Medicine and Health Sciences Commons^™

“Machine-Dependent”: The Lived Experiences Of Patients Receiving Hemodialysis In Pakistan, Haseeba Shouket, Eyal Gringart, Dierdre Drake, Ulrich Steinwandel

Research outputs 2022 to 2026

This study aimed to explore the lived experiences of patients receiving maintenance hemodialysis in Pakistan. Purposive sampling was used to recruit 24 patients and six healthcare professionals, each participated in a semi-structured interview. Interpretive Phenomenological Analysis was used to analyze interviews’ data. Two superordinate themes, “The experience of hemodialysis” and “The conceptualizations of hemodialysis” as well as six sub-themes were identified. The experience of hemodialysis was related to, the implications of HD procedure on everyday life, social, cognitive, emotional, financial, and occupational influences. While all participants recognized the importance of hemodialysis for their survival, their conceptualizations of the treatment varied. …

Doctoral Physical Therapy Students' Increased Confidence Following Exploration Of Active Video Gaming Systems In A Problem-Based Learning Curriculum In The United States: A Pre-And Post-Intervention Study, Michelle E. Wormley, Wendy Romney, Diana Veneri, Andrea Oberlander

Physical Therapy Faculty Publications

Purpose: Active video gaming (AVG) is used in physical therapy (PT) to treat individuals with a variety of diagnoses across the lifespan. The literature supports improvements in balance, cardiovascular endurance, and motor control; however, evidence is lacking regarding the implementation of AVG in PT education. This study investigated doctoral physical therapy (DPT) students' confidence following active exploration of AVG systems as a PT intervention in the United States.

Methods: This pretest-posttest study included 60 DPT students in 2017 (Cohort 1) and 55 students in 2018 (Cohort 2) enrolled in a problem-based learning curriculum. AVG systems were embedded into patient cases …

Physical Activity Interventions In Children With Juvenile Idiopathic Arthritis: A Systematic Review Of Randomized Controlled Trials, Maura D. Iversen, Marie Andre, Johan Von Heideken

Physical Therapy Faculty Publications

Introduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.

Materials and methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and …

Progression Through Return-To-Sport And Return-To-Academics Guidelines For Concussion Management And Recovery In Collegiate Student Athletes: Findings From The Ivy League–Big Ten Epidemiology Of Concussion Study, Douglas J. Wiebe, Abigail C. Bretzin, Bernadette A. D'Alonzo, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Objective To examine the progression of collegiate student athletes through five stages of a return-to- activity protocol following sport-related concussion (SRC).

Methods In a multisite prospective cohort study, we identified the frequency of initial 24–48 hours physical and cognitive rest, and the sequence of (1) symptom resolution and return to (2) exertion activity, (3) limited sport, (4) full sport and (5) full academics. In resulting profiles we estimated the likelihood of return to full sport ≤14 days or prolonged >28 days and tested for variability based on timing of the stages.

Results Among 1715 athletes with SRC (31.6% females), 67.9% …

Head Impact Exposure In Youth And Collegiate American Football, Grace B. Choi, Eric P. Smith, Stefan M. Duma, Steven Rowson, Eamon Campolettano, Mireille E. Kelley, Derek A. Jones, Joel D. Stitzel, Jillian E. Urban, Amaris Genemaras, Jonathan G. Beckwith, Richard M. Greenwald, Arthur C. Maerlender, Joseph J. Crisco

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The relationship between head impact and subsequent brain injury for American football players is not well defined, especially for youth. The objective of this study is to quantify and assess Head Impact Exposure (HIE) metrics among youth and collegiate football players. This multiseason study enrolled 639 unique athletes (354 collegiate; 285 youth, ages 9–14), recording 476,209 head impacts (367,337 collegiate; 108,872 youth) over 971 sessions (480 collegiate; 491 youth). Youth players experienced 43 and 65% fewer impacts per competition and practice, respectively, and lower impact magnitudes compared to collegiate players (95th percentile peak linear acceleration (PLA, g) competition: 45.6 vs …

