Medicine and Health Sciences Commons^™

The Implementation Of Animal Assisted Therapy In Adult Neurological Rehabilitation, Rachel Camilleri

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with Pi Beta Phi Rehabilitation Institute at Vanderbilt University Medical Center. The focus of this project was to develop animal assisted therapy interventions that could be utilized amongst occupational therapy practitioners with the clinic’s facility dog in an effort to increase utilization of animal assisted therapy. The process for this project required a thorough review of the literature on animal assisted therapy and neurological rehabilitation, conversations with current and past facility dog teams to learn about their work, and trialing animal assisted therapy activities in patient sessions. The outcome of this …

”To Be Or Not To Be – It’S Good”: Actor And Student Experiences In A Drama Club For People With Aphasia, Jade K. Hannan

Senior Theses

Individuals with aphasia, a disorder caused by damage to the brain’s language network, confront a variety of social and emotional struggles. While leaving their cognition largely intact, aphasia tremendously impacts a person’s ability to communicate confidently, fracturing their social network and contributing to feelings of loneliness and frustration. To address this persistent need in the chronic aphasia population, the Play on Words drama club at the University of South Carolina provides a forum for people with aphasia (PWA) to engage in dramatic exercises focused on non-verbal communication of emotions, ideas, and stories, culminating the production of an original devised play. …

Dance Intervention For Stroke Rehabilitation: Restoring Occupational Performance Through Creative Movement, Olivia Paige Allen

Graduate Theses, Dissertations, and Problem Reports

Thousands of individuals are affected by cerebral vascular accidents, (CVA), also known as strokes in the United States each year, (CDC, 2023). Cerebral vascular accidents are one of the leading causes of death among the elderly population in the U.S. each year, (NIH et al., 2023). The deficits caused by a CVA can be global, from hemiparetic limbs and sensory loss to psychosocial impacts on an individual and their support system. In occupational therapy, the goal is to regain as much function and independence as possible for the individual who has experienced a CVA. Although many evidence-based intervention tools are …

Developing Rehabilitation Treatment Decision Aid For People Living With Complex Regional Pain Syndrome (Crps), Erfan Shafiee

Electronic Thesis and Dissertation Repository

This Ph.D. dissertation aimed to develop a treatment decision aid for people with Complex Regional Pain Syndrome (CRPS) using the Ottawa Decision Support Framework (ODSF). The decision aid was developed throughout a two-phase process.

The first phase involved understanding the existing evidence and the factors influencing decision-making in CRPS rehabilitation: priorities and preferences of patients and therapists were considered. This phase encompassed the integration of diverse sources of evidence, including systematic reviews, overview of systematic reviews, critical appraisal of guidelines, and a survey exploring patients' and therapists' priorities and preferences for CRPS rehabilitation interventions. All forms of evidence were used …

Nutrient Supplementation For Pre- And Post Acl Operation & Rehabilitation In Female Basketball Players, Mackenzie Steele, Joshua Munoz

Department of Nutrition Student Projects

Understanding how nutrition and dietary protocols can help female athletes in the process of “returning to sport” after an anterior cruciate ligament (ACL) repair surgery should be discussed amongst interprofessional post-operational care teams. Amongst athletes, female counterparts experience ACL injuries at a higher incidence rate than males, this is due to a variety of biological factors while returning to sport at a lower rate. Due to this, it is important to analyze and evaluate the data available from sports journals on the effects diet and supplements may have on the musculoskeletal system. ACL grafts are often taken from a donating …

Expanding The Occupational Therapy Oncology Rehabilitation Program At James A. Haley Veterans' Hospital, Annalisa M. Rodriguez

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Functional Outcomes Of The Graduated Length Prosthetic Protocol For Bilateral Transfemoral Amputee Prosthetic Rehabilitation, Mackenzie Pipes

Master of Science in Kinesiology

The aim of this paper was to evaluate the functional outcomes of the Graduated Length Prosthetic Protocol (GLPP) in individuals with bilateral transfemoral amputations. The GLPP is a rehabilitation program designed to facilitate a successful transition to full-length prostheses, enhance independence, and improve functional outcomes for bilateral transfemoral amputees. This study utilized a prospective design to assess the effectiveness of the GLPP compared to traditional rehabilitation strategies.

