who presented to tertiary care and appeared appropriate for a PRP, we prospectively mapped their PRP journey, explored factors influencing attendance to pre-program assessment and captured program attrition. Results: Of the 391 participants, 31% (95% CI 27 to 36) were referred to a PRP (n = 123; age 68 ± 10years, 62 males [50%], FEV1 45 ± 19%predicted). Of those referred, 94 (76% [69 to 84]) attended a pre-program assessment. Ex-smokers and those who had …

Case-Based Ebm Instruction For Osteopathic Medical Students: A Case Report., Laura Lipke

Library Scholarship

Background: Evidence-based medicine (EBM) is an important part of graduate medical education and a learning outcome necessary for preparing students to become effective residents. However, many medical educators and librarians struggle to offer EBM instruction that is contextualized, relevant, and engaging. Case-based learning (CBL) can establish the relevance of EBM instruction sessions by using clinical scenarios that link theory to practice. Experience: This case report describes how a college of osteopathic medicine (COM) liaison librarian redesigned a large cohort, lecture-based learning approach to EBM instruction into interactive, relevant, and contextualized CBL labs. CBL labs with smaller student groups were designed …

Teaching Cultural Humility Practices In Appalachia: The Value Of Conducting Conversations Based In Education, Bailey A. Riggs

Graduate Theses, Dissertations, and Problem Reports (ETD)

Recent literature highlights the paradigm shift from utilizing cultural competence practices to cultural humility practices within the field of occupational therapy, and health sciences (Fisher- Borne, et al., 2015). The idea of cultural competency suggests that culture is unchanging, and individuals can master cultural knowledge. The perception of knowing culture can be perceived as an unwillingness to learn about culture. In contrast, cultural humility promotes the value of lifelong learning and introspection, encouraging greater self-awareness, reflection of personal biases, and recognition of power imbalances. This approach aims to better integrate educational approaches to serve diverse populations in a culturally affirming …

Developmentally Appropriate Care In The Neonatal Intensive Care Unit (Nicu), Ashten Cenkus

Graduate Theses, Dissertations, and Problem Reports (ETD)

As specialized healthcare professionals educated in developmental care, occupational therapy practitioners (OTPs) have a role in educating, coaching, and assessing the needs of infants, their families, and the staff in the NICU. These high-risk and medically fragile infants require specialized care that considers the incorporation of neurodevelopment, neurobehavioral regulation, sensory stimulation, and motor development through supportive and appropriate interventions. A project addressing these needs across 14 weeks was implemented as part of an Occupational Therapy Doctoral (OTD) capstone experience at WVU Medicine Children’s in Morgantown, West Virginia. This project examined the results of the NICU staff's confidence, knowledge, and awareness …

Development And Implementation Of Occupational Therapy Group Protocols For Individuals In Recovery For Substance Use Disorder: Considering Social Determinants Of Health And Occupational Areas Of Need, Samantha Jane Windisch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Substance use disorders (SUDs) are becoming a more widespread issue globally. According to the National Survey on Drug Use and Health, 19.7 million adults in the U.S. suffered from an SUD in 2017. (SAMSHA, 2018). Recurrent alcohol and/or drug use that results in significant disability, including health issues, and/or a failure to prioritize obligations like employment, school, or family life are characteristics of SUD (SAMHSA, 2022). Research suggests that healthcare providers must integrate cutting-edge and successful treatments for this population to lower the risk of overdose and relapse rates, given the swift global spread of addictive disorders. In the past, …

Usage Of Peer Mentoring Workbooks: Enhancing The Transition Of College Students With Intellectual And Developmental Disabilities, Taylor Nicole Grout

Graduate Theses, Dissertations, and Problem Reports (ETD)

This doctoral capstone project assesses the impact and effectiveness of using peer mentoring workbooks as a tool to enhance the transition of college students with intellectual and developmental disabilities. A peer mentoring workbook was developed using theoretical frameworks to guide its design and identification of primary occupations, roles, and routines of college students. From here, four domains of college student life (dorm living, college social life, classroom management and participation, and community engagement and transportation) were developed to act as a framework for the workbook. Through the usage of Participatory Action Research, key stakeholders provided essential feedback that allowed for …

Limb Speed Perception Accuracy In Neurodegenerative Disease, Brandmeir Lynn Cheryl

Graduate Theses, Dissertations, and Problem Reports (ETD)

Movement is a fundamental human activity, enabling us to engage with our surroundings. Consequently, a well-operating neuromuscular system is essential for maintaining quality of life. Motion is not only integral for the basic function of daily living, but also plays a significant role in enhancing our physical, mental, and emotional health. The importance of this system becomes abundantly clear when it is compromised, such as with neurodegenerative disease.

