Medicine and Health Sciences Commons^™

The Effects Of Mindfulness And Exercise On Symptoms Of Parkinson’S Disease: A Systematic Review, Collin Tyler Garner

Dissertations

Parkinson’s Disease (PD) is the second most common neurodegenerative disease affecting which affects motor control, emotional regulation, cognition, and sleep through degradation of dopaminergic neurons. As of 2019, PD affects approximately 8.5 million individuals worldwide, with prevalence estimated to increase to between 8.7 and 9.3 million by 2030. The primary therapeutic approach to PD management is pharmaceutical, relying on dopamine replacement therapy. However, recent research has identified promising complementary therapies such as exercise and mindfulness training.

This review was conducted to compile and present evidence related to the efficacy of exercise, mindfulness, and combined exercise and mindfulness protocols as complementary …

Examining Complementary Health Approaches And Integrative Health (Chaih) Practices Among Occupational Therapists In The United States: A Mixed Methods Approach, Sarah M. Renner

Dissertations

The use of complementary health approaches and integrative health (CHAIH) is increasing among adults and children in the United States and continues to grow within various health care settings. With Health and Wellness identified as a key practice area for occupational therapists and the American Occupational Therapy Association supporting the use of CHAIH in occupational therapy (OT) practice, practitioners must offer safe, research-driven treatments supporting this movement. Research around CHAIH continues to grow; yet the gaps in the literature make it difficult to determine how CHAIH is being used in OT practice as well as the practitioner’s perspectives on the …

Characterization, Implementation, And Impact Of Low Stimulation Precautions In Acute Neurological Injury, Alexis Kurek

Dissertations

Recommendations provided by clinical and professional organizations that encourage providing patients with a low stimulation environment following acquired brain injury are prevalent but supported by expert opinion only. Such recommendations are based on extrapolation of what is known about physiological response to environmental stimuli, however such findings are not specific to the patients with acquired brain injury. Recommendations for low stimulation environments lack guidance for their application and implementation of precautions, and there have been no studies investigating their effectiveness at improving clinical outcomes.

The objective of this study is to determine what patient characteristics are associated with prescription of …

Occupational Therapy As Part Of A Team-Based Approach In Primary Care Settings, Lydia Royeen

Dissertations

The purpose of this project was to study issues related to occupational therapists integrating into primary care settings, as part of a team-based approach and to best meet the needs of the clients.

This is a mixed methods study that examined quantitative and qualitative data for members of the primary care team and occupational therapists working in primary care clinics. The Team Climate Inventory-14 (Kivimaki & Elovainio, 1999) was selected as the quantitative measure because it examines themes related to team functioning, which include vision, participative safety, task orientation, and mutual support. Participants completed a semi-structured interview that examined themes …

Methods For Improving Quality Of Care Within Acute And Post-Acute Settings, Kelly L. Vankoevering

Dissertations

According to the Centers for Medicare and Medicaid (CMS), over the next 7 years, U.S. national healthcare spending is projected to grow at an average of 5.7% per year, up from 4.8% in 2019. Additionally, personal health care cost is expected to increase by 2.7% per year. As a result, there have been increased efforts among healthcare systems and hospital organizations to improve quality of care while decreasing healthcare cost. The research reported in this dissertation builds upon the existing literature regarding interventions to improve hospital performance and quality metrics. Two of the most researched and effective strategies for improving …

Pinch Span And Force: Normative Data, Requirements For Functional Tasks And Life Roles, And The Influence Of Carpometacarpal Joint Osteoarthritis, Nancy Hock

Dissertations

The three studies that form this dissertation build knowledge related to functional pinch. Study 1 provides normative data for the Baseline® 5-Position Hydraulic Pinch Meter, which may be used in clinical practice. The data collected in this study demonstrate the relationship between lateral pinch strength and age and reveal that strength decreases with age in both males and females. Through examination of the lateral pinch force produced at the 5 different pinch spans, it was found that the strongest lateral pinch strength was produced at 4-5 cm of pinch span. This information can be used by clinicians as they modify …

