Medicine and Health Sciences Commons^™

Imagine A World …, David A. Nelson

Journal of Patient-Centered Research and Reviews

The author and issue editor introduces the second half of Journal of Patient-Centered Research and Reviews’ two-part series on health disparities and inequities in the United States. The chasm between an ideal health care system and the current reality may appear vast, and closing it insurmountable at times, but acknowledging and working to address the many health conditions that disproportionately affect specific patient populations is one step health providers and researchers can take toward closing the gap.

The Magic Wand: A Case Study Of Chronic Neck Pain, Sandra L. Winkler

The Qualitative Report

Medications used to manage chronic pain have documented side effects including drug dependency, drug interaction, and adverse systemic reactions. This case study used Interpretative Phenomenological Analysis to understand how one individual experienced chronic neck pain including pharmaceutical and non-pharmaceutical interventions. Convenience sampling identified Ms. P, an individual with a 10-year history of chronic pain. The research questions were: “How does one individual with chronic neck pain describe their experience living with neck pain?” and “How does one individual with chronic neck pain manage their pain?” Three super-ordinate themes emerged: pain pervades everything, finding relief, and recovery. Findings suggest that living …

Girls In The Boat: Sex Differences In Rowing Performance And Participation, Kevin G. Keenan, Jonathon Senefeld, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Men outperform women in many athletic endeavors due to physiological and anatomical differences (e.g. larger and faster muscle); however, the observed sex differences in elite athletic performance are typically larger than expected, and may reflect sex-related differences in opportunity or incentives. As collegiate rowing in the United States has been largely incentivized for women over the last 20 years, but not men, the purpose of this study was to examine sex differences in elite rowing performance over that timeframe. Finishing times from grand finale races for collegiate championship on-water performances (n = 480) and junior indoor performances (n = 1,280) …

Physical Therapy Considerations For Chronic Kidney Disease And Secondary Sarcopenia, Michael O. Harris-Love, Haniel J. Hernandez, Gideon Obamwonyi

Exercise and Nutrition Sciences Faculty Publications

Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the …

The Art And Science Of Occupation As Therapy, Jennifer Fortuna

The Open Journal of Occupational Therapy

Ashley Woo Lee, an occupational therapy student based in Loma Linda, CA, provided the cover art for the Winter 2018 issue of The Open Journal of Occupational Therapy (OJOT) (Figure 1). The piece, titled “Tree of Life,” is a 11” x 14” drawing made from mixed media. As a child living in Korea, Ashley enjoyed drawing as a favorite pastime. After her family relocated to the United States, art became Ashley’s primary means for self-expression. When a career in art was not an option, the field of occupational therapy satisfied Ashley’s artistic and scientific interests. In a recent interview, Ashley …

Factors Associated With Academic Performance Among Second-Year Undergraduate Occupational Therapy Students, Tore Bonsaksen, Brian J. Ellingham, Tove Carstensen

The Open Journal of Occupational Therapy

Background: Research into occupational therapy education and its outcomes for students is growing. More research is needed to determine the factors of importance for occupational therapy students’ academic outcomes. This study aimed to investigate factors associated with academic performance among second-year undergraduate occupational therapy students in Norway.

Methods: Occupational therapy students (n = 111) from two education programs completed questionnaires asking for sociodemographic, work-related, and education-related information. Hierarchical linear regression analysis was used to examine factors independently associated with the students’ academic performance.

Results: A higher age was associated with better average academic performance among the students, whereas having …

Co-Constructing Simulations With Learners: Roles, Responsibilities, And Impact, Diane E. Mackenzie, Kathleen E. Collins, Mylene J. Guimond, Abby C. Hunter, Kassia J. Jurcina, Johanna L. Mcdonald, Nikki L. Richards, Stephanie. H. Sinclair, Kelsey Y. Taylor