Constructing Neural Network Models From Brain Data Reveals Representational Transformations Linked To Adaptive Behavior, Takuya Ito, Guangyu Robert Yang, Patryk Laurent, Douglas H. Schultz, Michael W. Cole

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The human ability to adaptively implement a wide variety of tasks is thought to emerge from the dynamic transformation of cognitive information. We hypothesized that these transformations are implemented via conjunctive activations in “conjunction hubs”—brain regions that selectively integrate sensory, cognitive, and motor activations. We used recent advances in using functional connectivity to map the flow of activity between brain regions to construct a task-performing neural network model from fMRI data during a cognitive control task. We verified the importance of conjunction hubs in cognitive computations by simulating neural activity flow over this empirically-estimated functional connectivity model. These empiricallyspecified simulations …

Affective Flexibility As A Developmental Building Block Of Cognitive Reappraisal: An Fmri Study, Jordan E. Pierce, Eisha Haque, Maital Neta

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Cognitive reappraisal is a form of emotion regulation that involves reinterpreting the meaning of a stimulus, often to downregulate one’s negative affect. Reappraisal typically recruits distributed regions of prefrontal and parietal cortex to generate new appraisals and downregulate the emotional response in the amygdala. In the current study, we compared reappraisal ability in an fMRI task with affective flexibility in a sample of children and adolescents (ages 6–17, N = 76). Affective flexibility was defined as variability in valence interpretations of ambiguous (surprised) facial expressions from a second behavioral task. Results demonstrated that age and affective flexibility predicted reappraisal ability, …

The Politics Of Drug Rehabilitation In The Philippines, Gideon Lasco, Lee Edson Yarcia

Development Studies Faculty Publications

The international consensus to end compulsory drug treatments and close forced rehabilitation facilities needs urgent transformation to country policies. In the Philippines, as with other countries in Asia, rehabilitation can be compulsory and is seen as the humane alternative to the “war on drugs.” In this paper, we present the landscape of rehabilitation and narrate the ways in which people who use drugs are forced to undergo treatment. We unpack the politics behind rehabilitation and explain the sociocultural foundations that support compulsory treatment. We argue that a transition to a human rights-based approach, including voluntary alternatives in community settings, is …

Cross-Education Balance Effects After Unilateral Rehabilitation In Individuals With Chronic Ankle Instability: A Systematic Review, Briana Lawry-Popelka, Sunghoon Chung, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Objective: To conduct a systematic review of existing literature on cross-education balance effects after unilateral training in the population with chronic ankle instability (CAI).

Data Sources: PubMed, SPORTDiscus, CINAHL Plus.

Study Selection: To be included in the systematic review, studies were required to have been published in English, included participants with CAI, had participants undergo a unilateral therapeutic exercise for the lower extremity, and measured balance performance of the untrained lower extremity before and after the intervention.

Data Extraction: The certainty of evidence in each included study was assessed via the Downs and Black checklist. A score of 24 to …

Characteristics Of Patient Encounters For Athletic Training Students During Clinical Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, R.Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients that have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences.

Objective: To describe the characteristics of patient encounters (PEs) ATSs engage in during clinical experiences. Design: Multi-site, panel design.

Setting: 12 professional athletic training programs (ATPs; 5 Bachelor, 7 Master's).

Patients or Other Participants: 363 ATSs from the ATPs that used E*Value software to document PEs during clinical …

Statistical Analysis Plan For The Stepped-Wedge Clinical Trial Healing Right Way - Enhancing Rehabilitation Services For Aboriginal Australians After Brain Injury, Elizabeth Armstrong, Tapan Rai, Deborah Hersh, Sandra Thompson, Juli Coffin, Natalie Ciccone, Leon Flicker, Dominique Cadilhac, Erin Godecke, Deborah Woods, Colleen Hayward, Graeme J. Hankey, Meaghan Mcallister, Judith Katzenellenbogen

