Medicine and Health Sciences Commons^™

Upper Extremity Kinematic And Kinetic Comparison Of Anterior Versus Posterior Walkers During Functional Activities In Children With Cerebral Palsy, Chris Burckardt

Theses and Dissertations

Introduction: Investigating the differences in upper extremity (UE) joint biomechanics between anterior and posterior walkers has been explored in limited contexts, even though research has shown that prolonged use of walking aids can lead to UE joint weakening or musculoskeletal injuries. Recent studies have investigated some of these differences in children with spastic diplegic cerebral palsy (CP) during gait; however, no research has been conducted that compare these UE joint biomechanical differences during functional activities or activities of daily living (ADLs). The aim of this study is to use motion analysis to compare kinematic and kinetic differences between anterior and …

Determining Accessibility For Ios Applications: Piloting A Checklist For Practitioners, Katelyn White

Theses and Dissertations

Background: Mobile technologies have infiltrated every part of daily life, including the school system. While these technologies are highly customizable, there are 6.4 million children with disabilities who may not be able to utilize these devices because of their lack of accessibility. The iOS Application Accessibility Checklist (iA2C) is a “first of its kind” tool, used to determine if an iOS app is accessible for users with a variety of disabilities.

Hypothesis: When using the iA2C, novice users with little experience in accessible design will determine apps to have a statistically similar number of accessibility features as experts, assessing the …

Improving Mental Health Literacy: A Single-Subject Design Experiment Examining The Effects Of Text Messaging On Adolescent Mental Health Literacy, Emma Coffman

Theses and Dissertations

The purpose of the study is to determine the feasibility of delivering a text-based mental health literacy intervention for adolescent children who have family members with mental illness. The effectiveness of the text message intervention was measured using a single subject, multiple baseline study design. Each participant received three text messages per week for a total of 6 weeks, containing information regarding mental illness, managing crisis, resources, stigma, and assertiveness. The subjects were evaluated using qualitative and quantitative measures at multiple periods throughout the study. Assessments utilized include: Schizophrenia Vignette quiz developed by Jorm et. al. (1997), Perceived Stress Scale-14(PSS-14) …

Development And Testing Of An Occupational Therapy Intervention To Promote Medication Adherence, Jaclyn K. Schwartz

Theses and Dissertations

Many persons with chronic health conditions fail to take their medications as prescribed, resulting in declines in health and function. Unfortunately, current interventions for medication nonadherence are not very effective. Medication adherence is a daily activity, which many occupational therapists believe would be responsive to occupational therapy intervention. Unfortunately, few resources support occupational therapists in this role. The purpose of this dissertation is to create the foundational work for occupational therapy medication adherence interventions. In this dissertation, I accomplish five objectives. First, I identify the role of occupational therapy practitioners in the medication adherence field. Second, I create a manualized …

Growing Up In Ireland: Factors Impacting Sleep Patterns Of Preterm Infants, Joanne Fallon

Theses and Dissertations

GROWING UP IN IRELAND: FACTORS IMPACTING SLEEP PATTERNS OF PRETERM INFANTS

By Joanne Fallon MS, OT, PhD

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2015.

Major Director: Shelly J. Lane, PhD, Professor, Department of Occupational Therapy

Preterm infants represent the largest child patient group in the European Union (EU), accounting for 5.5-11.4% of all births (European Foundation for the Care of Newborn Infants, 2011b). Preterm birth is defined as birth prior to 37 weeks gestation. Infants born late preterm (34-36 weeks) are considered more …

Relieving Post-Stroke Fatigue Using A Group-Based Educational Training Approach, Catherine E. Emery

Theses and Dissertations

Post-stroke fatigue is a common problem that may limit participation in everyday activities. Emerging evidence suggests that group-based training in fatigue management may be an efficient means of reducing the effects of post-stroke fatigue. This mixed methods, quasi-experimental study proposed to determine whether a group-based educational program could be successful in relieving post-stroke fatigue and improving participation in daily activities. A convenience sample of stroke survivors (n=20) from retirement communities in southeastern PA were invited to participate in the research. Participants were screened for depression, motor and cognitive recovery, and sleep quality. Fatigue was measured using the Fatigue Severity Scale …

Workplace Discrimination And Visual Impairment: An Analysis Of Eeoc Charges And Resolutions, Jane Mcneil

Theses and Dissertations

Workplace discrimination for individuals with visual impairments in the U.S. is an ongoing issue dating before the founding of the EEOC and the enactment of the ADA. Despite laws enacted to protect against unequal treatment in the workplace, the EEOC continues to receive submissions of formal discrimination charges from individuals with visual impairments.