The Open Journal of Occupational Therapy

Co-constructed simulations were designed and piloted with senior occupational therapy master’s students in a neurorehabilitation practice module. The instructor served as the guide for the students through all phases of the case creation, simulation development, delivery, and debrief. The instructor facilitation promoted self-regulated learning (SRL) of knowledge and skill development through independent discovery and peer learning. This paper provides an evidence-informed co-construction simulation design with outlined stages, roles, and responsibilities for the instructor and learner. Thematic qualitative analysis of student feedback highlighted enhanced insight and SRL as a result of multiple role preparation, observation and interaction with peers, close interaction …

Pennsylvania Occupational Therapy Fieldwork Educator Practices And Preferences In Clinical Education, Kaitlyn Ryan, Melanie Beck, Lee Ungaretta, Magdalena Rooney, Elaina Dalomba, Leamor Kahanov

The Open Journal of Occupational Therapy

The shortage of clinical education fieldwork sites coupled with a concern over the quality of the required fieldwork experience poses an unintended outcome for the recent changes in the health care system and an increasing number of occupational therapy students. While the Accreditation Council for Occupational Therapy Education (ACOTE) issues standards for fieldwork education, the quality of the experience is known to vary. The present study employed a mixed methods concurrent nested design with a quantitative online survey alongside qualitative individual semi-structured online interviews to examine the practices and preferences of fieldwork educators in Pennsylvania ACOTE accredited programs. From the …

Balancing Efficacy And Effectiveness With Philosophy, History, And Theory-Building In Occupational Therapy Education Research, Barbara Hooper, Jyothi Gupta, Andrea Bilics, Steven D. Taff

The Open Journal of Occupational Therapy

The preferred focus for education research in occupational therapy increasingly rests on studies that investigate efficacy and effectiveness in the teaching-learning context. While important, the almost exclusive promotion of outcomes-focused studies can come at the expense of other forms of inquiry, including philosophy, history, and theory-building. To fully inform education and enhance practice, outcomes-focused research needs the conceptual foundation provided by philosophical, historical, and theory-building studies. In this paper, the authors suggest that the research enterprise in occupational therapy education is in its infancy and, therefore, quite susceptible to shortcuts that head straight to outcomes. To address this issue, the …

Use Of Religious Observance As A Meaningful Occupation In Occupational Therapy, Kelly Thompson, Bryan M. Gee, Sara Hartje

The Open Journal of Occupational Therapy

Background: Research shows that religious and spiritual beliefs influence a person’s health and quality of life. Studies have found that religious people are healthier and require less access to health services, and that clients want to have their religious and spiritual needs addressed as a part of their plan of care.

Method: This study used a descriptive survey design to explore the attitudes and behaviors of occupational therapists concerning religious observance in clinical practice. The survey yielded 181 responses from a random sampling from members of the American Occupational Therapy Association.

Results: The study found that while …

Occupational Therapy Employers’ Perceptions Of Professionalism, Vicki C. Mason, Kathleen Mathieson

The Open Journal of Occupational Therapy

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey, the Hospital Readmissions Reduction Program, and the Bundled Payments for Care Improvement Initiative in the Affordable Care Act (ACA) are affecting expectations of professionalism in health care. These initiatives and shifts in expectations are especially concerning for occupational therapists whose services historically have not been well understood.

Method: Eighteen supervisory and managerial occupational therapy practitioners were interviewed regarding perceptions of professionalism in occupational therapy employees. The semi-structured interview guide explored professionalism in occupational therapists’ interactions with patients and co-workers and in an employer’s organization. …

Expressive Art To Facilitate The Development Of The Occupational Profile: A Scoping Review, Verna G. Eschenfelder, Christina M. Gavalas, Taylor M. Pendergast, Colleen A. Gorman

The Open Journal of Occupational Therapy

Background. The American Occupational Therapy Association and the American Medical Association have changed CPT codes to require a completed occupational profile at every evaluation and re-evaluation session for reimbursement as of January 1, 2017. A revitalization of art in occupational therapy has led to a recent increase in the evidence supporting the use of expressive art in practice. The benefits of expressive art can directly enhance the occupational profile required by these changing reimbursement requirements.

