Medicine and Health Sciences Commons^™

Traumatic Brain Injury: A Case Study Of An Atypical Rehabilitation Progression Due To Unmodifiable Circumstances, Brianna Gustafson

Physical Therapy Scholarly Projects

Background and Purpose Traumatic brain injuries (TBI) are very prevalent throughout the US. They are often caused by a head injury leading to alterations in brain functioning and often result in lifelong disabilities. Current literature is limited on the aspects of rehabilitation following a TBI because of the many factors that differ within each case. This study will explore an atypical pathway for rehabilitation following a TBI.

Case Description The patient was a 32-year-old male who sustained a TBI following a motor vehicle accident (MVA). The Glasgow Coma Scale (GCS) and Rancho Los Amigo Scale (RLAS) were assessed initially and …

Conservative Treatment Of 'Flail Chest' Following Non-Union Fractures Of The Thoracic Rib Cage With Secondary Shoulder Pathology: A Case Report, Chase Kerber

Physical Therapy Scholarly Projects

Background and Purpose - Fractures of the thoracic ribs are common injuries with a high incidence of secondary co-morbidities which may require a slower rehabilitation progression and result in a delayed return to full function. Patients with these diagnoses often seek physical therapy intervention in order to regain their prior level of function.

Case Description - A 51 year-old male sustained multiple rib fractures, pneumothorax, and a left shoulder injury as a result of falling backwards off a 6 foot platform. He presented to physical therapy for evaluation and treatment with the goal of returning to his occupation as a …

Barefoot Versus Shod Training: Effects On Navicular Drop And Foot Pressure Analysis, Evan Condry, Daniel Himmerick, Tiffany Vanhaaften

Physical Therapy Scholarly Projects

Background and Purpose: Running is a popular form of exercise around the world. The running population generally runs in a rear-foot strike pattern (RFSP), yet there is questioning on the possible benefits of running in a forefoot strike pattern (FFSP). The main goal of FFSP is the possible reduction of running related injuries by reducing the stress on the medial longitudinal arch. The purpose of this research study is to determine if a barefoot running retraining program will have an effect on navicular drop height, plantar pressure area, and peak plantar pressure of the medial aspect of the foot.

Material/Methods …

Shinrin-Yoku (Forest Bathing) And Nature Therapy: A State-Of-The-Art Review, Dr. Margaret M. Hansen, Reo Jones, Kirsten Tocchini

Nursing and Health Professions Faculty Research and Publications

Background: Current literature supports the comprehensive health benefits of exposure to nature and green environments on human systems. The aim of this state-of-the-art review is to elucidate empirical research conducted on the physiological and psychological effects of Shinrin-Yoku (or Forest Bathing) in transcontinental Japan and China. Furthermore, we aim to encourage healthcare professionals to conduct longitudinal research in Western cultures regarding the clinically therapeutic effects of Shinrin-Yoku and, for healthcare providers/students to consider practicing Shinrin-Yoku to decrease undue stress and potential burnout. Methods: A thorough review was conducted to identify research published with an initial open date range and then …

Are Preseason Functional And Biomechanical Measures Associated With Lower Quadrant Injury Risk In Division Iii Athletes?, Natalie Ellis, Jordan Petersen, Jordon Reyes, Victor Wilson, Cj Zita

Student-Faculty Research - College of Physical Therapy

A recent trend in sports medicine research is to determine risk of injury during sport based on preseason functional performance test (FPT) measures.

Equivocal findings associated with prior studies may leave PTs with uncertainty as to which FPT, or combination of FPTs, can best identify athletes who have a greater risk for injury.

Previous studies have utilized "low-tech" FPT measures: standing long jump (SLJ), single-leg hop (SLH), lower extremity functional test (LEFT), and the Y-balance test (YBT) (1,3,4).

These "low-tech" options may not be able to identify potential deficits that could be collected with "high-tech" measures (e.g., DVJ measures collected …

Morphological Changes In Achilles Tendon Thickness Following An 8-Week Heavy Load Eccentric Exercise Program, W. Howe, B. Telfer, J. Leung, M. Suzuki, C. Young, Tyler Cuddeford

Student-Faculty Research - College of Physical Therapy

• Achilles Tendinopathy (AT) is an overuse injury characterized by pain, focal tenderness, and intratendinous imaging changes.

