Medicine and Health Sciences Commons^™

Intermittent Theta Burst Stimulation: Application To Spinal Cord Injury Rehabilitation And Computational Modeling, Neil Mittal

Theses and Dissertations

Loss of motor function from spinal cord injuries (SCI) results in loss of independence. Rehabilitation efforts are targeted to enhance the ability to perform activities of daily living (ADLs), but outcomes from physical therapy alone are often insufficient. Neuromodulation techniques that induce neuroplasticity may push the limits on recovery. Neuromodulation by intermittent theta burst transcranial magnetic stimulation (iTBS) induces neuroplasticity by increasing corticomotor excitability, though this has most frequently been studied with motor targets and on individuals not in need of rehabilitation. Increased corticomotor excitability is associated with motor learning. The response to iTBS, however, is highly variable and unpredictable, …

Intentions To Use Telerehabilitation For Communication And Treatment For Vision Impairments, Eric E. Hicks

Theses and Dissertations

BACKGROUND: Approximately 8.1 million people in the United States 18 and older have difficulty performing one or more daily activities because of vision impairment or blindness (Erickson, Lee, & von Schrader, 2020; Taylor, 2018). If the impairments caused by vision loss are not addressed, they can result in financial difficulties, suffering, disability, loss of productivity, and decreased quality of life (National Center for Chronic Disease Prevention and Health Promotion, 2011). Currently, in-person low vision rehabilitation services are the gold standard for teaching people how to adapt to and compensate for these deficits, however, the access and utilization of these services …

Upper Extremity Kinematics And Pain Outcomes During Activities Of Daily Living In Pediatric Hypermobile Ehlers-Danlos Syndrome, Olivia Yanez Wilwert

Theses and Dissertations

Ehlers-Danlos syndrome (EDS) is a group of heritable connective tissue disorders, consisting of thirteen different subtypes. Among the thirteen, Hypermobile Ehlers Danlos Syndrome (hEDS) is the most common. Individuals with this condition present with frequent joint instability that results in ongoing subluxations and dislocations. Secondary diagnoses of this condition include chronic pain, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Major Depressive Disorder (MDD), and Generalized Anxiety Disorder (GAD). The diagnostic process of hEDS is convoluted by the lack of a genetic identifier (Malfait et al., 2017). Individuals with hEDS are often not diagnosed until later in adulthood, leaving their adolescent life full …

Biomechanical Analysis Of Stroke Patterns And Functional Outcomes In Pediatric Manual Wheelchair Users, Paige Louise Aschenbrener

Theses and Dissertations

Approximately 88,0000 manual wheelchair (MWC) users are under the age of 21 in the United States (Kaye, LaPlante, & Kang, 2000). More than half of pediatric MWC users with spinal cord injury (SCI) report shoulder pain later in life and are at higher risk for developing upper extremity (UE) overuse injuries (Vogel & Zebracki, 2015). During MWC propulsion, a stroke pattern is the path the hand follows with respect to the pushrim (Boninger et al., 2002). Current clinical guidelines for adults recommend sole use of the semicircular stroke pattern as best practices because a MWC user is able to spend …

Comparing Sensory Accessibility Needs In Deaf And Low Vision Populations: An Explorative Study, Anna Bruckbauer

Theses and Dissertations

Objective. The objective of the study is to compare hypothesized similar sensory accessibility needs of Lighting, Acoustics, Openness, Color/Contrast, and Services/communication for the hard of hearing and low vision population. Background. The Americans with Disability Act – Architectural Barriers Act Design Guidelines (ADA-ABA, 2004, 2015) provides guidelines to increase accessibility of public buildings for individuals covered by the ADA (1990). However, these guidelines often fall short of providing functional and practical guidelines to be accessible for all. Extant building rating tools fail to attend to the overlap of functional needs for the hard of hearing and/or low vision populations. Thus, …

College Students' And Educators' Attitudes Toward Offenders With Mental Illness, Sulema Perales

Theses and Dissertations

The purpose of the present study was to examine college students’ and college educators’ attitudes toward offenders with mental illness (MI). A non-experimental, exploratory research design was used to measure the following variables: demographics characteristics, academic major/teaching discipline, and personal relationships with offenders. Correlational and regression analyses and a one-way analysis of variance were used to analyze the data for 349 college students and 35 college educator participants. The results of the study showed there was a significant relationship between college students’ attitudes toward offenders with MI and students’ academic major. The results also showed significant relationships between college students’ …