Methods. A scoping review method was applied in the current study. Out of 347 initial articles, 12 met the inclusion criteria and were analyzed through …

A Bibliometric Analysis Of Peer-Reviewed Journal Publications By British Occupational Therapy Authors, Ted Brown, Yuh-Shan Ho, Sharon A. Gutman

The Open Journal of Occupational Therapy

Background: A bibliometric analysis was completed of the peer-reviewed literature from 1991 to 2015 written by British occupational therapy authors that was indexed in the Science Citation Index-Expanded (SCI-Expanded) or Social Sciences Citation Index (SSCI) databases.

Methods: “Occupational therapy” and “occupational therapist” were used as keywords to search journal articles’ publication title, abstract, author details, keywords, and KeyWords Plus. One of the authors had to be identified as a qualified occupational therapist with a British affiliation.

Results: From 1991 to 2015, 680 journal articles were published by British occupational therapy authors. The top three journals in which authors published …

Discovering Perspectives On Health And Well-Being From Parents And Teachers Of Preschool- Aged Children, Divya Sood, Delawnia Comer-Hagans, Dirk Anderson, Diana Basmajian, Ashley Bohlen, Michelle Grome, Irada Imanova, Kimberly Martin

The Open Journal of Occupational Therapy

Background: This study explores the concept of health and well-being as perceived by teachers and parents of preschool-aged children in the specific context of a child day care facility. The study also identifies the barriers parents and teachers encounter and the supports they require in promoting the health and well-being of preschool-aged children.

Method: A qualitative phenomenological research design combined with a projective technique of Photovoice was used for data collection. A total of eight participants, four teachers and four parents of preschool-aged children from a child day care facility, participated in the study.

Results: Several themes were identified related …

Feasibility Exploration Of Electrodermal Response To Food In Children With Asd Compared To Typically Developing Children, Michelle A. Suarez

The Open Journal of Occupational Therapy

Background: Children with Autism Spectrum Disorder (ASD) frequently have food selectivity that causes additional health and quality of life stressors for the child and the family. The causes of food selectivity are currently unknown but may be linked, at least in part, to sensory processing problems.

Method: The purpose of this study was to test the feasibility of using electrodermal activity (EDA) measurement in response to food to gain insight into the physiological processes associated with eating for children with ASD compared to typically developing children. In addition, differences in food acceptance and the relationship between food acceptance …

A Retrospective Pre-Post Treatment Study Of Occupational Therapy Intervention For Children With Sensory Processing Challenges, Sarah A. Schoen, Lucy Jane Miller, Joanne Flanagan

The Open Journal of Occupational Therapy

Background: This study investigated the impact of an intensive, short-term program that incorporates the principles of sensory integration and relationship-based therapies with extensive parent collaboration. The goals were to identify measures sensitive to change and explore the relation between sensory modulation characteristics and change in behavior after intervention.

Method: A retrospective chart review examined routine clinical data pre-post intervention from 179 children identified with sensory processing challenges without comorbid autism. Change in measures of adaptive behavior, emotional functioning, sensory-related behaviors, and motor functioning were evaluated. Relations between sensory modulation and behavior were explored.

Results: Improvements were noted …

Selection Of Post-Acute Care For Stroke Patients, Kathryn M. Gulfo, Glen Gillen, Lauri Bishop, Clare C. Bassile, Randy B. Kolodny, Joel Stein

The Open Journal of Occupational Therapy

Background: Significant variation exists in post-acute care for stroke survivors. This study examines referral practices of occupational and physical therapists for patients after acute stroke.

Method: Occupational therapists (OTs) and physical therapists (PTs) were surveyed either electronically or in person at a national conference. The respondents selected the most appropriate referral for each of five case vignettes. The referral choices included Inpatient Rehabilitation Facility (IRF), Skilled Nursing Facility (SNF), Long-Term Acute Care Hospital (LTACH), home with home services, or home with outpatient services. Demographic data included practice location, setting, and duration. The respondents were also asked to rate …

Occupational Adaptation As A Construct: A Scoping Review Of Literature, Lenin Grajo, Angela Boisselle, Elaina Dalomba

The Open Journal of Occupational Therapy

Background: This study integrates research on practice applications of the construct of occupational adaptation with occupational therapy and occupational science literature.

