Medicine and Health Sciences Commons^™

The Effects Orthostatic Hypotension Has On Falls: A Study Done In San Francisco With The Patient Population Of The Veterans Affairs Hospital, Sherry A. Ballard Ms.

Master's Projects and Capstones

The Effects Orthostatic Hypotension has on Falls: A Study Done in San Francisco Represented

Population of the Veterans Affairs Hoapital

The global AIM of this project is to Identify patients that are at risk for Orthostatic Hypotension (OH) with in the first 24 hours of addmission. It was identified that 50% of the falls over the last 4 quarters at the VA were OH related. The patients were not identified as a fall risk and over half of them had fallen multiple times. After performing a nursing survey online, a SWOT analysis, and a Root Cause Analysis using a fishbone …

Identification And Intervention For Action Planning Deficits In Children With Hemiplegic Cerebral Palsy, Swati M. Surkar

Theses & Dissertations

The primary purpose of this investigation was to describe and quantify action-planning deficits during goal-directed movements in children with hemiplegic cerebral palsy (HCP). Three specific topics were addressed: brain activation, kinematics, and the use of visual input. First, we assessed prefrontal cortex (PFC) activation during complex goal-directed actions in children with HCP. The outcome suggested that children with HCP have higher PFC activation than age matched typically developing (TD) children during action planning, potentially due to the difficulty in allocating attentional resources for simultaneously processing the cognitive (i.e., attention, memory, information processing) and motor demands of the goal-directed task. Reduced …

Juvenile Idiopathic Arthritis: A Systematic Review Of Occupational Therapy Interventions, Meredith L. Aja, Katie L. Cole, Trenton S. Warning

Pediatrics

Background: The purpose of this systematic review is to describe the current role of occupational therapy (OT) in the treatment of Juvenile Idiopathic Arthritis (JIA). JIA is an umbrella term that encompasses six subtypes of the disease. JIA is one of the most common childhood chronic diseases and can be accompanied by symptoms such as pain, stiffness, and loss of function, as well as psychosocial impacts. JIA participants generally receive pharmacological treatment, but less commonly receive therapeutic interventions to help reduce symptoms. Individualized treatment plans are necessary for clients with JIA due to the diverse nature of the disease. …

Clinical Instructors Perceptions Of The Pta-Cpi Assessment Of Critical Thinking, Trudy L. Hansen

Electronic Theses & Dissertations

The purpose of this study was to analyze how critical thinking skills are assessed for Physical Therapist Assistant students within the state of Kansas. Eight face to face interviews were conducted with clinical instructors who use the Physical Therapist Assistant Clinical Performance Instrument (PTA-CPI) as the instrument to assess critical thinking. Physical Therapy educational facilities supplied the names of clinical instructors who met the study’s criteria. Clinical instructor’s gave their definition of critical thinking, stated the advantages and disadvantages of the PTA-CPI, described their perceptions of a PTA student’s critical thinking skills in the clinical educational setting, and discussed what …

A Wilderness And Art Therapy Program For Children With Social Concerns, Ashlynn C. Wardle

Honors Projects

For my honors project, I created an alternative therapy program for children with special needs. Activities were designed to support children with varied needs such as children with autism, ADHD, or learning disabilities. The program utilizes the most successful factors from the fields of art therapy, wilderness therapy, special education, applied behavior analysis, and speech and language therapy the program to form age appropriate, educational, and fun art and wilderness opportunities.

A Correlation Between Gpa And Physical Therapy Treatment Compliance, Courtney Griffith

Honors Projects

This study sought to find a relationship between students’ university grade point average and physical therapy treatment compliance. While other researchers have shown how important compliance is and have investigated factors that affect compliance and GPA separately, no one has studied how GPA and physical therapy treatment compliance are related. We investigated how these two factors interacted and were influenced by other aspects in a population that had not received much attention in literature regarding treatment compliance. This study was a cross sectional survey that used a source population of undergraduate and graduate students at Bowling Green State University in …

Optimizing The Composition And Delivery Of Assessment And Treatment Following Distal Radius Fracture, Michael L. Szekeres

Electronic Thesis and Dissertation Repository

Distal radius fracture (DRF) is the most common fracture.¹ The most recent Cochrane review indicated “The available evidence from randomized controlled trials is insufficient to establish the relative effectiveness of the various interventions used in the rehabilitation of adults with fractures of the distal radius”.²

Since the relative effectiveness of the various interventions used for rehabilitation after DRF is unknown, the main goal of this thesis is to focus on one aspect of both assessment and treatment to add to the current literature base. The first paper (Chapter 2) describes a new method using a modified finger goniometer …

Examining The Lived Experience Of Caregivers Learning A Home Program From A Pediatric Occupational Therapist, Michelle Finet