• Current protocols for treating mid-portion AT are not effective, likely due to not providing sufficient load to the tendon.

• Alfredson’s eccentric protocol, which utilizes high repetition with low load, reduces pain with mid-portion AT in 60.3% of individuals (Van der Plas, 2011)

• Research indicates that heavier loading of the Achilles tendon yields superior results to high repetition with low load (Stevens, 2014)

• Tendons have demonstrated plasticity in their ability to adapt to heavy resistance training. Combined with knowledge that …

The Neuropsychology Of Sport And Performance, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Neuropsychological theory has been a mainstay for understanding pathology within the brain-behavior context. However, our theories for predicting superior behavior are not as well developed. Sport neuropsychology was developed on the presumption that athletes represent a population in a relatively well-controlled environment for studying brain pathology due to injury. This study of pathology within a high-performance environment has been responsible for identifying the effects of mild traumatic brain injury (mTBI) on individual functioning. Far less attention has been paid to the other end of the performance continuum, and yet, viable brain-behavior hypotheses should hold true across the spectrum of function …

Validity And Reliability Of Baseline Testing In A Standardized Environment, Kathryn L. Higgins, Todd Caze, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Objective — The Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to determine cognitive recovery from concussion based on comparing post-injury scores to baseline scores. This model is based on the premise that ImPACT baseline test scores are a valid and reliable measure of optimal cognitive function at baseline. Growing evidence suggests that this premise may not be accurate and a large contributor to invalid and unreliable baseline test scores may be the protocol and environment in which baseline tests are administered. This study examined the effects of a standardized environment and administration …

Measurement Of Cortisol In Saliva: A Comparison Of Measurement Error Within And Between International Academic‑Research Laboratories, Jessica L. Calvi, Frances R. Chen, Victoria Brann Benson, Eleanor Brindle, Matt Bristow, Alpana De, Sonja Entringer, Helen Findlay, Christine Heim, Eric A. Hodges, Heiko Klawitter, Sonia Lupien, Holly M. Rus, Jitske Tiemensma, Silvanna Verlezza, Claire-Dominique Walker, Douglas A. Granger

Center for Brain, Biology, and Behavior: Faculty Publications

Objective: Hundreds of scientific publications are produced annually that involve the measurement of cortisol in saliva. Intra- and inter-laboratory variation in salivary cortisol results has the potential to contribute to crossstudy inconsistencies in findings, and the perception that salivary cortisol results are unreliable. This study rigorously estimates sources of measurement variability in the assay of salivary cortisol within and between established international academic-based laboratories that specialize in saliva analyses. One hundred young adults (Mean age: 23.10 years; 62 females) donated 2 mL of whole saliva by passive drool. Each sample was split into multiple- 100 μL aliquots and …

Patterns Of Referral In High School Concussion Management Programs: A Pilot Study Of Consultants From Different Disciplines, Jonathan Lichtenstein, Kate S. Linnea, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

School-based concussion management programs cover thousands of young athletes, yet there is little in the way of research to assess program processes or outcomes. This study examined the referral patterns of consultants working with ten high school concussion management programs. In addition to the number of referrals made to specialists, other potential outcome variables were explored. The sample included over 5,000 athlete-seasons and 298 concussions managed directly by certified athletic trainers. All programs used computerized neuropsychological testing (both baseline and post injury). Two groups were compared: five programs used a clinical neuropsychologist (NP) as the testing consultant and five used …

Attention Is Associated With Postural Control In Those With Chronic Ankle Instability, Adam B. Rosen, Nicholas T. Than, William Z. Smith, Jennifer M. Yentes, Melanie L. Mcgrath, Mukul Mukherjee, Sarah A. Myers, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Chronic ankle instability (CAI) is often debilitating and may be affected by a number of intrinsic and environmental factors. Alterations in neurocognitive function and attention may contribute to repetitive injury in those with CAI and influence postural control strategies. Thus, the purpose of this study was to determine if there was a difference in attentional functioning and static postural control among groups of Comparison, Coper and CAI participants and assess the relationship between them within each of the groups. Recruited participants performed single-limb balance trials and completed the CNS Vital Signs (CNSVS) computer-based assessment to assess their attentional function. Center …