Method: Using Arksey and O’Malley’s 5-step Scoping Study Framework (2005), we conducted a scoping review of 74 articles from five online databases and literature hand-searching and performed quantitative and thematic analyses.

Results: The Occupational Adaptation model (Schkade & Schultz, 1992; n = 74) and the Model of Human Occupation (Kielhofner, 2008; n = 37) were the most frequently cited literature influences. Occupational adaptation has been defined as a process (n = 49), an outcome (n = …

State Of The Journal: Past, Present, And Future, Diane Powers Dirette

The Open Journal of Occupational Therapy

No abstract provided.

Current State Of Commercial Wearable Technology In Physical Activity Monitoring 2015-2017, J. A. Bunn, J. W. Navalta, C. J. Fountaine, J. D. Reece

Physical Therapy

No abstract provided.

Critically Appraised Paper For “Adaptive Vs. Non-Adaptive Cognitive Training By Means Of A Personalized App: A Randomized Trial In People With Multiple Sclerosis.”, Erin Chaffee, Ty Duong, Kaylee Gothelf, Emily Minor, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

The purpose of this study was to evaluate the effectiveness of a working-memory program to improve the cognitive status of people with multiple sclerosis (MS). Given the increasing use of technology in modern-day society, further research is required to provide evidence supporting working-memory training devices that are easily accessible for people with memory deficits.

Critically Appraised Paper For “Effects Of Dance On Motor Functions, Cognitive Functions, And Mental Symptoms Of Parkinson’S Disease: A Quasi-Randomized Pilot Trial”, May Anne Gamueda, Caroline Lee, Susan Nguyen, Ajay Pala, Blanka Pentek, Kitsum Li

Occupational Therapy | Critically Appraised Papers Series

Parkinson’s disease (PD) is a systemic condition that presents not only motor but also nonmotor symptoms, as a result of dopamine deficiency in the basal ganglia. Rehabilitation typically focuses on motor deficits, however, despite the fact that nonmotor symptoms have a significant impact on quality of life. The researchers of this study investigated the effectiveness of dance on motor functions, cognitive functions, and mental symptoms of individuals with PD. They chose dance as their intervention because it has been shown to activate the basal ganglia as well as improve mood. In addition to motor function and mood, the researchers also …

The Comprehensive Pt Management Of A Patient With Chronic Low Back Pain And Lumbar Radiculopathy: A Case Report, Robin Mcguire

Case Report Papers

Background and Purpose: Low back pain is the most common health problem among older adults resulting in pain and disability. Lumbar radiculopathy is a disabling condition causing low back pain that radiates into the lower extremity along the sensory distribution of the spinal nerve root. The purpose of this case report is to describe a comprehensive physical therapy plan for a patient with chronic low back pain and lumbar radiculopathy that included: therapeutic exercises using directional preference, interferential current, and manual traction. Case Description: The patient was a 60-year-old male with lumbar radiculopathy due to nerve root compression. He presented …

Effect Of Individual Height And Testing Methods On Outcome Of The Forward Functional Reach Test, Jill Elaine Heitzman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: With falls a leading cause of injuries among those over age 65, early recognition of risk is imperative to reduce rising rates. The Forward Functional Reach test (FFRT) (Duncan et al., 1990) is frequently used to identify fall risk, however, the variability in cut values found in the research may be related to height and reach strategies.

Purpose: The purpose of this study was to determine if FFRT is affected by an individual’s height and if bilateral reach to height ratio could more accurately identify fall risk.