Theses and Dissertations

The purpose of this study was to examine the lived experiences of family caregivers as they learned a home program from an occupational therapist for their child. Gaining information from the caregiver on experiences with patient education may enable therapists to develop an understanding of the needs of caregivers during the educational process that occurs when a therapist is giving the caregiver a home program. Meeting the learning needs of the caregivers may possibly reduce the amount of overall therapy needed by the child. This phenomenological approach sought to answer the following research questions: (a) what are the lived experiences …

Conquering The Kitchen: Cooking And Older Adult Male Caregivers, Miranda Jenkins, George Kukich

Older Adult

Older adult men who have taken on an unfamiliar role as a caregiver find themselves at a loss with how to conduct meal preparation and cooking (Russell, 2007). The purpose of this study was to explore the effects of a specialized cooking class on the perceptions of older adult male caregivers. Method: This mixed method, retrospective study analyzed surveys from subjects who attended a cooking class designed specifically for male caregivers. Participants were 60 years of age or older and were required to be living in one of nine participating local counties. Results: The participants reported that the course expanded …

Video Modeling To Increase Interaction For Children With Autism Spectrum Disorder In A Museum Setting Using An Application On A Tablet, Bethany Miota Miota

Theses and Dissertations

The purpose of this thesis was to perform an exploratory study to determine if the ScanDo! app intervention is an assistive technology that increases interaction for children with Autism Spectrum Disorder (ASD) in a museum setting. The ScanDo! app intervention presented a video demonstration that modeled the interaction for each learning station by scanning the QR code attached to the station. Using a naturally occurring baseline single-subject design with ABA and reversed ABA phases, two children with ASD and their parents visited the grocery store exhibit at a children’s museum. Observers of the trials and questionnaires completed by parents before …

Perceptual Variations In Thermoregulation During Exercise In A Hot Environment, William C. Alger

Electronic Theses and Dissertations

ABSTRACT

Professionals are seeking to find ways to prevent exertional heat illness (EHI) in populations working in hot environments as well as populations that are physically active. The purpose of the present study was to evaluate individuals’ ability to accurately perceive core temperature ranges associated with homeothermic and EHI temperatures during exercise. Ten physically active males exercised on a treadmill at a self-selected rate until core temperature reached 39°C. Participants rated perceived core and skin temperature on 100 mm scales each time core temperature increased 0.25˚ C (37.5-39.0˚ C), along with thermal comfort and sweating sensation. During exercise core temperature …

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 …

Evaluating Cardiovascular Dysfunction During Increased Activity And Exercise Rehabilitation Following Incomplete Thoracic Spinal Cord Injury In The Adult Rat., Kathryn A. Harman

Electronic Theses and Dissertations

Spinal cord injury (SCI) results in whole-body dysfunction. While the majority of SCI research is focused on improving locomotor function after injury, cardiovascular (CV) disease continues to be the leading cause of morbidity in the chronic SCI patient population. The combination of injury-induced destruction of autonomic pathways, maladaptive plasticity within lumbosacral circuits, and the progressive decline in physical fitness contribute to the poor CV status of SCI individuals. Currently, there is little emphasis on implementing appropriately-timed acute rehabilitation techniques aimed to curtail maladaptive remodeling and improve CV outcomes. Furthermore, no pre-clinical or clinical studies have investigated the most appropriate time-course …

A Feasibility Study Of Using Headspace For Mindfulness Among Individuals Undergoing Surgical Repair Of The Rotator Cuff, Hanna Rae Paul

Theses and Dissertations

Mindfulness-based interventions (MBIs) have been found to help reduce psychological distress and pain in chronic musculoskeletal conditions. However, very limited evidence exists determining the impact of mindfulness on psychological distress and pain in acute musculoskeletal conditions including rotator cuff tears. Among individuals undergoing surgical repair of a rotator cuff tear, it is not clear how mindfulness may be combined with usual care, given the requirement of intense training as part of frequently used MBI protocols. The purpose of the present study was to determine if it was feasible to combine Headspace, a mobile application for mindfulness training that can be …

Effect Of Heavy Lifting With A Head Strap On The Pelvic Floor Across The Menstrual Cycle, Yvonne Biswokarma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Pelvic organ prolapse (POP) occurs in 10% of women in Nepal, even 6% of nulliparous women have symptomatic POP.1 This may be linked to the heavy lifting tasks performed by women using a head strap.2 This study explored the impact of hormonal changes on the pelvic floor when performing these tasks during each phase of the menstrual cycle. Methods: The study included 22 female Nepali participants with a mean age of 27.4(3.6) years; all were from rural villages and frequently carried with a head strap. Using intravaginal pressure transducers (IVT), the mean change in intraabdominal pressure (IAP) was found …

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 …

The Debt Burden Of Entry-Level Physical Therapists In Florida, Steven Benton Ambler

