Medicine and Health Sciences Commons^™

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Effects Of Chronic Diabetes And Attentional Focus On Performance And Learning Of A Novel Stabilometer Balance Task, Rebeca Carolina Armagnac Gonzalez, Yinny H. Lee, Alicia Marie 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 …

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 …

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 …

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 …

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) …

Addressing Vision Impairments Following Neurological Injuries: A Vision Protocol For Occupational Therapists, Dyrin Cordero

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vision impairments have a high prevalence in adults with a stroke or traumatic brain injury (TBI), potentially affecting up to 90% of this population. However, these impairments are often overlooked during the rehabilitation process due to a lack of education and training provided to occupational therapists (OTs). Limited research also contributes to no standardized best practice guidelines for OTs to follow (Aravich & Troxell., 2021). This issue is important to occupational therapy practitioners because vision impairments negatively affect a person's capacity for recovery, quality of life, safety, and mental health (Berger et al., 2016). Occupational therapists aim to utilize holistic …

Ergonomic Education For Entry-Level Administrative Staff, Mitzi De La Cruz-Garcia

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the United States, 2.6 million work-related musculoskeletal disorders (WMSDs) were reported in 2020, which are costly to employers, individuals, and our healthcare system. The most commonly affected workers are entry-level staff, who often do not receive training or education on office ergonomics during their onboarding process. Evidence exists on the benefits of ergonomics for workers, but there is a gap in disseminating information to these individuals. In addition, what is available on the internet can be of low quality, not based on evidence, and written at a higher-than-average reading level.There is a need for easily accessible ergonomic education and …

Effectiveness Of A Workshop For Improving Awareness And Identification Of Racial Microaggressions Among Occupational Therapy Faculty And Students, Hannah Kalegzabher

UNLV Theses, Dissertations, Professional Papers, and Capstones

As a professor or student in occupational therapy (OT), an important role is advocating for students and clients. Taking action is important to practice and promote justice, equity, diversity, and inclusion (JEDI) within the profession. This quality improvement project aimed to determine the effectiveness of a racial microaggression workshop for OT, OT assistant (OTA) students, and faculty to improve awareness and ability to identify racial microaggressions to support Black, Indigenous, People of Color (BIPOC). Participants were recruited by convenience sampling through email to members of the Coalition of Occupational Therapy Advocates for Diversity (COTAD) and COTAD-Educators (COTAD-ED). The workshop was …

Utilization And Perception Of Peer-Support After Lower Limb Loss In The United States: Potential Benefits On Mobility Outcomes, Moriah Maluotoga, Roopkiran Thind

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Limb loss is a life-changing event that significantly impacts patients’ functioning as well as psychosocial well-being. Psychosocial support in the form of amputee peer-support is widely recognized as beneficial to individuals after lower limb loss (LLL). However, there is currently a lack of research on the utilization of peer-support after LLL and its perceived benefits to function. The purpose of this cross-sectional study was to examine and quantify participants’ experiences with peer-support after LLL, and how peer-support experience is associated with mobility outcomes. We hypothesized that participants with LLL would express generally positive experiences with peer-support and that it …

Nonpharmacological Pain Management Of Adult Patients In The Burn Unit: An Interdisciplinary Toolkit Through The Occupational Therapy Lens, Taylor Harrison-Merrill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Interdisciplinary care is the standard for individuals admitted to a burn unit, yet there is a lack of uniform education among different professionals regarding pain management (Kuhlmann & Tallman, 2022). Occupational therapists offer a unique and holistic lens to pain management by using nonpharmacological interventions to reduce patients’ perception of pain (American Burn Association, 2017; Nielson et al., 2022). The purpose of this quality improvement doctoral capstone was to apply this occupational lens in an educational toolkit designed for the interdisciplinary team that addressed nonpharmacological pain management for adults in the burn unit; effectively closing the knowledge gap across disciplines …

Exploring The Usefulness Of The Alert Program On Children With Developmental Delays Or Disabilities At Positively Kids, Ashley Cassandra Manabat Tolentino