Methods: Sixty-six participants (60 and older) were recruited from a senior center …

Use Of A Telerehabilitation Delivery System For Fall Risk Screening, Robert W. Nithman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem: The Centers for Disease Control and Prevention indicates that falls are the “leading cause of injury death and the most common cause of nonfatal injuries and hospital admission for trauma among people ages 65 and older.”1 Falls can have significant economic consequences to the individual and payer sources. To address these consequences, telerehabilitation was hypothesized to be a suitable supplement for fall screening efforts. Several sources concluded that support for synchronous telerehab was underdeveloped in the literature. Purpose: The purpose of this study was to explore the acceptability, feasibility, reliability, and validity of telehealth-delivered fall screening among community-dwelling older …

Predictors Of Shoulder Injuries In Female Collegiate Swimmers, Eric Lee Lippincott

Department of Physical Therapy Student Theses, Dissertations and Capstones

Competitive swimmers frequently injure their shoulders. The risk factors for shoulder injuries in competitive swimmers have not been clearly identified. The primary purposes of this study were to describe the characteristics of female collegiate swimmers at the onset of a swim season, identify the risk factors of shoulder injury in female collegiate swimmers, characterize the swim volume of female collegiate swimmers, and determine if swim volume is a predictor of shoulder injury.

A prospective longitudinal cohort multi-center design was utilized. Female collegiate swimmers [n=53, mean age=19.3+/– 1.2] from four NCAA Division II universities were recruited to participate in this study. …

Diagnostic Musculoskeletal Imaging: How Physical Therapists Utilize Imaging In Clinical Decision-Making, Hilmir Agustsson

Department of Physical Therapy Student Theses, Dissertations and Capstones

This qualitative study describes how physical therapist experts in musculoskeletal disorders evaluate and interpret imaging studies and how they employ imaging in clinical decision-making. The informants are physical therapists who are certified orthopedic clinical specialists (OCS) and/or fellows of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). The study employed web conferencing to display patient cases, record screen-capture videos, and to conduct interviews. Informants were observed and their activity video-captured as they evaluated imaging studies and, afterwards, interviews were employed to explore the processes they utilized to evaluate and interpret the images and to discuss imaging-related clinical decision-making, including …

Shoulder Symptom Irritability: Development And Testing Of A New Construct, Stephen Michael Kareha

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Physical therapists regularly make decisions regarding intervention intensity based upon pathoanatomy and symptom irritability, but the reliability and validity of classifying patients by symptom irritability are unknown. Purpose: Examine the reliability and construct validity of the shoulder symptom irritability classification (SSIC) system for the purposes of determining an appropriate treatment intensity. Design: Prospective repeated-measures cross-sectional single-blinded design. Methods: 101 consecutive subjects with primary complaints of shoulder pain were assessed by a pair of blinded raters. Raters recorded the SSIC level and selected the appropriate intervention intensities for the subjects. Data Analysis: Prevalence-adjusted, bias-adjusted Kappa for ordinal scales (PABAK-OS) and …

Impact Of An Exercise Program On Stress, Fatigue, And Quality Of Life For Individuals Living With Primary Immunodeficiency Disease, Kerri Sowers

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: There are over 300 Primary Immunodeficiency diseases (PID) that are a result of a genetic or idiopathic dysfunction of any aspect of the immune system. These conditions result in a higher frequency of infections, autoimmune conditions, or malignancies. Moderate intensity exercise is thought to help the immune system, while high intensity exercise may have a negative impact on immune function. The impact of exercise on individuals with an impaired immune system due to PID is not yet understood. Purpose: The purpose of this study was to investigate whether a low to moderate intensity exercise program would have an effect …

Development And Initial Validation Of The O&M Vissit For Orientation And Mobility Specialists To Determine Service Intensity, Heather R. Munro, Shannon Darst, Rona L. Pogrund

Faculty Publications

The purpose of this study was to provide initial validation of the Orientation & Mobility Visual Impairment Scale of Service Intensity of Texas (O&M VISSIT) intended for use by orientation and mobility (O&M) specialists to determine a recommended type and amount of O&M services for students on their caseloads based on each student’s identified needs. The validity and reliability of the scale were calculated using a mixed-methods survey research design, with purposive expert sampling. The O&M VISSIT was found to be significantly valid in social and content validity and moderately valid in consequential validity. The O&M VISSIT is a moderately …