Literature was reviewed to determine the current limitations in research regarding bilateral transfemoral amputee prosthetic rehabilitation. The Concordia University St. Paul online library was utilized to obtain access to current published research. Studies …

Developing Group Protocols In An Inpatient Rehabilitation Setting, Madison Quan

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with Vanderbilt Stallworth Rehabilitation Hospital (VSRH) in Nashville, TN. The focus of this project was the development and implementation of various protocols to be used in group therapy sessions in an inpatient rehabilitation setting. The project sought to provide guidelines for treating a variety of conditions in a group setting and promote individualized patient care. The process for project completion included a thorough review of current literature and available resources at VSRH to guide the creation of multiple evidence-based protocols. This process also included collaboration with the therapy staff to ensure …

Transcranial Direct Current Stimulation (Tdcs) To Improve Lower Limb Motor Recovery Following Stroke: A Review And Study Proposal, Jessica Fantz-Sands

Scripps Senior Theses

Strokes are the result of restricted blood flow to particular areas of the brain classified by their cause. The neural damage they cause are of growing concern as the number of young adults experiencing strokes has increased by 11% in the last decade. Following stroke, there is an imbalance of inhibitory and excitatory neuronal activity, and disruption of neural networks. These changes lead to neuronal death and loss of synaptic connections that, depending on which part of the brain is affected, result in behavioral deficits such as weakness, limb hemiparesis, and loss of coordination, as well as speech and cognitive …

The Impact Of Patient Characteristics On Dysphagia Therapy Utilization And Feeding Outcomes For Premature Infants In The Neonatal Intensive Care Unit, Tiana Nguyen

Theses and Dissertations

Medical advances have significantly increased the survival rates of preterm infants at lower gestational ages. However, infants born at lower gestational ages have an increased risk for developmental disabilities and oral feeding difficulties. A stay in the neonatal intensive care unit (NICU) is very costly and inadequate oral feeding is the most common barrier to discharge for premature infants. Infants can receive dysphagia therapy services during their NICU stay that focuses on the development of oral feeding and swallowing skills. However, literature to this date has mainly focused on the impact of therapy services for premature infants after NICU discharge. …

The Clinical Value Of Oculomotor Assessments Across The Continuum Of Concussion, Dillon Richards

Electronic Thesis and Dissertation Repository

Concussions are complex conditions that are difficult to manage medically. Variations in symptom presentation, intricate neurophysiological processes, and the availability of a variety of possible assessment tools may contribute to this complexity. Clinicians must use a broad approach, employing both subjective symptom assessment and objective assessments to confirm a diagnosis and/or monitor progression and recovery. Oculomotor function after concussion may be an important indicator of injury, given the interconnectedness of oculomotor function, vestibulo-ocular and visual systems, and even cognition. Oculomotor function may be assessed objectively or indirectly using patient-reported symptom checklists as part of subjective assessments. One way of objectively …

Reframing Childhood Disability: Pushing Boundaries In The Rehabilitation Sciences, Emily J. Cox

Electronic Thesis and Dissertation Repository

The purpose of this study was to critically examine the ways that dominant discourses surrounding childhood disability, as constructed in the neoliberal context, shape knowledge and practice in children’s rehabilitation. I carried out a critical discourse analysis of text within the rehabilitation sciences, including peer-reviewed research, websites, and qualitative interview transcripts. Drawing on disability studies scholarship as well as my Foucauldian conceptual framework, I called attention to complex interactions between discourse, power, and knowledge that shape thought and action in the rehabilitation sciences. My findings suggest that despite a growing recognition of the harms associated with deficit-based understandings of disability, …

Development And Application Of 3d Kinematic Methodologies For Biomechanical Modelling In Adaptive Sports And Rehabilitation, Anne Marie Severyn

All Dissertations

Biomechanical analysis is widely used to assess human movement sciences, specifically using three-dimensional motion capture modelling. There are unprecedented opportunities to increase quantitative knowledge of rehabilitation and recreation for disadvantaged population groups. Specifically, 3D models and movement profiles for human gait analysis were generated with emphasis on post-stroke patients, with direct model translation to analyze equivalent measurements while horseback riding in use of the alternative form of rehabilitation, equine assisted activities and therapies (EAAT) or hippotherapy (HPOT). Significant improvements in gait symmetry and velocity were found within an inpatient rehabilitation setting for patients following a stroke, and the developed movement …

Direction Of Attentional Focus In Prosthetic Training: Current Practice And Potential For Improving Motor Learning In Individuals With Lower Limb Loss, Alexander Bonczyk, Maria Katrina Tillada Dimapilis, Sarah Partridge, Samantha Ruiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting.