The workplace is experiencing changes with increasing amounts of older adults, women, minorities, and the use of technology and the Internet. By examining characteristics of the discrimination charges and the resulting outcomes, the knowledge gained can describe the current situation and the historical progression of workplace discrimination …

Individuals With Fetal Alcohol Spectrum Disorder: Predictive Factors For Successful Occupational Performance, Mary Culshaw

Theses and Dissertations

As awareness and diagnoses of FASD grow in Canada, there is increased need to support these individuals across their lifespan. One study suggested the prevalence of FASD may be as high as 10 per 1000 births (May & Gossage, 2001). The impact to society is growing as well, since this population requires support across their lifespan due to cognitive and sometimes physical impairments. It was estimated that the annual cost to Canadians was $53 billion (in 2007 dollar value) to support individuals aged 0-53 years (Stade et al., 2009). There is mounting evidence identifying the cognitive and physical impairments that …

Biomechanical Joint Demands And Functional Outcomes During Manual Wheelchair Use In Pediatric Patients With Spinal Cord Injury, Christine M. Aurit

Theses and Dissertations

The biomechanical demands of the upper extremities (UEs) during pediatric manual wheelchair (MWC) use have not been fully explored. Children who use MWCs for mobility engage in a range of functional activities that may place large biomechanical demands on the UEs leading to a high risk on overuse injuries. This study aims to analyze the kinematics and kinetics of pediatric manual wheelchair use during propulsion, starting, stopping and weight relief tasks. Fourteen pediatric patients with spinal cord injury were recruited and data were collected using a 14-camera Vicon MX motion analysis system (Oxford Metric Group, Oxford, UK) and a SmartWheel …

Effect Of Accessibility Information On Restaurant Selection Of Consumers With Disabilities, Rachael Nicole Baumann

Theses and Dissertations

OBJECTIVE: The study addressed the research question, "How does accessibility information about restaurants affect the diversity of restaurant choices for people with disabilities compared to others who only have general review information about restaurants?" The literature describes that people with disabilities experience limited participation in community activities. One community activity is dining out at restaurants. It is hypothesized that the availability of accessibility information will diversify restaurant choices, as it would minimize the risk of encountering unforeseen barriers that enable them to prepare for ones that they anticipate.

METHOD: Participants (N-14), half with disabilities and half without disabilities, selected dining …

Two Single-Subject Experiments Of An Ipad Protocol When Training Special Education Professionals In Video Modeling, Alyssa Schmitz

Theses and Dissertations

Objective: This research was conducted to determine if an iPad training protocol using a teach-back strategy can feasibly be used in an educational setting and to determine if measures of use and technology perception are appropriate outcome measures. The studies were carried out in Wauwatosa, Wisconsin school district and involved two elementary level special education teachers. Utilizing single-subject methodology, two studies were carried out, including one study in which a subject received iPad training protocols and completed them independently and one study in which another subject received the same iPad training protocols combined with a teach-back strategy. The teach-back strategy …

Factors Associated With College Students' Excessive Alcohol Consumption Within The Occupational Therapy Practice Framework: An Epidemiological Analysis, Beom-Young Cho

Theses and Dissertations

OBJECTIVE: The purpose of this study was to estimate the relative influence of predictor variables on excessive alcohol consumption among college students for providing effective prevention and intervention. Also, this study suggests the roles of occupational therapy in Health promotion and Well-being. METHOD: The data from 7,166 college students (3,176 males, 3,990 females) aged between 18 - 25 years from the 2012 National Survey on Drug Use and Health (NSDUH) conducted by the US Department of Health and Human Services was used. Two criterion variables, binge drinking and heavy drinking, were used as indicators of excessive alcohol consumption. There were …

Examining The Effects Of Human-Animal Interaction On Individuals With Developmental Disabilities, Jennie Feinstein

Theses and Dissertations

Companion animals play a pivotal role in typical human development. It remains unknown how animals affect individuals with developmental disabilities. Based on the knowledge that companion animals help typically developing individuals, this research examined the effects of human-animal interactions on individuals with developmental disabilities.