Sandbagging On The Immediate Post-Concussion Assessment And Cognitive Testing (Impact) In A High School Athlete Population, Kathryn L. Higgins, Robert L. Denny, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a computerized neuropsychological test battery commonly used to assess cognitive functioning after a concussion. It is recommended that application of ImPACT utilizes a baseline administration so athletes have an individualized baseline with which to compare post-injury results should they sustain a concussion. It has been suggested that athletes may provide suboptimal effort, called “sandbagging,” in order to return to their baseline cognitive scores, and thus to play, more quickly. This research examines ImPACT baseline scores when high school athletes were asked to attempt to “sandbag,” and compares those scores with scores …

Psychological And Neural Contributions To Appetite Self-Regulation, Luke E. Stoeckel, Leann L. Birch, Todd Heatherton, Traci Mann, Christine Hunter, Susan Czajkowski, Lisa Onken, Paige K. Berger, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty Publications

Objective: This paper reviews the state of the science on psychological and neural contributions to appetite self-regulation in the context of obesity. Methods: Three content areas (neural systems and cognitive functions; parenting and early childhood development; and goal setting and goal striving) served to illustrate different perspectives on the psychological and neural factors that contribute to appetite dysregulation in the context of obesity. Talks were initially delivered at an NIH workshop consisting of experts in these three content areas, and then content areas were further developed through a review of the literature. Results: Self-regulation of appetite involves a complex interaction …

Pilot Study Of Endurance Runners And Brain Responses Associated With Delay Discounting, Laura E. Martin, Jason-Flor V. Sisante, David R. Wilson, Angela A. Moody, Cary R. Savage, Sandra A. Billinger

Center for Brain, Biology, and Behavior: Faculty Publications

High levels of endurance training have been associated with potentially negative health outcomes and addictive-like symptoms such as exercise in the presence of injury and higher levels of impulsivity. This pilot study examined the relationships among self-report measures of addictive symptoms related to exercise and behavioral and neural measures of impulsivity in endurance runners. We hypothesized endurance runners would have increased preference for immediate rewards and greater activation of cognitive control regions when making decisions involving delayed rewards. Twenty endurance runners (at least 20 miles/week) were recruited to undergo measures of self-report exercise addiction symptoms, impulsive decision-making (delay discounting) and …

Lateral Hypothalamic Activity Indicates Hunger And Satiety States In Humans, Omid Talakoub, Raquel R. Paiva, Matija Milosevic, Marcelo Q. Hoexter, Ruth Franco, Eduardo Alho, Jessie Navarro, Jose F. Pereira Jr., Milos R. Popovic, Cary Savage, Antonio C. Lopes, Pedro Alvarenga, Durval Damiani, Manoel J. Teixeira, Euripides C. Miguel, Erich T. Fonoff, Marcelo C. Batistuzzo, Clement Hamani

Center for Brain, Biology, and Behavior: Faculty Publications

Lateral hypothalamic area (LHA) local field potentials (LFPs) were recorded in a Prader–Willi patient undergoing deep brain stimulation (DBS) for obesity. During hunger, exposure to food-related cues induced an increase in beta/ low-gamma activity. In contrast, recordings during satiety were marked by prominent alpha rhythms. Based on these findings, we have delivered alphafrequency DBS prior to and during food intake. Despite reporting an early sensation of fullness, the patient continued to crave food. This suggests that the pattern of activity in LHA may indicate hunger/satiety states in humans but attest to the complexity of conducting neuromodulation studies in obesity.

Efficacy Of Kinesio Taping As An Adjunct Intervention To Traditional Physical Therapy In The Treatment Of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial, Hossameldien Elkholy

Department of Physical Therapy Student Theses, Dissertations and Capstones

The Efficacy of Kinesio Taping as an Adjunct Intervention to Traditional Physical Therapy in the Treatment of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial Background: Acute low back pain (LBP) is a significant health problem worldwide and is one of the leading causes of disability. Objective: The purpose of this study was to examine the effect of Kinesio Taping (KT) on disability, fear-avoidance beliefs, and pain intensity in patients with acute, nonspecific LBP. Research Design and Methods: A prospective, randomized controlled study of consecutive patients referred to physical therapy with a primary complaint of LBP. Seventy-eight patients …

Sensory-Based Group Treatment In Reducing Physically Acting-Out Behaviors And Perceived Levels Of Distress, Tiffany Barnette

Occupational Therapy Doctorate Capstone Projects

Background: Mental health legislation over the last several decades has focused on restricting the use of seclusion and restraints within facilities receiving federal financial assistance. Facilities serving psychiatric populations have looked for strategies to eliminate the need for these forced interventions. One strategy is the use sensory-based treatment in occupational therapy intervention. Sensory approaches that have been adopted as ‘best practice’ include the use of sensory rooms, groups and kits to help users learn how to regulate psychological and emotional states of arousal.