Choice Of God/Higher Power, Perceptions Of God/Higher Power, Religious Beliefs And Behaviors, And Social Support As Predictors Of Length Of Sobriety, Satisfaction With Life, And Quality Of Life Among People Recovering From Alcohol Addictions In Three Midwestern States, Carlton Martin

Dissertations

Problem

An estimated 12.7% of the US population meet the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) (American Psychiatric Association, 1994) criteria for Alcohol Use Disorder (AUD). The annual cost to the society, including emergency room visits, lost days at work, and accidents on the road is in the billions. The impact of this disorder on the family, the community, and the individual is immeasurable. A growing body of literature supports an association between religious and spiritual beliefs and behaviors and recovery from alcohol addiction. This project is an investigation of this association. The goal is to offer some …

Exploring Wheelchair Service Delivery In A Dedicated Seating Department, Cara E. Masselink

Dissertations

This study is a series of three studies aimed at exploring wheelchair service delivery in a department of physical and occupational therapists dedicated to wheelchair seating. The three studies utilized a retrospective analysis to investigate the clinical documentation written by the practicing clinicians between 2007 and 2017. The first study aimed to describe the wheelchair and accessory recommendations made in the 11-year period, in relationship to age and gender. The majority of recommendations in the dedicated seating department were for complex wheelchairs. The results indicated the ratio between standard and complex power mobility devices and four complexities of cushions changed, …

How Professional Physical Therapist Education Programs Develop Cultural Competence Within Their Students: An Exploratory Concurrent Mixed Methods Study, Dustin E. Domingo

Dissertations

Purpose: The purpose of this exploratory concurrent mixed methods study was to describe experiences that shape the factors of cultural intelligence (CQ) as perceived by students of professional physical therapist education programs. In addition, it was the purpose of this study to determine whether any particular factor of cultural intelligence influenced one’s overall cultural competence according to the cultural competence continuum by Cross et al. (1989).

Methodology: Students in a professional physical therapist education program completed a questionnaire, which included Likert scale questions, open ended questions, and a 37-item self-assessment based on the expanded cultural intelligence scale by Van Dyne …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

From War To Home: The Systematic Issues Operation Enduring And Iraqi Freedom Veterans Face Transitioning With Ptsd, Tiffany D. Ware

Dissertations

Purpose: The purpose of this phenomenological study was to describe the perceptions of Operation Enduring and Iraqi Freedom veterans with PTSD, who are transitioning from active duty to civilian life, regarding their participation in the Disabled Transition Assistance Program.

Methodology: The methodology for this research study will be qualitative from a phenomenological perspective. When thinking of research as it pertains to qualitative methods, it is appropriate to use when a researcher is trying to study the lived experiences of individuals (Flipp, 2014; Patton, 2015). This method will describe perceptions of Operation Enduring and Iraqi Freedom veterans with PTSD, who are …

Factors Affecting Community Participation In Young Adults With Intellectual And Developmental Disabilities, Molly Bathje

Dissertations

Young adults with intellectual and developmental disabilities (IDD) participate less frequently in communities than other disabled and non-disabled peers (Verdonschot, de Witte, Reichrath, Buntinx, & Curfs, 2009) even though they express a desire to participate (Kampert & Goreczny, 2007) and federal policy mandates community inclusion (Haertl, 2014). Participation in one’s community is linked to health and quality of life (World Health Organization, 2002). The broad goal of this three paper dissertation is to contribute to a deeper understanding of what facilitates and impedes community participation for young adults with IDD by (1) developing a new conceptual model, (2) evaluating a …

A Comparison Of Multipath And Conventional Neuromuscular Electrical Stimulation, Cody Brian Bremner

Dissertations

Neuromuscular electrical stimulation (NMES) is the use of an electrical current for the purpose of eliciting a muscular response, and these treatments are most often used clinically for the specific purpose of increasing quadriceps strength. It is commonly accepted that the effectiveness of NMES for this purpose is primarily determined by the NMES training intensity. However, spatially limited motor unit recruitment, fatigue and discomfort negatively impact NMES-induced torque, which subsequently reduces NMES training intensities. Due to the importance of NMES training intensity, a substantial amount of research has focused on strategies designed to increase NMES-induced torque production, as well as …