Establishing Content And Face Validity Of An Assessment To Evaluate The Attitudes, Self-Efficacy, And Knowledge Of Pre-Professional Students Related To Assistive Technology For Children With Autism Spectrum Disorder (Asd), Cynthia Amy Ruedinger

Theses and Dissertations

OBJECTIVE. The purpose of the study was to create an online assessment in order to better understand the knowledge, attitudes, and self-efficacy that pre-professional students have in the fields of assistive technology and ASD and establish content and face validity for this assessment.METHOD. 12 content experts, both professors and practitioners, within the fields of occupational therapy, physical therapy, speech language pathology, and special education, as well as experts in autism spectrum disorder and assistive technology, participated in the content validation process. A total of 16 students within these disciplines completed the assessment with pilot data gathered and provided feedback on …

Dialect Use, Language Abilities, And Emergent Literacy Skills Of Prekindergarten Children Who Speak African American English, Erika Rose Baldwin

Theses and Dissertations

Purpose. The purpose of this study was to gain a better understanding of the complex relationship between spoken language and emergent literacy skills for children who speak African American English (AAE). Therefore, this study examined children’s language proficiency, dialect use, and emergent literacy skills at the beginning of Head Start preschool and throughout the entire academic year.

Methods. This study analyzed scores from a database of 120 preschool children who spoke AAE. Data included narrative retells of the wordless picture book Frog Where Are You? that were transcribed utilizing Systematic Analysis of Language Transcript (SALT) Software. Narrative retells were then …

A Comparison Of Two Devices For Isometric Lingual Strengthening In Healthy Adults, Daniel Laurensio Gutierrez

Theses and Dissertations

The purpose of this study was to compare tongue pressure measurements recorded by an established device, the Iowa Oral Performance Instrument (IOPI) and a new device, the TongueometerTM.

Eight healthy adults ages 18 to 59 were subjects. Independent variables included device type (IOPI & TongueometerTM) and bulb placement in oral cavity (anterior & posterior). The dependent variable was tongue pressure in kPa. Each subject attempted three trials of maximum tongue pressure at both the anterior and posterior bulb placement location for both devices. The order of device and bulb placement position was counterbalanced to reduce potential carryover effects. Subjects were …

Factors Associated With Quality Of Life And Dialysis Compliance, Viviana Garcia Guerra

Theses and Dissertations

This dissertation study explored the relationship between quality of life (QoL) and dialysis compliance with family support, spirituality, age, gender, and socioeconomic status (SES) among people with end stage renal disease (ESRD). Utilizing the Biopsychosocial Spiritual Framework, this study pursued to inform mental health professionals working with people undergoing dialysis about the factors that influence QoL and dialysis compliance. This descriptive quantitative dissertation study included 79 participants who self-identified as persons receiving either hemodialysis or peritoneal dialysis. Participants were members from closed social online forums and the National Kidney Foundation.

The current study found that family support and SES predicted …

Improving The Classroom Experience By Providing Teachers With A Mindfulness Intervention, Andrea P. Almaguer-Botero

Theses and Dissertations

The purpose of this study was to improve the classroom environment for teachers by providing them with a mindfulness-based intervention. This experimental study evaluated the outcomes of an eight-week stress and mindfulness prevention intervention (SPAM) created specifically for teachers. The current study measured the following variables: mindfulness, stress, self-efficacy, job satisfaction, and well-being. This study used a four-way ANOVA (2 X 3 X 2 X 5) with two between subjects’ factors, groups and levels, and two within subjects/repeated measures factors, pre-test-posttest and scales. There were 14 teacher participants in the experimental group and 19 teacher participants in the control group. …

Individual Difference As A Factor In Ethical Decision-Making, Dan W. Reagan Jr.

