Medicine and Health Sciences Commons^™

Effects Of Chronic Diabetes And Attentional Focus On Performance And Learning Of A Novel Stabilometer Balance Task, Rebeca Armagnac Gonzalez, Yinny Lee, Alicia Letkiewicz, Meiko Nagano Mamauag

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Chronic diabetes is a prevalent systemic disease that impairs physical functioning and often leads to increased risk of falls. Adopting an external focus of attention during motor skill practice has been shown to improve learning outcomes, however, it has not been examined in this population. We examined how attentional focus instructions (internal vs. external) affect balance performance and learning in older adults with and without diabetes.

Methods: Fifty-three older adults (27 with diabetes, 63.7±7.0 years) participated in the randomized, pre-post intervention study. The balance training involved 50 practice trials of a stabilometer task that was novel to …

Better Gait Quality And Speed In Adults With Down Syndrome When Wearing Supportive Shoes Compared To Unsupportive Shoes And Barefoot, Bailey Gosse, Kimberly Nguyen, Zoe Zelensky

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals with Down syndrome (DS), often experience a slower gait speed and decreased quality of gait. Different types of footwear have shown changes in gait in people without DS. The current study aimed to examine the differences between wearing commercially available supportive shoes, unsupportive shoes, and no footwear on gait quality and speed in people with DS.

Methods: In this repeated measures study, 20 adults with DS walked under three footwear conditions: supportive, unsupportive, and no footwear. Gait deviations were scored according to the Rancho Los Amigos Observational Gait Analysis (OGA) and gait speed was measured using the 10-Meter …

The Impact Of Anatomy Academy In Underserved Las Vegas Elementary Schools, Jean Angeles, Edgar Armengual, Katrina Myers, Perceval Vollmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anatomy Academy is an interactive, service-learning experience that allows doctoral physical therapy students to pose as educators for elementary-aged adolescents. Through instructional and activity-based learning, mentors formulated the program to encase anatomical, physiological, nutritional, and general health and wellness topics that translate into overall healthy behaviors. The experiment enveloped 7 major sectors of anatomy, including the musculoskeletal system, cardiovascular system, pulmonary system, oral cavity/nutrition, gastrointestinal system, sensory system, and central nervous system. Throughout the length of the program, the doctoral candidates reviewed the quality of the content delivered, the engagement of the students and staff, and the effects this had …

Modulating Cortical Excitability To Improve Functional Movements In Individuals With Patellofemoral Pain: A Randomized Controlled Trial, Jeno Aquino, Bryce Broadwell, Connan Wallace, Makenzie Whimple

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Persons with patellofemoral pain (PFP) often exhibit increased knee valgus during functional tasks that is traditionally addressed by strengthening weak hip musculature. However, research related to this topic has revealed altered cortical reorganization in individuals with PFP contributes to dysfunctional movements and underscores the critical role of central neural control in this condition. Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that alters cortical excitability to enhance neuroplasticity. Research using tDCS priming supports its feasibility as a possible treatment for other musculoskeletal conditions. However, its application specifically targeting the corticomotor function of the gluteal musculature in individuals with …

Effects Of Exercise On Level Of Support, Mobility, And Quality Of Life In Adults With Down Syndrome, Jorge Lorza-Lopez, Jolena Sagaya, Simone Schroder, Paige Melvin Zink

UNLV Theses, Dissertations, Professional Papers, and Capstones

Down syndrome (Ds) is a genetic disorder characterized by the autosomal abnormality of a third copy of chromosome 21. Due to the physical and intellectual disabilities that many people with Ds experience, they often need support with (instrumental) activities of daily living. Since adults with Ds are living longer, it is important to determine how exercise can affect mobility and quality of life in the Ds community. The impact on more functional outcomes, such as level of support and quality of life has not been systematically investigated. Therefore, the aim was to investigate whether twelve weeks of a remote, structured …

Implementing Physical Therapy Services And Screenings For The Students Of The Unlv College Of Fine Arts For Health And Injury Prevention: A Service-Learning Approach, Selene Barajas, Justin Dietrich, Brenna Ganzon, Payton Mack, Katherine Metzger, Tanner Mueller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals who participate in Fine Arts such as orchestra, dance, and theater at high levels are predisposed to injury. Many of these injuries are preventable, and when not adequately managed, they can result in lost rehearsal time and prevent participation in performances required for degree completion. While collegiate athletes typically have access to healthcare resources such as a team physician, athletic trainer, and physical therapist, collegiate performing artists often must navigate the healthcare environment on their own. Furthermore, available healthcare providers may lack knowledge and experience working with performing artists and be less able to treat the unique healthcare needs …