Is Preoperative Functional Status A Predictor Of Postoperative Mortality, Morbidity And Quality Of Life In Open Heart Patients?, A. Kate Macphedran

Dissertations

The very nature of mortality and morbidity surrounding cardiac surgery is complex with numerous risk factors involved and researchers have found functional status to be a stronger predictor of outcomes than the admitting diagnosis. Preoperative functional status, however, is not measured by any of the cardiac risk scores. Functional status can be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). In 3 studies, the impact and association of functional status changes over time was explored in patients who have undergone elective open heart surgery. Analyses in Study 1 demonstrated significantly improved functional status …

Co-Construction Of Personal Narratives In Supporting Identity And Communication In Adults With Aphasia: The ‘My Story’ Project, Katie A. Strong

Dissertations

Stroke and subsequent aphasia can impact a person’s identity negatively, interfering with quality of life. Co-constructing personal narratives about stroke and other aspects of a person’s life is a promising intervention for addressing identity issues. This series of three dissertation studies explored key aspects related to identity, personal narratives, and the perceived impact of telling one’s story.

Study 1 involved a survey examining whether speech-language pathologists view themselves as having a role in supporting the reconstruction of self-identity in adults with aphasia through the use of personal narratives. Results revealed that, whereas the majority of respondents viewed themselves as having …

Qualitative Study Of The United States Marine Corps Wounded Warrior Regiment, Webster F. Nicholson Jr.

Dissertations

Serious health care issues were discovered first at Walter Reed Army Medical Center in 2007 and later at U.S. Department of Veteran Affairs health care organizations in 2014 (Brady, 2012; Cohen, Griffin, & Bronstein, 2014; Wright, 2013). The continued success of the Wounded Warrior Program requires a system that will constantly assess and analyze health care quality from the patient’s experience. From a systems perspective, health care quality encompasses six dimensions, and the study involved examining the dimension and four core concepts of patient-centered care (Institute of Medicine, 2001; Lees, 2011; Wexler, 2002; World Health Organization, 2006). A qualitative, phenomenological …

Meeting The Needs Of Students With Traumatic Brain Lnjury, Heather K. Koole

Dissertations

School reintegration following pediatric traumatic brain injury (TBI) presents a number of challenges. This dissertation comprises three studies exploring common themes of best practice, training, and supporting success for students with TBI in school settings.

Study 1 reports the results of a survey of 70 speech-language pathologists (SLPs) who responded to questions about their use of clinical activities that described more or less contextualized services. Current literature supports contextualized service delivery as best practice. Findings indicated that 98% of participants reported using at least one contextualized practice. Higher use of contextualized practices was associated with working in schools (compared to …

Gdnf Content And Nmj Plasticity In Slow And Fast Twitch Myofibers Follows Recruitment In Exercise, Amy Morrison Gyorkos

Dissertations

Glial cell-line derived neurotrophic factor (GDNF) supports and maintains the neuromuscular system during development and through adulthood by promoting neuroplasticity. GDNF may play a role in delaying the onset of aging and help compress morbidity by preventing motor unit degeneration. Exercise has been shown to alter GDNF expression differently in slow and fast twitch myofibers. The aim of this dissertation project is to determine if different intensities of exercise can promote changes in GDNF expression and neuromuscular junction (NMJ) morphology in slow and fast twitch muscle fibers. Skeletal muscle fibers were analyzed from adult Sprague Dawley rats aged 4 weeks …

Grip Strength, Multimorbidity, And Disability, Amy M. Yorke

Dissertations

The presence of two or more chronic health conditions, also known as multimorbidity, is one of the most prevalent health disorders experienced by adults. Adults with multimorbidity and functional limitations represent clinical and financial challenges to the current health care system. The purpose of this three-paper dissertation is to examine the relationship between grip strength, multimorbidity, and the prediction of disability in adults. Data from the 2008 Health and Retirement Study (HRS), a nationally representative, longitudinal study completed on Americans age 50 years and over, are used for the dissertation.