Alzheimer’s disease (AD), followed by Parkinson’s disease (PD) are the two most common neurodegenerative diseases that profoundly affect millions of individuals worldwide (Lamptey et al., 2022). Characterized by distinct but sometimes overlapping …

Effectiveness Of Peer Support Groups For Mothers At Risk For Postpartum Depression, Natalie Paige Gates

Graduate Theses, Dissertations, and Problem Reports (ETD)

Motherhood requires a role transition, new maternal responsibilities, and changes in everyday life, which can impact the mother’s mental health, possibly leading to postpartum depression. Postpartum depression can, in turn, create additional challenges for the mother in engaging in her daily routines and occupations. Therefore, a peer support group for mothers at risk for postpartum depression was developed in hopes of improving the mothers’ management of routines, ultimately improving maternal mental health. The effectiveness of the peer support group was measured through quantitative and qualitative online self-report surveys, where the mothers reported their current mental health status, self-efficacy, and occupational …

Advancing Opportunities For The Autistic Community At West Virginia University, Drew D. Altizer

Graduate Theses, Dissertations, and Problem Reports (ETD)

Students with Autism Spectrum Disorder often have difficulties with social integration and sensory challenges on collegiate campuses. These difficulties are sometimes tied together as social integration spaces are not always sensory-friendly and can be overwhelming for the individual. Creating a sensory-friendly space within the potentially overstimulating environment can provide the student with a place to recharge and recover and still access the desired social events. This capstone project focused on the design and development of a sensory room in the West Virginia University Mountain Lair Student Union, working directly with the students in the West Virginia University Autism Support Program …

The Impact Of Occupational Therapy In Lactation Services, Sarah Adrienne Mcaninch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Many benefits to breastfeeding exist for both mothers and infants, yet exclusive breastfeeding rates remain low across the nation. These benefits include decreased chance of infections for infants, low infant mortality, and decreased chances of breast and ovarian cancers for mothers (Binns et al., 2016; CDC, 2023). Education strategies have recently become imperative for health organizations to help mothers sustain their ability to breastfeed within the recommended six-month timeframe. Current literature on education supports that women who receive education at some point in their lactation journey are more likely to reach the six-month period and have more confidence in their …

The Effects Of External Load Type And Eccentric Tempo On Hamstring Electromygraphy During Unilateral And Bilateral Prone Hamstring Exercise, Toraya Hughes

College of Graduate Studies: Theses & Dissertations

Isotonic hamstring exercises are employed to mitigate the risk of a future hamstring strain and after strain, incorporated into return-to-play protocols. However, research has negated leg dominance's influence on muscle recruitment and exercise form. Therefore, the purpose of this study was to compare muscle recruitment between the dominant (DOM) and non-dominant (nonDOM) during prone hamstring exercise (PHSE) variations. METHODS: Twenty trained participants aged 18 – 33 (M = 23 years, SD = 3 years) completed familiarization and experimental protocols > 72 hours apart. Participants underwent four PHSE variations that differed by load type (barbell vs. dumbbell), exercise strategy (bilateral …

The Lumbar Stabilization Exercise And Balance Training In Low-Grade Degenerative Lumbar Spondylolisthesis - A Prospective, Clinical Trial, Yun-Chung Lin, Mei-Yun Liaw, Tsung-Hsun Yang, Ya-Ping Pong, Yan-Yuh Lee, Chien-Wei Chen, Song-Chung Chen, Yu-Chi Huang

Rehabilitation Practice and Science

BACKGROUND: Patients with degenerative lumbar spondylolisthesis (DLS) may have low back pain (LBP), radicular pain and spinal instability. Current programs emphasize intervention of spinal stabilization exercise. However, no prospective, randomized studies have elucidated standardized treatment for DLS.

OBJECTIVE: To examine the effect of spinal stabilization exercise and Biodex balance system (BBS) training in patients with DLS.

METHODS: It was a prospective, clinical trial. Participants were allocated into three groups: (1) DLS-balance group treated with balance training (DLSB), (2) DLS non-balance training group (DLSNB), and (3) lumbar spondylosis without spondylolisthesis (SC). ALL patients underwent a rehabilitation program with lumbar stabilization exercises. …

A Case Report: Regenerative And Robotic Rehabilitation In A Patient With Chronic Hypoxic-Ischemic Encephalopathy, Chieh Chen, Sun-Hui Tseng

Rehabilitation Practice and Science

Hypoxic-ischemic encephalopathy (HIE) occurs when the brain is deprived of sufficient oxygen or blood flow, resulting in brain dysfunction. According to the relevant literature, no curative therapies are currently available for HIE-related lifelong disabilities. Regenerative rehabilitation employs regenerative technologies and cell therapy combined with conventional therapeutic exercises to restore normal function. This study used robotic-assisted gait training with the Lokomat and two infusions of human umbilical cord mesenchymal stem cells (hUC-MSCs) to treat an adolescent with chronic HIE. At the seven-month follow-up assessment, we determined that the patient’s motor function had improved based on the Gross Motor Function Measure-88 (GMFM-88) …

Severe Preeclampsia With Heart Failure: A Cardiac Rehabilitation Case Report, Han Yang, Yi-Ching Lai, Chien-Chu Huang, Nai-Hsin Meng

Rehabilitation Practice and Science

This study presents a case of a 37-year-old woman who developed severe preeclampsia with heart failure at the 36th week of her first pregnancy, with a left ventricular ejection fraction of 25%. After delivering her twin babies via emergency Cesarian section, she was successfully weaned off mechanical ventilation and discharged in two weeks. We prescribed cardiac rehabilitation and assessed her functional recovery using cardiopulmonary exercise testing. During the 8 months after the delivery, we observed improvements in the left ventricular ejection fraction, peak oxygen uptake, anaerobic threshold, and oxygen uptake efficiency slope although improvement in oxygen pulse was limited. Our …