Implementation Of Evidence-Based Practices To Improve Treatment For Patients With Neck Pain: A Pilot Study, Kristine David, Sarah Kaderka, Christoffer-Judd Villarias

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: To determine physical therapists’ barriers to implementation and subsequent maintenance of evidence-based practices (EBPs) for treating neck pain from the American Physical Therapy Association (APTA) neck pain Clinical Practice Guideline (CPG) over the course of six months.

Materials and Methods: Participating physical therapists were trained on the EBPs of treating neck pain through a live 90-minute webinar followed by a hands-on, in-person 90-minute session. Clinics were supplied with all necessary equipment and reference guides. Assessment of participant maintenance to neck pain EBPs included data collection from a baseline Knowledge Check survey prior to educational sessions, an Implementation survey at …

Development And Pilot Testing Of A Surface Discrimination Test For People With Lower Limb Amputation, Colin Kruger, Kyle Mcknight, Sharlene Lim, Samuel Straus

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: There is a lack of understanding as to how sensory loss and sensory deficits impact those with LLA. The purpose of this research is to determine the extent to which people with LLA can discriminate between surfaces underfoot, in order to better understand the relationship between people with LLA and their perception of the ground they are walking on. We developed a test to determine which qualities of surfaces may be easier to distinguish.

Methods: 10 unimpaired adults and 2 adults with LLA participated. Participants compared surfaces underfoot that consisted of ceramic, rough tile, gravel, sand, and sandpaper to …

Biopsychosocial Occupational Therapy Interventions For Complex Regional Pain Syndrome – A Pilot Manuscript, Cinthia Hartman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists (OTs) have an essential role in the treatment of upper extremity Complex Regional Pain Syndrome (CRPS) in outpatient therapy settings. Occupational therapy (OT) guidelines and research focus treatment on the Budapest Criteria’s biological signs and symptoms. The International Association for the Study of Pain (IASP) now recognizes CRPS as a primary chronic pain condition and not an autonomic disorder, as it was thought to be in the past. This recognition, along with the psychological and social impacts of the condition, highlight the need for updated OT treatment interventions incorporating a biopsychosocial model. Combining evidence-based CRPS OT interventions for …

The Impact Of Educating Interprofessional Healthcare Workers On The Role Of Occupational Therapy In The Cardiac Acute Care Setting, Jennifer L. Taosuvanna

UNLV Theses, Dissertations, Professional Papers, and Capstones

The acute care setting has been a vastly growing practice area for the occupational therapy profession. Occupational therapists assist clients in the acute care setting with activities of daily living retraining and functional transfer training to increase independence. Each client demonstrates a different discharge course from the acute care setting and occupational therapists play a key role in assisting the clients the most appropriate rehabilitative setting. All professionals in the acute care setting work cohesively to provide clients with the best outcome.

The doctoral project explored the importance of interprofessional healthcare worker education about occupational therapy practices in the acute …

Pediatric Trauma-Informed Care And Implications For Occupational Therapy Practitioners, Quaneka Hoskin-Chase

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapy practitioners are provided a wealth of knowledge through school and professional fieldwork experiences to understand and skillfully address the needs of children who have been exposed to trauma. Therapists are competently prepared to provide holistic and client-centered care that is dedicated to meaningful and volitional engagement (Lynch et al., 2021). However, many therapists still lack the confidence and awareness of their role related to trauma-informed care in the pediatric environment (Piller, 2022). Trauma compromises each domain of occupation (Lynch et al., 2021). As early intervention specialists, the lack of responsiveness to children’s trauma can have devastating and enduring …

Effect Of Asynchronous Virtual Interviews On Ethnic Minority Matriculation Into A Doctor Of Physical Therapy Program, Conner Clark, Nanea Lagasca, Gladys Miller, Jasmine Puspos

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: This study examines the impact of the use of asynchronous virtual interviews (AVIs) in the admissions process of the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). This research aims to examine racial and ethnic subgroup differences in AVI scores, evaluate the influence of AVIs on applicant scores in the admissions process, and assess the AVI inter-rater reliability among faculty evaluators using data from the 2019-2022 admissions cycles.