Theses and Dissertations

Despite the dominance of modernistic ethics in counseling there has been a growing development of postmodern thought. There has been a growing understanding the limitations of ethical codes and purely rational thinking in ethical decision-making. Part of this new paradigm is an appreciation for the role of affect and context in the decision-making process. A post-modern approach to counseling ethics seems to be increasingly accepted among persons working in the social service field but little research has been attempted to evaluate the implications of such a change in training and practice. This study attempted to explore possible relationships between individual …

The Relationship Between The Use Of Hormonal Contraceptives And Ligamentous Knee Injury In The Female Collegiate Athlete, Nicole Michelle Thompson

Theses and Dissertations

Female athletes are three to six times more likely than males to sustain a ligamentous knee injury due to hormonal risk factors. Hormones of the menstrual cycle have been shown to alter the physiological component of ligamentous structures during the three phases of the cycle. Use of hormonal contraceptives (HCs) may influence the incidence and severity of ligamentous knee injuries in female athletes. The objective of this cross-sectional study was to determine the relationship between HC use and the type and severity of ligamentous knee injuries sustained among female collegiate athletes using an online survey distributed to NCAA female athletes …

“It’S Supposed To Be Super Easy And It’S Not”: Black And Latinx Student Experiences In The Doctor Of Physical Therapy Admissions Process, Melissa Yeung

Theses and Dissertations

Data provided by the Physical Therapy Central Application System (PTCAS) suggests that despite the large numbers of applicants to Doctor of Physical Therapy (DPT) programs on an annual basis, a gap remains between the number of White and Black and Latinx applicants who are offered admission to DPT programs. Efforts made by DPT programs to increase the diversity of their incoming cohorts include the use of holistic review processes and enrichment programs to recruit more diverse classes. However, research suggests that the undergraduate experiences of students of color have an impact on their aspirations to graduate and professional schools, and …

The Impact Of Occupational Therapy Acute Care Services On Readmission Rates For Patients In Medicare’S Hospital Readmission Reduction Program, Jessica M. Edelstein

Theses and Dissertations

The United States (US) health care system is faced with the daunting challenge to make healthcare payments commensurate with quality of care provided. To assess quality, metrics for reimbursement have been established by Medicare. One such quality metric is hospital readmissions (readmissions). Readmissions are associated with poor patient outcomes and costly. Associated poor patient outcomes include higher risk for mortality, deconditioning, nutritional issues and cognitive impairments. As a result, readmissions cost Medicare $26 billion annually. Current strategies for reducing readmissions in the US are fragmented and hospital-specific. While specific strategies may vary, hospitals that have low readmissions rates tend to …

A Review Of Factors, Seating Design, And Shape Capture Methods For Reducing Pressure Injury Risk, John A. Damiao

Theses and Dissertations

This dissertation in the form of three papers ready for submission to peer-reviewed journals is submitted toward the requirements of the PhD in Health Related Sciences program at Virginia Commonwealth University. Chapter One provides an introductory overview of the project, including: (a) an overview of pressure injuries, (b) the impact of seating as an intervention, and (c) aims of the three-paper dissertation in addressing various aspects of pressure injury prevention. Each paper is unique and singular in its focus, yet all share the overlying aim of addressing pressure injury risk associated with wheelchair seating. Paper One describes the unique facilitators …

The Effect Of Intermittent Theta Burst Stimulation On Biceps Corticomotor Excitability In Non-Impaired Individuals And Individuals With Tetraplegia, Blaize Majdic

Theses and Dissertations

Neuromodulation of the primary motor cortex (M1) in pair with physical therapy may be a promising method for improving motor outcomes after spinal cord injury (SCI). Increased excitability of the corticospinal motor pathways (i.e. corticomotor excitability) has shown to be associated with improved motor learning and skill acquisition. Intermittent theta burst stimulation (iTBS) is a form of non-invasive brain stimulation which can increase corticomotor excitability, as measured by an increase in the amplitude of motor evoked potentials (MEPs). However, the ability for iTBS to increase the corticomotor excitability of proximal muscles such as the biceps, and muscles affected by spinal …

Relationship Of Demographic Characteristics Of Occupational And Physical Therapists Towards Their Knowledge And Attitude On Person-Centered Care In Skilled Nursing Facilities, Sadashiv R. Aggarwal

