Medicine and Health Sciences Commons^™

A Case Study Of A Patient With Low Back Pain And Radicular Symptoms Treated With The Mckenzie Method, Reyn A. Hata

Physical Therapy Scholarly Projects

Objective: The objective of this case study is to describe the use of the McKenzie Method (MM) with a patient with low back pain (LBP) with radicular symptoms.

History: The patient is a 26 year-old, male with complaints of low back pain with radicular symptoms down his right lower extremity to his ankle. The patient presented with decreased range of motion to lumbar spine, a flexed and left laterally shifted posture, decreased strength of right lower extremity, and peripheralizing symptoms of pain.

Description: The treatment for this patient involved repeated flexion and extension movements, stretching, posture education, instruction in body …

Examination And Treatment For A Patient With A Distal Radius Fracture, Chuck Mccullough

Physical Therapy Scholarly Projects

BACKGROUND AND PURPOSE: This article describes the eight month outpatient physical therapy management of 67 year old female who had an open fracture of the left distal radius that was stabilized internally with K-wire and externally with the application of external fixator. Initially, this patient presented with a need for patient education on wound care, edema control techniques, splinting, and a maintenance program for finger and shoulder range of motion. The physical therapy intervention progressed to range of motion, strengthening, joint mobilization, and functional exercises for the wrist and hand. The purpose of this article is to describe the interventions …

Nonoperative Management Of A Client With A Full-Thickness Rotator Cuff Tear, Samantha Neary

Physical Therapy Scholarly Projects

Shoulder pain caused by a rotator cuff tear may inhibit one's ability to perform activities of daily living. Although surgery is a common intervention with this diagnosis, some clients are not surgical candidates or do not wish to undergo surgical intervention leaving conservative treatment as their only option. Therefore, the purpose of this case report is to describe the intervention used in the nonoperative management of a client with a full-thickness rotator cuff tear. The client was a 68 year old male with the diagnosis of a right shoulder rotator cuff tear. The client participated in physical therapy 2 times …

Physical Therapy Intervention In A Patient With Open Reduction Internal Fixation Of A Left Scapula Fracture, Amber Saienga

Physical Therapy Scholarly Projects

Background and Purpose. This case report describes the physical therapy intervention for a patient with an open reduction and internal fixation of a scapula fracture with decreased shoulder strength,

Description. A 53-year-old-man with decreased left shoulder strength resulting from a 9-week period of inactivity following his surgery received physical therapy services for 4 sessions consisting of therapeutic exercise and manual therapy techniques, Active range of motion and manual muscle testing were completed at the initial evaluation and at discharge,

Outcome . Following the physical therapy intervention, improvements were noted in shoulder strength and patient was able to return to most …

State Agency Promising Practices: Employment First! Making Integrated Employment The Preferred Outcome In Tennessee, Jean Winsor, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Tennessee Division of Mental Retardation Services (DMRS) implemented the Employment First! initiative in 2002. The goal of Employment First was to make employment the first day service option for adults receiving supports funded by DMRS, Medicaid, or the state. Employment First set the standard that employment was the preferred service option for adults with mental retardation and developmental disabilities (MR/DD).

State Agency Promising Practice: Shifting Resources Away From Sheltered Workshops In Vermont, Jennifer Sullivan Sulewski, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Over six years, regulations in Vermont gradually restricted and eventually prohibited the use of state funds for sheltered workshops or enclaves. Concurrent with the change in funding regulations, the state worked with providers to convert the remaining sheltered workshops in Vermont.

State Agency Promising Practice: Working Together To Convert The Last Sheltered Workshop In Vermont To Individualized Supports, Jennifer Sullivan Sulewski, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Vermont’s Division of Disability and Aging Services (DDAS) and Division of Vocational Rehabilitation (DVR) worked with a local service provider to convert its congregate day services to community employment. Implementation Between 1987 and 2002, DDAS and DVR worked with several providers to close down sheltered workshops and move people into community supports.

State Agency Promising Practice: Integrated Employment Outcomes Through Person-To-Person Technical Assistance: New Hampshire, Allison C. Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

New Hampshire implemented an innovative technical assistance model that promoted organizational change to expand individual employment opportunities. This person-to-person change began at the micro level but “trickled up” through organizations across the state. In 2000, realizing that the state’s growth in integrated employment had stalled, the Bureau of Developmental Services invested aggressively in expanding its intervention strategy by recruiting a community provider to work directly through the bureau. The bureau hired John Vance-the director of ACCESS, a small individualized support organization in New Hampshire-half-time to provide individualized technical assistance to providers across the state. As part of the bureau, Vance …