Results: Significant differences were found in AVI scores among racial and ethnic groups, with Black applicants scoring highest and Asian applicants scoring lowest. Additionally, inclusion …

The Effects Of Implementing An Early Childhood Education Health And Wellness Program In Underserved Elementary Schools In Las Vegas On Student Mentors And Elementary Staff: Anatomy Academy, Alexa Blazek, Amber Berumen Baker, Kevin Chan Shum, Alexander Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Academy (AA) is a seven/eight-week program implemented by select University of Nevada, Las Vegas Doctorate of Physical Therapy (DPT) students to promote health and wellness at a Title I elementary school and help bridge the health education gap that underserved youth populations may be facing. We aimed to assess and improve the overall satisfaction of both the faculty members at the elementary school and the physical therapy students who participated in the program, while enhancing the health education of 5th grade students. Our aim was centered on stakeholders (elementary school administrators) and student mentors (DPT students) having the desire to …

Implementation Of An Evidence-Based Program To Reduce Fall Risk Of Older Adults In Nevada, Hanna Brunty, Jordynn Cowan, Taylor Derose, Kanosha Gray, Kerry Margolin

UNLV Theses, Dissertations, Professional Papers, and Capstones

As Doctor of Physical Therapy (DPT) students from the University of Nevada, Las Vegas, we completed a service-learning project to deliver a free evidence-based fall prevention program to senior residents of Nevada. “Stepping On” is a 7-week fall prevention program from the Wisconsin Institute for Healthy Aging that is designed for older adults who are at risk or fearful of falling or for those who want to increase their awareness of fall prevention strategies. The program includes learning balance and strengthening exercises, discussing fall prevention strategies, and collaborating with community partners and healthcare professionals. The first objective of this service-learning …

A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: The hallmark gait deviation in individuals with post-stroke hemiparesis is slow walking speed. Reduction in gait speed after stroke is influenced by decreased propulsive forces, which may likely be related to impaired spinal circuit function and spasticity of the paretic plantarflexors. Chronic muscle tone maladaptations in paretic ankle plantarflexors can result in altered Achilles tendon (AT) morphology, therefore leading to altered mechanical properties, force transmission capabilities and subsequent insufficient propulsive forces during walking. The purpose of this study is to characterize the chronic maladaptations in both the spinal Ia afferent loop excitability and AT morphology after stroke lesions in …

Introduction Of The Anatomy Academy Program To Children In A Rural Elementary School, Rox Aurelio, Madison Dobbs, Nicole Horn, Gianni Terrana

UNLV Theses, Dissertations, Professional Papers, and Capstones

Children in rural communities experience health and education disparities. Early exposure to health promoting habits can positively impact future health habits. Healthcare providers who grew up in rural areas are more likely to practice in rural areas. Doctor of physical therapy students and physical therapists implemented Anatomy Academy, a service-learning program aimed at promoting healthy living and introducing healthcare occupations, to elementary students in a rural area as this program had previously only been implemented in urban areas. The Biomedical Institutional Review Board at the University of Nevada, Las Vegas approved this study. A 40-minute lesson was delivered weekly for …

The Psychometric Properties Of The Modified Fear Of Falling Avoidance Behavior Questionnaire In Parkinson’S Disease And Older Adults, Billy La, Arturo Aldaco, Ashley Haller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/purpose: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ), developed in 2011 to measure fear of falling avoidance behavior, has good evidence for reliability and validity. However, a recently modified version (mFFABQ) is theorized to be easier to understand for those completing the questionnaire because the Likert responses are more logical in completing the item stem. The purpose of this study was to examine the test-retest reliability and construct validity of the mFFABQ in adults with Parkinson’s Disease (PD) and older adults aged 60-90 years. Methods: Thirty-nine participants (age 72.21 ± 9.5; 29 men, 10 women) diagnosed with PD (diagnosis …