Human-animal interactions are based on the Biophilia hypothesis, an assertion that an emotional and beneficial relationship exists between humans and nature, in which there is an “innate tendency to focus on life and lifelike processes.” These are the shared, dynamic associations between people and animals, and the effects of those relationships on health and well-being. Sparse …

Examining The Sensory Characteristics Of Preschool Children With Retentive Fecal Incontinence, Isabelle Beaudry-Bellefeuille

Theses and Dissertations

Occupational therapists are concerned with individuals´ abilities to engage in daily occupations. When a daily activity such as bowel management is problematic, participation in key occupations can be limited. Retentive fecal incontinence is a common disorder in children. Behavior seems to be partly responsible for this condition. Occupational therapists have hypothesized that some behaviors could be related to sensory over-responsivity. This study investigated the relationship between retentive fecal incontinence and sensory over-responsivity and examined the Toileting Habit Profile Questionnaire, a tool designed to screen for toileting difficulties. The study showed that a group of children (n=16) with retentive fecal incontinence …

Potential Benefits And Withdrawal Effects Of Cranial Nerve Non-Invasive Neuromodulation On Functional Mobility For Individuals With Traumatic Brain Injury, Kati P. Liegl

Theses and Dissertations

Objective: Document and describe benefits and withdrawal effects of the Cranial Nerve Non-Invasive Neuromodulation (CN-NINM) intervention.

Background: Neuromodulation techniques can be used for the treatment of many diagnoses and conditions. Many current neuromodulation techniques have or can have negative consequences such as high cost, risk of surgical complications or infections, effects not lasting without the drug or stimulation presence, and need for medical experts' direct oversight. A new rehabilitation intervention called CN-NINM may eliminate these negative factors, making it a promising tool for clinicians and participants. CN-NINM combines targeted training activities with mild, portable, electrical stimulation of the tongue to …

Feasibility And Preliminary Outcomes From A Pilot Study Of The Smile Curriculum For Mother-Infant Co-Occupational Engagement And Maternal Self-Efficacy, Emily Whitlock

Theses and Dissertations

OBJECTIVE: To report on the feasibility and preliminary outcomes from a pilot study of the SMILE curriculum, a new educational program designed to enhance the mother-infant relationship by focusing on improvement of co-occupational engagement within daily routines.

METHOD: Six mothers, each with an infant diagnosed with special medical needs who received services in a local birth-to-three program, participated in an exploratory design study. Each mother was assigned to a SMILE curriculum intervention group or a waiting-list control group. Mothers were evaluated pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP-SE) Scale for measurement of maternal self-efficacy and the Center …

Measuring Outcomes Of Rehabilitation Among Persons With Upper Extremity Traumatic Injuries, Jamie Carl Grede

Theses and Dissertations

Grip strength is frequently measured to determine outcomes of rehabilitation among people with upper extremity traumatic injuries (UETIs). UETIs also affect rate of force-production during an isometric grip. However, we do not have a reliable and valid measure for detecting these force changes. The purpose of this study was to determine the validity and responsiveness, i.e. ability to detect change, of the Force-Time Curve (F-T Curve) to determine rate of force production. Twenty people with UETIs undergoing rehabilitation were recruited to participate in this study. Using an electronic Jamar dynamometer, each participant performed three maximal isometric grips, each lasting 10 …

Optimizing Hand Crank Configuration For Therapeutic Use Of Amtrykes® For Children With Upper Extremity Motor Deficits, Jennifer Hardy

Theses and Dissertations

Objective

The purpose of this research study was to create a model to assist therapists, that determines the optimal positioning of the hand cranks when fitting a child for an AmTryke® with a disability that limits upper body strength, such as a brachial plexus injury.