The objective of the first paper is to investigate the …

Impact Of Participating In A Short-Term Intervention Model Of Sports Education Camps For Children With Visual Impairments, John Michael Mcmahon

Dissertations

This three-paper format dissertation explores three topics relevant to participating in a short-term model Sports Education Camp for youth with vision impairments. The three papers are independent studies, yet build upon each other by first measuring physical performance in certain skills, then exploring their levels of self-perception, body mass index, and level of physical activity in their local communities, and finally describing the population of participants at various points over a 25-year period. Papers one and two examined differences in pre- and post-camp measures for first-time and repeat participants, with the first paper focusing on physical performance, and the second …

An Examination Of Executive Function, Mild Cognitive Impairment And Fall Risk In Community Dwelling Older Adults, Jennifer A. Blackwood

Dissertations

The aim of this three-paper dissertation was to examine the relationship between fall risk, executive function (EF) and mild cognitive impairment (MCI) in community dwelling older adults. Papers one and two describe how mild changes in cognition influence performance on four measures of fall risk, the Five Times Sit to Stand Test (FTSTS), usual gait speed, the Timed Up and Go (TUG) test, and the Activities Specific Balance Confidence Scale (ABC) in a group of community dwelling older adults. The third paper describes if participation in a progressively challenging domain specific computerized cognitive training intervention influenced performance on measures of …

Using Matching Methods From Both Fisher's Experimental Design And Rubin's Causal Model To Compare Between Two Medical Facilities With Extremely Skewed Number Of Subjects, Gideon D. Bahn

Dissertations

The present study deals with the problem of comparison between a two medical facilities' with extremely skewed sample sizes from non-experimental study. The data came from a study of rehabilitation interventions with patients diagnosed with cardiac and pulmonary issues who received treatment either in inpatient rehabilitation facilities (IRFs) or in skilled nursing facilities (SNFs). Due to inclusion and exclusion criteria, however, the study had failed to recruit sufficient number of participants between two comparison groups: 319 from IRFs and 27 from SNFs. As a result, the main hypothesis of the study was not tested due to the disparity of the …

Analysis Of Factors Related To Drop-Off Detection With The Long Cane, Dae Shik Kim

Dissertations

The purpose of this dissertation was to examine the three key factors related to drop-off detection with the long cane: (1) cane-technique-related factors, (2) user characteristics, and (3) ergonomic factors. A mixed-measures design with block randomization was used for the study, in which 32 visually impaired adults with no other disabilities attempted to detect the drop-offs using either the two-point touch technique or the constant contact technique.

Participants detected drop-offs at a significantly higher percentage when they used the constant contact technique (78.3%) than when they used the two-point touch technique (62.1%), p < .001. The 50% absolute drop-off detection threshold of the constant contact technique (1.65") was also significantly smaller than that of the two-point touch technique (2.91"), p < .001. Constant contact technique's advantage in overall drop-off detection rate over the two-point touch technique was significantly larger for the less experienced cane users (difference of 26.2%) than for more experienced cane users (difference of 12.9%), p = .001. Constant contact technique's …

Female Collegiate Gymnasts And Experiences In Sport Retirement Due To Injury, Coleen Harrington Barry

Dissertations

There has been very limited research on sport retirement concerning the experiences that female collegiate athletes face when retiring from a sport due to injury. The purpose of this qualitative study was to explore, understand, and describe experiences that former NCAA Division I female gymnasts had when they retired from gymnastics, part-way through college, due to injury. The main objective of the study was to attempt to understand female collegiate gymnasts' sport retirement experiences and the impact these experiences may have had on their identity development and college experience. The study also considered female collegiate gymnasts' perceived needs and coping …

Radiographic And Functional Analysis Of Movement Allowed By Four Wrist Immobilization Devices, Timothy M. Mullen

Dissertations

Immobilization of the wrist is a common practice throughout the healthcare industry. The main forms of wrist immobilization are short-arm casts, prefabricated wrist splints, custom volar wrist splints, and custom circumferential wrist splints. It is generally accepted, by the medical community, that each form of immobilization allows for some movement. The amount each device allows is unknown. Establishing data that accurately describe the amount of mobility in each immobilization device will allow clinicians to make an evidence-based decision each time they are confronted with the need to order an orthosis.