Creating A University-Based Performing Arts Clinic: Challenges And Lessons, Carissa Limtiaco, Alan Savanapridi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fine artists performing at the collegiate level are at a high risk for developing performance related musculoskeletal injuries due to the unique physical demands and repetitive nature of their movements. Previous research has reported incidence rates as high as 81% and 62% for student dancers and musicians respectively. Despite the high injury rates, research has shown that student performers underreport injuries and are reluctant to seek medical management from health professionals due to unhealthy beliefs and attitudes often held by this population as well as the lack of specialized healthcare. The goal of the UNLV College of Fine Arts (CFA) …

Developing A Physical Therapy Initial Evaluation Screening Tool For A Multidisciplinary Clinic For Adults With Down Syndrome, Isabella Russell, Alvin Lacap, Francis Lacap

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Down syndrome (Ds) is a chromosomal condition that can result in intellectual disability, as well as structural or functional disorders impacting the nervous, cardiovascular, and musculoskeletal systems. As individuals with Ds age, they can have an increased number of comorbidities that impact their health. Physical therapy can play an important role in managing many of the comorbidities adults with Ds have. Therefore, there is an increased need for physical therapists to efficiently screen, evaluate and treat adults with Ds. The purpose of this work is to create an Initial Evaluation Screening Tool and Patient Intake Form for physical therapists …

Effects Of A 12-Week Remote Exercise Program On Balance In Adults With Down Syndrome, Kayla Kotake, Sherwin Cadiao, Nicole Kaes, Jayston Prudencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis Individuals with Down syndrome (Ds) tend to have deficits in balance and postural control, which negatively affects their ability to perform physical activities safely and independently. Previous research has shown that exercise can improve balance in people with Ds, however, most studies looked at balance in children with Ds. As the average life expectancy for people with Ds has increased, there is a need for research investigating balance in adults with Ds. Also, there is a need to increase exercise opportunities (eg, remote exercise programs) for adults with Ds, as physical inactivity and sedentary behavior are prevalent among individuals …

The Impact Of An Ostomy Training Workshop On Occupational Therapy Practitioners’ And Students’ Confidence In Client Education On Ostomy Management, Amanda Rae Shizue Shimabukuro

UNLV Theses, Dissertations, Professional Papers, and Capstones

The objective of this quality improvement study was to assess if an ostomy training workshop with a hands-on component would impact the confidence of occupational therapy practitioners and students in client education on ostomy management. The hypothesis is that the training workshop would improve the confidence of occupational therapy practitioners and students in client education on ostomy management. Participants were occupational therapists, occupational therapy assistants, or occupational therapy students in Henderson, Nevada; North Las Vegas, Nevada; or Las Vegas, Nevada. The study utilized a time-series design with a preand post-workshop survey that included a sample size of 30. Occupational therapy …

Feasibility Of The Every Moment Counts Initiative At A Southern Nevada Elementary School, Amber Lee Eddy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over the past 20 years, multiple legislative acts have been passed mandating support and services for the mental health needs of children and youth in schools; however, Nevada continues to rank last for the provision of such services. Children and youth who are mentally healthy are more likely to be successful in their homes, schools, and communities (Arbesman et al., 2013). Those who have increased mental health needs are more at risk for developmental and long-term consequences that jeopardize overall health and wellness, not to mention the immense effects that the COVID-19 pandemic has had on children and youth. With …

Driving And Community Mobility: An Online Educational Program For Generalist Occupational Therapy Practitioners, Gerard Blanco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Driving is an important daily activity that often goes unnoticed, yet it enables individuals to engage in crucial tasks such as grocery shopping, going to work, and participating in social activities. Occupational therapy (OT) practitioners must recognize and address the significance of driving in their daily routines to promote clients' independence and fulfillment. However, despite being well-equipped to assist clients with driving-related issues, many practitioners avoid or neglect this area of occupation. A reluctance to addressing driving and community mobility (DCM) can arise from a lack of confidence, available resources, support, or fear of losing a client's trust. These barriers …

Development Of A Post-Op Transgender Care Program For Acute Occupational Therapy Practice, Marieliz Llanos

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transgender people have experienced adverse health outcomes and barriers to care, ranging from the inability to provide a safe environment for inclusive and equitable care, lack of social support, and limited cultural competency and healthcare provider training. Furthermore, the scarcity of research in transgender care within the field of occupational therapy contributes to the disconnect between the needs of the transgender and gender-diverse (TGD) populations and the lack of preparedness in addressing the occupational performance deficits of transgender clients and individuals undergoing the transitioning process contribute to disparities that are reflected deeply in the experiences of these individuals. In the …