Theses and Dissertations

The study aimed to assess the relationship of specific demographic characteristics of occupational (OTs) and physical therapists (PTs) with their knowledge and attitudes towards principles of Person-Centered Care (PCC) in skilled nursing facilities (SNFs). The study further examined if knowledge and/or attitudinal differences exist between OTs and PTs towards PCC. The proposed descriptive study used the Person-Centered Care theory, which is a holistic (bio-psychosocial-spiritual) health care delivery approach. PCC delivers services that are respectful and individualized, allowing negotiation of care, and offering choice through a therapeutic relationship where persons receiving care are empowered to be involved in health decisions at …

The Effect Of Attention To Self-Regulation Of Speech Sound Productions On Speech Fluency In Oral Reading, Chana Basya Halpern

Theses and Dissertations

Purpose: This study ultimately sought to test whether a condition of heightened attention to speech sound production during connected speech serves to trigger increased disfluencies. Disfluencies, or disruptions in the flow of speech, are highly variable in form and location, both within and across individuals and situations. Research to identify conditions that can predictably trigger disfluencies has the potential to provide insight into their elusive nature. A review of related literature covered the cognitive-linguistic theories related to speech fluency and stuttering. This review of previous literature also served as the foundation for why it was proposed that disfluencies would be …

Veteran Wellness And Reintegration: Factors Contributing To Their Success In The Community, Melissa A. Escamilla

Theses and Dissertations

The purpose of the following study is to determine if there is a relationship between veteran wellness based on gender, discharge status, theatre of operations, substance use disorder, veteran self-efficacy, community reintegration post discharge, stigma and veteran physical and psychosocial factors. Military veteran wellness has been the focal point of service providers for ensuring post-discharge veterans' success. During the last decade there has been an increase in military veterans reintegrating into society with chronic ailments and undiagnosed conditions. The study examined 85 Texas veterans: (a) the relationship between veterans' substance abuse and their perception of stigma, (b) the relationship between …

Complex Trauma: Counselors' Self-Efficacy And Treatment, Breeze Valenska Rueda

Theses and Dissertations

The purpose of this descriptive and exploratory mixed-method study was twofold: to explore counselors’ perceptions and knowledge regarding complex trauma and, assess counselors’ perceptions regarding their level of confidence when working with this population. The study determined what relevant factors were related to counselors’ perceived self-efficacy concerning complex trauma. Although complex trauma is emerging as an important issue, there is limited research regarding counselors’ experiences with complex trauma. The current study explored participants’ perceptions when providing services to individuals with prolonged and cumulative trauma and provided a greater understanding of counselors’ recognition and selfefficacy when working with this population. A …

The Moderating Effect Of Employee Bottom-Line Mentality On The Relation Between Personality And Unethical Pro-Organizational Behaviors, Jordan Thomas

Theses and Dissertations

Unethical pro-organizational behavior (UPB) refers to unethical actions that employees engage in to benefit the company they work for. The issue of employees engaging in UPB has been high-lighted in various high-profile scandals, such as the Volkswagen emissions scandal. The current study examined the interaction between employees’ personality traits, perceptions of bottom-line mentality (BLM), and UPB. The results suggested that when employees who are low on trait conscientiousness and honesty-humility are placed in an environment in which they perceive to have high levels of BLM, they are more likely to engage in UPB than those individuals who had higher levels …

Effects Of A Sensory Diet On Attention And Participation In Children With Autism, Leighanne Smith-Mrkaja

Theses and Dissertations

This applied dissertation was designed to provide initial knowledge regarding sensory diets and sensory-based interventions. The need for classroom-based sensory interventions are not always considered, especially with the high number of students diagnosed with ASD at the researcher’s school. Often sensory intervention may not be considered educationally relevant, especially in the prekindergarten level. With the proper training and materials, as well as the guidance of the school-based occupational therapist, teachers, other therapists, classroom assistants, parents, and school-based staff might be able to utilize sensory-based activities like sensory diets to increase participation, positive behaviors, and attention. The following applied research study …

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 …

Pre-Operative Versus Post-Operative Kinematic Assessment And Functional Outcomes Of The Thoracohumeral Joint In Adults With Rotator Cuff Tears, Margaret French

