Medicine and Health Sciences Commons^™

Examining The Differences In Functional Outcomes For Patients With Traumatic Brain Injury After Acute Rehabilitation And Subacute Rehabilitation: A Review Of The Literature, Michael Rangel, Ashley Kakkanatt

Rowan-Virtua Research Day

BACKGROUND/PURPOSE

Traumatic brain injury (TBI) is one of the major causes of morbidity in the US [1-4]. Studies suggest TBI patients’ enrollment in a rehabilitation program strongly predicts social reintegration. The structure and outcomes of inpatient rehabilitation programs, including acute and subacute rehabilitation, are not well-delineated [5-7].

DESIGN

A structured review of current literature was conducted. Articles were screened using the search string: (post-traumatic brain injury OR post-TBI OR traumatic brain injury OR TBI) AND (acute rehabilitation OR subacute rehabilitation) AND (outcomes OR functional outcomes) NOT (outpatient OR outpatient populations) NOT (pediatric OR pediatric populations). Articles were limited to 1990 …

Barriers And Facilitators To Enhance Interprofessional Education For Rehabilitation Science Graduate Students, Mary A. Riopel, Kimberly Wynarczuk, Taylor Grube

The Qualitative Report

Interprofessional education (IPE) aims to develop healthcare practitioners who work effectively in teams, demonstrate strong communication skills, respect others, and have a working knowledge of the roles and responsibilities of other professionals. Of identified research to date, it is unclear what students perceive as important for effective IPE delivery and learning. The purpose of this study was to identify graduate students' perceptions of facilitators and barriers to learning interprofessional practice using phenomenology. Three semi-structured focus groups were conducted including athletic training, occupational therapy, or speech-language pathology students and the transcripts were analyzed using thematic analysis. Four themes emerged about IPE …

What Is Task-Oriented Training? A Scoping Review, Erin Halford, Samantha Jakubiszak, Kassidy Krug, Amanda Umphress

Student Journal of Occupational Therapy

Task-Oriented Training (TOT) is an proven stroke rehabilitation intervention with significant evidence-based research that supports its effectiveness. The absence of a clear definition has led to variability in research reporting and subsequent confusion with practical implementation. A consistent definition seeks to remedy this ambiguity to facilitate knowledge translation. The objective of this study was to determine a comprehensive definition of TOT that encapsulates previous definitions and descriptions in the literature. In order to derive this definition, a two stage scoping review process was conducted across four databases searching for articles on the use of TOT in adult stroke rehabilitation therapy. …

Combined Interdisciplinary Rehabilitation For Persisting Symptoms Following A Mild Traumatic Brain Injury, Marquise Morrissey

Electronic Thesis and Dissertation Repository

Mild traumatic brain injuries (mTBI’s) are the most frequently experienced form of traumatic brain injury. Certain demographic characteristics, including older age, female sex, and pre-existing mental health conditions, increase the risk of experiencing persisting symptoms beyond the acute injury phase. Care for individuals with an mTBI is limited by geography, non-standardized trajectories of care, and gaps in healthcare provider knowledge. An interdisciplinary outpatient intervention has been created to address these issues, but has not been evaluated. Accordingly, the overall purpose of this thesis was to investigate treatment outcomes of individuals with persisting symptoms following an mTBI after completing a combined …

Developing Rehabilitation Treatment Decision Aid For People Living With Complex Regional Pain Syndrome (Crps), Erfan Shafiee

Electronic Thesis and Dissertation Repository

This Ph.D. dissertation aimed to develop a treatment decision aid for people with Complex Regional Pain Syndrome (CRPS) using the Ottawa Decision Support Framework (ODSF). The decision aid was developed throughout a two-phase process.

The first phase involved understanding the existing evidence and the factors influencing decision-making in CRPS rehabilitation: priorities and preferences of patients and therapists were considered. This phase encompassed the integration of diverse sources of evidence, including systematic reviews, overview of systematic reviews, critical appraisal of guidelines, and a survey exploring patients' and therapists' priorities and preferences for CRPS rehabilitation interventions. All forms of evidence were used …

The Clinical Value Of Oculomotor Assessments Across The Continuum Of Concussion, Dillon Richards

Electronic Thesis and Dissertation Repository

Concussions are complex conditions that are difficult to manage medically. Variations in symptom presentation, intricate neurophysiological processes, and the availability of a variety of possible assessment tools may contribute to this complexity. Clinicians must use a broad approach, employing both subjective symptom assessment and objective assessments to confirm a diagnosis and/or monitor progression and recovery. Oculomotor function after concussion may be an important indicator of injury, given the interconnectedness of oculomotor function, vestibulo-ocular and visual systems, and even cognition. Oculomotor function may be assessed objectively or indirectly using patient-reported symptom checklists as part of subjective assessments. One way of objectively …

Narrative Review - Optimal Occupational Therapy Experience, Kaylee G. Clay

Honors College Theses

This narrative review examines factors associated with optimal occupational therapy experiences, including patient perspectives of occupational therapy, cost-effectiveness, use of practices, organization, and patient involvement/experiences. The information found within this review provides information to those interested in creating the most optimal experiences for their occupational therapy patients.