State Agency Promising Practices: Washington State’S Working-Age Adult Policy, Allison C. Hall, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Washington’s Division of Developmental Disabilities (DDD) has recently issued a new policy which went into full effect on July 1, 2006. This policy “designates employment supports as the primary method of furnishing state-financed day services to adult participants.” Emphasizing community employment as the primary service option, the policy further states that: “services for persons under the age of 62 that do not emphasize the pursuit or maintenance of employment in integrated settings can be authorized only by exception to policy” (WA DHSH, DDD, “County Services for Working Age Adults” Policy 4.11). Initially adopted in 2004, this policy does not eliminate …

State Agency Promising Practice: The Tennessee Employment Consortium (Tec) - A Statewide Collaboration For Change, Jean Winsor, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Tennessee Employment Consortium (TEC) is a statewide organization focused on increasing the number of Tennesseans in integrated employment. The consortium comprises volunteers from the state’s Division of Mental Retardation Services (DMRS) and Division of Rehabilitation Services (DRS), the Tennessee Council on Developmental Disabilities, the ARC of Tennessee, the Center on Disability and Employment at the University of Tennessee, community rehabilitation providers (CRPs), family members, and other stakeholders. TEC’s ability to organize collaborative activities across state agencies, advocacy organizations, and CRPs has played an important role in increasing integrated employment outcomes.

An Outpatient Physical Therapy Non-Operative Management And Intervention For An Older, Athletic, Professional, Caucasian Male Patient With An Acute Gastrocnemius Medialis And Lateralis Muscle Rupture, Thea Loy Pallansch

Physical Therapy Scholarly Projects

Description: The gastrocnemius muscle is a two joint muscle originating on the femur and inserting into the calcaneus through the Achilles tendon. The gastrocnemius spans the knee and ankle joint providing important stabilization and movement functions in walking, running, and jumping activities. Rupture of the Achilles tendon is one of the most common tendinous injuries. Non-operative, conservative treatment of the acute Achilles tendon rupture demonstrates comparable results to surgical intervention. Non-operative management promotes patient tolerance, low cost, and positive clinical outcomes. Previous studies have supported the concept of functional bracing as a conservative, alternate treatment for an acutely ruptured Achilles …

Tendon Injury Rehabilitation: A Manual Of Algorithm Protocols For Therapists, Joni Armstrong

Occupational Therapy Capstones

In the field of hand therapy there are a variety of protocols for treatment of patients with tendon injury. Review other literature indicates that most of these protocols have a good anatomical and physiological basis, which then requires the application of clinical experience to decide which protocols to use when treating patients with hand injury. Experienced hand therapists tend to make observations and adapt protocols accordingly to provide patients with good therapy treatment and therefore achieve excellent treatment outcomes. However, therapists that do not see hand patients on a regular basis and do not have a consult base will tend …

The Wings Of Change: Occupational Therapy Activities For Women Of Domestic Violence, Lainie Donahue, Dianna Steen

Occupational Therapy Capstones

Literature indicates that the current services provided to women of domestic violence typically include emergency housing, crisis counseling, and short-term legal and financial assistance (Gorde, Helfrich, & Finlayson, 2004). While these resources provide necessary immediate support to the victim, she may often feel powerless to make long-term changes. If adequate long-term resources and support are not available to the victim, the victim is more likely to return to an abusive situation.

The review of literature focuses on obtaining a deeper understanding of the needs that exist for women subsequent to leaving an abusive relationship, and how to prevent the risk …

An Occupational Therapy Parent Education Handbook: Parenting In The Nicu, Olivia Donald, Angie Laakso

Occupational Therapy Capstones

Parents often feel overwhelmed by their premature infant's fragile medical state and intimidated by the Neonatal Intensive Care Unit (NICU) environment. The birth of a premature infant is a stressful event for parents because they are coping with their newborn facing life threatening immaturity and its possible consequences, such as handicap or even death. Due to the premature infant's fragile medical state parents often feel their infant does not belong to them but rather to the healthcare staff.