USF Tampa Graduate Theses and Dissertations

Despite the education, autonomy, and high demand for physical therapists both nationally and in Florida, recent graduates have seen steadily rising education costs with disproportionate changes in income once they have graduated and entered the workforce. The growing debt burden of physical therapists entering the workforce, coupled with the growth in projected need and stagnant wages, raises concern about where and how entry-level physical therapists will practice and if these choices will be affected by their debt burden. The purpose of this quantitative, cross-sectional survey study was to identify the debt profile of entry-level physical therapists and explore the relationship …

Effect Of Lighting On Performance Of Tasks Requiring Near Vision In Older Adults, Karen Leigh James

Occupational Therapy Program Student Theses, Dissertations and Capstones

With age, more light is needed in order to function, but the effect of lighting on occupational performance has received little attention in occupational therapy. The purpose of the study was to determine if lighting affects older adults’ ability to perform selected occupational tasks, which require near vision and if lighting levels affects their perceived effort while performing selected occupational tasks. A quasi-experimental, repeated measures design was used with a convenience sample recruited from a retirement community. Thirty participants met the inclusion criteria, which included visual and cognitive screening. The mean age of the 30 participants was 83 years, and …

A Retrospective Study Of Handwriting Skills Of Kindergarten Students, Danielle Benter, Dawn Fields, Catherine Nichols

Pediatrics

OBJECTIVE: The purpose of this study was to guide teachers and occupational therapist in recognizing handwriting needs in order to provide appropriate early intervention support for handwriting.

METHOD: 218 kindergarten students in a public school district were screened for handwriting ability using the Handwriting Without Tears and the Public School’s copy screeners. Students were assessed three times during the 2014 to 2015 school year on letter memory, line placement, letter orientation, copy legibility, and copy placement skills.

RESULTS: The results indicated that winter scores were a better predictor of spring scores. Significant effects in four out of five variables were …

Evaluating Factors That Affect Hand Dexterity After Distal Radius Fracture, Pavlos Bobos

Electronic Thesis and Dissertation Repository

Abstract

Objectives: The primary objective of this study was to determine the effect of age and gender on hand dexterity after distal radius fracture (DRF). The second aim of this study was to evaluate the recovery of hand dexterity in 1-year follow-up of DRF. The third purpose of this study was to determine the extent to which loss of range of motion (ROM) and grip strength predicts hand dexterity 6-months after injury

Methods: A prospective cohort study of 242 patients with DRF examined the recovery of hand dexterity across 3 time-points (3, 6 and 12 months). Dexterity testing was performed …

Occupational Therapy Services And Clinical Decision Making In Oncology Care: A Mixed Methods Approach, Sheila M. Longpre'

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this study was to explore the types and patterns of occupational therapy services implemented with clients who are cancer survivors, which utilized a mixed methods approach, specifically an explanatory sequential design. The Occupational Therapy Practice Inventory (OTPI) was used to gather information regarding the type and patterns of occupational therapy services provided for clients receiving oncology care. The results of the OTPI were analyzed and used to further develop semi-structured questions for exploring the perspectives of occupational therapy practitioners who practice in the area of oncology in the United States. The data were analyzed to generate a …

Fitness-To-Drive Screening Measure© : Constructing And Validating The Short Form, Shabnam Medhizadah

Electronic Thesis and Dissertation Repository

The valid and reliable Fitness-to-Drive Screening Measure^© (FTDS) is a free online proxy measure that screens for at-risk older drivers using 54 driving-related items. This secondary data analysis aims to construct and validate a short form FTDS, using 200 caregiver FTDS response sets and 200 older driver on-road assessment pass/fail outcomes. To construct the short form, exploratory factor analysis and classical test theory techniques were employed to determine the most interpretable factor model and the minimum number of items that might be used to predict fitness to drive. Next, receiver operating characteristics curves were generated to evaluate the concurrent …

Multi-Classifier Fusion Strategy For Activity And Intent Recognition Of Torso Movements, Abhijit Kadrolkar

Doctoral Dissertations

As assistive, wearable robotic devices are being developed to physically assist their users, it has become crucial to develop safe, reliable methods to coordinate the device with the intentions and motions of the wearer. This dissertation investigates the recognition of user intent during flexion and extension of the human torso in the sagittal plane to be used for control of an assistive exoskeleton for the human torso. A multi-sensor intent recognition approach is developed that combines information from surface electromyogram (sEMG) signals from the user’s muscles and inertial sensors mounted on the user’s body. Intent recognition is implemented by following …

Predicting Walking Ability And Prosthetic Candidacy Following Lower Extremity Amputation: Systematic Review, Treatment Pathway And Algorithm, Scott Love

Student Dissertations

Purpose: The purpose of this study is a systematic review (SR) of existing literature to examine characteristics of persons with amputation which predict walking ability and prosthetic candidacy following lower extremity amputation (LEA). The identification, synthesis and summary of this evidence could assist in developing clinical practice guidelines, including a physical rehabilitation treatment pathway and a clinical algorithm. The importance of this project is the establishment to further develop evidence based LEA clinical practice guidelines. This evidence will assist the healthcare team in decision making, specifically considering evidence and patient-centric predictive characteristics.