A Randomized Feasibility Trial Of A Novel, Integrative, And Intensive Virtual Rehabilitation Program For Service Members Post-Acquired Brain Injury., Kiara H Buccellato, Michelle Nordstrom, Justin M Murphy, Grigore C Burdea, Kevin Polistico, Gregory House, Nam Kim, Namrata Grampurohit, Jeff Sorensen, Brad M Isaacson, Paul F Pasquina

Department of Occupational Therapy Faculty Papers

INTRODUCTION: Acquired Brain Injury, whether resulting from Traumatic brain injury (TBI) or Cerebral Vascular Accident (CVA), represent major health concerns for the Department of Defense and the nation. TBI has been referred to as the "signature" injury of recent U.S. military conflicts in Iraq and Afghanistan - affecting approximately 380,000 service members from 2000 to 2017; whereas CVA has been estimated to effect 795,000 individuals each year in the United States. TBI and CVA often present with similar motor, cognitive, and emotional deficits; therefore the treatment interventions for both often overlap. The Defense Health Agency and Veterans Health Administration would …

Case Report: A Modified Early Passive Mobilization Protocol For A Zone Ii Flexor Pollicis Longus Repair, Brandon Ryan

OT Student Capstones

A hand can be injured in many ways, but rehabilitation of a tendon laceration following a surgical repair can be one of the most challenging aspects of hand therapy. For example, rates of secondary repair due to complications, such as tendon rupture or tendon adhesion, have been reported to be as high as 17% (Dy et al., 2012). This can be especially problematic when considering the unique characteristics of the dynamics of thumb flexion when compared with that of the other digits. There are many different protocols for flexor tendon repairs, which can make it difficult for a therapist to …

Effects Of Patient Characteristics On Outpatient Rehabilitation Outcomes In Patients With Lumbar Impairments, Jenna Powers

Theses and Dissertations

Lumbar spine impairments affect an individual’s ability to perform activities of daily living, making it pertinent to understand the importance of rehabilitation and variables influencing clinical outcomes. The purpose of this study was to examine variables (demographics, health conditions, and biopsychosocial) that contribute to larger functional status (FS) improvement for patients with lumbar spine impairments seeking outpatient rehabilitation therapy. This study was a secondary data analysis of data collected by FOTO Inc. (Knoxville, TN, USA). A sample of 221,168 participants with lumbar spine impairments were analyzed. Correlations were performed to examine the strength of the linear relationship between variables of …

Women Family Members’ Experiences Of Involvement In Adult Inpatient Traumatic Brain Injury Rehabilitation, Isabelle Savage, Mary Egan

The Open Journal of Occupational Therapy

Background: Traumatic Brain Injury (TBI) rehabilitation is an intensive process aimed at reducing disability. The experience of care is lived not only by the patient with TBI, but by the family as well.

Methods: Five women family members of patients with TBI were interviewed. Based on a descriptive qualitative approach informed by phenomenology, thematic analysis was completed to draw a general sense of family members’ description of their involvement.

Results: Two themes were identified: Wearing different hats and a balancing act, that highlight the many roles undertaken by the women family members as well as the difficulties …

A Mixed-Methods Study Examining Developmental Milestones And Parental Experiences In Ghana, Kate G. Barlow, Stacey Reynolds

The Open Journal of Occupational Therapy

Background: Ghana currently lacks a systematic method for identifying children with developmental delays, and there do not appear to be any culturally sensitive assessment tools available. The objectives of this mixed-methods research study were to explore normal developmental milestones and parental practices in the Ghanaian population. The study also aimed to identify and describe culturally specific factors that should be accounted for on assessments used in the Ghanaian culture.

Methods: Twenty-eight Ghanaian parents were interviewed and asked to participate in a developmental milestone picture-identification task. Quantitative and qualitative data analyses were performed.

Results: The interviews revealed several cultural factors that …

Rehabilitation Of An Injured Golden Eagle (Aquila Chrysaetos): A Case Study, Fida Muhammad Khan, Fakhar-I- Abbas, Abu Ul Hassan Faiz

Journal of Bioresource Management

Habitat destruction and anthropogenic activities cause wild birds to migrate towards urban areas in search of food and sometimes nesting in high-roof buildings, where they are caught by local people using different techniques and are further used for hunting or recreational purposes. An injured Golden Eagle (Aquila chrysaetos) was found entangled in bushes near the vicinity of Balkasar Research Complex, Chakwal, Pakistan. After complete physical examination, a wound on the right wing and closed leg fracture was diagnosed. The successful treatment was done by anti-parasitic and anti-bacterial drugs with careful monitoring. Splint was adjusted after aligning the fractured …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Vrshape: A Virtual Reality Tool For Shaping Movement Compensation, Matthew Hale Foreman

