Medicine and Health Sciences Commons^™

The Efficacy Of Constraint-Induced Movement Therapy Or Modified Constraint-Induced Movement Therapy In Improving Upper Extremity Motor Function In Adults With Hemiplegia After A Traumatic Brain Injury, Ryan Bizette, Adaire Deblanc, Rachel Ridenour, Lindsey Satterlee, Allyson Smith, Katya Vanausdall

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains 11 research articles from both national and international journals. Study designs include two randomized control trials, one systematic review, four quasi-experimental studies, one case study, two case series, and one pilot case study. All studies relate directly to components of the evidence-based practice question and will be used to draft new practice guidelines for using constraint-induced movement therapy (CIMT) or modified constraint-induced movement therapy (mCIMT) in occupational therapy practice.

Seven articles specifically describe the effectiveness of CIMT or mCIMT for adults with hemiplegia following a traumatic brain injury. The other four articles describe the effectiveness of …

A Tailored Occupational Therapist-Led Vocational Intervention For People With Stroke: Protocol For A Pilot Randomized Controlled Trial, Sophie O'Keefe, Kathryn Radford, Amanda Farrin, Jodi Oakman, Serena Alves-Stein, Geoffrey Cloud, Jacinta Douglas, Mandy Stanley, Natasha A. Lannin

Research outputs 2022 to 2026

Background: Resuming work after stroke is a common goal of working-age adults, yet there are few vocational rehabilitation programs designed to address the unique challenges faced following stroke. The Work intervention was developed to address these gaps. Objective: This paper presents a protocol that outlines the steps that will be undertaken to pilot both the intervention and trial processes for the Work trial. Methods: The Work trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. A total of 54 adults of working age who have experienced a stroke <4 months prior will be randomized 1:1 to either (1) an experimental group who will receive a 12-week early vocational intervention (Work intervention) plus usual clinical rehabilitation or (2) a control group who will receive only their usual clinical rehabilitation. Results: Outcomes include study and intervention feasibility and intervention benefit. In addition to evaluating the feasibility of delivering vocational intervention early after stroke, benefit will be assessed by measuring rates of vocational participation and quality-of-life improvements at the 3- and 6-month follow-ups. Process evaluation using data collected during the study, as well as postintervention individual interviews with participants and surveys with trial therapists, will complement quantitative data. Conclusions: The results of the trial will provide details on the feasibility of delivering the Work intervention embedded within the clinical rehabilitation context and inform future trial processes. Pilot data will enable a future definitive trial to determine the clinical effectiveness of vocational rehabilitation when delivered in the early subacute phase of stroke recovery.

Age-Dependent White Matter Disruptions After Military Traumatic Brain Injury: Multivariate Analysis Results From Enigma Brain Injury, Heather C. Bouchard, Delin Sun, Emily L. Dennis, Mary R. Newsome, Seth G. Disner, Jeremy Elman, Annelise Silva, Carmen Velez, Andrei Irimia, Nicholas D. Davenport, Scott R. Sponheim, Carol E. Franz, William S. Kremen, Michael J. Coleman, M. Wright Williams, Elbert Geuze, Inga K. Koerte, Martha E. Shenton, Maheen M. Adamson, Raul Coimbra, Gerald Grant, Lori Shutter, Mark S. George, Ross D. Zafonte, Thomas W. Mcallister, Murray B. Stein, Paul M. Thompson, Elisabeth A. Wilde, David F. Tate, Aristeidis Sotiras, Rajendra A. Morey

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

Mild Traumatic brain injury (mTBI) is a signature wound in military personnel, and repetitive mTBI has been linked to age-related neurogenerative disorders that affect white matter (WM) in the brain. However, findings of injury to specific WM tracts have been variable and inconsistent. This may be due to the heterogeneity of mechanisms, etiology, and comorbid disorders related to mTBI. Non-negative matrix factorization (NMF) is a data-driven approach that detects covarying patterns (components) within high-dimensional data. We applied NMF to diffusion imaging data from military Veterans with and without a self-reported TBI history. NMF identified 12 independent components derived from fractional …

The Role Of Reported Affective Symptoms And Anxiety In Recovery Trajectories After Sport-Related Concussion, Bernadette A. D'Alonzo, Abigail C. Bretzin, Douglas J. Wiebe, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender, Cary R. Savage

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

Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited.

Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery.

Study Design: Cohort study; Level of evidence, 3.

Methods: …

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 …

The Use Of Actigraphy And Its Impact On Perceived Sleep Quality And Activity Levels In Individuals With Traumatic Brain Injury In An Inpatient Rehabilitation Setting., Lina Shkokani, Amanda Reyes, Bachar Hazim, Jason Kisser, Philip T. Roskos

Conference Presentation Abstracts

No abstract provided.

A Single-Center Comparison Using Exoskeleton Rehabilitation For Cerebrovascular Accidents And Traumatic Brain Injury In A Cohort Of Hispanic Patients, Lisa R. Trevino, Kristina Vatcheva, Michael E. Auer, Angela Morales, Lama M. Abdurrahman, Sarajova Viswamitra, Annelyn Torres-Reveron

School of Mathematical and Statistical Sciences Faculty Publications and Presentations

Background Traumatic brain injury (TBI) is one of the leading causes of disability in the United States. The EKSO GT Bionics® (EKSO®) is a robotic exoskeleton approved by the Federal Drug Administration (FDA) for rehabilitation following a cerebrovascular accident (CVA or stroke) and recently received approval for use in patients with TBI. The aim of the study was to examine if the use of exoskeleton rehabilitation in patients with TBI will produce beneficial outcomes.