A parent's lack of involvement in their infant's care is a major source of stress, feelings of dis empowerment and a lack …

The Use Of A Sensory Integration Program For Children With Behavioral And Attention Deficits, Janel Evanson, Brenna Pitsch

Occupational Therapy Capstones

One of the challenges facing occupational therapy practitioners today is incorporating treatment approaches into psychosocial and school environments that address the needs of children who have difficulties maintaining an optimal level of arousal, who have a decreased attention span, who are non-engaged and have maladaptive behaviors and impulsivity, and who may have anger management difficulties. These characteristics may coexist with the diagnosis of a sensory integrative dysfunction. As a result, the authors anticipate an increasing demand for the implementation of sensory integration programming in a psychosocial or school setting. An extensive literature review was completed to gain a full understanding …

Achieving Success In College: An Occupational Therapy Approach To A Study/Support Group, Mattie Heckaman, Angela Sepe

Occupational Therapy Capstones

This project was designed to target the needs of students with psychiatric disabilities pursuing higher education. Kessler, Foster, Saunders and Stang (1995), noted that early-onset psychiatric disorders often disrupt attainment of higher education. According to Mowbray et al. (2006) epidemiological studies indicated that youth ages 15-21 years old had the highest prevalence rate of mental illness in 2005. These ages correlate with the conventional years that an individual may attend college. Consequently, the initial psychiatric occurrence of many young adults is experienced during college years. As noted in recent literature, increased supports are needed to retain students with psychiatric disabilities …

The Role Of Occupational Therapy In The Secondary Prevention Of Transient Ischemic Attacks, Alan Hodenfield, Amy Shulstad

Occupational Therapy Capstones

A transient ischemic attack (TIA) is a condition in which an individual experiences an "episode of temporary and focal neurological dysfunction of rapid onset, caused by cerebral circulatory failure and lasting no more than 24 hours" (Shah, Cooper & Lyons, 1992, p. 358-359). Even though a TIA is temporary and leaves no permanent effects, it's far from an irrelevant event. About one in three people who have a TIA eventually have a stroke, with about half occurring during the year after the TIA (Mayo, 2006). A TIA can serve as both a warning and an opportunity: a warning of an …

Occupational Therapy Assistant Mental Health Case-Based Learning Activities, Cassie Hilts

Occupational Therapy Capstones

Occupational Therapy Assistants (OTA) need to be skilled in clinical reasoning and able to apply principles, theories and approaches to functional problems (Neistadt, 1998; Royeen,1995; VanLeit, Crowe and Waterman, 2001). Occupational therapy assistant educational standards require that students be able to apply models of occupational performance and theories of occupation (Accreditation Council for Occupational Therapy Education, 2008). Research has shown that learners actively engaged in the learning process have increased satisfaction with their education (Robinson, 1994) and perform better on exams (Lord, 1997; Wilden, Crowther, Gubanich and Cannon, 2002). Scaffa and Wooster (2004) found self directed learning can significantly facilitate …

Caregiver Activity Guide To Promote Occupational Function In Individuals With Alzheimer's Disease, Lacey Konickson

Occupational Therapy Capstones

No abstract provided.

Life After War: An Occupational Therapy Resource Guide For Returning Soldiers With Prosthetics, Monica Lemoine, Andrea Longtin

Occupational Therapy Capstones

There are a growing number of U.S. military soldiers medically discharged due to injuries sustained while on active duty. A number of these injuries result in limb amputation. The purpose of this scholarly project was to develop an evidence-based resource guide for a population of soldiers returning from war having an amputation and utilizing a prosthetic.

An extensive literature review was conducted in order to develop the occupational therapy role for this population. Three main areas of concern were identified: 1) a lack of information related to prosthetic use during instrumental activities of daily living, 2) limited information regarding reintegration …

Handwriting From A-Z, Connie Lillejord

Occupational Therapy Capstones

Prevalence for the number of students with poor handwriting skills has been estimated to range from 12% to 21 % depending on grade, selection criteria, and instruments used (Graham & Weintraub, 1996; Hamstra-BIetz & Blote, 1993; Smits-Engelsman & Van Galen, 1997). During late elementary and middle school years there is an increasing demand for efficient work output, particularly in written requirements. Greater numbers of required reports, math assignments, and writing assignments tap into a child's capacity to develop ideas quickly and put them down on paper (Levine, Oberklaid, & Meltzer, 1981). Children who have not developed automatic, fluent handwriting will …

Get Involved: A Program For Kindergarten Students, Parents, & Teachers To Promote The Development Of Motor Skills For Daily School Occupations, Sarah Neall

Occupational Therapy Capstones

In the educational setting today, children are asked to acquire advanced academic skills at a faster pace and earlier age. Children entering the first years of school exhibit variances in their physical maturity levels, which affects both fine and gross motor skills and their performance in daily school occupations. Frequently, young children are unable to keep up with their kindergarten curriculum. Currently, the programs available to work on motor development in kindergarten age students focus solely on pre-writing skills and handwriting instruction. These programs lack information on motor skill development, home program activities, and specific occupations that kindergarten students are …

A Community Re-Integration Manual For Individuals With Amputations: Preparing For The Paralympics, Carmen Schempp