Purpose: The purpose of this Capstone Project was to examine the effectiveness of a sensory-based …

Workplace Factors Affecting The Delivery Of Occupational Therapy Services: Perspectives Of Occupational Therapy Practitioners, Robert J. Mullaney

Occupational Therapy Doctorate Capstone Projects

This research is a study on the occupation of being an occupational therapy practitioner. The work-related factors of focus are change, absenteeism, productivity/performance expectations, and work-stress and have the potential to influence the delivery of occupational therapy services in healthcare settings. Collective case-study inquiry and analysis was used to determine the overall meaning of the perspectives of 21 hospital, skilled nursing, outpatient, and community-based participants who were occupational therapists or occupational therapy assistants. Interviews and transcription took place, with a validation review. NVIVO-10 Qualitative Software was used to aid in the analysis and coding of the a-priori factors using deductive …

The Effectiveness Of Occupational Therapist Guided Remediation Through Handwriting Home Programs, Cindy W. Poole

Occupational Therapy Doctorate Capstone Projects

There is extensive research on the evolution of handwriting instruction, programs, the neuromotor components, the complexity of performance, and the long term effects of both adequate and inferior performance to occupational performance. The research supports occupational therapy intervention as effective for remediation of poor handwriting. With occupational therapy services limited to only those who receive special education services in schools, supplemental handwriting instruction and remediation responsibilities fall to the teachers and parents. This also creates a large unserved segment of children who struggle under traditional instructional approaches. Parents and teachers have instructional support needs related to current evidence based practice …

Are We Armed With The Right Data? Pooled Individual Data Review Of Biomarkers In People With Severe Upper Limb Impairment After Stroke, Kathryn S. Hayward, Julia Schmidt, Keith R. Lohse, Sue Peters, Julia Bernhardt, Natasha A. Lannin, Lara A. Boyd

Physical Therapy Publications

To build an understanding of the neurobiology underpinning arm recovery in people with severe arm impairment due to stroke, we conducted a pooled individual data systematic review to: 1) characterize brain biomarkers; 2) determine relationship(s) between biomarkers and motor outcome; and 3) establish relationship(s) between biomarkers and motor recovery. Three electronic databases were searched up to October 2, 2015. Eligible studies included adults with severe arm impairment after stroke. Descriptive statistics were calculated to characterize brain biomarkers, and pooling of individual patient data was performed using mixed-effects linear regression to examine relationships between brain biomarkers and motor outcome and recovery. …

Interhemispheric Pathways Are Important For Motor Outcome In Individuals With Chronic And Severe Upper Limb Impairment Post Stroke, Kathryn S. Hayward, Jason L. Neva, Cameron S. Mang, Sue Peters, Katie P. Wadden, Jennifer K. Ferris, Lara A. Boyd

Physical Therapy Publications

Background: Severity of arm impairment alone does not explain motor outcomes in people with severe impairment post stroke.

Objective: Define the contribution of brain biomarkers to upper limb motor outcomes in people with severe arm impairment post stroke.

Methods: Paretic arm impairment (Fugl-Meyer upper limb, FM-UL) and function (Wolf Motor Function Test rate, WMFT-rate) were measured in 15 individuals with severe (FM-UL ≤ 30/66) and 14 with mild-moderate (FM-UL > 40/66) impairment. Transcranial magnetic stimulation and diffusion weight imaging indexed structure and function of the corticospinal tract and corpus callosum. Separate models of the relationship between possible biomarkers and motor outcomes …

Resource Seeking As Occupation: A Critical And Empirical Exploration., Rebecca M Aldrich, Debbie Rudman, Virginia A Dickie