Methods This retrospective chart-review reports the use of the (EKSO®) robotic device in the rehabilitation of patients with TBI compared to patients with CVA. We utilized …

Predictors Of Swallowing Outcomes In Patients With Combat-Injury Related Dysphagia, Nancy Pearl Solomon, Angela M. Dietsch, Katie Dietrich-Burns

Department of Special Education and Communication Disorders: Faculty Publications

Background: Traumatic injuries, such as those from combat-related activities, can lead to complicated clinical presentations that may include dysphagia. Methods: This retrospective observational database study captured dysphagia-related information for 215 US military service members admitted to the first stateside military treatment facility after sustaining combat-related or combat-like traumatic injuries. A multidimensional relational database was developed to document the nature, course, and management for dysphagia in this unique population and to explore variables predictive of swallowing recovery using Bayesian statistical modeling and inferential statistical methods. Results: Bayesian statistical modeling revealed the importance of maxillofacial fractures and soft tissue loss as primary …

Diagnosing Mild Traumatic Brain Injury Using Saliva Rna Compared To Cognitive And Balance Testing, Steven D. Hicks, Cayce Onks, Raymond Y. Kim, Kevin J. Zhen, Jayson Loeffert, Andrea C. Loeffert, Robert P. Olympia, Gregory Fedochak, Samantha Devita, Aakanksha Rangnekar, John Leddy, Mohammad N. Haider, Zofia Gagnon, Callan D. Mcloughlin, Matthew Badia, Jason Randall, Miguel Madeira, Aaron M. Yengo-Kahn, Justin Wenzel, Matthew Heller, Hallie Zwibel, Aaron Roberts, Samantha Johnson, Chuck Monteith, Michael N. Dretsch, Thomas R. Campbell, Rebekah Mannix, Christopher Neville, Frank Middleton

Rehabilitation Sciences Faculty Publications

BACKGROUND: Early, accurate diagnosis of mild traumatic brain injury (mTBI) can improve clinical outcomes for patients, but mTBI remains difficult to diagnose because of reliance on subjective symptom reports. An objective biomarker could increase diagnostic accuracy and improve clinical outcomes. The aim of this study was to assess the ability of salivary noncoding RNA (ncRNA) to serve as a diagnostic adjunct to current clinical tools. We hypothesized that saliva ncRNA levels would demonstrate comparable accuracy for identifying mTBI as measures of symptom burden, neurocognition, and balance.

METHODS: This case‐control study involved 538 individuals. Participants included 251 individuals with mTBI, enrolled …

Does Generalization Occur Following Computer-Based Cognitive Retraining?—An Exploratory Study, Kitsum Li, Jonathan Alonso, Nisha Chadha, Jennifer Pulido

Collected Faculty and Staff Scholarship

Computer-based cognitive retraining (CBCR) intervention has gained great popularity in recent years. This study aimed to investigate the occurrence of skill generalization to daily living task for individuals with acquired brain injury (ABI) after completion of eight modules of a commercially available CBCR program, the Parrot Software. The study investigated changes in individuals’ global cognition as measured by the Montreal Cognitive Assessment, and changes in individuals’ performance during a medication-box sorting task, a novel instrumental activity of daily living. The medication-box sorting task resembled real life medication management with daily prescribed and over-the-counter medications. Twelve individuals with ABI from a …

Mitochondria-Associated Micrornas In Rat Hippocampus Following Traumatic Brain Injury, Wang-Xia Wang, Nishant P. Visavadiya, Jignesh D. Pandya, Peter T. Nelson, Patrick G. Sullivan, Joe E. Springer

Sanders-Brown Center on Aging Faculty Publications

Traumatic brain injury (TBI) is a major cause of death and disability. However, the molecular events contributing to the pathogenesis are not well understood. Mitochondria serve as the powerhouse of cells, respond to cellular demands and stressors, and play an essential role in cell signaling, differentiation, and survival. There is clear evidence of compromised mitochondrial function following TBI; however, the underlying mechanisms and consequences are not clear. MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate gene expression post-transcriptionally, and function as important mediators of neuronal development, synaptic plasticity, and neurodegeneration. Several miRNAs show altered expression following TBI; however, the …

Can Helmet Design Reduce The Risk Of Concussion In Football?, Steven Rowson, Stefan M. Duma, Richard M. Greenwald, Jonathan Beckwith, Jeffrey J. Chu, Kevin M. Guskiewicz, Jason P. Mihalik, Joe Crisco, Bethany J. Wilcox, Thomas W. Mcallister, Arthur C. Maerlender, Steven P. Broglio, Brock Schnebel, Scott Anderson, P. Gunnar Brolinson

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

Of all sports, football accounts for the highest incidence of concussion in the US due to the large number of athletes participating and the nature of the sport. While there is general agreement that concussion incidence can be reduced through rule changes and teaching proper tackling technique, there remains debate as to whether helmet design may also reduce the incidence of concussion. A retrospective analysis was performed of head impact data collected from 1833 collegiate football players who were instrumented with helmet-mounted accelerometer arrays for games and practices. Data were collected between 2005 and 2010 from 8 collegiate football teams: …

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Collected Faculty and Staff Scholarship

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …

Smart Rehabilitation For The 21st Century: The Tampa Smart Home For Veterans With Traumatic Brain Injury, Jan Jasiewicz, William D. Kearns, Jeffrey Craighead, James L. Fozard, Steven Scott, Jay Mccarthy

Rehabilitation and Mental Health Counseling Faculty Publications

No abstract provided.