Background: Currently, there is no multi-disciplinary physical …

Exploring The Critical Thinking Skills Of Respiratory Care Students And Faculty, Bshayer Ramadan Alhamad

Seton Hall University Dissertations and Theses (ETDs)

Introduction: Today, with the increased demands in health care, working as a competentrespiratory therapist requires being a highly skilled, critically thinking professional. Although students are expected to learn how to think critically mostly in the academic environment from their faculty, only a paucity of studies has assessed the critical thinking of respiratory care students, with none, to our knowledge, assessing that of faculty. Therefore, the purpose of this mixed method study was to (1) assess the overall critical thinking skill levels of both respiratory care students and faculty, (2) investigate whether respiratory care faculty have stronger overall critical thinking skills …

A Longitudinal Study To Investigate Changes In Functional Ability And Concerns In Head Neck Cancer Patients Undergoing Neck Dissection, Mariya Ehsan

Electronic Thesis and Dissertation Repository

Introduction:

The study investigated changes of shoulder/neck range of motion (ROM), shoulder strength, patient concerns and quality of life at pre-surgery and 1 month following neck dissection surgery.

Method:

Participants were 30 head and neck cancer patients selected for unilateral neck dissection. Shoulder/neck ROM and shoulder strength were measured at pre-surgery and 1 month post-surgery. The Patient Concerns Inventory-Level of Importance, University of Washington Quality of Life, Shoulder Pain and Disability Index and Neck Dissection Impairment Index were completed at the same time periods.

Result:

A significant drop in ROM and strength were found after surgery. Patients’ concerns changed over …

Investigating The Relationship Between Vascular Health, Gait, And Cognition In Community-Dwelling Older Adults Without Dementia, Michael A. Gregory

Electronic Thesis and Dissertation Repository

Cardiovascular disease (CVD) risk factors contribute to neuropathological changes within regions of the brain that are involved with both cognitive and motor control processes, and have been identified as potentially modifiable dementia and gait dysfunction risk factors. Exercise training is a corner-stone treatment for vascular risk factor control, and evidence suggests that physical and cognitive training can benefit cognition and gait; however, the exercise training modality that can provide the greatest cognitive benefit remains elusive. Therefore, the purpose of this thesis was three-fold: (i) to determine whether CVD risk factors and gait were associated with cognitive functioning, (ii) to determine …

Longitudinal Evaluation Of Patient Concerns After Surgery For Head And Neck Cancer, Isabel Wozniczka

Electronic Thesis and Dissertation Repository

The primary purpose of this study was to investigate and describe the longitudinal effects of shoulder and neck mobility, strength, and quality of life (QOL) following neck dissection (ND) surgery and identify the concerns of head and neck cancer (HNC) patients. ND is one of the standard procedures for treating HNC, which results in many complications and dysfunctions that can have an effect on a patient’s QOL.

The study had 27 eligible HNC participants who underwent ND, of which eight participated in the shoulder range of motion (ROM) and strength and 12 participated in the QOL patient-reported outcomes analysis. The …

Neuropsychological Effects Of Pomegranate Supplementation Following Ischemic Stroke, John A. Bellone

Loma Linda University Electronic Theses, Dissertations & Projects

Polyphenols are compounds found in fruits and vegetables that have antioxidant and anti-inflammatory properties. Mounting evidence suggests that dietary polyphenol intake can reduce the detrimental effects of various disease processes, and pomegranates have frequently been examined because of their particularly high polyphenol content. Since stroke induces both oxidative stress and inflammation and is currently the leading cause of long-term disability in the U.S., we sought to determine whether dietary supplementation with polyphenols could enhance cognitive recovery in individuals who had suffered an ischemic stroke. We administered polyphenols via 2 POMx pills containing polyphenols derived from pomegranates equivalent to the content …

The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip

Electronic Thesis and Dissertation Repository

The objective of the thesis was to describe the factors leading to falls in distal radius fracture (DRF) events, explore patient perceived risk of falls, and postural stability. A mixed method study described the type of fall in DRF patients (n= 1454) and patient perceived contributing factors (n=29). A prospective cohort study examined the postural stability and related fall risk of DRF participants (n=137) in Biodex Balance System (BBS) and compared to normative values. Environmental factors were a major contributor to DRF events. Older adults (44 to 65 years) had the highest rate of DRF (female: male ratio of 2:1). …