Methods: Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age=50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience=10 years, range=4-21 years) during …

Blood Flow Restriction And Various Intensity Exercise In The Upper Extremity, Noelle Ashlyn Kaminski, Andrew Lowe

Masters Theses

Purpose: To determine if using Blood Flow Restriction (BFR) combined with low-load exercise can elicit an increase in strength and tendon size of the distal biceps tendon when compared to high-load exercise protocol. Methods: Twenty-one participants (11 M, 10 F; 2 Left-handed: 19 Right-handed; Age range 18-25yoa) were randomized to either the treatment group (BFR + low load exercise) or the control group (high load exercise). Participants were enrolled in a 7-week exercise protocol, with exercise sessions held twice weekly. The first week included measurements of each participant's 1 repetition maximum (1RM) and ultrasound measurements of the dominant distal bicep’s …

Narrative Review - Optimal Occupational Therapy Experience, Kaylee G. Clay

Honors College Theses

This narrative review examines factors associated with optimal occupational therapy experiences, including patient perspectives of occupational therapy, cost-effectiveness, use of practices, organization, and patient involvement/experiences. The information found within this review provides information to those interested in creating the most optimal experiences for their occupational therapy patients.

The Experience Of Meditation, And Its Effects On Attention, For Adults With Stroke Or Attention Deficit Hyperactivity Disorder: A Three-Part Dissertation With Qualitative And Quantitative Evidence, Cheryl Carrico

Theses and Dissertations--Rehabilitation Sciences

Impairment of attention is common after stroke; is a defining characteristic of attention deficit hyperactivity disorder (ADHD); and has been shown to correlate significantly with difficulties in daily life for individuals with these conditions. More research is needed to establish effective interventions addressing impaired attention in such cases. Meditation is not a standard-of-care intervention for this purpose but may have therapeutic potential. Meditation has been broadly defined as an activity which has self-regulation of attention as its main aim. In other words, it can be considered a training of attention. To shed light on the therapeutic potential of meditation, including …

Sexual Health And Wellness For Women In Recovery From Substance Use Disorder, Paige Cassidy, Otr/L

Occupational Therapy Research Projects

The aim of this Capstone project was to produce a sexual health and wellness program for women in recovery from substance use disorder (SUD). Creation of the program includes an in-depth literature review and thorough needs assessment using key stake holders in the community of Southern Ohio. Through clinical practice, literature review, and needs assessment, two modules and six sections were developed. The two modules are physical and mental health aspects of sexual health. Module one is physical health and is composed of three sections that include practicing safe sex, postpartum care, and pelvic floor strengthening. Module two is mental …

Femoroacetabular Impingement Syndrome: Evaluating Postoperative Rehabilitation Progress And Return To Sport Readiness, Trevor A. Day

Electronic Thesis and Dissertation Repository

Femoroacetabular impingement syndrome (FAIS) is a common cause of non-arthritic hip pain and reduced physical activity in active young adults. It is defined as a motion-related disorder of the hip with a triad of symptoms, clinical signs, and imaging findings that represents symptomatic premature contact between the proximal femur and the acetabulum. There are two anatomical morphologies that can cause FAIS, cam, and pincer, and is a challenging clinical pathology. Patients typically undergo hip arthroscopy to repair damage to the joint and recess the bone causing the impingement. These procedures can result in positive outcomes for the patient, like reduced …

Relationships Between Perceived Quality Of Life And Spiritual Beliefs, Education Level, Socioeconomic Status, Gender, And Ethnicity In Cancer Patients And Cancer Survivors, Eva Arjona

Theses and Dissertations

The purpose of this study was to identify a relationship between perceived Quality of Life and religious/spiritual beliefs. Additionally, it aimed to explore relationships between perceived QOL and age, gender, ethnicity, education level, and Socioeconomic Status (SES). The research question examined in this study was: What is the relationship between perceived quality of life and spiritual beliefs, education level, socioeconomic status, age gender, and ethnicity in cancer patients and cancer survivors? A total of 100 cancer patients or cancer survivors were surveyed for this study. A regression analysis was conducted to explore relationships among the variables; the alpha level was …

Embodied Medicine: Integrating Dance/Movement Therapy Into Physical Medicine & Rehabilitation, Sneha Rajan

Dance/Movement Therapy Theses

Physical medicine and rehabilitation (PM&R) is a field of medicine that addresses a variety of disorders impacting the brain, spinal cord, muscles, and bones. When approaching patient care, the goals of dance/movement therapists are similar to those of physiatrists, because both strive for a holistic approach to treatment that considers more than just physical ailments. Adding dance/movement therapy sessions in parallel with PM&R services would enhance the overall patient experience and quality of life. Previous studies that explore the use of dance/movement therapy with various neurodegenerative diseases, neuromuscular diseases, and sustained injuries are reviewed for potential application in PM&R settings. …

Reducing Stroke Readmission Through The Implementation Of Telehealth, Leilani Hermosura

Student Scholarly Projects

Practice Problem: Readmission occurs frequently among patients with stroke and because of this, the Centers for Medicare and Medicaid Services (CMS) have imposed programs to reduce 30-day readmissions among hospitals. The health care system must respond with transition of care, especially during the period of recent stroke to improve patient outcomes.