Research outputs 2022 to 2026

Background: Aboriginal Australians are known to suffer high levels of acquired brain injury (stroke and traumatic brain injury) yet experience significant barriers in accessing rehabilitation services. The aim of the Healing Right Way trial is to evaluate a culturally secure intervention for Aboriginal people with newly acquired brain injury to improve their rehabilitation experience and quality of life. Following publication of the trial protocol, this paper outlines the statistical analysis plan prior to locking the database. Methods: The trial involves a stepped wedge design with four steps over 3 years. Participants were 108 adult Aboriginal Australians admitted to one of …

The Effects Of Home-Based Exercise Therapy For Breast Cancer-Related Fatigue Induced By Radical Radiotherapy, Georgios Mavropalias, Prue Cormie, Carolyn J. Peddle-Mcintyre, Daniel A. Galvão, Dennis R. Taaffe, Christelle Schofield, Sharon Ray, Yvonne Zissiadis, Robert U. Newton

Research outputs 2022 to 2026

Background: Radiotherapy (RT) can lead to cancer-related fatigue (CRF) and decreased health-related quality of life (HRQoL) in breast cancer patients. The purpose of this trial was to examine the feasibility and efficacy of a home-based resistance and aerobic exercise intervention for reducing CRF and improving HRQoL in breast cancer patients during RT. Methods: Women with breast cancer (N = 106) commencing RT were randomized to 12 weeks of home-based resistance and aerobic exercise (EX) or usual care/control (CON). The primary endpoint was CRF, with secondary endpoints of HRQoL, sleep duration and quality, and physical activity. Measurements were undertaken prior to …

Improvement Of Spasticity-Related Pain With Incobotulinumtoxina Treatment In Children/Adolescents With Cerebral Palsy: Pooled Analysis Of 3 Phase 3 Studies, Florian Heinen, Petr Kanovsky, A Sebastian Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Hanna Dersch, Irena Pulte, Michael Althaus, Marta Banach, Deborah Gaebler-Spirag

Conference Presentation Abstracts

Introduction: Spasticity-related pain (SRP) in children and adolescents with cerebral palsy (CP) is common, often neglected, and impacts daily quality of life. We assessed the effect of incobotulinumtoxinA on SRP using pooled data from 3 large Phase 3 pediatric studies.

Methods: Ambulant and non-ambulant patients (2–17 years of age; uni- or bilateral CP; Ashworth Scale score ≥2 in clinical patterns for treatment) were enrolled. Patients received total body incobotulinumtoxinA doses of ≤16 U/kg (≤400 U) for lower-limb (LL) treatment in 2 injection cycles (ICs) in TIM (NCT01893411). In TIMO (NCT01905683), TIM completers and new recruits received 4 ICs with 16–20 …

Corticospinal Activity During A Single-Leg Stance In People With Chronic Ankle Instability, Masafumi Terada, Kyle B. Kosik, Ryan S. Mccann, Colin Drinkard, Phillip A. Gribble

Rehabilitation Sciences Faculty Publications

Purpose: The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls.

Methods: Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.

Results: Participants with CAI had significantly longer CSP at 100% of AMT and lower normalized MEP at 120% of AMT compared to …

Core Competency-Related Professional Behaviors During Patient Encounters: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, it is important that athletic trainers integrate the components of the core competencies (CCs; evidence-based practice [EBP], patient-centered care [PCC], health information technology [HIT], interprofessional education and collaborative practice [IPECP], quality improvement [QI], professionalism) as a part of routine clinical practice. In what ways, if any, athletic training students (ATSs) are currently integrating CCs into patient encounters (PEs) during clinical experiences is unclear.

Objective: To describe which professional behaviors associated with the CCs were implemented by ATSs during PEs that occurred during clinical experiences.

Design: Multisite panel design.

Setting: A total of …

The Effect Of Concussion History On Lower Extremity Injury Risk In College Athletes: A Systematic Review And Meta Analysis, Vanessa Ramirez, Ryan Mccann, Eric Schussler, Jessica Martinez

Rehabilitation Sciences Faculty Publications

INTRODUCTION: Collegiate athletes who suffer a concussion may possess prolonged impairments even after clearance for return-to-participation, which may place them at an increased risk of lower extremity injury.