Promoting The Benefits Of An Occupational Therapy Health And Wellness Coaching Program For Adults Living With Chronic Illnesses And Their Self-Management, Natasha Findley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Improved health-related outcomes for individuals 18 years or older living with a chronic condition or multiple chronic conditions can be positively impacted by health and wellness coaching. The primary purpose of this capstone project was to develop a community-based health and wellness coaching program with an occupational therapy-based approach to empower and motivate individuals in discovering their strategies, make healthier choices, and be accountable for their self-management (medication adherence, physical activity, sleep hygiene, healthy eating, stress management, and pain management). According to the American Occupational Therapy Association (2015), occupational therapy focuses on promoting health and wellness by enabling clients to …

The Development Of A Pilot Program Related To The Application Of High-Intensity In Occupational Therapy, Philip Lamoreaux

UNLV Theses, Dissertations, Professional Papers, and Capstones

Among the many diagnoses affecting an individual’s ability to participate in occupation, strokes are among the most common (Tsao et al., 2022). With the decrease in mortality rates by 35.8% due to advancements in medicine (Wolf & Nilsen, 2015), there is a need to remediate, adapt, or modify the life-changing impairments associated with stroke. The most significant evidence for motor learning, which is associated with regaining function, is in relation to high-intensity training in the context of ambulation (Middleton et al., 2015; Moore et al., 2020). By utilizing the neural plastic principles of repetition, salience, task-specificity, and intensity, an individual …

The Importance Of Educating Patients And Staff About Implementing The Neurogenic Bowel Training Program (Nbtp) For Spinal Cord Injury (Sci) In The Acute Care Phase, Silvia Lobaina

UNLV Theses, Dissertations, Professional Papers, and Capstones

According to Borsh et al. (2019), a spinal cord injury (SCI) is damage to a tight bundle of cells and nerves, the spinal cord, that send and receive signals from the brain to and from the rest of the body. A direct injury can cause damage to the spinal cord itself or to the tissues and bones that surround it, which can cause temporary or permanent changes in sensation, movement, strength, and body functions below the injury site (Borsh et al., 2019). Unfortunately, the extent of the disability depends on the severity and location of the SCI; an injury higher …

Promoting Early Detection In Primary Care: Program Evaluation Of The Dementia Care Aware Program In Orange County, Ennah Cabading

UNLV Theses, Dissertations, Professional Papers, and Capstones

The aging population is growing quickly, raising concerns about the increasing numbers of those with Alzheimer's disease and related dementias, as age is the common risk factor for acquiring the disease. The increase in the elderly population may influence higher healthcare costs and the need for more healthcare professionals like primary care professionals. However, primary care professionals face challenges meeting this population's demands due to the lack of training, confidence, and understanding of dementia care. A new California initiative called Dementia Care Aware aims to support primary care professionals by offering training, tools, and resources to increase early detection and …

An Immersive Virtual Reality Treatment Learning Module For Unlv Occupational Therapy Students, Paolo Castro

UNLV Theses, Dissertations, Professional Papers, and Capstones

Virtual reality refers to the technology used to create multi-sensory, three-dimensional environments its users can interact with. Occupational therapists may find virtual reality-based therapy appealing as it allows them to access many virtual environments and tasks that would be difficult to recreate in traditional settings. Despite literature suggesting their willingness to use it in practice, there is an evidence-to-practice gap caused by low self-efficacy and knowledge of how to operate and apply it. The author created a learning module for occupational therapy students to see how it affects perceived clinical competency. The results of the learning module showed statistically significant …

Acquired Brain Injury: A Vision Screening Protocol For Occupational Therapists, Sebastian Cheung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists have a unique set of skills that allow them to assess individuals with an acquired brain injury who have visual impairments. However, it is frequently neglected in practice owing to a lack of confidence, knowledge, or training. There is a need for a vision screening protocol that will help occupational therapists learn more about visual impairments in adults with an acquired brain injury (ABI) and feel more confident in their ability to identify them. This quality improvement capstone project was a feasibility study and consisted of a sample size of N = 6, utilizing a one group pretest-posttest …