Occupational Therapy Publications

Occupational therapists and occupational scientists are committed to generating and using knowledge about occupation, but Western middle-class social norms regarding particular ways of doing have limited explorations of survival occupations. This article provides empirical evidence of the ways in which resource seeking constitutes an occupational response to situations of uncertain survival. Resource seeking includes a range of activities outside formal employment that aim to meet basic needs. On the basis of findings from 2 ethnographic studies, we critique the presumption of survival in guiding occupational therapy documents and the accompanying failure to recognize occupations that seem at odds with self-sufficiency. …

Precarity In The Nonprofit Employment Services Sector, Carlo Fanelli, Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

Drawing on interview and focus group data, this article explores research undertaken as part of a larger research project exploring precarity in the nonprofit employment services sector in a mid-sized Canadian city. We critically survey major legislative changes to Canadian employment and income security policies and programs, including the restructuring of work and labor relations, growth of performance-based contracting-out, erosion of intergovernmental transfers, worker stress, and emotional tolls. Our study’s results demonstrate how employment precarity in the nonprofit employment services sector is amplified by top-down and centralized relationships with funding partners and policymaking divorced from the employment experiences of frontline …

“You Got To Make The Numbers Work”: Negotiating Managerial Reforms In The Provision Of Employment Support Service., Debbie Rudman, Rebecca Aldrich, John Grundy, Melanie Stone, Suzanne Huot, Awish Aslam

Occupational Therapy Publications

No abstract provided.

Discerning The Social In Individual Stories Of Occupation Through Critical Narrative Inquiry., Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

Calls to ‘transcend the individual’ in occupational science have emerged in recognition of the boundaries of individualistic perspectives and the drive to develop a socially responsive science. In this article, we contend that transcending the individual does not equate to neglecting how individuals make sense of and experience occupation; rather, it requires looking at individual constructions of experiences and occupations in critically informed ways that highlight the socio-political influences on those constructions. This discussion article considers how critical narrative inquiry can be taken up as a methodological approach to interpretively link individual ‘stories’ with social ‘stories’ or discourses, enabling further …

The Comprehensive Professional Behaviours Development Log, Deb Lucy, Doreen J. Bartlett, Tianna D. B. Deluzio

Physical Therapy Publications

No abstract provided.

Development, Implementation, And Outcomes Of An Acute Care Clinician Scientist Clinical Placement: Case Report., Sarah Wojkowski, Janelle Unger, Magda Mccaughan, Beverley Cole, Michelle E Kho

Physical Therapy Publications

Purpose: This article presents the development, implementation, and outcomes of an innovative clinician scientist (CS) placement for a 2nd-year, entry-level MSc(PT) student at McMaster University. Client Description: All physiotherapy students participating in the third 6-week clinical placement at McMaster University were eligible to apply for one CS placement. A placement description and expectations were developed collaboratively by the clinical site and the MSc(PT) programme before placement matching. Intervention: A shared supervisory model between one acute care physiotherapist and a critical care CS was developed to provide supervision in both clinical and research-related activities during the placement. Measures and Outcomes: The …

Clinician's Commentary On Patterson Et Al., Sue Peters

Physical Therapy Publications

No abstract provided.

Career Paths, Barriers, And Professional Experiences: A Comparison Study Of Physical Therapy Program Directors In The United States, Tamara Nancy Gravano

Theses, Dissertations and Capstones

The entry-level degree for physical therapists today is a professional doctoral degree. It is similar to a medical degree program where the expected outcome of its graduates is clinical practice, and there is no formal training in academic teaching or administration. The purpose of this study was to determine the leadership characteristics, styles, and behaviors of accredited Doctor of Physical Therapy (DPT) program directors (PD) and to gain a better understanding of their preparation and path to program leadership. The survey instrument was sent electronically to all program directors of accredited DPT programs in the United States (N=233) and the …

Open Access Continuing Education Occupational Therapy Resources For Rural Communities, Amber L. Daly, Emily E. Germolus

Occupational Therapy Capstones

Occupational therapists working in rural areas face a number of barriers when trying to access continuing education courses, which are required to maintain licensure. Some of the largest barriers these practitioners face include: time, cost of the courses, and ease of access. Continuing education often requires travelling, time out of one’s day, and a fee ranging from $25-$300 (North Dakota Occupational Therapy Association [NDOTA], 2016; Continuing education, 2013). The purpose of this scholarly project is to address continuing education requirement-related needs and education access for occupational therapists working in rural areas. Following the completion of a comprehensive literature review and …