Occupational Therapy Capstones

Being an athlete with an injury is difficult, but an amputation poses even more challenges to one's life dreams for sports competition. This scholarly project focused on advancing an athlete's community re-integration, specifically back into the sporting community. Presently, there is a gap in existing occupational therapy services for persons with amputations between the completion of inpatient rehabilitation and the return to full community re-integration, particularly for the sports competitor. This scholarly project product is a manual of sequential therapeutic activities for athletes who have the goal of returning to the occupation of sports participation. This product is intended to …

An Occupational Therapy Intervention Program Addressing The Needs Of Older Adults As They Transition To New Living Situations, Judith M. Sokol

Occupational Therapy Capstones

As individuals age and approach retirement, face life changes (loss of spouse or significant others), or health changes, they often make the decision to relocate. Responses may vary; but frequently stress, depression, and anxiety are experienced to the level that they impede a healthy adjustment. This can lead to diminished self-care, difficulty engaging in meaningful occupation, and isolation. Older adults may experience a poor sense of personal mastery within their new environment, contributing to feelings of low self esteem, sadness, grief secondary to loss, anger, and loneliness.

The purpose of this scholarly project was to address the pre-relocation needs and …

Utilizing Leisure Activities During Upper Extremity Rehabilitation: An Occupational Therapy Treatment Protocol, Sherri D. Strohman

Occupational Therapy Capstones

No abstract provided.

Occupation-Based Interventions For Clients With Chemical Addiction Issues, Amanda Sylling, Alyson Wilhelmi

Occupational Therapy Capstones

Based on data from an extensive literature review and survey methodology, a product was developed to assist occupational therapists (O.T. 's) in providing individualized occupation-based interventions for clients dealing with substance abuse/dependence. Although the value of occupation-based interventions focusing on occupational performance and function has been established (Law, 2002), the literature suggests that O.T.'s working in substance abuse treatment environments generally provide group-based intervention consisting primarily of preparatory activities (Rychtarik et al., 2000). Because substance abuse often becomes a primary occupation for individuals with substance abuse issues (Stoffel & Moyers, 2004), it is imperative that O.T.'s address and support healthy …

Quality Of Life Occupational Therapy Measurement Tool For Patients With Lymphedema/Chronic Venous Edema, Marsha Waind

Occupational Therapy Capstones

The objective of this project was the development of a tool in the form of a patient questionnaire to be used by Occupational Therapists (OT) treating patients with lymphedema/chronic venous edema. This questionnaire was designed to identify life factors beyond limb volume reduction and activity independence that correlate with the patients' perceptions of an improved quality of life, therefore promoting Health Related Quality of Life (HRQoL).

Literature reviewed supported the premise that attainment of the typical OT goals of activity completion will not accomplish the desired result of lymphedema treatment, nor will lymphedema goal attainment of reduced limb measures achieve …

Pediatric Oncology: Parent Education Handbook, Lindsey Anderson, Lacey Harrington

Occupational Therapy Capstones

In America, approximately 12,400 children and adolescents are diagnosed with cancer each year (Harris, 2004). The number of newly diagnosed children is on a steady increase. With this steady increase it is important to ensure that parents of the child diagnosed with cancer have resources about cancer and the treatment process as well as support. A review of current literature, research, and resources was conducted in order to locate the gaps within pediatric oncology. The literature helped identify areas of concern related to pediatric oncology. The areas identified consist of the parents having minimal knowledge while under emotional stress when …

Occupational Therapy Feeding And Eating Manual For Parents Of Children With Oral Motor Deficits, Jessica Kovacevich, Genevieve Ziegler

Occupational Therapy Capstones

Having a child with feeding and eating difficulties can be a very stressful event for parents, and the process of occupational therapy assessment and treatment may also be stressful and confusing for the parents. Most parents are not familiar with feeding and eating difficulties in children, and many parents do not know where to find the information that they need to learn about their child’s diagnosis. After an initial review of literature, it was found that parents of children with special needs have few resources for eating and feeding strategies and approaches for oral motor deficits. It was also found …

Critical Thinking And Evidence-Based Practice In Problem-Based Learning Tutorial Groups: A Critical Case Study, Joanne M. Bortone

Occupational Therapy Faculty Publications

Little research has investigated how problembased learning (PBL) instruction influences students' critical thinking and evidence-based practice. This research sought to ascertain if PBL instructional practices facilitated critical thinking and EBP; identify those practices; and, identify changes students made in tutorials.

A qualitative, twocase, critical case study design used pretest and posttests of the California Critical Thinking Skills Test (CCTST) (Facione, 1990) and Self-Evaluation of EBP adapted from Straus et al. (2005) to select the critical case sample. Students who made the greatest gains from pre to posttest scores met selection criteria for the critical case sample and were invited to …