PICOT: The PICOT question that guided this project was among patients with a recent diagnosis of stroke (P), what is the effect of a telehealth appointment with a nurse practitioner (NP) for post discharge follow-up (I), compared to a standard face-to-face clinic appointment (C), on 30-day readmissions rates (O), …

Development Of Clinical Practice Guidelines For Chemotherapy-Induced Peripheral Neuropathy Rehabilitation, Rikki Silver

OT Student Capstones

In the past four decades, there have been significant improvements in early cancer detection and efficacy of cancer treatments, resulting in a growing number of cancer survivors. People diagnosed with cancer are now living longer than ever before; while lifespan after cancer is increasing, cancer survivors are experiencing health and functional challenges due to the persistent effects of curative therapy (Rowland et al., 2018). One of these effects includes chemotherapy-induced peripheral neuropathy (CIPN). Approximately 70% of patients receiving neurotoxic chemotherapy experience CIPN, an uncomfortable and sometimes painful sensation in the hands and feet (Seretny et al., 2014). The likelihood of …

An Exploratory Study Of Rehabilitation Services Available For Soft Tissue Sarcoma Patients In The Outpatient Setting, Amber Wojcik

OT Student Capstones

Little is known about the experiences of rehabilitation therapists treating soft tissue sarcoma (STS) patients in the outpatient setting. As the number of survivors of STS increases, so does the need for therapists who have the knowledge and skillsets vital for providing the highest quality of holistic care for this unique cancer population. Holistic cancer rehabilitation includes considerations for the physical, cognitive, and psychosocial needs of the soft tissue sarcoma patient. This paper explores the subspeciality of cancer rehabilitation and the experiences of physical therapists (PT) treating STS patients in the outpatient setting. A secondary aim of this study is …

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, …

Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

Cardiovascular Effects Of Exercise And Use Of Abdominal Binder In Patients Of Parkinson’S Disease With Orthostatic Hypotension, Faizan Ahmed

Electronic Thesis and Dissertation Repository

Orthostatic hypotension (OH) is a common manifestation of autonomic dysfunction in Parkinson’s Disease. It can adversely affect a patient’s functional capacity, exercise tolerance and quality of life, while increasing the risk of falls, cerebrovascular disease and overall mortality. Use of an abdominal binder (AB) can help counter OH; however, this has not been sufficiently studied in patients with Parkinson’s Disease (PwPD). Moreover, the hemodynamic effects of upper and lower extremity exercise are unclear in PwPD with OH. Although OH can impair the cerebral circulation, the consequences on the cerebral hemodynamics of wearing an AB or performing exercise are unknown in …

Return To School 1 Year After Traumatic Brain Injury: A Study Using The Traumatic Brain Injury Model Systems National Database, Kathryn Tarnai

Masters Theses, 2020-current

For many individuals, recovery from moderate to severe brain injuries involves returning to a level of pre-injury productivity. Specifically, previous research has focused extensively on factors predicting return to employment, where students are inconsistently categorized with those in competitive employment. Moreover, research dedicated to return to school for students in secondary and tertiary education is largely qualitative; very few studies have utilized predictive modeling on a sample composed solely of students. For this study, a model including days of post-traumatic amnesia (PTA), length of stay (LOS), rehabilitation discharge Disability Rating Scale (DRS) scores, and educational level was used to predict …

Controlled Observation: The Challenges Of Therapy For The Mentally Ill Incarcerated Population, Esther Tingué

Dissertations, Theses, and Capstone Projects

Popular perception and objective of incarceration is confinement, brutality and in some cases inhumane conditions. But what about the incarcerated population who suffer from the additional burden of mental illness? How does confinement affect mentally ill inmates? This capstone project asks: (1) how do individuals/organizations provide rehabilitative services in this evolved culture of crime and punishment? And (2) how is therapy provided in a restricted environment? I examine these questions from the perspective of the therapist, the person who (in a restricted environment) takes on the responsibility of treating and managing the effects of mental illness for this population.

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …