Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Rhythmic Auditory Cueing Of Gait In Parkinson Disease, Adam Patrick Horin

Arts & Sciences Electronic Theses and Dissertations

Parkinson disease (PD) is a neurodegenerative movement disorder characterized by motor complications such as gait deficits and is caused by the depletion of dopamine producing neurons in the basal ganglia (BG). Gait deficits, including decreased velocity and increased variability, are among the most debilitating symptoms of PD and lead to an increased risk of falls. Common pharmacological treatments do not target many gait symptoms. Therefore, gait rehabilitation methods that can improve these deficits in gait are highly important. A common form of gait rehabilitation is known as rhythmic auditory cueing, in which an individual matches their footfalls to the beat …

The Effects Of Bilingualism In Post-Stroke Aphasia Patients: Clinical Implications Within The United States, Kristen Bennett

Undergraduate Honors Theses

The consistent increase of cultural diversity and immigration within the United States over the last fifty years has contributed to a societal shift towards a growing bilingual population. The growth of this population has generated a need to evaluate current assessment and treatment plans for bilingual post-stroke aphasia patients within the United States to ensure that these individuals are receiving effective healthcare. This study aims to investigate the current knowledge gap surrounding appropriate methods of assessing and treating bilingual post-stroke aphasia patients within the United States and suggest potential approaches based on existing research. In order to synthesize information regarding …

Are All Instrumental Activities Of Daily Living Equal? A Pilot Study On The Performances Of Adults With Acquired Brain Injury, Crystal Lee, Samantha Schauer, Amy Tam, Yareli Vargas

Occupational Therapy | Graduate Capstone Projects

Aim: To determine if a relationship exists among performances of different instrumental activities of daily living (IADLs) in adults with acquired brain injury (ABI).

Methods: A two-group correlational design was used to examine the relationship among performances in cooking, medication management, and financial management in nine adults with ABI who returned to driving and nine adults with ABI who did not return to driving. The Executive Function Performance Test (EFPT) measured initiation, organization, sequencing, judgment and safety, and completion.

Aota Continuing Education: Occupational Therapy’S Role In Addressing Sexuality And Intimacy, Tiffany E. Lee, Jacqueline M. Marquez

OTD Capstone Projects

The purpose of this capstone project was to create a continuing education course for the American Occupational Therapy Association (AOTA) on the topic of OT’s role in addressing sexuality and intimacy. The topic of sexuality and intimacy is often under-addressed by healthcare professionals, despite its importance to clients. According to the Occupational Therapy Practice Framework, engagement in sexual activity is not only an ADL, but can be a key aspect of social participation in the context of familial and peer/ friend roles. Therefore, it is well within OT’s scope of practice to address sexuality and intimacy with clients. However, there …

Strategic Planning For A Psychosocial Occupational Therapy Program: A Swot Analysis, Kellie Roy

OT Student Capstones

PURPOSE

To examine and evaluate the Northern Arizona Veterans Affairs Healthcare System (NAVAHCS) psychosocial occupational therapy (OT) program using a SWOT analysis to inform solution-oriented strategies for future directions of the program.

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 …

Reliability And Validity Of Two Performance-Based Outcome Measures In Rehabilitation Following Total Knee Arthroplasty, Jennifer L. Van Bussel

Electronic Thesis and Dissertation Repository

Objectives: Performance-based outcome measures (PBOM) are suggested to evaluate change in function during rehabilitation after total knee arthroplasty (TKA). The purpose of this study was to evaluate the measurement properties of the 30-Second Chair Stand Test (30CST) and 10-Metre Walk Test (10MWT) in patients following TKA.

Methods: Eighty-three patients completed two PBOM on three occasions following surgery. Patients also completed the Western Ontario and McMaster Universities Osteoarthritis Index and Global Rating of Change (GRC).

Results: Intraclass correlation coefficients ranged from 0.82 to 0.96. The standard errors of measurement at 6 and 12 weeks postop, respectively, were: 30CST ±0.67 and ±0.79, …

The Nature And Consistency Of Exercise Reporting In Rehabilitation Following Rotator Cuff Repair, Dinesh Balachandran

Electronic Thesis and Dissertation Repository

Abstract

Purpose:

Rotator cuff repair is conventional surgery, and postoperative rehabilitation programs are routine. Optimization and implementation of evidence-based exercise are dependent on comprehensive reporting of intervention content and dosage. The purpose of this study is to examine the content and consistency of reporting of postoperative exercise programs following arthroscopic rotator cuff repairs.

Methods:

Keyword search of PUBMED, EMBASE, Scopus, SPORTDiscuss, AMED, CINAHL, and Cochrane were performed from January 1950 to March 2019. All the studies that discussed rehabilitation following rotator cuff repairs of human adults were included. A Proforma Consensus on Exercise Reporting Template (CERT) assessment form was used …

Quantifying The Outcomes Of A Virtual Reality (Vr)-Based Gamified Neck Rehabilitation, Shahan Salim

Electronic Thesis and Dissertation Repository

Neck pain is a major global public health concern and adds a significant financial burden to both the healthcare system as well as people suffering from it. Additionally, it presents measurement and evaluation challenges for clinicians as well as adherence challenges and treatment barriers for the patients. We have developed a virtual reality (VR)-based video game that can be used to capture outcomes that may aid in the assessment and treatment of neck pain. We investigated: (i) performance metrics of overall accuracy, accuracy based on movement difficulty, duration, and total envelope of movement; (ii) stability across sessions; (iii) accuracy across …

“There Was Something Magical About This Group”: Building Cohesion In A Psychiatric Hospital, Mariah L. Logan

Expressive Therapies Capstone Theses

This capstone details the development and implementation of Hope Notes, an expressive arts therapy intervention used in a private psychiatric hospital setting. Hope Notes was carried out in the group setting with adolescent and adult clients in a partial-hospitalization or inpatient hospitalization with a range of diagnoses and symptoms including, but not limited to, depression, anxiety, bipolar disorder, schizophrenia, trauma disorders including post-traumatic stress, and obsessive-compulsive disorder with symptoms of delusions, hallucinations, suicidality and homicidally. Using expressive arts therapy the clients worked together to collaboratively discuss, create, design, and build an art piece intended to increase group cohesion and connection …

Patterned Sensory Enhancement-Based Interventions In An Acute Rehabilitation Setting: Development Of A Method, Lionel Cheong

Expressive Therapies Capstone Theses

Constraint-induced therapy (CIT) or Constraint-induced movement therapy (CIMT) is used in rehabilitation to improve upper extremity function in patients who suffer from brain injuries, such as stroke or cerebral palsy. By engaging in repetitive exercises and increasing the use of the affect area of the upper extremity, the brain develops a change in neural pathways that helps recover the use of limbs by these patients. Unfortunately, one of the main limitations of CIT is the low compliance with patients involved in CIT, due to the stopping of use of compensation strategies, and the intensity and duration of the treatment, especially …

Physiotherapy Is Associated With Improvements In Gait And Balance In Individuals With Cognitive Impairment: A Retrospective Analysis, Steven Jackson, Elbert Chen, Jason Phan

UNLV Theses, Dissertations, Professional Papers, and Capstones

BACKGROUND: Evidence suggests that individuals with cognitive impairment (CI) exhibit significant motor impairments; however, these motor impairments receive little treatment attention compared to more prominent CI. Moreover, there is a lack of evidence about physiotherapy (PT) in individuals with CI. OBJECTIVE: The purpose of this study was to determine if PT was effective at improving gait and balance in individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI). METHODS: Retrospective data of 173 individuals with CI conditions and an initial evaluation for PT were extracted from electronic records from January 2016 …

Innovative Care Of Individuals In The Athletic Training Room: A Case Series, Kathryn E. Young

Senior Honors Projects, 2010-2019

This work follows three unique cases of athletic injuries and/or injuries in patients. These cases were selected because of the innovative nature of the rehabilitation process conducted by the sports medicine team via the athletic training room or the unique nature of the injury/case.

The first is a concussion sustained from a motor vehicle accident in a collegiate female thrower. This is unique because it’s a non-sport related concussion handled as an athletic trainer would handle a sports related concussion. It also demonstrates a new unique protocol for concussion management.

The second case is a patient with two complete anterior …

God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer

Theses & Dissertations

Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …

Importance Of Social Support In Athletics As It Relates To Injury Recovery And Preparedness To Return To Play, Haleigh Gray

Graduate Theses

Background: Recent studies have evaluated the physical problems as well as the psychological complications that arise from sport injuries. However, little research has been done on techniques to address or mitigate these psychological issues. Objective: The purpose of this study was to investigate how social support was perceived during the injury rehabilitation process and how it influenced return to play preparedness. Setting: National Collegiate Athletic Association (NCAA) Division I mid-major university. Participants: A total of 21 previously injured student-athletes participated in the study. Methods: Through this mixed method study, each student-athlete completed a validated social support survey that evaluated perceived …

Case Report: A Modified Early Passive Mobilization Protocol For A Zone Ii Flexor Pollicis Longus Repair, Brandon Ryan

OT Student Capstones

A hand can be injured in many ways, but rehabilitation of a tendon laceration following a surgical repair can be one of the most challenging aspects of hand therapy. For example, rates of secondary repair due to complications, such as tendon rupture or tendon adhesion, have been reported to be as high as 17% (Dy et al., 2012). This can be especially problematic when considering the unique characteristics of the dynamics of thumb flexion when compared with that of the other digits. There are many different protocols for flexor tendon repairs, which can make it difficult for a therapist to …

Impact Of Shoulder Pathology On Individuals With Distal Radius Fracture: A Mixed Methods Study, Sarah Beth Doerrer

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this convergent parallel mixed methods study was to expand the understanding of the impact of shoulder pathology on individuals with distal radius fracture (DRF). This included describing the population that had shoulder pathology, comparing participants who had shoulder pathology with participants who did not, and exploring their experiences. The occupational adaptation model guided this study. Recruitment for this study included 45 patients post DRF. Each participant completed a short questionnaire after informed consent was obtained which asked demographic information such as age, gender, race, date of injury, and if the dominant hand was fractured. Over 9 weeks, …

The Impact Of Depression On Treatment Outcomes For Patients With Aphasia Who Participate In An Intensive Comprehensive Aphasia Program (Icap), Harley B. Kincheloe

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Abstract

Background: Aphasia is a multi-modal impairment resulting from left-hemisphere stroke. Aphasia is often accompanied by post-stroke depression. Acquiring aphasia and depression is seen to hinder quality of life and rehabilitative outcomes. Traditional stroke therapy often does not monitor or treat psychological difficulties such as depression. Such psychological difficulties hinder progress in recovery and may need to be addressed in therapy to ensure the best possible outcomes.

Aims: In response to the lack of psychological support for persons with aphasia, this literature review aims to explore the impact of depression on functional outcomes. Furthermore, this literature review will explore how …

Independence Through Patient Education In A Spinal Cord Injury Population, Justin Mctish

Electronic Theses and Dissertations

The Know More, Live Better program was developed because the population of people with Spinal Cord Injuries (SCI) includes a substantial number of young people, who often readmit into hospitals for preventable causes such as pressure ulcers, respiratory infections, and bowel/bladder infections. These complications can be avoided through patient education. A needs assessment was conducted at the SCI unit at Good Shepherd Rehabilitation Hospital in Allentown, PA. This assessment included structured observation of patient education in the therapy process, semi-structured interviews about site needs and patient education topics completed with patients and occupational therapists on staff, and surveys of multi-disciplinary …

The New World Of Pet Prosthetics, Anna Brooks

Capstones

When an abandoned dog was found in Brooklyn with his paw gnawed off, the animal shelter had two options: amputate the leg, or put the dog down. But neither seemed like a solution. So they decided to do something different, and fit the dog for a prosthetic leg. Prosthetics for people have been around for millennia, and now these devices are moving into the animal kingdom. This story explores the new world of animal prosthetics, and how these devices have changed the lives of animals like Mr. Stubbs — the first alligator with a prosthetic tail — and saved the …

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 …

The Effect Of Patterned Sensory Enhancement On Balance And Ambulation In Persons Diagnosed With Parkinson’S Disease, Brittany Barko

Masters Theses

One rehabilitation protocol effective in delaying the symptoms of Parkinson’s Disease (PD) is Lee Silverman Voice Training BIG (LSVT BIG), comprising pre-gait exercises and gait training. This study seeks to determine if combining Patterned Sensory Enhancement (PSE), a music therapy intervention, with LSVT BIG will improve quality of movement. During physical therapy sessions with three participants, a music therapist adapted the PSE stimuli to support each patient’s motor needs, which were then recorded on CD and sent with patients to exercise with at home. Results showed improved balance and ambulation comparing pre- and post- measures of the BERG balance scale …

Understanding The Process Of Recovery From Critical Illness From The Patient Perspective: A Constructivist Grounded Theory, Tania Larsen

Electronic Thesis and Dissertation Repository

Critical illness creates long-term physical, psychological and cognitive deficits that negatively impact quality of life, persisting well beyond hospital discharge. The purpose of this constructivist grounded theory study is to understand and develop theoretical propositions on factors that patient’s perceive influence the process of recovery from critical illness in order to inform more comprehensive patient care management strategies.