Theses and Dissertations

PRE- OPERATIVE VERSES POST-OPERATIVE KINEMATIC ASSESSMENT OF THE THORACOHUMERAL JOINT IN ADULTS WITH ROTATOR CUFF TEARS

by

Margaret E. French

The University of Wisconsin-Milwaukee, 2018

Under the Supervision of Brooke A. Slavens, PhD

This project investigated upper extremity (UE) motion and functional outcomes before and after full-thickness supraspinatus rotator cuff (RC) repair through kinematic analyses of three Activities of Daily Living (ADL) tasks. RC repair is a standard procedure known to alleviate pain, weakness, and stiffness, with improvements of decreased pain and increased range of motion (ROM). Eight (8) subjects (63.6 ± 6.3) with a supraspinatus RC tear participated in …

Cost Of Caring: The Effects Of Euthanasia On Animal Shelter Workers, Kim L. Nguyen-Finn

Theses and Dissertations

This mixed-methods study focuses on animal shelter workers, a population that has often been overlooked in research and clinical practice, and the emotional strains of the task of euthanasia. The effects of employment in a kill or no-kill shelter, participation in euthanasia, and number of years employed on mental health issues of substance abuse, anxiety, depression, secondary traumatic stress, and burnout were examined. A three-way MANOVA was run to test the hypothesis that there is a cell effect among the type of shelter employed in, participation in euthanasia, and years of experience on mental health, which was not supported by …

Vocational Rehabilitation Counselors' Experiences, Perceptions, And Readiness Related To Self-Employment Of People With Disabilities, Deborah Ashley

Theses and Dissertations

The purpose of this dissertation study was to explore the experiences, perceptions, and readiness (EPR) of vocational rehabilitation counselors (VRCs) supporting people with disabilities (PWD) in self-employment. While PWD are twice as likely to be self-employed than the general population, self-employment case closure rates within vocational rehabilitation remain historically low around 2%.

Descriptive, inferential, and correlational statistical analysis were used to investigate the EPR of 205 Certified Rehabilitation Counselors across the nation via an online survey, the Vocational Rehabilitation Counselor Self-Employment Process Survey (VRC-SEPS). The VRC-SEPS consists of demographic items, two Likert-type scales examining experiences and readiness, and a set …

Factors Contributing To Successful Employment Outcomes For Individuals Who Are Hard-Of-Hearing, Sergio Cuevas

Theses and Dissertations

This study examined the relationship between demographic variables (gender, race and ethnicity, age, level of education, and secondary disability), state-federal vocational rehabilitation (VR) services, and VR employment outcomes among individuals who are hard-of-hearing. This study also explored what VR services contribute to employment outcomes for individuals who are hard-of-hearing. Data from The U.S. Department of Education Rehabilitation Service Administration Case Service Report (RSA-911) FY 2014 was used to focus on individuals who are hard-of-hearing. Logistic regression, Chi-square, and Chi-square Automatic Interaction Detector (CHAID) analyses were used to analyze the RSA-911 dataset.

A Study Of Counselor Trainees' Self-Perceived Competency In Social Justice Advocacy, Mary Ann Rocha

Theses and Dissertations

The purpose of the study is to examine the social justice advocacy competencies of rehabilitation counselor trainees. The study aims to explore rehabilitation counselor trainees’ self-perceived social justice advocacy competencies. More specifically, counselor trainees’ demographic and training variables will be examined to understand the process of social justice advocacy competency. Also, the study will explore the correlation between social justice advocacy competency and ethical awareness. A convenience sample of counselor trainees who are in a master’s-level or doctoral level rehabilitation counseling program or related counseling program was utilized for this study. In total, 132 counselors in training completed the online …

Certified Rehabilitation Counselors' Self-Perceived Competency In Facilitating End-Of-Life Care Services, Miranda Lopez

Theses and Dissertations

As of 2010, certified rehabilitation counselors (CRC) have been provided ethical guidelines addressing end-of-life care (EOL) service delivery for persons with disabilities. Due to the plethora of pertinent knowledge and skills sets needed to facilitate comprehensive EOL issues, it is vital to examine rehabilitation counselors’ self-perceived competence in facilitating EOL care service delivery. The study was conducted as a non-experimental exploratory design. Based on the study’s sample (N = 188), descriptive statistics reported 70% of counselors lacked education while 69% had not participated in EOL training. Approximately 81% of the participants reported the need for EOL education and training. …