Method

A fitting model was developed by testing the amount of force required to start moving the hand cranks on the AmTryke® when various amounts of weight were applied to the seat of the device. The data collected inserted into a table. A questionnaire developed and emailed to a convenient sample of pediatric physical and …

Impact Of The Arthritis Foundation's Walk With Ease Program On Self-Efficacy, Quality Of Life And Pain Reduction In A Group Format, Kelly Nicole Reese

Theses and Dissertations

Objective: To evaluate the effectiveness of the Arthritis Foundation's Walk With Ease Program for individuals with self- or medically-diagnosed arthritis within a group format. The study also investigates the individuals' perceptions on self-efficacy, quality of life and pain reduction pre- and post- intervention.

Background: The prevalence of arthritis is increasing and this places a major burden on individuals, health systems and social care systems globally. Osteoarthritis, the most common arthritis condition, is a major cause of impaired mobility and disability for aging populations. Osteoarthritis affects millions of people around the world. Self-management programs like the Walk With Ease Program have …

Kinematic And Kinetic Comparisons Of Arm And Hand Reaching Movements With Mild And Moderate Gravity-Supported, Computer-Enhanced Armeo®Spring: A Case Study, Qussai M. Obiedat

Theses and Dissertations

Background: Stroke has been recognized as a leading cause of serious long-term disability in the United States (U.S.) with 795,000 people experience a new or recurrent stroke each year (Roger et al., 2011). The most apparent defect after stroke is motor impairments (Masiero, Armani, & Rosati, 2011). Statistically, half of stroke survivors suffer from upper extremity hemiparesis and approximately one quarter become dependent in activities of daily living (Sanchez et al., 2006). There is strong evidence that intensity and task specificity are the main drivers in an effective treatment program after stroke. In addition, this training should be repetitive, functional, …

Examining The Lived Experience Of Student Veterans Using Photovoice Methodology, Nikhil Tomar

Theses and Dissertations

The primary objective of this study was to understand the lived experience of student veterans using photovoice methodology. After returning from service veterans struggle most with school (Plach & Haertlein Sells, 2013). Student veterans experience difficulty in time management, and transitioning to student life (Radford, 2009). They spend more time working at jobs and caring for dependents than non-veteran students, but spend equivalent time studying. They perceive less engagement with faculty and campus support than their peers (NSSE, 2010). For many veterans, education is a primary occupation but there is dearth of data about their lived experience and factors that …

Quality And Coordination Of Care For Persons With Brain Injury In The Community: Developing A Survey, Brian Philip Johnson

Theses and Dissertations

Background: Because of increasing demand on primary care physicians and a complex, fragmented, healthcare "system", people now must coordinate their own healthcare and services. In response, care coordination has become a clinical specialty, typically done by nurses or social workers. People with disabilities (PWD) also must coordinate their care, including health and disability-support services, knowing who to call, advocating for themselves, and scheduling appointments, among other things. Such demands can be particularly problematic after brain injury, which may impair abilities to prioritize, coordinate, manage, and schedule activities. Coordinating services requires participation of the PWD, and supportive significant others (SSO). At …

Using The Strain Index And Tlv For Hal To Predict Incidence Of Aggregate Distal Upper Extremity Disorders In A Prospective Cohort, Tiffany Amber Cash

Theses and Dissertations

Work-related distal upper extremity (DUE) musculoskeletal disorders (MSDs) are very prevalent and costly in the United States. It is important to recognize working conditions that lead to these disorders, in order to lessen the impact that they have on workers and their employers. Identifying jobs that are likely to cause DUE MSDs is difficult because there are many factors that are believed to contribute to DUE MSD development. The current study aims to determine if the Strain Index (SI) and the ACGIH TLV for HAL (two DUE job physical exposure assessment methods) predict increased risk of workers developing aggregate DUE …

Effects Of Progressive Lens Eyeglasses On Gait Performance Factors Among Young And Middle-Aged Groups, Autumn Marie Milanowski

Theses and Dissertations

Background: It is estimated that over 85% of adults over the age of 45 develop a condition called presbyopia (Holden et al., 2008). Multifocal lenses (MfLs) are used to functionally adapt to this condition to allow for convenient near and distance vision. However, this causes vision distortion in the lower part of the visual field at ground level while walking. Since safe ambulation relies on the lower visual field to detect obstacles (Marigold et al., 2008), and vision acts as a moderating factor for increased fall rates as individuals age (Heasley et al., 2005), there is a need to investigate …