Semi-structured interviews were conducted with 17 participants admitted to an ICU. All interviews were audio-recorded and transcribed verbatim. Data collection and analysis occurred concurrently using the constant comparative method. Data were analysed initially with line-by-line coding, then focused coding. Initial codes were …

Prospective Memory Impairment In Parkinson Disease Without Dementia: Cognitive Mechanisms And Intervention, Erin R. Foster

Arts & Sciences Electronic Theses and Dissertations

Cognitive impairment among non-demented individuals with Parkinson disease (PD) produces significant disability, reduced quality of life, and restricted participation. This dissertation will cover PD-related impairment in prospective memory, or the ability to remember to execute delayed intentions at the appropriate moment in the future. Prospective memory impairment in PD is increasingly recognized as a functionally and clinically relevant problem and viable target for cognitive intervention. To lay the groundwork for the development of effective interventions for prospective memory in PD, this dissertation examines the cognitive mechanisms underlying prospective memory impairment in PD and the potential of training in a targeted …

Neuromuscular Adaptations Following Slope Walking In Individuals Post-Stroke, Eric Akoopie, Brooke Conway Kleven, Trisha Koch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The excitability of the H-reflex pathway in the non-impaired nervous system can be augmented by altering the different parameters of a walking task, specifically slope. We sought to examine the adaptations in soleus H-reflex excitability and foot force control following an acute bout of upslope or downslope treadmill walking in people post-stroke compared to those who are non- impaired. Methods: We recruited 12 individuals with chronic post-stroke hemiparesis and 9 age-similar non- neurologically impaired individuals. Each subject was tested over 2 sessions separated by at least 7 days. For each session, subjects walked at a self-selected walking speed on …

Functional Cognitive Activities For Adults With Traumatic Brain Injury: Pilot Case Studies, Ajay Pala, Karen Huang, Ashley Cook

Dissertations, Masters Theses, Capstones, and Culminating Projects

The purpose of these pilot case studies were to investigate the effectiveness of the Functional Cognitive Activities for Adults with Brain Injury: A Sequential Approach (FCA) in generalizing functional cognitive skills across meaningful occupations for adults with traumatic brain injury (TBI). This study was a pretest-posttest design consisted of two participants with TBI.

Both participants attended 14 out of the 16 intervention sessions, twice-a-week for eight-weeks. Pretest-posttest measurements, including the Canadian Occupational Performance Measure (COPM), Kohlman Evaluation of Living Skills, and Goal Attainment Scale (GAS), were used to measure changes in occupational performance. Additionally, a four-month follow-up phone interview using …

Treatment Interventions For Medial Tibial Stress Syndrome, Nathan Cook, Alexa Srolovitz

Thinking Matters Symposium Archive

Medial Tibial Stress Syndrome (MTSS) or more commonly referred to as “shin splints” is characterized as an overuse or repetitive stress injury that causes vague pain over and around the tibia. Researchers are yet to determine a definitive cause though numerous risk factors have been noted. They are as follows; over training,type of surface, poor footwear, muscular imbalances at the ankle, over tight or weak triceps surae muscles, imbalances at the thoracolumbar complex, other muscular imbalances and BMI above 30. Rehabilitation and treatment interventions often call for a pause in training entirely or at the very least an immediate scaling …

Concussion Rehabilitation: Vestibular And Physiotherapy, Amia Pelletier, Jordan Wing

Thinking Matters Symposium Archive

Recent research has come out to suggest that a prolonged resting period after a concussion may not be the most beneficial way to recover. Many doctors of physical therapy seem to have a consensus that athletes that acquire a sports-related concussion should seek treatment through body movement, not the typical resting and abstaining from exercise protocol. Recent research has shown that vestibular and physiotherapy will reduce the recovery time after a concussion. Seventy-one percent of a treatment group had returned within eight weeks, compared to seven percent in a control group. The participants in the treatment group were four times …

Exploring Occupational Therapists' Approach To Treating Children With Autism In The School Setting, Melissa Brauner

Honors Theses

Autism spectrum disorder is one of the fastest growing developmental disabilities, affecting more than 3.5 million Americans. In order to ensure that the autism population receives the highest quality of care, it is extremely important that health professionals be equipped with the knowledge to care for individuals with the disorder in an effective manner. Occupational therapists play an important role in assisting people on the autism spectrum. For many children with autism, occupational therapy services are primarily received in the school setting. This study explores occupational therapists’ approach to managing the treatment of children on the autism spectrum in the …