Arts & Sciences Electronic Theses and Dissertations

The majority of persons living with chronic stroke experience some form of upper extremity motor impairment that affects their functional movement, performance of meaningful activities, and participation in the flow of daily life. Stroke survivors often compensate for these impairments by adapting their movement patterns to incorporate additional degrees of freedom at new joints and body segments. One of the most common compensatory movements is the recruitment of excessive trunk flexion when reaching with the affected upper extremity. Long-term use of these compensations may lead to suboptimal motor recovery and chronic pain or injury due to overuse. Rehabilitation focuses on …

Occupational Therapy In The Intensive Care Unit, Kelsie Colombini, Kristen M. Henderson, Michelle Huie, Courtney Malachowski

Dissertations, Masters Theses, Capstones, and Culminating Projects

In recent years, the number of inpatient cardiovascular surgeries has significantly increased in hospitals around America. Occupational therapists in the intensive care unit (ICU) at Mills-Peninsula Medical Center (Burlingame, California) lack a standard protocol for addressing physical, cognitive, and psychosocial factors in patients post cardiac surgery. Furthermore, individuals’ experience and clinical reasoning frequently guides interventions rather than current evidence. The American Occupational Therapy Association’s Centennial Vision encourages occupational therapists to pursue science-driven practices and provide evidence-based interventions. In response to this Vision, an evidence-based clinical pathway was developed for the occupational therapists at Mills-Peninsula Medical Center. The clinical pathway facilitates …

Occupational Therapy In The Intensive Care Unit, Michelle Chan, Kelsie Colombini, Kristen M. Henderson, Courtney Malachowski

Student Research Posters

In recent years, the number of inpatient cardiovascular surgeries has significantly increased in hospitals around America. Occupational therapists in the intensive care unit (ICU) at Mills-Peninsula Medical Center (Burlingame, California) currently lack a standard protocol for addressing physical, cognitive, and psychosocial factors in patients post cardiac surgery. Furthermore, interventions are frequently guided by professional experience and clinical reasoning instead of current evidence. The American Occupational Therapy Association’s Centennial Vision encourages occupational therapists to pursue science-driven practices and provide evidence-based interventions. In response to this vision, an extensive review of current literature was conducted and applied to develop an evidence-based clinical …

Methods To Improve Rehabilitation Of Patients Following Breast Cancer Surgery: A Review Of Systematic Reviews, Siew Yim Loh Assoc Prof, Aisha Nadia Ms

Siew Yim Loh

Context: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search …

Successful Management Of Barth Syndrome: A Systematic Review Highlighting The Importance Of A Flexible And Multidisciplinary Approach, Stacey E. Reynolds

Occupational Therapy Publications

This review describes and summarizes the available evidence related to the treatment and management of Barth syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify articles published between December 2004 and January 2015. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach was used to guide the article selection and evaluation process. Of the 128 articles screened, 28 articles matched the systematic review inclusion criteria. The results of this review indicate the need for a flexible and multidisciplinary approach to manage the symptoms most commonly associated with Barth syndrome. It is recommended …

Home-Based Constraint Induced Movement Therapy Poststroke, Stephen Isbel, Christine Chapparo, David Mcconnell, Judy Ranka

The Open Journal of Occupational Therapy

Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors.

Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL).

Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]): Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 – 10.18, …

The Effect Of Balance Training With An Innovative Approach Compared To Traditional Balance Exercises, Brian Curtis Waite

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the use of an X Box 360 KinectTM game as a modality for improving balance. Specifically, this study explores the use of the Target Kick mini game on Kinect SportsTM as a tool for VR rehabilitation. Subjects (N=18, age 23.3 ±2.87 yrs, mass 71.83 ±15.25 kg, height 168.4 ±7.79 cm) with no lower extremity injury were randomly placed into three groups (X Box n = 6, Traditional n = 6, and Control n = 6). The X Box (XBOX) group performed ten minutes of balance training by playing an X Box game …

The Impact Of Powered Mobility Devices On Occupational Performance : A Systematic Review ; And, The Experience Of Being A Motorised Mobility Scooter User, Ryan Fomiatti

Theses : Honours

The impact of powered mobility devices on occupational performance: A systematic review

Purpose: To systematically review the impact powered mobility devices have on engagement in independent occupations for adults with acquired mobility limitations. Method: The following databases were searched electronically: CINAHL Plus, Medline, PsychInfo, OT Seeker, Joanna Briggs Institute and Physiotherapy Evidence Database. The search terms used a combination of words to encompass all terms which are used for powered mobility. Studies were included if they evaluated adults’ use of a motorised mobility device, and if individuals used a powered mobility device due to acquired mobility limitation. Results: Eleven studies …

Observation Of Amounts Of Movement Practice Provided During Stroke Rehabilitation, Catherine E. Lang, Jillian R. Macdonald, Darcy S. Reisman, Lara Boyd, Teresa Jacobson Kimberley, Sheila M. Schindler-Ivens, T. George Hornby, Sandy A. Ross, Patricia L. Scheets

Physical Therapy Faculty Research and Publications

Objective

To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

Design

Observational survey of stroke therapy sessions.

Setting

Seven inpatient and outpatient rehabilitation sites.

Participants

We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

Interventions

Not applicable.

Main Outcome Measures

We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were …