Effectiveness Of Sensory Integration And Behavioral Interventions On Nonengagement In Preschool Aged Children, Tiffany Kuyper

Theses and Dissertations

Abstract EFFECTIVENESS OF SENSORY INTEGRATION AND BEHAVIORAL INTERVENTIONS ON NONENGAGEMENT IN PRESCHOOL AGED CHILDREN By Tiffany Ann Kuyper, OTR/L A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Occupational Therapy at Virginia Commonwealth University Virginia Commonwealth University, 2012 Director: Marie Anzalone ScD, OTR, FAOTA This single subject pilot study explored a combination of sensory-based interventions and behavioral interventions in a preschool aged child identified with Sensory Over-Responsivity (SOR). Children often display nonengagement associated with escaping and avoiding tactile and/or vestibular information because they perceive sensory input as negative or aversive. The subject …

A Study On The Effects Of Therapeutic Listening On The Social And Functional Behavior Of Preschool Children With Autism Spectrum Disorder, Robin Abbott

Theses and Dissertations

Auditory sensory differences and sensitivities are often mentioned by parents of children with Autism Spectrum Disorder (ASD), and in research involving children with ASD. Addressing these auditory processing differences is the goal of various auditory treatment techniques, but current research does not yield a body of evidence in support of auditory therapy as a treatment for children with ASD. This study is a single-subject study, repeated across two subjects, to investigate the effect of the Therapeutic Listening program on the social engagement and self-care skills of preschool-aged children with ASD. Both social engagement and self-care skills increased with for both …

Stress And Anxiety In Adhd: Links To Sensory Over-Responsivity, Stacey E. Reynolds

Theses and Dissertations

Sensory Modulation Dysfunction (SMD) is characterized by an inability to consistently and accurately grade responses to sensory information. SMD, and specifically sensory over-responsivity (SOR), has been correlated with stress and anxiety in some developmentally delayed populations and has been associated with structures and functions of the hypothalamic-pituitary adrenal (HPA) axis. Recent attention has been given to HPA functioning in children with Attention Deficit Hyperactivity Disorder (ADHD), with a majority of studies identifying blunted or diminished cortisol patterns. In contrast, elevated cortisol has been associated with anxiety and anxious behaviors in both animal and human studies. The purpose of this study …

Parent And Therapist Perceptions Of Sensory Based Strategies Used By Occupational Therapists In Family-Centered Early Intervention Practice, Juliet Bertaut Copeland

Theses and Dissertations

A qualitative approach was used to explore the perceptions of parents and therapists in early intervention regarding sensory diets and their efficacy, particularly their goodness of fit within family routines and occupations. Open-ended interviews were conducted with therapist and parent participants and analysis of the data resulted in a model depicting how sensory diets became a "way of life" for families. The Sensory Diet "Way of Life" Model revealed seven themes that illustrated how occupational therapists in early intervention enter the homes of the families they serve and establish a "partnership" with parents to address a child's needs. Once this …

An Exploration Of How And Why Primary Care Providers Educate Infant Caregivers About Positioning, Amy Greenspon Choffin

Theses and Dissertations

A review of the literature indicates that how infants are positioned is related to the risk of SIDS, the incidence and severity of plagiocephaly, torticollis, and developmental delays. A quantitative approach with survey methodology was used with 66 pediatric primary care providers responding to 26 questions. Overall, PCPs are educating caregivers about sleep positioning with a high frequency. There was a relationship between practice site, and the frequency of sleep positioning education is provided. While the participants provide education about awake positioning, and the use of positioning devices, it was with less frequency than they do about sleep positioning; there …

The Effects Of The Handwriting Without Tears Program On The Handwriting Of Students In Inclusion Classrooms, Lisa Owens

Theses and Dissertations

Many handwriting programs are currently used in schools, but little research has been conducted on their effectiveness. A quasi-experimental non-equivalent comparison group pretest posttest design examined effects of the Handwriting Without Tears program with special and general education students enrolled in inclusion classrooms. Two experimental classes received instruction with the HWT method while two comparison classes received instruction using traditional methods. Handwriting performance was measured using the Minnesota Handwriting Assessment. One-way analysis of covariance tested the differences between rates of handwriting improvement for experimental and comparison groups while controlling for pretest scores. Students in the experimental classes showed no statistically …