The purpose of this study was to identify the specific …

Perceptions Of Physical Therapy Faculty On The Inclusion Of Spirituality In Physical Therapy Education, Janice C. Pitts

Dissertations

Problem

The physical therapy profession currently does not require the integration of spirituality in patient care in the physical therapy curriculum, and it is unclear how physical therapy faculty and practitioners view its inclusion. There is limited research literature on the integration of spirituality in the field of physical therapy or within its academic environment.

Method

The study utilized standard survey research methodology to gather data relating to spirituality and its inclusion in a physical therapy curriculum. Five participants from each of 101 sampled programs received a survey instrument along with instructions and consent form disseminated through electronic mailing. Data …

The Role Of The Academic Physical Therapy Department Chair As Perceived By Physical Therapy Teaching Faculty And Chairs, Wayne Louis Perry

Dissertations

Problem

The purpose o f this study was to determine the roles, responsibilities, and characteristics o f the physical therapy department chair as perceived by physical therapy unit administrators and teaching faculty in accredited, entry-level physical therapy programs.

Method

The research population consisted o f current administrators and teaching faculty who work at least half time in accredited physical therapist education programs. The data were analyzed utilizing descriptive statistics, chi-square analysis, and ANOVAs with post hoc tests where appropriate.

Results

The results o f this study indicate that physical therapy unit administrators tend to be older, more experienced, carry higher …

A Study Of The Emotional Responses And Coping Strategies Of Male And Female Athletes With Moderate And Severe Injuries, Donna S. Eaton

Dissertations

Emotional responses and coping strategies of injured athletes was the focus of the study. Several emotions have been identified in injured athletes such as frustration, depression, anger, and shock. Questions remain whether males and females feel similar emotions and engage similar coping strategies and whether severity of injury is a significant factor in responses and coping.

Quantitative data were obtained on emotional responses and coping strategies using the Emotional Response of Athletes in Injury Questionnaire (ERAIQ), the Profile of Mood States (POMS), and the COPE. The study examined whether gender and severity of injury may influence emotional responses and coping …

A Descriptive Study Of The Development And Validation Of A Curriculum Development Process For Occupational Therapy In An Institution Of Higher Education, Alfred G. Bracciano

Dissertations

This was a descriptive study of a curriculum development process for occupational therapy at Saginaw Valley State University in Michigan. A four-stage process was designed and documented. These stages included: (1) feasibility , (2) curriculum design and development, (3) review and evaluation-validation for each component, and (4 ) implementation stage.

The study was conducted to develop a curriculum development process that was academically appropriate for occupational therapy programs for institutions of higher education and which met identified needs as set forth by the feasibility study and the American Occupational Therapy Association (AOTA), Division of Education. Further, the study undertook to …

Inclusion Of Gregorc's Mind Styles Concepts In Physical Therapy Curriculum And Instruction In Selected Baccalaureate And Post-Baccalaureate Programs, Keith R. Gaden

Dissertations

Topic

The topic under study in this paper was the application of Gregorc's mind styles concepts in two baccalaureate and two post-baccalaureate physical therapy programs.

Purpose

The purpose was to determine how these concepts were used while addressing the teaching and learning theory competency of the accreditation standards.

Sources

I examined intra- and extra-classroom activities, noting how information on styles was given and/or modeled to the students. Gregorc's Energic Model of Styles formed the basis for style determination. The research design was multiple-case study (embedded). Accreditation documents, curriculum file materials, handout materials, and videotaped classroom sessions were interpreted to determine …