OBJECTIVE: To conduct a systematic review and meta-analysis of studies examining risk of lower extremity musculoskeletal injury following a concussion in collegiate athletes.

METHODS: A literature search was performed using the following databases: PubMed, CINAHL, SPORTDiscus. The following search terms were used to identify relevant articles, ["concussion" OR "brain injury" OR "mild traumatic brain injury" OR "mTBI"] AND ["lower extremity injury" OR "musculoskeletal injury"]. Articles were included if they were published between …

Bridging The Gap Between Clinical Service And Academic Education Of Hand-Splinting Practice: Perspectives And Experiences Of Thai Occupational Therapists, Anuchart Kaunnil, Veerawat Sansri, Surachart Thongchoomsin, Kannika Permpoonputtana, Mandy Stanley, Piyawat Trevittaya, Chirathip Thawisuk, Peeradech Thichanpiang

Research outputs 2022 to 2026

A gap in knowledge about current splinting practice exists between the educational program and clinical service. To bridge this gap, we investigated the perspectives and experiences of Thai occupational therapists regarding contemporary hand splinting practices in clinical use. A mixed-method study was designed. An explanatory sequential mixed methods design was used. In the first quantitative phase, a survey questionnaire was mailed to occupational therapists. The questions were regarding contemporary hand splinting practices in clinical use at seven hospitals in the capital city of Bangkok and outskirt areas. In the second phase, semi-structured interviews were completed to explore expert occupational therapists' …

Self-Care: An Occupational Therapy Student Perspective, Isabelle Laposha, Stacy Smallfield

Journal Articles: Occupational Therapy

Health professional students, including occupational therapy students, report increasing rates of stress, anxiety, depression, and burnout while completing their academic programs of study. Self-care is one potential solution to this crisis, as engagement in evidence-based self-care practices has been found to improve the health and well-being of various student populations; however, the self-care practices of occupational therapy students have not been well studied. Therefore, this study explored how occupational therapy students understand and practice self-care, and how self-care correlates to perceived stress. Twenty participants engaged in a focus group and completed a 72-hour time diary. Focus group results indicated that …

Pooled Efficacy Analysis Of Incobotulinumtoxina In The Multipattern Treatment Of Upper- And Lower-Limb Spasticity In Children And Adolescents With Cerebral Palsy, Florian Heinen, Petr Kanovsky, A Sebastitan Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Hanna Dersch, Irena Pulte, Michael Althaus, Marta Banach, Deborah Gaebler-Spirag

Conference Presentation Abstracts

Introduction: This pooled analysis assessed the efficacy of incobotulinumtoxinA for lower-limb (LL) and upper-limb (UL) spasticity in children and adolescents with cerebral palsy (CP) using data from the first controlled injection cycle of 2 large Phase 3 studies, TIM (NCT01893411) and XARA (NCT02002884).

Methods: Ambulant and non-ambulant pediatric patients with spasticity due to CP (2–17 years of age; uni- or bilateral CP; Ashworth Scale [AS] score ≥2 in clinical patterns for treatment) were enrolled. Patients were randomized (2:1:1) to 3 incobotulinumtoxinA dose groups: 8, 6, 2 U/kg body weight (BW), maximum 200, 150, 50 U per LL clinical pattern in …

Effects Of A Nurse-Led Tai Chi Programme On Improving Quality Of Life, Mental Wellbeing, And Physical Function Of Women With Breast Cancer: Protocol For A Randomized Controlled Trial, Carol Chunfeng Wang, Sadie Geraghty, Caitlin Fox-Harding, Calvin Wang

Research outputs 2022 to 2026

Objectives:

Quality of life, mental wellbeing, and physical function deteriorate among women with breast cancer. Tai Chi is a moderate form of exercise that may be effective in improving the mental and physical wellbeing, therefore, the quality of life of women with breast cancer. This protocol paper outlines a trial to determine the therapeutic effects of a Tai Chi programme on breast cancer management.

Methods:

The study will be an interventional, single-blind, double-armed, randomized, and controlled trial involving a 12-week Tai Chi programme for women with breast cancer. Forty participants aged 18 years and above who are diagnosed with breast …