UNLV Theses, Dissertations, Professional Papers, and Capstones

This quality improvement project explored the implementation of the Alert Program's (AP) first and second phases within the Foundation for Positively Kids social skills program, PK Social ETC. This study focused on three staff members' perception of the Alert Program's usefulness on their clients' self-regulation skills and occupational participation when engaged in their daily social skills group. The Alert Program was delivered through weekly education sessions for the staff, followed by two groups involving the children to provide visual demonstrations for the staff over eight weeks. Data was collected through a pre- and post-survey using a Qualtrics survey to capture …

The Efficacy Of An Educational Toolkit To Enhance Knowledge Of Pediatric Reflux Management Among Occupational Therapists, Kelly Cullerton

UNLV Theses, Dissertations, Professional Papers, and Capstones

This manuscript describes a quality improvement project completed by a student in the University of Nevada Las Vegas Occupational Therapy Doctorate Program. The project tests the efficacy of an educational toolkit for occupational therapists staffed at an acute care hospital in Las Vegas, Nevada, to increase their perceived knowledge of and ability to educate families on conservative management techniques for pediatric reflux management. Results indicate that the toolkit demonstrated efficacy in achieving this objective. The toolkit provided useful staff education and parent handouts for the occupational therapists to utilize in patient care as appropriate. This project’s ultimate aim was to …

Stepping On - Virtual Fall Prevention For Older Adults, Sean Conners, Tyler Greener, Kaitlyn Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Three student learners in a doctoral physical therapy program completed a service-based learning project dedicated to reducing falls in the elderly. The program, called Stepping On, is a fall prevention initiative supported by the Wisconsin Institute for Healthy Aging (WIHA) whose goal is to identify risk factors for falls in the older population and provide exercises and recommendations to reduce falls. The eleven volunteer participants in this student learners’ Stepping On program completed online fall prevention classes and provided feedback at the completion of the program. Participants reported being more conscientious while walking and noted improved balance and flexibility.

Anatomy Academy Service-Learning Project: Attacking The Epidemic Of Childhood Obesity, Kelsey Kjer, Rosedaveia Howell, Brennan Kitchen, Francesca Schutte

UNLV Theses, Dissertations, Professional Papers, and Capstones

The World Health Organization has classified childhood obesity as one of the most serious public health concerns in the world. Obesity is known to have detrimental health consequences and be a risk for comorbidities. On top of the consequences of obesity already seen in young children at school, a lack of health education interventions in many elementary schools remains a significant health disparity. Anatomy Academy (AA) is a seven-week curriculum designed to educate children about their bodies and the importance of gaining and maintaining a healthy lifestyle. The purpose of this service-learning project was to educate elementary school students in …

The Feasibility Of A Large-Amplitude Aquatic-Based Exercise Occupational Therapy Program For Individuals With Early Parkinson’S Disease, Brigitte Baker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this research was to determine if a 4-week aquatic-based, large-amplitude exercise program would increase strength and coordination for occupational performance in areas of activities of daily living (ADLs) and mobility in individuals with Parkinson's disease (PD) stage I-II, functional mobility as measured by Timed Up and Go test, and quality of life as measured by PDQ-39 in relation to occupational engagement.Methodology: Recruitment was through capstone placement site, Hands on Rehab, 7921 Professional Circle, Huntington Beach, CA 92648, in which a signed EAA was on file. Informed Consent was reviewed by the student-clinician as well as the …

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 …

Lumbopelvic Biomechanics And Muscle Performance In Individuals With Unilateral Transfemoral Amputation: Implications For Lower Back Pain, Jason Ciccotelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

Many people with lower extremity amputation (LEA) experience lower back pain (LBP). The amount of pain they experienced can be debilitating and severely interferes with activities of daily living. Previous studies have explored LBP in populations without LEA, and the evidence is also growing within the limb loss population. However, the mechanism for the high prevalence of LBP after LEA remains unclear. The lower back muscles, specifically the multifidi muscles, play an important role in stabilization of the spine during motion, and LBP has been associated with decreased mobility in patient populations, but the degree of dysfunction in the spinal …